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Efficiency in the Urology Practice, Part 3: After the Patient Leaves Your Practice

Neil H. Baum, MD
Professor, Clinical Urology, Tulane University
Medical School, New Orleans, LA

The patient is in the office and is ready to leave the practice. Are you done with the patient encounter? No, you must continue to interact with the patient after he or she walks out the door.

Every patient who leaves the office should walk out with some written material that has the name of the practice and/or the name of the treating physician. In my practice, every patient receives a testicle self-examination card, and a breast self-examination discussion on the opposite side of the shower card. All patients also receive a wallet medication card that lists all their medications, including over-the-counter medications and supplements, the dosage for each drug, the instructions for use, and the name of the prescribing doctor (Figure 1).

Table

It is also a good idea to give out a frequently asked questions sheet on all prescribed drugs. This 1 page lists the instructions for the use of the medication, how the medication is to be taken, what are the contraindications for using the drug, a list of the most common side effects, and any other specific advice on the use of the medication (Figure 2).

Table

In addition, we provide patients with a sheet listing credible websites for common urologic conditions. This prevents patients from looking all over the Internet only to find material that is inaccurate, is only a front for selling a product to patients, or is outdated and not applicable to the patient.

Finally, I recommend that you provide patients with an educational summary of their urologic problems, so they may read your recommendations after they leave the office. We have educational material from the American Urological Association (AUA) that is available from the AUA and can be downloaded from the AUA website, at www.auanet.org/resources/patient-information.cfm. The file allows you to add your name and practice to the educational material.

Again, this should answer the most frequently asked questions that patients may have about a disease, a condition, or a procedure.

Communicate with Patients via E-Mail

I suggest that you collect the e-mail addresses of your patients, which will allow you to send them your quarterly newsletter that showcases your practice. An example of our newsletter to patients is located at the end of the article.

I strongly recommend that doctors develop a policy of communicating with patients via e-mail. Let’s be honest: patients (especially women who have a male urologist) are nervous when they are lying on an examination table wearing a paper gown, with their legs in stirrups, and they are trying to protect their dignity. In this situation, patients are not in the best frame of mind to understand a series of complex instructions from their physician.

In addition, the clinical jargon physicians and nurses use may as well be a foreign language. This affects the quality of care and results in poor patient satisfaction scores. Many of these problems can be overcome through the effective use of e-mail. Despite fueling nearly 18% of our nation’s advanced economy, the healthcare industry is notoriously slow to adopt transformative technological changes, including the adoption of the least cutting-edge of all innovations, the humble e-mail.

An e-mail response is far better than telephone calls, makes good use of the physician’s time, creates a written document of the communication, and is very appreciated by patients. Furthermore, because using efficient and popular technology such as e-mail delivers the results to patients faster, it has a high value for the patient and improves patient satisfaction scores. Despite its potential, the use of e-mail for physician–patient communication has not been widely adopted.

Regretfully, secure messaging is not reimbursed by the Centers for Medicare & Medicaid Services or by insurance companies. High-deductible health plans for patients is an increasing trend in the current healthcare system, and patients in these plans are going to be price-sensitive. Physicians may find that they can successfully compete for these “picky” patients only by communicating with them successfully, such as by using e-mail.

The Bottom Line

A current trend in healthcare is moving toward a decrease in reimbursements and rising overhead costs for physicians. This translates into a reduction in income for many urologists. Therefore, the challenge is to make our practices more efficient so we can see more patients in the same period and yet preserve patient satisfaction.

By following some of the suggestions in this 3-part series, you will be able to manage the patient before the patient arrives in the practice, during the doctor–patient encounter, and after the patient leaves the office. As a result, you will have happier patients, happier staff, and therefore a happier urologist.

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