Dispelling 10 Practice Management Misconceptions

1. You will lose your patients if you do not treat all their concerns in one visit, even though the scheduled time does not allow for it.

False. The only thing you will lose is the trust of those compliant patients who arrive on time and feel put out for waiting. Patients who request “overtime” care must understand the limitations of their appointment time and the practice is responsible to enforce a policy that is fair to all patients. If time permits, it is okay to treat more than one complaint as long as patients understand this is not normal protocol. Otherwise, they will continue to behave with entitlement. What's the bottom line? If extending a 15-minute visit to 45 upsets patient flow, it is time someone put his or her foot down and truly manage the schedule.

2. One of the biggest reasons for medical malpractice is a poor outcome.

False. Studies on this topic have overwhelmingly found that malpractice claims resulted from “a breakdown in the patient-physician relationship, most often manifested as unsatisfactory patient-physician communication.”¹ Examples in the study included doctors not listening, not talking openly, attempting to mislead, poor information delivery or failure to understand the patient’s perspective.

3. Twenty percent of all employees who steal do so because they can.

False. According to the 10-10-80 Rule, 10 percent of people will always steal, 10 percent will never steal and 80 percent may steal if they can. In addition to putting security measures in place (e.g., job sharing, background checks for new employees, spot checks) to prevent embezzlement from becoming an opportunity, it is wise to pay closer attention to your staff’s actions. Interestingly, managers account for 55 percent of embezzlers and “stealing” includes not only money but work hours, supplies, etc.

4. It makes no sense to ask our geriatric patients to go to the website to complete their new patient paperwork because they do not have computers.

False. Don’t generalize, discriminate against age or assume the elderly are not “connected.” Six in ten seniors now go online, 47 percent have high speed Internet and 77 percent have cellphones.² Those numbers are growing rapidly. All it takes to include them is to ask first if they have Internet access. Second, if they have a printer, they can go to your website, and download and complete the paperwork in advance of their visit.

5. It is okay if some patients cannot pay their copay at the time of service.

False. Not collecting your patient’s copay is a violation of their insurance contract.

6. A patient cannot really form a first impression until after the visit is complete.

False. The time it takes for a patient to form an opinion of the doctor, staff and practice surroundings can vary anywhere from “a blink of an eye” to 60 seconds. Make no mistake: those initial seconds matter. That first impression may likely form on the first phone call. As a Harvard study suggests, “It will take eight subsequent positive encounters to change that person's negative opinion of you.”³ If the intent is to work smarter, not harder, it pays to get it right the first time.

7. Small practices do not need employee manuals.

False. All practices need an employee manual to clearly define office policy and HR guidelines for employees, and clarify employee and employer expectations. Ultimately, these details serve to reduce confusion and stress, diffuse conflict, improve communications and create uniformity and fairness. Have a manual regardless if your employees number two or 200.

8. “Squeezing into the system” is a typical occurrence in every office.

False. “Squeezing into the system” is an inefficient way to run a practice and if it has become your standard operating procedure, those unsuccessful processes need to improve. Which functions happen routinely because that is the way you have always done them (even though, admittedly, “the way we have always done it” no longer works)? Scheduling is a good example. Just because the schedule allocates 15 minutes per patient, that does not mean every doctor in the practice works at that pace or every patient’s visit effectively fits into a 15-minute slot. Customize the schedule to fit the practice, not the other way around.

9. “To be honest with you” is a good customer service phrase.

False. While we may say phrases like these with good intentions, they only leave the patient to wonder, “Are there times when you are not honest with me?”

10. Good employees are hard to find (in our area).

False. There are good people everywhere so take a new perspective. Step #1: Stop making experience your top criteria and instead consider a person who has a cheerful personality, good values, is self-sufficient and a great fit in your team. Step #2: Invest your time and knowledge into that person's training. This is the key that separates the average staffer from the exceptional one. Step #3: Treat the staffer well and pay him or her fairly.

References

1. Huntington B, Kuhn N. Communication gaffes: a root cause of malpractice claims. Proc (Bayl Univ Med Cent). 2003; 16(2):157-61.

2. Smith A. Older adults and technology use. Pew Research Center. Available at https://www.pewinternet.org/2014/04/03/older-adults-and-technology-use/ . Published April 3, 2014.

3. Stillman J. Nine ways to fix a bad first impression. Inc. Available at https://www.inc.com/jessica-stillman/9-ways-to-fix-a-bad-first-impression.html .