Episode Details

Here's something I never really understood: how physicians and nurses more often than not get to be responsible for the entire patient journey, including, start to finish, patient satisfaction. But if you just take one look at any random poorly rated physician's reviews, they're usually littered with complaints about the front desk in the practice. Negative reviews, of course, are not limited to front desk diatribes; but there's often a lot of front desk commentary in them.

It has always seemed to me to be a common and strange phenomenon in health care provider practices where the front desk is like a totally separate little fiefdom with a different mission statement and goals from the health care providers in the same exact office. Isn't that odd when you think about it? I mean, first, the front desk is literally physically separated from everybody else. No matter which direction you approach from, there's at a minimum a half-wall barrier surrounding them. Sometimes, in directions most likely to receive an attack, I suppose, there's been added a big glass barrier.

Liliana Petrova pointed this out in EP236 of the Relentless Health Value podcast, and it was really the first time that I had thought about it at all and also thought about the implicit message this sends not only to patients but also to clinicians. That whole physicality of the setup, it just screams, "We over here have nothing to do with the mission or vision of anyone else in this place. We have our own thing going on over here, and to do it, we need to be protected from you all and all of your chicanery and untoward goings-on, you doctors and nurses and patients!"

I was really inspired the first time I heard Jerry Durham from The Client Experience Company talking. His message, as I understood it, was that a practice really on board with helping patients achieve the best patient outcomes and, nothing for nothing, erode clinician burnout includes the front desk in their thinking. Jerry has said that there's four phases in the patient life cycle, as he calls it, which is sort of a synonym for the patient journey:

1. Marketing
2. The moment that a patient/person engages with the clinic or office
3. Provider interactions
4. The post course of care

So, all of these phases—all four of them—are critical to both patient outcomes and experience but also, really, to business success. So, you kind of almost have to do well by doing good. The front desk is mostly responsible for that phase two: what happens when that person/patient engages with your office or clinic.

In this health care podcast, as mentioned, I'm talking with Jerry Durham. He's a former physical therapist and practice owner who has worked with a whole lot of PT (physical therapy) practices and also other MSK (musculoskeletal) specialties among other clients. His message transcends the specialty, however.

In this health care podcast, we get into a lot of aspects in terms of how a front desk can work for or against patient experience and outcomes. One of them is how a front desk can help secure a patient's relationship with a practice. Trust follows from a relationship. Lately, maybe even earlier than lately, study after study is coming out—including some that Rebecca Etz, PhD, talks about in EP295—which shows that, without a relationship and trust, patient outcomes are meh at best. (You can always count on me for scientific terminology.) But a lack of trust is a big hairy factor behind disparities in outcomes among different ethnic groups, for example, as one point to ponder.