“The doctor was wonderful, but her staff …” “The receptionist was so rude. I won’t be back.” “They never sent the referral even though I called several times.” Ever seen reviews like these?

No matter how good a doctor you might be, you’re not the one making the first impression at your practice. Your office staff and their practices set the tone of the visit. Their conduct can make or break patient retention. I’ve given up on doctors because of their staff—at some point, running the gauntlet wasn’t worth it anymore. Here are four common sense hacks to improve the practice experience for your patients.

1. Consider patients who need ADA accommodation.

Hard of hearing patients might not be able to hear the medical assistant calling their name in the waiting room. How is that handled? Could someone who has a vision condition navigate your entire practice from check-in to the exam room? What about someone using a wheelchair or another mobility device? Are your forms printed in a font that is easy to read? If you only use tablets for check-in, is someone available to help a less tech-savvy patient, or do you have paper forms to give them as an alternative? Are immunocompromised patients able to wait outside or in an isolated place instead of the crowded waiting room?

Unfortunately, front desk staff sometimes blow off accommodation requests or simply do not know how to handle them. No, you can’t predict every potential request, but developing protocols in advance so patients with common accommodation needs are able to access care at your practice is important. So is handling ADA requests with sensitivity, not indifference or exasperation.

2. Send invoices that don’t look like scams.

“Denise, this is your endodontist! Click here to pay your balance.” The text popped up on my phone out of nowhere one afternoon. There was one red flag after the next: the sender’s number matched neither the practice’s contact information nor any other business when Googled. There was no way to investigate without clicking on the suspicious link, which was an incoherent jumble of letters. I wasn’t expecting any bills. I assumed it was a phishing or malware attempt, blocked the number, and deleted the text.

I called the endodontist’s office—at the phone number on their official website, not the one in the text, of course—to see if they were aware of the scam. To my great surprise, I discovered the message had been an actual invoice for charges denied by insurance. They’d gone paperless, hired a third party to do all their billing, and somehow assumed I’d click an unidentifiable link in an unsolicited text message and cheerfully hand over my financial information to whatever questionable website was on the other side.

Going paperless does not relieve your practice of the responsibility to send verifiable and identifiable bills. Expecting patients to click random links on their phones isn’t it. If your patients need to submit anything for reimbursement or medical expense deductions, they will need a clear invoice to do so, not a sketchy text message, as well.

3. Do the paperwork. Make sure your staff does the paperwork. Please.

Yes, insurance red tape is downright hellish. I think we all would prefer a system that is friendlier to both patients and practices. Unfortunately, things are as they are, and your patients usually can’t take care of that paperwork themselves. If you accept their insurance, they likely believe you will do prior authorizations or referrals as needed for ordered care. If you have no intention to do so, at least have the courtesy to clearly inform them before their appointment so they can go to a different doctor.

Whether the paperwork is blown off by procrastinating office staff or a doctor who thinks they’re making a grand statement by refusing to do PAs, it only hurts one group: patients. Considering how many in our country are struggling to afford basics like housing and food and how expensive medical care can be, no, “just pay cash” isn’t a reasonable response, either. The entire point of insurance is to cover expenses that would be prohibitive out of pocket.

4. Insist on precision and accuracy with coding and charting.

I’ve had to get my records at a particular medical system amended several times due to completely bizarre incorrect conditions that have randomly appeared in my chart. Last year, for example, someone added codes claiming I was missing part of my digestive tract and was on medication for organ transplants. They’d clearly confused me with someone else, but now their errors were on my chart.

Incorrect coding, inaccurate condition lists, and incomplete or outdated medication lists aren’t harmless goofs. They can actively hurt your patients, both financially and physically. They’re also often difficult to correct once they are in a chart, so it’s far more efficient to keep them out in the first place. If your patient ends up in the emergency room and can’t speak for themselves, their chart might speak for them. If they receive treatment based on inaccurate information, it could be a fatal misunderstanding.

Patients can’t do their own charting. We depend on medical professionals and their support staff to maintain accurate records.

If your patient is aggravated before they even see the doctor, or tangled up in paperwork afterwards, it will likely impact their overall opinion of the practice and the quality of their care. Stepping into their shoes for a moment can help a practice run more efficiently and pleasantly for all.

Denise Reich is a patient advocate.