Patient satisfaction: What restaurants can teach doctors

Americans are notoriously generous and good tippers.  However, there are some servers who get “over the top” gratuities.  How do they do it?

1. They make a concerted effort to reach out and touch someone.  How many physicians enter a room and never touch a patient?  They are touching more keyboards than hearts.  I have learned from complementary healthcare providers that there’s a medicinal value of touching the patient.  Every chiropractor, reflexologist, or massage therapist touch their clients.  Doctors would do well to learn from their practitioners by touching our patients.  Examples can include a handshake, a gentle touch on the shoulder, or even taking the patient’s blood pressure instead of assigning that task to a nurse.

2. Get eyeball to eyeball with the patient. Excellent servers will often stoop down or squat and become eyeball to eyeball with the customer.  Doctors who stand during the entire visit are not communicating as well as the doctor who pulls up a chair and is at the same level as the patient.

3. Give them something extra.  Everyone likes something above and beyond what is expected.  In New Orleans we call something extra “lagniappe” and in the Northeast it is referred to as the baker’s dozen.  In the restaurant industry it may consist of a plate of small appetizers as soon as the guests take their seats, a taste of the wines that are sold by the glass, or a few peppermints delivered with the check.

In my practice, I offer the patient to take magazines from the exam rooms that they are reading when I walk into exam room.  This is one way to avoid that dictum: “never go to a doctor with dead plants, dead fish, or magazines more than 6 months old!”  Every patient receives sample medication of any new prescription, a FAQ form on the use of the medication, and additional written educational material on their disease state or the treatment that was suggested.

4. End each encounter by saying something positive.  Servers have known that if they mention something positive about the weather that their tips go up compared to talking about how terrible it is outside.  We should try to end each visit by giving the patients hope and provide encouragement.  Even if the patient has a terminal illness, you can offer to be helpful in relieving pain and discomfort.

Bottom line:  Physicians don’t make their living on tips.  But we do make our living by patient satisfaction.  Patients who are satisfied with the care that we provide will become loyal patients and will tell others about the superior service that they have received with their doctor and the practice.  Take a tip from your restaurant server and use a few of these ideas with your patients.  Your satisfaction surveys will significantly increase.

Neil Baum is a urologist at Touro Infirmary and author of Marketing Your Clinical Practices: Ethically, Effectively, Economically. He can be reached at his self-titled site, Neil Baum, MDor on Facebook and Twitter.

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  • azmd

    There are few things that irritate me more than a server pulling up a chair or squatting down to be at eye level with me. I am there to eat, not to develop a personal relationship with the waiter.

    Likewise, attempts by my physician to promote my satisfaction with the encounter fall flat when I feel that the doctor is “handling” me, without any genuine sense of connection, interest or caring.

    • M.K.C.

      +1

      • guest

        Exactly. I try to concentrate on genuinely empathizing with the patient and to the extent that I am able, spending adequate amounts of time with him or her. Trying to skimp on time with the patient but substituting half-baked customer service maneuvers like free magazines will fool some patients but annoy the rest.

        Although I do agree that touching the patient and offering hope are two critically important things we must always try to do.

        • Guest

          Touching the patient is NOT something you “must always try to do”, thank you. You are not my mother, my father, my siblings or my spouse. You are not my long-long best friend. You are a service provider, and I would like you to keep your hands to yourself, if it’s all the same to you.

          • guest

            How is the doctor supposed to do a physical exam if he or she doesn’t touch you? That is what I referring to. Are you aware that you sound slightly irrational?

          • Guest

            I’m talking about the gratuitous “touchy-feely” touching, designed to hopefully up his ratings. “I think a really warm handshake, usually using a second hand to cover theirs …then another touch to end the visit, like a pat on the shoulder etc.”

            Eew. Don’t go around patting people like they’re dumb animals to be won over. That’s just creepy.

          • guest

            I feel the same way, which is why what I was talking about was actually the importance of the old-fashioned physical exam. By the way, a lot of people do “gratuitous touchy-feely touching” in social situations. Do you generally come this unglued in such situations, too?

          • Guest

            A doctor’s office is more akin to a work setting than a social setting. I am not socializing with my doctor., he is not my oldest dearest friend. I am, more often than not, sitting there, cold and humiliated in an inadequate paper gown, with him definitely in a position of power over me. He needs to keep his hands to himself.

            P.S. I work in a regular office, among mere mortals, but somehow all of our workers have grasped the concept that they can’t go around patting and pawing subordinate co-workers and/or clients. If my boss understands he can’t pat and paw me, why can’t my doctor?

    • Guest

      Correct. I have actually become irritated with the “fill in” pediatrician who tried to BS me with his suave and charm rather than medical knowledge. “Your child really needs vit D and calcium and you’re going to find it hard to get her needs filled without milk.” Really? But he did sing “Row row row your boat” to her while he examined her. Barf.

      Give me a knowledgeable curmudgeon any day.

    • drgn

      Hi azmd and especially PCP’s or anyone on this blog for that matter. The AMA just answered my post on Why the Accuracy In Medicare Physician Payment Act should pass by Brian Keppler. Please read it. You will all be most interested.

      • azmd

        Actually I found that response a little depressing. If we can’t count on the AMA to pursue, in a fair-minded way, advocacy for our profession, who can we count on??

        • drgn

          I know I can be sarcastic sometimes but it comes out of feeling pretty betrayed by them myself. I agree it is pretty depressing for both patients and PCP alike. At least I am glad to know the truth.

  • Ron Smith

    We too look at the patient relationship differently than most Pediatric practices. At the base our goal contains the same mantra as most medical practices…we strive to provide the best, most personal care possible. This is like eating dry oats though if you a patient hearing that. Who DOESN’T want to do that in medicine, particularly private practice and still plan to be in business, and yes, competitive!

    We tell the patients that our goal is to get you in the room on time, and get you seen quickly and efficiently. We will get you out as quickly as possible, but limit your total time in the exam room to an hour. An hour might sound like a like a lot, but not if you are doing a 4 year old’s checkup. There are a lot of things that sometimes have to happen.

    We don’t have TV in the rooms…we frankly don’t want them to be in the room that long. We have TV’s in the waiting area, and free WIFI everywhere. Magazines are sparse.

    We tell patients we want to respect their time and if they don’t need to be in the office we don’t want them there. We answer email, we have a triage phone nurse available throughout the day, and we use technology to the max.

    I set aside time to visit with parents who want to come and take a look at the practice, and we have staff that are very good at patient hospitality.

    None of these are excessive. They are geared for the young families I see, and are what I would want for my daughter and son-in-law and their four children.

    Ron Smith, MD
    www (dot) ronsmithmd (dot) com

  • edpullenmd

    I think a really warm handshake, usually using a second hand to cover theirs, along with a smile and eye contact is very effective as a greeting, then another touch to end the visit, like a pat on the shoulder etc.

    • Trina K.

      No. Just no.

      Pat me on the head (or the hand, or the shoulder) at your peril.

      Do a good job and I’ll be happy. Paw me like a fawning uncle and I’ll cringe just as I would if my plumber or pool guy did that.

    • LIS92

      The germophobe in me doesn’t want you to shake my hand.

      • M. O’r.

        Not a germophobe. Research backs up that hand hygiene is dismal in hospitals and clinics. If I don’t see the dr or nurse wash hands when I am called back, I ask them to do it.
        Public health research….
        Don’t need to reinvent the wheel.

        I want them to listen to my concerns and make sure they are addressed. If I start hearing the “party line” to get me out the door, I explain how important it is for me to be a partner in my therapy and treatment. Or, that I have been getting sinus infections for years and I KNOW their protocol first line cheap one won’t work. So – wasted money, lost wages, use of more time… If they don’t listen and acknowledge when I have a question — or they give me a printout from the computer … Nope, doesn’t cut it. I am there because I need their expertise. If they don’t have it I will find someone who will.

        And I advocate for friends, neighbors (many of whom one spouse is a physician or surgeon) and anyone who needs it.

        But don’t shake my hand after you open the door before you wash your hands…because I bet no one cleaned that door knob….

    • Suzi Q 38

      I am fine with a handshake and a pat on the shoulder.
      Everyone is different.

  • Rita Chobanian Swisher

    I think it depends on the patient. Unfortunately, in private practice, doctors have to spend the first 10-15 minutes of every visit “reading” who the patient is in order to determine who that patient wants the doctor to be. Do they want the doc who is confident, somewhat direct, kind, but more “take charge” of the problem, or do they want the doc who completely eats crap and insinuates that the patients ALWAYS know 1000x more than any doctor in any situation and is willing to listen to the patient drone on about some bizarre, unrelated story? In our office, patients’ desires fall in the complete range of those described above, all inclusive. Our physicians are top notch and competent, but that has little to do with why they are liked so much. The reason people like them is that they bend over backwards for people’s whims personality-wise, and unfortunately this is time-consuming and not always easy to accomplish.

  • EmilyAnon

    I like touching. I also like when the doctor positions themselves eye-level with the patient. After my first operation, the surgeon came in, sat on the side of my bed to give me the results of the surgery. So long ago, but I always remembered that gesture.

    My second surgery, I was given the results by a strange doctor standing in the doorway. What’s worse was that I wasn’t facing the door, so I had to crane my neck to see him. Maybe I’ll forgive him a bit as he was so young he may have been a new resident or med student uncomfortable with eye-to-eye contact while giving bad news.

  • drjoekosterich

    In simplest terms be a doctor treating a person rather than an arm of a faceless government and bureaucracy treating to a target

  • PrimaryCareDoc

    I can’t agree with giving patients sample meds. I find that it’s rare that patients need the expensive brand-name meds that are available as samples.

    Give your patients a real gift- treat them with generic meds that are just as effective and will save them a bundle in the long run.

    • Suzi Q 38

      Excellent.

  • Tiredoc

    Touching is a highly variable cultural expectation, as is eye contact. As doctors, our primary concern in inpatient settings should be avoiding spreading pathogens. I often wonder just how much of our iatrogenic infections could be avoided by ending the parade of doctors tramping from one end of the hospital to the other, carrying bacteria on our lab coats, ties, pants and stethoscopes. In the hospital, every time you touch the patient is an invasive exam. Find another way to connect with the patient. Touch only when absolutely necessary.

    • Suzi Q 38

      How about wash your hands thoroughly when you enter the exam room?

      • Tiredoc

        Hand washing does not address the issue of transmission of pathogens on clothing and stethoscopes. Numerous studies have implicated ties, long sleeves, lab coats and stethoscopes as prime mechanisms of iatrogenic infection. Hand washing is fine, but there is no legitimate reason to wear long sleeves, lab coats, or ties in an inpatient setting. There is absolutely no reason to carry a stethoscope from room to room.

        Ethically, any medical intervention with risk to the patient must have some quantifiable benefit to the patient. A perfunctory physical examination with no expectation of changing the treatment plan is unethical.

        • Suzi Q 38

          Thank you for your answer.
          I appreciate your detailed explanation.

          I did not know this.

  • querywoman

    I’m fortunate. Never had a doc stare at a computer screen! I do have one who puts her notes in a laptop. Better than pen and paper! Hope she has a backup system!

    • Suzi Q 38

      I have. It is annoying, I tell you.

  • Frustrated Patient

    I think everybody needs to remember that restaurants also are forced to listen to their clients. I’ve struggled with an undiagnosed condition since I was 8 years old, and absolutely no doctors have been willing to listen to what I have to say about it. Admittedly the condition is very usual, but don’t forget that the patient knows more about it than you do despite all that you know about the human body. Restaurants(successful) understand their products, customer service and aim to please. The medical industry could definitely focus more on all three of those attributes.

  • Frustrated Patient

    I meant unusual*, sorry

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