By Ruth Carol, contributing writer

Whether or not you view patients as customers, there has been a growing emphasis on their overall experience and satisfaction at the dermatologist’s office in recent years. “The idea continues to grow that we should not only provide excellent medical care, but also provide as good an experience as possible,” noted Charles Ellis, MD, who practices in Ann Arbor, Michigan. “Whether we should speak of patients as customers is a semantic issue because patients have always been our customers. The real question is: How much attention do doctors want to pay to the patient’s experience?”

The word ‘customer’ may not sit well with physicians because it is perceived as being too commercial, Dr. Ellis said. “It sounds like we are trying to sell a service, but we are providing medical care, whether the patient comes in for a skin condition or a cosmetic procedure. ‘Customer’ doesn’t capture the responsibility that physicians have to their patients,” he added.

Beth Goldstein, MD, who practices at Central Dermatology Center in North Carolina, concurs. “You have a higher responsibility than just keeping a customer happy. You have to deliver the best care possible,” she said. “Of course, you’d like all of your patients to have a very positive experience, but at the end of the day it’s less important than providing great care and doing no harm.”

This nuanced shift started with the growth of cosmetic dermatology, noted Dr. Goldstein, who provides mostly medical and some cosmetic dermatologic services. “For those of us who have a cosmetic component to our practice, we’re already in that mindset for those patients,” she said. “They’re customers, but they’re still your patients. It’s not different in terms of your mindset,” Dr. Goldstein said, “but it is different in terms of their expectations.”

This mindset may have started with cosmetic procedures, which have more of a retail feel to them, but it has spread to the medical side of dermatology for myriad reasons. The use of electronic health records — which has made medical records more accessible to patients — and the advent of high deductible health plans — which has made patients responsible for more of their health care costs — has helped make this shift to the medical side in recent years, stated Tony Davis, president of the Association of Dermatology Administrators and Managers. “People are more cognizant of how much health care services cost,” he said. “They realize that they have a choice and can be more selective about which physicians they see.”

Consumer-driven approach

So what else enhances the patient experience aside from optimal medical care? What other considerations does being more customer- or consumer-service oriented require?

“We know that no matter how good the quality of your care is,” Dr. Goldstein said, “if the person answering the phone is rude or uncaring, the caller will never make an appointment.” It’s about how patients are greeted when they come in, how they’re treated when they are brought back to the exam room, and how long they’re waiting in the room. Does staff make them feel welcome and important? If there is a wait, are patients given an option to wait, reschedule, or see another physician in the practice? Do they understand everything that happened during the appointment and were all their questions answered? “When you put your hand on the door do you ask, ‘is there anything else I can do for you today?’” she said. When patients are checking out, how are they treated when asked about payment? How are issues with the bill addressed?

“We teach staff that they play a vital role in the patient experience,” said Davis, who is also the executive director of Dermatology Specialists and manages 15 dermatologists in Minneapolis and St. Paul. “They set the tone from taking the first phone call, to addressing billing issues.”

Staff training

Staff training has evolved to promote a consumer-driven approach. Dermatology Specialists has adopted the “on stage, off stage” concept coined by the Disney Corporation to train all new employees, Davis explained. “When staff is behind the desk in their uniforms, they are considered to be on stage in costume and should act accordingly. They shouldn’t be checking their cell phones, eating snacks, or having personal conversations that can be overheard by the patients,” he said. There are spaces where employees can go off stage to eat and take care of personal matters.

Recently, all employees working at the front desk/reception area at the three locations of Central Dermatology Center received customer-service training. The instructor emphasized ways to enhance patient interactions by, for example, maintaining eye contact, greeting people individually, and focusing on them when speaking, said Robin Sigismondi, practice administrator. The instructor talked about the importance of body language and facial expressions when interacting with patients in person, and even smiling when conversing with patients on the phone to help keep the conversation positive. Having the same training reinforces key messages and spreads them across all staff, she added.

When hiring new employees, there is now more of an emphasis on an individual’s personality and service qualities because — assuming that the person is otherwise qualified — he or she can be trained to do specific tasks, said Dr. Ellis, who is also a professor in the department of dermatology at the University of Michigan Medical School. “However, you can’t train someone to have a warm and engaging personality,” he said. Dr.