Practice Tips and Efficacy

The Patient Experience

By Sherrif F. Ibrahim, MD, PhD, FACMS

In this day and age of social media and online reviews, medicine has not been spared. I often ask patients how they found our practice, and increasingly I hear, “Oh, I looked online and you guys had the best reviews.” While many of us may not rely on Google to find our physicians, the truth of the matter is that this is the new reality and has been for some time. While I still cannot convince myself to directly ask patients to write a good review, there are certainly aspects of our practice that we have worked on diligently to ensure that patients have the optimal experience and outcome at our practice.

The successful patient experience begins with education. We spend a great deal of time with each Mohs surgery patient explaining the nature of their diagnosis and the impact on their lives.  While many of us treat hundreds or thousands of skin cancers per year, it is important to recognize and address the fact that this may be their first. It is important to avoid phrases like “don’t worry about it” or “it’s nothing” when in fact the patient is indeed very worried and takes their diagnosis very seriously. We then spend a great deal of time explaining the Mohs procedure, repair options, and immediate and long-term post-operative expectations. Many patients feel Mohs surgery is “just like the biopsy” when in fact it can be significantly more, especially when a complicated flap repair is involved. Likewise, during the procedure, our team always speaks with the patient about what we are about to do and gives the patient a moment to process these words before we actually do it. Once the procedure is complete, aftercare is reviewed in detail, the patient is provided written instructions and office contact information (text, email and phone – many patients prefer options besides traditional phone calls), and then they receive a phone call or text from us that evening. The more the patient is prepared, the smoother things will go both during and after the procedure.

Personalize the experience for the patient. Because we ask patients to arrive at their specific appointment time, we can usually ascertain who is walking in the door. We know the patient’s gender and age and, more often than not, can match the name of a new patient with a face. For returning patients, we have their photograph in the chart.  The simple gesture of saying “Hello, Mr. Smith!” with a smile versus “NAME??” immediately changes the patient’s demeanor and has a positive impact on their experience. Ask them how their drive in from Pleasantville was instead of asking them where they are from, wish them a happy birthday if it’s close to their big day, and say “welcome back” if they’ve been to the office before rather than asking if they’ve ever been to your office. Use elevated speech and look at the patient at eye level when you are speaking to them, not at the back counter of the procedure room or standing while they are seated. Lastly, if you ask a question about their life, take time to actually listen to their responses. Clear bloody gauze and instruments before undraping the patient and from the kick bucket while they are waiting for their Mohs stage to be processed. The more the patient is made to feel like you actually care about them and that they are not a cog in an assembly line, the better their experience at your practice will be.

Standardize your office flow. Most offices are experiencing challenges with staffing and turnover in personnel. We have found that a great way to address these hurdles is to create protocols and standards for all employees. An office handbook that describes everything from appropriate dress, hair, nails, eating and drinking policies, vacation policy, etc. is a fantastic way to start the onboarding process, but also to make sure that employees are held accountable. They can no longer say “You never told me that my hair needs to be up,” if it is written in the handbook. It is much easier to say, “No gum chewing is noted in the office handbook,” than to deal with an employee who feels you are targeting them or singling them out. Third-party human resource agencies are an excellent resource for this type of activity and save you a great deal of time. Our nursing staff wears a standard uniform and receptionists follow a dress code. As your office staff grows or experiences turnover, standardized processes for check-in, scheduling, rooming, surgical procedures, Mohs lab organization, supply ordering, instrument handling, phone triage and wound care make training proceed more smoothly and ensure that the patient experience is consistently excellent. When staff follow protocols, they are less likely to make mistakes.

Communication is central to all of these aspects of office flow. Great communication with your staff and your patients and implementation of some of the above concepts will ensure that your patients feel they are well cared for and instill a sense of pride in your staff. At the end of the day, maybe the reviews ARE meaningful after all. It is easy to scoff and say, “I don’t care what our online reviews say,” but if you try some of these ideas and you start seeing 5-star reviews come through your Google Business page, you may just be delighted!