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Posted By PPMA,
Friday, July 23, 2021
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Written By Lynn Homisak, PRT, CHC, SOS Healthcare Management Solutions, LLC Originally published in the Sept/Oct 2017 PPMA Newsletter
As a healthcare management consultant I spend a lot of time making and returning phone calls to a lot of offices. What I hear, your patients hear; and I’ve got to tell you some of it is NOT pretty. Making an effort to improve efficiency, offering the latest/best treatments and building relationships with patients are all critical components of a successful practice. But equally important is your patients’ first phone experience with your office. Now, understand what I am about to reveal is not a reflection of EVERY office I phone-connect with. However, of the first ten calls I made yesterday, SIX sent up red flags. Six out of ten! Following is a peek into just one morning of my recent phone call attempts. Look at them from a customer/patient perspective.
#1: People that know me, know I am pro-automation and there is no question that automated attendants (“press one for ___, press two for ___”) have their place in a busy office. It is extremely helpful to give the patient who wants to bypass the receptionist and speak to the billing department that option. It is also equally efficient to relieve an overburdened receptionist from sorting through every incoming call by re-routing those calls and freeing up their time to accomplish other duties. However, be careful of turning a positive into a negative. Typically, patients will listen to two or three options if it means a direct connection to the proper individual. Now, put them through a menu of TEN options. Hmmm, not happy. Impatience, irritation, frustration or worse, a hang up? Think about it. Are all ten options really necessary? Must patients sit through multiple selections that do not apply to them? Three of the calls I placed yesterday subjected me to a long menu and NONE of them addressed my reason for calling! In the end, I went with “Press #5 if you want to make an appointment” just to reach a human. (By the way, shouldn’t that have been #1?) So, while automation is time saving and at times, appropriate, customer service is also providing warm, personal, HELPFUL human contact. We all agree, it’s nice to be treated nice.
#2: Answering the phone with a mouthful of sour grapes is unacceptable. Patients can tell when someone is smiling and when they are not. An upbeat staff reflects a positive attitude of the entire practice, top down. This phone call is the first impression of you and your office! Answering the phone with a proper greeting is critical. My second call, no joke, was answered: “Doctor’s office” and nothing more. Whose office did I reach? An MD? Cardiologist? Dentist? Did I misdial? Hmmm, no warm fuzzy feeling here. It was not informative, welcoming, or professional. As a reminder try placing a smile button next to every phone in your office and have staff reflect on it prior to answering every call (every potential new patient). “Good morning, Dr. Pod’s Office, Sue speaking, may I help you?” is a great opening! Why not include “How can I make your day better?” As a patient, I’m already smiling. You had me at “Hello!”
#3: “May I help you” – if you say it, and you should, how about making good on that offer? I spent more time than was necessary trying to drag words out of one of the receptionists I spoke with. “Hi, my name is Lynn Homisak and I’m calling to speak with Miss deCall.” Crickets. “Is she available? Can you connect me?” “No.” “Oh, can I leave a message?” “She doesn’t take messages.” “She doesn’t TAKE messages?” “Email only; she only answers emails.” Getting information was like trying to pull teeth. After a few more related questions and one word responses, I accepted defeat. Hung up. FYI, I did email Miss deCall. No reply. No surprise.
#4: One ring to the next office immediately activated their voice mail system. I am always aware of the time zone differences with offices I call, so let me note the time of my call was 3:30 p.m. on a weekday. Voice mail: “Thank you for calling Tick Tock Podiatry. Our office is currently closed. Our office hours are Monday through Friday 8:00 a.m. to 5:00 p.m. Please stay on the line and our answering service will help you.” Waiting patiently, still waiting, turning impatient. At last—
“Hello, Tick Tock Podiatry’s answering service. The office is closed, may I help you?” Me: “The office is closed? What time do you have?” Operator: “3:35 Ma’am.” Me: “The message said hours were until 5:00. Are they really gone?” Operator: “Yes, I’m sorry Ma’am, they are. May I take a message?” Me: “No, I’ll call back, thank you.”
My call was important enough that I will likely make another attempt but the whole experience did not sit well. The bigger question is will a new patient hitting that same roadblock call back, or simply call another podiatry office that actually keeps posted hours?
I hope this mini exposé resonates—20–30 percent of potential new patients are lost on the first phone call to your practice. This is generally the result of staff not properly trained, failing to “close the deal,” careless office policy, or just lousy attitude. Doctors, I repeat, receptionists are often a patients’ first encounter with your practice, they represent your practice. Are you aware of how each phone call is handled? For more insight, consider having someone you know call your office as a new patient. Was your staff helpful? Was the call positive? Friendly? Could you hear them smile? Were they successful at making that appointment? Sound a little shifty? It’s not, if you do this without the intent to “catch them”; rather, to educate and improve their skills.
Whether blessed or cursed by technology, Email, Texting, Skype, Voice Mail, Answering Service, Facebook, Twitter, etc., have made their way into many of our practices. And yet, the phone still remains the KEY communication link. Do not neglect the critical importance of this tool, and the skills of the staff person that picks up! Can you hear me now?

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Posted By PPMA,
Friday, July 23, 2021
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Written by Lynn Homisak, PRT, CHC, SOS Healthcare Management Solutions, LLC Originally published in the Sept/Oct 2020 PPMA Newsletter
I doubt any of us thought we would wake up six months ago to internal emergency alarms and confronting the worst pandemic in over a century. And yet, here we are. Of course, it feels like a personal battle for each one of us, but we are not alone. Generally, people are struggling to cope all around us —some financially, some emotionally, some physically —all trying to weigh options.
Here in healthcare, thriving Lynn Homisak practices in many places have come to a full stop. Some turned to Telehealth visits, with the understanding that the handicap of virtual-only evaluation, diagnosis, and appropriate medical care can be somewhat of a challenge. Sadly, other practices will no longer have the necessary resources to survive. The number of patients seen per day dropped significantly along with revenue. Meeting payroll was difficult. Staff were furloughed until further notice, others let go indefinitely. Full-timers reduced to part-time, part-timers, laid-off, and in some cases, staff working from home became a viable option. So did delegating clinical duties to administrative staff and vice versa in an effort to keep them employed. While some offices have fully re-opened, it’s not to the extent that they were pre-pandemic. And they did so only after necessary alterations and added expenses were incurred to help stop the spread of the virus and assure patient safety, e.g., enhanced PPE, reception area restructuring, sanitizing, and new training techniques on patient handling. Let’s face it. Healthcare as we know it, temporary or permanent, is different.
If ever there was a need for optimism, the time is now. But what will it take? Of course, the promise of a vaccine is encouraging, provided it can convince skeptics that it is not “rushed through at warp speed” or “experimental” as tagged. This, accompanied by a unified implementation of necessary safety precautions (i.e., fast and accurate testing, contact tracing, hand-washing, masks, social distancing) sends a hopeful message. Until all the pieces come together, we need to refocus on more positive thoughts. If not, current circumstances, tedium, and feelings of despair are factors for a form of low-grade depression.
While more patients might be the ideal scenario, it’s just not happening right now. What we DO have more of, however, is free time! So why not be the optimist and use it wisely. Here are just a few ideas. And bonus—none are cost prohibitive: 1. What a great opportunity to work on a more robust marketing plan! Make educating your patients a team effort and use the technology you already have. Staff can set up and manage a routine mail merging system for mass emailing, and doctors can write informative content. Some ideas: - Inform them of the changes you’ve made in the practice FOR THEIR SAFETY.
- Broaden their education by enlightening them on various podiatry conditions that you treat.
- Change the mentality that corns, calluses, and nail care are the only things DPMs see!
- Perhaps your patients (or their loved ones) have Diabetes. Explain that now is not the time to be neglecting their feet and educate them on how to examine both feet daily and call the office immediately should they discover any changes in skin color, temperature, pain, drainage, etc.
2. Start (or revive) a long forgotten patient recall project. Recall is NOT a dentistry-only service! Consider a general recall program, by groups of alphabetized patient last names, orthotic recall, Diabetic shoe recall, surgical recall, pediatric recall … sky’s the limit.
3. Just say Hi! Increase patient correspondence with some fundamental patient letters—Birthday, congratulatory, sympathy, get well, or just a friendly “How are you doing?” These greetings go a long way in boosting patient attention and satisfaction. “Welcome to our office” and “Thank you for your referral letters” are also great ways to stay connected.
4. Get your house in order. Set up neglected, standard operational procedures: - Create activity logs (paper or computerized) to effectively manage routine tasks and track current status of orthotics, e.g., signify-ing dates when patient was casted, sent to lab, returned, dispensed;
- Biopsy lab results: Date test taken, sent, received, patient contacted, documented;
- Checklist of duties expected of the front desk staff that allows them to self-monitor their progress;
- An insurance appeals document log;
- Inventory and ordering checklist; and a
- Patient wait-list to fill any daily cancellations or voids in the schedule.
Creating these NOW will lead to more efficiency and improved patient flow LATER, when things get back to “normal.” 5. DIY. Roll up those sleeves and break out the tools. Whether it be a paint brush or a mop, a hammer or a broom, a squeegee or a wrench. Do that deep cleaning you’ve been meaning to get to. Tidy up the parking lot. Fix that squeaking door, or wash the windows, address the dripping faucet, paint a wall or two. Purge —Clean out closets and drawers. Just eliminate “stuff ” you don’t really need. 6. Hold necessary training sessions to assure that everyone in the practice is on the same page with how to properly manage patient visits and maintain adequate safety measures.
Optimism refuses to believe that the road ends without options. Optimism is a choice that will make you feel better.

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Posted By PPMA,
Friday, July 23, 2021
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Written by Lynn Homisak, PRT, CHC, SOS Healthcare Management Solutions, LLC Originally published in the Sept/Oct 2018 PPMA Newsletter
“What happened to Mrs. Baker today?” asks the doctor. “She had a two o’clock appointment and didn’t show up.” Patient no-shows are a daily scheduling occurrence that is more common than any of us would care to admit. Why do they happen? What do we do about them? And finally, how can we prevent them? Let’s start with “Why?” The reason for no shows from a patient perspective could revolve around many things. Of course the possibility exists that their absence could have been the result of an unavoidable last minute conflict or an unfortunate mishap; and in those particularly rare cases, you find it easy to empathize. But most likely, one of the following occurred: They were too busy, they forgot, didn’t feel it was a priority, or just didn’t understand the value of going. Then there are those who make a habit out of not showing, and you can predict two weeks out, thanks to the road-map of red markings in their charts, exactly who they will be. What do we do about these patients? By intentionally disregarding their actions, we are irresponsibly allowing these patients to diminish the value of our time. Except for those offices who have a rigid policy when dealing with patients who don’t show, e.g., charging a fee or inconveniently re-scheduling them, there is often times, little to no consequence to a patient who fails to show for this appointment, or the last one, or the one before that, or the one, well you get the picture. Sometimes without our realizing it, we allow our patients to sit in the driver’s seat of our practice, instead of taking control of the wheel ourselves; and the only way to avoid unwanted future wrecks is to realize that we need to reposition ourselves. So how do we do that? First, by attaching value to our time and once we do, make the patient aware that we do. Unfortunately, some patients who have been told by the doctor to reschedule a follow-up appointment do so without fully understanding the reason why. Without proper doctor–patient communication, the patient is at a loss to associate any “value” to the appointment, and so if they happen to miss it, it’s of no real significance. It is up to each one in the office—beginning with the doctor —to impress upon the patient that a follow up appointment is suggested for THEIR benefit, not ours. If the patient fails to appreciate that by the time they leave the office, there is a hole in the protocol/system somewhere that needs to be fixed. It is important for the receptionist to be proactive when making the patient’s follow-up appointment. Again, reinforce the importance. Next, emphasize to the patient the courtesy of a call if he/she cannot keep the appointment; while also explaining that their failure to keep the scheduled appointment could severely limit their chances for rescheduling at a convenient time. The strategy in this case should be, “Mrs. Baker, if you cannot keep this appointment, we would appreciate the courtesy of a call so that we can then make it available to someone else who’s been waiting to get in. We realize your time is important, and should the situation ever arise where YOU would need to be seen, we would like to be able to offer you the same consideration.” Remember, when we speak in terms of appointments to the patient, they only translate that into “increments of time”: 15 minutes, 30 minutes, 45 minutes. They are merely time slots in your book to them. So, in addition to conveying the message that our time is valuable, we need to take the extra step to prove it and make them believe it. Think for a minute of the mixed message we send when scheduling two or more appointments in the same time period. And don’t be so naïve to think that they don’t compare appointment notes while they are sitting in your reception room. You cannot expect a patient to understand the value of that appointment knowing that you double-booked them with someone else and forcing them to wait 40 minutes or more! Maybe the next time they are scheduled, they’ll think it is “no big deal” if they don’t show, with the notion that you already have someone else penned in to fill that “valuable” time slot anyway. And so, we come to our final question: What can we do to prevent No-Shows? Without starting a debate on the pros and cons of calling patients to remind them of their scheduled appointment, I can only tell you that if you do call, from a patient’s perspective, you continue to live your philosophy by example; showing them that you assign importance to the time you have set aside for them. In addition, calling your patients to confirm a day or so prior to their appointment allows for two very important things to occur: 1) You can verify your schedule for the next day; 2) You have an opportunity to fill newly vacant appointments with other patients who may be waiting for an opening. Make your call count— - Inform your patient that you will call to remind them of their appointment and be sure to ask where they can best be reached.
- Rather than just leaving a message on their machine, you want to call them at a place where you are sure to make a live connection.
Some prefer home or cellphone, while others, their office phone or email. It can be argued that there are still the occasional no-shows even with a reminder call, but the truth is there are far less than without it. However you choose to deal with those patients who repetitively cancel, change, or break their appointments, it’s important to first follow up with a phone call for completeness of care. Document your call, their response, and reason for not showing, and their rescheduled date if they choose to make one. At every available opportunity stress the value of the time you are setting aside for them. It’s up to you to teach them. If you don’t, who will?

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Posted By PPMA,
Friday, July 23, 2021
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Written by By Lynn Homisak, PRT, CHC, SOS Healthcare Management Solutions, LLC Originally published in PPMA's Sept/Oct 2019 Newsletter
In an effort to take a more practical approach, here are my top five management tips, along with a brief explanation of the role they play in operational management. Feel free to use them. Every day. I insist. You won’t be sorry. Promise. 1. Communicate More Communication and management go hand-in-hand; they cannot be separated; like a cake without icing. Yet it is a key component absent in many offices (communication, not icing). I’ve seen the damage this missing ingredient can do firsthand (again, communication, not the icing). If staff feel they are not listened to or worse, not heard; if they feel they are not encouraged to offer new ideas or suggestions for improvement; cannot share difficulties they face or occurrences they’ve observed, they don’t feel like part of the practice. It is a communication barrier that not only feeds a declining morale, but minimizes productivity. Participating in regular staff meetings is one way to give them a voice; a feeling of inclusion. Keep that door of communication open. Shut them out, and you’ll shut them down. 2. Pay Attention
Staff are like sponges, they absorb information and want to learn from you. So you can represent a loofah and learn from them as well. They’re the eyes and ears observing things you may never see, and hear things you may never hear. They do good deeds you might never know about that are great for the practice. If you pay close attention, you should have no trouble acknowledging three things that you’ve learned from your staff at the end of each week. Tap into their insight. If it is criticism you receive, accept it openly for it will only improve your management skills, maybe even expand your circle of friends. 3. Pay it Forward
The Oxford Dictionary defines paying it forward as responding to a person’s kindness to oneself by being kind to someone else. The tone and philosophy of the office starts at the top; and what better way to create more of the same than to be a first-class example. Give new meaning to paying it forward by encouraging your team to do as you do. In other words, you can inspire your staff to follow policy because they see you do it: - Motivate them to treat others with compassion and empathy because they watch you do it.
- Demonstrate a praiseworthy work ethic because they observe that you always strive to do the right thing.
- Finally, create job satisfaction and staff retention by providing an enjoyable and safe work environment.
- You will find that being a good example to them is a lot like paying it forward. “Do unto others ...” and believe me, it pays off!
4. Give Constructive, Honest Feedback Say this five times fast: “Nix the notion that performance reviews are useless face-to-face confrontations that compel you to give a raise under pressure and with resentment to undeserving staff.” Nothing could be further than the truth. First of all, giving raises when they aren’t earned is on you. By the same token, if justified, don’t avoid giving raises. The true purpose of having written job descriptions, clarifying expectations, and giving constructive feedback (via aforementioned performance review) are for staff improvement and building on their strengths. Reviews should be honest and straight-forward with a plan for ongoing development. A formal evaluation should be scheduled annually; however, giving advice and guidance should be a daily occurrence. Staff want to do the right thing the right way and given proper tools, support, and encouragement along the way, they envision their work not just as a “job” but as a career. That kind of employee adds tremendous value to a practice. 5. Provide Large Doses of Appreciation, Fairness, and Respect We all know that treating staff with fairness and respect and showing them appreciation brings about positive vibes in the workplace in terms of boosting productivity, engagement, and dedication. Even better is that praising good behavior encourages repeat behavior. Were you also aware that psychologically, your positive reinforcement in these areas can actually influence your employees’ health and well-being? You have the power to make impactful, attitudinal changes! Scary, huh? Use it generously. Don’t waste it. Of course, there is much more to being a manager than these five factors, but consider them a running start. You can. You should. And if you start, you will. And that, is the icing on the cake!

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