This week's tip was inspired by an e-mail question from Richard Newson of Harrington Eyecare in Richmond, New Zealand. The Management Tip of the Week has a distribution of about 14,000 readers and I receive many nice comments and suggestions from colleagues all over the world. Your feedback is always appreciated.
It is important on many levels to train staff members who make appointments by phone about the appropriate handling of eye emergencies. These appointments have vital implications from a clinical standpoint and, if handled well, they can also be a major practice builder.
We probably all agree that patients with true medical emergencies should be seen immediately. Receptionists should be trained to question callers about the reason for the requested appointment and listen for clues that a serious eye problem could be present. The doctors in your office should develop a list of symptoms that should be regarded as urgent, and this can be posted at the front desk where appointments are made. Our list includes:
We have built our practice by having our receptionist reply to callers who say they have an emergency by saying: "how soon can you get here?" This is the response the caller is looking for and it creates a powerful bond between the patient and the practice.
- Any painful and/or red eye
- Eye injury or foreign body
- Any sudden loss of vision
- A curtain or veil over the vision
- Flashes or floaters
- Cloudy vision or halos around lights
- Extreme sensitivity to light
- Sudden onset of double vision
Beyond these true medical eye emergencies, we take pride in making appointments available promptly to any caller who believes they have an urgent problem. These urgent (but non-emergency) appointments are worked into the schedule that same day or within the next couple days. Since urgent calls are in the minority, a skilled receptionist can always find a way to accommodate them even if the appointment book is generally filled well in advance - see below for tips on how to do this. We hardly ever receive a walk-in patient - but some offices do. If I were in a setting where walk-ins occurred, I would structure my office to try to accommodate them, with the understanding that people with appointments have precedence.
- Remember that marketing is identifying and satisfying patient's wants and needs. Convenient and fast appointments are a big one.
- Our practice is capable of performing eye exams quite efficiently - so adding an extra patient does not create major scheduling backups. We also fine-tuned our appointment schedule over time with some pre-inserted block-out slots in the morning and afternoon to allow time for emergencies - as well as general catch up, returning phone calls, etc. We work hard to stay on time for appointments.
- Cancellations, brief follow-ups and family clusters are good places to squeeze in urgent visits.
- An emergency patient may not have the luxury of seeing the doctor of their first choice in our group. Emergencies are a great way to fill the schedule of a new doctor.
- We book these patients for a comprehensive eye exam and charge them for it. Office visits for a red eye actually take longer and require a higher level of decision making then routine annual eye exams. We do all the tests normally included in a comprehensive exam. Why charge for an intermediate or brief visit?
- We inform callers of the exam fee over the phone and let them know that the fee is due at the time of visit. We will bill Medicare - but we let patients get reimbursement themselves for major medical insurance.
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