Overwhelming nurse phone call volume

Many physician offices have hard time dealing with the continual increase in nurse phone call volume.  In most cases, the vast majority of total call volume is for the nurse.  However, many nurse calls require physician involvement before the call can be returned.  To compound the situation, many times patients call back several times per day to find the status of their issue, which just serves to clog the phones further.  Are there any options other than just hiring more nurses to man the phones?? 

"Triage" phone traffic is a constant struggle.  I heard a speaker identify this problem as a leftover from the HMO/capitation days.  As such it becomes a matter of re-education for patients, staff, and physicians.  Basically, the goal is to turn those calls into income producing office visits, as well as better patient care. 

The resistance to change in this area comes from all players:

· Patients want free medical care

· Staff wants to maintain an important role, and job security

· Physicians don't want to work more by seeing those patients in office

Consider an attempt to change this paradigm by:

1.    Convincing the physicians that medical care should not be given away - oath, liability, reputation, income.  Educate the nurses that their skills and time are better used for actual triage situations.

2.    Creating physician-nurse-developed protocols for telephone receptionists that quickly identify problems where the response is "The doctor must see you for that.  There is an appointment  . . . ."  The call never gets to the nurse who interrupts the physician mid-office visit.

3.    Short stop all prescription "refill" calls, not renewals, at the auto-attendant, pharmacy, website, and telephone receptionist.

4.    Outsource lab results to a patient call-in service.


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