Doctors > Resources for Physicians > Guidance for Doctors and Staff

How to make office visits a positive experience

Last update: 04/24/2004

Patient Perspectives on ...

Personnel | Waiting Rooms | Scheduling & Test Results | Consults | Treatment Days

Personnel

Your personnel sets the tone.
 

• Hire friendly, smiling, optimistic office staff personnel who genuinely care about your patients. This is the most important aspect of making me feel comfortable in your office. 

• Please have your staff wear name tags. People like to know the names of those they speak with. First names are sufficient. "Rank" is optional.

• If it is necessary to keep the glass in front of the staff area closed, please put a sign on the patient side to the effect that if patients or caregivers need anything, please tap on the glass or open it.

• Designate a staff person for patients to call if they have concerns or a problem - a contact person. If you are willing to communicate via email, please include your (or your staff's) email address on your appointment card, in addition to your telephone and fax numbers. 

• Advise your personnel to reach out and comfort those who may be alone or seem apprehensive.

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Waiting Rooms

Please pay attention to the atmosphere in your office. 
The more home-like it is the more relaxed and comfortable your patients will be.
 

• Create a pleasant and friendly environment in the waiting room.

  • flowers or live plants, or an aquarium with colorful fish, it helps to pass the time;

  • attractive (non-institutional) art, 

  • photographs of patient success stories (if HIPAA will allow), 

  • a wide variety of magazines that appeal to all ages (including small children) and interests, and sufficient lighting to read in comfort;

  • a display place for any free newsletters or catalogs of items of interest to oncology patients (wigs, head coverings, etc.),

  • a bulletin board for notices of support groups or seminars of interest to patients

  • a few lap throws; ill people sitting for long periods of time get chilly.

• Remember odor control. An air purifier will go a long way towards removing sometimes aromatic remnants of a lot of people packed into a small space.

• Remember noise control. There should be sufficient insulation to prevent patients from overhearing other conversations in exam rooms. "Elevator music" or easy-listening radio music can help, too, in the waiting room, and can make it seem less sterile.

• As you open and close your doors, think of your patients. Does it take both arms and a little muscle to open them? Patients may not have the strength to do so.

• Easy access to restrooms is critical. If yours has a key, make certain it is hung in an easily accessible place that is readily visible. A "call button" in the restroom is a nice feature, too.

• When choosing office furniture, please remember patients come in all sizes. A couch that will comfortably seat a man more than six fee tall will not comfortably seat a five foot tall woman who has just had abdominal surgery.

• A source of water and cups are nice. If you want to go all out, a coffee/tea/cocoa/hot water tray would be welcomed by patients who often must wait for long periods of time. 

• If possible, provide Internet connections for family members who may have to wait for patients are a real plus. 

• Kleenex boxes are essential.

• Utilize waiting time:  

  • provide educational information, 

  • provide pamphlets on special services, such as pain specialists and care managers.

  • check if labs or imaging results have been received, and that authorizations and referrals are in order. 

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Scheduling and Test Results

When patients know what to expect, 
they are less anxious and able to participate effectively in the consult.
 

• See patients as close to on time as possible. 

• Please inform patients when delays are unavoidable.

• Please return results of scans and similar tests as quickly as possible to reduce patient anxiety. 

• When patients are to be scheduled for a diagnostic test, it is helpful for them to have information about the test. What will it show? How do they prepare? What can they expect? How long will it be before they get the results. 

• Try not to leave anyone alone for too long. Designate a person or care manager to be with patients who are alone, especially if you sense that they are feeling overwhelmed.

You can't have both on time appointments and plenty of individualized attention to all of your questions. I vote for the latter as more important. Some work to do and my ipod can make long waits go by and I appreciate getting my oncologists full attention. One day they were running quite far behind and I was amazed that when I did get seen, we had her full attention to every question we asked and never felt rushed at all. I couldn't do that, I would be stressing over the schedule, but I am glad my oncologist has that sort of concentration. I'm sure I made the delays even worse on the next people. ~ Andy

Patients seem to be viewed as a captive audience in any place that I've ever gone to, and an infusion of "customer service" mentality would go a long way to improve the overall experience with scheduling, delays, billing issues etc. ~ Rick

"Besides being tiring and annoying, extensive waiting times are disheartening. We have been made to wait in the outer waiting room one hour minimum at XYZ for our doctors appointments, and then we are shown to an exam room where we wait an additional 1/2 to one hour." ~ David 

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Consults

Caring, realism, inspiring trust and hope 
 

• Provide seating in the clinic room for the patient and their caregiver, as well as the doctors.

• Please read my chart before you come in.

• Smile, and be attentive. 

• Sitting communicates that this time belongs to me. Talking up to the standing doctor reduces eye contact.

• Remember a few things about me, and ask questions about my life, such as how I'm managing.

• Please do not make me feel rushed. Let me know if you are running late. 

• Be realistic, but always provide me with some hope. 

• Please try to bring the medical terminology to my level.

• If you don't know what my diagnosis is, be comfortable saying "I don't know." 

• Don't discount the symptoms or feelings I describe. 
  (Patients can know that something is wrong, even when it doesn't show up on lab tests.)

• If you see that I'm too overwhelmed to absorb the information, please schedule a second appointment for a few days later, and refer me to a care manager or other resources for assistance if needed.

• Please do not give me more than I am ready to hear or see. If I tell you I don't want to see an actual scan that shows tumor spread, please, please respect my wishes. 

• During a consult, please answer phone calls only when they are emergencies. 

• Please respect, rather than discount, my level of my knowledge, and correct any misinformation that I might have received from the Web or other sources. 

• Please ask me if I'd like copies of test results, and explain abnormal finding, or provide me with the educational materials necessary to interpret it.

• It inspires trust when you encourage me to get a second opinion. Please do not leave it to me to ask.

• Please include  involve me in the treatment decision, including clinical trials that I might be eligible for. (see Clinical Trial) 

On active listening: When I was first diagnosed, that oncologist spent all of the time talking about how wonderful the UP Health System was and how they had the greatest staff and newest treatments. I expected cheerleaders to show up at any second. When I met with my current oncologist for the first time, he spent lots of time asking questions of me, listening to my questions and responding accordingly. He is a good active listener. ~ Rick

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Treatment Day

When patients know what to expect, 
it can go a long way to prevent problems and optimize treatment results.
 

• Patients who are scheduled for chemo want to know what to expect. This is new and unknown, and it can be scary. The more the patients know about what to expect, the less anxious they will be. 

  • How should I dress? 

  • What should I bring with me? 

  • Can someone stay with me? 

  • Should I eat first, or not? 

  • Should I take my usual medicines or not? 

  • How long will I be there? 

  • Will I be able to return to work? 

  • Will someone need to drive me and pick me up? 

  • Can you provide a tour of the chemo room beforehand and introduce them to the staff who will be caring for them? 

  • Please provide me with readable information about each of the chemo drugs I will be taking. 

  • If drugs to control nausea will be needed, please provide the prescription several days prior to the first chemo treatment. 

    Prior approval may be required by my insurance company. Delays - and unnecessary suffering - can be avoided with sufficient advance notice. 
     

  • Which post-chemo symptoms require attention?

    • Which ones merit an immediate call?

    • A call the next day?

    • Which symptoms can wait until the next appointment?

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Summing it up: "He is very excited about what he learned at the ASH meeting this year. His PA, chemo nurse and office manager/receptionist are efficient, friendly and even at times a little zany. We feel lucky to have found this practice close to our home. To sum up, we need doctors who listen, who learn, who realize we have our own best interest at heart and who keep their staff happy. ~ France (NHL-Info)