Recently, I received an interesting e-mail from Karen, a newsletter reader. After many years with the same primary care physician, she was considering a switch.
Was it because she had grown dissatisfied with her doctor? No, not at all. In fact she thought her doctor was wonderful. She had, however, grown dissatisfied with her doctor’s practice – so much so that she was ready to leave.
As Karen explained, there were a number of things which were causing her frustration. She had a series of unsatisfying experiences with other physicians in the practice; she found the administrative staff difficult to work with; she had problems communicating with her doctor in-between visits.
Her dissatisfaction had grown to the point where she had even begun using the local “Doc-In-A-Box” facility when she was really sick, to avoid having to deal with the practice itself.
A wide variety of experiences
Unfortunately, Karen’s frustration with the logistics and administrative bureaucracy surrounding one’s physician is not uncommon. I interact with physician offices on behalf of my clients on a daily basis and have experienced a wide variety of approaches, ranging from “delightful” to “I am ready to pull my hair out!”
The best arrangements are those in which I can either e-mail back and forth with the physician directly or in which a nurse or assistant troubleshoots the problem and relays an accurate message to and from the physician within 24 hours. In cases where a conversation with the doctor is necessary, a mutually convenient “span of time” is agreed upon during which I receive a call back.
If you find yourself in a less satisfying situation – even if not quite as extreme as Karen’s – here are three things to keep in mind when working with your doctor’s practice:
- Focus on the relationship
I know I’m a broken record on this but it really is all about the relationships! So for starters,make sure you understand how the practice operates (every practice has an administrative structure) and make connections with those in charge.
Begin by asking to speak with the practice/office manager; then introduce yourself. Explain that you are a patient and want to more fully understand the administrative structure of the organization. Then ask specific questions regarding the practice:
- When I call here, who generally answers the phone and what are their responsibilities?
- How are appointments made within your practice?
- When I call with a question for my doctor, exactly what happens to my request?
- When I call when I am sick, what can I expect?
- How do I get test results?
- Can I communicate via email with my doctor and if so, how?
- Can I outline my questions/concerns in a fax so that when my physician calls me back, the issue has been outlined in writing?
- Are you the appropriate contact person if I want to pass along a really positive experience or if I run into any difficulties?
- Who else is it important for me to know within the practice?
- Communicate your concerns clearly
If you’ve had a negative experience within the practice, it is important to relay that to both your physician and the practice/office manager. In the case of Karen, she could have said:
“There was an occasion when I saw my physician’s colleague, Dr. ________. It was not a comfortable experience for me and I do not want to see that physician again. How do I make that arrangement within your practice?”
(I would expect the office manager to ask for more specific feedback so as to address internal issues, so you should be prepared for additional questions and share to your level of comfort.)
Note that my advice above is in addition to the direct conversation you must have with your physician. In my experience, the physician is often completely unaware that you are having administrative issues and that you are unhappy.
Karen’s doctor was shocked when she found out. Her response to Karen was, “I have two open slots in my patient panel every day for sick patients that are often not used. If you need to see me, you are to ask for ________, the nurse who works directly with me and she will fit you in or we’ll come up with an alternative plan. I can’t believe you were considering leaving my practice, I feel we’ve had a great relationship and I am so sorry.”
- Remember who the customer is (you!).
Don’t be afraid to “interview” the practice as you consider where you’ll be bringing your business. In most cases, I contact practice/office managers proactively, letting them know that I am considering making a new appointment for a client. I begin by saying:
“I am a private healthcare advisor to ________ and she asked me to make an appointment with Dr. ________. I went online and read about your practice and in addition, I wanted to speak with you about how your practice operates. Would you be willing to share some information with me?” (You can have this same conversation on your own behalf.)
Reluctance to respond to this request and the tone of the conversation will give you a clue as to the culture of the organization. From there, you can decide if you want to proceed. Most practice managers (thankfully) respond positively to this approach. After all, they want your business, so don’t be afraid to take the reins!
When Karen got in touch with me she was at the end of her rope and in the process of going elsewhere. She described herself as feeling “helpless” and “trapped.”
After speaking with her physician and bringing her concerns to light, however, she was relieved and happy to remain a patient. That’s good news for her and good news for her doctor!