Patient Care – Empathy

I watch a short 4 minute clip from you tube called Empathy from the Cleveland Clinic and would like to share it with you all. It really is worth a look. As a Receptionist working in a Doctors Surgery, a Healthcare Clinic or a Hospital it is a reminder that behind every person there is a story. The people in this film could have at one point spoken to you as a Receptionist on the telephone or at the desk. We do not always know what is going on in people’s lives. So perhaps if someone is a bit short or angry or out of turn with you or appears to be upset in any way they could be that they couldn’t get an appointment with the Doctor that same day, or angry that you cannot discuss their loves ones because of patient confidentiality, when people are upset, distressed and in pain they often hit out at others. They could have been someone in this film. Knowing how to deal with a difficult / upset person at the desk is so very important – and being able to turn a negative situation into a positive one.

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Does Your Practice Employ Staff That Live Local


I always find it interesting to learn how other Practices operate. I used to attend a Practice Managers Group who held monthly meetings. Each Practice would take it in turns to host the meeting. A Practice Manager would take minutes and these would be distributed soon after the meeting. We would discuss all relevant matters in running our busy surgeries. I always found these meetings very interesting, helpful and I formed a good working relationship with the other Managers.

What I did find interesting was some of the Practices employed many of their reception staff that lived local to their Practice. Whilst other Practices had a policy not to employ any reception staff that lived local to their Practice.

At one of our meetings this was a subject that we discussed. It was surprising how the Managers all seen the advantages and disadvantages in both.

Employing staff that live local


  • The Receptionists would know the area well. This can often be beneficial to patients and staff at the practice especially when a locum came to the Practice that would often not know the area.
  • This could be beneficial when allocating house visit for the doctors or other health care professionals (this task was done by some receptionists at some of the Practices)
  • Some Practice Managers like the fact that the receptionists are known by the patients and some felt that this could be a benefit. They felt that if a patient was known to the receptionist that they would be less likely to complain at the desk.
  • The ability for the Receptionist to get into the Surgery easily in the event of bad weather – or if needed to do extra time to cover for sickness at short notice.


  • Some patients are not very keen on people that they know having access to their medical notes.
  • Some receptionists can often be “seen” to having favourite patients (*Scenario 1 see below)
  • Receptionists can often find this difficult as patients that are known to them often expect more from the Receptionist.

Employing staff that do not live local


  • Patients are not known to the Receptionists and therefore have no pressure on them from people that they know.
  • The Reception Desk is often more “professional”. Often if a patient is known to a Receptionist idle chit-chat can often take place.


  • The Receptionist does not always know the local area.
  • Not being able to get to the surgery easily in the event of bad weather or in the event of having to cover for sickness at short notice.
  • Not wanting to cover for just a short period of time (ie 2 hours etc)

*Scenario 1

Not long after the meeting when we discussed this I was in Reception and witnessed an incident where we employed a Receptionist that lived very close to the Surgery.

The Receptionist was chatting to a patient and it was pretty obvious that they knew each other. There was another patient standing just behind them. The conversation didn’t go on for very long but enough that both I and the other patient were aware that both knew each other very well.

The “friend” chatting to the Receptionist asked if there was an appointment available that morning and the Receptionist replied that there was one available in the next 10 minutes. The patient when and took a seat.

The next patient can to the desk and ask for an appointment that same day and they Receptionist told the patient that she had no appointments that day – they we were fully booked. The patient then asked why the patient in front had got an appointment and asked the Receptionist was it because she was a friend that she got an appointment. The patient did not look too impressed.  

I felt at this point I had to go over and intervene. I asked if I could help. The Receptionist explained that the appointment she had in fact just given her “friend” was in fact a cancellation that had just be made moments before therefore freeing up an appointment. The Receptionist sitting close by confirmed that she in fact had just taken the cancellation. The patient was good enough to accept this explanation and made an appointment for another day.

This was discussed at the next Receptionists meeting and they all agree it could have looked like the patient was being “favoured” and given an appointment as they were known to the receptionist. The girls all agreed that from the other patients point of view it certainly did look like the “friend” was being favoured and given an appointment.

We all agreed although while it is nice to chat to patients  and it was important that we continued to give our friendly service, there are times when friends come into the surgery that care has to be taken and that other patients were not given the impression that “friends” were given special treatment.

We all agreed that all patients should be treated in a professional manner and that included friends.

We used to employ a mixture of staff that lived both local and afar and I must say apart from that one incident it never really did cause any other problems.

My Live BBC Radio Interview on Being A Doctors Receptionist


Last Thursday I was approached from BBC Radio via my blog to do a live radio broadcast in response to a broadcast the previous evening. The previous evening there was a GP speaking about patients and the “stiff upper lip of the British” and that they should go and see their Doctor “sooner rather than later”.

The radio station received several replies from some “unhappy” listeners saying that they have often found it difficult to get appointments at their surgeries. They mentioned lack of appointments, and rude Receptionists.

I was asked along to talk about the role as a Receptionist. Whilst I didn’t have enough time to answer some of the emails sent to the radio station I would like to share a couple with you and what I feel would be a response I would have made.


Sender’s message

“Stiff upper lip? Certainly not.

Over crowded surgeries, unapproachable doctors (and receptionists) creaking overloaded health service not working on a Saturday YES YES YES”

My response would be

I agree that surgery clinics can often be extremely busy. Practices do acknowledge this and will try all avenues to spread the various clinics over the day/week. As the healthcare service continues to expand into general practice unfortunately the surgeries get busier. Many Practices offer baby clinics, various Nurse Clinics, minor surgery clinics, Health Visitors Clinics and many more and are often scheduled to run outside normal Doctors appointment clinics. Most Surgeries these days do have extremely pleasant waiting areas. Patients often have TV’s or a radio in the waiting room, magazines to read, an area for children, water drinks dispenser and other items  hopefully making  any waiting time as pleasant as they can. Many also have free wifi. Unlike not so long ago when you just had a waiting room and nothing else.

A busy surgery is often one that is offering several different healthcare services under one roof meaning patients do not have to travel to their local hospital for treatment.

Just because you might “see” a busy or “crowded” surgery does not mean it is not being run efficiently.

It saddens me to read that the gentleman finds the doctors and receptionists unapproachable – to this I cannot comment as I don’t have pacific details , if I was dealing with this gentleman at my surgery I would be asking in what way he found them unapproachable and would deal with it from there. Of course he also has the choice to move to another surgery if he is very unhappy with his present practice.

And as for not working on a Saturday – many surgeries that I know of certainly do work on a Saturday morning. But, is this gentleman aware that there is always the out of hours service and they are there every evening and weekend after the surgeries have closed and therefore he has access to either speak or see a GP or healthcare professional 24/7. Many surgeries are now open to accommodate people who are working and often open from 07.00 through to 20.00 – 5 days a week. A pretty good service I think!


Sender’s message

I phoned for an emergency appointment when I realised I was suffering from depression. I was so distressed that I blurted out that I had been having suicidal thoughts. The receptionists’ response was to repeat “sorry to hear that, you’ll have to phone back in the morning”.

My response would be

The patient I am sure was pretty distraught by this conversation. Only she knew just how bad she felt – the Receptionist had no way of knowing how bad she actually was – but she was saying she was having suicidal thoughts – bad enough in my opinion.

.My advice to her if she was refused an appointment was to ask if she could speak to a Doctor. In the event that there was no Doctor available to speak to her she should ask to speak to the Practice Manager or someone else in charge. As a patient if you feel that it is urgent enough that you need to see a Doctor that same day and the Receptionist cannot offer you an appointment ask to speak to someone about it or ask for a Doctor to call you back.

 As a manager I would be alarmed if this had been a Receptionist at my Practice but I feel very confident that this would not have happen. All of our Receptionists would have received training in dealing calls similar to this.

This should never have happened. What is to say that there would not have been an appointment the following day? Why ask her to phone back again only to be told there are still no appointments.  The patient requested an urgent appointment. That needed to be taken into consideration straight away. The Receptionist didn’t even have to ask why she needed the appointment, the patient explained why she needed the urgent appointment.

Someone suffering with depression and admitting that she was having suicidal thoughts should have had alarm bells ringing.

If the Receptionist really could not offer the patient an appointment that same day she should have tried her utmost to either speak to a Doctor or nurse and ask their advice. In the event she was going to get a Doctor to call the patient back the Receptionist should not have let the patient end the call without taking a contact number first. (Even if the patient has a number on her records always check – because it has happened many times that patients change their telephone number and do not notify the surgery)

If Surgery had finished and perhaps there was no doctor on the premises (lunchtime) then the Receptionist should have called the duty doctor for advice.

Receptionists are dealing with calls like this on a regular basis, especially for “emergency” and “same day” appointments, it is a difficult task for them as they only have so many appointments that they can offer to patients on a daily basis. A good Receptionist will often be able to give a helpful solution to the patient by either offering an alternative appointment/day or perhaps offering an appointment with another healthcare professional i.e. the nurse or getting someone to call the patient back.

But at the end of the day if the patient insists they need an urgent appointment and the Receptionist is unable to give them one then the Receptionist needs to speak to her Senior Receptionist or perhaps a Doctor for advice.

And then there was a letter from a listener that goes to show that there are many patients out there that are more than happy with the service that we give.



Sender’s message

Can I – as a patient – stand up for those receptionists who are anything but rude, especially those in our local surgery in Hillsborough, Co. Down who are simply exceptional. As a family with two young children we have all had our fair share of visits and always been treated with the utmost courtesy and care.

My response

Whilst we take on board the negative comments , and hopefully deal with them in the appropriate way, it is always nice to get positive feedback. You don’t know how much that means to staff to hear that they are appreciated and the job they are doing are doing it well. Everyone thrives on good feedback.

Thank you.

As a Receptionist and a Manager I am still always overwhelmed at the positive comments and feedback that we get on a regular basis from the patients. This is what makes the job so very special.


The Lost Faxes

When a patient is suspected of having cancer it is vital that the correct procedures are met to ensure that they are seen by the correct consultant / healthcare professional.

Every possible action will be taken to ensure that the referral letter will get to the consultant / healthcare professional at the hospital concerned as soon as it possibly can. Surgeries will have their own protocol of dealing with this situations.

Let me share a story on a referral letter that was never received at the hospital.


True Story

It was 6.00 on a Friday evening – the doctor had a patient in with him who he suspected had a mass – possible cancer. It was too late to phone through to the consultant’s secretary for an appointment and too late for a letter go out in the post that same evening – so the procedure was the doctor had to fax the letter through – something that was done on several occasions.

All of the receptionists knew the procedure.

The fax went – and the letter format went on the Monday in the normal post. Tuesday there was a call from the hospital asking why they letter had not been in fact faxed through on the Friday – the Doctor said it was – but the hospital said they had no record of receiving it.

I was asked to investigate what had actually happened.

I went and spoke to the receptionist that sent the fax. She was obviously concerned and upset that I had to speak to her about the incident – to her it looked like I was accusing her of not sending the fax – I soon put her fears at ease and explained that I had to find out what had actually happened.

This was one of those moments where I was pleased that we kept a printed receipt of every fax sent and this was attached to the fax and filed. We found the letter and the receipt was attached that confirmed that the fax as indeed sent – and no errors had occurred whilst it was sent.

I telephoned the hospital – they were adamant that they had never received it. We had the “proof” that the fax was indeed sent from our office. But the still said they had not received it.

I am pleased to say the patient was not put at any extra risk and was seen within the allocated timescale.

Some weeks later I received a similar call from the hospital – they were waiting on a fax coming through and they had not received it. I checked again with Reception that they had sent it and they had all the confirmation that the fax had been sent. This happened for a 3rd time and I started getting concerned. Something was not right.

The faxes had been sent by 3 different receptionists – all very competent receptionists I might add and ones that took pride in their work. All of the receptionists were long serving receptionists and had been at the surgery for some years. Each and every one of them was concerned about the incidents that had taken place.

I went along to see the supervisor at the outpatients department where the faxes were going. She I was as concerned as I was about what was happening. This is where I found it very useful to have a good working relationship with the hospital because I felt that I could go along and chat to the supervisor about the incident – at the end of the day we wanted to get this matter sorted out and make sure that it didn’t happen again. After all we both wanted the best possible outcome for the patient.

(see my blog on Communication between the Surgery and the Hospital. )

I asked her if we were the only surgery that this was happening with – she told me it was – they made me feel that for whatever reason the error was happening at our end – but I could not for the life of me work out WHY. Each fax had been sent and the receipt of that fax kept and attached to the fax sent – we got a print out from the fax machine to back that up and it confirmed that the faxes had in fact been sent.

So, I went back to the surgery. One by one I asked each of the receptionists to send a text fax through to the supervisor at the outpatients department – who was waiting at the other end for them.

After the third fax had been sent I phoned the supervisor – she said that they had not come through – she confirmed that they had received many others from other surgeries in the time I was with the girls sending ours. I was baffled. I had actually witnessed the faxes being sent through.

I called another receptionist in – I asked her to send the same test fax – she did and I straight away got a phone call from the supervisor to confirm she had received the test fax.

Then it dawned on me – I knew what was happening……………………….

We had recently had a new fax machine installed in the surgery. The old fax machine used to send faxes face down – this new fax machine sent faxes face up! Such a simple error to make but such a bit impact when it did.

They were actually sending blank pages through to the hospital as they were sending them upside down.

I telephoned and spoke to the Supervisor – I explained what had happened – she went into the fax office (the fax machine was in an office on its own and secretaries and administrators would pop in every so often to take the faxes off the machine) The supervisor confirmed there was in fact 3 blank sheets amongst all the other faxes waiting to be sorted. She agreed that the secretaries or administrators would have just thought they were blank pages that had just come through with other faxes.

So a simple thing like a new fax machine caused so many problems. The receptionists were mortified that they had made the mistakes – but said they were so used to using the old fax machine at times when they were so busy they just put them through as they would have normally.

So, I put a big notice over the fax machine that said

~Pease send fax facing UP!

A reminder email was sent out to everyone in the surgery including Doctors/Nurses/District Nurses/Health Visitors and other healthcare professionals who all at times used the fax machine.

That seemed to do the trick thank goodness. No more episodes of blank faxes.

So never take it for granted that a new member of staff can send a fax – always make sure that you run through the procedure with them – just in case!

I must admit I have never been a fan of fax machines!


Patients With Special Needs (Patients Special Needs Board)

How do you keep staff informed about patients that perhaps need special attention?

What do I mean by “special attention”? Well this could come in many forms but for me as a manager I felt that certain patients needed to be at times “highlighted” to the rest of the staff.

Who would these patients be?

I know a lot of people think that Receptionists ask too many questions – that they are “nosy” or perhaps a barrier to seeing the Doctor – but believe me this is not the case – Receptionists ask these questions on behalf of the Doctors and Nurses and try their very best to ensure than anyone that needs to see the Doctor sooner rather than later does – if everyone was give this priority then the system would be in quite a mess. Then where would that leave the people who are possible at risk and do need urgent medical attention.

For me it was important that these people did not slip through the system without being given any necessary follows ups that were needed.  These people at times needed urgent appointments, urgent prescriptions or just access to the doctors without having to go through the many questions that sometimes a Receptionist has to ask.

Most of your staff will be dealing with these patient and will know of such cases – but what about the staff that work part-time – or those that have been on holiday for 2 weeks – it is amazing what kind of changes can go on in a surgery in this short space of time.

How many times I have seen a Receptionist that has been away ask a patient how their husband/wife/mum/dad are only to be told that they had died. It will happen – but there are ways that you can keep staff updated these issues.

What sort of things would these patients or their families phoning or coming into the surgery about?

An urgent prescription might need to be generated for a terminally ill patient. This could be done almost immediately instead of the usual 48 hours.

An urgent Doctors Visit might be needed for a terminally ill patient.  The visit would be logged without question. And then when the Doctor does his visits he could prioritise this patient if needed.

A patient might need an appointment that day due to a bereavement, or a miscarriage. The patient might be too upset to discuss with the Receptionist and might need to be seen immediately.

A relative of a patient that has recently died might need to see a Doctor. They would not want to wait a few days for this – does your surgery have a policy on patients that have recently been bereaved.

Often if the Doctor is aware that a patient has died he or she will often phone the relatives of the patient – this can be very comforting at this very sad time.

All of the above would mean the patient would need to be dealt with quickly, without fuss or questions and with compassion.

To have their call / query dealt with efficiently without question will no doubly help they already stressful situation.

I decided in creating a “message board” a “specials needs board” or  “patient board” it could be called whatever you like but at the end of the day this is how it worked.

In reception we had a wipe clean board. We used a wipe clean board simply because it was easy to use and update quickly. This would have three sections headed with:

  • Terminally Ill
  • Ante Natal
  • R.I.P. (recently deceased)

At the start of any entry the date that the entry was made should be dated.  This is a way of knowing when the message was written.


Any patients that were terminally ill either in hospital in a Nursing home or at home their name would be entered onto the board and the place that they were at.


If we had an expectant mum that was having a difficult pregnancy, had recently had a miscarriage or a still-born their name would be entered onto the board.


Any patient that had died their name and date that they died would be entered onto the board.

Beside each of their names we would have the patients Date of Birth. This is important to identify the correct patient.

The board would be kept in the Reception Area – but most important not in view to anyone other than staff. This is most important – remember patient confidentiality.

This board would be seen on a daily basis by all staff in the surgery. District Nurses used to come in each morning and have a look to see if any of their patients had died over night.  The health visitors would also check the board on a daily basis. The midwife would look before she started her clinic and the doctors would look before their started their morning and afternoon sessions.

By having the board in Reception it is there for all staff to see – and the good thing about this board is you don’t even think you are looking at it – but when you answer the telephone and one of the names on the board is mentioned you immediately are drawn to the board – the board is almost subliminal you see it without realising it.

You will need to ensure that the board is kept up to-date. You could allocate this job to one Receptionist.

The terminally ill will need to be there until they sadly die and then go onto the R.I.P. (This also highlights those terminally ill that have died)

Your surgery will have to agree on how long you keep the Ante Natal information on there – at our surgery we kept it up there for a month after the entry.

R.I.P – again you will need to agree how long you want to keep the information on there – again we kept it up there for one month.

Try this board system – it really does work and those patients that need special care can get it without having to go through lots of questions to get what they want.

Here is an example of how the board might look.

Terminally Ill

  • Mrs Jessie Jones    DOB 30.03.29   (ca breast)
  • Mr John Smith       DOB 25.06.57  (heart disease)

 Ante Natal

  • Annie White           DOB 26.09.80   (miscarriage)
  • Joan Brown            DOB 25.08.86   (stillborn)

 R.I.P. (recently deceased)

  • Mr Alex Swords       DOB  06.04.75   (died at home)
  • Mrs Susan Bird        DOB 12.12.45    (died in St Marys Nursing home)

You can of course make the board up in any way you think will fit in with your Surgery. But I must stress how important it is that this information is not seen by anyone other than staff.


Below are some simple but powerful words. Discuss them (or some) at your next staff team meeting. Use them for discussing customer care, patient care and working together as a team.

1.   Give people more than they expect and do it cheerfully.

2.   Don’t believe all you hear

3.  When you say sorry look the person in the eye

4.  Never laugh at people’s dreams, we all have dreams.

5.  In a disagreement, fight fairly, no name calling.

6.  Don’t judge people by their relatives, creed or wealth

7.  Talk slowly but think quickly

8.  When someone asks you a question you don’t want to answer, smile and ask “why do you want to know”.

9.  When you lose don’t lose the lesson.

10. Remember the three R’s

  • Respect for self
  • Respect for others and
  • Responsibility for all your actions.

11.  Don’t let a disagreement ruin a good friendship.

12. When you realise you have made a mistake take immediate steps to correct it.

13. Smile when picking up the phone. The caller will hear it in your voice.

14. Treat people as you would want to be treated.

Me – the patient

If you have been following my blog you will know that I am passionate about

  • Customer care
  •  communication and
  • Team work

It is vital in any job that you are doing when working with the general public.

When I am out I love to ‘people watch’. It might be in a restaurant, a shop, on a bus or train or in an  Airport – I love to watch how people react and how good people are at giving a good service.

So, it was no different when I had to go into hospital recently for a day procedure – a colonoscopy.

Let me take you through my day and the build up to it and see if you feel that I had “good customer / patient care”.

It started 3 weeks ago when I had to phone the consultants secretary to see if she had received my referral as I had not heard anything –  I phoned 2 times and left 2 messages before she phoned back and confirmed that she had in fact received the letter from my GP and went on to give me a date for my procedure.  I did not find her very helpful and found myself apologising for phoning and bothering her! Why did I feel I needed to do that?

She said that they would phone me the day before to let me know what time I have to book in for my procedure.

It got to 2.30 the Friday before my procedure and I had to phone to see what time they wanted me in – the secretary still did not know – but did phone me back at 4.30 and confirmed that I have to be in for 10.30 the following Monday. Still appeared to be cold and uncaring.

The day before my procedure I had to starve from 08.00 – that was pretty hard going I must say as everywhere I looked there was food being advertised. On the telly, in magazines and every social network that I looked on everyone was talking about the wonderful roast dinners they were about to have. It was a tough day.

I woke up the next morning feeling pretty awful – I had one almighty headache and was sick – perhaps a combination of not eating and taking medication the day before.

I arrived at the hospital at 10.15. I reported at the front desk giving my name and the name of the consultant that I was seeing that day. The receptionist said that I needed to have an ultrasound and would I please go to the 2nd floor.

I went up to the 2nd floor – I went to the nurses’ station. The nurses were obviously busy and flying backwards and forwards – one stopped and asked if she could help me – I said that I had been sent up for an ultrasound – she asked my name and  pointed me towards the waiting area asking me to take a seat. There were 3 other people waiting there too. One by one they went in –  a nurse came along and asked my name – again. I gave it to her and she said that they would be long before someone would call me. The third person went in – and then two more people came into the waiting room. Another nurse came along and asked my name again, the two people who came in after me went in. An hour after I have arrived I was still sitting – feeling quite unwell.

Then a nurse came along and asked my name – for the 4th time! She asked me to go back down to the reception desk. No explanation given.

So, I went back down to the main desk – there was a woman (I now know was a secretary) who promptly said “oh there you are – I had to come down to see if you have arrived”.  No introduction to who she was – no name badge that I could see for myself who she was – but was just ordered to “follow me”.

We then went back up to the 2nd floor – and into a different area – I was asked to take a seat and then was called in for my ultrasound. Up to this point I had no idea where I was going or why. I explained to the secretary that I had in fact been in the hospital for over an hour at this point – but no apologies to the fact that I had been sent to the wrong department in the first place. No conversation – just left sat in silence.

Then, after the ultrasound was done I was asked to go BACK down to the main reception desk and report in there. So, off I went.

Got to the ground floor, the receptionist ticked me off ‘her list’ and I was asked to go to the patients waiting room on the lower level. So off I trotted again. At this point I was getting to know the hospital very well.

I waited 5 minutes and was called  – I booked in and was asked to report to the nursing station on the 2nd floor.

So off I went to the 2nd floor again – getting to know this area pretty well at this point – and reported to the nurses’ station – for the second time that morning.

A nurse took me along to the ward and asked me to get ready and pop myself into bed – she then came along and took my blood pressure and gave me an ECG – how on earth they were not both through the roof at this point still amazes me. I certainly felt pretty stressful.

I waited, and I waited – many had already gone down to have their procedure or had already had it done back up and eating tea and toast – and I waited and I waited – nothing – no one came to tell me anything.

Eventually I was taken down – it was about 4.00. I actually have visions at this point of being told they had run out of time and I would have to come back. I wonder if they have ever had a “sit in” from a patient before – because I certainly was going through this again in a hurry. I vowed I would have stayed there until they had done it come hell or high water.

I came back up from my procedure – I should have been left to rest for an hour – but after half an hour the tea and toast was there in front of me. Not that I was complaining at this point – and boy it tastes as good as those roast dinners people were talking about the previous day. If not better.

I looked around – I was the last one in the ward – the nurse then came up and asked who was picking me up – I told her my husband – she asked me to call him which I did.

The cleaners then started coming in the ward clearing up around me – I really felt like I was in the way.

5.30 came and my husband arrived to pick me up.

I was never so pleased to see him and be going home.

I was more than happy with the procedure and the consultant, but I did feel that communication, and patient care could have been a lot better and perhaps prevented me from feeling so very drained and stressed from it all.

Did I really need to go to all of the different places to book in? Had I gone to the lower ground floor first and booked in then on to the 2nd floor that is where the ultra sound and day ward was – why send patients up and down all over the place.

As a manager I certainly would be looking for a more stress free way of admitting patients into the hospital.

There certainly was a lack of communication, and in areas lack of team work – no one knew what the other teams/departments was doing – something that really needs addressing.

And to top it all this was a private hospital – somehow you would expect a slightly better service that what I got.