First impressions: Make it a good one

En route to the hospital one recent Saturday, internist Joseph Turner, MD, had an experience that reminded him of everything he tries to avoid in his practice, and validated the attention his group gives to hiring, training and supervising receptionists.

He slipped into a fast-food drive-through to grab a quick cup of coffee. He placed his order and drove on to the window. Dr. Turner could see a lot of scurrying inside, but he had to wait an annoying 15 minutes. Dr. Turner says he doesn't blame the restaurant for the wait time. He's had plenty of experience with unexpected rush periods. But he does fault it for lack of good customer relations procedures.

"All they had to do was have someone pop her head out the window, apologize for being backed up, and say they'd get to me as soon as possible," he says.

That's what Dr. Turner, founder of 26-doctor Affinity Health Group in Tifton, Ga., has trained his receptionists to do. "We acknowledge patients, try to serve them as well as we can, and apologize and explain when an emergency or unexpected event delays things."

Experts say Dr. Turner is right in paying so much attention. In most cases, the receptionist is the first person any patient will deal with in your practice, whether in person or on the phone. A pleasant receptionist who can read the mood of a patient can kick off a pleasant experience for the patient. A gruff, curt receptionist oblivious to your patients' needs can make a patient think twice about coming back, regardless of the quality of care. Even an overly chatty or giddy receptionist can annoy some patients.

And, personality aside, a receptionist who can't answer patients' basic questions can torpedo a good patient-physician relationship, experts say.

Experts say there are three keys to making sure you have the right person as the face and voice of your practice: hiring the right person, training that person and supervising him or her. What sort of personality do you want representing your practice, and how do you find it? How do you make sure that personality comes through, and that the person can handle the nuts and bolts of the job? How do you keep tabs to make sure the face of your practice is still as pleasant as the person you hired?

This is important not just for marketing and keeping up your practice's good name. Having the right receptionist (often the subject of patient survey questions) can help boost your patient satisfaction scores.

Hiring and training the right person

Lee Wan, MD, an ophthalmologist with two-physician Coastal Eye Specialists in Oxnard, Calif., believes that to a certain extent, receptionists are born, not made. "When we interview for that job, we look for someone who's naturally a people person," he says. "Someone who communicates well; and someone with a smile in her voice as well as on her lips." (Not that every receptionist has to be a woman, though traditionally most are.)

Finding that type of person is usually an intuitive process for an experienced administrator or physician. "You can get a pretty good idea of an applicant's personality just by spending some time with her," says Peggy Tedesco, practice administrator in a three-doctor internal medicine and family practice in Park Ridge, N.J.

Besides just chatting up potential receptionists, Tedesco questions them closely on how they would handle various situations, such as patients who are angry because people who came in after them seem to be going in first.

But for Tedesco's practice, an interview isn't enough. Any receptionist starts on a 90-day trial period before being hired permanently. That way, the practice can work with people who are having problems and try to accommodate an individual's strengths and weaknesses. For example, if someone seems to be more adept at phone than live interactions, Tedesco may try to schedule that person accordingly. But the trial period is just that: People who do not work out are terminated.

Experts also advise that the issue is less getting someone with a bubbly personality than someone who projects energy, confidence and a positive attitude.

If hiring right means getting the best ingredients for success, training is the recipe that makes it happen.

Lisa Forshee, director of marketing at Dr. Turner's Affinity Health, also is responsible for setting up receptionist training programs.

She likes to set the tone with months-long, or even year-long, themes, such as "attitude" or "customer service." She holds classes, provides literature, decorates the office with material that exemplifies the theme and holds optional book club meetings.

Barry Himmel, senior vice president at management consulting company Signature Worldwide in Dublin, Ohio, agrees that maintaining good office morale and avoiding the sense that training is being stuffed down receptionists' throats improve the program's effectiveness. "In a one-day course with receptionists, we'll spend literally one-third of the time developing buy-in," he says. Receptionists need to know why the skills they will be developing are important for the success of the practice, and why it's important for them, both as employees and as caring people, to help the practice to serve patients to the best of its ability.

Once receptionists understand and accept the importance of the program, Himmel moves on to basic skills such as getting the patient's name early and using it often; cultivating an enthusiastic tone of voice; empathizing with patients when they have problems; and never expressing frustration even at patients who seem difficult or demanding.

Himmel also believes that training classes should allow receptionists to voice concerns and reasons why they may not be able to fulfill the customer service requirements. "I have had times when, after we explain that the phone should be answered in no more than three rings, receptionists respond that during certain times of the day, that's impossible," he says. So sometimes a change in office procedure is essential to move the training from being merely theoretical to practical. Accordingly, Himmel encourages the office administrator and even doctors to attend the receptionist training.

At the end of each program, Himmel distributes a tip sheet that receptionists can keep at their desks to remind them of such things as how to answer phones and greet patients at registration.

As far as medical terminology training, most doctors rely on current staff to train newcomers. Dr. Wan says he has been fortunate in that "we've always had at least one very experienced receptionist on staff to act as tutor to new receptionists." In addition, Dr. Wan keeps training manuals on hand.

Also, he has created a triage matrix to help get the patient to the right person at the right time. He says his practice is very complex, with some people coming in for ophthalmic care and others for vision care (the practice has one optometrist). In addition, some patients need to schedule a regular eye exam, while others are having problems that require more immediate attention. The guide takes a lot of the guesswork out of the receptionist's decision.

Supervising your receptionist

Despite well-thought-out hiring procedures and effective training programs, problems can arise at any time. Even the best and most pleasant receptionist might, because of personal problems or burnout, require refresher training in customer service skills, or even some time away from the practice. For that reason, experts say physicians and any office administrators have to be diligent about looking for telltale signs that a receptionist might not be operating at peak performance.

In general, doctors will be the first to hear patients' complaints about receptionists. But consultants say that too often, doctors merely try to pacify the patient and do little administratively to ferret out the problem. That could be a serious mistake.

"Any complaints [about receptionists], no matter how minor, should be referred to the office administrator," says Donna Weinstock, a medical management consultant with Office Management Solutions in Northbrook, Ill. And if you don't have an office administrator, that means you will have to correct the complaints yourself.

Weinstock, who was an office administrator for a four-doctor practice for 17 years, will linger around the receptionist areas to listen to how they interact with patients. She also listens to telephone conversations, but never to both sides.

"I can usually determine that there's a problem by hearing the receptionist's side of the conversation," she says. After the call is over, Weinstock will sit down with the operator and find out the details of the problem. If she feels the operator handled the situation well, she offers a verbal pat on the back. If not, she might discuss better ways to handle similar situations.

Behind-the-scenes checkup

Himmel is a big believer in using mystery shoppers -- people hired to act as potential patients -- as part of the supervising process.

Typically he'll have different people call in at different days and times during the week asking questions about the practice: who the doctors are, how long it takes to get an appointment, what insurance programs the practice accepts and so on. He usually also will send at least one person through the entire process from check-in to check-out (with the doctor being the only one who knows the "patient" is actually a mystery shopper).

Himmel believes transparency increases morale, so he suggests warning the staff ahead of time that a mystery shopper will be showing up at some point. And he doesn't use the results as a hammer to hit the receptionist over the head, but as a training tool. In fact, he sometimes plays back recordings of the telephone conversation to the receptionist to help point out areas that could be handled a bit better.

Finally, many experts say that as the face of the practice, receptionists can also be its eyes and ears. "Receptionists may see patterns that aren't obvious to other staffers," Weinstock says. For example, receptionists are usually the first to notice that the time between check-in and check-out is getting longer. And they hear patient grumblings that indicate problems -- even seemingly minor ones such as uncomfortable seating -- that other staffers are unaware of.