The $2Million Practice Part 3 – Hospitality (S1E12)

Creating a Welcoming First Impression

Welcome to the Cash Practice Solution Podcast. I’m your host, Dr. Jay. Today, we’re getting into another critical aspect of the 2 million dollar practice. We’re discussing the power of hospitality and customer service in creating a practice that patients love to visit. They actually like coming here, as opposed to other places where the response is usually, oh God, you have to go to the doctor’s office?! People actually like coming to our office, and first impressions matter. The moment a patient walks through your door, that’s when the experience begins. Your reception area should feel like walking into a good friend’s home: warm, welcoming, attentive, and lovely—not smelling like sterile alcohol and cleaning solution. And it’s not hard to do. In fact, from the very beginning, when we opened our office 20 years ago, we put a wind chime over the door so that when a patient walks in, there’s this little ring.  When a patient comes in, it’s not intrusive at all; it’s very gentle. It’s also Zen; it’s feng shui, and you’re supposed to do that.

Prioritizing Patient Experience Over Everything

It’s very nice and welcoming. The patient’s arrival is obvious, and the staff is alerted that someone has arrived. At that point, your reception staff should make eye contact, not look down at their paper, and not be distracted. They should greet the patient warmly. It helps if your technology has a picture of the patient and their name so the staff can greet them by name. You know their name, say hi, and set clear expectations. The patient is very clear about what’s going to happen next. They are not told to have a seat; we’ll be with them in a little bit. You tell them, “I have a room ready for you; it will just be a couple of minutes.” Or, “Come with me; we’re going to get you in a room.” The patient in the building is the number one priority. Put the phone on hold. Leave messages and paperwork for later; set them aside. Every other piece of business is secondary to the patient and the reception area. This is a problem that happens in so many offices. Patients come in, and they’re ignored. It doesn’t make any sense at all. No one will feel welcome if they’re not welcomed. Your staff should greet them, “Hey, how are you doing? Come on in”. In our reception area, and as we recommend this to docs, we have a relaxed setting with a beverage station, with water, tea and coffee. You can use a Keurig if you want, to make it easier. And of course you have to have guest wifi. You have to have it. It’s essential to the patient experience.  It’s kind of interesting. We’ll talk about selecting staff and building a team later, but part of the greatness of our staff is they’re always on the lookout for really comfortable, living room furniture that’s easy to clean, on sale at Furniture Stores as part of their participation in our office. They’re always finding cool looking stuff that we can put in the waiting room, in the reception area. It’s not a waiting room. You don’t want people to wait, you want to receive people.  That’s part of the mojo of a really good practice. It’s comfortable. It feels like you’re in somebody’s home. It’s welcoming. The front office staff greet the person who walks in, and then they continue the process by moving the patient to a treatment room as quickly as possible. 

Enhancing Comfort and Engagement

Getting a patient to a treatment room quickly causes them to experience a very positive feeling that they were expected. They feel, “I’m important to participate in this process”. And if we can, before they even sit down, we like to get them moved from the welcome, come on in to I’ve got a room waiting for you. Quickly followed by, Let’s walk down the hall. We call the reception area furniture a trampoline. Think of it that way where you bounce right off. You don’t spend any time there. You don’t refer to the reception area as a waiting room, it’s a bad idea because it puts the wrong idea in your mind [and that of your patients]. The patient should hardly ever have to wait and if you set up your appointments right and you’re not too packed in  (sometimes there’s emergencies you can’t help it), but generally, you want to have enough time for the  front office staff  and your M. A. ‘s to have casual visiting time.  They’re not in a rush. You should never have a patient feel as if they’re being rushed and you don’t want to feel a time crunch. Once the patient gets to the exam room, the treatment room, they should feel that they are the most important person here. The room should be completely spotless. Everything should be stocked. This is probably stuff that you know, but when you’re in the flow and your practice is working well,[or if you are completely overwhelmed] you can miss these things, so don’t miss them. The workflow should be really smooth that gives the patient a much better experience. Your professionalism and that sense that everything is just waiting for the patient solidifies the positive patient experience. In our office we use lots of little caddies so that they can be restocked and easily moved around in a room. That way we never run out of things and there’s never any surprises. Then I have my “venerable” snacks. We go to big box stores, Costco, Sam’s, whatever, and we get huge packages of little snacks. They’re set out in every room. That and drinks. We have water available, if they don’t want water or they for some reason have run out in a room, our staff offers them drinks. The snacks that we have, they fit every kind of demographic. Some people like peanut butter crackers. They’re not my favorite. Some people need to have pure protein. We have protein snacks, little meat sticks, those kinds of things. For little kids, we have gummies. In case a parent comes in with a child, we want to be able to occupy them with something and make them feel like, I want to come back to that doctor’s office. We want patients of all ages to say he’s really nice. That’s a big part of the experience. You want to show the patient they matter. Snacks are a very important part, unbelievably inexpensive. You might spend a dollar per patient visit. Most patients don’t take advantage of the snacks there. Often they don’t have a water.  Some patients will fill their pockets with snacks. That does happen, but don’t let that inhibit you. It’s rare, and you won’t go broke doing this and it’ll make a huge difference. They feel loved and cared for,  but what we also do, which is amazing, this is probably kind of a revolutionary thing, but you can do it’s not super expensive. We have touch screen TVs in each room on the wall, so instead of having a computer in front of you blocking the patient, the touch screen is on the wall with the software set up on the touch screen TV, so the patient can review their labs and other documentation. For instance, an MRI scan comes in. We can pop it up  and we can review the MRI together.  Prescriptions, you can do it on the wall with the patient, so you review the prescriptions, maybe their current medications and eScribe. During the visit, on the wall, the patient will have the recollection of Oh, that’s right, I’m supposed to take that just in the morning. Oh, I thought it was twice a day.  So you’re killing two birds with one stone. You’re getting that patient to have an experience of your prescribing, and then you’re getting clarity, and then ultimately compliance, which is great. Instead of creating a barrier to engagement with that laptop, the touchscreens make it easy to engage, and it’s actually true, shared decision making because you’re sharing a screen  and you’re doing the consultation with the patient actively with them. Any number of  Essential services can be added at this point to maximize the value of the encounter. With the screen in front of you’re able to say, “and also I notice here that you wanted to have a trigger point injection today.”  This kind of interactive technology, is actually a legal requirement in the OpenNotes systems.  The high tech act actually requires us to do this, and the touchscreen makes it a huge value. Instead of it being a hassle, with the thought of I have to share this information, it becomes useful and you can actually do it in a context where the patient feels like they’re being welcomed into an educational experience.

Fostering Long-Term Relationships

The patient will see that your technology is excellent and they can tell that you’re very professional. When I’ll send them up front. Closing out the visit in the treatment room should always include, and this is something I’m pretty conscientious about, I rarely miss it,  “Thanks for letting us take care of you today.” Or, thanks for letting me take care of you today.  It’s a privilege that I have, that I get to share with the patient, that I get to have them in my space. It’s not a privilege for them, it’s a privilege for me. And I communicate that. And then, instead of saying, well we should do a follow up in three or six months you invite them to follow up.  Even if it’s as far as a year in the future. Then you want to say, “Hey, let’s not let another year go by, or let’s not let a few months go by, or the holidays are coming. But before the holidays, let’s make sure we get together again”. So you’re really inviting them almost to a friendly meeting, not so much an appointment. They’re being engaged on a much more personal level. The front office staff should manage your refills on the way out, making sure if they have supplements they need to get or other products, they can check the record, make sure that’s all there. And making this really convenient to patients is good patient care. Supplements, prescription updates, next appointments, that’s good patient care. And it’s really important to your bottom line as an independent practice that those things get done. You have to have your follow ups, every patient should have a follow up. No matter how long out it is, they should have a followup. Their supplements and prescriptions should always be reviewed. And the great hospitality doesn’t end when the patient leaves the office. Follow up care is one of the best ways to build a strong doctor patient relationship. So if you want to send a thank you note or a follow up appointment note, that’s great. Somehow patients, they’ll walk out of your office and forget that you’re involved in their life, unless you remind them. Our technology and some really good systems, they’ll send a thank you note automatically, which is great. Some things can be automated, but more than anything, customer service, taking really good care of a patient, making them feel welcome, making them feel like they’re at home, that if they need a snack, they have it. If they need a drink, they can have it. Make sure that all the information that’s at your disposal you want to share with them is readily available for shared decision making. This doesn’t need to be a formulaic or a highly administrative process. It can be a very friendly process. And if you design it that way from the beginning, patients will respond by being friendly to you and telling their friends to come, and they’ll be happy to be your patient for a long time, rather than the revolving door of an urgent care style practice. In our next episode I’m going to get into a lot of the procedural stuff that can be done within this context. Great hospitality, outcomes and incomes matching, including in that the use of really well placed procedures to improve your bottom line and also patient convenience. They usually have a lot more money to spend than they have time to go running around to a doctor’s office for hours of delay and delay in care. In a technology driven world where more and more AI is happening, these procedures are going to be critical, so we’re going to get into it and get pretty deep into it. Maybe spend a couple episodes because I think it’s that important. So join us next time as we reveal those simple steps for outstanding patient results and financial success. Thanks for tuning into the Cash Practice Solution Podcast. I’m Dr. J and I’m here to remind you, a fulfilling cash practice is within reach and we can help you get there. If you want to maximize your current cash practice or start out on the right foot, check out all the resources at The Cash Practice Solution. Until next time, listen to your patients,  learn their stories and love them with all of your heart and you’ll be unstoppable.