First Impressions Important in Building Long-term Relationships

NOVEMBER 29, -0001
Ed Rabinowitz

“First-time, long-time,” is a frequently used expression by callers to talk show radio programs, indicating that they are calling in for the first time, but have been a long-time listener to the program.

Physicians, however, would like to attach new meaning to the expression, using it as a rallying call, of sorts, to turn first-time patients into long-term patients. According to Stephen Beeson, MD, a board-certified family medicine physician practicing with San Diego-based Sharp Rees-Stealy Medical Group, and author of Practicing Excellence (2006) and the just-released Engaging Physicians: A Manual to Physician Partnership, the first impression is critical to making that happen.

“Every point of contact is critical to the patient experience,” Beeson says. “Everything from the first phone call. If we say that we’re committed to service excellence and then the patient waits seven or eight minutes on hold before somebody answers the phone, that’s going to create an impression in the patient’s mind.” And it won’t be a positive one.

Turning Negatives into Positives
Akram Boutros, MD, FACHE, is founder and president of i3 Business Performance Solutions. He explains that many patients of primary care physicians come to their doctor’s office with significant prejudices; opinions fostered by the media and personal experience that the physician’s office will be inefficient and that time spent with the doctor will be brief. Boutros explains that this is an excellent opportunity for physicians to create “new” impressions.

“Patients are truly the customers of physicians, especially for primary care,” Boutros says. “Satisfaction is a mathematical formula, which is perception minus expectations. The lower the expectations, the more opportunity to have a satisfied customer. Physicians need to seize the opportunity and turn those patients into long-term customers.”

Boutros says first encounters are critical. He explains that social scientists have demonstrated that in the first 10 to 30 seconds of an encounter, people form credible opinions. As such, when a patient has to wait at a counter for registration, and the office staff member doesn’t address them right away—doesn’t even make eye contact—it de-personalizes the experience and makes it very difficult for the physician who then sees the patient after that first impression has been created.

The Call-back
It might not seem that important, but Beeson and Boutros agree that the physician call-back can go a long way toward making and solidifying that first impression. Beeson explains that 100% of the patients who visit his practice for the first time receive a call back the day after their examination to make sure all instructions received were clear and understood, and to find out if there’s anything additional the physician and his or her staff can do for them.

“These are simple things that aren’t necessarily pervasive in the healthcare community, but they make a difference,” Beeson says, “particularly when people have come from a different experience. These are tactical and specific things that both attract and retain patients.”

Boutros points out that for a busy practitioner, the call-back can often be made by a member of the office staff. The introductory line can be, “Dr. Boutros asked me to check in with you.” Call-backs, Boutros adds, also play a role in what he calls service recovery. If a patient has had a negative interaction at the physician’s office, a call-back noting that “we want to make sure your complaint has been registered, and we promise to be more attentive and sincerely apologize,” goes a long way toward righting any wrongs.

Communication Is Key
Jon Black is the CEO for, a website that fosters relationships between physicians and patients through communication. He says research indicates that about 75% of all malpractice claims are actually due to either a lack of communication or miscommunication with patients. Only 25%, he adds, are due to actual malpractice.

“People understand that you’re human and you make mistakes,” Black says. “If you communicate about it, if you’re honest about it, and if you start that relationship in the right way, then that relationship will always stay on a human, person-to-person level and won’t get to the legal level.”

Black adds that caring, or the perception of quality of care, is another key factor when fostering long-term relationships with patients. He says that whether the first communication is face-to-face or via the telephone, patients can tell when physicians and their office staff care about them. “As long as that feeling [of caring] is there from the first communication with a new patient, then I think you’re starting the relationship on a person-to-person level.”

Ed Rabinowitz is a veteran healthcare writer and reporter. He welcomes comments at

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