Behind the desk: Another side of patient care

Behind the desk: Another side of patient care

Administrative professionals are the front lines of health care, the first people patients speak to or see when they schedule appointments or come in for an office visit. This month The POST highlights the important role they play in patient care.

By Laura Mize

Treatment coordinator Tara Taylor (front) works closely with patients in the College of Dentistry and offers crucial support to students like Sara Nofallah (left) and faculty members like Dr. Jon Baxter.

Phyllis Stephens doesn’t carry a stethoscope. She can’t draw blood or prescribe medications. But without the work she does, many of the patients at Archer Family Health Care wouldn’t get the care they need.

Stephens works as a financial assistance counselor at the practice, which is run by UF’s College of Nursing and primarily serves uninsured and underinsured people from Alachua, Levy, Gilchrist and Marion counties. She calls the patients who receive care at the practice “my patients,” and for a decade she has checked them in, scheduled their appointments, processed referrals for them and verified their incomes.

But many need even more help to ensure they get care.

“If they miss an appointment, I’ll say, ‘Why did you miss your appointment?’

“They’ll say, ‘I didn’t have the money. I didn’t have the gas.’

“I explain to them, ‘We can work something out.’ That’s what it’s all about, is taking care of their health needs.”

Providing extra guidance and encouragement for patients isn’t strictly a requirement of her job, but Stephens says doing so is part of her role in providing patient care.

“I love my patients,” she says. “I’ve been here for so long, I feel like I know my patients inside and out. I have grown to know them, they have grown to know me and, basically, I care about their needs.”

Denise Schentrup, D.N.P., A.R.N.P., a family nurse practitioner working at the practice, says Stephens’ close relationships with patients allow for better, more individualized service.

Phyllis Stephens, a financial assistance counselor at Archer Family Health Care, talks to a patient.

Across the nation, administrative professionals such as Stephens are often the unsung heroes of patient-care facilities. An estimated 386,300 receptionists and so-called “information clerks” worked in American health care in 2008, according to the U.S. Bureau of Labor Statistics. Another 39,600 people filled such roles in the category called “veterinary services.” The agency estimates that in 2018 there will be 448,600 of these employees working in health care, plus 54,900 staffing veterinary services.

Health-care receptionists’ duties go well beyond answering phones and checking in patients. Each practice offers its own set of challenges for these professionals, and requires a slightly different set of knowledge and skills.

In addition to giving patients their first impressions of the practice, Schentrup says a good receptionist at Archer Family Health Care needs “to know the ins and outs of what types of procedures we do, the types of cases we can see.”

Whether they’re called receptionists, secretaries, assistants or a myriad of other titles, the roles these people play in health care are vital.

“They are the gatekeepers, basically, to the practice,” Schentrup says.

It’s all about communication

What do you get when you combine complex medical conditions and treatments; the rigmarole of health insurance, referrals, finances and jam-packed schedules; and the sensitive nature of health care? One word: stress. That’s why, for administrative professionals working in health care, communication is key.

“You have to like people, first of all, to work up there (at the front desk), because you get a lot of unhappy people that come in,” says Ryan Osborne, a clinical clerk at the Speech & Hearing Center at Shands at UF, run by the College of Public Health and Health Professions.

In addition to interacting with patients when they arrive for an appointment or call the center, he also is responsible for organizing a complex care schedule that involves the center’s regular patients and people receiving inpatient care at Shands at UF. Like many receptionists and secretaries, Osborne has not attended any of the formal certification programs offered for employees in this field. Instead, on-the-job training, experiences from previous health-care administrative work and common sense guide his work.

“You’re juggling a bunch of things at one time,” he says, “like dealing with the hospital. You don’t have just your patients, you have the ENT (ear, nose and throat) patients that come up and you have the inpatients off the floor that are trying to get in. You have to work that around the schedule that’s already set for the day, try to squeeze them in.”

All that juggling means he can’t always make everyone happy.

When patients get upset, Osborne has a strategy for dealing with them.

“You’ve got to kill them with kindness. Then you go to your supervisor and try to further see if there’s anything else that you can do to make that appointment happen that day or if you can squeeze them in or try to make them happy some way.”

This exchange can be tough enough when both parties understand each other. But sometimes Osborne’s communication with patients is complicated by their speech or hearing disabilities.

“Most of them, they read lips. That’s a help,” he says. “(Otherwise,) just take your time and be patient with them. If you have to, get a pen and a paper and write it out and go through a conversation like that.”

Ida Thimann-Grantham also deals with special communication challenges in her role as an administrative associate for UF Pediatric Primary Care at the Gerold L. Schiebler Children’s Medical Services Center. She spends most of her time interacting with patients at the front desk, but also serves as a certified English-Spanish interpreter at the practice.

“We do try to schedule (Spanish-speaking) parents with Spanish-speaking doctors, but it depends on the availability of the doctor and the schedule of the parents,” she says. “I’m here most of the time, and I’m happy to help both parties communicate.”

The role of receptionists at UF Physicians practices is changing. The organization opened the Patient Access Center in August to provide a central number for patients to call when they want to reach a UF Physicians practice.

“The goal of the Patient Access Center is to improve access for our patients and referring physicians to all aspects of the patient’s care with one phone call,” says Kelly Kerr, M.B.A., senior director of operations for UF Physicians, “including appointment scheduling, prescriptions refills, test results, medical questions and other needs with a focus on patient-centered hospitality. We are in the process of rolling this program out to all of the practices.”

Access coordinators at the center answer calls that normally would have gone directly to individual practices. They schedule appointments, help with referrals and connect patients with nurses or physicians when necessary.

Thimann-Grantham still performs some of these duties from her desk at the Children’s Medical Services Center but says the opening of the center has lightened her load. The new system appears to work well for patients’ parents.

“Parents don’t seem to complain much when they come here, so I think they’re getting what they need when they’re calling them,” she says.

Ashley Pankey answers phones at the center from 7:30 a.m. to 4:30 p.m. every weekday. She’s assigned to the surgery “pod” and takes calls that come in for clinical personnel from the department of urology and from the department of surgery’s division of general surgery. A triage nurse accessible via cell phone speaks with patients who have urgent medical questions.

Pankey says the Access Center has reduced phone wait times for people who call UF Physicians practices.

“Most patients are so excited to be able to get a real person on the phone so quickly, and to be able to actually speak with someone that knows how to facilitate their needs.”


A whole different animal

Christ Sproule helps patients and their owners at the UF Small Animal Hospital.

Christi Sproule has worked as a receptionist at a UF practice for about four years.

Like Stephens, she takes great satisfaction in providing quality service to the people who depend on her for access to care. But the folks Sproule interacts with aren’t seeking remedies for their own health problems. Rather, they need help for their pets.

Sproule works at the check-in desk for primary and emergency care at the UF Small Animal Hospital. She says her job as an office assistant there fits perfectly with her love of people and animals.

Working with animal patients provides its own set of challenges for customer service. The hospital doesn’t offer ambulance transportation, so clients typically transport their own animals in emergencies, making these situations nerve-wracking from the start. Patients can’t talk to providers about what’s wrong and, in emergencies, pet owners have to stay in the lobby and speak with a veterinary medicine technician or student while their animals are evaluated in a treatment room.

Sproule says she tries to keep things in perspective when a client expresses frustration.

“The art of client service that we’ve learned here is not taking that personally,” she says, “and realizing the bigger picture — why that client could be upset — and having empathy (for) what a stressful situation they’ve been in.”

She says she strives to assure clients she’s there to help them through the experience and to communicate with providers on their behalf.

“Often times, that is all a client needs to hear — that they (have not lost) control, that we’re including them and that I am their advocate,” she says.


Influencing tomorrow’s providers

Clients, patients and providers aren’t the only ones who benefit from the work of health-care receptionists at UF&Shands.

Tara Taylor is a treatment coordinator in a College of Dentistry student clinic, where third- and fourth-year students provide general dental care to patients at a discounted fee. She has held a variety of administrative jobs in the college since 1996 and has worked in her current position for five years. Her enthusiasm for the patients and students she serves is contagious.

“The last five years working with the students and the patients have been the best ever,” she says. “I wouldn’t trade it

for anything.”

One of those students is Kyumee Yo, now in her fourth year of dental school. Yo says Taylor helps the students keep up with administrative tasks and makes everyone feel important.

“It gives me an idea of what to look for in the future when I hire a receptionist or secretary,” Yo says. “She’s kind of set the bar, in terms of who I want to fill that position, and it’s more than just being able to be good at your job. It’s more about being well-rounded and the fact that she can always smile.”

But Yo says Taylor’s example has taught her something else, too: to be more understanding with her patients.

“To not push them so much, but to guide them,” she says. “But also to be able to just sit back and listen and have patience with them.”

Stephens, too, says caring for patients is the most important part of her job.

“It’s all about love, and I give them that,” she says. “They give me that in return. They let me know that my job is not in vain.”