Improving Patient-Provider Communication to Enhance Patient Outcomes

From the first phone interaction with a new patient to the end of an office visit, communication with patients is a crucial component of clinical outcomes and patient satisfaction. This article examines the many factors that influence communication in the medical visit and tools for improving patient-provider interactions.

In today’s technology-driven world, the channels used to communicate with patients have, perhaps, never been more numerous and more challenging to navigate. But one thing remains the same: The goal for dermatology professionals is, and always will be, to help patients achieve optimal skin health. Honest communication with patients is the best way to achieve this, no matter which medium is used. This holds true from the first interaction with patients to the moment they leave the office.

First Impressions

The first interaction can be a make-or-break situation for a dermatology practice, and, as the old adage goes, first impressions are often the last. This initial communication with a new dermatology patient is almost always over the telephone.

Reception staff members are often gatekeepers; they are the face of an organization. Encourage office staff to answer the phone with a smile. A customer can tell — and it can make all the difference in whether or not rapport is established with a patient.

When answering the phone, there are several key points to mention in the “hello.” The employee’s name, the name of the facility and a friendly “How may I help you?” are most important. A clear, articulate introduction puts the client at ease and opens up the first lines of communication. Try not to let the phone ring more than two or three times. If it can’t be avoided, apologize to the caller and thank them for their patience.

When a patient arrives for his or her first appointment, a clean reception area with friendly, organized staff will reinforce the great impression that has already established over the phone.
At our practice, Southern Tier Dermatology & Aesthetics, we once had a patient say that she immediately felt like she could trust the doctors in the practice before she had met anyone, simply because of how the reception staff communicated with her during her first phone call. This demonstrated what a significant impact the first impression on the phone can have on setting the stage for great relationships with clients.

Meeting Patients for the First Time

A new patient’s first appointment is typically a consultation. During this time, it is important to learn as much as possible about a client’s problems, concerns, goals and medical history. It is important to remember that each patient communicates differently; ask patients many questions and encourage them to do the same. Some clients prefer to write their answers on a survey sheet rather than discuss them verbally. And there is no such thing as a stupid question.

In our practice, the first thing we do is shake a patient’s hand, introduce ourselves and spend a few moments getting to know the patient as a person, not just as a medical case file. It’s important to greet patients by name and then dive into their history. Many people are turned off by a setting that is overly institutionalized or too ‘medical,’ which can damage the doctor-patient relationship. Taking time to inquire about a patient’s day and learn a bit about him or her beyond the medical chart can be a crucial step in establishing loyalty in patients.

The Internet is a double-edged sword when it comes to patient education. It allows clients to keep abreast of important facts, but they are also bombarded with myths. You may meet a patient who has serious concerns based on something he or she read online. Confirm or refute the information based on medical knowledge, and make sure to research a question if it requires more thought.

Occasionally, patients are unsure about what, exactly, they want to change or improve. Patient handouts, including pamphlets and other literature that explain all of the services offered by a practice, allows clients to have something to take home and digest. Patient education resources to help them learn how to reduce the risk of skin cancer and other skin conditions are also invaluable.

Managing Expectations

Honesty on the part of both the patient and the provider is the key to healthy outcomes. All staff members must be on the same track when it comes to customer communication and the mission of the organization. If a patient isn’t clear on what he or she can gain from seeing a dermatologist, and if we, as clinicians, aren’t transparent, we will, inevitably, lose a client.

One of the most prominent challenges dermatology facilities face is that many patients, especially new ones, are slightly unsure what to expect during the visit. In a specialized field like dermatology, it is important to help all patients understand the range of issues we treat. A nurse practitioner is especially helpful in explaining what occurs during a procedure and what medical side effects should be expected. For example, an injectable can cause light bruising. If a patient is not alerted to this potential issue, he or she may feel as though the practice cannot be trusted to perform procedures properly or communicate vital information. The goal of dermatology is to help patients look and feel great, which can only be achieved if all members of your staff and your patients understand the practice’s methods. Managing expectations of patients as a provider is also important.
    
Listening and Establishing Trust

Dermatology professionals are entrusted with some of a patient’s deepest, most personal health concerns. Imagine if your doctor sat with his arms folded and legs crossed and lacked eye contact while you divulged your signs and symptoms. There would be an immediate lack of trust as a result of these non-verbal mannerisms.

Repeating information back to a patient or paraphrasing points that a patient makes shows that you are listening. In our experience, this helps us better understand our patients’ needs and establishes trust. One thing that must never be forgotten is that describing and showing skin issues can be an inherently embarrassing experience for many patients, which can be alleviated with a caring bedside manner.

It’s important for dermatologists to be adept at reading patients’ personalities. If a patient likes to joke around, it is typically okay to laugh along. But if a client is a little more on the serious side, try to mirror this. People naturally feel more comfortable when they can relate to someone.

A study cited in Physician’s News Digest found that clinicians allowed patients only an average of 18 seconds to describe their illness before interrupting.1 This is a scary statistic, because it is not only outright rude, it can also lead to a misdiagnosis. The saying ‘Treat people how you would want to be treated’ can be applied very well to patient care.

Reaching Patients Via Technology

Although the Golden Rule is timeless, the paths we use to communicate with patients are evolving every day. About a third of patients turn to social media to communicate with healthcare providers,2 and nearly half of consumers said information found on websites would affect their decision to seek a second opinion.3

Not every patient is going to want e-mail newsletters with health tips or text message reminders about upcoming appointments. But many patients appreciate them, and it is crucial to deliver. In our practice, we've found that clients like young professionals and busy moms often schedule their lives using their smartphones. For them, using e-communication can make it easier for them to fit dermatological care into their everyday regimens.

Technology is certainly a way to increase transparency. Websites like www.vitals.com and Angie’s List allow patients to rate and review dermatologists. Reception staff should keep an eye out for notably satisfied patients and politely ask these patients to visit one of these sites and voice approval. One of the authors holds a 3-out-of-4-star rating on Vitals, and one patient remarked that the doctor was “professional and courteous.” The reviewer also mentioned that he had positive interactions with the staff. Even clients who have had a mediocre experience can contribute to a well-rounded picture of the facility by writing their honest opinions, according to an article in the blog Physicians Practice.4

Social media such as Facebook and Twitter are easy ways to stay connected with patients, but, in most cases, doctors should avoid becoming “friends” with patients on Facebook. Create a Page for your practice instead, one that your patients can ‘like.’ Healthcare professionals are warned to use these platforms responsibly, always remembering to respect patient confidentiality.
Tread lightly, as a little can go a long way, even if it is 140 characters or less. There is still such a thing as too much information. It is easy run the risk of annoying or even scaring patients if they are barraged with new facts and statistics constantly.

Communicating With Unsatisfied Patients

So, is the customer really always right? Realistically, no. But, despite that natural “fight or flight” reaction, it is imperative that staff approach tense situations in a calm and respectful manner. It is never appropriate to argue with a client; every attempt should be made to be empathetic and proactive. In some cases, a patient may become distraught not because of poor medical care but because of administrative mistakes. One of the most common complaints from patients is how long they waited to see a doctor. According to an article in The Permanente Journal, an effective reaction is to acknowledge the long wait, empathize and use this to transition to the actual reason for the visit.5

Sometimes, a shy patient might not feel comfortable expressing discontent. This goes back to reading patients’ body language. If it seems that something isn’t quite right with a patient, ask. The answer may be an unpleasant one, but merely inquiring will immediately offer a level of comfort to an unsatisfied client.

Conclusion

The authors have learned an important lesson in engaging patients through many collective years of experience: it’s not about saying the right thing, it’s about saying the honest thing. Stepping in clients’ shoes for even a brief moment can provide a new viewpoint into patients’ desires, concerns and feelings. Learning to manage your image as a practice is a catalyst for healthy relationships with clients, which can only be achieved if all staff members perform their roles to the best of their ability. Honest communication can be more valuable than any procedure or product; equipping patients with knowledge is the final step in effective communication. Whether a client becomes a patient for one day or for years to come, the relationship will eventually end, but, if they leave with the ability to be proactive in their own skincare, we have done our job as professionals and as communicators.

Southern Tier Dermatology & Aesthetics was founded in 2006 and specializes in medical, surgical and cosmetic dermatology. The practice lists nearly 25,000 patients.

Dr. Crandell, co-owner of Southern Tier Dermatology & Aesthetics, founded the practice in 2006. Dr. Crandell is a Fellow of the American Academy of Dermatology, an active member of the American Society of Dermatologic Surgery and a recognized expert in medical, surgical and cosmetic dermatology.

Dr. Fenkl is co-owner of the practice. He has undergone extensive training and professional development in all areas of medical, surgical and cosmetic dermatology.

Disclosure: The authors have no conflicts of interest to report.