What has happened to Dr. Chilek’s office? Answers to your questions, and explanations of how things are changing, by Dr. Chilek
There have been a lot of changes over the past year and many of you are wondering what is going on around here! Thanks to feedback from you all, we are sorting out the best from the worst and trying to create an efficient, smoothly running clinic. There have been some glitches and growing pains along the way and I want to address those issues. Most of the comments focus on the following topics:
“You’re growing too much and we’re losing the personal connection.”
In order to stay open, I needed to cut overhead costs. We all know the difficulties associated with our healthcare system, and the increasing requirements and hoops. Instead of increasing my patient volume and shortening visits, having other doctors help share the rent was the best option for my practice to survive. We each have our own patients, but we can help each other and see each others’ patients when we are overbooked or out. This prevents you from having to use urgent care clinics and ERs, where they don’t know you. It also allows us to have weekend hours, and possibly late hours in the future.
Overhead costs continue to rise and insurance company demands have increased substantially over the past 2 years. We now require 5 staff members in the front office for 3 doctors instead of one staff for each doctor. This results in increased overhead expenses, while the insurance companies and medicare are cutting our reimbursements yearly. In order to try to balance this, I have added new doctors to help share the rent and overhead costs. I added the Annual Fee to help cover the extra costs associated with electronic medical records and handling the increased demands of patients for notes, billing paperwork, work releases, prescription assistance paperwork, refills, and time trying to assist in coordinating care with specialists.
Why can’t I see you? Are you too busy to see me?
I still have my same patient base I always have had, and continue to limit my new-patient appointments. My patient panel has not really changed in the past year. However, recently, Drs. Jezierski and McWilliams have been helping me out. I have been focusing more of my attention on improving office flow, and then my gallbladder issues got in the way! Unfortunately, our staff was trying to protect my privacy and was not relaying the fact that my being out due to surgery was the reason patients got shifted to the others’ schedules. But, sometimes patients are put on other schedules by mistake. We are working on communication between staff and patients in order to make sure you see who you want to see. However, if you want to be seen at a specific time, you will be offered an appointment with another doctor for your convenience so my schedule isn’t overbooked if I already have someone in that slot. Our same day/next day appointment policy will continue to be in effect- which means you will be offered an appointment that day or the next day, depending upon the severity of your condition. I do not like to schedule patients out more than a few days because patients tend to no-show and it is hard to predict schedules. Other offices routinely “double-book” appointment slots in order to balance the no-shows, but this tends to backfire and cause delays. I prefer to have specific appointment times and only overbook in urgent or emergent situations.
If my appointment is at 2:40 and I show up at 2:45 why does Ashley tell me I might have to reschedule?
We allow 20 and 40 minutes for appointment slots starting at 9 am. I am ready to see my first patient at 9:00, therefore, you need to be checked into the room by 9:00 for me to see you from 9:00 to 9:20. If you show up at 9:00 and it takes 10-15 minutes to check in the front and the back, then you get into the room at 9:10-9:15, leaving me 5-10 minutes for your appointment time. So, the staff is asking that you arrive 10-15 minutes prior to your appointment time in order to get checked in thoroughly without interrupting the time scheduled with me. I like to run on-time, but honestly, patients being late is usually why I get behind. If you show up at 2:45 for your 2:40 appointment, and the 3:00 appointment person shows up as they should at 2:45, then both patients are ready in the rooms at 3:00 and the person who was “only 5 minutes late” just threw the whole schedule behind 20 minutes. The only way I can be on time is if my patients are on time. I am starting to have to enforce this so I can spend the time I need to with everyone.
“Why don’t you answer your phone?”
We have four staff available to answer phones at most times. We try our best to answer every call as soon as possible. However, we can’t. You can leave a message and someone will get back to you, but we recommend using the patient portal to reach us. The message gets routed to the correct person and it is in your own words, not summarized by a third person, and it is a part of your chart. Our phone call volume has increased, as it has with other offices as well. Changing insurance plans, increased complications with insurance billing, prescription and testing authorizations, and the desire by some patients to receive care over the phone has bogged down the phone system. This is why some offices have gone to only voicemail and never have a person answering. They simply take all messages off the voicemail and return calls. We don’t want to create that barrier, but sometimes we just can’t answer the phone.
Why doesn’t someone get back to me right away when I leave a message?
Each message is handled as quickly as possible, and messages are prioritized depending on the urgency. Medical problems take priority over billing and insurance problems. Referral questions tend to take some digging, and often we are consulting with multiple people about your questions. Our staff has been working on trying to relay a message back that we received your message and are working on it, and will let you know as soon as we have a final answer. We are also bound by privacy laws and cannot relay much information in voicemail messages, which results in endless phone-tag sometimes. Portal messages eliminate this for the most part. So, we are trying to get everyone on the portal in order to free up the phones for urgent matters and improve our response times.
Who am I supposed to talk to when I call the clinic?
Everyone should be able to handle most requests, but some people in the office are specially trained to handle certain things.
Ashley handles the front desk check-in process, and answers phones.
Hunter handles referral coordination and answers phones. He also assists patients with portal education.
Meg answers phones and voicemails, returns calls, and assists Ashley and Hunter.
Amanda is the Patient Care Coordinator who oversees all above employees and manages patient information. She is the go-to person for difficult situations and helps coordinate all care for patients. She also answers phones and assists in the back office as needed.
Shannon is a nurse in the back office. She checks in patients and assists the doctors, as well as returning phone calls for the doctors. She also runs the new IV infusion clinic and performs various procedures.
K.C. is a medical assistant in the back office. She checks in patients, assists doctors, performs various procedures, and returns phone calls for the doctors.
Earlynn is our newest member of the team and she starts full time soon. She is our new Business Office Manager and brings years of experience to our office. She handles all billing, insurance, and claims issues. She and Amanda work together to manage the entire office and oversee all aspects of patient relations.
Nurse #3? As you all know, Holly has been out since having her new baby. Although she will not be returning, we have several people in mind for the position and will be making a choice soon. As of now, all the nurses work with all the doctors and can assist with any of your needs.
My goal is for each of you to get to know the staff and be able to trust any of them to meet your needs. We are constantly revising job duties and responsibilities in order to make things run more smoothly and efficiently.
Who do I call to set up an appointment at the Wellness Center?
If you have been referred to a specialist/doctor who sees patients at the Wellness Center on some days, then you will schedule this through Hunter in our office through a standard referral from us. Hunter will get you in touch with the specialist’s main office to get you on the schedule the day they are at the Wellness Center.
If you want to schedule other services at the Wellness Center, like massages, acupuncture, hypnosis, or counseling, then you can call Kathy at the Wellness Center directly and she can assist you.
Sometimes we refer you to the Wellness Center for certain things, like counseling, RMR metabolic rate testing, clinical stretching/Yoga, and other services in order to try to get your insurance to cover them. In these instances our staff will assist you in setting up the first appointment there. Not all services are covered by insurance plans, but sometimes we can try.
Hopefully, this has helped answer some questions and let you know what is going on here at the office. I know there are problems right now, but please be assured that I am doing everything possible to continue to be the most efficient, caring, high quality office you are used to. We will continue to make the necessary changes until this goal is achieved.
If you have any comments or suggestions about the office, the changes, or the staff, please use my new feedback form. I am the only one with access to anything you submit and your issues will remain as confidential as possible. Both positive and negative feedback is the only way to make this office the best it possibly can be and I appreciate your comments, even when they are painful to hear.