Four pillars of a successful practice: 1. Keep your current patients happy

FIGURE 2: Focus of the appointment

Develop an on-time practice philosophy

You know the adage: Timeliness is next to godliness. (Actually, it’s cleanliness that’s next to godliness, but timeliness is vital, too.) The most common complaint patients have about the health-care experience is “waiting for the doctor.” Spending time in the reception area probably accounts for more patient dissatisfaction than any other aspect of medical care. In one recent survey, nearly one in four patients (24%) claimed to have waited 30 minutes or longer. With so many more women entering the marketplace, this statistic is only going to get worse.

In order to gain an accurate picture of what is happening in regard to the schedule in your practice, I suggest conducting a “time and motion” study. For a period of 3 to 5 days, place a sheet on each patient’s record or superbill and log in the following:

• time of her appointment
• time she arrived
• time she left the office
• how much time she spent with her physician.

You will be amazed to discover that patients are waiting 1 or 2 hours or longer to see the physician, and that the physician is spending only 5 minutes with the patient. Ask any patient on a survey if she feels she is getting bang for her buck, and she will answer, “No!”

By conducting a time and motion study, you will discover that there are predictable periods when backlogs occur. Often, these delays are the result of “working a patient in” to the schedule. Unscheduled patients who call to report vaginal bleeding, pelvic pain, urinary tract infection, or another problem are often told to come in without an appointment, but they inevitably displace women already scheduled and delay their visit. This problem affects almost every ObGyn.

One way to avoid this scenario is to create “sacred” time slots. These are 15-minute intervals at the end of the morning or afternoon in which unscheduled patients can be worked into the round of visits. Instead of telling the patient to “just come in,” I tell her to report at a specific time. These time slots cannot be filled with routine appointments. Nor can they be filled prior to 9 am each day. This leaves two or three slots open for patients who must be seen immediately.

Few ObGyns can change health-care policy. But all of us can be more sensitive to our patients’ time and make an effort to see them as soon as possible, thereby eliminating one of patients’ most common complaints: the long wait to see their doctor.

Make the patient’s experience memorable

All of us can provide a diagnosis and treatment strategy for most women’s medical problems. But how many of us can make the experience memorable for the woman? Often, it is a few little things that can be easily and inexpensively performed that make a big difference.

Go with cloth, not paper. There’s a sharp contrast between a paper sheet, a paper gown, and a soft robe. You don’t step out of the shower in a fine hotel and put on a paper robe. If you are offering five-star service, you need to offer five-star amenities. If you want to attract special patients, treat your patients special. It doesn’t cost that much to add a few dozen robes to your office supplies, laundering them after each use and placing them on hangers or in a plastic bag that each patient can use during her visit. I can assure you that this single idea will set you apart from most other ObGyns in your community.

Stirrups are cold! Here’s another idea: Use pads to cover the metal of the stirrups for the pelvic exam. Those stirrups are cold steel, and no woman who is already naked and concerned about her dignity wants to place her feet on those chilly structures. You can have lamb’s wool pads created by a seamstress for a few dollars—or if you prefer to go low-tech, you can use potholders to cover the stirrups.

Warm the speculum. My wife shared with me how uncomfortable it is to have a metal speculum inserted and how much she appreciated her gynecologist warming the instrument with tap water before its insertion. I have found that this saves on the use of lubricant jelly, too, because the water serves as a lubricant!

Keep the temperature in mind. Most medical offices are kept at 70° to 72° F to keep the doctor and staff comfortable. However, when a woman puts on her gown or robe, she often becomes cold and uncomfortable. On days when it is cold outside or the office is cold, use an inexpensive heater to make the room comfortable for the patient.