Summary: Medical answering services can seem fairly routine in the arena of family medicine and general practice. But safe and effective services provided by fully trained agents are available to specialized practices as well. In short, answering services have a role to play in specialty care.
Anyone who works in medical reception can testify to the fact that it is a high-pressure environment. The front desk is no longer just a small office with a window to the waiting room. It is a digital gateway and communications center. A practice might rely on an answering service to handle call overflow and basic appointment scheduling. But when it comes to specialty care, the stakes are much higher.
Calling a specialist is often related to chronic illness or an acute crisis. So in a specialist’s practice, taking messages is both inefficient and not the best choice for patient care. It can be dangerous in some situations. A specialty practice requires more. When it comes to answering services, specialties require tailored protocols that reflect the unique clinical and emotional nuances of each type of care.
To better understand how answering services can be applied to different specialties, let us take a look at four of them along with some specific use cases:
1. Mental Health: The Nuance of Crisis Intervention
The telephone is often a lifeline in mental health. Unlike some other specialties, for which calls can be routine, a mental health call can represent anything from a prescription refill to an active suicide crisis. Both office staff and answering service operators need to know how to handle them all.
Clinical or Crisis Care?
The biggest thing in mental health is distinguishing between clinical and crisis care. An answering service offering specialized responses in a psychiatric or psychological setting must be fully trained in risk assessment triage. If a call is routine in nature, an operator responds in a particular way. But if a caller expresses any inclination of self-harm, it is a different response. The patient cannot wait for the doctor to call tomorrow.
Within the scope of risk assessment triage, there are three things an operator must be cognizant of:
- Transfer Necessity – What the industry refers to as ‘warm transfers’ refers to making immediate contact with an on-call provider or crisis hotline. Operators must always be ready to make that warm transfer if circumstances warrant.
- Operator Tone – In mental health, it is critical for operators to use a calm and non-judgmental tone. The way an operator speaks to a caller is as important as the message they take.
- Privacy – HIPAA compliance is always a concern with answering services. Privacy is especially important in mental health, given the stigma associated with conditions like depression and anxiety. How messages are taken and delivered are non-negotiable.
Mental health is a specialty like no other. Whether it is a psychiatry or psychology practice, great care must be taken whenever calls are answered.
2. Oncology: Managing Immunity and Fragility
Oncology patients have their own unique needs when they call in. For them, a fever is not just a symptom of the common cold or flu. It could actually mean a medical emergency. So operators must be trained in the Neutropenic Fever Protocol. Otherwise, neutropenia – a common problem among cancer patients because of chemotherapy – could encourage a common infection to become septic.
The Neutropenic Fever Protocol operates on a number of red flags phone operators need to be aware of. For example, a patient calling to report a fever should trigger a discipline-specific script that addresses the following:
- Immediate Notification – The operator pages the on-call oncologist immediately.
- Data Collection – The operator asks when the last treatment occurred. This information is critical because the lowest white blood cell counts usually occur within 7 to 14 days following chemotherapy.
- Symptoms – The operator asks questions for the purposes of mapping symptoms. They attempt to distinguish between the normal side effects of treatment and any urgent complications requiring immediate intervention.
Time is critical when an oncology patient complains of a high fever or certain post-treatment symptoms. Therefore, operators must be specifically trained and how to handle oncology calls.
3. Pediatrics: Parental Anxiety After Hours
In pediatrics, triage plays a huge role in helping anxious parents get a handle on medical events after hours. Triage is even more critical in specialties like pediatric cardiology or neurology. The answering service acts as a gatekeeper tasked with balancing clinical necessity and reassuring parents.
Baron Schmitt Triage Guidelines are the gold standard for medical answering services. The guidelines emphasize three things:
- Differentiating urgency to ensure that each patient receives the appropriate response.
- Clear communication that assures patients while still allowing operators to gather accurate symptom information.
- Safety protocols that ensure anxious parents do nothing to endanger their sick children.
Particularly where safety is concerned, medical answering services are prohibited from giving medical advice. But operators need to understand when it is best to get a clinician on the line – like a situation in which a parent wants to administer rescue medication.
4. Hospice and Palliative Care: The Need for Empathy
Hospice is the only medical specialty in which the primary goal is comfort rather than cure. Calls often come in from family members struggling as they witness the final stages of a loved one’s life. This creates a unique circumstance for medical answering services, who become the first point of contact during some of the most vulnerable moments. For example:
- ‘Death’ Calls – The operator becomes a comforter when a family member calls to report a loved one’s passing.
- Symptom Management – Hospice patients being comforted at home often have comfort kits provided by the doctor. Calls relating to such kits will often trigger a visit from the hospice nurse.
- Response Times – Returning calls to family members as soon as possible is rarely comforting. Even a 10-20-minute delay can seem like an eternity to family members.
Whether it is oncology, hospice, or any other medical specialty apart from general practice and family medicine, answering the phones requires a full understanding of a specialty’s nuances. Clinicians do not have to be afraid to use medical answering services. A reputable answering service offers fully trained agents who understand each unique specialty they serve.
FAQs
How does a medical answering service differ from a call center?
Call centers tend to focus on volume and message-taking. Medical answering services use clinical triage protocols to address each call individually.
What is a warm transfer in a healthcare setting?
A warm transfer is a scenario in which the operator stays on the line with the patient while making contact with a clinician. Once connected, the operator introduces the clinician to the patient.
Are medical answering services HIPAA compliant?
Absolutely. All federal and state regulations pertaining to privacy apply to medical answering services. Service providers must always maintain compliance.
Do medical answering services rely on specific protocols?
Yes. Two of the more common are the Barton Schmitt and David Thompson protocols. Each one offers a standardized, evidence-based decision tree to guide operator responses and decisions.
Can a medical answering service integrate with my EMR/EHR?
A modern medical answering service using the latest technologies should have no trouble with EMR/EHR integration. Full integration increases efficiency and communication clarity.
