Guest commentary: Empower employees to bend the rules to wow patients

Brandon Betancourt

Brandon Betancourt

Guest post by Brandon Betancourt

The calendar alarm on my phone sounded, reminding me of my doctor's appointment for the next day. I realized at that time I wouldn't be able to make it and needed to call and reschedule.

However, I didn't have the specialist's telephone on my cell so I gave my internist a call to get the specialist's number. 

After following the phone prompts, I got a live person at my internist's office and explained I needed the phone number for the specialist's office to which they referred me. The person on the phone said she would take the message and somebody would call me back later with the number. "Huh?" I thought.

"Can't you just look in my medical records?" I asked. 

"I don't have access to it from here," she said. 

"Can you transfer me to medical records then?" I asked. 

"Let me put you on hold."

She came back on the line and said that "she" isn't available and that somebody will call me with the telephone number. 

After hanging up, I got a decent Internet connection for just long enough to find the specialist's number. 

After dealing with yet another series of prompts, I got somebody on the line from the specialist office.

The first thing the woman on the line said was that I would incur a charge because I was calling within the 24-hour period.

"Are you that strict with the time? I'm giving you 22.5 hours notice," I said.

"I'm just letting you know that there might be a charge!" she insisted. 

I insisted back, "C'mon, it's only been a little over an hour, and I am calling to reschedule. It's not like I 'no-showed.'"

"I'm just letting you know that there may be a charge for the cancellation," she reiterated as if I didn't understand the first two times.  

Instead of rescheduling, I canceled the appointment altogether in a futile attempt to make a point.

I reasoned that if I was going to get charged the same for rescheduling as I would have for no-showing or canceling the day of, I wouldn't give them the business that would have resulted from the reschedule. So I told her to forget it. "I'm going to make you work for that cancellation fee," I said under my breath. 

As a practice administrator myself, I understand that rules are important. We need rules. And the more rules the better, right? The more rules a practice has, the more efficient it will run. Rules ensure that people remain on the same path; rules help practices provide consistent service, ensure safety, set boundaries and prevent chaos.

Setting ironclad rules is also a great way to prevent employees from thinking or discerning the best way to handle specific situations. When staff are empowered only to follow the rules by the book, you run the risk of losing critical opportunities to provide exceptional service that really impress people.

How do we, then, set explicit regulations that govern employees' conduct to keep the office running in order, yet are flexible enough to accommodate a patient's needs? 

To me, the answer is clear. We must focus less on imposing rules and focus more on teaching employees the practice's values. 

If a practice is willing to establish fundamental governing values, those fundamental practice truths can serve as the foundation for employees to decide when exceptions are appropriate.

By doing so, a practice increases the probability that the employee will make a decision with the practice's best interest in mind when faced with the decision to either follow the rules to the letter or meet the needs of the patients. 

I'm not suggesting that clinical or administrative staff disregard rules, protocols and procedures or begin to use practice "values" to direct their clinical task. Doctors with all their intellect, reasoning, knowledge and empowerment follow protocols, guidelines and procedures.

What I'm talking about is enabling the staff to make decisions using the practice's stated values to meet patient needs--when the situation dictates--without compromising the practice's modus operandi.

If you are not convinced, think about the last time you had a customer service issue with a store, restaurant or airline and the company exceeded your expectation when they resolved the issue. 

Now, did you get wowed because of the employee's ability to follow the rules or because the employee went above and beyond, thus exceeding your expectation despite the rules? 

My guess is that your expectations were exceeded because the manager broke the rules in order to make it right for you. --Brandon

Brandon Betancourt is practice manager of Salud Pediatrics in Chicago and author of "Pediatrics, Inc." You can follow him via Twitter @PediatricInc.

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