Memo From The Editor

Those *#!?#* phones

Marianne Dekker Mattera

The telephone is a lifeline. At least it can be. It can also be the source of untold frustration—and, in a physician's office, litigation or, worse, a cause of death.

I'm well aware that, at a busy office, the phone can drive both staff and doctors mad. There are calls from patients, pharmacists, other doctors, insurance companies, labs. And you make outbound calls to those same groups. Never mind the personal calls—and we all get them and make them at work, no matter what the official policy.

I'm also well aware that every call that comes in disrupts something. I can't imagine there's even one practice out there today that can afford to have someone on staff who simply sits in front of the phone and waits for it to ring. So, the phone rings, and someone must stop what she's doing, answer it—politely, we trust—and then either deal with the caller's needs or pass the call on to someone who can deal with them. Then she has to remember what she was doing before the interruption and try to get back to it with the same level of concentration. Then the phone rings again.

In an effort to triage those phone calls, a lot of practices have taken a page from corporate America and set up automated systems that route callers through a lengthy menu of buttons to press, depending on whom they're trying to call and what they're trying to call about.

On systems in medical offices, the choices are also directed by who the caller is. Well, let me give you a clue: The most important caller, the one who should have to listen to the menu only as far as the first or second selection, isn't necessarily the patient!

Need proof? Here's what I heard when I called a physician's office recently:

First came a cheery greeting telling me I'd reached the offices of Doctors A, B, C, D, and E. Then came details on where the practice is located—address, suite number and floor of the building—followed by the phone and fax numbers.

I was on the phone for 45 seconds before being told that if the call was an emergency I should press 1. Those 45 seconds can be an eternity to someone who really is in the midst of an emergency. They can also make a critical difference in the outcome of his care.

And the emergency number isn't even reserved for emergencies. You also press 1 if you're "a doctor, hospital, or visiting health service."

The next level of priority (press 2) goes to callers from "an assisted living center, nursing home, doctor's office or patients calling to obtain test results."

The poor person who's calling to make an appointment gets to press No. 6! (He's really sick, but being a trouper, he realizes he's not an "emergency" and has waited for the appropriate prompt.) It takes a minute and a half before he hears that prompt. Again, not a long time, but if the patient has dragged himself out of bed, feeling rotten, he doesn't want to be standing around on the cold floor waiting to speak to a real person.

Being sixth and last on the list also tells the caller that he's less important than someone calling from a pharmacy or even someone who wants the billing office. When in fact, aside from the true emergencies, that patient calling for an appointment should be the MOST important caller, the one who gets triaged first.

That caller is the one who pays your bills. That caller is the one who reports to his managed care company on a physician report card on whether it's easy to get in to see you. That caller is the one who may—or may not—recommend you to friends.

So I urge you, if you've gone to an automated answering system, dial in from outside. Listen all the way through the message. If the patients—who are, after all, your practice—come too far down the list, make a change. Do it soon, so they won't dread calling your office and listening to your *#!?#* message.

 

Marianne Mattera. Memo from the Editor: Those *#! Medical Economics Dec. 3, 2001;78:4.