8 reasons why your practice needs to stay open during lunch

Most professional business enterprises nationwide understand that they could never expect to compete in the marketplace if they shut down their phones 20 – 25% of important business hours every day. Yet that is exactly what your medical practice is doing if you are shutting your phones down for a “lunch break”.

You might be wondering how important can this really be for a medical practice? Can’t patients just wait an hour?  Though it may seem overwhelming to offer lunchtime phone coverage after years of an entrenched habit, it’s worth your effort to make this change.  Many of your colleagues are keeping phones open during the lunch hour and are growing their practices at a rapid pace.  In fact, some of your own patients might be leaving to go to a practice that keeps lunch hours open to provide better service.  In addition, you are likely to learn that opening phone lines at lunch time reduces a lot of staff stress and work created by trying to ‘catch up’ while manage telephone demand. You will certainly discover within a short time that inbound calls during peak hours will be substantially reduced.

Keeping phone lines open throughout business hours can be accomplished with some creative scheduling and a clear protocol on how to handle these calls. Your practice is a business and must serve the needs of patients when it’s convenient for them – your customer. When you make this change, you would expect patients to be delighted, but you might be surprised at how much your staff appreciates the difference too. Here are eight concrete reasons keeping your phone lines open during lunch is better for patients,  better for your staff and no longer optional for practices that want to compete and thrive.

1. Mixed messages. Saying on your website, practice brochure or mission statement that your practice has excellent customer service, that your focus is meeting patient’s needs doesn’t jibe with the practice of closing the phone lines and locking the doors at lunch.  An inconsistent message creates an identity crisis for your practice and renders those messages meaningless and hollow. As the old adage goes, “Actions speak louder than words” – Render business practices that reinforce your message and create trust, build patient loyalty!

2. Lost opportunity. Often new patients are working off of an online list of doctors provided by their insurance company or simple pulled up from Google when searching their condition or your specialty. When they call your office and get voice mail they will likely move on down the list to the next physician – and if that practice is smart enough to know to keep phone lines open through the lunch hour, you bet they have a good chance of scheduling and acquiring that new patient. Keep the highway to your practice open during the lunch hour and capture new patients with a stellar first impression!

3. Increased cost. When patients call and leave messages at lunch or hang up and call back again later, you’ve just made the post-lunch hour laden with duplicate work. Messages have to be processed and responded to, in the meantime new calls are coming in, patient visits have resumed and some of those patients may decide to call back again, not trusting that their message got through – all of this amounts to more work and less efficiency for your staff –costing more to run your business while getting less accomplished. Receive calls and process requests in this small way during the lunch hour, and boost after-lunch efficiency!

4. Frustrated patients. Every business exists to solve a problem of its customers. In the medical practice, customers are patients and their problems feel very personal and important. Meeting a patient’s immediate need to get through to their doctor’s practice and be assured that their concern is being handled is not difficult with live phone coverage and it means so much to your patients. On the other hand, frustration mounts when a patient can’t get through and doesn’t feel confident in leaving a voice mail message in hopes that someone will pick it up and respond. These patients will often call again creating duplicate work – and when they do call back they are already agitated creating a less-than-positive experience for patients and staff.  Assure callers that they’ve been heard through the lunch hour and your staff and your practice come out smelling like a rose!

5. Image wars. We can no longer ignore the fact that competition for customers exists. Patients are less trusting and loyal toward their physicians than in years past, making it easier for them to ‘try out another practice’. Online reviews of restaurants and hotels are commonplace, the online review of physicians is growing rapidly – why wouldn’t potential patients look to see what your patients are saying about you online? You want patients in your community talking about your incredible accessibility and patient-centered philosophy to woo new patients and underscore existing patient’s loyalty. Your image matters and live coverage of phones throughout the day makes patients feel valued, giving them the service they expect.  Express value by meeting patients’ needs with excellence and watch your image soar!

6. Attrition. When patients are not getting through to your practice when they need to their loyalty wanes, making them more likely to go shopping elsewhere. Attrition is costly to your medical practice because of the expense of attracting and processing a new patient. Keeping existing patients satisfied is cost efficient as subsequent visits are more profitable. Besides, building long-term relationships with patients is rewarding for you and your staff.  Open up those phone lines – build loyalty and reduce attrition!

7. Valuable referrals. All of the above speaks to increased quality of customer service. No one wants to refer someone they care about to an office they aren’t sure will meet the needs of the new patient.  When you outshine your competition by simply being available to patients when they need to get through, you increase your patient referral base. You bet they are going to tell their friends and family about how quickly they got through, how friendly the staff was and how they didn’t have to wait for a call back! Taking patient calls throughout the day gives your patients all the more reason to refer with confidence!

8. Timely medical care. When a patient leaves a message because they have a medical need and your staff calls back at a time that isn’t convenient for your patient and the call is missed, you have a case of ‘phone tag’ that is not only frustrating to your patient but is resulting in delayed care. Sometimes several calls, messages and return calls occur before the patient is able to make an appointment to be seen, get an answer to an important question or obtain needed prescriptions when phone coverage is not available. When care is delayed, overall health service is compromised – this is not healthy for your practice or your patients. Process calls at lunch, expedite healthcare for patients!

When I bring these issues to the attention of a practice, often the change is made quickly and the philosophy embraced.  Other times, however, I hear reasons why they think they can’t provide this to patients.  Whether it’s the lack of staff, the need to ‘catch up’ at lunch or the camaraderie of a shared lunch hour, these excuses simply don’t hold water when we see practices everywhere finding a way to do this and thriving.

There are other ways to successfully meet the needs of your staff and the practice while staying on top of calls throughout the day. If you want camaraderie – have a shared meal once a month, staff meetings during low-call volume hours and out-of-office events. There will be less need to ‘catch up’ when lunch hour calls are not put off until the afternoon.  In addition, staff hours can start a half hour before phone lines open in the morning or extend afterward – putting calls off does not decrease workload. When a practice adopts this philosophy and comes to understand the benefits to the overall practice, solutions can be found that meet the needs of your staff while keeping phone lines open to receive patient calls.

Some practice administrators or physicians may be concerned that they or other staff members will be disturbed during their lunch break with interruptions resulting from these calls.  It’s crucial that all staff members take a lunch and other breaks –  not only is it important for them to recharge from dealing with a sometimes demanding public but it’s also a legal requirement for employers to enforce breaks.

Smaller practices might wonder how to accomplish this coverage with just a couple employees.  Some practices stagger or rotate lunch hours and others use part-time employees who come in later to cover the phones during the lunch break. During peak hours for some practices, employees who don’t usually cover the phones will direct their focus to meet demand – such as a biller – this same practice-specific ingenuity can be put to work to relieve your staff of the after-lunch crunch and kick up customer service a notch by offering lunchtime phone coverage.  A little creativity and teamwork are required but the benefits to your practice and your patients are worth the effort.

Finally, more practices are recognizing that, indeed, their practice is a business and needs to model behavior, processes and customer service that already exists with other professional health enterprises, professional businesses – such as accountants, lawyers, and financial advisors, and their own colleagues.  Surely you are among the best, so get on the bandwagon of superb customer service and practice efficiency – and stick with it once you start. Reap the rewards of being among the best practices and be amazed at how having phones open during all your business hours can contribute to increased efficiency, a better bottom-line and happier patients!

Cheryl Bisera is a marketing consultant for healthcare professionals and founder of Cheryl Bisera Consulting.  This article is reprinted with permission from The Journal of Medical Practice Management.

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  • Ian

    I used to work in a two physician office. Billing done offsite. One front office person, two MA’s, two docs. EMR. Good luck hiring an MA or a front office person with “you don’t get a lunch break.” I may not have had attrition of patient’s but I would predict attrition of employees.

    • azmd

      Attitudes like this are why we docs are getting our lunch eaten by insurance companies and regulatory agencies. I agree that it’s inexcusable for a medical practice to close its phones during lunch, when that’s the exact time that the vast majority of working patients have time to make personal phone calls. Where I live, though, it’s common practice, which is frustrating when I try to schedule appointments for myself or my kids.

      The fact that we as a profession have a tendency to sit back and even when confronted with an obvious need for change in practice, respond by saying in effect “That’s the way we’ve always done it and it can’t be changed,” sets us up for others to step in and mandate change for us, usually in ways that don’t work as well as if we got less stubborn and more flexible and figured out how to change by ourselves. It also just reinforces negative misperceptions that the public has of our profession.

      For example, if you have one front office person, two MAs and two docs, it seems like you could have each person take a 15 minute turn on the phones while everyone else got a 45 minute lunch break. Or have everyone take a 20 minute turn so that everyone can get an hour. Most other workers don’t get an hour for lunch anyway. It sends a terrible message when someone who gets 30 minutes for lunch tries to call and hears your message saying your phones are off for 90 minutes. It just reinforces the mistaken notion that docs are all fat cats out playing golf and being wined and dined by drug reps.

      • Ian

        Phones were off for 45 min and the docs were often across the street seeing patients. I suppose we could have done 15 minute rotations but it would have sucked to be the one with the middle shift. Sucks that they would have had to clock back in and back out too (Satellite hospital specialty clinic).

        • azmd

          Well, it’s just another example of the way that hospitals and doctors seem to struggle with having a basic orientation to customer service. If you’re a hospital specialty clinic it totally seems like the hospital could figure out a way to provide centralized scheduling capability during lunch for your clinic, rather than have you all run the clinic like it’s a mom and pop private practice. They’ve clearly figured out how to have you all on time clocks.

          • Ian

            There were many things there that should have been run differently, all of which were suggested to a deaf ear. Thus the used to work at….. That being said there are rural mom and pop offices that turn off their phones for just that reason.

      • http://warmsocks.wordpress.com/ WarmSocks

        Maybe laws are different elsewhere, but in WA, a 30 minute break is required. It wouldn’t be legal to split it into two separate 15′s (or 20′s).

  • buzzkillerjsmith

    Every office I know of has open phones over lunch, even out here in the sticks. it’s been that way for years. I’m surprised this is an issue.

  • Drk

    Where i practice i am flooded with calls and do my best since i am one of few who take insurance. I am not worried about losing business whether i have lines open or not during lunch and i dont appreciate an article that sounds almost like political propoganda trying to scare physicians. Remember there is a shortage.

  • JPedersenB

    I would add that if offices insist on voice mail during lunch or after hours that the option to leave a message should be the FIRST option on your message rather than after a long, laundry list of other options…

  • Ileana Balcu

    I am a patient and agree that the patients should be able to call during the lunch hour. For one, we might be working too and that is our only time to make a private phone call.
    I however do not understand the restrictions on phones. Make online forms (they can’t be that difficult to write) and gather all the information you need securely, during lunch hour or at any hour, maybe at 10 PM when the kids are in bed… A good system might help the clerks and the patients.

    • azmd

      Or, set up online scheduling. There are tons of good programs out there, if my son’s golf pro can do it for lessons, why on earth can’t a doctor’s office??

      • Anon_FL

        I’m with Mayo Clinic in St Augustine & Jacksonville, and they have quite a good iPhone app. It’s very easy to fill out an appointment request form online.

  • jp

    you basically said the same thing 8 times: Be accessible; that’s what patients expect.

    • azmd

      Actually she provided 8 reasons that it would be positive to keep phones open during lunch, including some reasons that have to do with the benefit of the practice. Not all patients have reasonable expectations for accessibility. Quite often my practice encounters patients and their families who expect to be able to call at 6 am or 8 pm regarding routine matters and receive an immediate callback. Clearly that’s not reasonable, but it constitutes a somewhat natural extension of the idea that doctors should be available around the clock for emergencies.

      There’s a need in our profession to clarify what’s a reasonable expectation of accessibility and what’s not. But part of that involves physicians making more of an effort to provide reasonable access, which appears to include open phones at lunch. We all need to work together to clarify expectations and set limits on both sides.

  • http://warmsocks.wordpress.com/ WarmSocks

    Many businesses have staff stagger lunch breaks so that the phones are always covered. The receptionist takes lunch from 11-12 or 1-2, and somebody else covers phones during that time. Another option is to have a part-timer work 10:30-2 every day, and that person covers the phones during lunch.

    However, I don’t think it’s as big a deal as you’re making it sound. My family physician’s office closes for lunch every day from 12:30 to 1:30. Patients who take lunch at noon still have half an hour to phone or be seen. I’m not sure why that’s construed as a problem. People need to eat, including doctors. If it’s an emergency, I’d be dialing 911 instead of the doctor’s office.

  • EmilyAnon

    Another annoyance for patients who experience voice mail is that the voice mail is still on after staff is supposed to be back from lunch. And sometimes voice mail comes on (“we are currently closed”) after advertised opening hours or before closing hours. I don’t think most doctors are aware this happens. They should try calling their office occasionally to check. And then there are the 10-15 minutes being put on hold. That’s when I hang up. I’m sure there might be legitimate excuses, but still…very annoying.

    • John Henry

      Depending on the size of the phone hunt group, which may be as few as two lines, more than two callers mean a third caller will get rolled over to voicemail. The voicemail message may be the same you hear at the lunch break.

      Many small practices don’t have the size of staff to always have someone covering phones at the expected lunch hour, and remember, those staff people are also workers who need a lunch break and sometimes a few minutes to take care of personal matters. And then there is the issue of state labor laws that mandate breaks of minimum lengths and at reasonable time periods during the workday.

      As for the “customer service” angle, that is fine for businesses where people actually pay for their services, which these days in medicine is rarely the case, and neither is it usually the case that patients will pay more for “better” service. The idea that you will march down the street to someone else who will answer your calls at lunchtime because that represents superior customer service is really just laughable. Seriously? I would have to say more than a few doctors would be happy to see patients with such extraordinary entitlement do just that. People who expect extraordinary access should consider concierge practices, where you can expect to get what you are expected to pay for.

      • EmilyAnon

        My complaint was about unanswered calls during times the office advertises its “office hours”. It’s based on my experience with a practice of 8 doctors whose staff includes 3 dedicated assistants at check-in. I’ve been seated in the waiting area hearing the phones ring without being answered while they are chatting among themselves. One of those calls going to voice mail at that time could have been me. Wouldn’t you consider that unacceptable? If a friend asks about my doctor there, I say I like him very much, but then warn about the uncaring help.

        • southerndoc1

          “The help”??????

          • C.L.J. Murphy

            Well, look. If the help don’t know their place, it just ruins everything, and I don’t care how nice the chateaubriand is. I’d probably withhold a tip, just on principle.

          • EmilyAnon

            Is the word “help” demeaning to you? Where I live it just means people you’ve hired. Must be a regional sensitivity. I apologize if I offended anyone, I could have used another word. But now I’m curious…. many times I’ve read about doctors “serving” the needs of their patients. Double meaning with that word too?

          • Bonnie

            Emily, I think alot of people think of black servants & maids when they think of “the help” o_0

          • EmilyAnon

            It was unintentioned. Servants or maids were never part of my life, nor vernacular. But thanks for the heads up.

          • Bonnie

            :)

        • C.L.J. Murphy

          “If a friend asks about my doctor there, I say I like him very much, but then warn about the uncaring help.”

          Quite so. No point sticking with any après ski or tennis club if they’ve got bad help. Ruins the whole ambiance.

          Oh, wait. This is a doctor’s surgery you’re rating?

          • EmilyAnon

            It’s unfortunate if doctors don’t think that the actions of their staff affect their reputations. Unfair or not, it most definitely does.

          • Noni

            Absolutely. I’ve left practices because of the rudeness of the staff. When I informed the physicians of their staff’s behavior 100% had no idea.

  • Bob Newbell

    At lunch time my office closes for lunch. Patients can leave a message which will be responded to within an hour or can page me if it’s an emergency. My staff and I need to eat and run an errand or two. For a small office like mine, trying to stay open during lunch would be difficult. And quite frankly all of the eight justifications for remaining open during lunch listed here seem dubious at best.

  • http://www.facebook.com/cheryl.bisera Cheryl Capko Bisera

    Thank you for all the great feedback everyone. Just to clarify, I am in no way suggesting that employees reduce or skip their much-needed and legally-required breaks. I think patients deserve the same or better treatment at their medical practices as they get from any other industry dealing with the public and perhaps even more so, considering the nature of the business. It’s just smart business and a win-win!

  • Jennifer

    I manage a physician practice and we feel very strongly about keeping our phone lines open all day and about having a real, live person answer the phone. We don’t have a phone tree. When you dial our number you get a person. Unless our lines are full and then you get voice mail. But we are working on that. We do have a patient portal and a lot of our patients do choose to send us messages and refill requests via the portal. We realize that it takes more of our time to answer the phone with a real person but we also believe we provide better customer service.