Dr. Greer also makes it a point to physically examine every patient, which includes a full rheumatology and internal medicine exam. “This ensures that I will obtain the information I need, and also makes the patient feel that I am more involved in their care,” he says. An exception would be if they had an isolated condition, such as trigger finger. He believes this is important because most rheumatology patients have multiple conditions and co-morbidities. For example, rheumatoid arthritis patients may also have high blood pressure, obesity, diabetes or coronary artery or gastroesophageal reflux disease. “Don’t only focus on the one arthritic complaint, because other medical problems will interact with how you treat them.”
Dr. Mascarenhas has found that many patients link how well they understand their physician with the quality of care that is delivered. “It can be helpful to inform patients of your ultimate game plan, so they can see the big picture,” she says. For example, during a visit she might discuss her plan for stepwise testing. This way, there are fewer surprises if they receive a follow-up call advising further testing. She might also discuss long-term medication plans. In addition to discussions about typical side effects, it can be helpful to let a patient know how long it will take to see the full effects of a particular medication. Discuss an alternative plan in case the treatment regimen fails.
To improve wait times, Dr. Mascarenhas considered what medical assistants were asking patients in exam rooms & realized that some questions were unnecessary. ‘Reducing their duties to essential questions decreased the time spent rooming patients, which again improved our clinic flow,’ she says.
Promptness
Patients need to understand that their physician is attending to many other clinical challenges, not only their own. And physicians need to understand that patients lead an existence outside of their practice. “Mutual respect and understanding of the time constraints of both parties [are] essential,” Dr. Rosenstein says.
Dr. Mascarenhas says promptness involves staying on time with your schedule and, if you’re running behind, having staff inform patients of the wait time. But going beyond this, she has found that giving patients reasonable expectations about timeframes works well. “Some patients expect to get results back before they may even be available,” she says. “Other patients may expect paperwork, such as Family Medical Leave Act forms or prior authorizations, to be completed immediately, which may not be plausible in many practice models.”
