Guest Blog: Make Someone Happy – Julie Bissett, Practice Managers Magazine


I would like to thank Julie Bissett who is a freelance journalist and editor of Practice Management Magazine for her guest post

 

Make someone happy

Julie Bissett asks what better way to improve your patients’ day than with a smile and some good humour

‘Smile if you’ve had it lately’ – these were the words on a bumper sticker my father slapped onto the back of our Ford Escort during the 1970s. I believe it was promotional merchandise for a local garage advertising their servicing provisions. Not a man given to crude innuendo, I was mortified at dad – and the sticker’s – suggestive tone. Dad, meanwhile, thought this even funnier than the cheeky message it conveyed to car drivers behind us.

We may have missed a trick here – what a fabulous tagline for a GP practice! Or maybe not…

But the real point is that, firstly, we all love a laugh and, secondly, we all welcome a smile, especially when stressed. On a bad day, the meeting of patient and GP receptionist can seem like the paradox of immovable object versus an unstoppable force – and, surely, something’s got to give?

Sassy

It may be tough to do – but a smile really does conquer the toughest of customers’ attitudes. We all need something to positively trigger our thoughts, senses and actions when we’re feeling fraught, ill or worried – and nowhere is this more relevant than at the reception desk of a GP practice.

In the increasingly competitive world of healthcare, a practice now needs to promote itself in the same sassy style as an advertising campaign might, for it cannot afford to get left behind, remain staid and prescriptive, or, indeed, come under fire in an increasingly ‘TripAdvisor’-esque world of online healthcare feedback forums.

A front desk team is a GP practice’s shop window that needs to welcome its audience – the patients – with a massive desire for them to be on side in an environment hugely pressurised. It’s you, the receptionist, often taking the brunt of the day-to-day demands on a practice. Many people demand your time – from GPs and practice nurses to pharmacists, specialists and hospital consultant PAs.

There are equipment suppliers to consider, recruitment agencies on your tail and protocols to adhere to and to remind everyone else about, also. You handle referral letters, prescription requests, and doctors’ letters. Patients –whether on the phone, in an email or face to face – should live up to their name while you juggle all this and more, shouldn’t they?

KISS principle

The KISS principle (keep it simple, stupid) – the acronym used by designers and engineers – translates well into the medical arena. Without meaning to offend, we should all strive to reach the lowest common denominator when communicating; not because we consider our patients incapable of understanding the science behind the mechanics of their care but because we all lead busy lives and bullet-point information is the perfect way to ensure we convey – and they retain – knowledge we expect to be squeezed into brains already jam-packed with ‘stuff’.

Look at life around us and consider what works and what we now instantly recognise – and why:
• Golden arches means ‘fast food here’
• A flashing SLOW DOWN sign means that: slow down in a built-up area
• And a beautifully shot retro TV ad of a truck ploughing through the snow with Coca Cola on its side can only mean that the Christmas ‘Holidays are coming’.

A smile could be YOUR practice’s very own marketing icon – it’s very difficult to remain angry when anyone smiles at you. It’s a reminder that we’re all human – even tricky patients and much-maligned doctors’ receptionists. It’s simple idea; it may also prove great marketing – but, most importantly, it’s a healthy option for us all.

 

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Its Not Always About The Patient #Dementia #Carer


There are currently approx 800,000 people with dementia in the UK.

Over 17,000 are younger people with dementia and there will be over a million people with dementia in the UK by 2021.

Two thirds of people with dementia are women. One third of people over 96 have dementia.

60,000 deaths a year are directly attributable to dementia.

The final cost of dementia to the UK will be over £23 billion in 2012.

There are 670,000 carers of people with dementia in the UK

Carers of people with dementia save the UK over £8 billion a year.

Identify

Do you identify on the patient’s records that they have dementia; this will often help when the carer is making an appointment on their behalf.

If the carer is a patient at your Practice do you identify them as a carer? Often carers have medical conditions related to being a carer.

  • Back problems due to lifting the patient.
  • Depression. Often due to isolation.
  • Not sleeping due to caring for the patient.
  • Other medical conditions

If medical issues are not identified it can often lead to the carer becoming unwell and the patient having to go into hospital or a nursing home.

Carers save the NHS a lot of money caring for people in their own home. Carers need the support to help them continue caring for their loved ones at home.

Yearly flu vaccinations are vital, if the carer has a bad attack of the flu the cared for person will often have to go into respite care.

Appointments

If a carer telephones for an appointment always try and accommodate them in a time or day that is suitable for them.

Carers will often accompany the person with dementia to the GP. The carer can often describe the symptoms or problems to the GP or Nurse. The carer can often remember afterwards what was said and provide the appropriate support.

Confidentiality

Sometimes people with dementia prefers to see their GP alone, or it may not be possible for anyone to go with them. If this is the case a family member may wish to talk to the GP afterwards. When a carer or relative contacts a GP with concerns about a person, the GP may decline discussion on the ground of breaking patient confidentiality.

The General Medical Council (GMC) has issued guidance on this matter (confidentiality 2009) The guidance states that doctors should listen to the concerns of carers, relatives, friends or neighbours because they may have valuable information that can help the patient. The GP should make it clear they may tell the patient about the conversation.

Respecting Cultural Values

Some patients might have cultural or religious background. If so it is important if these are identified that everyone at the Practice acts accordingly. These may include:

  • Religious observances, such as prayer and festivals
  • Touch or gestures that are considered disrespectful
  • Ways of undressing
  • Ways of dressing the hair
  • How the patient washes or uses the toilet

The person with dementia might not be able to explain about their culture so it is important that the carer informs the Receptionist or the Doctor before the appointment.

Training for Receptionists

It is important that your Receptionists are not only aware of patient needs but the needs of carers too.

By understanding any illness or disability it can often help when dealing with patients and their carers over the phone or at the front desk.

There are lots of organisations dealing with dementia that would be more than willing to come and talk to your receptionists and give them some insight into the life of someone suffering with dementia and that of the carer too.

Here are so do’s and don’ts of communication that might be useful for Receptionists.

Do

 

Don’t

Talk to the person in a tone of voice that conveys respect and dignity.

Talk to the person in “baby talk” or as if you were talking to a child.

Smile – this will help relax the person.

Don’t argue – the demented brain tells the person they can’t be wrong

Maintain eye contact by positioning yourself at the person’s eye level. Look directly at the person and ensure you speak clearly.

Glare at the person you are talking to. Always use good body language.

Use visual cues whenever possible.

Begin a task without explaining who you are or what you area about to do.

Be realistic in expectations.

Talk to the person without eye contact, such as while typing on the computer.

Observe and attempt to interpret the person’s non verbal communication.

Try and compete with a distracting environment; Loud noises, other people talking at the same time.

Use positive body language and a reassuring tone of voice.

Provoke a reaction through unrealistic expectations or by asking the person to do more than one task at a time.

Speak slowly and clearly

Disregard talk that may seem to be “rambling”

Encourage talk about things that they are familiar with

Shout or talk too fast.

Be kind – treat them, as you would want your family to be treated.

Interrupt unless it cannot be helped.

Keep your explanations short. Use clear and flexible language.

Invade their personal space if they are showing signs of fear or aggression.

 

Invade their personal space if they are showing signs of fear or aggression.

 

Use complicated words or phrases and long sentences.

Carers

Does your practice have a Carers Group? Such groups have proved to work extremely well in many surgeries.

I formed a Carers Group at my Surgery and the group would meet every 3 months, at lunchtime. Carers that were caring for people with all disabilities would come along for 2 hours to sit and chat. We would have different organisations attending the meetings on subjects that would help the carers in many different ways. We would have someone in from Social Services to talk about their entitlements. Someone in from Help and Care would come and help out, the local Fire Officer would come in and talk about safety in the home, and we would often have local businesses coming in to show support in many different ways.

But the most important part of these Carers Meetings were that the Carers had someone to talk to, people who understood what they were going through. Friendships were formed and often problems halved.

And finally……….

Each person with dementia is an individual with their own experiences of life, their own needs and feelings, their own likes and dislikes.

Dementia affects each person in a different way.

We all needs to feel valued and respected and it is important for a person with dementia to feel that they are still valued.

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© 2011-2017 Reception Training all rights reserved

Communicating with your Receptionists #Managers


Being a doctors receptionist is no easy task, and certainly not the job some people seem to think it is, some think it’s sitting at the desk booking patients in to see the doctor and handing out prescriptions, oh no it’s so much more and more again. Being a doctors receptionist is a bit like marmite, you either “love it or hate it”. The receptionist that ‘loves’ his/her job will be loyal, hard-working and very proactive. They are the ones that can see problems ahead, make the best suggestions and really want the best for the practice. They are the ambassadors of your practice.

It saddens me when at some of my training sessions I hear that they sometimes do not feel appreciated and they don’t feel part of the team. They often blame Management for lack of communication who are occasionally not caring and unapproachable. This might not be true, but it’s how they feel. Lack of training is also another complaint that I hear of often. Many Receptionists feel that they could do so much more in their role, if only they had the appropriate training. This is where I step in and defend the managers! I know how hard the role of a manager can be, often being piggy in the middle; the Partners shouting on one side and the Staff on the other. There are budgets to follow and targets to hit, whilst trying to stay loyal to both sides. Being a manager can often be a very lonely job. Who is there for the Manager when it gets tough?

My role of manager soon taught me that communication is key. In communicating with the receptionists I came to learn, first hand, what the problems in reception were, before it got too late and became a bigger problem than it already was. Receptionists need to know what is going on, if they don’t they often jump to the wrong conclusion. They will often gossip between themselves and make up their own minds, which can often cause bad feeling within the team. Having a team with a low morale is often extremely hard to turn around.

What is the best way to communicate with your receptionists? Hold Regular staff meetings; weekly, twice monthly or monthly.

  • Ask the staff to contribute to the agenda, make the meetings their meetings.
  • Make the meetings interesting! If they are interesting the staff will actually want to come, they will contribute and as a result they will be a success.
  • Rotate the meetings on different days and times to enable part-time staff to attend at least every other meeting.
  • It’s your chance as a manager to give the facts, to tell them as a team what is happening within the practice; it’s a great way to avoid rumours and discontent.
  • Take minutes for future reference and make copies available for those that were unable to attend. Make a copy for the partners too.
  • Ask a Partner to attend a couple of meetings a year, this shows support, and in my experience, always goes down very well with the receptionists. It also gives the Partners an insight in what is happening in reception and how hard their roles can often be.
  • Use the meeting to discuss any issues that have occurred and ask the team how they feel it could have been dealt with, often they will come up with the solution. This will help in the future as they will then start to solve problems themselves, rather than running to you every time, expecting you as the manager to have the answer. Meetings can often make the team more proactive.

Another complaint is lack of communication. Often, many of the staff will be told something but others don’t hear about it. This can lead to confusion and often anger, which can result in jobs not being done properly, as some staff have not been informed. A lot of the time this happens to staff who are on holiday or that work part-time. Memos or emails sent to every member of the team seems to work well. Having a receptionist message book works extremely well. Receptionists can leave messages that everyone can read before they begin their shift.

Communicating with your team will often highlight concerns, and often they will share good ideas,  after all they are the “experts” in their field and will often offer very productive ideas. Many of my training issues, ideas and changes came from my experiences of “walking in their shoes”

Another way of communicating with your staff is to simply show your support. Go and see what they are doing and praise them regularly. Most importantly, always remember how difficult your job as a manager would be if the receptionists did not do their job well.

 

© 2011-2017 Reception Training all rights reserved

Is your Practice/Staff at risk #SocialMedia


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Many of us use social media, Facebook, Twitter, LinkedIn and more. Most of us use it for social purposes, sharing news, pictures, keeping in touch with family and friends, and some of us use it for business purposes.

There is no doubt about it social media is a marvellous thing but it also has a darker side. People sharing information and pictures without the permission of others, to comments being made that could result in bullying or even worse.

I have a friend who was mortified last Christmas to find that pictures that had been taken on a Practice works night out when she was “a bit worse for wear” had found their way onto her Facebook page. She had a few too many drinks and unfortunately tripped up a curb, someone took a picture and thought it would be funny to post this with other pictures of the night on their Facebook page. Unknown that these pictures had been taken; she only discovered them when she was tagged into the pictures. This resulted in he sons, husband and other members of her family and many friends seeing her in pictures she would rather them not have seen. She was not happy and it in fact caused a row at work on the Monday. There was bad feeling between the two for some time, and this in turn affected the moral within the team. The team divided in their opinions some feeling that the person who had posted the pictures had done no wrong, and some feeling that my friend was right in feeling angry. The row developed and a complaint to the Practice Manager and it all got very unpleasant.

Another article I found interesting recently was a Doctors Practice displayed a notice in their surgery asking patients not to use Facebook or Twitter to complain about their service. The notice asked patients if they had any complaints or comments about the surgery would they please contact the Practice Manager as any comments on social media sites may be seen as a breach of their zero tolerance policy. The surgery said in the notice that they would be happy to deal with comments/complaints in the usual way.

The “zero tolerance policy” referred to appears to be NHS guidance on dealing with rude, abusive or aggressive behaviour towards staff.

Apparently the online comments about the surgery named staff and swearwords were used and this what prompted the decision for the practice to put the notice up.

I think the practice was right in asking patient not to use social media for this, as the practice would not have been able to respond to any of the comments because of confidentiality issues. If staff were named this could have been seen as a form of bullying, and the staff member would have every right to feel threatened about it.

see a recent blog with a similar story :

The Threatened Receptionist http://wp.me/p1zPRQ-x6

There are other stories that have recently been in the headlines, which have involved Facebook, a Neapolitan woman following a marital row her husband demanded that the photographs of their honeymoon be taken down from her Facebook page. His argument was he had not given his permission to publish them, and he even took her to court over it. The Naples court has not only agreed with him but the wife may have to pay him damages. The pictures were taken on the couples honeymoon 10 years ago and included photos of the couple.

Another article recently has also highlighted the importance of holidaymakers sharing their plans on social medial. It could be read and used by criminals planning a burglary.

This information can be seized by thieves – from research said that some 78% of ex-burglars said that they strongly believed social medial platforms are being used to target property.

I think we all need to be aware of the repercussions of staff sharing information on their personal social media sites – especially if it involved their workplace. It could be a very interesting topic to have on your next Receptionist Meeting to discuss using pictures on social media that might be anyway involved their place of work. But most important as an employee they must understand never get drawn into any arguments about their place of work on any social media sites.

Perhaps you could put something about social media usage in your staff contract.

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© 2011-2017 Reception Training all rights reserved

Guest Blog: How to Diagnose a Difficult Patient #Practice Index


 

I would like to thank Practice Index for their guest post. Practice Index is a site where GP Practice Managers and surgery staff can go and read reviews of suppliers and add their own. Suppliers are then ranked according to feedback received making it easy to find reliable and trusted companies.

 

 

How To Diagnose a Difficult Patient

Blame Dr Google or the ‘era of entitlement’, but the difficult patient is on the rise and they’re costing your practice dearly – and not just financially. GPs with a high number of problem patients – or ‘heart-sinks’ as they’re best known in the profession – are less likely to report feelings of job satisfaction, and more likely to feel burned out. More often, it’s the doctor-patient relationship that needs to be assessed rather than merely the gripes of the patient, and we’re here to help.

Tell-tale symptoms

Studies suggest that most GPs will have around eight ‘heart-sinks’ on their patient list. A problem patient is one who – for whatever reason – impedes the GP’s ability to establish a therapeutic relationship. Someone who refuses to assume the typical patient role, and who may have ideas and beliefs contrary to those of the caregiver. Typical problem patients are men and women over forty, often with marital or other family problems. Sometimes they are isolated in their domestic situation, and may have co-existing depression. New GPs inheriting a patient list can often spot a problem patient a mile off: bulging medical file and appointment / referral / investigation list as long as their arm. A study in the 1950s separated problem patients into the four categories below, and it seems not much has changed…

  • The dependent clinger
  • The entitled demander
  • The manipulative help-rejecter and
  • The self-destructive denier

Relationship surgery

Interestingly, doctors polled in the seventies painted a portrait of the ‘ideal patient’ as one who was trusting, non-complaining, compliant and undemanding. Patients who were perceived as not being seriously ill but complaining, emotional, and uncooperative were often discharged from care early or referred to psychiatric care. Could it be that some of these attitudes remain today, and that part of the problem lies in a GP’s perception of their patient?

 Know your team

As a practice manager you will know better than anyone that GPs can often fall into a number of personality brackets – more of that in another post soon – and it’s your responsibility as overseer to manage personality clashes between doctor and patient. Is the problem actually being exacerbated (or created) by the insecurities of a new doctor, or one with too much on her plate at home? Is it a GP who won’t seek second opinions, or one whose tolerance levels need checking? Talk to your GPs about their patient gripes and see whether the problem can be alleviated by their own perceptions.

…And if all else fails, try encouraging them to book with a different GP next time. Perhaps one with a specialism in their area of need.

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Guest post by Practice Index.

The Threatened Receptionist


Working in general practice as a Receptionist, Supervisor and a Manager nothing ever surprises me anymore, and just when you think you have seen it all something else comes along to add to the endless stories that working in a surgery brings.

The highs and lows the funny and the sad you never get two days exactly the same.

This story was a new one to me, one that I haven’t come across.

I was chatting to a friend yesterday to works in a GP Surgery. She told me that there had been an incident in their admin office. Whilst she was talking to a patient she could hear raised voices at the end of the office. When my friend had finished her call she turned her attention to the receptionist who was obviously very upset by the call.

She presumed that the caller has been an “unhappy patient” – she was wrong.

The caller phoned the Surgery and asked for the receptionist by her first and surname. The caller was put through to her and she was not expecting what came next.

The receptionist explained the nature of the call and how it involved Facebook.

A couple of days previous the Receptionist had been on Facebook. She came across a random post that one of her friends had shared. She didn’t know the person but she left a comment, which she didn’t think was upsetting or rude but obviously the person that had posted the comment felt very strongly about the comment she had left and was not happy.

The person traced the Receptionist to her place of work. How? She had it on her Facebook Profile where she worked and that she was a Receptionist.

The Receptionist was worried, as the caller had her name, knew where she worked, and of course could easily be identified due to the fact that all the staff wears name badges, with their first and surname on and she had no idea what this caller looked like – it could be anyone that walked in through the Surgery doors.

The caller told her that she was going to come along to the surgery and give her a black eye. The Receptionist was obviously worried and upset as the caller sounded angry and threatening.

She worried that the caller might wait for her outside of the surgery and follow her home.

As a Manager how would you react to this? Would you see it as a problem you would have to sort out, or seeing it started outside of work would you not want to get involved?

We then have to question should staff be putting information on their Facebook to where they work and what they do? Have you a right as a manager to say staff cannot do this? Perhaps not, but it is something that could be discuss at a team meeting, to make people aware of the consequences when they do put where they work.

A similar story to this happened when I first starting working as a Receptionist and one of my colleagues had an unusual surname, a patient that used visit the surgery on a regular basis took a liking to her. He asked out on a date a couple of times and each time she gently let him down.

The patient had mental health problems; because he knew her name he was able to get her address and number out of the telephone directory (this was before internet times). He then started stalking her, telephoning her at all hours of the day and night. The incident involved the police, many sleepless nights, which resulted in her moving out of her flat for a while. It was sorted, she changed her telephone to ex directory and everything calmed down.

At the time this incident affected the whole team. Name badges were questioned.

As a manager I always kept this story in my mind, and would only ever have first names on name badges for Receptionists who deal with the general public.

Does your staff give their full names whilst working?

Are first names sufficient on name badges for Receptionists? I think so.

 

© 2011-2017 Reception Training all rights reserved