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| Hanging on the telephone |
26-Feb-2008 |
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Dodgy music, out-of-date information and unanswered
phones are all ways
to aggravate your patients when they call
—
but it doesn
’
t have to be like that.
By Bianca Nogrady
HELL is hold music that is a tinny, expressionless facsimile of a once-beloved tune, mangled beyond belief and painful to listen to. Unfortunately, this musical travesty is still inflicted by businesses on captive customers whose only crime has been to ring when lines are busy.
For general practices this hold ‘music’ can be a patient’s first impression of the practice —Mozart sounding like it’s being played by a one-fingered, heavily sedated pianist.
“It’s a window on your practice,” says Dr Lynton Hudson, a GP in Warwick, Queensland, and chairman of the RACGP’s national expert committee on standards.
Like any good shop window, a practice’s phone message should give potential customers a sense of the practice and inform them about its services, its people and its requirements.
“Where else do you advertise your practice and about what you do?” Dr Hudson says.
There are no formal guidelines governing the use or content of phone messages in general practice. The only requirement stipulated by the RACGP is that there is a provision for 24-hour care for patients, which means a practice that operates during normal working hours must have an after-hours message redirecting patients to an available facility. This might be the local hospital, a locum agency or members of a GP roster, but the most important thing is that the message is clear and straightforward.
Beyond that, the possibilities are endless.
Ms Jan Chaffey is senior practice manager at Camp Hill Medical Centre in Brisbane, where the size of the practice — 15 doctors and four receptionists — requires a fairly high-tech phone system to manage incoming calls.
“What is accepted, as should happen in business, is that a phone should be answered within three rings,” says Ms Chaffey, also immediate past-president of the Australian Association of Practice Managers.
However, she says the practice does take into account the reality that if a receptionist is dealing with a patient at the front desk, “it’s quite rude to leave them to answer a phone”.
If an incoming call isn’t answered within four rings, it is diverted to a phone message that first advises patients experiencing a medical emergency to hang up and call 000, but then advises patients with an urgent medical problem to press 7.
Patients who push 7 can jump others in the on-hold queue, whereas if they are content to wait their call is answered in the order that they phoned, Ms Chaffey says.
Answering phones within four rings is not just for the benefit of callers. “Apart from everything that happens [at the practice], you’ve got these phones ringing all the time, which really makes the situation more tense,” Ms Chaffey says. “So we’ve ended up making the front desk and waiting area and reception area calmer while attending to the needs of the patients.”
In contrast, Dr Hudson’s surgery has opted for a more simple approach of “all hands on deck” during busy times. “When we first started the practice we had problems with phones and we agonised over what to do,” he says. “You can do all these ‘push 1, push 2’ things, but in the end, someone’s got to answer the phone.”
During busy times, every member of staff is required to answer the phone, even the practice manager. “Messages are great but there’s nothing like the personal service,” Dr Hudson says. And for the few callers who do end up on hold, the practice has a simple message apologising for the wait and reminding patients with a medical emergency to hang up and call 000.
Another tactic to help is knowing the busiest times for phone calls, so the practice can adjust staffing levels and ensure as few patients as possible do end up on hold. “You’ll have times when the phone doesn’t ring but have times when 20 people ring at the same time,” Ms Chaffey says.
Phone companies can map the phone activity of a practice over a period of time, providing graphs of peak activity, and also tell a practice how many calls were picked up and how many were missed, she says.
External phone answering services, where a third party takes unanswered calls and forwards the information to the intended recipient, are becoming more commonplace in business but do not really suit a general practice setting.
Ms Chaffey says there would be privacy concerns with such a service dealing directly with patients, but says also that patients usually call to make an appointment rather than to speak directly with a doctor.
While individual doctors might use paging and messages services, Dr Hudson says the closest thing to a third-party answering service in general practice would be an after-hours, nurse-operated phone triage service, one of which operates in Queensland.
Dr Tony Hobbs, a GP in Cootamundra, NSW, and president of the Australian General Practice Network, says his practice has taken full advantage of having patients on hold, with an informative message put together by their local division. Patients on hold are a captive audience, providing a unique opportunity for communicating some important messages.
“Our on-hold message is a voice recording from the division with basic information about general practice, about making appointments, about listing down things you might want to do, making sure you’re on time,” Dr Hobbs says.
While Dr Hobbs’ local division was forward-thinking enough to arrange such a service for practices in the area, most practices will have to organise their own hold message.
Mr Ben Cork, marketing manager for Messages On Hold — a company specialising in phone message services — says the most important issue with on-hold messages is that the content of the message must be fresh and up to date. “The idea is you want to get people listening and engaging and getting that information heard,” Mr Cork says. “Patients listening to the same message played over and over again are, not surprisingly, likely to tune out pretty quickly.”
One way to keep patients listening is to intersperse the usual information about office hours and cancellation policy with more seasonal information — for example, reminding them when it is time for influenza vaccination.
Practices can also use their hold message to update patients on any changes in their clinic, such as new staff, Mr Cork says. It’s also a great opportunity to introduce existing staff and provide patients, particularly those who are new to the clinic, with information about doctors’ interest areas and specialties.
Hold messages can also sometimes answer a patient’s question without the need for them to engage a staff member. Mr Cork says the message can answer common questions such as parking availability. “It takes a load off the receptionist, as a person might hang up before they get to the receptionist.”
Some practices also take the opportunity to drum a few public health messages into patients. The hold message at Dr Hobbs’ practice includes advice on quality use of medicines and suggestions for things to ask the GP. “From my point of view, I think it is an opportunity to give patients some straightforward, simple education,” he says.
However, Dr Hudson warns that nagging captive patients with anti-smoking and healthy eating messages could grate on nerves. “That probably has some merit, but I guess we often convey those in other places, and the thing to remember is that sometimes it just annoys people.”
So how much does it cost a practice to put together a message that educates, informs and placates patients, and is regularly updated with seasonal messages? Mr Cork says most of the surgeries on his company’s books spend $34-$54 a week, which buys multiple four-minute productions over the course of the year using different voices and sound effects to keep callers interested without annoying them. Mr Cork also recommends keeping individual messages short and to the point, because a caller may only be on hold for a short time.
IN TUNE WITH YOUR PATIENTS
SMALL or rural practices where patients are rarely on hold or only for brief periods might consider music as an option.
Some clinics may opt to connect to a local radio station, while others may choose their own selection of music to play to patients on hold. However, both these options mean the practice will need a music licence from the Phonographic Performance Company of Australia (www.ppca.com.au) or they will breach the Copyright Act. A ‘music on hold’ licence costs from $64 a year for a practice with 1-2 lines up to $703 for a practice with 21-50 phone lines.
Doctors should also consider the wisdom of inflicting their own musical choice on others. Buddy Holly or Britney Spears may well rock your world, but not everyone will take a shine to it, particularly if they are already in considerable pain or discomfort.
When thinking about what music to play to patients on hold, it is perhaps worth first listening to the song 10 times in a row with a painfully full bladder or a migraine. Music should only be considered suitable if the prospect of an 11th round doesn’t cause you to flinch.
“My pet dislike is piped music,” Australian General Practice Network president Dr Tony Hobbs says. “That’s the thing that really turns me off.”
10 SONGS NOT SUITABLE FOR PATIENTS ON HOLD
* Bad Case of Loving You (Doctor, Doctor) — Robert Palmer
* Bad Medicine— Bon Jovi
* Heart Attack— Olivia Newton-John
* An Apple A Day— Aqua
* You Keep Me Hanging On— Diana Ross and the Supremes
* Whiter Shade Of Pale— Procol Harum
* Easier to Walk Away— Elton John
* Praying For Time— George Michael
* I
’
m Not Dead— Pink
* Catch My Disease— Ben Lee
What
’
s the worst
‘
on-hold
’
music you have encountered? E-mail mail@australiandoctor.com.au
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