ORLANDO — Optimize patient interaction, staff training, professional relationships, and office setup to increase office efficiency and personal satisfaction, Roger I. Ceilley, M.D., said in a presentation at the annual meeting of the Florida Society of Dermatologic Surgeons.
“Patient satisfaction plus personal satisfaction equals fun. And I'm having more fun in my practice now than I ever had,” said Dr. Ceilley of the department of dermatology at the University of Iowa, Iowa City.
Ask patients about their personal lives on the basis of a few words written in the record, look directly at patients when you speak—“some older patients have a component of lip reading”—and sit down with patients whenever possible, Dr. Ceilley suggested. Have a warm handshake and touch patients reassuringly, he added. “Laying on of hands lets the patients know that you care.”
Always review the chart before entering the room. It is okay to enter a room quickly, but always leave slowly, Dr. Ceilley said. “Look at the patient before you leave. Ask: 'Is there anything else you need?'”
Other factors that increase patient satisfaction include:
▸ Patient registration forms available on the practice's Web site, so patients can fill them out ahead of time if they desire.
▸ Dedicated check-in and check-out areas.
▸ Absorbable sutures when indicated. “Patients who travel a great distance really appreciate not having to return for suture removal,” he said.
▸ Good handouts and oral and written postoperative instructions. Advice on acceptable postoperative activities is critical. Emphasize the use of ice packs at home after surgery, Dr. Ceilley said. He suggested that patients use bags of frozen vegetables from their freezer.
▸ Free medication samples, and a prescription with enough refills to last until the next office visit.
▸ A sense of humor. “Humor is very important,” Dr. Ceilley said.
In addition, patients appreciate receiving letters ahead of time outlining a surgery or procedure. Physicians must give patients realistic expectations.
Always make a follow-up call to ascertain how patients are faring after an in-office procedure, he added.
When it comes to office assistants, it is critically important to train your own staff, Dr. Ceilley said. “When I used to have someone else train them, I realized after a few years that I was doing things the way my staff wanted, not the way I wanted.” He added that there are only two criteria for good office employees—intelligence and a positive attitude.
Another tip is to develop a close relationship with other physicians in the community. “That way, you don't call them only when you are in trouble,” Dr. Ceilley said.
He offered a wide range of practical tips for improving office setup. For example, a communication center separate from a patient reception area does not take front desk people away from the patients to answer the telephone. It is also a good way to meet the privacy requirements of the Health Insurance Portability and Accountability Act (HIPPA).
The communication center staff can make appointments and referrals, and recall patients. Dr. Ceilley has a dedicated pharmacy line in his communication center and encourages refills via fax. “The biggest waste of office time is medication refills and the time it takes to call in refills,” he said.
A sheet of preprinted labels in a patient chart can save time as well, Dr. Ceilley explained. Use a label maker to print out current patient information, including critical data, contact numbers, and insurance information, he suggested. “Just stick them on [documents] when needed, such as pathology requests.”
Track patients carefully; in his office, an oversized orange sheet is placed in the patient file. The sheet can be removed only by the physician. “That way, no one falls through the cracks.”
Standardization and organization are key to managing equipment in the office.
“We have each room in all three offices set up the same way for materials and supplies,” Dr. Ceilley said. He suggested limiting the number of different suture types in the office. “For the rare cases where you need a different suture, keep them in a separate bin,” he said.
Arrange the surgical tray in a standard fashion. “We color-code instruments by room. This saves us time after autoclaving,” Dr. Ceilley said. Consider a piece of sterile foam rubber for storing sharps before and after use, he added.
Keep a dressing tray in each room, he advised. “We use a lot of Micropore tape, which is just as effective as Steri-Strips, and a lot less expensive.”
Trim and place dressings carefully, Dr. Ceilley said. “Send patients home with a couple of days' worth of dressing material and information on where to buy more if needed.”