The work of a registrar combines two sensitive topics: money and health.

“This makes the level of professionalism and persona of a registrar even more important,” says Rebecca Steve, director of electronic health record training for the revenue cycle at Texas Health Resources in Arlington.

Registrars need to “remain calm under pressure and operate with unconditional empathy,” Steve says. “Having sensitivity to a patient’s circumstances often diffuses a difficult patient situation.”

When treated with compassion, patients are more likely to be more engaged with their clinical care — and to pay their hospital bill. “The work registrars do will ultimately impact larger ticket items,” Steve adds.

Patient access employees at Texas Health Harris Methodist Hospital Fort Worth receive specific training on empathy and the importance of listening. “They learn that not all problems need fixing. But all people need listeners in their life,” says Patient Access Director Maureen Bottom.

Staff use role-playing scenarios to practice showing compassion. Supervisors watch for the right eye contact, body language, facial expressions, and tone of voice. It is easier to train someone to verify insurance than to display compassion. That is why managers look for people who are good at it already.

“We give the interviewee a handful of patient scenarios. We ask how they have dealt with them in the past,” Bottom explains. Managers look for responses that are focused on what the patient was going through.

Empathy is the focus of a three-hour class taken by all patient access employees at The Ohio State University Wexner Medical Center. “We stress to our employees: ‘You never know exactly what that patient in front of you, or visitor in the hallway, is in the hospital for,’” says Kylie Sokol, manager of patient access services, financial counseling, and preregistration.

Staff keep in mind that an irate-sounding person might have just received a cancer diagnosis. Maybe a loved one is on life support or is giving birth. “Avoiding judgment and recognizing emotions in other people is key,” Sokol says. The words registrars use do not need to be complicated. At Wexner Medical Center, registrars start by asking, “How can I help you?” They end by asking, “Is there anything else I can do for you?”

When a patient offers thanks, registrars say, “You’re welcome!” Further, registrars tell patients, “I appreciate your time.”

Registrars are observed continually to be sure they are sticking to these habits. Managers listen for introductions by name and open-ended questions (e.g., “What can I do for you today?” or “Do you have any other questions for me?”) Meanwhile, in addition to listening for the common courtesies of “please” and “thank you,” supervisors also watch for good nonverbal communication (i.e., eye contact, facial expressions, and body language).

If registrars are performing these tasks well, they are heaped with praise such as “Very clear explanations!” and “Great eye contact!” Otherwise, they will hear reminders such as “Please use please” or “Please introduce yourself.” Sokol adds that any constructive feedback is delivered to registrars right away.