The threat of a potential malpractice suit is never far away. Start with the patients—they are less loyal, less trustful, and more demanding than they were in days gone by. These attitudes can quickly turn to anger, frustration, and pointing fingers when their expectations aren’t meant. Take heed, good doctors, having the best training and clinical skills is not enough! Protecting yourself from risk involves the actions and non-actions of everyone in the practice.
A common-sense approach to risk management deals with many aspects surrounding patient care—the way you operate your practice. If you give these matters the attention they deserve, it will go a long way in keeping you out of court. Let’s look at what you can do to reduce the potential risk.
Building the relationship
It’s not your job to be friends with the patients, but it is your responsibility to be friendly. Take it seriously. People are not likely to sue the people they really like, so make sure your patients like you and see you as any ally.
If you think most patients select their physicians based on clinical skills you may be misled. Most patients pick their doctors and recommend them to their friends based on how much they like the doctor and how good she makes them “feel.” Their confidence in your skills and judgment is subjective. They assume you are clinically competent.
Beyond the clinical mission of diagnosing and treating a problem, medical practice leaders would be wise to dedicate more time to being personable with patients and set an example that inspires staff to do the same. Strive to meet both the wants and needs of the patients. If most patient satisfaction is based on how you make the patient feel, it makes sense to treat the person, not just the condition. Following are a few things you can do that make a difference.
I have conducted mystery patient visits for doctors across the country and been amazed at the lack of attention to patients. Many practices have sign-in sheets, an excuse not to greet patients. Seldom does a staff member introduce herself or properly greet me, including the nurse who escorts me to the room. And no one welcomes me to the practice. Generally, only the physician introduces himself. I wonder, why haven’t they trained staff to do the same?
These visits inspired me to develop rules that I’d like to see adapted in every medical office. It’s bound to result in a more cooperative, compliant, and satisfied patient.
The golden rules:
1. Everyone in the office (not just the physicians) should greet new patients by introducing themselves. This is an important first step that is often overlooked by staff. It goes a long way in making patients feel welcome and important.
2. Call patients by name repeatedly during the encounter. It makes them feel connected and cared about.
3. Read the chart notes before you go in the exam room so you are familiar with the patient’s history and why he is there. If your nurse has taken the history and recorded the symptoms this should not be difficult. Patients don’t like it when you ask them why they are there when they just told your nurse.
4. Once the exam is completed, sit in a chair to talk with the patient. Looking down on patients makes them feel inferior. You want patients to know and “feel” that you are connected and care about more than their condition.
5. Get personal. It only takes a few minutes to ask a patient about his hobbies, job, or family and it leaves a powerful impression.
6. Apologize if you’re late and, for heaven’s sake, don’t act rushed. Your patients deserve your time. If you are relaxed and calm, they feel they have both your attention and your time.
7. Never ask a patient a question unless you are willing to listen to his response with your full attention. Look at the patient when either of you is speaking. Avoid looking at his chart or electronic medical record while conversing, and don’t interrupt the patient.
8. Avoid medical jargon that the patient is unlikely to understand.
9. Ask for affirmation once you’ve provided the diagnosis and treatment plan and willingly repeat instructions if necessary.
10. At the end of each encounter, verify that the patient understands his condition and treatment, and ask if he has any other questions. It will make him feel important and is likely to reduce phone calls that disrupt workflow later on.
Do and give more to nurture the relationship. For example, when a patient has an office-based operative procedure or has been in the hospital, why not have the nurse call the patient the following day to see how she is doing? When the doctor is delayed and the patient is waiting in an exam room, the nurse should tell her there has been a delay and ask if there is anything she can do for the patient during the wait.
Staff can play an integral role in getting patients connected to other services such as “Meals on Wheels” or “Dial a Ride.” Finally, train your staff to always ask the patient, “Is there anything else I can do for you?” before the patient leaves the office or at the end of a phone call.
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