Saturday, March 7, 2009

Improving Medical Office Efficiency

I recently talked with two acquaintances, about a week apart, who had complaints about their doctor's office. Neither of these families had ever been patients of mine, but people tend to bring up medical subjects when they learn that I write about medicine. Both had complaints about their doctor's office help.

"It was embarrassing," one told me. "The doctor told his office girl to make me an appointment with the urologist (kidney specialist), and she made one with a doctor who turned out to be a neurologist (brain specialist). The neurologist sent me to a urologist not far away, and didn't charge for his own office visit, but why wouldn't she have known the difference?"

The other patient had had at least six back surgeries over the years (laminectomy) and no surgeon would now touch his scarred back. His local doctor was trying to manage the pain on various pills and patches, some of which eased his chronic pain, but not the "lightning spasms" that struck when he moved wrong. Additionally, over the years, he had developed reactions to some of the medicines, and the doctor was trying a new one. Medical insurance refused to pay for it. The doctor's office clerk said she would try and straighten the matter out, and would call him back.

She never did, not even to let him know the problem. He finally called his pharmacist to see if he could afford to pay for it himself, and found to his horror that a month's supply was priced at $525.00, half his entire monthly income, Presumably, the clerk could have found that out, but if she did, she never let him know. Presumably, also, the doctor should have known the price of the new medicine, but salesmen rarely mention that. Most doctors subscribe to a service that publishes latest drug prices, however.

Such things happen when new help is hired and isn't taught what the job involves, beyond how to fill the doctor's appointment book and send out the bills. Often there is frequent turnover of staff, either because of low pay, poorly qualified help, or poor instruction.

I learned, early on, to pay my staff a little more than the going pay rate, and to make an office instruction book covering phone etiquette, appointments, unhappy patients, inability to pay, emergencies, unavoidable delays, prescription refills, salespeople, etc. and updated it as needed. Knowing the price of my patients' medicines was my responsibility, and I tried to keep up to date and practical. I learned to try the more familiar, less expensive medicines first before going on to the "latest new drug" unless there was some specific reason to go directly to the latter.

The way our patients perceive us depends a lot on the people we employ. If you don't enjoy training new help every few months, Doctor, pay attention to them - the nurse, the technician, the clerk, the janitor, everybody, so they will stay with you. Competence and caring count, both yours and theirs.

Your office staff is one of your biggest assets. Treat them right. Don't leave it all to an office manager.