How to overcome the biggest bottleneck in the doctor's clinic

Difficult relativesAngry patientsLazy staffUntrained nursesIT officerSpouse

Try to do too much. Overbook patients, run from clinic to clinic, always late

Rude to patientsShout at staff and micromanage. Do not delegate

Waste time talking to MRsUndisciplined and disorganised

You are the problem - which means you are also the solution !

You need to get out of your own way and stop hurting yourself

•Only 1 of 20 unhappy patients bother to complain.•Others walk out of your clinic and tell ten others about their bad experience.

You are the most valuable resource in your clinic

You are the bottle neck in your clinic

Problems have become worseSmartphone - expected to be

on call 24/7Our time is not our own -

doctors live chaotic livesDaily wage earnersNo work life balanceBurnout !

Set prioritiesDelegate responsibilitySay NO !Organise your work area

Don’t waste time !

Do it nowDo it soonPut off until laterDoesn't need to be done

You are the bottle neck in your clinic – and the most highly paid resource

What can you get someone else to do ?

Create clear SOPs with a due dateRemember there is a learning curve –

be patient and follow up Don’t dump your work on an

assistant!

Doctoring time = doing valuable clinical work. When you are in flow = in the Operation Theater

Delegate-able timeDowntime = wasted time. Causes frustration

Time lost while waiting for meetings; patients; and while commuting.

Reclaim this time !Read medical journals on your smartphone

Listen to CME podcastsMultitasking !

Staffing issues ( insufficient, unreliable, unproductive staff)

Emergencies (unexpected complications)

Scheduling problems (overbooking)The heartsink patient – long list of complaints and inquiries

Like making patients wait !

Brainstorm about the ways that time is wasted

Come up with strategies to reduce these inefficiencies

The consultation is free if you are more than 60 min late

Convenience ? Cost ? Clinic ambience ?Reputation ?Justdial ? Practo ? Google ?Referral ?Parking availability ?

Not your perception – the patient’s perception

Life is not always fair.Not all busy doctors are good – and not all good doctors are busy

No point in complaining about this. Learn to accept reality !

Soft skills are often more important than clinical skills

UnderpaidNot respectedOverworkedGet flak from doctor and patients

No training providedNo infrastructure for better customer service

I. The patient is never an Interruption - the patient is your work.

Everything else can wait ! II. Greet every patient with a smile.III. Call patients by their name. IV. For patients, all staff members are as important as the doctor !

V. Never argue with a patient. Be a good listener.

VI. Don’t say, "I don't know.” Say “ I will find out”.VII. The patient pays your salary - treat him like your boss !VIII. Choose positive wordsIX. Always go the extra mile. Exceeding patient expectations is the best way of

keeping patients happy !X. Brighten every patient's day. This will

make your own life happier.

• Follow flowcharts for improving workflow!• Need processes which your staff can followHow to answer the phoneHow to greet a new patientHow to help them fill up a form

Doctors usually create bottlenecks !

No interruptions when you are with a patient

No phone calls during clinic hoursReturn all calls at a fixed timeIntelligent phone systems for recording all calls. Cloud based virtual receptionist

I prefer email – no phone tag

•Reminder SMSes to reduce “noshows”•Prescribe apps to your patients•Set up whatsapp groups•Ezines

This does not mean that there are no problems or that all your patients are happy with you

The truth is that most patients are scared to complain and will not tell you they are unhappy to your face

How many of your patients refer their friends to you ?

“The patient will never care how much you know, until they know how much you care !”

Medical training is arduous and kills our humanity. Sleep deprivation and fatigue means residents are overburdened

Juniors are treated badly, and they in turn treat their patients badly

No good role modelsPoor , illiterate patients are scared

and will not speak up

E - Eye contactM - Muscles of Facial Expression

P – PostureA - AffectT - Tone of Voice, TouchH - Hearing the whole personY - Your response

There will be slips and lapsesMaster the art of service recovery

Take ownership of the problem – it’s your clinic !

Don’t abandon the patient !

• R = Re-establish rapport ( empathy)• A = Agreement ( get the patient to say

Yes)• P = Problem ( define this)• S = Solution• A = Ask Permission ( is the patient happy

with the solution you have offered ?)• N = Next step ( Follow up)• D = Document

Doctor did not explain properlyNot enough time with the doctor

Unnecessary long wait time Rude staffOverchargingPoor documentation

Learn to give a second opinion tactfully

Highlight all the correct things the earlier doctor has done

Don’t play the game of oneupmanship

Anatomy Hardware Software – Human resources

Physiology Pathology

Diagnosis Patient feedback Learn from other doctors

Treatment Staff Consultant

Treat all patients as VIPs.

Respect them !The lifetime value of a patient