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Under-Promise and Over-Deliver: Adjusting Patient Expectations

September 27th, 2019 by Guest Communications


Wendy Leebov, Ed.D.
Partner & Founder, Language of Caring, LLC

Last week, I was waiting at the doctor’s office. Waiting, waiting, waiting. Several times, the receptionist told me, “It won’t be long.” But it seemed excruciatingly long…and the receptionist’s repeated empty promises only made the wait more annoying, as the clock ticked and I sat there with no idea how much longer it really would be before the doctor would see me. It was not a positive patient experience.

Adjust patient’s expectations: Under-promise and over-deliver.

The receptionist undoubtedly thought she was comforting me with assurances that the wait wouldn’t be long, but it had the opposite effect. Vague promises such as ‘not long’ are not helpful. Neither is predicting unrealistically short wait lengths. We should encourage healthcare staff to proactively and realistically shape patients’ expectations regarding wait times. It is better to prepare the patient for a lengthy wait and pleasantly surprise her when she’s seen sooner than predicted, rather than promise a short wait and set her up for frustration and disappointment.

This is true for all services, not just healthcare. Imagine that you call your bank for information and the banker says, “It will take some time to find the answer. I’ll get back to you within 24 hours.” Not expecting to get the answer until the next day, you won’t be antsy. If the banker returns your call four hours later, you will feel pleased and impressed. If, instead, the banker tells you, “I’ll get back to you within the hour,” but calls four hours later, you will spend three hours being anxious and annoyed at his failure to keep his promise. In other words, it isn’t the actual length of the wait that matters as much as what you’ve been led to expect and whether that prediction turns out to be fact or fiction.

Saying nothing to waiting patients or family members is problematic as well, because waits of uncertain length are hard to tolerate. Too often, staff members give no information about the upcoming wait because they are embarrassed or don’t know how to estimate how long it will be. The patient winds up feeling ignored and forgotten.

If you know there is likely to be a long delay, the safest policy is to over-estimate. It is better to say, “It may take up to three hours before the doctor can see you,” and have the patient be pleased when she is seen in two hours, rather than repeatedly promising, “The doctor will see you in ten minutes,” while the patient stews for two or three hours.

We need to develop message points that staff can use to advise patients of the waiting time: apologize for the inconvenience (without blaming anyone), give reasons for the wait, offer distractions, give an estimate of the wait remaining—and over-estimate!

“Mrs. Jackson, I’m sorry for the long wait. You have not been forgotten. The procedure for the previous patient is taking longer than expected, and we want to make sure all our patients get the care and attention they need. Can I get you a magazine to read while you wait? It may be up to three hours before the doctor can see you.”

The moral: although waits are often inevitable in healthcare services, we can improve the patient experience by adjusting their expectations (downward) so we can meet or exceed them.

This post appeared on the Language of Caring Blog and has been shared with consent:

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