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 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
I have had several people contacting me regarding my posts on DNA’s.
The first blog I did was the impact DNA appointments have on Hospitals and Surgeries.
The second blog was in response to a comment made by a Reception Team Leader and how her surgery is proactive in dealing with this problem, which I might add I think is a great system.
This the 3rd blog on DNA’s is from a patients point of view.
Someone contacted my regarding DNA’s and how this impacts on the health service resulting in people having longer waiting times for appointments.
This lady had a hospital appointment a couple of weeks ago, she realised the week before that due to unforeseen circumstances she was unable to keep the appointment the following Monday afternoon, and working in the healthcare sector knew how important it was to cancel the appointment and give someone else the chance of the appointment.
On the Wednesday the week before her appointment she tried to call the consultants secretary to cancel the appointment.
She was greeted with a recorded message saying that the secretary was on holiday and the secretary actually said in the recorded message there was no facility to leave a message. She asked that people call back on her return in 10 days time.
Obviously this would be too late to cancel the appointment. So this lady phoned the hospital and asked for outpatients department, the switchboard put her through and it rang and rang and no one answered. So she had to phone the main switchboard back again. She explained that no one was answering in outpatients, but she was put through again anyway – and again no one answered. So, she had to phone back yet again, she explained about wanting to cancel her appointment, before she could say much more she found she was put through to the “secretary” again, and heard the message she originally heard – and the fact she couldn’t leave a message!
She gave up at this point and left it until the next day when she tried again. She said that she was put through to several different departments, no one wanting to take responsibility for the call she was even told to phone the secretary on her return in 10 days time. She explained that the appointment was in fact in 4 days time and wanted to cancel it and not have a DNA against her name.
She got nowhere – so tried again on the Friday – the same run around.
Monday morning the day of the appointment she phoned the hospital and finally got put through to someone – she explained that she was unable to attend her appointment that afternoon and could they cancel it and ask the secretary to send her out a new appointment. After taking the woman’s name said she would.
Two weeks went by and this lady had heard nothing so she telephoned the consultants secretary who was not back from her holidays – and to no surprise she found that they appointment had NOT been cancelled, she in fact had a DNA against her name, and the secretary did not get the message about her wanting another appointment made.
To say she was fuming was an understatement.
So, in order to get the DNA rates reduced it takes time and effort from all involved.
Patients have to be more responsible for cancelling appointments and this needs to be dealt with in a delicate manner.
Surgeries and Hospitals need to ensure that if a patient does cancel their appointment that it is recorded and cancelled and the patients does not received a DNA against their name.
Hospitals and Surgeries cannot moan about the amount of DNA’s they have unless they have a policy in order that will actually deal with this when the patients requests to.
And systems have to be in place that these messages are getting through to the right people.
The lady involved felt that no one wanted to listen to her – the operator just didn’t listen to what she was saying which resulted in her being put through to departments that if she had been listened to could have been avoided.
I would suspect that most patients after the first 2 or 3 phone calls would have simply given up trying to cancel the appointment.
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.
If you could stand in someone else’s shoes…..hear what they hear…..see what they see…..feel what they feel would you treat them any differently?
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. http://www.youtube.com/watch?v=cDDWvj_q-o8&sns=em 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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A Practice that I worked for did have several staff that was registered as patients. Normally this worked out well until one Monday morning…………………
I answered my phone to the Supervisor from one of the surgeries – it was 9.00 am and of course very busy. She told me that one of the Receptionists on her team was poorly. She told me that the Receptionist had just seen the doctor and he had told her that she had shingles – and that he told her it was ok for her to carry on working.
I got in the car straightaway and went down to the surgery to see what was happening.
The Receptionist in herself was feeling ok – but the shingles were on her hand and she was on the front desk booking patients in. The shingles were obvious on her hands and arm. The other Receptionists were also concerned about her working.
I went in to to the Doctor and suggested that I sent her home – he first reaction was but the girls are short-staffed in reception and we are busy!
We talked it through and agreed that she would be sent home and I would get another Receptionist to cover her shift.
I put this incident onto the agenda for the next Doctors meeting. It was interesting to hear what each of the doctors had to say about it – most agreed that she should have been sent home, but the doctor in question did raise the issue of it being difficult he said that he felt torn as a doctor and as an employer. As a doctor he would have signed her off work but as an employer he knew it would have caused a lot of problems in reception if he sent her home. At that moment in time he said that being the employer took over – he knew they were short-staffed in reception, and that the receptionist was in fact ok in herself so took the decision that she could carry on working. The Receptionist was also happy to continue working.
I asked if she had not been an employee what his decision would have been. He replied that he would have signed her off sick.
This did raise some concerns within the meeting and from that meeting a decision was taken that any new employee was told that they could not register with the practice as a patient while they worked there and all other staff that was registered at the practice they were told that they could stay on the practice list but would have to be seen by another Doctor at one of the other surgeries. That way no pressure would be put on any of the doctors not to sign off staff at their own surgery.
Some Receptionists chose to register with another practice because of this, the others were happy to be seen at one of the other surgeries.
There was also another incident where a Receptionist was registered at the practice she worked in. She had gone for her usual 3 yearly breast screening.
The Supervisor of the Receptionist came up to me one morning asking if she could talk to me in private. She had the results of the Receptionist that showed she had breast cancer. The Supervisor was very upset by this as she was not only a colleague but a very good friend to the Receptionist.
It was by sheer luck that the Supervisor had in fact opened the results that morning – not a job she normally done – it usually was done by one of the other Receptionists. The Supervisor was upset by the fact that she knew the Receptionist has breast cancer and was sitting in Reception laughing and joking not knowing what lay ahead of her.
I took the results down to her doctor who spoke to the Receptionist concerned.
So, while there might be benefits to having staff registered as patients it can also lead to problems.
Do you have a system whereby if staff are registered as patients that their records are blocked so their notes are not open for everyone to read?
How would you have managed the above?
The events described in my blog are based on my experiences as a Receptionist and Manager. For obvious reasons of privacy and confidentiality I have made certain
changes, altered identifying features and fictionalised some aspects, but it remains an honest reflection of life as a Receptionist and Manager working within the Healthcare sector.
Patients come in all shapes and sizes – literary.
In all my years working in the NHS I would actually say that 90% of patients were always courteous, friendly and extremely grateful. There of course were the other 10% those that would complain and were always ready for an argument. Unfortunately these people can spoil any good organisation they come across.
One thing I learnt working within the healthcare sector is that you have to learn very quickly not to be judgemental.
I believe that you should always treat people as you would want to be treated.
I quickly found the best way forward was to gain the trust of the patients. Listen to their needs; get to know them as people – after all everyone is different. Let them get to know you as a person. The trust soon builds up – but it has to work two ways and when it does it works well. The patient won’t push their boundaries and they will trust you to do the best for them – and you do.
On a daily basis receptionists will come across people from different backgrounds, cultures and beliefs. Receptionists will come across people who are often frightened, anxious, nervous, or just downright rude. That is the nature of the business that we are in.
The key to dealing with these people especially is the rude patients is to remember that there might be a reason why they are being rude – now don’t get me wrong rude is not acceptable – but in some cases these people might be in pain, be worried about what might be wrong with them or perhaps a loved one – maybe worried about the unknown or recently suffered a bereavement. You can’t always see on the outside what is going on in the inside.
But of course there are those patients who are just downright rude – and when I trained new staff the best possible advice I could give them was to try to not to take rudeness personally. Rude people are usually rude wherever they go – it’s not just the Doctors Surgery they keep their rudeness for.
The first rule I would advise a Receptionist when they were faced with a rude patient at the desk would not to answer back. Don’t get involved in a disagreement or argument. Don’t fuel an argument. But it is important to listen to what the patient is saying.
Sometimes a person just needs to let off steam – not right but it happens – and nothing more will fuel an angry person is another person arguing back. So, listen, apologise if the fault was on our part and after a while you will find that the rude/angry person starts to cool down – they have nothing to fuel their anger – and usually the Receptionist will find that the patient will actually end up apologising for their outburst or anger.
Another thing is to sit and think to yourself – this person is not directing this at me “Ann”
they are venting their anger at the “Receptionist” the person sitting in front of them and if someone else was sitting here behind the Reception desk they would be saying exactly the same to the that person. I always found this a good one to remember when someone was being rude to me at the desk.
But if this continues as sometimes it did 3 or 4 times in a morning or afternoon you can soon start to take it personally. I always would advise a Receptionist if she ever found herself in a situation that she couldn’t handle then she should walk away from it and pass the patient over to someone else to deal with. We all have had to do that at sometime. We all came across situations they we felt was out of our control – but it was the way you dealt with it that was important.
At times we also had to face violent patients – I am pleased to say that our Surgery didn’t have many of these – but when we did it was unpleasant not only for staff but for other patients in the surgery too. In all my time there were only a couple of times we had to call the police – thankfully. But unfortunately there were Surgeries not so far from us that had that had violent patients to deal with on a daily basis.
Another thing I found in my journey from Receptionist to Manager is well-trained staff are confident staff. Often Receptionists are faced with a situation that they are unable to handle. Confident staff can usually defuse a situation before it starts getting out of hand.
I will be sharing some of my experiences and stories when dealing with patients throughout the years in future blogs.
It is important that new staff have availability to addresses and telephones numbers of all agencies that the Practice might use. Some of these might be required in a case of an emergency and will be needed quickly.
This does not only apply to new Receptionists/Secretaries but to anyone starting at the Practice including locums.
You should include a copy of the list in the locum handbook which should be available for all Locums when they begin their shift.
I suggest that a file of such contacts is kept in Reception, together with a list in each of the consultation rooms including the nurses rooms – often other healthcare professionals will use these rooms for example a midwife might work once a week and use either a Doctors or Nurses room. Your Practice might also have a counsellor or a physiotherapist working from one of these rooms. Locums will more often than not be put into most of these rooms depending on who they are covering for.
The numbers will vary according to your location but a few suggestions are given below to start off your list.
- Nearest with an accident and emergency department
- Local maternity hospital
- Neighbouring hospitals (in case local is busy/closed)
- Psychiatric hospitals (ENT, eye, neurosurgical, etc)
- Direct line to emergency service
- Routine bookings
Out Of Hours Service
- Admin Office
- Number for patients to call.
- Local Police Station
- Security alarm firm
Family Planning Clinic
Local Funeral Directors
Practice Staff (always ask permission before displaying information)
- Practice Manager
- Other Receptionists
- Other Staff
- General Administration Office
- Various numbers that will be applicable to your surgery
- Social Services Department
- Child Protection Department
- Refuse Collection Services
- Hospital Transport
- Taxi firms
- Local transport
- Volunteer drivers (if applicable)
Other Local Doctors
- Especially those providing emergency services
- Alcoholics Anonymous
- Bereavement Service
- And so on……………
The list can be expanded as much as you like, but keep the names in a logical order so that others can find them easily.
It is vital that the list is checked on a regular basis, updated as required and all old copies removed and replaced with the updated ones. I suggest that this is typed and saved on the computer for easy assess and updating. A address book can sometime get messy and often does not get updated as it should.
Again, before you add any personal numbers of staff or Healthcare professionals please ask their permission to do so.
It is vital that you have such a list – as often you might have a locum working late on a Friday evening with possibly just one receptionist when one of these numbers might be required.
Something so simply can go a long way to helping not only the Doctor/Receptionist but also the most importantly – THE PATIENT.