Article from the Boston Globe’s On Call Magazine, March 2000

By Helen Osborne, M.Ed., OTR/L
President of Health Literacy Consulting

Making the Phone a Useful Tool for Working with Patients

If all you do all day is answer the phone, you can soon learn to hate it. But if you know how to use it wisely, it can save time and help build rapport with patients and their families.

Denise and Frank were irate. Their father, John, had been a patient in the ICU for seven days. They craved news about his medical condition, but they lived too far away to make daily visits and relied on the telephone for information. But whenever they called they felt as if the doctors and nurses didn’t want to talk with them. Many of their calls were not even returned, and when they were, clinicians seemed to be in a rush to get off the phone.

The doctors and nurses were also frustrated. Denise, Frank, and several other family members called the ICU each day. It seemed that this family had no sense that John was one of many patients on the unit.

This mutual impatience was taking its toll, wasting precious time and energy that the family and ICU staff could have spent caring for John. A meeting was held, and the staff and family both agreed that regular communication was essential. Together, they planned that an ICU nurse would call Denise each day between 11 and 11:30 A.M. The nurse would update Denise on John’s medical reports and test results, and Denise could ask the nurse all her questions and concerns. Denise, in turn, would be responsible to pass information along to her family.

This plan worked well. Denise and Frank received timely information about their father, and the ICU staff cut down on the volume of incoming calls during their busiest time of day. While it had first been seen as a problem, the telephone became the solution.

A Tool of Many Uses

Patients both want and expect medical information, and the telephone can be a way to provide this. The telephone is an important source of communication with patients and families,” says Suzanne O’Connor, RN, MS, CS, president of Health Care Satisfaction in Andover and Clinical Nurse Specialist at Massachusetts General Hospital.

The phone can be used to establish and maintain patient relationships. It can be a friendly way to welcome new patients or give comforting information to patients who are already known. It can also be a reasonable alternative for patients who cannot meet with their clinicians.

Clinicians can use the phone to communicate routine test results and lab data, and to follow up with patients who are discharged. “It usually takes no more than four to six minutes to complete a call,” says O’Connor. “Clinicians should think of the phone as a time saver, not an interruption.”

Guidelines for Making Effective Use of the Phone

Here are ways you can use the telephone as an important tool for communicating with patients and families.

Encourage patients and their families to call. Many patients and their families worry about what to do when they leave a clinician’s office. For instance, they may have concerns about how to recognize symptoms, manage side effects, or deal with emergencies. Clinicians can help ease these anxieties by saying, “Call us with your questions.” Be sure your patients know that the offer is sincere. While it has been found that patients and their families seldom take advantage of this offer, they certainly appreciate knowing that they can.

Make calls before and after clinical visits. Statistics show that a reminder call before a scheduled appointment can cut down on patients who are “no-shows.” These reminder calls not only confirm an appointment, but also build a relationship between the medical office and patient. After an appointment, a phone call can be a way for clinicians to make needed referrals and answer a patient’s unanswered questions. A follow-up phone call can be particularly helpful after a traumatic event because it can give patients the opportunity to talk after a crisis has passed.

If the patient is not available when you call, leave a brief message that includes your name, phone number, and best times to reach you. Do not leave more specific information unless you have the patient’s explicit permission to do so.

Use appropriate tone and word choice to convey your message. Since body language goes unseen when you talk over the phone, only your words and tone of voice can deliver the message. Express empathy through your tone and have ‘help’ in your voice, suggests O’Connor. Use positive words and powerful language such as “I will” rather than “I will try,” and “I can” rather than “I can’t.”

Triage calls, and relay accurate messages. “Patients often don’t know what they need, and it is up to us to decide by asking good questions,” says O’Connor. When patients call, be sure whoever takes the calls learns about their specific concerns and then, as appropriate, offers to relay their message to a clinician who can return their call in the shortest period of time. Let the caller know an approximate time in which the call will be returned, and make it office policy to adhere to these times.

Deliver “no” in a service-friendly way. Sometimes you need to turn down a caller’s request. While nobody wants to hear a “no,” there are ways to communicate this message that are better than others. Show your respect, and appeal to the caller’s sense of fairness. Say, “I’m unable to do what you requested for these reasons.” Then state what the reasons are. Demonstrate your understanding and empathy by using words that show you see the caller’s perspective, such as, “I would feel frustrated too.” After the “no” is clearly established, give control back to the caller by offering a range of possible alternatives.

Be ready to redirect a talkative caller. Accept that it is legitimate, not rude, to interrupt a talkative caller. Focus the caller by asking specific questions and assessing immediate concerns, and then stop the flow of unnecessary information, information that doesn’t relate to how you can help. Redirect a talkative caller to a person who can best meet his or her needs, and then transfer the call as quickly as possible.

Consider using an automated phone system. A large percentage of calls to medical offices are for routine matters such as prescription refills, out-of-work notes, lab results, and referrals to specialists. An automated phone system can be an efficient way for patients to get this information; patients can call at their convenience, and clinicians can be free to talk with those who truly need a personal call. “An automated phone system does not necessarily decrease customer service,” says O’Connor. “What does decrease customer service is waiting on hold, or getting a busy signal.”

To Learn More

For more information about Health Care Satisfaction, or to obtain a copy of a “Phone Skill Reminder Card,” contact Suzanne O’Connor at (888) 611-3880.

Related Publications:

• Anderson, K. and Zemke, R. (1991). Delivering Knock Your Socks off Service. AMACOM: New York.
• Baker, S. Keane (1998). Managing Patient Expectations. Jossey-Bass: San Francisco.
• Finch, L. (1990). Telephone Courtesy and Customer Service. Crisp Publications, Menlo Park, CA.
• Gerteis, M., et al (editors) (1993). Through the Patient’s Eyes: Understanding and Promoting Patient-Centered Care. Jossey-Bass: San Francisco.