While this is our first special section on improving relations with patients, the subject has been a particular focus of FPM throughout our five years of publication.

Confidentiality

“What Are the Limits of Patient Confidentiality?” September 1995, p. 28.

When a patient's condition has the potential to harm others, the ethical and legal considerations are difficult to resolve. When privileged information must be disclosed to prevent harm, you should warn potential victims directly, if possible.

Difficult situations

“Teaching Staff to Say ‘No’ Graciously,” September 1994, p. 84.

When a patient's request must be denied, staff members should explain why. To do so effectively, they must understand the reasons behind your policies.

“Improving Difficult Patient-Physician Interactions,” February 1994, p. 49.

The starting point for improving difficult encounters is demonstrating empathy. When a patient is upset, acknowledge the patient's feelings and ask what's behind the anger.

“Talking to the Healthy About Dying: Time Well Spent,” July/August 1996, p. 45.

Consider adding general questions about advanced care directives on patient questionnaires as well as introducing the subject during routine visits.

“Delivering Bad News to Patients and Their Families,” September 1996, p. 48.

When giving bad news, be truthful, avoid jargon and don't dash the patient's hope.

“Using Common Sense With Difficult People,” January 1997, p. 67.

You can't control how other people act, but you can influence how they respond to you. Often, the key is to set an example.

“Remember Even Angry Customers Are Always Right,” September 1997, p. 87.

Although some patients' requests and complaints may seem unreasonable, you and your staff should do all you can to make patients feel they're receiving excellent customer service, even when they don't get their way.

E-mail and web sites

“Getting Patients Off Hold and Online,” in this issue, p. 34.

You can use the World Wide Web and e-mail to communicate with patients in a more timely fashion and to strengthen their sense of being connected with you and your practice.

Office visits

“Off to the Right Start,” October 1993, p. 16.

Start your physician-patient relationships on the right foot by asking questions like these: Who has been your family doctor? Why did you leave that practice? How (or why) did you select me? What expectations do you have of me?

“Enhance the Patient Visit With Counseling and Listening Skills,” November/December 1996, p. 70.

One effective way to approach patient counseling is to remember the acronym BATHE (background, affect, trouble, handling, empathy). This helps you quickly uncover the patient's psychological and behavioral background and the context of the visit.

“Nine Ways to Conduct More Efficient Office Visits,” May 1997, p. 83.

Try to address the patient's priorities first, but let the patient know you also have an agenda.

“A Sure Way to Revive the Physician-Patient Relationship,” July/August 1997, p. 76.

To improve communication with patients, even in brief encounters, start by asking questions that explore not only the presenting problem but other background issues that might affect your diagnosis and treatment.

“Are Poor Nonverbal Skills Slowing You Down?” September 1997, p. 90.

Since you communicate 55 percent of the time without ever saying a word, pay attention to what your nonver-bal signals are saying to patients.

“Keys to a Positive First Impression,” January 1998, p. 51.

A few simple strategies to improve your practice's image can lead to greater patient satisfaction. For example, if you give your patient your undivided attention for the first 60 seconds, he or she will perceive the visit as worthwhile.

“Reducing New Patients' Anxiety During the First Visit,” February 1998, p. 54.

One of the best things you can do for a new patient is to prepare a first-visit handout that describes your practice philosophy, tells what patients can expect during the first exam and offers a brief biography of each physician.

Patient-centered care

“Managing Diversity: The Mandate of the '90s,” June 1996, p. 30.

A physician's insensitivity to cultural differences can jeopardize the quality of patient care. Heightened self-awareness is the first step in becoming culturally competent.

“Patient-Centered Care for Better Patient Adherence,” March 1998, p. 46.

Educating patients about their diseases and treatment plans is a must if you want them to follow through with medication, new diets and lifestyle changes. The best results, however, come when you combine education with behavior modification and emotional support.

“Demand Management: Putting Patients First,” September 1998, p. 43.

Where managed care may seem designed to thwart patients, demand management seeks to engage them.

Patient education

“Making a Newsletter Work for Your Practice,” June 1994, p. 65.

A newsletter can be an integral part of patient education by emphasizing preventive health measures, updating patients on medical research and answering common medical questions.

“Patient Education for Pennies,” July/August 1995, p. 46.

By implementing one facet of patient education at a time, you can minimize the financial impact of even elaborate programs.

“Demand Management: The Patient Education Connection,” September 1998, p. 65.

Physicians should choose patient education tools themselves to make sure the messages correspond with what they teach.

Patient satisfaction

“Patient Satisfaction Surveys: How Well Are You Treating Your Patients?” January 1996, p. 60.

While there are many excuses for not surveying patients, it is a valuable way to find out how they really feel about your services. A variety of survey tools and measurement services are available.

“Improving Service and Increasing Patient Satisfaction,” July/August 1998, p. 29.

Service standards are one way to articulate your expectations for your practice and to foster consistent employee behavior.

“Measuring Patient Satisfaction: How to Do It and Why to Bother,” in this issue, p. 40.

A well-designed patient satisfaction survey can help you improve your practice. The key is to keep it simple and act on what you learn.

Referrals

“Strategies for Managing Referrals ... Without Losing Your Patients,” January 1994, p. 109.

Be sure you fully explain to patients why you are sending them to a consultant and when you expect to see them back in your office. Develop a system for reminding yourself when to make follow-up calls to patients you refer.

Scheduling

“A Checklist for Scheduling Success,” January 1995, p. 68.

No system, no matter how well designed, can substitute for good, old-fashioned customer service and the personal touch.

“A Method for Decreasing Missed Appointments,” February 1997, p. 77.

The number of missed appointments your practice logs each week may surprise you. Creating a patient reminder system can help you minimize them.

Telephone communication

“Are Your Phones Patient Friendly?” May 1996, p. 66.

Increase the effectiveness of your phone service by improving your staff's phone skills, testing your answering service, conducting a phone availability study and educating patients while they are on hold.

“How the Telephone Can Transform Your Practice,” October 1996, p. 56.

Using the telephone proactively, you can improve patients' access to care, spend more time with patients who really need you and boost patient satisfaction.

“How Does Your Practice Sound on the Phone?” in this issue, p. 45.

Many patients derive their impression of your practice from telephone contacts. Physicians and consultants offer their best advice.