The careful balance between a high-risk practice and a safe, successful practice often centers on achieving patient expectations. In other words, try to give the patients what they appropriately seek and desire. There are two parts to fulfilling patient expectations.
Honest representationsThe first is to honestly represent a realistic outcome approach to the patient. Some prospective patients desire very minimal surgery, but expect an unrealistically improved result.
The practice has an obligation to dispel fanciful views and bring the patient back to a realistic expectation. Minimal scarring and minimally invasive surgery may yield very good results, but patient selection is critical. Be careful not to misrepresent expectations to capture the patient.
The second part of meeting expectations is to educate the patient about realistic outcomes and goals. The more the practice can educate the patient and family about the important issues, such as choice, procedure technique and options, risks, instructions before and after surgery and realistic goals, the happier the patient will be.
The real end result is a satisfied patient who stays with the practice and even recommends friends and family. It has always been accepted that it is less expensive to keep a patient than to recruit or find a new patient.
Sound business advice is to "wow" the patient with ethical and realistic information resulting in met expectations. Technology offers new ways of achieving this.
For example, Expectation Management and Medical Information (Emmi) is an Internet-based program (Inamed, Rightfield Solutions) that helps the practice focus on patient expectations while informing the patient and family in their own environment.
The procedure of breast augmentation is presented with visual aids as well as user-friendly audio information that clearly helps the patient better understand what is a realistic expectation and overall result. The practice can interact with the patient to fine-tune her goals and choices.
Visual, auditory, kinesthetic
Education-based practice enhancement must encompass multiple learning styles. The three most common learning styles are visual, auditory and kinesthetic.
I do not believe it is satisfactory now to only describe risks, alternatives and procedures while the patient listens. This auditory form of learning is effective in only about 35 percent of the population.
More patients learn by using visual aids as well as citation of examples that personally relate to them. The later kinesthetic learning style may be used, for example, when a postpartum mother with slightly decreased breast volume seeks augmentation.
Size choices are presented by discussion (addressing auditory learners), photographs and visual aids (addressing visual learners) and now interaction of how large the patient became during pregnancy (addressing kinesthetic learners). The patient may say that she does not desire to be as large a "D" cup as she was during pregnancy. This personalized knowledge by the patient aids in kinesthetic learning.
The more the practice team includes all three types of learning style aids, the better educated and realistic the patient's goals. Emmi helps achieve this by including all learning styles in the interactive presentation.
Team approach critical
Every contact in the office must be positive and complement each other so the patient's overall experience is good.
The physician cannot completely delegate this responsibility, but the patient coordinator and nursing personnel can supplement and respond to patients' questions and issues.
Emmi facilitates this interaction. The end result, I believe, is a better-educated patient whose expectations and goals are more realistic and are simultaneously clearer to the physician. All of this leads to better risk management, but more importantly, results in a happy, loyal patient.
Dr. Reisman is associate chief of plastic surgery, St. Luke's Episcopal Hospital, and clinical professor of plastic surgery, Baylor College of Medicine, Houston.