His colleague asked the physician, “How is it that you are able to see tens times as many patients each day as the rest of us?”

“You guys spend too much time meeting with patients and asking them questions. I do Facebook Care. I just look at their picture on Facebook, and if I don’t see anything wrong, I move on to the next one.”

“That is not the way it works. You have to observe them. You have to ask questions, and run some tests, and then ask more questions. That is the only way to know how they are doing. Where did you go to medical school?”

“I didn’t,” came the reply.

In another part of the hospital I overheard this conversation.

“What is going on with the call center?”

“The call center? What is it?”

“It’s a big room with a lot of phones, but that’s not important. How is it running? How well are people able to access us?”

“Everything is fine.”

“How do you know?”

“Because there is a big room with a lot of phones in it and I can hear them ringing?”

I interjected myself into the conversation. “Where did you go to patient access school?”

“I didn’t,” came the reply.

That is one way to know how well patient access is functioning in your organization—if the phones are ringing, everything related to patient access must be okay.

Here is another way to assess patient access. Go into the big room, the one with a lot of phones in it.

Here is what every health system executive should know about their patient access system. Let’s assume your system receives one thousand calls a day. On average, of those thousand calls:

• 600 callers already went to your website to seek the information they wanted or to complete a task.
• When those 600 people call, they have already been disappointed once
• Of the 1,000 callers, 700 of them will have to call more than once
• Of the 700 people who have to call more than once, 120 of them will not bother calling a third time

Patient access may be the single largest business system in your entire health system. A business system has three components; people, processes and technology. Each component must function well for the system to function.

Now, pretend you are a physician diagnosing the patient access function, and do what they do when they see a patient; ask questions, observe, run tests. Go through a process of discovery:

• Can you prove that the caller’s reasons for accessing your health system were met
• Were the callers’ needs met in a single attempt; how do you know
• Were calls transferred because the person who was speaking with them could not meet their needs
• Were callers placed on hold
• Did callers hang up before speaking with someone
• Can callers accomplish anything online
• Can callers get their needs met whenever they have a need, or do they have to call your health system only when it is convenient for the health system
• Do callers praise their access experience, or do they compare it to calling their cable company

Unless you have already run this diagnosis you have no way of knowing how dysfunctional patient access is in your health system.

I have never seen your health system, but I can tell you that I do not need to see it to know that it is in trouble. And when your access business system is in trouble patients leave. And they don’t just leave, they run for the exits and they tell others why they left.

A colleague of mine was finishing her cancer treatment at one of the top three hospitals in the U.S. She called to make a follow up appointment. It took her three hours on the phone to get her appointment.

She called me just to tell me about her frustration with that hospital. And she concluded her call saying; “I will make it my mission in life to tell everyone I meet not to go to that hospital.”

The time has come to diagnose the health of your patient access business system. And after you diagnose it, write a prescription to fix it.