Patient call centers are BAD medicine


After reading the article,”Using Centralized Call Center Technology to Boost Patient Access”, I was very frustrated with the author implying that patient call center’s motives are to increase access to care and improve office efficiencies and the “patient experience”.  In reality, it is all about the money and controlling doctor’s schedules.

My favorite part is when she states they meet individually with their doctors to better understand their needs to make their day manageable; what a crock.  In the same breath it’s clearly stated that a “standardized schedule” is developed to maximize the physician group’s revenue and that is what it is truly all about.

There are many more pitfalls than benefits to a centralized call center: physician and patient dissatisfaction, non-clinical operators who don’t actually triage, delays in messages, patients sent to other “providers” which has the opposite effect of enhancing the physician-patient relationship they state it improves.  Corporate thinking is that patients are willing to just see anyone for convenience and not their personal physician, that they are willing to see midlevel providers when in reality most would like to see their physician who has the highest level of training and who knows their health needs better than anyone. In the article, Ms. Heath specifically lists goals that the call centers will ensure patients get an appointment with the “right type of provider”.  Well, how about they see their physician who can direct them to a specialist if even necessary. Call centers are not the answer. It would be much more effective to have mechanisms built into the schedule to ensure acute visit slots are more available, lessen physician workload so they can accommodate these patients rather than packing our schedules so tight we have no flexibility. Patient want and expect to speak to someone at the office who works directly with their physician and whom they’ve developed a relationship, not a faceless telephone operator.

Implementation and cost of these call centers is huge, in my previous job after the implementation of our call center, every time it was announced more operators (sorry, they like the term patient liaisons) were being added, all I heard in my head was cha-ching, cha-ching, cha-ching!  So, how are these call centers paid for? By the doctors of course who are required to see more patient to cover additional overhead expenses.

My second favorite part is how it will lower “physician burnout”. Are you kidding me? All it does is add to more burnout.  See more and more people, get every open slot full or have your cherished patients sent to someone else who is “more appropriate” or has better availability.  

In my recent experience after our company implemented their new call center, much like the one listed in the article, patients HATED it.  They soon realized they were not speaking to someone directly in the office, there was a loss of the personal connection, delays in getting information to the doctor and inappropriate time slots utilized.  Recall the term “standardized schedule”, just say it like it is which is using the least amount of time possible to get the most patients in.

There are several inherent potential dangers of call centers such as patient being sent to urgent and walk in centers to see less trained providers and not allowing the individual physician’s offices the ability to appropriately triage and schedule high priority patients with their doctor.  Operators with no or minimal clinical training are able to place patients on the schedule without being properly triaged. I can list several examples of how this happened to me on a regular basis such as “severe abdominal pain” placed on my schedule 2 days later or an elderly gentleman with chest pain put in 15 minute slot at end of day.  What if this abdominal pain was a rupture appendix or the chest pain an impending MI. As a physician, I was very frustrated with the implementation of our call center, it was another mechanism for corporate medicine to control my practice, divert my patients elsewhere and not allow me to have a manageable schedule that was individualized to my and my patient’s needs.  My patients told me loud and clear they did not receive a better experience, they were just as frustrated when they realized they were not speaking directly with someone from the office, there was lots of miscommunication and mistrust.

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Jaclyn Nadler MD

Jaclyn S. Nadler, MD, MBA, FACP is a practicing internal medicine physician in Southwest FL. She received her medical degree from the University of Miami and undergraduate (BSN) and graduate (MSN/ARNP) training from the University of Florida in Gainesville. She attended residency at Wake Forest Baptist Medical Center in Winston-Salem, NC and completed her MBA degree with a concentration in medical management from UMass, Amherst. Dr. Nadler recently joined the Direct Primary Care/DPC movement when she became disillusioned with the current state of healthcare including physician abuse, corporate medicine’s focus on quantity of care over quality and the loss of physician autonomy. She started her own DPC clinic, CoastalMED DPC in January 2019 where she can practice medicine on her own terms and provide her patients with the time and superior care they have grown the expect. She is passionate about physicians regaining their rightful place at the helm of healthcare and physicians reverting back to independent practice and regaining autonomy. She is a member of the Florida Medical Association and Direct Primary Care Alliance, she is a Fellow in the American College of Physicians and received her certification as a physician executive (CPE) through the American Association of Physician Leaders. You can learn more about Dr. Nadler and view her blog at www.JaclynNadlerMD.com 

  3 comments for “Patient call centers are BAD medicine

  1. Steve O'
    May 13, 2019 at 11:29 pm

    I give many patients my personal cell #. They respect it and don’t misuse it. I have a panel of 1300 and my biggest criticism of patients is NOT calling me. People can be real decent except the MedBusIndustry treats them like shit. Amazing.

  2. Rick
    May 13, 2019 at 5:02 pm

    The birth of the medical-industrial complex (see Obamacare) has done nothing but hurt medicine. Call centers, medical facilities springing up like mushrooms–oh the good old boys in business have learned the secret to generating revenue. What makes it all more painful is the BS spewing from administrators about how this is all to help the physicians. My God, that they say that with a straight face just galls me.

  3. Phil Fogle
    May 13, 2019 at 3:12 pm

    Yes, kinda like trying to figure out why your computer hardware and software are having an allergic reaction and speaking to someone “off shore” in an other language. It looks good, sounds good, makes or saves money for someone, but it doesn’t work.

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