conflict management Archives

Patient rudeness affects physician performance — what should practices do about it?

A new study from the University of Florida found that patients' rudeness towards their physicians can have a "devastating" impact on medical care. Patient rudeness may play a critical role in medical errors, which by some analyses are now the third leading cause of death in the US. The Florida researchers determined that patient rudeness causes more than 40% variability in hospital physician performance. (By contrast, poor judgment due to lack of sleep led to a 10-20% variance.) The reason for the huge variance is that despite intentions to 'shake it off,' experiencing rudeness disrupts cognition, even when physicians are determined to remain objective. The researchers found that key cognitive activities such as diagnosing, care planning, and communication are all affected -- and the effects last the entire day. The study suggests that patients need to understand the potential for rude behavior to undermine their care, even when clinicians try their best to be patient and understanding, and even when the rudeness is driven by understandable frustration. But I think the results are also a reminder to practices to try to limit patient frustrations in the first place. Doctors often bear the brunt of patient rudeness when aggravation and anxiety boil over, even though most of what bothers patients happens before they even see their physician. Because administrative issues are frequently the source of dissatisfaction, it's possible for practice staff to prevent or ameliorate many blow-ups. Doing so may help patients have more productive visits with their clinicians, while also helping to protect the practice's reputation and maintain a pleasant work environment for the entire team. If you're concerned about emotional patients disrupting your practice, here are a few ideas to consider: Evaluate, minimize your wait times. A long, unexpected wait in reception is a sure-fire source of patient frustration. When it happens in your practice, is it a rarity or SOP? If running significantly behind is an everyday occurrence your practice, consider a review of your scheduling processes, to come up with a schedule that is attainable. And make sure your front and back office staff are working together

By Morgan|2022-01-01T22:51:53-08:00January 15th, 2017|

Prepare for employee salary negotiations

Practice managers and physicians often feel like they're fumbling in the dark when negotiating salaries with prospective employees, and feel unsure about whether their compensation structure is adequate to retain their best people. But, this is at least partly because they're not utilizing all of the tools available to stay on top of market compensation rates -- some of which have only really taken hold in the last five-ten years. For example, sites like Salary.com provide market data on job content and salaries -- all matched to your local market. (This type of data used to be available only in pricey salary surveys! On Salary.com, the base data is good -- but, more detail can be had for a fee.) Even scanning online ads, such as on Craigslist, can give you a quick read on what others are offering. We often work with physicians and practice managers who are very concerned about over-paying staff. If you're among them, take heart: as this story from Freakonomics observes, sometimes getting the 'best deal' on labor is no deal at all. I'm usually much more alarmed when practices are under-paying than over-paying by a bit. Freakonomics (via Marketplace): A Cheap Employee Is ... A Cheap Employee

By Morgan|2016-08-19T18:12:26-08:00May 31st, 2013|

Another interesting (dispiriting) take on medical billing

A recent New York Times article and follow-up blog post discuss the challenges patients have understanding medical bills, through the eyes of a consultant named Jean Poole who has made a career of deciphering (usually highly erroneous) medical bills and helping patients recoup incorrect charges or reduce their outstanding bills. Billing is so challenging for practices -- even though specialized staff are usually handling the task, they have to contend with constant changing rules, reluctance of some payers to address issues, and the myriad of payment schemes with varying patient responsibility. But imagine how it is for patients -- who don't have any specialized knowledge to help them deal with the strange language and calculations of their bills. Ms. Poole's service would seem to be a godsend for patients who find themselves unexpectedly owing thousands of dollars (as the article points out, patient out-of-pocket obligations and opaque hospital fee schedules can lead to big surprises). It's great that she offers this service, for sure -- but how frustrating that it's so needed. The frequency of errors and lack of transparency in insurance company documents to patients is a big source of difficulty for practices. When patients feel they've been incorrectly charged or can't understand their bills, it undermines the trust they have in their physicians and other care providers. When your practice provides services in conjunction with a hospital, their billing clarity and accuracy (or lack thereof) can rub off on your patient relationships. While you can't control how hospitals manage their side of billing, you can at least make sure you're communicating as clearly and directly as possible with patients about what your practice will bill and how much of that bill their payer has declared to be the patient's responsibility.

By Morgan|2022-01-01T22:52:39-08:00June 27th, 2012|

Leadership: It’s about treating people well

Joe Capko did a webinar with Medical Practice Management Web Advisor earlier this week on how effective leadership translates to more productivity from your staff -- and vice versa. One of his themes was establishing trust by listening and treating people fairly, and letting them know they are valued. People give more to their jobs when they know you care! Aptly, today's email tip from Harvard Business Review was called "Engage Your People," and featured some of the same ideas Joe offered. Basically, less top down, more listening, more working together. To read the HBR tip, click here.

By Morgan|2022-01-01T22:52:41-08:00October 27th, 2011|

Office Squabbles? Three Areas to Look for a Fix

Do you have conflicting personalities in your office? Do such differences result in petty squabbling? While inter-office conflicts are common, there are a few things an administer can do to greatly reduce conflict in the workplace. It's important to address conflicts before they affect the professionalism of your practice, the morale of your staff, and your practice's productivity. Most of what is attributed to personality conflicts in the workplace can be traced to a just a handful of sources for which you most likely are responsible! Job descriptions: It's all too easy for disputes to emerge when responsibilities are not well defined. In today's changing medical field, jobs change -- don't let those job descriptions lead to finger-pointing in the office. Clearly delineated responsibilities allow staff to both receive credit and take responsibility for tasks. Without clear definitions it's too easy for misunderstandings (of differences in performance) to escalate into personal resentments. Cross-training: The counterpart to clearly job descriptions is that your staff should be well cross-trained and able and willing to fill-in where they are needed. Cross-training has the benefit of helping everyone in the office truly appreciate what important roles the others are fulfilling. Additionally, it shows that you are interested in the well-being and career and skill advancement of your staff. There's a fine line between a groove and a rut! To the extent you are able, provide variety in the work environment so that your staff doesn't fall into an abyss of boredom. Fairness: If your staff perceives that some receive preferential treatment, morale will suffer and, with falling morale, it's only to be expected that friction will increase. An under-appreciated fact is that perceptions of fairness and openness to communication go hand-in-hand. If your staff feels they can approach you to complain because you have a sincere interest in their well-being, you are well on your way to resolving squabbles among your staff. Challenge yourself to hear that which is difficult for you to hear. No one is free from biases and your staff can serve as a mirror to your own policies -- it's important

By Joe Capko|2022-01-01T22:52:42-08:00September 30th, 2011|

Be Respectful

Respectful engagement is about real behaviors that make a difference in patient safety, productivity and financial performance - your bottom-line, according to Dr. Mitchell Kusy and Dr. Elizabeth Holloway of Zolo Healthcare Solutions and authors of the fabulous book: Toxic Workplace! Managing Toxic Personalites and their Systems of Power. Here are a few tips from these experts. Develop zero tolerance strategies to reduce productivity losses Support staff engagement to uncover bad behaviors Designate an accountability partner for every leader Certainly a blog does not give this topic the attention it deserves. I highly recommend you buy the Kusy-Holloway book as an investment in your permanent library and make it required for every physician and manager. It is your responsibility to keep things civil and protect the workplace environment. Failure to do so will cost you plenty! Capko & Company is a leading healthcare consulting firm.

By Judy Capko|2022-01-01T22:52:56-08:00February 3rd, 2011|

Dealing with conflict

Addressing and resolving conflicts is something most people avoid, including doctors! But in reality, conflicts will always emerge. But, conflicts left unattended will cause much anxiety and furor. Resolving conflict requires a specific set of actions and determination.Know where you are. Get a grip and examine the situation with the intent to reach a “realistic” solution. Recognize that this can’t be accomplished if either side is unwilling to budge. Help the opposition to understand your position and seek to understand theirs and how they arrived at such an outlook. A reasonable solution is likely to require compromise on both sides, so be willing to bend.Be impartial. This is not an easy task. You may have an inflated opinion of the value of what you bring to the table or possibly a misconception about the opposing party. Data is the best way to achieve objectivity. This can be accomplished by comparing data to national averages for your specialty. Such standards are available through professional associations such as the Medical Group Management Association,MGMA, and the National Society of Certified Healthcare Business consultants, NSCHBC. Be a good sleuth. Listen carefully to everyone’s viewpoint, most importantly those you are trying to sway. Understand where they are coming from and what is important to them. The more you know about the opposition, the better prepared you are to address the issues important to them.Clarify the desired outcome. What is essential to you and what are pracdtice leaders “really” want to achieve. It’s a matter of recognizing the ideal outcome and the “acceptable” outcome that prepares you for effective negotiations.Respect different viewpoints. It’s unlikely that everyone will see things from the same perspective, but without respecting others varying opinions we are unable to dig dipper to understand them and how to achieve an acceptable solution from their viewpoint.Just the facts. Bring facts to the table. It will diffuse subjective opinions and provide an opportunity to sway others and develop a consensus. Objective reasons will outweigh subjectivity, but you must stay on course and keep coming back to the facts. This is when you will begin to

By Judy Capko|2022-01-01T22:52:59-08:00February 6th, 2009|