Phone consultation

As soon as the phone rings, every staff member in the office should be cued (on alert) to respond; staff members should think “3 rings and dive for the phone.”

Although there is usually 1 staff person who has the major responsibility for answering the phones, it is mandatory that every staff member appreciate that “no one is exempt from this vital process.” It is hoped that a great deal has already been invested in getting the phones to ring and therefore everyone should be able to at least handle the basic questions. Whoever answers the phone should be capable of keeping the caller engaged until the appropriate person can take over the phone call.

Answering the phone should never be considered, or actually perceived and heard, as an intrusion by a caller. When the phone is answered the staff person must have a smile on their face because that smile is transmitted and heard through the phone.

In a cosmetic practice the phone should never be answered as “doctor’s office.” If the practice does not have a fictitious name (eg, The Aesthetic Center) then the staff should answer with the name of the doctor so that there is no question that the person has reached the correct number.

The staff person should then quickly ascertain the reason for the call and determine the most effective person to handle the call. If that person is not available then whoever answers the call should at least be able to help the caller and keep the caller engaged in considering services by your practice. This point is especially critical if it is obvious that this is a first-time caller desiring information regarding a cosmetic service or procedure.

Nine times out of 10 the caller immediately indicates why they have called in the first sentence (eg, “Do you do Botox?”; “How much does the procedure cost?”; “I saw your ad on your holiday special”; and so forth).

From securing this information it should be easy for the staff person to determine what is next. Standard phone training emphasizes that the most important goal is relationship building with the caller. This relationship is started by the staff person identifying themselves so that it is easier to ask the caller’s name.

If the person answering the call is not the staff person that schedules the phone consultations, the staff person should state that up front and indicate that if the appropriate person is not available they will attempt to obtain enough information so that the correct person can call them back. However, it has been my experience that individuals calling about costs fall into 2 categories: (1) those truly needing to hear the cost before proceeding with committing to the conversation and (2) those who ask the cost because they do not know what else to ask. I call this a common denominator question. If the person is truly interested in the cost before proceeding with the call, the question should be answered the best way that it can.

The biggest change that has occurred in the most recent years is dealing with empowered shopping consumers who are demanding the fee information before they make their commitment for a consultation.

Although it is risky to quote fees on the phone, quoting ranges, sometimes broad ranges, at least allows the caller to know if it is worth their time to proceed with additional information. Also, this allows the staff to quickly qualify the caller. This problem underscores the importance of providing phone training to the entire staff. In my experience in staff training, I have recommended that the best way to determine if it is a common denominator question is to indicate that you will answer the cost question but ask a question to clarify what service the caller is seeking first. If the question that is asked by the staff moves the conversation away from the cost, then it was not the key question. If the person still insists to know the cost first, then the staff person must answer the cost question.

There are times when cost shoppers can be persuaded to see the benefits of spending more than they first had planned; however, it is important that the caller at least appreciate the approximate cost of the service for which they are shopping.

Once the fee hurdle has been addressed, the staff person can then move on to assuring the caller that the procedure or service they are considering could be a good decision for them and that their doctor has the skills to accomplish the caller’s goal.

If the person handling the phone inquiry has done their job properly, it should be an easy step to book the consultation to come in to meet with the doctor and determine if they are a good candidate for the procedure or service.

Another challenge is that often the staff person allows the caller to take charge of the call. This scenario usually leads to a lengthy conversation that could have been shortened if the staff person had maintained control of the conversation and anticipated questions and objections. The staff person should:

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  Determine how the caller heard about the practice. This information lets the staff person know how knowledgeable the caller is about the service or procedure.

  
  
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  Determine the caller’s goal. This information helps the staff person to qualify the caller.

  
  
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  Anticipate the caller’s concerns or questions. Anticipating and answering questions allows the staff person to stay in control of the conversation.

  
  
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  Get a commitment (ie, the caller’s name, phone number and e-mail address).

  
  
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  Close the call (ie, set an appointment or be able to send out additional information on the service or procedure).

  
  
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  Reassure the caller (ie, assure the caller that the practice is a caring practice and even if the caller is not a good candidate for the procedure, they may become a positive referral in the future).

This process should take from 7 to 10 minutes in most cases. For more information on phone techniques refer to www.pumc.com/training.htm .

Follow-up for appointment booked

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  Tell patients, in advance, that you will be sending a confirmation letter and will call to confirm the day before the appointment. Obtain the best time and number to use for the confirmation call. An e-mail follow-up is an option; even though you may not actually speak to the person, this may be the best that can be done with select phone inquiries.

  
  
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  Send the letter signed by the staff person who talked to the caller. Remember that the staff person established the relationship with the caller, not the doctor. Therefore, the staff person is the touchstone for the caller until they get into the practice.

  
  
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  Include personal comments in the letter in at least 1 paragraph. The staff person has established a relationship, but they also need to remind the caller why they are seeking the service. Therefore, during the stage where the person is rethinking the decision to come in, the staff person needs to remind them of their ultimate goal.

  
  
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  Put a copy of the follow-up letter in the chart, which will also notify the staff that sees the patients during the visit of the patients’ desired goal. This is to insure that the other staff can reinforce the desired goal and also to notify the doctor to validate the goal.

  
  
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  Make the actual reminder call. This is the single most important step you can take to reduce no-shows. The staff member who makes the reminder call does not have to be the staff person that spoke to the caller. However, whoever makes the call should indicate that the staff person they spoke to is really looking forward to meeting them in person. It is a good idea for the person confirming the appointment to know what the goals are for the visit.

Follow-up for no appointment booked

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  Tell the person inquiring, while they are on the phone, that you will be sending information and will follow up with a call to confirm they have received the information. During the conversation confirm the most appropriate telephone number, time, and place to call to follow-up. You are making an appointment to follow-up and you want to be sure that the caller will anticipate the follow-up call.

  
  
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  Send the letter hand signed by the staff person who spoke to the caller with a brochure or other information about the doctor and the practice.

  
  
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  Call within 1 week to follow-up.

  
  
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  During the call, determine if the person is ready to make an appointment. If the caller is not ready, see the next step.

  
  
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  Confirm that the person desires to remain on the mailing list. Yes, you do have a mailing list. It is the list you should be keeping so that you can send out your newsletter or announcements of new services or of office seminars.

  
  
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  Set a reminder to call in the future, if indicated.

Even if a person does not schedule they can still be a referral source in the future.

The front office

The office should be inviting to all visitors. That means that the environment should be positive, attractive, and convenient. Seating should be comfortable. There should be ample but not severe lighting and the reading material should be available and kept in good order.

Patients should be acknowledged as soon as they arrive. Even if the receptionist or front office person is on the phone there should be some type of acknowledgment so that new patient feels welcomed. Nothing is more annoying than standing in front of the receptionist’s desk being ignored. Even if the staff person is on the phone they should be able to at least recognize new patients with eye contact.

At no time should new patients have to sign in. Not only for confidentiality but because the environment for a cosmetic-oriented practice should be more upscale and less clinic related, all patients should be expected as a guest. They should only need to give their name to the receptionist who would then alert the other staff, who should also be expecting the patients. If the environment allows, patients, should be given a tour of your facility and an introduction to other staff members who are on hand to further solidify the relationship with your practice.

I have found that it is always best to provide forms to patients before they come into the office so that there is less time wasted on the first visit. However, many practices now offer a format that allows the forms to be filled out on line so that the office has the information before new patients come into the office. This format not only reduces the consultation time but also allows the staff to review patients’ information in case there are some missing sections that need to be completed before the consultation. This format also reduces the possibility of no-shows.

During the greeting, the receptionist should take the time to review what new patients should expect during the consultation, which will alleviate some anxiety new patients may have.

Once the chart is completed, new patients are ready to be taken to the back office.

The back office

When the staff person comes out to take patients to the back, they should not stand at the door and shout the patients’ name. They should walk over to the patients, introduce themselves, offer their hand, and then escort patients to the examination room or interview area.

Because there are various methods of handling patients once they are in the back I will not try to describe the most effective method for seeing patients in the consultation. However, the following should be covered at some point during the initial part of the consultation. The sequence or who conducts the various steps is best determined by the practice and the staff’s ability to handle the situations.

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  Review the purpose that caused the new patient to make the appointment. The follow-up letter should be in the chart so that the staff person can lead with information covered during the phone conversation.

  
  
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  Go over the general details of the specific procedure.

  
  
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  Provide before and after photos as examples of possible results.

  
  
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  Determine if patients have any general questions.

  
  
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  Examine patients to determine if they are good candidates for the procedure.

  
  
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  Inform patients immediately whether or not they are good candidates for the procedure.

  
  
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  Assist patients in scheduling the service.

All of the aforementioned should be handled by clinical staff or individuals knowledgeable enough with the procedure to be able to answer the basic questions. Of course, the examination and determination if patients are good candidates for the procedure should be the ultimate responsibility of the physician.

If the staff is knowledgeable, the time spent with the physician can be minimized. I have found that even when the doctor spends a great deal of time with patients there are still some questions that are best addressed by the staff. I strongly recommend that the physician never discuss fees with patients. I have observed that physicians are not good at quoting fees and they have a tendency to reduce the fees. In many test cases where I have compared the fee quoted by the physician with the agreed-to fees of the practice, I have seen where physicians have lost thousands of dollars because of discounting their work. Also, physicians are not good at addressing complaints from patients about the fee. Frankly, it would require the physician to sell themselves. We all know that someone else can always sell you better than you can. Lastly, it cheapens the physician in the eyes of patients. The physician should never be put in the position of negotiating.

Even if the physician feels that he or she is better at determining what the costs are, I have recommended not stating it to patients, but leaving the room and giving the staff the information to present to patients. If the staff is well trained, knowledgeable, and mature they are able to provide the information effectively. Additionally, I recommend that the physician begin to train their staff on how the physician determines the fees so that eventually the staff is able to handle the patient fee quoting with minimal input on costs from the physician.

Once the physician has completed the examination, patients should be directed to the staff person that will review the steps to schedule the procedures. This person is often called the patient counselor. In my organization we coined the position “Patient Care Coordinator” in 1980 and it has been used by our clients and others ever since. This individual is trained in how to address all fees and fears or objections and assist patients in seeing the benefits of having the procedure or service done.

When the staff person is meeting with patients, she (although there are exceptions, I always recommend this staff person be a woman, even when interacting with male patients) should begin by confirming that the patients are good candidates in good health for the procedure and ascertain if all questions have been addressed. She should then review the fees with patients, being sure to mention how many visits after the procedure are included in the fee. All of this information should be in writing so that patients can see everything.

In truth, the fee objection is the easiest to overcome. In today’s environment most individuals have credit cards and can use them as an option if they do not have the full funds in the bank. I also recommend that every cosmetic practice have at least 1 finance company option that works for most individuals. Although many physicians have been reticent to use financial services because most charge a fee, it has been my experience that if you do not provide a financing option, many patients will go where they can finance it. Additionally, is it not better to have 90% of something than 100% of nothing?

Once the fee has been presented, the staff person needs to remind patients of their initial goal for deciding to make the appointment, which helps them to remember and focus on the end result, a more attractive and confident self.

Then the staff person should provide procedure date options so that patients can begin making plans for the surgery or procedure. If patients are planning the procedure around a special event the staff can focus on what it will take to achieve their goal by that event, if that is a possibility.

Unfortunately all patients do not choose surgery or a procedure during the first consultation visit. In fact, some patients are not candidates for surgery and will not have it. We have confirmed that a high percentage of these patients will leave the consultation but be excellent referral sources for other consultations. For patients who are candidates, every effort should be made to assist patients in seeing the benefits of having the procedure performed.

I often recommend that the staff develop a list of some added benefits of having the procedure. These are the positives that patients have mentioned that they discovered once they were completely healed. When these things are brought up, patients begin to appreciate that there is more than 1 reason to move forward with the procedure.

However, if the procedure is not scheduled during the initial consultation, the staff person should set an appointment to call patients within 3 to 5 days to determine if there are additional questions and assist them in scheduling at that time.

During the follow-up, if patients are still not ready to schedule based on fees or fear, the staff person should recommend some nonaggressive options (eg, MediSpa services) in the interim. We have found that often the fear is alleviated once patients undergo a procedure. They then become excited about having more aggressive procedures.

Using current data from our clients, we have confirmed that when our protocol as outlined is followed with vigor, the practice’s consultation closure rate should be in the range of 65% to 75%. In the current economic environment you may need to start with a smaller ticket item like a filler or skin-enhancement procedure if finances are an issue, but patients will be sold on the practice and not be lost to your competition.

Patients who have scheduled the procedure

As indicated, even if someone has scheduled the procedure, until the actual day of the surgery or service there is a chance of cancellation. Therefore the follow-up is necessary for reassurance. The following are the reassurance steps:

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  Immediately send a thank you note to patients (this can be signed by the doctor).

  
  
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  Confirm the date of the procedure.

  
  
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  Review the plan for surgery (need for preoperative visits, additional test, and so forth).

  
  
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  Review the payment plan (when the final check needs to be in the office).

Patients who have specific needs to consider before scheduling

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  Set time to call within 3 to 5 days to determine if the need has been satisfied.

  
  
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  Make the call.

  
  
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  Schedule the service.

  
  
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  Put them on a tickler for later.

  
  
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  Confirm their desire to remain on the mailing list.

Patients who did not schedule but have no specific reason

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  Send a thank you letter.

  
  
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  Call 1 week later.

  
  
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  Determine if the person has additional questions or wants to have a second visit with a companion or spouse.

  
  
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  Set a reminder for a later follow-up.

  
  
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  Confirm their desire to remain on the mailing list.