patient satisfaction

Directories still pretty inaccurate

If you've followed us for a while, you know I've been urging practices of all sizes to take their payer directory listings more seriously for years now. It's not that insurers shouldn't do a better job. It's just that (as someone who once owned a directory company) I know how hard it is to keep directories accurate, especially if it's not your core competency (like, when your actual job is providing health insurance). It's also something that requires effort on both sides to be done properly. There's just no way around this. The insurer can't be expected to know when anything changes on your side unless you inform them. And while insurers should do a better job of accurately publishing information you provide them, mistakes are inevitable. It's up to you to catch them and make sure they're fixed. And it's absolutely worth monitoring and correcting your listings! I can think of few marketing tasks that are more directly connected to attracting new patients. Patients want to know that you're (1) in their network (2) accepting new patients and (3) convenient to them before deciding to contact you. If you're not listed accurately in their health plan directory, you're basically turning them away at your door. More on the latest study showing directories just haven't gotten any easier to maintain: https://www.healthcaredive.com/news/inconsistent-physician-directories-no-surprises-act/645307/

By |2023-05-25T14:22:03-08:00March 17th, 2023|

Have you seen Laurie’s popular article about the deductible reset?

Laurie's 2018 article for Phreesia's blog is one of their most popular posts. If you haven't seen it yet, here's a link to check it out. It includes time-tested ideas for dealing with the roller-coaster ride that is the transition from the busy-busy fall season to the slowdown in January, including: Identifying the patients who can benefit most from booking services they've postponed before the year ends Making sure staff are trained and confident they can explain the pros and cons of booking care before year end Deploying and taking full advantage of all the tech at your disposal that can make it easier for patients to pay Planning to make conscious use of downtime in the spring--whether by increasing patient visits through promotion, using the time for other important tasks you've put off, or both There's still time to make a plan to have your practice business's best fall/winter season yet. If you'd like to discuss more ways to do so--and how we can help--please get in touch!

By |2022-01-01T22:51:43-08:00November 10th, 2019|

Teaching patients about their health insurance shouldn’t be your job–but it is

If you are frustrated by how confused patients can be about their insurance, and by the conflicts this confusion often leads to (especially about patient balances), you have good reason. Insurance is provided by employers, who theoretically should be able to explain it (it's an important part of employee compensation, after all). And it's offered and managed by insurance companies, who set and enforce the terms. There seem to be several good ways, logical ways to get information about insurance rules. So why do many patients misunderstand how it works? A few things are obvious. One is that health insurance can be very complicated. (It is complicated for those of us who work with it every day, even.) And the training and information patients have access to from their employers and insurers is simply not clear or accessible enough for many patients and many situations. This gap shouldn't be your problem. But it ultimately becomes your problem, since you'll have to deal with patients' confusion and corresponding reluctance to pay. All of which is a long way of saying that helping patients understand how their insurance works may not be something you should have to do, but it is something you're better off doing. And the earlier in the relationship you start the education process, the better. The clearer patients are on their financial responsibility before they receive care, the less likely they will be surprised by a large balance they didn't expect to owe. There is an old saw in marketing about how you have to repeat a message seven to ten times before anyone really absorbs it. The seven to ten is not regarded as a scientific analysis by anyone. But the idea that you have to repeat things, usually more often than you expect, and ideally via different media, is well accepted. (There's a reason you see and hear advertising by the same companies in different places and via different channels.) To this end, we often suggest to medical practices that they have some explanatory material at the front desk that covers common insurance issues--things like what

By |2022-01-01T22:51:44-08:00September 3rd, 2019|

Don’t believe the hype: patient portals aren’t “largely unused”

A provocative headline got my attention recently. It proclaimed that patient portals are "largely unused." It caught my eye partly because it didn't sound all that plausible -- and because taking such a headline at face value could be unhealthy for your businesses, dear clients and friends of Capko & Morgan.  I decided to dig into the matter. The article text actually mentioned that 37% of patients have recently used portals. Could the author actually believe that 37% utilization is trivial? That seemed to be what they were saying, yet it's hard to imagine they believe that. (Would a 37% decrease in salary leave one's pay "largely" unchanged?) Perhaps, you may be thinking, this was just a forgivable, inadvertent misuse of "largely." But I tend to think not. This type of exaggeration is just too common in modern media, even in our world of the business of healthcare. I tend to think the headline intended to sensationalize. Yet even if that wasn't the intention, it's still not a benign error, which is why I'm calling it out. Mischaracterizing portal adoption has a hidden cost Clients often tell us they've held back on technologies that could make their practices more efficient because they're concerned patients won't use them. But that thinking usually means practices miss out on significant benefits, since the tools they delay adopting (or forgo altogether) could make interaction easier for patients or make their practices more profitable (or both). This tendency to hesitate has been especially true for patient portals, and it's often very costly. Somewhere along the way, the idea took hold that portals aren't worthwhile unless nearly every patient uses them. But this is not true. It's not even close to true. If even a small percentage of patients regularly uses a portal, those patients will benefit -- and their physicians will save time, too. (And that's strictly on the clinical side. Portals have the potential for even more dramatic benefits on the payment and administration side, even when utilization is very low.) What's more, relative to other recent technologies, portal adoption is arguably not that

By |2022-01-01T22:51:45-08:00December 20th, 2018|

Enter through the front door [practice management tip: patient service]

In a typical medical office layout, there’s a front door that’s used by patients and a rear door (or staff entrance) for employees. Of course, this can be quite convenient, especially when connected to employee parking. But an interesting consequence of this configuration is that physicians and managers never experience the reception area from the patient’s perspective. Next time you head out of the office during the day, come back in through the front door. Have a seat in the reception area. Are the seats comfortable? Are there enough of them? Are they spaced appropriately or too close together? (Imagine yourself sitting next to a sneezing flu patient if you need helping deciding.) If there’s a television, is it audible, but not too loud? Are there recent magazines on hand, or raggedy old ones from last year? What does the front desk activity convey to people waiting? Do patients look impatient – like they’ve been waiting too long? If so, does anyone behind the front desk seem to notice? In our consulting engagements, we almost always have comments on how the reception area can be easily and inexpensively improved. But you don’t need consultants to figure this out. It’s easy to self-diagnose – and the upside on improving could be huge. Patients start deciding how they feel about the quality of the care they receive the moment they walk into the office. Even ill patients will feel better about their visit – and their experience in the exam room – when their first moments in your practice reassure them they’re in a welcoming, professional, and caring environment. Patients view their entire practice experience as their “care” – not just the 15 minutes they get with a clinician. An inviting reception area is a cost-effective way to reinforce your practice’s caring attitude – and get the patient visit off to a strong start.

By |2022-01-01T22:51:46-08:00May 16th, 2018|

Patient service is your competitive edge [practice management tip: patient service]

Independent primary care and specialty practices alike worry about increasing competition from hospitals and integrated systems. It’s not uncommon to see hyped-up headlines pronouncing independent practices “doomed” and the consolidation trend “inevitable.” But the naysayers always conveniently overlook a big advantage independent practices have versus larger organizations: the personal touch. In consumer settings, small players often find ways to compete against giants – and win. Maybe your town has an auto mechanic who outshines the dealer shops, thanks to better prices and more convenient hours. Perhaps your neighborhood has a family hardware store that’s going strong in the shadow of a big-box store, thanks to expert staff and a unique range of products. Or, if your area’s like mine, maybe you’ve got weekend farmer’s markets selling fresh vegetables by the truckload, despite the supermarkets down the street. Of course, these are just a few examples – but you get the idea. “Little guys” can flourish – if they find ways to serve their customers their super-sized competition can’t easily match. Competing against bigger, deeper-pocketed opponents can be scary. But it’s easy to forget those competitors have weaknesses as well as strengths. In medicine, it’s hard for a large, bureaucratic organization to provide the personalized experience a smaller practice can. And in what setting could a personal touch be more valued than in healthcare? If you’re worried about a big player setting up camp in your backyard, start thinking about how you can attract and retain patients with better patient service. Take a seat in your own reception area – and think about how it can be upgraded. Start looking at metrics like wait times and overall visit length, and consider how you can improve them. Check online reviews for comments you can learn from, and do your own confidential surveys to give patients a chance to tell you what they value – and what needs work. You just might find that you practice won’t just survive – it will thrive.

By |2022-01-01T22:51:47-08:00May 9th, 2018|

Does “personalizing” the patient experience sound impossible?

Personalized, customized service has become the norm in our lives as consumers. We've come to expect even everyday items like coffee and sandwiches to made to our specific preferences. But when we're talking about the administrative side of the patient experience, customizing can seem like a much bigger deal. With so many other demands on our medical practice processes, is the idea of personalizing beyond our reach ... or even a little nuts? It may seem that way, but it doesn't have to be. The wonderful thing about offering more choices in how to do business with your practice is that so many of the options patients seek can be cost-saving for you. For example, studies have shown that consumers prefer to pay bills electronically over sending checks. The trend towards paying online, on-the-go, at any hour of the day has become so pervasive, many people don't keep stamps or even checks on hand. If you're not allowing your patients to exercise this preference, instead hoping they'll mail a check (or only taking credit card payments by phone or in person at the office), you're making it harder for patients to pay. That probably means you're getting paid more slowly -- and at higher cost to your practice. But what happens if you do offer patients the ability to receive statements electronically and make payments that way, too? When patients can pay electronically, it's easy for them to do it immediately -- even if they receive your bill at 10:00PM. They avoid the unpleasant feeling of being behind on their bills, and your staff avoids the more unpleasant task of calling them to collect. And you'll get paid faster -- at less expense, since staff won't have to spend time on the phone with the patient or stuff an envelope with a statement. Best of all, when you implement an option like a payment portal or automatic debit, your patients will thank you for it, even as they're paying you more promptly and reliably. Electronic patient payments are just one of several examples of technology-enabled services that conserve staff resources

By |2022-01-01T22:51:47-08:00February 12th, 2018|

The power of you front desk to influence the patient experience – and your reputation

One of our previous clients decided to move on from her group practice to set up her own practice.   After being in town for just a few short years it would be important for her to have a following of loyal patients. For this reason, I decided to research how patients were rating her, and discovered her average rating with several major sites was a 4+ stars.  Sounds pretty good, doesn’t it?  I decided to dig deeper and read some of the reviews.  4 out of 5 had wonderful things to say, but the one critical rating was brutal and contrary to the glowing comments other patients made about this fine doctor.  The strong negative comments by this single reviewer related to his experience with the front office.  I suspect this could have been avoided if the front office team took pride in their work and understood that a major part of their role is to greet each patient properly and make sure their needs are met, as well as preparing them for the visit. Such comments as: “I waited an hour in the reception and was completely ignored; the receptionist was rude and acted inconvenienced; I was a new patient and no one seemed to care” reflect a patient that feels discounted and gets upset before ever being escorted to the exam room to meet the physician.  Unfortunately, it’s not rare to hear patients complaining about the way they are treated at the doctor’s office and how poorly it compares to their experience at Starbucks or their local bank.  It’s time for medical practices to implement some training standards that put patients first. It starts with creating a culture where physicians and managers believe their staff is their number one customer. Staff will only treat patients as well as they are treated by their superiors and the respect and care they are given.  A practice will not thrive unless the work environment is one of respect and appreciation – and it starts at the top! Hire good people and treat them right Be selective in who you hire. The

By |2022-01-01T22:51:48-08:00August 28th, 2017|

New ebook on the ROI of investing in the patient experience

Recently, the check-in automation company Phreesia invited me to write an ebook on one of my favorite topics: the patient-centered practice. It's called "Beyond Five-Star Reviews: Why the Patient Experience Matters, and How to Improve It," and it's available free with registration -- just click on this link. The idea of being more patient-centered and creating a better patient experience attracts more controversy and confusion than it should. The bottom line is that being more patient-centered fits with clinical goals as well as business ones, because it may help patients become more engaged and more receptive to clinical advice. "Patient-centered" is not about chasing positive reviews, and it's not about being patient-led. It's about understanding the patient perspective and communicating that you do, while also maintaining your practice's clinical integrity and mission. And it's about focusing on administrative processes patients interact with every day that can make your practice more or less welcoming and convenient for patients. The ebook contains some ideas that any practice can implement to improve the patient experience. I hope you'll check it out -- download it here.

By |2017-03-27T08:19:14-08:00March 27th, 2017|

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

Can the federal government solve the health plan directory problem? You should hedge your bets

Paraphrased from my Management Rx blog: The New York Times reports that the federal government hopes to fix a problem that many citizens complain about: inaccurate health plan directories.  When health plan directories are incorrect, patients can wind up unintentionally receiving services out-of-network, which usually leads to unexpected, significant out-of-pocket costs. The administration is naturally concerned about the impact of directory errors on patients, but out-of-date directories are a huge problem for medical practices, too.  Out-of-network errors mean the practice probably is paid less, and the patient may blame the practice for not catching the costly mistake.  Patients may share their disappointment with others, via word-of-mouth or even publicly via a review or rating. And besides out-of-network errors that everyone would like to avoid, practices lose even more when they're not listed at all by a plan they participate in, or they're listed with the wrong address, wrong specialty, or wrong status (i.e., accepting new patients or not).  When these errors occur -- and they're common -- the directory is turning prospective patients away from your practice. You can read the rest of my post at the Management Rx site. But the short version is, health plan directories are such an important source of information for prospective patients, medical practices can't afford to leave their accuracy to the insurers alone, even if the government gets involved. And on the plus side, health plan directories may be your single best source of new patients, and fixing and enhancing your listings is free!  It's rare to find a marketing effort that can be so easy, so effective, and free. My practical, step-by-step ebook on the subject -- "The Quick Guide to Online Physician Reputation Management" -- will empower you or a staff member to take control of all your online directory listings, and start seeing the benefits of being easier to find online.  It's just $6.99, but you can download a free sample at Amazon to try before you buy.  (If you don't have either a Kindle device or the free Kindle reader on another device, you can also purchase a PDF version for the

By |2022-01-01T22:52:00-08:00May 12th, 2015|

If you missed Laurie’s webinar, “Front Desk Collections: the New Linchpin of Profitability,” here’s how to watch it now

If you missed Laurie's webinar, "Front Desk Collections: the New Linchpin of Profitability" (sponsored by Wellero) -- one of her most popular webinars ever! -- you're still in luck.  Sign up here and watch it whenever you like. This practical presentation hits on some ways you can immediately increase profitability while avoiding pitfalls that can erode your practice's financial health. Take a look (it's free to sign up), and, if you have questions or comments after watching, please don't hesitate to contact Laurie. [yks-mailchimp-list id="87d94b707e" submit_text="Submit"]

By |2022-01-01T22:52:03-08:00October 27th, 2014|

New rounds in the patient satisfaction debate

On July 8th Medscape presented a thought provoking discussion with three primary care physicians titled “The Good and Bad of Patient Satisfaction Measures.” This fuels the ongoing debate of the value and  scores as part of physicians’ payment for their patient services -- a subject of keen interest to me. In March 2012 the Archives of Medicine published a study conducted by Joshua Fenton, MD, MPH, and colleagues at the University of California, Davis. The study analyzed data from more than 50,000 adult patients, indicating the most satisfied patients were 12% more likely to be admitted to the hospital and their healthcare and prescription drug costs were 9% higher. One of the most interesting findings to the study’s readers was that the report revealed more than 26% of these patients were more likely to die. What a startling fact! One of the strengths of this study was its nationally representative sampling. The findings were derived from the assessment of satisfaction based on 5 measures from the well-known CAHPS survey, emergency department visits and inpatient admissions. The tension between patient satisfaction and patient outcomes and cost savings continues two years after the study was released. There is discussion about whether physicians motivated by payment structures based on patient satisfaction are influenced in the ordering of diagnostic studies typical treatment standards in order to keep patients happy. An article in appearing in Forbes on July 21, 2013; “Why rating doctors is bad for your health” by Kai Falkenberg discusses this issue. "THE MATH IS NOW SIMPLE FOR DOCTORS: More tests and stronger drugs equal more satisfied patients, and more satisfied patients equal more pay. The biggest loser: the patient, who may not receive appropriate." When physicians are pressured and financially incentivized to keep patients happy an ethical dilemma occurs and some physicians succumb to appeasing patients by ordering tests they might not otherwise order. Forbes reported that the South Carolina Medical Association asked its members whether they’d ever ordered a test they felt was inappropriate because of such pressures, and 55% of 131 respondents said yes. Nearly half said they’d improperly prescribed

By |2022-01-01T22:52:06-08:00July 21st, 2014|

The patient-centered specialty practice (how special are you?)

In 2013 NCQA rolled out the Patient-Centered Specialty Practice, PCSP, Recognition Program to distinguish specialists that achieve specific marks with: Developing and maintaining referral agreements and care plans with primary practices; Providing superior access to care (including electronically) when patients need it; Tracking patients over time and across clinical encounters to ensure patient care needs are met; and Providing patient-centered care that includes the patient, and when appropriate, the family or caregivers, in planning and setting goals. The motivation behind the PCSP program began when reporting discrepancies were identified between referring physicians and the specialists they refer to.  For example, referring doctors claimed that between 25 and 50% of time they were unaware if the patients they refer are actually seen by the specialists.   Another discrepancy was the specialist claiming they sent consult reports 80% of the time, but the primary care physicians state they receive this information only 60% of the time. With the PCSPs intent on improving care coordination and communication between specialists and their primary care physician, managing chronic and acute conditions across continuum of care will be better accomplished. The PCSP program also evaluates medication management, test tracking and follow-up and information flow over care transitions. This recognition program is expected to result in a better patient experience and improved outcomes.

By |2014-04-17T18:31:36-08:00April 21st, 2014|

Small practices: PCMH is not out of reach

The Patient-Centered Medical Home is so much more than just a payment innovation -- it's an idea that appeals for clinical reasons to so many physicians and practice managers, who were already aiming to provide the higher level of care-coordination and patient engagement that is the foundation of the PCMH.  But many small practices we work with have been nervous about the hurdles for certification -- is it too much for a solo or two-physician practice to take on? A recent AAFP blog post offers a wonderful idea for smaller practices daunted by the prospect of tackling the PCHM checklist on their own: form an informal network with other, like-minded practices in your area, and divvy up the research and learning.  What a great solution -- and a great way to expand your connections with other professionals in your community. Read about it here.  

By |2022-01-01T22:52:08-08:00March 24th, 2014|

What’s the payoff for being patient-centered?

The buzz about being patient-centered is not just hype, the patient-centered movement is very real and there is much to gain.  The primary premise of the patient-centered movement is that by building stronger relationships with patients they will be healthier.  Healthier patients mean a healthier population.  A healthier population reduces healthcare expenses which have soared in the United States over the past few years. Reducing these expenses is a goal that health plans are increasingly willing to pay practices to help achieve. Understanding what it means to be patient-centered is a complex process as it intends to recognize patients in terms of their own social worlds.  This means throughout the patients’ healthcare experience they should be respected, listened to, informed and involved in their care.  It is believed that shared decision-making results in better compliance and reduces health risk factors.   Focusing on individual patient’s needs an applying evidence-based medicine is meant to improve the healthcare population. Insurance companies, recognizing these factor,s are in the process of implementing financial incentives and bonus structures based on key elements that improve the delivery of health care and manage costs by reducing complications and emergency room visits, and by complying with best preventive practices. Your intentions to be more patient-centered can be reached by: Strengthening the patient clinical partnership; Promoting communication about things that mater to the patient; Helping patients know more about their health and healthcare needs; Facilitating patients’ and caregivers involvement in the patient’s care; and Setting metrics to measure improvement. Being patient-centered is rewarding for your practice in so many ways: happier patients, potential financial upside, and stronger relationships between providers and patients. All of these themes are discussed in greater depth in my and Cheryl Bisera’s new book:  The Patient-Centered Payoff (click the link to see the book's page on Amazon).

By |2014-02-24T11:21:01-08:00February 24th, 2014|

Six steps physician leaders and practice managers can take to improve the patient experience

Leadership sets the tone for the entire practice.  Staff will model your commitment and follow your expectations.  Much of the manager’s role focused on managing practice finances, maintaining practice viability, and keeping a highly motivated and efficient staff that is respectful and trustworthy.  Add to the list a new yardstick that changes how physicians get paid based on a patient experience that improves compliance to result in better outcomes. Develop a plan and set up programs to help staff understand how the patient experience relates to both outcomes and practice finances. Show your commitment through continued communication and actions that reveal a consistent effort to improve the patient experience. Give staff the education and tools to succeed in delivery consistency in your customer service organization-wide. Coach staff to improve performance.  Provide them with the support and encouragement with implementing essential changes on the road to being more patient-centered. Manage progress well.  This means conducting a baseline patient satisfaction study based on key performance areas and periodic follow-up to be sure targeted areas of improvement results in satisfactory results. Set your goals for becoming a best practice. Be explicit in what you expect and intend to achieve.  Honor each person’s contribution and celebrate successes that achieved along the way. Leaders have the ability to set the stage for success, instill a sense of pride and hope within the organization, and meet the challenges of strengthening the relationship between the clinical practice and the patients they serve.  In the end, we seek to improve the health of our patients, enjoy the relationship we have with patients and be among the best.  

By |2022-01-01T22:52:11-08:00December 14th, 2013|

Upcoming webinar: know what patients really think

I will be conducting a webinar called “Nothing but the Facts: Find out What Your Patients Really Think, hosted by Kareo, on January 15th, 2014.   Physicians and staff typically focus on what’s clinically the matter with patients and how to make them better. No question this is paramount, but there’s more to the patient experience. It’s time to find out if you are really meeting the patient’s expectations.  This webinar will talk about the importance of conducting patient surveys to get the real facts about your patients’ level of satisfaction. You will discover key factors that influence the patient experience, and why healthcare reform is making this a priority.  You will discover the impact of patient satisfaction on the overall practice performance. You will learn the technical details involved with conducting surveys that tell you what your patients need from you, and how to get the most out of the feedback information you gain.   You cannot assume how patients feel about your practice.  Your patient service performance depends on getting facts and learning what it takes to be a best-practice when it comes to the patient experience.

By |2013-12-07T14:54:59-08:00December 12th, 2013|

Does your staff treat patients well?

Healthcare reform is placing the relationship between the patient and the medical practice front and center in hopes of improving compliance and clinical outcomes.   It’s all about strengthening the relationship between patients, their physicians and the entire practice and making patients feel valued.  Although physicians are working hard to strengthen their relationship with the patients, the staff seems to fall short. In 2013 Capko & Morgan conducted a patient satisfaction survey that spanned five metro areas of the U.S.  It revealed staff is falling short on making patients feel valued by their practices.  37% of the respondents felt the staff performed only adequately in terms of making them feel valued and respected, another 7% rated staff poorly, and suggesting there is much room for improvement.  So what can you do to get staff on board with providing a better patient experience? Talk about it.     Help staff understand that they are a reflection of the practice to every patient. It is an important role and they hold the key to making patients feel valued. Build in accountability.   Schedule a customer service planning meeting with staff to collectively set some performance standard dealing with staff-patient interaction. New Patients:  Every employee is expected to honor new patients and making them feel comfortable Get rid of the sign-in sheet. Introduce yourself and make a statement that welcomes them or thanks them for choosing your practice. Don’t just hand patients a clip board, explain why you need them to provide information and let them know you appreciate their cooperation. Thank them when they are finished. When rooming the new patient give some information about her new physicians to provide important reassurance that she is in good hands. All patients: Greeted with a smile and by name within one minute of arrival for a visit Kept informed of expected wait time in reception room and exam room Before ending the conversation with a patient ask “Is there anything I can help you with?” On the phone Staff will identify themselves by name. Callers will not be kept on hold more than 30 seconds without further communication

By |2022-01-01T22:52:12-08:00December 7th, 2013|

Does Satisfaction Make Patients Sick?

A recent UC Davis study revealed a surprising finding - an inverse relationship between patient satisfaction scores and health outcomes.  In other words, those most satisfied with their healthcare providers were, on average, sicker and more likely to die than their less satisfied counterparts! As might be expected from these findings, healthcare costs were also higher - by about 9% -  among highly satisfied patients. The study compared health outcomes and patient satisfaction scores of over fifty thousand adult respondents of the Medical Expenditure Panel Survey, a product of the Agency for Healthcare Research and Quality under the U.S. Department of Health and Human Services.  The survey is designed to be representative of the U.S. adult population and is the most comprehensive data set of its kind. Response rates for the survey have varied between approximately 60% to 70% over the last decade. Among the possible explanations is that physicians, motivated in part by physician compensation structures that consider patient satisfaction, stray from standard treatments and instead meet patient expectations. Under this scenario, patients are satisfied because tests and procedures are viewed in a more-is-better light, but clinical outcomes suffer, e.g., patients receive treatments that carry risk as a result of false positive lab results. The trend toward elevating patient ratings in measures of quality of care are likely to continue with the Center for Medicare Services (CMS) starting this past December with its initial phase of 1% rewards or penalties for hospitals under Value Based Purchasing. One-third of the evaluation process relies on patient data, i.e., survey data. These intriguing study findings certainly call for further research to solidify our understanding of the value of patient satisfaction ratings.   This study and our firm's experience especially calls into question the value of very broad measures of patient satisfaction, e.g, how satisfied are you overall, because patients are notorious for confusing bedside manner with the quality of clinical care. The implications of this study may be far reaching, but enterprising providers can take simple steps to educate their patients, preferably long before they see them in the exam room. With email and social media making communication easier and less expensive,

By |2013-01-24T14:40:12-08:00January 24th, 2013|

13 for 2013 Tip #4: Patient service=patient care

Physicians only need to peek at their ratings on sites like Yelp, Healthgrades and Vitals to realize the unfair truth: patients lump every aspect of their interactions with your practice into their view of your "care."  Worse, at times it seems like their reviews give more weight to things like staff courtesy and billing hassles than to their clinical outcomes! The good news is, however, is that this also means that making people feel cared for is a team effort at your practice -- and that means that the burden doesn't fall entirely on the physicians' shoulders.  The key, though, is to make sure the importance of patient service is understood by everyone on the team, and that everyone takes responsibility for it.  Some steps in the right direction: Educate your staff about the importance of patient service, and reward them for their good work.  Let them know that your practice's reputation depends on their contributions -- and that you value it! Invest in training if improvement is needed. Survey your patients.  Learning what's on their minds -- before they vent on a social media site or medical directory -- will allow you to address issues before they become problems.  And, some patients will perceive your service to be better simply because you took the time to ask their opinion. Strive for a personal touch.  Medicine is becoming bigger and more impersonal -- and that trend is only worsening with consolidation.  But, this spells opportunities for small practices to stand out!  Be sure your clinical routines allow for a bit of personal interactions with patients -- even just stating the patient's name at the start of the encounter conveys a touch of caring. Bring in outside help. If you're not 100% sure of how patients view your service and care, an objective analysis can be very valuable.  Contact us* if you're ready for a comprehensive, cost-effective service review and action plan.  When it comes to patient service problems, and ounce of prevention is worth a pound of cure! *our San Francisco office works on patient service projects -- contact us via email at "info" at capko.com,

By |2022-01-01T22:52:36-08:00January 10th, 2013|

Scheduling for Profitability and Patient Satisfaction

Many practices fail to appreciate how critical a role scheduling has in a practice's profits and the way patients perceive care.  As an example, consider how an ineffective reminder system can cause a cascade of ill consequences for your practice: the patient forgets their appointment -- the provider sits unproductive -- patients can't get into see their "fully-booked" provider.  Both practice profitability and patient care are compromised. To avoid these scheduling problems, it's important to periodically review your scheduling operation from a patient's perspective. For each step make sure you have a comprehensive understanding of the full range of outcomes. Do you know, for example, what happens when your reminder system fails to deliver to a patient?  Is someone on your staff charged with following up? Do you effectively track "no-shows?" Do you have goals for reducing them? Whether you conduct a review of your scheduling procedures using an outside consultant or your own staff, you may be surprised to see a boost in morale because scheduling staff have a tough job and are rarely consulted by management. Understanding the challenges that your scheduling staff face and their ideas for improving processes are great first steps toward increasing your practice's finances and improving the mood of patients and staff alike.

By |2022-01-01T22:52:38-08:00October 25th, 2012|

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

Hotel Hôpital

What if hotel billing were like medical billing? A funny-but-sad video by Costs of Care in partnership with Harvard Medical School and the University of Chicago explores the possibility in a tongue-in-cheek way (click "continue reading" to view the video). "Surprise" medical costs do more than just frustrate patients -- they hurt practices, too.  By helping patients understand the costs of their care, practices can help patients make more informed decisions, plan better, and maintain a positive relationship with the practice.  And, patients who are better informed and understand what they'll be charged are more likely to pay their bills.

By |2022-01-01T22:52:40-08:00March 25th, 2012|

Master referrals and build a medical practice that rocks!

Mastering referrals is an art and a powerful tool in helping you create the practice of your dreams! Define your perfect patient, the demographics, the type of cases and the kind of patient you  like to treat. Identify  how you can  reach those people and build a solid referral network. Create a marketing plan that nurtures the ideal referral sources and keeps your name front and center. Train staff on the solid principles of mastering referrals:  Probing the patient to ensure you accurately documenting how the patient heard about your practice and tracking it in your practice management system  Provide an outstanding patient experience: an aesthetically attractive and comfortable office;  well dressed professional staff; staff and physicians that make each patient feel special from the time she or he calls the office until the bill is paid in full and everything in between; and thank the patient for choosing your practice. Conduct patient surveys to be sure you are on the mark with delivering an awesome patient experience. Honor and nurture referral sources.  Thank them, ask if they are pleased with your service and find out if there is something else you can do to make sure they are satisfied. Network and be visible throughout your community.  Be grateful and give back: giving of time and resosurces to support the community and causes you believe in. Stay constant in your efforts and measure your progress every quarter.  This will help you build strategies that work and make your practice shine. You can be the master of your practice and build the practice of your dreams!   Capko & Company; experts in medical practice management, strategic planning and medical marketing.

By |2022-01-01T22:52:55-08:00May 7th, 2011|

Get patients on your side

By Joe Capko, Senior Consultant Not every patient walks in the door with a smile - and for good reason. Some of them are worried about their health, but others simply aren't convinced you are glad to see them. Once in awhile an employee will get so caught up with what he or she must accomplish during the patient visit that they leave their table manners behind. This doesn't make a patient feel important. When patients think you care they get on your side. This will save time and contribute to making your day run smoother. Here's three easy tips that will get the patient on your side. Get rid of that terrible sign in sheet. It's an excuse to ignore a patient. Greeting a patient is your responsibility and the right thing to do! Introduce yourself and put a smile in your voice. It helps Mr. Nervous feel he has a friend he can depend on. Before you say goodbye always ask the patient if there is anything else you can do for her. She will feel important and know you are on her side. These tips are easy to implement, will improve patient satisfaction, result in a more compliant patient, and make your day at the office more pleasant. Judy Capko is one of America's leading healthcare consultants and author of the now famous book: Secrets of the Best Run Practices.   Check out: Capko & Company; https://capko.com/

By |2022-01-01T22:52:57-08:00November 18th, 2010|

There’s no mystery to making patients happy

Here are some steps you can take to keep your patients happy and make life at the office that much better. Start by treating patients like an important guest. This means everyone in the practice should say hello and smile when they greet a patient. Yep, you got it! Each staffer should sels inntroduce to each new patient and end the visit by asking "Is there anything else I can do for you today?" By the way get rid of that dreaded sign-in sheet - it's offensive! Make your waiting room a reception room. It should be attractive and comfortable, like a room in your home. Good lighting, good reading material and up-to-date decor are essential. Honor the schedule. Keep the patient wait times short by starting on time and staying on time. If you are having difficulty doing so read Judy Capko's new book "Take Back Time - Bringing time management to medicine" Go to www.capko.com. Next, communicate better! Keep good eye contact and watch for signals that tell you how the patient is feeling or responding to you. Use the patients' name frequently throughout the encounter and you will stay connected. E-mail. Your patients are doing it and so should you. E-mail to improve timeliness and efficiency when communicating with patients. The nurse, biller and scheduler are likely to manage most of the e-communication so it won't be eroding your time but is sure improve the communication link. Finally, amp up your website. Have a patient portal so patients can get information about you, the practice and their own healthcare. Give them access to past appointment history, routine lab results, their prescription patterns and other useful information that communicates without tying up telephone lines. Contact Judy Capko, one of America's best known practice management consultants: www.capko.com

By |2022-01-01T22:52:59-08:00December 30th, 2008|
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