Skip to content

Raising Concerns over the Impact of Call Centers on U.S. Medical Practices

The emerging trend in U.S. healthcare that poses a threat to its quality involves shifting administrative duties away from patient care locations, i.e., doctors' offices.

India-Based Call Center Operations
India-Based Call Center Operations

Raising Concerns over the Impact of Call Centers on U.S. Medical Practices

When I worked at a primary healthcare facility, I was responsible for looking after a group of patients.

I might have conjured up the illusion of managing those patients all on my own.

However, in actuality, I was not alone in catering to their needs. I had the assistance of Sandra, a skilled medical assistant with years of experience, and Linda, our scheduling expert who kept our appointments in order.

Sandra and Linda were well-acquainted with our patients and could offer guidance when needed.

Required an emergency appointment?

"No problem, I'll arrange something for you."

Need a prescription refill?

"Let me check if I can get one processed without needing a visit."

Need a word of comfort?

Sandra and Linda knew our patients and their situations well enough to lend a reassuring word when I was not available.

Moreover, they were adept at distinguishing what was urgent from what was not, and prioritizing the patients accordingly.

Should I need to reach out to a patient, Linda was proficient at making contact.

If I wanted to speak with "Ruby," for example, she would know that I needed to connect with her daughter "Dee."

Ruby, who was older and visually impaired, found phone calls challenging, and attempting to contact her directly would have been futile. On the other hand, delegating the call to her caring daughter, Dee, was a far more effective solution, thanks to Linda's understanding of their family dynamic gleaned from their interactions in the clinic's waiting area.

Unfortunately, in contemporary American medicine, there are fewer Sandras and Lindas available to lend a hand.

While the number of administrative staff in the healthcare sector may have increased, they are often misaligned in their roles.

Why?

The drive for "efficiency" is the primary reason.

Across American healthcare, the reception areas of clinics are being reorganized (a.e., dismantled) under the guise of optimizing call center operations and improving administrative efficiency.

Consultants in management degrees borrow concepts from elementary microeconomics and argue that consolidating call centers can enable the division of tasks, thus boosting productivity.

Outsourcing these tasks to low-cost locales — and voilà! A win-win situation.

Now, when you seek an appointment from a prominent healthcare system or medical group, you are more likely to be diverted to a centralized offshore call center.

You will speak with a helpful individual who excels at scheduling appointments within the system’s parameters. These call center agents are also adept at recording your requests and forwarding emails to your doctor.

Effortlessly securing your prescription refill, providing you with the comfort of a familiar face, or swiftly arranging an appointment with your doctor?

Unfortunately, they do not possess the ability to carry out these tasks, and are not often authorized to do so.

Understanding the nuances of your case well enough to get in touch with you – or the right member of your family during an outbound call (like Dee, Ruby's devoted daughter)?

There's no chance of that happening.

The reason?

They do not know you, and are utterly unfamiliar with your doctor.

As a result, they set off the frustrating round-robin of communication that many of us are all too familiar with.

An inquiry to the call center will result in an email to your doctor, which may remain unanswered. The free time in their calendars is already allocated to other administrative tasks.

(In the olden days, a receptionist might simply walk down the hall for an answer to your query)

This unwanted delay will result in offering you an appointment six months ahead, which your doctor might have been able to schedule that very day.

A few months ago, a colleague's mother discovered a creative loophole in this system by her doctor's office's call center centralization.

She required an urgent consultation with her orthopedic surgeon, but her messages went unanswered.

If she had an urgent concern, the call center suggested visiting the emergency room.

However, her predicament – confusion surrounding pre-operative guidelines – was significant and warranted attention, without requiring an expensive trip to the emergency room.

She needed to bypass the call center.

Therefore, she availed herself of the option in the call center menu reserved for physician calls and was connected to her surgeon's office.

Though the individual who answered the phone was irritated, she was able to address her inquiry, and she prepared confidently for her upcoming surgery.

Was there any other option to reach the doctor's office?

No other option was available – save for visiting in person.

An unnecessary burden for an elderly woman with mobility issues (requiring surgery).

The call center experts, the healthcare system executives, and quality improvement specialists will likely refute that the issues with call center centralization are not attributable to call center centralization itself.

They will argue that the issues stem from the processes that follow the centralization, and that additional measures are required.

Unfortunately, this argument is flawed.

Why?

Because it misunderstands the essence of excellent healthcare.

Healthcare at its best is a harmonious team effort that relies on skilled individuals who work closely together and continuously improve their collaboration through familiarity and camaraderie.

Centralized call centers, however well-intentioned or efficient they may be in scheduling appointments, tend to disrupt this teamwork and coordination.

In addition, they weaken the bond between Lindas and Sandras – and the doctors they collaborate with – by relocating them to distant locations.

Furthermore, centralized call centers make the care experience less personal and gratifying.

The comprehensive understanding of their patients that service providers once held is sacrificed for the sake of "efficiency."

Instead of improving the service and attention given, they're actually degrading it. In the process, they're losing the essence of exceptional healthcare: Deep, emotional bonds at every stage.

Credit: Unnamed doctors from various U.S. healthcare systems and medical organizations contributed substantial insights to this article.

In the new approach to patient scheduling and management, call centers have become centralized, which means patients often interact with these centers for appointments and prescription refills. However, these call center agents may not possess the ability or authorization to carry out tasks like securing prescriptions or swiftly arranging appointments, as they are not familiar with individual patient cases or doctors. On the other hand, in traditional doctor's offices, medical assistants like Sandra were well-acquainted with patients and their families, such as Ruby and her caring daughter Dee, and could provide personalized assistance with patient follow-up and scheduling.

Read also:

    Comments

    Latest