Communication is the Key: Take Small Steps to Avoid Big Problems

You have surely heard it several times: patients who believe they have a good relationship with their physician are considerably less likely to sue in the event of an adverse outcome. But a physician need not spend hours with each patient, have a stunning personality or exhibit world-class bedside manner to be held in high regard by their patients. Regardless of the physician’s personal attributes, good communication protocols and practices are essential in cultivating a patient’s trust and respect. While practice management consultants can surely create a list of dozens of expensive recommendations, taking a few simple steps can reduce your risk without breaking the bank.

• Review the Chart Before Entering the Room – Since the patient’s medical condition is among the most important and unique occurrences in their life at the time, they need to believe it is important and unique to you, as well. By taking the simple step of reviewing the chart before entering the examination room instead of reading it in front of the patient, the patient is more likely to believe that you have dedicated sufficient time and concern to their care. The prevalence and demands of Electronic Medical Records have made this practice more difficult; but by strategically positioning computers and establishing effective workflow, it is still possible and desirable.

• Think Like a Patient – Every patient needs to feel like they are the most important case you are addressing that day. While this is not practical, taking a moment to understand this desire to be treated as a unique case may just spark an extra bit of empathy that converts the patient’s perception of you from “cold and methodical practitioner” to “concerned caregiver.” These few seconds may save you from an immeasurable amount of hassle down the road.

• Keep Staff Conversations to a Minimum – While you may perform the same procedure numerous times every day, this is likely the only time the patient will undergo the procedure. Therefore, conducting personal conversations with staff while performing the procedure will cause the patient to believe you are not paying attention and thus, doing a poor job. By way of example, an urologist was sued by a patient who suffered a known, disclosed, and correctable complication after a vasectomy. In his deposition, the plaintiff stated the doctor and nurse were discussing their children’s sporting events and future vacations during the procedure, and the doctor and nurse confirmed they likely had such a conversation. Despite the defensibility of the medical aspects of the case, settlement was necessary because even the slightest bit of evidence that a doctor is not giving the patient their full and undivided attention can cause a jury to “send a message” by way of an excessive verdict. The patient’s perception of your commitment to their care matters, so while fostering a collegial workplace is important, it is often best to do so outside of the presence of your patients.

• Follow Up! – Every time your office “touches” the patient with communication, their perception of the practice improves. Additionally, studies have shown that practices with protocols requiring timely reporting of all test results (not just adverse or major results) had a statistically significant lower number of claims than practices without such protocols. Further, practices with protocols requiring a telephone follow up with a patient a certain amount of time after a visit to check on their progress generally report lower claims and higher patient retention rates. These practices also reap the benefit of additional patient visits if a contacted patient is still experiencing issues and needs to be seen again. So while it sometimes seems as if there is not enough staff to get through the patients in the office during the day, dedicating staff time to result reporting and patient follow up has proven to be economically beneficial through both patient loyalty and the savings that come from a clean claims history.

• Encourage Feedback – As with any good or service, patients will have thoughts regarding how to improve their experience. Harness the ideas of your customers through a suggestion box, email, patient survey, or some other method of obtaining ideas. While several will be so terrible that you will wonder why the practice takes the time and effort to receive them, you may also receive a simple suggested change that can yield a significant increase in patient satisfaction. It is also possible that the practice has a customer service problem of which it would remain unaware if patient opinions are not solicited. Further, research in several fields indicates that the simple act of asking customers how to improve a product or service results in the customer having a higher opinion of the product or service. Thus, a minimal investment that tells patients you are concerned about their satisfaction can yield great results through both practice growth and claims avoidance.

While there is no silver bullet that guarantees your practice avoids claims, improved communication is the closest thing available. By taking simple steps to communicate to the patient that they are special and worthy of your practice’s best efforts, you are encouraging patient loyalty while discouraging claims.