Increase patient and provider satisfaction by reducing phone messages

Incoming telephone calls should be a good thing in a medical practice, right? Requests for appointments from new patients and established patients are the lifeblood of the practice. But for many practices, the phones are an overwhelming burden for everyone, from the receptionist and nurse to the provider with an inbox full of patient messages to sort through.

In general, approximately 25% of incoming calls to a medical practice are repeat calls because the reason for the first call is still unresolved. More than half of the calls are for non-appointment requests — patients asking for prescription re-issues and test results, for instance, or who have general health questions.

Why are there so many calls? And, even worse, why do so many of the calls result in messages for the doctor?

How can you eliminate waste and improve customer relations in your phone operations? Start with a simple manual tracking of how many calls come in each hour for prescription requests, test results, appointment requests, and other questions for the nurse/doctor.

How many of these calls result in taking a message from the patient? Several messages result in scheduling visits for patients; why aren’t the appointments just scheduled instead of taking a message and then ultimately scheduling (or adding on) the patient visit? Create an initiative among your team to reduce the number of messages.

How many times are calls transferred? Would it be more effective to provide direct lines rather than a call-switching step in the process? Design operations to reduce the time to deliver the service. There is no value added by a phone operator answering a call, listening to the patient’s story, and then transferring the call to a nurse who will also need to listen to that story. Provide direct lines to nursing by adding an option to your auto-attendant to dial directly to a nurse.

Eliminate telephone requests for prescription reissues by writing prescriptions for chronic medications to last until the next visit (i.e., if a patient is to be seen in 6 months, the medication order should be for 90 days with one refill).

Manage your volume of messages. Make the number of messages, by reason for the message, a monthly metric to review.

Another metric to manage is your patient Web portal utilization. Train all your staff (front desk, nursing, billing, and physicians) to direct patients to your Web portal for prescription refill requests, as well as other functions that will improve communication efforts for them. Your on-hold message should instruct patients about the functionality available via the portal (scheduling appointments, requesting prescription refills, viewing lab results, etc.).

Standardize schedule slots for all providers on the Web portal to allow patients to schedule appointments themselves. Imagine the delight of the patients when they realize they don’t have to wait for your phone lines to open to schedule an appointment; they can do it online.

All staff members whose jobs include extensive phone work (staff who answer phone calls, inbox triage nurses, those who handle referrals and prescription refills) should be trained more extensively on the portal functionality from the patient’s perspective so they can comfortably speak to patients about it and even assist the patient attempting to use the portal.

To reduce telephone “waste,” establish and articulate your expectations for the staff; implement the change with dedicated training for all staff, nurses, and providers; monitor and modify the changes as necessary but allow the change to take hold before reacting to the immediate, and natural, resistance to change.

Focus on the target of reducing messages and share the metrics across the practice.

Reduced phone messages will allow more time for interacting during patient encounters, which increases satisfaction for all.

Rosemarie Nelson is principal, MGMA Health Care Consulting Group and blogs at Practice Pointers.

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  • whoknows

    That’s the whole idea of it.

  • Ron Smith

    Hi, Rosemarie.

    Ever since I separated from the only practice partner I’ve ever had in 2010, I’ve been on call. All the time.

    The first thing I did was fully implement e-mail. We have a secure email server so for us HIPAA just does’t come into play when the patient initiates the email conversation.

    What amazes me is not only how perfectly acceptable it is for parents of my patients, it is something they outright crave. At first blush you would think that increasing my access by email would overwhelm me.

    It did not. What I have found is that the MORE modern access (email, etc) that I provide for patients, the fewer phone calls I had to answer.

    I’m almost to the point of considering eliminating the after hours phone calls altogether. It is not helping my practice while at the same time its a significant drag on me. The only reason I get out after 5:30 pm is to answer the few phone calls my triage nurse needs my expertise.

    Her phone triage during the day handles most of those calls as well.

    Even some of the specialist I interact with fairly routinely have email and we have discussed patient care (carefully hiding the patient name of course). It is just as easing to me to send an email to my friendly Pediatric dermatologist and say, “do you think you need to see this?” I’m sure they appreciate the email too.

    Warmest regards.

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

  • mj

    I continually play phone tag with my provider. They call me back to answer a question or provide info and I’m not able to answer so they just leave a message to call them back. I have asked them repeatedly to just leave me the info. Rarely is the info confidential. The answers usually are “yes the doctor will call in the prescription” “yes she can take two a day” or “the insurance company should give you an authorization code for that” yet they refuse saying HIPAA prevents them from saying anything other than their name and number. My voice mail is as secure as the one they have me leave messages on. And, I have asked them to do it. It saves everyone time and money! Am I wrong to ask them to leave a real message?