Vouchers ease wait in doctors' offices Patients' time seen as valuable, too

August 17, 1993|By Sherry Joe | Sherry Joe,Staff Writer

Minutes before Karen Kolan arrived at Columbia Medical Plan off Thunder Hill Road for a scheduled pediatrics appointment, the doctor was called away on an emergency.

Staff members apologized for the inconvenience -- and gave the Ellicott City woman a $5 voucher for her trouble.

Ms. Kolan said the staff did "all they could do" under the circumstances -- "apologize and give me a voucher."

That voucher, and thousands like it, are the core of an unusual program intended to demonstrate the health plan's commitment to prompt service.

Known as the Quality Service Voucher program, it gives $5 vouchers to patients who have to wait more than 20 minutes for scheduled doctor appointments, lab visits, or the filling of prescriptions.

The vouchers can be used instead of cash for purchases in the optical department, for prescription and non-prescription medicine, for office fees, or for other services at the plan's facilities in Columbia, Annapolis, Frederick and Greenspring, which is its mental health facility.

"It's not paying them for their time," said Philip Miller, the HMO's quality service director. "It's meant to show them we know, we care, and we're sorry."

Under the 18-month-old program, nearly 15,000 vouchers have been distributed to medical plan patients. That amounts to about one out of every 200 visits, Mr. Miller said.

So far, more than 14,000 of those vouchers have been redeemed, in a program medical plan officials say may be the first of its kind in the health care field.

"We're not aware of anyone else doing this," Mr. Miller said.

Patient satisfaction

Though the program probably will not eliminate waiting times, he said, it demonstrates to members that the organization is committed to quality service.

"Our ultimate goal was patient satisfaction," Mr. Miller said. "We know people are fairly happy with our waiting times."

Patients say the vouchers let them know the organization cares about their busy schedules.

"I see it as a commitment to valuing our time," said Ms. Kolan, who used her voucher for an office visit to test for allergies. "They're not going to leave us waiting forever."

The vouchers also have encouraged staff members to be more considerate of patients' schedules.

"I think it's a token understanding that everybody's time is valuable," said Dr. Michael Kelemen, medical director and chief of cardiology and internal medicine at Columbia Medical Plan. "I think it's focused all of the staff's attention on the importance of -- trying to do everything you can to make people's visits as comfortable as possible."

For example, in the pharmacy at the the medical plan's Columbia Regional Medical Center, where delays are often common, workers have identified the hours between 4:30 p.m. and 6 p.m. as the busiest time. Patients are encouraged to use the facility at less hectic times, and more employees are assigned to work at busy hours, Mr. Miller said.

The voucher program was introduced in three phases starting last year, in the pharmacy, pediatrics and family practice departments at the medical plan's Annapolis and Columbia Regional Medical Centers. The program now is available in all 36 medical plan departments.

"We figured if we can do it in our pharmacy, we should be able to do it elsewhere," Mr. Miller said.

Keeping focused

MA Although staff members and patients appear happy with the pro

gram, there was some initial resistance.

Dr. Kelemen said physicians feared they would be criticized if their appointments with patients ran longer than 20 minutes.

"There was a lot of concern about what that would mean: an indication that somebody wasn't doing a good job," Dr. Kelemen said.

But those fears have not materialized, he said.

"I think it's worked out pretty well," said Dr. Kelemen. "It keeps me focused. I don't feel as if I've short-shrifted any patients because I have to give a $5 voucher to another patient."

Other area hospitals cope with waiting patients in different ways.

At Howard County General Hospital, a hospitality program was established last year where volunteers in the front lobby and emergency room tell patients about any unforeseen delays.

"We've found out that if we're upfront with people, tell them what's happening, they're much more accepting, rather than just sitting there silently," said Pam Karwan, assistant vice president for public relations and marketing for Howard County General Hospital.

For special, free countywide health programs where heavy demand is expected, Ms. Karwan said, more staff are called in to handle patients. Videos and snacks are provided to ease the wait.

In addition to conducting patient satisfaction surveys, the hospital also is establishing a program to show employees how they can better relate to patients, Ms. Karwan said.

Mr. Miller predicted that other health providers will follow the Columbia Medical Plan's lead in using vouchers as one way of responding to waiting room delays.

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