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The Modern Medical Practice: A Case Study in Communication Gone Wrong

By Dr. Rich Castellano

It's Pajama Time again - a nightly ritual for many doctors today. Time to finish the day's notes and electronic filing, before the hustle and bustle of a new office day begins. Whether or not you call it Pajama Time, we have all experienced the tedious task of filling out electronic health records (According to a recent Forbes article, physicians spend 27% of their time in their offices seeing patients and 49.2% of their time doing paperwork!)

While precision, consistency, and thoughtful documentation are crucial to the job, new requirements for electronic health records are forcing doctors to spend more time documenting care than actually providing it. This not only reduces the amount of time a doc spends with patients, it also cuts into a doctor's personal life. - This results in doctors that are stressed, overworked, and resentful - which may not seem like a huge problem on the outside, but it's a ticking time bomb.

Patients feed off of this resentment and they add to the dysfunction. They see a stressed doctor and react with a mixture of contempt and fear depending on the situation. The modern medical practice is a case study in communication gone wrong. This results in a negative cycle of dysfunctional communication that ultimately impacts the level of care. In this environment, patients can react, and important symptoms can be missed.

Without healthy communication, it becomes impossible for doctors to motivate their patients to take action. The future of care is behavioral care. Whether it's taking medications, adopting a more plant-based diet, or engaging in physical activity, it is essential that a doctor be able to influence a patient's behavior after they leave the office. If they don't, others have little chance of making a difference.

I have been working to change this trend. I think the solution is found in the world of business. A great deal of the stress and pressure in the modern practice can be attributed to communication skills and customer service issues. My process has received widespread acclaim recently for taming the chaos of the modern practice. Using some of these lessons there may actually be not just relief, but even a cure for the modern burnout crisis.

Here are 4 ideas to improve the function and flow of your practice:

  1. Schedule and Block Time for Staff Training

In other industries, weeks are dedicated to training staff (even if it is to simply use a deep fryer!) Yet today, most medical office staff are expected to jump in and perform flawlessly from the moment they start.

Even highly skilled staff members should have regular training to improve teamwork and efficiency. Communication between staff members and well as communication between patients and staff need to be planned and practiced. Multiple training sessions are the key to eventually create flawless performance.

  1. Have Written Protocols and Policies

There is only one known way a person can read your mind: write down your thoughts and show it to them. People are not mind readers. Written protocols are essential to avoid misunderstandings that training on-the-fly can bring. Remember, speaking is not the same as communicating, being understood is communicating. Training also needs to be focused. Many offices practice the art of the "On-the-Fly Training," (They wait for a situation to arise naturally and then respond with a sentence or two about how staff should react.) Imagine if professors taught a class using this method. How could anyone pass? Take the time to go over the ideal way your office should operate no matter the size of the practice. Plan out all the details in writing and commit to proper and regular training. Ultimately, communication is not what we say, it is the response we receive.

  1. Provide Excellent Customer Service

We don't often think of a doctor's office as a business, but patients still expect customer service. This is a skill that does not come naturally, and it applies to every single task an office is involved in. Unfortunately, many doctor's offices don't train staff regularly and thus they seem disorganized and short with patients. Make customer service a priority in your office and positive changes will come.

How do you improve customer service? Smiling, training, "protocol-ing," and cultivating your team over time!

  1. Hire a Person Who Smiles ... A Lot

Nonverbal communication accounts for the majority of a customer services experience. Attitude and nonverbal skills are measurable, reproducible and predictive of human behavior. The kind of person you want to greet patients is the high smiler. When someone makes eye contact a smile should be instant, setting the entire experience with that patient on the right course.

How is the function and flow of your office? Does it add to your stress or does it help reduce it? Remember, the doctor is the core of a practice and the positive cycle starts with you.

It's true, good communication takes a bit of work - you may even have to spend an extra hour of pajama time planning... but it will save you stress and burnout in the end. If we all implement these strategies it may even reverse the medical burnout crisis.

Wall Street Journal best-selling author Rich Castellano MD, (known as The Smile Dr.) is an experienced facial rejuvenation artist, innovator, and highly sought-after trainer. As the Founder/Medical Director of ImageLift® Dr. Castellano has performed over 10,000 laser and cosmetic treatments, making him one of the most sought after facial plastic surgeons in the U.S. today. His new book "The Smile Prescription" explores the art of smiling, facial expression, and innovative communication strategies. Dr. Rich now teaches plastic surgeons and cosmetic doctors from across the country as private clients with his award winning, online coaching and mentoring program, His 2-Day LIVE event in Tampa, Florida offers 15 CME credits to most categories of healthcare professionals Dr. Castellano has made hundreds of live appearances including guest interviews on The Daily Buzz, FOX, NBC, ABC, CBS, and numerous other media outlets.

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