Creating a Customer-Friendly Environment
Medical assistants are the first to encounter the patient in many instances. Therefore, they are responsible for the initial impression the patient has of the practice or facility. The concept of “The customer comes first” should be a primary goal for all health care providers and must be maintained in order to sustain a satisfied client base.
Medical assistants should view the patient as a consumer of health care. Today, patients and family members are more knowledgeable about health care options because of the Internet and other media and sources of information. They no longer place the physician on a pedestal as patients may have done in the days when physicians made house calls. In fact, many patients can experience a certain amount of alienation from their health care providers, because most physicians today are specialists. Specialization can lead to viewing the patient and the patient’s injury or procedure as one and the same—“a broken leg” or “an appendectomy”—a viewpoint that is both too narrow and degrading. Instead,
the patient should be considered holistically and treated with dignity and respect.
Using good interpersonal skills to establish a positive environment in the health care setting generates a customer friendly atmosphere and a comfortable workplace. A warm, friendly greeting, showing respect to the patient, being sincere and sensitive, and demonstrating a caring attitude can help set a positive tone.
Greeting Patients A patient should be greeted within one minute of entering the office. If you are speaking on the telephone when the patient comes in, be sure to acknowledge the patient’s presence with a smile and nod. Give your full attention to the patient as soon as you complete the telephone conversation.
Know Your Patient It is important to understand the patients who come to your office. Become familiar with their background, culture, education level, and socioeconomic status. Knowing and appreciating this information about your patients will help you to build a climate of respect and trust. It is said that patients don’t care how much you know until they know how much you care about them.
*FIGURE 5-5 Effective listening skills demonstrate empathy to the patient and break down barriers to communication.
COMMUNICATION BARRIERS
As a medical assistant, you can overcome communication barriers by exercising both observation and patience. Communication barriers are factors that prevent a message from being received or that distort its meaning. Identifying and overcoming these barriers is essential for effective communication (Figure 5-5).
Distractions of various types can become communication barriers. External or environmental distractions include factors such as temperature and noise. The medical assistant can usually eliminate these distractions by taking the patient to a quieter location, offering a seat away from an outside door, finding a cooler spot if the patient is too warm, or providing a blanket if the patient feels cold. Internal distractions, such as pain, hunger, or anger, might not be so obvious, but your skills of observation and empathetic listening may help you to establish communication. Table 5-5 gives examples of internal and external barriers to communication.
An incorrect approach is giving the patient false reassurance. Saying something like “Everything will be all right” can result in the patient’s reluctance to talk to you if you give the impression that you don’t understand or are dismissing the seriousness of their personal or health-related situation. Such comments can also lead to liability issues for the physician if the patient believes that a promise for recovery has been made. The medical assistant also may unintentionally put up barriers to communication. Such obstacles include not looking at the patient who is speaking, interrupting the patient, abruptly changing the subject, and—as in the “everything will be all right” example—using meaningless statements to soothe the patient.
Medical assistants must remember that patients come to see the physician because they have a problem. Patients should never be treated in a condescending manner.
*FIGURE 5-5 Effective listening skills demonstrate empathy to the patient and break down barriers to communication.
**TABLE 5-5 | Internal and External Barriers to Communication
Internal Communication Barriers External Communication Barriers
Fatigue Noise
Disinterest Temperature
Past experiences with the medical care Body language
Home or work problems Odors/scents
Pain Children (your own or someone else’s)
Hunger Language
Anger Malfunctioning equipment
*FIGURE 5-7 Emotion: anger.
Emotions
As a medical assistant, you will experience and witness all types of emotions and feelings. Emotions can vary from person to person because of the person’s general emotional makeup or because of that person’s past experience.
Medical assistants encounter patients who are frightened, depressed, or angry. How do you know a patient is experiencing such emotions? How can you help that patient? Take time to think through the following scenarios.
- Holly Sutter, CMA, was given a medication order by Dr. Baldwin for Christine Liu. After preparing the medication, she entered the examination room to give Ms. Liu the injection as ordered. Ms. Liu asked, “Am I getting a shot?” Her eyes widened, she began to sweat, and her heart started to beat faster (Figure 5-6).
Holly responded by saying, “Yes, I have your injection right here.” Ms. Liu stated, “I’m not getting a shot,” and walked out of the examination room. Holly did not recognize that Ms. Liu was displaying fear. Holly was focused only on completing the task of giving the injection. Before Holly entered the examination room with the injection, she should have explained to Ms. Liu that she would be receiving the medication Dr. Baldwin ordered by injection. This would have given Ms. Liu the opportunity to express her negative feelings
about receiving an injection, and it would have given Holly the opportunity to maintain control over the situation. If unable to help Ms. Liu accept the injection, Holly could have offered to convey Ms. Liu’s response to Dr. Baldwin, who might have been able to provide appropriate medication in a different form.
- You are working in the front office when a patient comes to the front reception window and starts screaming, yelling, and cursing at you. Even a patient who doesn’t attack you verbally may show signs of anger that you can recognize. How can you recognize and deal with an angry patient?
If a person is angry, a reddish color may appear on the face and ears, eyes may be slightly squinted, lips may be pursed or tightened, and fists may be clenched (Figure 5-7). These are just some of the signs that a person is angry. Once you recognize that a person is angry, remain calm. As long as the patient is not being aggressive, allow him or her to communicate the anger. First, make it clear that you understand the patient is angry. Next, so you can resolve the issue, inquire about what is making the patient angry. During the conversation make sure you are empathic so the patient knows you are concerned about the issue.
- Holly Sutter, CMA, is taking a patient’s vital signs when the patient tells her, “I failed all my courses last quarter, and if I fail any more courses I’m going to be kicked out of school.” During the conversation, the patient starts crying and tells Holly, “I’m having trouble sleeping, and I am tired of trying so hard in my courses and not succeeding” (Figure 5-8).
During the conversation with the patient, Holly should be empathic and caring. After Holly allows the patient to express his feelings, she should immediately tell the doctor about the conversation and the statements the patient made. It is also important for Holly to document the situation in the patient’s medical record.