Make their day… and reduce repeat visits

An approach to involving people in decisions that affect their lives may hold a key to reducing repeat GP visits, increasing adherence to medical advice without increasing costs. 

This approach began as an exercise in finding ways of improving service-user experiences of social services.

Working with deputy director of a social services directorate and one hundred senior managers we ran an exercise called, “Make my day”.

The method was simple: we asked the service managers to identify things they believed they or members of their staff could do that would literally “make the day of their service users”.

None of the actions added cost.

The participants focused behaviours: using clients’ names, saying hello and ensuring they knew what was happening when. Just introducing oneself has an impact on patient perceptions as the success of the My Name is… campaign will attest.

The approach confirmed advice in “The Long and Winding Road”, a report on communication with patients by the Marie Curie Foundation.

Amongst its findings the authors suggest that enabling patients to participate in decision-making improves outcomes. This might also help reduce repeat visits and improve health outcomes.

How might you apply this thinking in your own consultations – without increasing costs?

Make your ideas, their ideas 

Here’s an approach you could trial.

First, make patients receptive to your messages. GPs don’t have much time to do this; consultations are already stretched.

But the whole GP experience – from car park to car park – could contribute to “priming” patients to be more receptive.

Look at your patients’ journeys. Is your surgery bright and airy with soothing music? Is the reading material designed to aid self-awareness and self-improvement? Are your staff warm and friendly? Do they address patients by name and lift their moods with small talk and informed comment? Do they help reduce levels of patient anxiety whilst increasing receptiveness to advice?

Now look at the consultation itself. Essentially, you are seeking not only to diagnose but to ensure that advice offered is followed. This is done against a backdrop of knowing that most people don’t take drugs as prescribed and some people will keep coming back for reassurance. So define a successful consultation as one where patients increase their chances of well being by following advice. Patients need to want to do what you advise – not to feel that they’re being dragged kicking and screaming into changing their behaviour.

What about your opening remarks to each patient? Do you greet them warmly? Do you use their name? Do you create a sense of interest in them and their challenges? Do you inspire or boost their confidence? Do you look interested in what they have to say? Do you use the words that they use in building rapport? Do you smile and cause them to smile, where appropriate?

When offering advice on what course of action to advise, do you first seek their views? Do you ask what would make them more likely to take a course of medicine as prescribed? Do you leave them thinking that they’re in the driving seat of their own health?

What about your closing remarks? After thoughts matter too. We all mull on things during the day. Sometimes anecdotes or tugging thoughts will affect our actions. The private sector through powerful advertising recognises that jingles and advertising slogans will keep brands alive in our heads so that they will get buying attention during the day.

Nobody would suggest that you should whistle a catchy tune as patients leave your surgery. But you might leave them with a thought on which they might mull and which could affect their behaviour. Sir Muir Gray did just this last week whilst speaking about redefining Type 2 Diabetes as Walking Deficiency Syndrome: if we walk for half an hour a day every day for a year we will lose 9 pounds in weight. I wonder how many people are racking up daily steps now as a result. 

Do you leave them with inspiring and insightful anecdotes to chew on in the days ahead, thoughts that might cause them to right unhelpful behaviours? Do you give them reading material that might steer them towards better health?

Doctors have the kind of influence and depth of trust that major influencer brands would die for. Creating an outcome focused well-being experience could help drive down repeat visits and help your patients enjoy better health.

And it won’t cost a penny more.


Mark Fletcher-Brown is a partner with reputation counsel, a communication consultancy. He has been a journalist, columnist and university lecturer and has written extensively about communication management in articles and books. He has worked with PCGs, CCGs and health trusts as well as housing organisations and over 70 public sector organisations and has lectured on communication in the UK, Cyprus and at Moscow State University.

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