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Sun 19 Oct 2008 04:00 AM

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Answering back

Outsourcing your practice's phone line might seem an unnecessary cost, but the engaged tone could be costing you hundreds of patients a year.

Outsourcing your practice's phone line might seem an unnecessary cost, but the engaged tone could be costing you hundreds of patients a year.

Good medicine needs a personal touch, even down to a practice's phone lines. Experience shows that for new patients, phone manner ranks alongside bedside manner when it comes to making a good impression.

However, smaller clinics with minimal - if any - reception staff can struggle to keep the phone lines manned. For many physicians, answerphones can offer additional and cheap front-of-house support.

Anyone who works in a physician’s office should spend more time with patients than on the phone.

Any busy clinic has to find a way to deal with busy phone lines, but if you aren't careful about how you approach diverted calls then you could be turning away a silent majority.

The reality is simple: if it's an emergency, people don't leave a message - they find another doctor. Even if it is not an acute case, prospective patients will often try another doctor rather than wait for a recall. So, short of employing an army of receptionists, what can practices do to stop patients from losing their patience?

Call gone wrong

Joe Peres learned the hard way how traumatic an inadequate answering service can be for patients and their families. "In 1995 my mother was diagnosed with terminal lung cancer," he explains. "I was her primary care giver and it was during that time that I realised how frustrating and worrying it is when you try and contact a physician and you can only get an automated answering service."

Peres cites one evening when his mother desperately needed medical attention. While his call to an out-of-hours number for her practice was answered, the receptionist simply reiterated the clinic's opening hours before hanging up. "It wasn't a great experience and it seemed to me that there must be something better than what they were doing at that point," Peres says.

Having worked in customer service for several years, Peres and his brother-in-law decided to apply call skills learned in sectors such as hospitality and retail and apply them to healthcare.

"We answered every phone call ourselves for the first two years and we slept here 24 hours a day and provided this service," he says. Now, 12 years later, Peres' US-wide Call 4 Health has 70 employees working out of two locations and handles several million inbound phone calls a year.

Hanging on the telephone

Addressing how a medical practice handles incoming calls is not rocket science, shrugs Dr Lawrence Gordon, founder of New York-based Waiting Room Solutions. If you are not answering every call in person, you run the risk of losing a patient every time you make a booking.

For a small practice that might only have one desk person who can only handle one call at a time, then you can lose people who are on hold," he warns.

"When you are working so hard just to get people to call you, losing the opportunity to take care of these patients because you haven't thought out a good scheduling method is just a disaster."

It's a simple statement - but what is the simple solution? Small practices typically need to keep overheads down, but that also means they cannot afford to be losing patients before they make it past the switchboard.

The answer, argues Peres, is to pay somebody else to take care of the whole process. "Traditionally the healthcare industry is nervous about outsourcing," he admits. "The mentality is that ‘nobody can do it as well as I can', but the economics are difficult to argue with."

Peres point to a recent deal Call 4 Health struck with a chain of clinics that originally signed up only to the after-hours service. "After we had built a working relationship with them we were able to show them that in each clinic they have three people just answering the volume of phone calls," he says.

From a salary standpoint, that's three people per office, in 10 offices, and none of them are doing it efficiently because they are being rushed off their feet - they have someone in front of them, they have to pull a chart or whatever."

Physicians often don't realise that only a few administrative tasks in a medical office can't be handled remotely - and it is these processes that clinics should really be concentrating on.

"We showed them how by outsourcing all of that to us...we were able to act as their communication hub and then their people can focus on their core capabilities," Peres explains.

"My philosophy is that anyone who works in a physician's office should spend more time with patients than on the phone."

Crossed lines

A common concern is that outsourcing leads to a drop in quality - or that patients might recognise the practice is trying to cut costs. When a call to a local bank is answered by a call centre thousands of miles away, for example, people often react negatively. Practices must resist the temptations of low prices, argues Peres.

"The industry that I am in has traditionally been a commodity industry where the lowest price tends to win," he concedes. "But if you don't invest in the right company that is going to promote the relationship you need to build with that patient, then you are going to lose out.

"While you might save a few dollars on a lower price, all you need is for bad referral to happen and it is a catastrophe."

Call 4 Health has built its business by bypassing technological solutions in favour of hiring trained staff to answer calls, claims Peres. That is not to say, however, that technology does not have a part to play.

While a practice receptionist is unlikely to break down and classify the type of calls they have fielded in the last three months, for a specialist answering service company, that information should be available almost instantly.

"We have clients now that are finally realising that ultimately any answering service is collecting data," says Peres. "For example, in month X we can tell them that Y number of patients called asking about diabetes.

"Eventually healthcare will have to be about preventative care and not just reactive care, and we are at the frontline for that because we are gathering information and logging it."

Not exactly a scientific breakthrough, one might say, but for a modern medical practice, outsourcing answering services is more appropriate than ever.

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