The beginning of a new year is an ideal time to scrutinize your practice's image. One place to start is at your front door. What does a patient experience when he or she arrives? A first impression is an opportunity that never repeats itself. Are you doing all you can to give your patients the most positive first impression possible? Here are 10 tips that can make a big difference in your practice.

1. Hire the kindest, most sincere person you can find as your receptionist. The receptionist's attitude has a lot to do with how a patient experiences a medical visit. Consider the example of Williamsport Hospital and Medical Center in Williamsport, Pa. Administrators found that although the patient's encounter with the Emergency Department physician and nurse was important, it was the encounter with the receptionist that was most important to satisfaction. Improving that experience improved satisfaction ratings with the ED dramatically. Granted, an ED is not a family practice office, but the effect is the same. So hire the smile and teach the skills for this position. Also try not to overload this individual. Assigning too many duties to a receptionist can interfere with making patients feel welcome and comfortable.

2. Respect patient confidentiality. Patients should not have to state the reason for their visit when other people are present. Avoid sign-in sheets, especially the kind that ask for the patient's chief complaint. An alternative is to have numbered pads printed. The patient signs the top sheet, tears it off and gives it to your receptionist. The receptionist can then use this information in whatever way the sign-in sheets were used (e.g., to keep track of how many patients are seen, order of arrival, etc.).

3. Make sure your reception area is spotless. Cleanliness in the reception area is extremely important. People seek to confirm their first impressions. If the reception area furnishings are stained, patients will be checking to see if your examination room equipment is dirty, too.

4. Monitor your reception area materials. Airlines don't run movies that involve plane crashes, and you should think twice about displaying magazines with headlines such as “How I Made Millions Suing Doctors for Malpractice.” Also keep in mind that the tremendous amount of medical information in consumer magazines creates expectations for patients. For example, the October 1996 issue of Good Housekeeping contained an article titled “Breast Exam: Is Your Doctor Doing It Right?” A patient who read that article while waiting for you to do a breast exam might have wondered about your competence if you didn't do the exam exactly as described in the article. (Being familiar with such articles can also alert you to increased concerns about certain procedures or medications.)

5. Consider the impressions that signs in your office create. Do the majority of your signs pertain to insurance and billing rather than helping the patient feel comfortable? An example of a helpful sign would be one that says, “Please see our receptionist when you arrive.” A sign that reads, “Patients are seen in order of appointment, not arrival,” can ease tensions in a crowded reception area. Discourage staff from posting flip or inappropriate sayings in prominent places. A sign that says, “The worst day at the beach is better than the best day at work,” may relieve staff tensions but should be kept out of public view.

6. Be the first to say hello. Everyone in the practice should take the initiative in greeting patients. Don't wait for the patient to speak, because some patients will interpret your reticence as indifference. Use the patient's name whenever possible. Asking staff to review the schedule at the beginning of the day makes it easier for everyone to remember names. Also keep in mind that, while having staff members wear name tags encourages patients to ask the appropriate person for information and assistance, tags are not a substitute for a personal introduction.

7. Be prepared for the patient. Always review the patient's chart before entering the exam room. Your ability to know and remember information will impress patients. Social information, such as a spouse's first name, can help you make the personal connections that are important to many patients. One physician has discovered an effective way to start every visit. He makes a note of the last thing the patient says as he or she is leaving a visit. Glancing at the chart just before the next visit, he can recall that topic of conversation and introduce it at the start of the visit. “Did your daughter's team win the state championship?” This strategy makes each patient feel important. If a patient has been referred to you by another physician, saying something like “Dr. Verri and I spoke about you and she told me that ...” reassures the patient that his or her care is being coordinated.

Does this sound artificial to you? If so, think about this: You do care about your patients, right? But unless your memory is better than most, you won't be able to show your patients that you care if you don't give yourself some memory aids like these. There's only one of you, and there are hundreds of patients.

8. Put the patient at ease. Be alert to factors that might hinder physician-patient communication. One patient decided to look for another physician because his physician had a habit of talking with his back turned. Another patient opted not to return to a physician who greeted and examined her wearing a surgical mask. The physician never explained why he was wearing the mask, and the patient never asked.

9. Focus first on the patient's needs. Every member of your practice should use this strategy. When your receptionist asks about insurance first, before asking how the patient is feeling, an impression is created that you care more about the patient's insurance than his or her wellbeing. Early in the visit, find out what issue is on your patient's mind. It may not be the most significant problem clinically, but when you address this concern first, the patient can relax and concentrate on what you have to say.

10. Create a favorable impression in 60 seconds. The amount of time a physician spends with a patient contributes significantly to the patient's satisfaction with an office visit. In a busy practice, it's not always possible to dedicate as much time to a visit as a patient may want or expect. If, however, you give a patient your undivided attention for the first 60 seconds of your encounter, you will leave the patient feeling that he or she had a meaningful interaction with you — and not feeling that the visit was too short.

Editor's note: Baker expands on the points in this article in her upcoming book, Managing Patient Expectations, which will be published this year by Jossey-Bass Inc.