In recent years, cosmetic surgeons have seen an increase in the number of patients undergoing cosmetic procedures as well as an increase in the knowledge these patients have when they arrive at the office.

and well-trained staff to prompt surgeons about misinformed patients, potentially problematic patients, and myriad other patient-related concerns as the media age and the youth craze collide,” says Dr. Patseavouras in a recent article.

He noted that many of his staff members have been with him for decades and are the cornerstone of his practice.

An office’s first line of defense is an experienced receptionist. According to Dr. Patseavouras, he or she can gather a lot of information about the patient over the phone by listening to the patient’s tone of voice and whether he or she sounds “pushy.”

“Unfortunately, in a lot of offices, the receptionist is the least paid position, but it is the most important position. Therefore, it is best to have someone trained and keep him or her there. The longer the person has been associated with the practice, the better he or she is able to answer the phone and know the answers to questions that patients may ask,” he adds.

If an office hires a new receptionist, Dr. Patseavouras recommends providing in-service training about the practice. His practice has developed a list of commonly asked questions and answers for the front-desk staff.

IDENTIFYING PROBLEM PATIENTS

He also ensures that all of his staff members understand which characteristics indicate a good patient and which characteristics indicate a problem patient. “If a patient comes in loaded with questions and is being unrealistic about what we do, that’s one of the things to highlight,” he explains.

Other patient characteristics that raise a red flag include a sense of entitlement, withholding key medical information, only wanting to interact with the doctor and not other staff members, and being prone to complaint.

Dr. Patseavouras conducts all of his own patient interviews. “Many practices have patient care coordinators. In my office, this person plays a secondary role. During the interview, I review the patient’s history with him or her. Sometimes, people do not disclose that they have had previous cosmetic surgery because many times they do not consider cosmetic surgery to be real surgery. Then, we assess whether we can correct what they want corrected. In that period of time, you get a feeling for the patient and whether he or she understands what you are saying,” he adds.

After he consults with the patient and determines the best procedure for him or her, he gives the patient written information about the procedure and what the office expects from the patient both before and after surgery. Then, the office administrator discusses the fees. During this discussion, the office administrator can assess whether the patient thinks the fee is reasonable or whether it is too high.

“If the patient decides to have surgery, he or she comes in for a preoperative consultation where we review the surgery that has been proposed and make sure he or she is clear about the risks and complications,” he says.

After surgery, the office staff stays in close contact with the patient. “This helps us to know what is going on with the patient, and it helps us prevent liability. If a patient has a concern, he or she is sometimes hesitant to call the office, but if we call and ask, the patient will mention it,” he says. He notes that lawsuits are often caused by miscommunication or lack of communication. Having the office staff contact patients after surgery keeps the lines of communication open.

He explained that, when dealing with patients, communication has to go both ways. “Don’t ever hide anything from a patient. The most important thing is communication. I can usually tell within the first 2 to 3 minutes whether that patient is a good patient or not,” he says.

If a staff member alerts him of a potential problem patient, Dr. Patseavouras pays close attention and often will bring the patient back to the office for a second interview. “Sometimes, patients will react differently to the office staff than they will to the doctor. However, they have to interact well with the office staff, too, because that’s who is going to be doing a lot of interfacing with the patient between visits. There have been instances where the staff says the patient doesn’t have a grasp of what I am saying. Also, we don’t want patients to have surgery that is a surprise to their family. The family should be involved, and a lot of that information comes from our staff being involved. There are also things that they will tell the staff that they will not tell the doctor even if we ask,” he says.

He advises his staff not to render medical opinions during the post-surgery phone calls. “If a patient has swelling, rather than telling the patient that it’s okay, they say let me check with the doctor,” he explains.

MEDICAL MALPRACTICE ENVIRONMENT

Dr. Patseavouras notes that the overall medical malpractice environment in North Carolina is static. “However, there is a theory that, because of the economy, we might be seeing more malpractice suits as a way of making money,” he says.

He notes that when assessing the medical malpractice environment, it is important to look at the number of claims as well as the reward amount. “Even though the number of claims may be down a little bit, sometimes the rewards are higher,” he adds.

Reference

Patseavouras LL. The importance of staff in the facial plastic surgical practice: dynamic staff interface with patients in support of the surgeon’s objectives. Facial Plast Surg Clin North Am. 2008;16:191-194.