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Practice Managers | Sept/Oct '14

Setting Expectations

As practice administrators, we are tasked with a multitude of responsibilities across the practice enterprise. From managing billing, collections, and clinic efficiencies to patient satisfaction and human resource needs, the sheer range of duties can sometimes challenge even the most organized and experienced professional. The one commonality across all of these challenges lies within the ability to achieve positive outcomes through a simple technique: setting expectations.


Setting patient expectations is a little tricky. By the very nature of the beast in which we work, we can try our best but often simply cannot dictate how the day will go. We can, however, implement efficient systems that rely on clear communication to keep patients informed about what to expect from their experience and aware of issues or delays surrounding their care. Ways we can set patient expectations are as follows.

•Establish a scheduling template that accounts for work flow, staffing, and doctor efficiencies and that identifies types of visits related to “short,” “long,” or “surgical.” An efficient template that yields consistency in patient exam times will create trust among patients and indicate what to expect during their appointment.

•Update patients on your practice’s financial policies. For example, mailing new patients a welcome packet will help them plan ahead for their copay, deductible, or testing charges that may be due on the date of service.

•Educate patients about their condition and treatment options. Ask your technicians to describe to patients what they are doing during their workup. Have them explain a refraction, topography, and visual field and why they are being performed. The techs have to be in front of the patient anyway, so encourage them to provide an educational experience during the process. We have discovered a secondary benefit to this as well in that it provides patients the foundation to better comprehend future billing statements, as they understand what was done during their appointment.


Just as patients are also customers, we should remember that our employees are as well. It’s sometimes challenging to think of employees as customers because they are paid for their service, but if we cultivate a culture that is positive and productive, the return on the investment can be exponentially beneficial to the team. Our practice has only been open a few years, so we are in constant development, but we have discovered that when setting personnel policies that are consistent, fair, and openly communicated, employees are more confident in their abilities, less threatened by weaknesses within the practice, and better motivated to perform tasks at the top of their abilities. Examples of setting employee expectations are listed below.

•Publish an employee handbook that outlines expectations, dress code, hours of work, vacation policies, disciplinary procedures, and the overall vision and goals for the practice. As simple as this sounds, most employees truly want to know what you expect from them, and there may be unrest if they are left to manage themselves. Your staff members are looking to your leadership for direction and guidance. Give it to them.

•Implement consistent human resource procedures that include staff meetings, training, follow-through with disciplinary policies, and annual reviews. Lax policies can lead to lax behaviors, so make it clear to your staff what you expect from their performance, where you expect them to be each day, and what feedback they can expect from you in return.


Similar to patients and employees, establishing expectations with referring partners can increase trust, strengthen communication, and ultimately influence referral patterns. Your practice providers are receiving referrals from the community because there is a level of trust for the care that your practice provides. In return, those doctors expect proper communication, clear direction on the financial and comanagement policies related to the care of your shared patients, and an understanding about patient wait times, availability for new appointments, and the types of technology or treatment options that will be offered to these shared patients. Establish expectations with referring partners by doing the following.

•Host educational events for referring partners to introduce them to your practice, your patient care philosophies, and your offerings for superior patient care.

•Provide referring partners samples of the educational materials your office gives to patients.

•Communicate preferences for referring patients to your office. Provide a referral template, doctor cell phone numbers, fax numbers, and preferred method for contact should a question arise.

•Send a letter back to the referring partner after every referred patient’s visit.

At the end of the day, each of us wants to feel involved in the process, committed to the team, and clear on what our different roles and responsibilities may be. By setting expectations within our different customer groups, more efficient levels of communication can be established and a more positive overall experience achieved.

Ashlie Barefoot, MBA, COE

Ashlie Barefoot, MBA, COE, is the Practice Administrator at Carolina Cataract & Laser Center in Ladson, South Carolina. She may be reached at abarefoot@carolinacataract.com.