Phoning a Patient at Home


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Does your Practice have guidelines on phoning patients at home? We all know of the obvious one and that’s not to leave a message of any kind on a landline because of confidentiality.

But when is it a good time to phone when you need to speak to a patient? Perhaps it’s relaying on a message from the Doctor or Nurse, or just to let them know there is a prescription to collect due to recent tests coming in.

I will give you an example on how consideration should be made when phoning a patient at home.

Someone close to me has for the past 6 years been trying for a baby without any success. The couple have been through many hospital and doctors visits, pregnancy results and alternative treatment to try help them achieve a pregnancy. They finally went through IVF earlier in the year with the daily injections, hormone changes and finally the heart-breaking news that it hadn’t worked. They set their sights on more IVF in 3 months’ time. An eternity to them both. But to all our surprise and delight a month after the failed IVF they fell pregnant naturally.

Fast follow to her being 6 months pregnant. She hadn’t had an easy time, morning sickness and fatigue hit with a vengeance, she also has an over active thyroid that needs monitoring throughout the pregnancy and she also found out that she was rhesus negative blood type and tests would have to be done when the baby was born to see if she needed an anti D injection but the delight of finally being pregnancy got them through all of these hiccups.

Her symptoms were getting worse and she was feeling poorly with no energy she seen the doctor and bloods were sent off to check for her iron levels.

So last Wednesday morning she was in bed. It was 7.55 and the telephone rang downstairs. They have elderly relatives and she immediately worried something was up. No on every phones at that time unless its urgent she thought.

She rushed out of bed, rang down the stairs and as she picked up the phone it stopped. She waited for a message but then her mobile started ringing upstairs – she panicked as someone was trying to get hold of her.

As she ran upstairs to get to the phone she tripped on the stairs and fell. In the panic she got up and answered the telephone to find it was her Doctors Receptionist telephoning to say that there was a prescription in reception for her to pick up for iron tablets.

As you can imagine she was upset as the fall. As the day went on she couldn’t feel much movement from the baby and this caused her a lot of distress, until she finally telephoned her midwife to asked her to come straight into the maternity hospital to check the baby and to have an anti D injection.

So, did the Receptionist really need to phone at 7.55 in the morning? I don’t think so. This telephoned caused a lot of unnecessary worry and inconvenience not to say how awful it could have been – but we wont do there! And not to mention how bad the Receptionist would have felt had she had known about the fall.

There should always be a guideline for people being telephoned at home unless it is urgent of course. 7.55 is far too early, what if it had been an elderly or disabled person doing the same thing? A fall could have been a disaster for them.

When training staff I always told them unless urgent no patient should be telephoned at home before 9.00 and if possible leave it until around 10.00.

More and more surgeries are opening up earlier than every before, so perhaps guidelines should be set to what time Receptionists can start to phone patients.

© 2011-2017 Reception Training all rights reserved

 

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From a Patients Point of View #Guest Blog #Dr’s Receptionists #Empathy #Ireland


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My guest posts are becoming very popular and it is nice to read how important patient care is to the patient from their point of view, and reading about their experiences in difference countries.

This post has come from Ireland and the experiences the writer has found when dealing with Dr’s Receptionists.

The most important thing we should remember that as a Dr’s Receptionist our actions do impact of people’s life, and we can leave lasting impressions – we what are in control of is that the patient is left with the right impression.

Some of the feedback from this post included:

–  intimated by the receptionists I have to deal with 

–  Seemed cold and hard

–   wishing for is someone to show a little bit of empathy 

–   one receptionist who was the most amazing woman I came across 

–  really cared about the patient’s 

–  All we ask is that someone understand our position too.

Thank you A for your contribution to my blog…….

Guest post………….

About 5 years ago I was diagnosed with Benign Intracranial Hypertension and chronic migraine. It was a long road to get diagnosed and then an even longer road to get treatment and eventually to be able to live a somewhat normal life. As you can imagine I dealt with many different doctors including neurologists, surgeons, migraine specialists, pain specialists, ophthalmologists and physiotherapists. That’s a lot of doctors and departments which in turn means a lot of doctors receptionists.

When I was first diagnosed I was if I am honest a little intimated by the receptionists I have to deal with. They all seemed so cold and hard and when you are in as much pain as I was all the time then the one thing you are wishing for is someone to show a little bit of empathy, a little bit of emotion and maybe even a little bit of care. It seems that all they do is try to block you from getting the treatment you need.

However there is one receptionist who to me was and still is the most amazing woman I came across through all this. She was the receptionist for the migraine specialist in Beaumont. From the outset it seemed she actually really cared about the patients and would ask you how you were if you called or would have a chat with you when you went for an appointment.

I had just been discharged from hospital a week when I began to have extreme pain. Now I was very good at managing my pain and would only really call the hospital if I really needed to. This was one of those times. I always tried to bypass the receptionists because I knew I would get nowhere with them. This day however I failed to do that and got transferred to the receptionist. I explained the situation and by the end of the explanation I was in tears. To my utter shock, she put me in for an appointment the following day. This was completely unheard of in Beaumont. It turned out the pressure in my head was really high and if she hadn’t given me that appointment, I could have been in serious trouble.

From a patient’s point of view, a doctor’s receptionist is like the gate-keeper. The problem is when you have been in so much pain for so long and all you want is someone to help you, it can be tough to understand the harshness with which some receptionist treat you.

I can also understand the receptionist’s position; it’s a tough job having that much responsibility put on you. All we ask is that you understand our position too. We need help and you are the first person who can give it to us

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thank you and this just highlights what was said “from a patents point of view, a Doctor’s receptionist is like the gate keeper” how very true this is.

As a Receptionist how would you like to be remembered?

Handling Difficult Patients #Guest Post #PracticeIndex


I would like to thank Practice Index for letting me share their post on ‘Handling Difficult Patients’. Practice Index is a support site for GP practice managers and surgery staff. Their popular online discussion forum allows you to ask questions and gain advice and guidance on any surgery issues from the community of NHS professionals. They also have a resources library within the forum which contains hundreds of policies and protocols that you can use in your own practice. You can join the Practice Managers’ forum for free by clicking here: http://practiceindex.co.uk/gp/forum/register

Concept of relax with businessman doing yoga

April 28, 2015 by Practice Index in Patients

Handling Difficult Patients

Dealing with difficult patients at the reception desk and in the waiting room is, like it or not, part and parcel of your job as a Practice Manager. It’s your responsibility to demonstrate confident and compassionate handling of difficult patients, displaying techniques your team – especially newer recruits – can learn and gain self-assurance from.

Keep Calm

Aggressive patients are particularly likely to try and bully you into an argument, but your role here is to stay calm and unemotional. An emotional response from you – irritation, laughter or anger – will only fuel their attack and potentially cause a situation to escalate. In nursing as much as in the general practice, sensible steps to take would include the following:

–  Speak softly and abstain from being judgemental
–  Put a little more physical distance between yourself and the patient and avoid intense eye contact which could be seen as  provocative
–  Be in control of the situation without seeming either demanding or overly authoritative
–  Show your intention to rectify the situation rather than reprimanding the patient for their behaviour

Defy Logic

An angry patient won’t respond to logical arguments, so try to resist the temptation to reason with someone who is clearly in a terrible temper. It’s also important in situations like these to not resort to all-out grovelling if the practice is not at fault. Accepting responsibility is irreversible and could do the practice damage, as well as your own reputation. What you can do, however, is apologise for the particular inconvenience your patient is aggrieved by at this moment – and offer what immediate action you can (if any) to rectify the situation. Make a note of all complaints received, formal or informal – this includes patients storming out of hanging up on phone calls.

Rise Above It

Patients can be rude and downright insulting on a bad day, but try to refrain from letting them know what you think of them or how they’ve made you feel. Stay professionally detached and see this objectivity as your ‘protection zone’ from hurt. Ignore their rudeness and you may find that, with no visible impact, their insults start to die down. Equally, treating an angry adult like the adult they are – despite the toddlerish tantrum they’re throwing – should encourage them to gently return to adult form if you’re consistent enough with it. Patronising, belittling treatment will only inflame that childish rage.

We’ve all come up against it in our time and this just scratches the surface in coping tools for difficult patients. Why not share your best advice for diffusing tempers and managing quarrelsome individuals in the waiting room?

Speaking to Receptionists on the importance of Training


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Would you employ a Doctor or Nurse at your Practice that didn’t have any qualifications? No – so why did I even ask such a stupid question? Of course you wouldn’t. You go for the best candidate there is don’t you?

What is the first thing you look for on a CV? Previous experience, qualifications/training and the availability they can offer.

When you employ a Practice Nurse or another member to the healthcare team they are usually offered ongoing training. This will benefit the Practice, more clinics can be run, and therefore a better service offered to the patients.

So, why should a Receptionist be any different? They are part of the team, they are there to give a good service to the patients, and to support the Doctors, Nurses and the Practice Management Team and to achieve that they need the appropriate training to do this.

A good majority of General Practice Receptionists are woman, over 40 years of age and on average half have been in the job for more than five years. Four-fifths work part-time.

Comments from Receptionists are they have chosen the job because it dovetails with the rest of their lives.

What they get from their job is satisfaction from helping patients, meeting people, having a good relationship with colleagues and doing varied work.

Sources of stress include difficult patients, work pressures often down to shortage of staff, problems finding appointments to give to patients, and feeling caught between the doctors and the patients demands (piggy in the middle effect)

Dealing with difficult situations at the front desk, or over the phone is often highlighted in training courses, and often Receptionists feel unsupported when dealing with these incidents.

Many had a sense of teamwork with colleagues, but many did not perceive the whole practice as a team. Many felt the doctors failed to appreciate the pressure and complexity of their work.

A receptionist’s work is very complex, demanding and intense often involving a high level of commitment to patients, colleagues and the practice.

Speaking to Receptionists at various training sessions always bring different responses on how they feel supported by their Practice especially when it comes to training.

They vary from hardly any support at all, and having to learn whilst doing the job, to others that have support and training on a regular basis.

A role as a medical Receptionist is a bit like Marmite – you either love it or hate it. I have seen Receptionists lasting as short as a day to perhaps a week before saying “this isn’t the “nice little job I thought it was going to be’

A Receptionist that lasts is there because of their love for the job. If they do not feel supported they will leave, and move on to a Practice whereby they will be supported and appreciated. Don’t be that Practice that loses all your good staff.

I asked a group of Receptionists what did they think is most important when it comes to training for the role of a Doctors Receptionist – their replies included:

Quality time to get used to the job and the rest of the team”

Shadowing and taking notes, one to one time somewhere quite and more so when it comes to getting to grips with the computer system”

“Training on confidentiality – understanding what can and cannot be said”

“I must admit I was frustrated at being  “thrown in at the deep end” approach. There has to be an element of this because of the nature of the role, but some protected time is needed”

“Reception training is an investment and saves time (and often tears) in the long run”

Learning to deal with difficult situations at the front desk – I was faced with a bereavement at the front desk recently and didn’t know how to handle it”

“Being able to ask questions that get fully answered”

I asked, “What training their Practice had for their Receptionists” and the replies included”

“I was told at my interview that an induction programme would be put in place for me when I started, and it never happened – although the intentions were there. There simply was never the right time”

“The two receptionists asked to train me on the job felt resentful and that they had been “landed with me which made me feel awful”

“Other staff members were often reluctant to explain things in fear I might ask more questions, they clearly felt under pressure”

“The office Manager was immensely encouraging to me and I learnt so much from her. She proved very canny at sensing when I was struggling and would step in with down to earth words and support”

“I had to cancel a couple of training courses due to staff shortages which meant I was needed in Reception – and to date I haven’t had the chance to re-do them”

“My Team Leader and Practice Manager are wonderful and support us Receptionist with ongoing training”

A new Receptionist needs time to pick up a wide range of skills and variables associated with this underestimated role. People learn in different ways and often at different speeds. Some are ace at IT and pick up the computer system in no time, but perhaps struggle with terminology. Some get flustered easily and find it difficult dealing with difficult situations; others are able to cope with the pressure that patients (and often doctors) throw their way on what can sometimes be an hourly basis.

The role of the Receptionist is endless. You never get to the point and are able to say “there I know it all now” every day brings something new.

I asked Receptionists how their felt that training has benefited them and their replies were”

“Good training can be enjoyable, fun and such a benefit to the Receptionist, the patients and the Practice”

“Patients deserve to have staff that are confident and comfortable in their role”

Patients will leave satisfied, and hopefully reassured’

“I enjoy training – I feel I have the space to ask questions and enjoy meeting others in similar roles”

“Doctors, nurses, Practice Management will be supported by the reception team and therefore be able to work more effectively themselves.

“Jobs are completed and not just “left” because the Receptionist is unsure about completing a task, be it a letter, phone call or a query at the front desk.

“Team members work more efficiently when everyone understands their role, and the role of others around them”

It is so important that a new Receptionist is given time, and more time if needed. Investment in staff right from the start is so important.

Take some time to find out the needs of your Practice and also the needs of the Receptionist.

You’re Receptionist are the ambassadors of your Practice and deserve to be supported in the role.

 

© 2011-2017 Reception Training all rights reserved

Questions and Answers / GP Doctor Consultations #Guest Post


I would like to recommend a brilliant site called GP Doctor ( http://www.thegpdoc.com )who have kindly allowed me to share with you one of their posts. As a Receptionist you will all be very familiar with many of the questions below, and maybe even some that you have not come across or had the answer before.

I hope you enjoy it.

Guest Post

GP Doctor Consultations – Question and Answer Session
BY GP DOCTOR · MARCH 7, 2015

GP Doctor Consultation Q&A
Patients often have many questions about the GP Doctor consultation process and all of the questions asked below are genuine questions posed by patients. Hopefully it addresses some misconceptions about the GP consultation.

How long does my GP Doctor have to see me? It seems very rushed.

10 minutes. Realistically 7 minutes as the 10 minutes includes calling the patient to the consultation room, referring if required, prescribing and writing our notes (which is very important for your records so there is an accurate picture of your medical history which helps in future consultations).

Why not offer longer appointments?

There is already a recruitment crisis in GP and currently there are not enough GPs in the UK. If we offered longer appointment times, fewer patients would be seen in the day, contributing to longer waiting times for appointments.

Why have I been waiting to be seen? My appointment was 15 minutes ago.

The patient before you may have been very unwell with multiple complicated conditions requiring more time. Furthermore your GP may be running a little late if they had to discuss a patient with hospital specialists or had to deal with other emergency situations or telephone calls. It could also be simply that the patients seen before you presented with multiple issues that they wished resolved.

Is your time more important than mine that I have been waiting so long?

No GP feels their time is more valuable than the patient’s time. We do try to keep to time. However situations out with our control contribute to sometimes running late as also mentioned above.

I am only 5 minutes late. Surely this is not an issue?

Bear in mind that you may only feel it is 5 minutes. However if lots of patients attend late for their appointment your GP is then automatically running late for patients later in the day.

What if I have a list of things?

You may have a list. But if you tell me this at the start of the consultation, I may be better able to help you. Mentioning this at the last minute makes it more difficult as we may have spent a large proportion of time on only 1 issue.

I don’t come to the GP often. Surely I am entitled to have longer or discuss all my issues?

We try to discuss and manage as much as we can in 1 consultation. However bear in mind that there are other people waiting so it doesn’t mean I can solve all your problems in 1 appointment especially if they are more routine matters and you have, for example, 5 things you want addressed.

Years ago my GP had time to have some social chit chat. Why not now?

It’s not that your GP is not interested but is pushed for time and the next patient will already be waiting to be seen. We feel it is important to actively engage with patients and firmly believe that part of this is building a good doctor-patient relationship. Unfortunately due to time constraints we may not be able to talk to you for as long as we would like.

The waiting room only has a few patients in it. Surely the GP must not be very busy?

This shows an effective appointment system that is working well and not large queues still waiting to be seen.

Why can’t my GP see patients constantly in the whole day?

See the other related post “GP Myths – Appointments” which answers this question.

Why do you not know all my medical history when I come to see you?

It may be the first time you have met the doctor and he/she will not have had time before seeing you to go through all of your notes in any great detail. In addition it is better for us to ask you to get accurate information rather than just rely on the notes.

Have you read my notes before seeing me?

With anywhere between 5,000 – 15,000 patients we can’t know everything about your medical history off by heart. We probably haven’t had a chance to look at your notes in great detail before seeing you. However if we need to know more we can ask you or look at your medical notes during the consultation.

The GP called me back today. Why is he/she asking me what I wish to discuss?

We cannot assume why you are here. You may be attending to discuss something else and that’s why even if we have asked you to come back we ask at the beginning the reason for your attendance.

My GP is looking at the computer during the consultation. I’m sure he/she is using Google to diagnose me?

No we are not diagnosing you using our computer. We need to look at the computer for your medical notes. We also may use the computer to check doses and local guidelines regarding drug prescriptions.

Why is my GP asking me what is wrong? Doesn’t he/she know? I just want a diagnosis.

If your GP asks something similar to “What do you think may be causing your symptoms?”. It isn’t because he/she wants you to self-diagnose. You may have thoughts about what you feel may be causing your symptoms or condition. Everyone has thoughts about what may be wrong. If we know this we can answer questions you may have regarding this or to address misconceptions you may have. Furthermore it also helps us identify how much detail we need to give as you may already know a great deal about your symptoms/condition. If we don’t know what you think may be causing your symptoms you may leave the consultation feeling that your questions haven’t been answered or that you are adamant it is something else. We don’t want you to leave thinking “My GP told me I have X condition. I think I have Y condition”.

Why does my GP ask so many questions rather than just tell me what is wrong?

Most diagnosis by all doctors is reached from information gathered from the patient. Therefore it is important that we gather as much relevant information as necessary to do this. Investigations can be helpful to diagnose but remember most diagnosis is reached from talking to you. In addition we do not have access to immediate scans and blood results.

My GP looks at a book for drug doses. Why?

We can’t remember all drugs doses and sometimes have to look these up. It’s better to be accurate if we are unsure. In addition there are multiple doses for children depending on their age.

I have been asked to come back for a follow up. Should I?

Yes. If your GP feels you should attend again to review your condition it is important to do this. This will also prevent asking for an emergency appointment in case things haven’t improved. If your GP has asked that you come back in a few weeks he/she may also want to see how your condition is evolving or discuss blood results that you have yet to have done.

I came back a few weeks later and another GP said I had something else? Was I misdiagnosed?

Not necessarily. Symptoms evolve. We can only base our diagnosis based on what you present with at the time of seeing us. Symptoms and conditions evolve over time.

I came about my sore foot. Why am I having my BP taken or asked about smoking or if I am up to date with my smears?

We may try to opportunistically help with health promotion. You may not attend to see us often and it may be the only chance we get to discuss these areas which can help improve your health.

Bradford CCG’s fund GP Receptionist Training


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Bradford clinical leaders are funding customer care training for GP Receptionists to help improve patients’ experiences at surgeries.

They are responding to patients concerns by looking at ways to improve access to local GP services and are going to hold training sessions for practices in the Bradford area to help staff make each patient feel valued and at ease.

I have included links regarding this topic.

http://www.dailymail.co.uk/news/article-2946645/Stop-grumpy-patients-Training-doctors-receptionists.html

http://www.bbc.com/news/uk-england-leeds-31420045

http://www.bradforddistrictsccg.nhs.uk/news/bradford-ccgs-fund-gp-receptionists-training-to-improve-patients-experience-of-primary-care/

I am very passionate about good patient/customer care, and feel very strongly that Receptionists need the correct support in the way of training. I am saddened by the hard times that Receptionists often get and I do appreciate that there are some that perhaps come under the category of not been the most helpful, but in my experience there are so many good Receptionists out there doing an excellent job.

I am a firm believer that a good trained member of staff is more confident, and therefore able to deal with the many different situations that they are faced with in Reception on a daily basis.

Well done to Bradford CCG for investing in this training programme which will benefit patients, staff and Practices throughout the region.

Lets hope that other CCG’s follow this great example.

Recipe for A Successful Team


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*  Respect

*  Trust

*  Commitment

*  Communication

*  Diversity

 

© 2011-2017 Reception Training all rights reserved