Efficiency in the Urology Practice, Part 1: Preparing the Patient for the First Visit

Neil H. Baum, MD
Dr Baum is Professor of Clinical Urology, Tulane Medical School, and Principal, Neil Baum Urology, New Orleans, LA

Never before has the concept of efficiency been more important than in 2016 and beyond. Urologists are experiencing a decrease in reimbursement and rising overhead costs, resulting in a potential contracture of their incomes. It does not matter the kind of practice you are in, its size, the location of your practice, or if you are in private practice or are an employed doctor—you will need to place an emphasis on how efficient you are in your practice.

This is the first article in a 3-part series that will discuss:

  1. How to prepare the patient for the urology visit before the patient enters your practice
  2. Managing the patient once he is in your practice
  3. How to continue the encounter after the patient leaves your office.

Before the Patient Enters Your Practice

The patient’s interaction with your practice begins long before the doctor is face-to-face with the patient. It usually starts with the telephone, which is the lifeline of your practice. Far too often, office managers delegate the job of answering the telephones to the employee with the least amount of training and the lowest salary. However, a new patient’s initial telephone call is the first interaction between the patient and your practice. During that interaction, you have a golden opportunity to create a positive first impression on the patient. If you (or your office ambassador, the receptionist) fail to create a positive impression, the patient may form a negative opinion of you and your office even before the patient has met you or your staff. The take-home message is that you only get one chance to create a first impression.

Next, the receptionist should be directing the patient to your practice’s website. If possible, the receptionist should identify the reason for the patient’s visit. Then, the well-informed and knowledgeable receptionist should direct the caller to a webpage with educational material that is pertinent to the reason for the patient’s visit to the urologist. For example, if the patient is requesting an appointment for an evaluation of elevated prostate-specific antigen (PSA) levels, the receptionist can direct that patient to an article that discusses the concept of PSA elevation, and the tests and procedures that may be done to evaluate an elevated PSA level.

To become more efficient, patients should complete their demographic information and a health questionnaire before they come to the office. These forms should be available on your practice’s website, and should be able to be submitted electronically or printed and brought by the patient to your office, where the forms can then be scanned into the patient’s electronic medical record.

By completing these documents before their office visit, patients can avoid a 20- to 30-minute wait in the reception area to complete this information. Patients should be told that they will be seen on time if they complete this information before the visit, and should be asked to bring a list of all of the medications they are taking, including any over-the-counter drugs or supplements.

Patients should also be informed that they will be seen in a timely manner if they bring copies of their laboratory work or the results of any tests or procedures they have had. For example, if patients had previous blood tests, imaging studies, or pathologic reports, they should bring these to your office at the time of their first visit. This prevents having reports sent to the office and not being easy to locate. It also avoids the need to call another office to receive a copy of a report, which usually necessitates a signed request, retrieval of the report, and the time it takes to fax the report to your office, all of which can significantly delay the patient’s visit.

Another simple suggestion is for the receptionist to tell the patient that a urine specimen will be necessary at the time of the first visit. Patients should also be informed about consuming fluids before they come to the office, and should let the front desk know that they are ready to give a specimen on arrival, or if a flow rate is needed, they will have to be hydrated to have a full bladder.

The receptionist should tell the patient approximately how long the first visit will take, and what will be done during that visit. For example, if a man is being evaluated for an enlarged prostate gland, he may be told that he will be requested to do a flow rate, a bladder ultrasound, and possibly a cystoscopy. He should then be informed that the procedures are explained on your website, and that he should read about the tests so he is ready to have the tests on arrival at the office.

These simple steps can easily be accomplished in any urology practice, and can result in a significant improvement in practice efficiency. With these steps in place, a new patient can begin the process of becoming part of your practice before that patient enters the practice. These few steps are easy for the patient and for your staff, and can improve the efficiency of your practice, allowing the doctor to see more patients and to be more productive.

Dr Baum is Editor of The Complete Business Guide for a Successful Medical Practice, 2015 Edition.

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