The best practice managers are those who truly understand the specific needs of GPs and other healthcare professionals, and there’s no better way to learn than by having first-hand experience. Marites Cross, managing director and practising ultrasonographer at East Anglia Ultrasound Services tells us all about what it takes to provide the ultimate in patient satisfaction.
How did you start your career in healthcare? What took you from being solely a practitioner to setting up and running your own clinic?
I was in the last month of my placement as a radiographer trainee in one of the ambulatory diagnostic centres in the Philippines when I was approached by a Cardiologist and asked if I would like to be trained to become an ultrasonographer and cardiac physiologist. As it was difficult to find a job in the Philippines, I did not hesitate to accept the offer even though I was already enrolled in the last year of my bachelor degree in radiologic technology.
It was hard work as I had to work during the day from 08:00 to 17:00 and go to university for evening classes from 18:00 onwards, but it was worth it in the end because I completed my degree in four and a half years. From there, I developed my career through working with patients in different healthcare management organisations. I worked mostly with private companies while in the Philippines, and that’s where I got all my ideas.
I then had an opportunity to work in Saudi Arabia, which I took as I wanted to build on my experience, skills and knowledge. I enjoyed working in Saudi Arabia for 5 years. However, working there was difficult. Although I loved the job, my freedom was limited and the opportunity for my professional development was non-existent. Hence, I moved to Europe.
I loved the first job I was offered here in Cambridge even though it was a great challenge in the beginning on account of the different culture and being a foreigner. When I gained some confidence, I realised that I should continue until I had all the confidence that needed. Over time, things started to change, and I could no longer give the best care to my patients because of staffing issues. What I enjoy most about my job is giving the best quality of care that I would like to deliver to all patients, but this level could no longer be maintained at that time.
I started thinking about starting a private diagnostic clinic, and it took me two years before it all went through. I wrote down all my ideas, but it was hard because I was still working full-time. I approached two of my colleagues and they were interested in helping. We discussed and shared our ideas and the machines we would have liked to use, but then one of them gave up. The other one just encouraged me to go on and do everything we needed to do, and that’s how I started.
Having successfully started your clinic a few years back, what would you say you have learned from the experience? Is there anything that new practice managers should watch out for?
I learned that if you would like to achieve something, then you should never give up. No matter what the challenges are in front of you, don’t stop because this is how you build your strength.
When I started, I went to the bank to open a business account and applied for a business loan, but they refused and asked whether I was contracted to any hospital, private organisation or insurance company. They wondered how they could find out whether the business would be successful. I went to the bank twice, but they turned me down.
That was not it for me, and I didn’t give up. Instead, I financed myself and got the job done. We started with personal capital, and that’s how we got all the machines and everything else sorted like finding premises. It took us 6 months before we started trading, so new practice managers should be willing and prepared for challenges and failures.
You shouldn’t treat failure as a reason not to carry on. Instead, treat the experience as a challenge. You can do it!.
However, once you’ve set up your clinic, you can’t just sit back. You must watch what’s going in and out, looking at how your clinic is growing and progressing. Especially with all the development and progress that’s being made, you must be innovative. You must be able to multitask and learn new technologies. For example, I didn’t know about social media or how to create adverts on Google. I had to learn these.
Another thing to remember is communication, because you’ll be talking not just to patients but to other businesses. In fact, business skills in general are very important. Just like a celebrity, you must make the effort to be nice to everyone.
Private healthcare is a small world, and if you’re not very nice to other people or businesses, then of course you will lose opportunities. Remember to always be professional, polite and approachable.
I know that you have your patients’ needs at the front of your mind at all times. In your experience, what are the key things to think about when it comes to engaging and satisfying patients?
It’s interesting because you can’t just let them in and get on with the appointment. Communication is number one again, and before you start any procedure, you have to explain the examination you’re doing and ensure they understand the limitations of it. Patients come to the clinic with the highest expectations because it’s in the private sector, but there are always going to be limitations to given examinations and tests. Just make sure that you do meet most of their expectations.
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What you should do when they first arrive is to address their concerns and reasons for visiting. Make sure you listen to them and make them feel at ease. A lot of patients are anxious before their examination, and once you’ve got a better window to their concerns and have made them feel comfortable, you can start a real conversation and they won’t be too worried. Continuing to explain what you’re doing throughout the appointment is essential to making patients feel reassured.
Knowledge is also very important. We see a lot of professionals like scientists and lawyers, so we really need to know what we’re doing. If you’re asked a difficult question, you need to answer smartly, but be honest if you don’t know. Giving them information about the examination and their concerns is how you make them feel reassured and confident that you know what you’re doing. You also need to be passionate, so they can see that you love what you do.
Another thing that is crucial is patient feedback. We send out an email asking them about their recent experience with us, and the majority of feedback is good to excellent! But we still accept any negatives as we can then improve our service. We audit our feedback and learn from it.
Even if negative feedback is seemingly trivial and a patient complains about the water being offered, we still take that on board. For us, it’s personal, so we always introduce ourselves to new clients and offer them a hot drink or some water while they wait. The first thing your client will realise is that you are nice and welcoming, and this works towards changing the attitude of even very anxious patients.
Combining your clinical duties with running your practice surely takes plenty of work. Do you have any advice to share with other private practitioners who are trying to juggle clinical work with the business of operating a practice?
My top piece of advice is that you have to be well organised. It’s about communication too, and you shouldn’t ignore emails. Make sure you reply to people as soon as possible. Don’t delay, as you might put your business at risk if you miss something important because you’re not opening emails.
Using a checklist every day should be part of your organisation, and you have to set it up starting from top priorities down to tasks of the least priority.
At least separate tasks into things that need to be done immediately and those which can be done later. I also set a target time for tasks, and time management itself is all about organisational skills.
Decisions need to be made, and you shouldn’t delay them. You have to think and weigh the situation up. Study the situation and see whether you can justify your decision. It’s all about learning how to expedite your decision making. Consider whether the outcome will be beneficial or less so, and think whether it will increase the quality of the service and the clinic’s income. If something is beneficial to the business, it’s easy to decide.
I would also say that you ought to be highly able in terms of using computers and performing clinical skills. After all, you have to train your staff. You can’t rely on someone else if you’re the one who is deciding what applications you’re going to use, and you should know how they are going to be effective. Once you have learned this yourself, you have to pass it on to your staff, all of whom will be different. That’s why you need patience and a passion for teaching as well. There are some who find it easy to learn and some for whom things will take a little longer.
Another thing is to stay updated, especially when it comes to technology, because we are always moving forwards.
Not all clinics are able to acquire and retain the optimum number of patients to match their practitioners’ capacity. In your view, what is the best way to attract patients and then keep them loyal to your practice?
You must always provide the best quality of care, and make sure you meet most of their expectations. They are paying for your quality, and if you don’t meet their expectations, they’ll be disappointed, make complaints, and they’ll tell their friends. They’ll discourage other service users if you can’t give the optimum service.
If your patients are happy and satisfied, they come back and will advise their family and friends to go to your clinic. The best advertisement is free – it’s word of mouth!
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