Awkward moments present marketing challenges

How should they be addressed?

Spend enough time in any of your physicians’ waiting rooms, and you will witness one of those awkward moments where a physician is running late and patients are angry about it. How will staff react?

The way the physician’s staff handle such moments, sometimes called "moments of truth," can go a long way toward determining patient views of the practice — and your health system.

Moments of truth can occur in the reception area, in exam rooms, and even during phone calls to collect overdue bills. They are critical patient contacts because patients tend to judge a practice based on the way they are treated when they feel stressed, says Kevin Sullivan of the San Diego-based health care consulting firm Sullivan/Luallin.

Patients may be stressed over their illnesses, length of recovery, cost of treatment, or any number of things. "It is when things go badly, and somebody knocks themselves out for me — that’s what sends me into the street singing their praises and referring my family members and friends," says Sullivan.

Physician practices have many moments of truth daily, and each one puts the reputation of the practice — and your health system — on the line. The question is, how should those difficult situations be addressed, by whom, and to what extent?

For staff members, the best rule of thumb is that each employee should handle such challenges only to the extent that they feel comfortable doing so, says Carole Batten, marketing director for the Charlotte (NC) Surgery & Laser Center.

For example, recent hires generally feel less comfortable explaining practice policies than do long-term employees. By the same token, practice management probably is more comfortable having its experienced staff handle most patient inquiries.

It is up to the physicians, the practice administrator, and practice management staff to set the tone for the way patients are treated in difficult situations, says Batten. Her recommendations are as follows:

Convey empathy.

Staff should tell patients they understand why the patients are concerned about whatever is troubling them, says Sullivan.

Demonstrate a good example for staff.

A practice manager can be a positive role model, especially for younger staff members who aren’t experienced with medical practices or working with patients. For instance, when a staff member approaches Batten with a patient’s question about a practice policy, Batten will bring the staff member back to the patient with her to explain the policy. The employee can observe not only the response to the question, but how it was presented to the patient.

Focus on how the message is conveyed.

In any moment of truth, how you come across is more important than what you come across with, says Sullivan. Sometimes that is a difficult concept for physicians to understand because their many years of training focus almost exclusively on the content of the communication.

Nonverbal communication, such as your body language and eye contact, should match the content of the words you speak. Practice management should explain to staff the importance of all aspects of communication.

Prepare for the occasion.

Practice makes perfect. Managers can help staff members prepare for their moment of truth by practicing responses to commonly asked questions. Sullivan has prepared scripted responses for some of his clients.

Consider having employees record themselves on video or audio tape, Sullivan suggests. "A lot of times when people hear their own voice, they will say something like, ‘Gee, I sound tired. I didn’t know I came across like that.’" With practice and coaching by managers, improvement becomes achievable.

Putting it into practice

Waiting room.

The waiting room is perhaps the most common site of moments of truth. Patients who have been kept waiting often glare at front desk personnel. The typical practice’s high turnover among receptionists means practice managers have comparatively little confidence in employees’ ability to respond to patients, says Batten.

Her suggestion is to keep it simple for the receptionist. First, the receptionist should acknowledge a patient’s lengthy wait by offering coffee and magazines. If the long wait continues, the receptionist should offer to go into the examination area to check how much longer the wait might be.

Further interaction with patients in the waiting area is probably best left to practice managers.

Exam rooms.

As in the reception area, patients should be aware of how long they will have to wait. "If a medical assistant or nurse can keep them apprised of their status, that will help," says Sullivan.

When drawing blood, a nurse should be sensitive to the fact that most people don’t like to be stuck with a needle. Express compassion and tell them it will only take a minute, says Sullivan.

Nurses also should take time to explain why procedures are necessary or what purpose a test serves. That can relieve patient anxiety.


Collection efforts are the ultimate test of how well a practice responds to a moment of truth.

How a collections person handles the job can make a huge difference in the success of a practice, says Batten. "Circumstances could be such that you want to be able to work with the patient, especially if they have been a long-term patient," she says.

A collector has to convey two thoughts to the patient, says Sullivan:

— Money is owed to the practice.

— The collector understands the problems facing the patient.

"That does not necessarily mean that you agree with me," he says.

The collector expresses understanding primarily through tone of voice but also through words. Phrases like "we understand" and "yes, it is a difficult time" are tools of the successful collector, says Sullivan.

It is difficult to find someone who can be sensitive, yet know when he or she is being conned. "The person who does our collections for us has done it for 19 years. We have the wonderful benefit there of her knowing those patients that are long-term and being sensitive to that," says Batten. "Yet she also is a very wise person who knows when she is being taken for a ride."

Although most of the skills necessary to succeed in responding properly to one of these moments can be taught, Batten says not all employees are cut out to be goodwill ambassadors. "Some people are blessed with common sense and automatically do them," she says.

On the other hand, there are people who have a terrible time trying to respond to patients appropriately in almost any circumstance. "For them it’s better that they not go out on that limb," she says.