Tell me about it

01 June 2011
Volume 27 · Issue 6

Sim Goldblum explains the importance of communication in management.

We cannot afford upset patients, demotivated and uninvolved team members and anyone else who is unable to contribute fully to the effective operation of the practice.

Although each of these people is demonstrating that something is not going well at the practice, there is no single solution to fix the problem, except for communication. Our challenge is to recognise the type of communication that is required to help bring the undesirable state to a welcome state that is beneficial for both or all parties. Before we deal with each in turn to see how we might help, there are some important basic principles (occasionally clichés) to remember:

  • Communication is a two-way process
  • We have two ears and one mouth and they should be used in that proportion
  • The patient isn't always right, and we can learn from every complaint they make
  • Silent patients are not necessarily happy ones
  • Be hard on the system and soft on the person, people are not deliberately inefficient or rude.

Patients

The upset patient may be in that state for many reasons: you may have been running late, the treatment may have been more complex, expensive and time-consuming than he thought, you may have caused him pain instead of taking it away; he could be just having a bad day. So when he leaves the surgery and returns to reception feeling less than charitable towards the practice, what can your receptionist do? Here are a few suggestions:

  • Get in first with a smile, mention the patient's name, focus on feelings and ask what seems to be the matter: 'Hello, Mr/Mrs Smith, I see you're upset, tell me what the problem is,' is a start.
  • If the patient is 'loud', it would be better to move him/her away from reception and into a quiet space, an office, staff-room or waiting area if not busy, and get another staff member to help out at reception. It's not always easy but is better for the practice and prevents the patient grand-standing if that's what they'd like to do.
  • Invite the patient to tell you what's happened, while you remain calm and objective; listen actively (with nods or 'I see', or other indications that you are listening).
  • Get to the root of the problem by asking questions. 'Tell me exactly what happened', 'What treatment were you expecting?' 'Were you told how long it would take?'
  • Sympathise, explain and offer help and/or a solution. 'I can see you were surprised that it took so long', 'I appreciate your pointing this out to us', 'I will speak to the dentist as soon as they are finished with their patient.'
  • Give a little extra (as a thank you). 'We really appreciate your taking the time to explain this; we can learn from it and we'll be pleased to give a friend or relative a five per cent discount on their first examination if you refer them to us.'

Of course, your complaints policy needs to be clear and the patient offered an opportunity to make a formal complaint if required; it's much better that they tell you rather than their friends; and if you've handled the problem well, you could turn them into your ambassadors.

Team

The demotivated or uninvolved team member behaves that way for a reason and it's your role as principal or practice manager to find out what that is and to change the situation. Ken Blanchard's One-minute manager gives us many ideas how to 'catch our people doing something right'. Too often we focus on the negatives, the mistakes and the poor performances; rarely do we say 'well done'. In Blanchard's terms this is a one minute praising, a soon-after-the-event explanation of what was done correctly, the effect is has, and how it helps the practice meet its goals. So, what happens when you catch someone not doing something right?

Blanchard recommends a 'one-minute reprimand'. This reprimand should be as soon as possible after the event, be specific as to what was incorrect, tell them how it made you feel and remind them that you value their usual contribution.

Does the team buy-in to your vision? Do they share your sense of purpose? If a team member is lethargic you need to make their goals very tangible and ensure they have the training to deliver. These types of people need encouragement around the delivery of the practice's goals. For example, 'You need to make sure the appointments deliver 40 UDAs or £1k per day', 'Now we're in our new building, the patients are not familiar with the place, so you need to collect all our patients and escort them to the surgery.'

Ensure they understand their role in the team, 'As a member of the team, you need to convert 85 per cent of all new patient enquiries into appointments; then we can convert them into long-term patients.'

Build on their experience, 'You've worked with me on these types of procedures lots of times; please mentor our new nurse, so that she can become effective even more quickly.'

Whether you are trying to deliver five-star service, or manage a team that is not performing as coherently as possible, your communications and people skills are those that will help you address the problems you will inevitably face. Be an active listener, focus on the problem, not the person and you'll have a much better chance of achieving your ambitions.

References available on request.