The power of the first call: What you don't know can hurt you

CG-CAHPS and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores are a big focus of attention these days, and for good reason. The better the scores, the better the reimbursement. And higher levels of patient satisfaction likely lead to loyalty and positive word-of-mouth. That’s certainly true to a large degree but as healthcare administrators and providers focus on improving the patient experience for those they serve, they may be overlooking an audience that is equally as important to their continued success — potential patients. In particular, those patients who may have attempted to engage with your organization but who have been thwarted in some way.

The adoption of the CAHPS Clinician and Group Survey (CG-CAHPS) puts the spotlight on the patient experience within medical practices, asking patients to report on their recent experiences with a specific primary or specialty care provider, including satisfaction with appointment access, clinicians and staff. The first phone call placed by a consumer is also essential in determining if the caller becomes a patient. But how do you measure what might have been?

While medical practices can measure patient retention and satisfaction, until now there has not been a method for measuring and understanding the percentage of potential patients lost as a result of a less-than-positive first encounter. “The Power of the First Phone Call,” a 2016 study conducted by Baird Group, was based on an analysis of 1,875 medical mystery shopping phone calls made to physician practices. The research reveals that there are universal behavioral practices that clinics and attendants either do, or don’t do, that are associated with callers’ impressions and their likelihood of returning to the clinic. There also are distinct factors of satisfaction that contribute to callers’ likelihood of recommending.

First impressions are fleeting, but powerful. One of the key findings from this study is that 35% of callers reported that they were not likely to return to the medical practice based on their first call. Understanding the factors of the phone encounter that influence consumer impressions, as well as the consumer response, holds important implications for training and ongoing quality assurance measures. Too often in healthcare we simply don’t know what we don’t know.

Implications for your practice

The bottom line is that most patients are calling because they want an appointment. The better able the clinic is in providing an appointment, the higher the likelihood that the patient will return. That’s not surprising. What is surprising, though, is the extent to which being able to get an appointment when desired impacted patients’ interest in returning:

• Those who felt the appointment was worse than expected were 4.5 times less likely to report they would return in the future.
• For every one level of increase in the appointment rating, patients were 1.7 times more likely to indicate that they would return.

Your phone attendants are your first opportunity to engage with potential patients. Even in a short encounter, callers will form an opinion about the entire practice. Unfortunately, phone attendants are often some of the lowest-paid staff and receive little training to ensure that high-quality phone encounters take place consistently. Having multiple, simultaneous demands on the attendant will also determine how much attention is given to each individual call. Many of the people answering phones for the practice are also greeting and checking patients in or out, which means they are splitting their attention between the patients in front of them and those on the phone. This is a role that also experiences a high level of turnover, further threatening the chances of patients having a positive and rewarding interaction. 

Based on the results of this study, there are several best practice considerations for medical practices to focus on in order to boost the odds of return for their potential patients:

• Setting phone standards to explicitly guide key behaviors
• Training staff on standards and building service skills, including the ability to handle difficult situations
• Consistently monitoring calls to assess quality and to provide coaching and training as needed

It’s highly likely that many healthcare organizations have little to no indication of how their phone calls are being handled and to what extent these calls are either delighting or disheartening their potential patients. By focusing on this important but often overlooked touchpoint for the medical practice, providers can ensure that they’re making a positive impression at this very crucial moment in the delivery of care.