Fam Pract Manag. 2007 May;14(5):53.

Give your staff kudos

Our clinic has created a system to recognize staff who provide excellent patient care and service. We put “kudos cards” in exam rooms and other areas that patients can use to express appreciation for exemplary experiences they have with our practice. The colorful postcards read, “You make the difference when …” and allow plenty of space for the patient to finish the sentence. Providers and staff can also use the cards to compliment one another. We display them all on a bulletin board so that the recipients' efforts can be acknowledged more broadly. Our system provides positive reinforcement for outstanding patient care, promotes a positive attitude throughout the practice and builds camaraderie among staff.

Display waiting times

We hung a dry-erase board near the reception area in our office that lists the names of the clinicians in the office that day and the number of minutes they are running late. A staff member updates the waiting times throughout the day. Patients appreciate knowing how long to expect to wait. If their doctor is running significantly late, they may decide to reschedule, or they may just hunker down with a couple of magazines until we're ready to see them.

Examine your waiting area

Take a few minutes after hours to sit down in your waiting area and survey your surroundings. You may see things that need freshening up that your staff has overlooked and that you would never notice just passing through. Identify those things that might give patients a negative sense of your practice, and ask your staff to help you deal with them. Cut away plant leaves that are brown and wilted. Throw away old, tattered magazines and books. Take down out-of-date patient handouts and posters. Remove chewing gum that is stuck on the undersides of tables. Clean or replace rugs and curtains that look worn and frazzled. Consider whether the area is as clean as it should be. The condition of your waiting area says more about your practice than you might think.

Writing off charges to deter malpractice litigation


Should I write off charges to reduce the likelihood that I will be sued by a patient who was dissatisfied with my care?


Writing off the charges may be the best decision because a patient's receipt of an invoice for care that he or she perceives as suboptimal may be the catalyst that drives a lawsuit. While there are no guarantees, what can be gained by writing off the fee can far outweigh the financial and emotional strain of litigation.

However, you should also bear in mind that if a lawsuit is ultimately filed, you may be asked why you did not bill the patient for your service. You may be asked if you felt guilty because you did something wrong. Explaining that you made the decision because you felt bad for a patient who had a lot on his or her mind will demonstrate that you are a caring person. In some jurisdictions, not billing a patient is inadmissible to prove negligence. You should always discuss the option of not invoicing a patient with legal counsel in your state.

Your success in avoiding litigation will ultimately depend on the relationship you have established with your patient and the quality of your communication. An informed patient who has a realistic understanding of his or her medical condition, the proposed treatment and potential outcome, and who feels that he or she has been part of the decision-making process, is generally more accepting if the treatment is not successful. Thoughtful, thorough communication with the patient, carefully documented, will foster satisfaction and loyalty and will deter potential litigation by any lawyer who reviews the chart.


Send us your best pearl (250 words or less), and if we publish it, you'll earn $25. We also welcome questions for our Q&A section. Submit your pearls and your questions to


Practice Pearls presents readers' advice on practice operations and patient care, along with tips drawn from the literature. Send us your best pearl (250 words of less), and you'll earn $50 if we publish it. We also welcome questions for our Q&A section. Send pearls, questions, and comments to, or add your comments below.


Copyright © 2007 by the American Academy of Family Physicians.
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