A couple of years ago I gave a talk to a group of surgeons at a medical conference about SERVICE in the medical office setting. I dug that out recently and thought our patients might be interested to read some excerpts from it. Maybe we are giving away our trade secrets, but we truly believe the world would be a better place if ALL business had a true service mentality, so we are happy to share what we have learned!
“What my group does exceptionally well that sets us apart from others and has made is well known is Houston is SERVICE, and becoming a real 5 star customer service provider is what I would like to talk to you about today. Everyone here wants to be the best; we are all here today pursuing that goal. But being the best individually is not enough. You can be the best surgeon, but your entire office is a team, and becoming the best requires transforming everyone and everything in your office, not just yourself. My group has done many things to adapt to the market and I have tried just about every new thing out there, but the single thing that transformed our practice and improved patient satisfaction and physician quality of life more than any other, was adopting and committing to a new service mentality.
What does that mean? We are all providing a SERVICE to our patients, but are we really providing SERVICE? Having a service mentality is something that is very rare in a doctor’s office setting and is usually only seen in 5 star restaurants and hotels.
I came to this realization quite suddenly about 3 years ago. Since starting my practice 12 years ago as a solo practitioner I knew I wanted to excel, and I expected that everyone else wanted the same. As a business owner with a very busy and growing practice I found myself frequently frustrated that my employees and patients would not behave the way I wanted. I paid my staff well and treated them kindly but they seemed dissatisfied, my office was gossipy, staff turned over too frequently and patients seemed to complain about the same things such as wait times and turn around time on results. I would tell my staff to fix those things but we never made much progress. I had 3 practice administrators in 3 years; they would burn out and seemed frustrated and unable to live up to my expectations. Our general attitude towards patient complaints was to support our staff and tell the patient why the staff were doing the best they could. My partners and I thought our group was pretty great. We had experienced rapid growth and had impressive numbers on paper to support this conclusion, so why was our staff not feeling the same way and working together?
The answer eluded me for some time and I became more and more unhappy with the idea of going to work. The business was growing, we were showing up on all the “best doctor” lists and getting more new patients than we could see, but something felt wrong, something wasn’t working. I sincerely wanted our office to be the best, and wanted our doctors and staff to be happy and well behaved, but many of them weren’t. I am quite certain that this is the norm for most successful doctor’s offices, but we made a decision not to settle for normal and decided to go for that 5th star.
I decided to study businesses with happy staff who consistently follow the highest standards without deviation, and in turn have a high level of customer satisfaction. This proved pretty easy because I came up with the idea while sitting on the beach at a Four Seasons resort in Mexico where I have many of my great ideas. I had been to the Four Seasons many times, I knew that I loved it and always felt good there, I knew that the staff rarely changed and always looked happy and relaxed and always behaved in ways that were in line with their employer’s wishes. How did they do it? How does the a 5 star hotel chain collect thousands of perfectly behaved and happy employees from all walks of life all over the world? This really was a “Eureka” moment for me, and I realized that if it could be done, that I could do it too. I spent the rest of that week observing, taking notes , talking to staff and managers, then went back to my group and told then we were going to change everything.
We can learn a lot from fine hotels about SERVICE. In our office, adoption of simple philosophies like the “patient is always right” and the “golden rule” really changed the angle from which we performed business. Previously we were performing a service but we were not SERVICE PEOPLE. We were arrogant. Service people are humble. Service people cater to their customer, always. They do not expect the customer to do anything for them. They assume a position of servitude, which is tough for a doctor. It is a real mind shift for some doctors to genuinely move from : “I’ll take care of you on my terms and you are lucky to have me” to “I am here to serve you and your satisfaction is my primary goal.”
The “golden rule” basis of the service culture means putting yourself in the patients’ shoes, sometimes literally. I will have my staff sit where patients sit and see how things look from there, try out the bed and the stirrups, are they comfortable, is it hot or cold, is the gown scratchy, can you see dust that we may not have seen from our angle?
We talk about “never events”, which in the hospital setting means removing the wrong body part of giving the patient a drug she has a listed allergy to. These are behaviors that are not all described in a protocol but are just part of the culture. Without this level of detail, your 5th star will elude you. You can’t let your staff do these things, ever, and you can’t do them yourself. In my office some examples would be:
– Chewing gum
– Being out of uniform
– Smelling like smoke
– Walking past a patient without making eye contact and using an appropriate greeting
– Leaving a patient anywhere for more than 15 minutes without an update
– Not retuning a call before the end of the business day
– Failing to respond to a complaint
– Speaking negatively about anything in earshot of a patient
A few years ago I would hire a medical assistant or receptionist from Craig’s list, have her follow one of my current staff members for a couple of days and then set her free to interact with patients. Usually we were short staffed and I felt like we didn’t have time to have her train for a long time, and I never spent much time assessing how much they really knew. That pattern was the basis of most of our problems. Even our long term staff sometimes had gaps in their knowledge that I wasn’t aware of and were not prepared to train anyone else.
So bad habits got passed down and ingrained. With the new business model we found that many of our nursing staff had gaps in their medical knowledge, so the doctors as a groups wrote a nursing manual with a list of ob and gyn topics with a 1 page medically correct explanation that would given them the information they need to talk to a patient intelligently on the phone. All the nurses have to read it and are tested on the content regularly. A new member of the nursing staff now has a several week training program supervised by the clinical staff manager and ending with the passing of several tests. Only then can she interact with a patient. Reception staff similarly train for a week on each of several functions and are not allowed to interact with a patient unsupervised until they have completed all phases and passed a test. This process although expensive and time consuming is absolutely necessary if you want to go for that 5th star. Patients are given a higher level of care, staff is happier because they are comfortable that they know what to do and have been well trained.
What happened to my staff morale when this was put into place was amazing. I realized that people are unhappy when they don’t really understand what is expected of them and when they get inconsistent messages from their leaders. Now they know the way we measure success, they know how to do a good job. They have the tools to excel. The other thing I learned is that people are happy when they behave well. Following the “golden rule” makes you feel good. You are in sync with the universe, part of the greater truth doing the right thing.”
Did you learn something from this post? If so let us know! What topics would you like to see discussed in future posts? Please send feedback regarding this post to firstname.lastname@example.org.