Communication

Quality Patient Care Through Listening

Improve the level of care by paying closer attention to what your patients really say.

Donna Suter, Chattanooga, TN.

One of the single greatest keys to long-term practice success can be summed up in three simple words: quality patient care. Yet, as patients in other healthcare offices, you and I are painfully aware that outstanding care, or service, is far too rare. Why is excellent service so rare? Basically, there are three reasons:

1. Employees don’t know the basics of communication. All too often, employees understand the importance of documentation and data gathering, but may be deficient in core communication and listening skills.

2. Critical points in the patient encounter are not properly managed. Beginning with that first phone call, every experience either leaves the patient feeling like “a diagnosis,” rather than a patient, or happy they chose you.

3. Lack of training. Conveying care and caring often mean going beyond complying with patient requests (and converting chief complaints into billable hours) to becoming a better listener.

That doesn’t mean sitting back passively; it involves ensuring that the person to whom you are talking actually feels heard. Many people confuse the words “listening” and “hearing.” Hearing is a physical activity meaning that the sound made it to the ear. Listening is a mental activity that requires the coordination of many activities.

Apply The Four Goals

Consider these four main listening goals in eye healthcare offices:

■ Listen for what is missing.

■ Listen for concerns patients may have or what is important to them.

■ Listen for what patients value.

■ Listen for what patients want and need in order to fill in the gap between what they have now and what they want.

Eliminating Improperly Booked Appointments … Forever

Not only is listening critical in making a positive first impression, it can also eliminate a costly error that sometimes occurs with that first interaction — that is, improperly booked appointments. Consider the following approach to improve appointment scheduling.

Answer every call with an open mind (without filters or judgment). Turning away from the busy office setting helps to still your racing thoughts. Just as you can tell when people you call are multi-tasking and not paying attention, so does the caller. Consider this sample script for answering a call.

Good morning. May I have your name please? (pause) Mrs. Smith, thank you for calling our office. How may I help you?

This shows that you have a genuine interest in helping the patient, not just yourself. By capturing the caller’s name, you are able to easily use it throughout the conversation, which helps establish rapport.

When was the last time you visited our office? (pause) You are a new patient? Mrs. Smith, welcome to our patient family.

Depending on the reason(s) the patient provides for her call, you may ask some of the following questions:

Have you noticed a sudden change in your vision or are you thinking of refractive surgery? Is there a medical reason, like diabetes, cataracts or flashes and floaters? Have you broken your glasses or failed your driver’s license test?

You may be thinking that your phone lines are too busy to spend that much time listening to the patient. However, consider the scenario from another perspective: If you are like most practices, one improperly booked patient twice a week could be costing you $14,400 or more a year. (a modest $150 × 2 a week × 48 weeks a year).

More importantly, asking these questions in a caring tone of voice reassures the caller that you are not just hearing, but listening. Clarifying what the caller has said during the conversation ensures proper booking, which results in less confusion the day of the patient’s appointment.

Rephrase comments or questions in your own words in order to ensure that you not only heard but understood the nature of the appointment request.

Four Steps to Eliminating Distractions

When was the last time you meant to listen and got distracted with your own thoughts? It’s easy to do. Consider pretesting. It is the pretester’s duty to help the patient communicate. Yet, technology (diagnostic equipment, electronic health records, etc.) has made it easier for us not to listen. This means going beyond listening to facts and jotting down figures. It’s important to concentrate, clarify, capture and control countenance.

Concentrate. Especially because it is natural to mentally finish the patient’s sentences while adjusting instrumentation and completing the required tests, it is important to engage the patient and be fully attentive. 1) Use neutral comments 2) Make eye contact 3) Confirm what the patient has shared during pretesting with head nods and “uh-huh” to keep the dialogue going.

Clarify. Rephrase key comments or questions in your own words in order to ensure you not only heard, but understood the patient. If you need greater context and a fuller picture, ask:

■ “For my own understanding, what you are truly saying is …”

■ “To further clarify this …”

■ “What I am hearing is …”

■ “Help me understand …”

■ “Tell me more …”

Capture. You can listen four to five times faster than someone can talk so use the time to evaluate what is being said and take notes. Do it in a transparent way because it indicates you are interested in what the patient is saying.

Control Countenance. One of the most important ways to relax the patient and gather the best possible information is to appear relaxed and pleasant. Smile and let the patient know you are attentive with your body language. Frowning suggests you don’t agree or that the raw data the diagnostic instrumentation just generated suggests bad news. While you don’t want your patients to ramble on, you must give them an opportunity to express their concerns and the appropriate venue is pretesting. The doctor will then have the time to address those concerns.

Lessons from the Optical

The practice’s ultimate goal is moving the patient towards understanding. The doctor recommendation must match the patient’s visual and lifestyle needs. For this, knowledge is power. Listening for understanding minimizes the need for the doctor to go through a time-consuming list of questions.

One of the key factors that determines the success of the optical dispensary is the staff ’s ability to listen attentively and understand the patient’s needs and desires. The following tips, while directed to the optical staff, can also be adopted by those who work outside the optical dispensary.

The optician should listen 70% of the time and talk and ask questions the remaining 30%. Here’s why: We know what patients’ typically say, we think. Feelings are often more important than the words themselves. Take the phrase, “How does my insurance work?” The eyewear consultant may think this means a budget-minded patient. The feeling may be confusion.

The solution is to allow the patient to tell her story. “What do you like best about your current glasses” or “What is the most visually challenging activity that you encounter on a routine basis?” are great open-ended questions.

Asking questions, however, is not one-way… Often the best questions are ones that build on prior statements — resulting in dialogue that resembles a business conversation with a smooth flow between those participating.

This necessitates the eyewear consultant not only hearing what the customer says but actually listening to what’s been said. And the customer must know you have listened. To succeed, avoid the following mindsets:

■ Mind-reader. You’ll hear little or nothing as you think “What can this person really afford?”

■ Rehearser. You zone out as you mentally tryout lines for “Here’s what I’ll say next” when the customer stops for air.

■ Filterer. Some call this selective listening – hearing only what you want.

■ Identifier. If you refer everything you hear to your years of optical experience, you probably didn’t really hear what the problem is that the customer/patient expects you to solve.

■ Placater. Agreeing with everything you hear just to be nice or to avoid explaining how premium technology is recommended but not covered by basic insurance coverage does not mean you are a good listener.

Listening for Life

A patient-driven practice is one in which every single person, both the doctor and the least tenured employee, believes the patient is the most important part of the practice — the most valuable asset. To listen actively and thoroughly takes concentration, hard work, patience, the ability to interpret other people's ideas and summarize them, as well as the ability to identify nonverbal communication such as body language. Listening is a both complex process and a learned skill; it requires a conscious intellectual and emotional effort. OP

Ms. Suter is a national practice management consultant specializing in increasing profitability by improving communications, teamwork and customer perception. Her office is located in Chattanooga, Tennessee. She may be reached at suter4pr@gmail.com or www.donnasuterconsulting.com. She invites you to like Suter Consulting Group on facebook.