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Small changes leave big impact on doctor-patient relationship


Dermatologists can make small changes in their practices to improve the doctor-patient experience, according to Ranella Hirsch, M.D., a Boston dermatologist in private practice. By placing themselves in the position of the patient, physicians can evaluate the user experience and then make adjustments accordingly.

Dr. Hirsch

Many physicians believe credentials and experience are key in leaving a good impression with patients. While of critical importance, patients can have a different perspective, Dr. Hirsch explains.

“Often, patients do not understand the subtlety of a difficult diagnosis or the extensive research required to create a successful treatment,” she says. “When patients are asked about their experience with a doctor, it is notable how often they cite their experience with the person who answered the phone or how long they had to wait rather than the doctor’s background.”

Details such as the waiting room environment are apt to be noticed too, she says. “Many patients don’t see our diplomas, but they do see the waiting room, and the reality is that the impression that you make is based on what the patient does see.”

Customer service cues

Making little changes that seem too small to matter can make a significant difference to the patient, Dr. Hirsch says. For example, to give the practice a patient-friendly feel, ask staff to answer the telephone like this: “Thank you for calling, how can we help you today?”

And while physicians do gather feedback, they often do so from people who don’t share patients’ perspectives. “Sometimes, it’s like we are in a bubble. We get feedback from staff and family who, being our staff and family, are inclined to say nice things,” Dr. Hirsch says. “The truth is, when three people voice a criticism, 30 people are thinking it, if not more.”

Emphasize environment

Entering the office and looking at it from the patients’ perspective can be a real eye-opener, Dr. Hirsch says.

“Are the reading materials in the waiting room timely and of interest? If a bathroom doesn’t have toilet paper, people will notice, just as we would entering a doctor’s office as a patient. Trying to place ourselves in their shoes has proven very insightful. Really trying to understand the patient’s user experience will translate to having patients who will ultimately walk away with a better impression,” she explains.

Dr. Hirsch says she has made these small modifications a part of her practice’s daily routine. For example, one staffer is assigned the job of going into the bathroom at set times to ensure it is well stocked.

At specific intervals throughout the day, another staff member tidies up the waiting room by adjusting pillows, discarding trash and straightening the magazine piles. And yet another staff member is responsible for making sure that coats are hanging neatly while patients are waiting.

Patients also appreciate a free Wi-Fi network in the waiting room, Dr. Hirsch says. “These days, it is an expectation to be able to stay online while out, and such a simple thing to provide. In addition, they can use their own devices when they are waiting, which allows them to stay productive.”

Open communication

Dr. Hirsch says the most successful consultations are those in which she listens closely to the patient; in so doing, she helps the patient organize his or her thoughts.

After the lengthy initial conversation with a patient, Dr. Hirsch suggests that dermatologists end with taking a minute to ask what messages patients have taken away from the conversation.

“You might be surprised, of all the things you said, what a patient actually hears,” she says. Constant, open communication is crucial, Dr. Hirsch stresses.

“In our practice, medical and office staff frequently asks patients about their office experience and how might it be improved. You don’t want a patient to leave your practice with an unsatisfied feeling. You want to be exactly the person who they tell when they are unhappy,” she explains.

Patient safety

Improving the doctor-patient relationship also improves compliance and the patient’s overall well-being, Dr. Hirsch says.

“Studies have shown patients hear only a percentage of what is being said,” she says, adding that this can affect patient compliance, especially when a complicated set of instructions is given. Physicians can set up a system to help patients get the best care.

Dr. Hirsch says her patients fill out safety paperwork with every procedure visit. The practice staff asks numerous times about data regarding patient history, medications, last menstrual periods, and other conditions (such as cold sores) that could affect procedures and results.

For example, all female patients, regardless of age, are respectfully asked about their menstrual cycles and the possibility of pregnancy. 

“As the clinician, you can’t be faulted for asking the question, but you can be for not asking,” she says. “Patients leave my office with written instructions, and that is the whole point,” Dr. Hirsch adds. “I am going to say it, my staff will say it again, and patients leave with a packet with instructions written down. We try to make this as straightforward as possible.”  DT


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