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?

My Experience with Dr’s Receptionists in South Africa #Guest Post #1/2


My blog is mainly about my experiences working within the NHS in the UK as a Receptionist and then as a Manager highlighting the important of Patient Care and how important it is to reward valuable hard working staff with the appropriate training. I am delighted that I have followers from over 160 countries that read my blogs on a regular basis, and I have often wondered what the Patient Care is like in their own countries. I would like to thank a friend for answering these thoughts in two different posts; she is an expat firstly moving to South Africa in 2011. For me it just highlights how important good Customer Care is, and often the answers can be found with the Receptionists or the Practice Manager. As you will read, sometimes it just takes a bit of time, effort and compassion to turn a difficult time for the Patient into a less stressful one. My Guest Posts are proving to be very popular and I would like to thank my friend for sharing her experiences with us. **************************** Guest Post #1 images My experience with Dr’s Receptionists in South Africa. One of the biggest issues we had to deal with when we started our lives as expats in South Africa in January 2011 was the medical aid. This is something we weren’t used to doing, having moved from the UK. Trying to explain to the medical aid company that while their vitality points and credit card was a very good idea, we weren’t switching from one scheme to another, so therefore the ‘extras’ at that stage were of no interest. 8 days after arriving in South Africa the oldest child who moved with us was rushed into hospital after being hit in the neck with a cricket ball, our medical aid hadn’t been registered on the system and so began a very long and complicated matter to recover the money we’d been made to hand over on our American Express card on arrival at the hospital before we were allowed to see our son. It took around 6 months to sort and during that time I received phone calls from all the various departments demanding payment and I’m afraid to say the day the receptionist at the hospital called me to tell me I’d under paid by around £10, having handed over several thousand for scans, x-rays, ambulance, paramedics, doctors, medication, you name it, it is charged individually. I flipped my lid and screamed at her ‘some bloody help would be nice instead of just all these demands’ And that was the end of visiting the Dr’s and dentists for a while as I just couldn’t cope with what to do and how to do it, until the youngest child broke his arm and needed surgery. I was much more assertive. I refused to pay any money until I knew my son was being seen and once he’s been given pain relief, then, I firmly told the receptionist that ‘I will open a file, in the meantime here is my medical aid card and no, I haven’t had time to get any authorised as I don’t know what the doctor wants to do, do you?’ This was a fast learning curve, but I still had no idea how to use the medical aid and the Dr’s and the dentists for none emergencies. I visited a dentist, asked if they accepted the medical aid, but didn’t know I had to ask if they worked within our medical aid fees and was left paying nearly half the bill. I suffer with migraines, the stress was making them worse, along with the heat, so I decided I should visit the local doctors and try to work out what I needed to do in order to make sure that I wasn’t out of pocket financially and that when I had to pay for hospital visits, how to get reimbursed. So pitching up at the surgery I asked the receptionist if she could explain to me step by step what I needed to do and how. She could see I was still confused and called for the practice manager who took me to her office, informed me they worked with my medical aid, they worked within the payment scheme, there were no fees or excess to pay and checked our current balance online for me. She then informed me we were actually in what is known as the payment gap and I did I have the receipts from the dentists? If so I could log them online and I’d be out the payment gap and then our bills would be paid as normal. She then informed me that had we chosen to keep our son, with the cricket ball incident, in hospital over night rather than bringing him home, because we thought it would cost us more money, that all costs would have come out of the inpatient fund which is unlimited and not our out-patient funds that were for doctors and dentists. She also explained the allowances for medication, dental and opticians and told me to come back to her if I had any further problems. Sending me back to the receptionist who made me a cup of coffee and squeezed me in there and then with the doctor as she herself thought I may need to speak to someone about my stress levels. I could not thank the receptionist and the practice manager enough and whenever I visited in the future the receptionist would chat with me, ask after my husband and the children and tell me to help myself to the pot of coffee whilst waiting for the doctor. *****************************   Follow my friend’s experiences when she relocated to Dubai  #2 to follow

5* Customer Service – #PremierInn #CustomerCare


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We often take time to complain about a bad service, but very little of us complement a good one, so I would like to share with you a 5* customer experience.
We recently had to make a trip to Middlesex as a family member has just gone through major heart surgery at Harefield Hospital.
Arriving at 07.30 tired and hungry we booked into the Premier Inn near Heathrow Airport, (Shepiston Lane, Hayes) (Heathrow M4 Junction)
We had no reservation but the receptionist couldn’t have been any more helpful, and booking in at such an early time was no problem.
What we thought would have been a ordinary “run of the mill” Inn turned out to be 5* accommodation rounded off with the best customer service we have come across in a long time.
From the time we stepped through the front door the staff could not have been any more helpful, polite and extremely friendly.
The Reception staff we extremely friendly and nothing was too much trouble, the cleaning staff could not have done enough for us, and for the restaurant staff well they just went out of their way to ensure that our dining experience was as best as it could get.
Then there was the accommodation, oh wow it was just amazing. I can see why Premier Inn guarantee a good nights sleep – we certainly had that. The king size hypos bed was lush – and a good nights sleep we certainly had. Hard to believe that we were about 2 miles from Heathrow Airport, not a sound to be heard! We even had the most delightful pillows to lay our weary heads on! We found firm pillows on the bed and softer ones were also supplied in the room if needed then.
We had a good supply of tea, coffee, drinking chocolate, water and biscuits and more if we wanted them. We just had to ask.
After a hectic day visiting the patient we returned to have an evening meal. I can honestly say the restaurant was probably one of the best I have been in for a long while. The staff were very attentive, nothing too much trouble and we had two courses, a drink plus unlimited breakfast the next morning all for £22.99 each. The food was excellent. There was not one thing we could have found fault with.
When we returned to our room we found the telly had a range of Freeview Channels – my hubby was delighted to say the least!
The room was lovely and warm, with its own thermostat control panel.
After a really good nights sleep we went down for breakfast. The choices we had were unbelievable and again, I think that this was the best breakfast that we have ever had. The staff were tremendous and couldn’t do enough for us. They put the hot food out little at a time so there was a constant supply, which was fresh and hot.
And to add to all of the above, the checkout time was 12.00 midday. No rushing to book out of the room by 10.00 or 11.00 as some required. We were able to take our time, have another lovely cuppa before going on our way.
I cannot praise our whole stay enough. From the staff, to the accommodation to the food – all perfect in every way.
So, thank you Premier Inn for the lovely experience, and to the staff you have trained so well in giving such a great customer service.
We would certainly recommend your Inn and we definitely will be coming back.

link to the Premier Inn Heathrow

http://www.premierinn.com/en/hotel/HEAPTI/london-heathrow-airport-m4/j4

 

© 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.