Predictably, the most sought after and most efficient medical practices have a common denominator: the ability to educate and communicate in a timely and effective manner. Patients do not come to us for our ability to make a buttress pad or apply an Unna boot. They come to us for our diagnostic ability and to be effectively educated on their condition and the available treatment options. As an educator, you are viewed as the authority and the relater of valuable information. Patients will retain information differently but all learn by different methods: verbal, tactile, visual or auditory. Most patients have a dominant method of learning. As educators, our job is to convey information in a way that is processed best by each individual patient. How do I find out how my patients process and learn information? You communicate with your patients to ascertain their learning style. While your medical assistants are rendering hands-on care, you can effectively listen and communicate. By using key words and feedback, you can determine the patient’s learning style. As an example, a visual learner will respond by saying “I see” when affirming questions that you ask them for feedback. A visual learner responds best to drawings and pictures. The verbal learner will say “tell me more” if he or she has additional questions. These patients learn best by verbal communication and will give more feedback during the course of your dialogue. Tactile learners process information best when you show them a “model,” such as a negative cast, positive cast and orthotic. These are hands-on people. Auditory learners will ask you to repeat what you have said if they do not understand. These auditory patients learn best if you give them a cassette that describes their diagnosis and various treatment plans available. In the patients who have combined learning styles, combine drawings and pictures for the visual type, skeletal models for the tactile, cassette tapes for the auditory and clear communications for the verbal learning style. Informed patients make better patients because they know what caused their condition and understand their treatment better. This education process makes your practice more productive and more rewarding. You will have a happier patient in the long term and less frequent calls to your office with questions. Emphasizing Staff Education And Staff ‘Contributors’ Education starts with the initial phone call to our office. Callers are given feedback regarding their condition and potential treatment plans. These initial educational “bites” are based on the extensive training program that all of our medical and front office staff undergo. The staff education is supplemented with educational seminars and monthly staff meetings that are focused on treating patients. Our meetings are the same day and time every month in order to allow the part-time staff to adjust their schedules so they may attend. We have an educational lecture each month by one or more staff members. At least one of us is prepared to share new pharmaceutical information, biomechanical principles, insurance problems, surgical criteria and other topics of value. Each staff member is encouraged to share an idea, insight or observation during the course of the meeting. A typical meeting may be held on the third Tuesday of the month from noon to 1:30 p.m. with lunch provided in the office. If the lunchroom is too small or non-existent, have the meeting in the reception room or hallway. The meeting starts with a flexible agenda that is prepared ahead of time. The agenda usually lists the contributors, topics and time allocations. Notice that I said “contributors” and not “speakers.” Not everyone is a speaker, but everyone can be a contributor. We start with prepared topics. Last month, Lisa shared how to take impressions for a diabetic shoe and I spoke on the biomechanical examination. Peggy, our primary receptionist, shared how she was able to educate and encourage a caller to come in as a new patient. Rhonda shared her recommendations on durable medical equipment and how more insurance companies are not paying for durable medical equipment. She recommended and followed up with a “No Durable Medical” sticker to place on appropriate patient charts. Angie shared her positive experience with Lidoderm Patches and we resolved to share the topical treatment with appropriate patients. Chris shared her experiences with Neurontin when she worked with a neurologist and we adapted her recommendations for our neuropathy and restless leg patients. Colleen shared our new patient feedback forms to elicit input from patients regarding their care. We moved to review the input received from patients at our next staff meeting. Understanding The Benefits Of Having Two Medical Assistants During the course of one of our monthly meetings, one of the staff members asked, “Why couldn’t we have two medical assistants during peak treatment times?” Peak times are those high demand appointment times that are most frequently requested by patients. For our patient population, these times usually fall between 8 and 8:30 a.m., 11:30 a.m. and noon, 1:30 and 2 p.m., and at times relative to the commute between 3:30 and 5 p.m. Initially, we started scheduling an additional back office medical assistant at these peak times. We have since found that our patients appreciate having two medical assistants as it results in more care and less delay. After a two-month trial, we now employ two medical assistants for each doctor at all times. All medical staff undergo six weeks of training. Both front and back office staff have three notebooks of reference material they are tested on. Each new employee has a checklist that a senior staff person oversees. Front office staff are trained in eliciting information over the telephone and how to handle the irritated patient in the office. Our training staff report weekly progress to our office coordinator who helps both trainer and trainee reflect on the process and career fit. Most of our staff is part-time, which gives us more flexibility. Some of our staff are trained for both front and back office duties. This advantage allows the front office staff to help the back office or vice-versa during times of increased patient flow. For example, when one medical assistant is busy taking off a BK cast and the second medical assistant is interviewing a new patient, the multi-talented front office staff can take an X-ray of an emergency ankle fracture that was referred on an emergency basis by the patient’s primary care physician. To uncork the discharge desk, back office staff can set up appointments and answer the appointment phone. Increased Flexibility Leads To Increased Referrals We have found that not only do our patients appreciate being cared for more thoroughly, but our referral doctors appreciate our ability to accommodate their patients in a timely fashion. Usually we are able to schedule their referral the same day they call, if requested. Referring doctors are no longer impressed by a two-week wait to accommodate patients. We are now receiving new referrals from 16 doctors who previously referred to other orthopedists or podiatrists in the area. The reason given for this change in their referral pattern was our ability to get their patients into the office when requested, and our reputation for better patient education. We have also seen an increase in patient referrals from patients. A greater percentage of patients who have made appointments keep them. Prior to utilizing two medical assistants, we had a 12 percent no-show rate. With the presence of two medical assistants, our no-show rate with new patients is down to 5 percent. We believe this decreased rate of new patient no-shows is directly due to our ability to reduce the patient wait time from 10 days down to less than three days. Also, patients usually come in on the day that they call if they request that day. Are two medical assistants cost effective? With a second medical assistant working 20 hours each week at $14 an hour, you will generate at least three more patient visits. It does not take long to see that you can easily justify the second medical assistant. You will work smarter but not harder if you consider a second medical assistant for better patient education and patient care. Dr. Vance is board certified by the American College of Foot and Ankle Surgeons and is a practice management consultant. He practices with Gordon Nishimoto, DPM, at Northwest Foot And Ankle Specialists in Everett, Wa.