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MANAGING PATIENTS

How to handle “emergency” appointment requests that really aren’t emergencies

Does your practice seem to be getting a lot of emergency appointment requests lately? If so, you’re not alone. Patients are under the impression that if they say they have an emergency, they will get the earliest possible appointment.

Obviously, all these emergencies present challenges. There are only so many emergency appointment openings, which means you or someone on your staff has to determine which patients truly require immediate attention. At the same time, because a patient’s health and wellbeing are potentially at stake, you certainly don’t want to make a screening error.

And then of course there is the patient communication piece. If you tell a patient his or her symptoms do not fit the definition of emergency, there may be repercussions.

So, how do you navigate this difficult situation?

Establish guidelines with medical staff

Although you may believe you know which symptoms require immediate attention, don’t rely on your experience. Instead, meet with the medical practitioners in your office to come up with a list of symptoms that will be used as the basis for emergency appointments.

Once you have determined these symptoms, create a simple, easy-to-reference document, preferably with bullet items, and ask the medical staff to review and approve it.

Make it known this is the tool that will be used when patients request emergency appointments.

Review guidelines with office staff

Once you have an approved list of symptoms, provide each office staff member responsible for scheduling patient appointments with a copy of the final document and explain how to use it.

Stress the importance of the document, while indicating it is only a guide.

As you share the document, review the importance of proper screening. Remind staff there are only so many emergency appointments, while emphasizing that the practice has a responsibility to patients and must take patient concerns seriously.

This is also a good time to stress the importance of remaining professional, even when a phone conversation with a patient suggests a so-called emergency is a ploy for a convenient appointment.

Tell staff members that if they have any questions or doubts when speaking with a patient, they should transfer the call for the emergency appointment to you, while letting the patient know you are the office manager. Even if you end up reiterating what was previously said, it may now resonate with the patient because they hear it from a manager.

If the patient still does not seem willing to wait for a regular appointment, as the manager, you are in a position to decide what to do next.

When in doubt

Unfortunately, even a handy reference tool won’t address every situation. Symptoms may be conflicting or a patient may not be able to clearly articulate his or her health issues.

What should be done in these situations?

If there is the slightest possibility this is an actual emergency you have two choices: schedule the emergency appointment or arrange for the patient to speak with a medical practitioner by phone.

Although you want to run an efficient office, it’s important to remember the scope of your position. You are not a medical practitioner; and, as familiar as you may be with symptoms and terminology, you are not qualified to make a diagnosis.

If symptoms suggest there may be an emergency, the most expedient course of action is to schedule an appointment. When in doubt, let the patient know one of the practitioners will call him or her to discuss treatment options.

If possible, let the patient know when s/he can expect the call. This provides the patient with a time frame and shows that you respect him or her, and hopefully prevents a second phone call from the patient about the same issue.

Meeting patient demands

These procedures will generally serve you well, but what happens if you’ve determined a patient doesn’t require emergency attention and s/he becomes insistent or even irate?

Remain calm and professional and explain why an emergency appointment isn’t warranted. If the patient continues to push for immediate attention, ask again for symptoms.

Then, to show you’re listening and take the patient’s concerns seriously, summarize what was said. Do your best to reassure the patient that an emergency appointment is not necessary.

What if the patient still demands an immediate appointment?

This is the time to refer the call to a medical practitioner, who will likely convey the same message. However, once the patient hears from an authority, s/he will have no choice but to respect the practice’s policy.

Meanwhile, you will know you have performed your job to the best of your ability, and set boundaries that are in line with your knowledge and responsibility.

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