Physical Therapy top 10 customer service Initiatives By Chris Bryan
Top 10 • 1.) Access • 2.) Friendliness • 3.) Thoroughness • 4.) Clarity • 5.) Quality • 6.) Empathy • 7.) Attentiveness • 8.) Continuity • 9.) Humor • 10.) Measurement
Access • Physical Therapists are making great strides toward improving our accessibility; however, most of our referrals still come from physicians. Most 3rdparty payers won’t pay for PT without physician referral. This directly increases our patient’s costs. Direct payment for direct service must be a priority for all PTs. • Copayments should be reasonable. PTs are currently classified as specialists. Increased costs, in the form of higher specialty copayments, reduces access. Some states have mandated that PT copayments equal primary care physician copays. We should all support this national initiative. • 49 states have some form of direct access for PT, but few patients know this. We need to do a better job of marketing our accessibility to the public and employers. If they only knew our skills and our effectiveness.
Friendliness • It’s critical that all staff members foster a positive and friendly environment; moreover, it must maintained throughout the patient’s course of care. Healthcare is a demanding field,but rudeness and indifference to patient problems will likely destroy loyalty and repeat business. • A smile and a kind greeting in the waiting room set the tone for the session. • Answer the phone with a smile. Our attitudes and emotions are easily perceived in our voices. • It’s also important to be personable and friendly to the patient’s spouse or significant other. Take the time to learn their names and consider their perspectives.
Thoroughness • The musculoskeletal examination of a physical therapist must be second to none. I think this is where our profession can shine. I suspect that cursory physician examinations are driving patients to insist upon imaging studies and lab tests. A comprehensive examination is simple to conduct, inexpensive, and increases the patient’s confidence in our conclusions. • It’s tempting to rush through simple examination procedures for familiar diagnoses, but don’t. We may miss sinister pathology mimicking a MS disorder if we rush. Diligent ongoing examination and assessment is a fair price for autonomy.
Clarity • We must define what we are treating. Provide a quick summary of your findings at the end of your examination and use the patient’s feedback to rank the findings/problems in order of importance. Your top concern may not be theirs • We must state the length of a course of care, what are realistic goals, and give a reasonable approximation of costs. • Briefly explain why you are proctoring certain tests and procedures. I have found that most patients are fascinated by the human body/medicine, and how a diagnosis is formulated. I find this form of patient education creates a bond of trust. Moreover, some patients feel like you are providing them with secret trade knowledge. We should seek to demystify what we do, not cloud it with jargon.
Quality • Health care is expensive! Often patient’s don’t receive optimal care for their problems. PTs must strive to formulate treatment plans based on the three legs of the EBP stool: current best evidence, patient values, and clinical expertise. • Continued professional development is critical! Mentorships, residencies, fellowship, advanced degrees, journal clubs, continuing education courses, annual conferences, and APTA section meetings are all methods that can be used by therapists to improve their skills and reasoning. We simply can’t keeping doing things the way we used to unless it’s supported by evidence. • Patient’s know quality when they experience it.
Empathy • Patients need to know we care about them. I think most physical therapists truly care about the wellbeing of their patients, but it’s important that we demonstrate our empathy to patients in a way they can understand. For instance, the mother of a patient of mine died during his course of care. My PTA and I offered our condolences when he told us, but we also mailed him a bereavement card. This simple gesture profoundly improved our interactions with him. • A follow up phone call, email, or letter will positively affect patients. Typically the only thing a patient receives from us upon their discharge is the bill, and a call from a third party customer service surveyor. Therapist follow up communication demonstrates compassion, concern, and in my experience improves loyalty
Attentiveness • There is no greater kindness or endearment than providing your patient with undivided attention. We all know how it feels when a patient takes a cell phone call or texts during a consult or treatment session. Patients feel similar when we are jockeying our computers, and or speaking with our colleagues and other patients across the gym. • Listening is the key to attentiveness. • Hearing is not listening. Listening is an active process which requires thoughtful communication/interaction. Physical therapist are extremely busy and it takes time and great effort to properly listen in a crowded gym. Usually the person in the room, with the best insights into a patient’s problem, is the patient.
Continuity • Patients bond with their therapist during their initial consult. Their PT may be the first medical profession in years that took the time to listen to their concerns, educated them about their problems, and answered their questions in a way they could understand. They may consider seeing your assistant as an act of betrayal. Moreover, seeing multiple assistants or providers in your department is sure to destroy continuity and foster frustration. Patients do tire of explaining their problems again and again to new providers. • Repeat patients don’t always see the same clinician where I work, and when they see different a PT that PT should provide similar treatment, examination, and education. Our product should be the same. A heart catheterization is essentially the same all over the country. PT should be too.
humor • Robin William may have taken some artistic liberties when he portrayed Dr. Hunter Adams, in Patch Adams, but humor does heal. We don’t have a particular clinician in our department like Dr. Adams, but our clinical staff is great about including patients in funny stories and jokes. Not a day goes by where the whole gym isn’t in a uproar from a joke a patient or staff member told. • Humor takes the edge off. Let’s face it PT is not always fun! It can be painful to have a tight shoulder or knee stretched or boring to participate in a work conditioning programs for 2-3 hours per day for 2 weeks. Humor is a great way to keep patients interested in coming to the clinic and keeps their mind of the reality of their situation.
Measurement • We cannot play to our customer service strengths or redress our weaknesses is we are not measuring them. • Data collected by third party surveyors can be helpful, but a according to article, The One Number You Need to Growby Frederick Reichheld, we should be asking all our patients how likely is that they would recommend our services to friends and family? • Not only does this question measure loyalty it also measures growth. • Customer service metrics may vary by other factors such as culture, geography, and by the market pressures.
References • Larry Benz-Customer Service Principles • Sanders T. The Likeability Factor. How to Boost Your L-Factor & Achieve Your Life’s Dreams. Crown Publisher. New York. 2005 • Wood D. Money Talks: Reimbursement and other payments issues are top concerns in 2013. Today in PT. 2013; 5:10-12. • http://www.apta.org/StateIssues/FairCopays • http://www.apta.org/PTinMotion/2012/3/Feature/FightforFairCopays/ • Reichheld F. The One Number You Need to Grow. Harvard Business Review OnPoint Ed 5534. 2003(12).