American Association for Physician Leadership

Operations and Policy

Customer Service 101: An Introduction for Medical Practice Employees

Laura Hills, DA

December 8, 2018


A lack of customer service in a medical practice is sometimes called a “poor bedside manner” or a “cranky receptionist.” Whatever you call it, it all boils down to the same thing—a problem taking care of patients’ needs and solving their problems satisfactorily. This article provides an introduction to customer service for medical practice employees. It explores what we mean by the term customer, and, more specifically, who the internal and external customers are in a typical medical practice. It defines customer service from the medical practice employee’s point of view, and describes 15 characteristics of good customer service. This article also suggests that employees use the CARP method—a simple four-step customer service process—for handling complaints. Finally, this article suggests 21 tips for excellent customer service that medical practice employees can use to assess their own customer service skills.

Your patients’ perceptions of your medical practice usually are as good as their most recent interactions with you. Even loyal patients who have been satisfied or even enthusiastic about the quality of care they have received from you can sour the moment they have a bad exchange with a member of your staff. Keep in mind that patient perception is the key. According to Practice Builders,(1) “When consumers judge the quality of healthcare, perception is more important than reality. And your patients’ perceptions are most often based on how well they’re treated.” In fact, customer service generally influences patients’ perceptions of you more than the quality of your clinical care, which is much harder for them to assess. That’s why customer service directly relates to patient retention and referral rates, as well as to the reputation of the medical practice in the community.

That puts a lot of pressure on the medical practice team. Every employee has the potential to foster, build, or destroy goodwill with your patients. And it takes only a moment for the good or the damage they do to be done. For this reason, it is essential that every employee share your consistent vision for customer service in your medical practice and have proper training. This article provides an introduction to customer service for medical practice employees and can serve as a basis for further training.

Who Are Customers?

We don’t typically use the word customer in medical practices. Nonetheless, customer is an apt description of the individuals the practice serves. According to TutorialsPoint,(2) a customer is anyone who is provided with a good, product, service, or idea. “Financial transactions may or may not be part of this provision,” TutorialsPoint suggests. Overall, the medical practice has many customers. However, these can be divided into two categories:

  1. Internal customers: Quality management writer Joseph M. Juran introduced the concept of the internal customer in 1988, TutorialsPoint says. Internal customers are customers directly connected with your practice. They usually are part of the practice (e.g., employees, departments, owners, and other stakeholders). Board members are internal customers for organizations governed by a board.

  2. External customers: Clearly, patients are external customers of the medical practice. So, too, are their families and friends when they visit your office or otherwise interact with you. Referring physicians and other providers also are external customers, because they want to know that the patients they refer to you are treated well, and they may interact with you personally. Pharmacies and insurance carriers with whom you interact also may be considered to be your external customers, because they require information from you and timely responses to their questions.

It is generally believed that any organization that is able to satisfy its internal customers is better equipped to satisfy its external customers, TutorialsPoint suggests. Therefore, medical practice employees must take very seriously their responsibilities to both internal and external customers of the practice.

What Is Customer Service?

Customer service is everything a medical practice employee does to take care of customers’ needs and to solve their problems. It begins the moment the employee connects with the customer to fill his or her needs, and it continues even after the customer’s requirements are met. Every medical practice employee, department, or organization that takes customer requests, processes them, addresses their concerns and problems, and acts as an interface on behalf of the medical practice is a customer service provider.

Every organization that has customers automatically has customer service. Of course, this includes medical practices. The question is, is that customer service good or is it bad?

Fifteen Characteristics of Good Customer Service

We would be hard-pressed to find a customer who enjoys poor customer service. Customers want and often expect to encounter good customer service. That means that your customers are looking for two things. As Root(3) explains, “Good customer service is a combination of well-trained employees and an efficient system.” Customers want to encounter knowledgeable and professional customer service representatives who use an efficient system to resolve their issues. When that winning combination is in place, Root says, customers will be satisfied and organizations will be more likely to retain them and their business.

Good customer service generally shares the following 15 characteristics:

  1. Responsiveness: When customers enter your medical office, speak to you on the phone, leave you a message, or e-mail you, how long does it take for you or someone else to acknowledge them? As Allen(4) warns, “One of the most dreaded customer experiences is waiting to be serviced [sic] or even just to be acknowledged!” Furthermore, when issues arise, how long is it before the situation is addressed and a resolution is provided to the customer? According to Allen, “The responsiveness clock is ticking in your customer’s head while waiting to be serviced or to receive a reply to inquiry.” A slow response time is not a component of good customer service, and it often makes bad situations worse.

  2. Knowledge: Every employee who represents your medical practice should know a great deal about it. This includes what your practice does and why, how you do it, who does what in the practice, and your basic policies and procedures. A new employee who doesn’t know such information is not ready to serve customers. As Marta(5) suggests, “Being knowledgeable communicates trust.” Of course, beyond the basics, every employee can’t be expected to know how to answer every question or how to address every problem. Wild cards will show up every now and then that you could not possibly have anticipated. However, if you don’t know the answer to a specific question or problem, don’t try to bluff your way through it. According to Marta, “It’s better for service employees to admit they don’t know the answer at the moment and to make an effort to find the right answer.” This type of honesty is sure to increase customer loyalty, Marta says.

  3. Clear-cut policies and procedures: Every medical practice needs to establish policies and procedures for handling the problems and requests it is likely to encounter. Likewise, the practice’s employees must know these policies and procedures inside and out and be able to implement them. They must identify and whenever possible fix recurring customer service problems. Record-keeping and follow up are keys to doing this. Procedures for recording customer requests, problems, and complaints, as well as steps taken to resolve them, must be laid down unambiguously.

  4. Reliability: Good customer service includes being punctual in doing whatever you have promised to do to serve a customer, whether it be to provide information, call back, make an adjustment to his or her account, or keep an appointment. As TutorialsPoint(2) suggests, “Changes or cancellations later in the day can be harmful to you and your organization’s reputation.”

  5. Striking a personal chord: Good customer service is a very personal experience. It is an opportunity for the employee to humanize customers’ experiences with the medical practice. It is a chance to make them feel that they are valued as people, not just for the medical services they need and dollars they represent. Respectfully calling each customer by his or her name is a good start to personalizing the experience, TutorialsPoint suggests. But there are good other ways to strike a personal chord, too, such as by offering the customer a warm and genuine smile, an expression of care, a compliment, and a sincere apology when one is warranted. Be mindful, however, that customer service is always customer-centric. As Ciotti(6) warns, “Make sure you’re getting to the problem at hand quickly; customers don’t need your life story or to hear about how your day is going.”

  6. Empathy: Empathy allows medical practice employees to keep their cool even when an irrational customer shouts at them for a mistake they did not make. It is essential to good customer service. However, creating empathy means more than being nice. As Marta(5) explains, “Being empathic means having a natural understanding of the other’s point of view.” Empathy helps customer service representatives deal with all types of customers no matter their anxiety or anger levels, Marta says.

  7. Courtesy: Courtesy goes a long way with customers, especially when they are unhappy with something you’ve done. However, courteous words alone are not enough. As Allen(4) suggests, “Body language and facial expressions also contribute to the courtesy factor.” Therefore, medical practice employees must not only sound courteous, but also look courteous to customers face to face, and they must use a courteous tone on the phone and in writing. This is true even when customers are discourteous to them. Medical practice employees must stay above the fray. In trying customer service instances, medical practice employees must act maturely and they must exercise a great deal of self-control. Remember: Courtesy is not a luxury or a nicety. It a requirement of the job.

  8. Good language skills: Medical practice employees will speak with people who may be non-native speakers of English, who have hearing or cognitive difficulties, who are upset and not communicating clearly, or who have other communication challenges. As Marta suggests, “Good service employees are sensitive to language style and can tailor their style to each individual customer.” That means in the interest of good customer service, employees may need to speak more carefully, more slowly, more simply, or even more loudly to accommodate some of their customers. They must be sensitive, perceptive, and accommodating to each customer’s individual communication needs.

  9. Positive language: Your customers will create perceptions about you and your medical practice based on the way you say things. According to Hills,(7) “When the medical practice employees learn to reframe negative ways of communicating into sincere positive ones, they may not change the basic situation or problem; rather, they will change the way that they and others look at it.” Of course, all communication with customers must be sincere, or customers will see through it. Your communication with your customers can never be patronizing. But when communication is sincere and positive, the payoff can be huge, Hills says. As Ciotti(6) readily admits, “Sounds like fluffy nonsense, but your ability to make minor changes in your conversational patterns can truly go a long way in creating happy customers.” How can the medical practice employee use more positive language? In many ways. For example, an employee might tell a patient that the practice doesn’t have an opening in the doctor’s schedule for three weeks and leave it at that. Or the employee can say, “You’re in luck. Dr. _______ has an opening in her schedule on [date] at 2:00 pm. And I can put you on a call list in case we have a cancellation between now and then.” For more information on using positive language in your interactions with both internal and external customers, see my article, “Teaching Your Staff to Reframe Negatives into Positives” in our September/October 2018 issue.(7)

  10. Patience: Patience on the part of the medical practice’s employees is important to customers, who often reach out for support and help when they are confused and frustrated. They do not want employees to rush them as they are telling their stories, to cut them off, or to jump ahead to the wrong conclusions. As Ciotti(6) suggests, “Be sure to take the time to truly figure out what they want—they’d rather get competent service than be rushed out the door!” Fortunately, even though both nature and nurture have conspired to make us impatient, the situation is not hopeless. There are many ways that medical practice employees can develop and improve their patience. For more information on this subject, see my article, “How to Develop Patience in Your Medical Practice Staff” in our July/August 2018 issue.(8)

  11. Acting skills: Medical practice employees not only serve in various jobs and roles in the medical practice, but they also play one every day. Specifically, they play the role of professional, capable, polite, and upbeat customer service representatives of the practice. And they must not deviate from this role even when they are stressed and challenged. Situations outside your control can and do creep into your usual routine. Expect it. You will have monkey wrenches thrown into your schedule. Equipment will malfunction. You won’t feel your usual best. The weather will be a downer. You may have been stuck in traffic on your way to work. And some days, you’ll be greeted with what Ciotti calls “barnacle” customers, those people who seem to want nothing else but to pull you down. But you can’t give in to these challenges. Ciotti’s advice: “Every great customer service rep will have those basic acting skills necessary to maintain their usual cheery persona in spite of dealing with people who may be just plain grumpy.”(6) Don’t let the negativity around you derail you from your role. Don’t break character. Just as in theater, the show must go on.

  12. Ability to read others: What works well for one customer may not work well for another. You must be able to read each individual and to make an educated guess about what is going to be most effective with him or her. As you interact with your customers, Ciotti(6) suggests, “Look and listen for subtle clues about their current mood, patience level, personality, etc.” Give each customer your full attention. Notice his or her words and phrases, posture, body language, facial expressions, and gestures. Hone your observation and listening skills. As Lorette(9) says, “Instead of planning an answer or retort as the customer is speaking, listen with the goal of comprehension.” Take notes and summarize your customers’ words back to them to ensure understanding, Lorette suggests.

  13. Asking good questions: Customers will express themselves and their needs to you however they will. However, it is up to you to get at the heart of what is troubling them. As Lorette suggests, “Quality questions help to uncover the actual needs, goals, objectives and concerns of the customers.” For example, if a customer complains to you that your services are “expensive,” ask her what she means. Of course, you must do this in a sincere, nonjudgmental way, expressing your genuine concern and curiosity. You might say simply, “It is a considerable sum. Please, tell me, how do you mean expensive?” Then let the customer answer. She may mean that she will have trouble paying your fee and that she needs a payment plan. She may be sad that your fee will use up the funds she had in mind for a vacation or a purchase. She may think that your fees are higher than other providers would charge her, even if this is not true. She may not understand the services she received well enough to know why they cost what they do. Or you may find that there is something else at play. You will be able to help your customers with their concerns or problems only if you know more precisely what they are. Thoughtful, sincere, curious questions will help you get there.

  14. Consistency: Why do customers keep going to their favorite restaurants, stores, gas stations, or hotels? Why do you? It’s because you like what you get every time you go there. The same is true of a medical practice. Customers who like what you do and who appreciate knowing what to expect every time they interact with you will keep coming back to you. This is true even when they have other choices of provider available to them. In fact, Allen(4) suggests, consistency is “the glue that holds it all together.” It is what creates long-term customers. Therefore, your customers must be able to depend on your employees and your medical practice to provide the same high level of service every time they choose or need to use your services. This is going to be true no matter how busy your medical practice is, how understaffed it may be, who is having a bad day, or who on your staff is interacting with them. When consistency is added to other good customer service characteristics, Allen says, “Long-term retention is usually the result.”

  15. Optimism: Optimistic medical practice employees truly believe that they can provide great service. Therefore, Landsman(10) says, they try harder, and they do end up providing better experiences that their customers notice and appreciate. Genuinely optimistic medical practice employees are invested in helping the medical practice grow, and believe that it can. They care about each customer’s experience, Landsman says. They firmly believe that what the medical practice does, along with the support they provide, can result in a positive experience. They don’t jump to negative conclusions. They assume that problems can be solved. But they’re not all rainbows and unicorns; they live in the real world, too. As Landsman suggests, “They balance their optimism with honesty, giving members of the public and your internal team real answers that help everyone make progress.” Ultimately, because optimistic employees go into every customer service encounter believing that it will turn out well, they usually are right.


  1. Practice Builders. Customer service excellence. Practice Builders. . Accessed July 18, 2018.

  2. TutorialsPoint. Customer-service introduction. . Accessed July 18, 2018.

  3. Root GN III. Characteristics of good customer service. Chron. . Accessed July 23, 2018.

  4. Allen E. 6 characteristics of great customer service. Errol Allen Consulting, June 3, 2013.
    6-characteristics-of-great-customer-service/. Accessed July 23, 2018.

  5. Marta. The 5 crucial characteristics for people in customer service. Userlike. October 30, 2014. . Accessed July 24, 2018.

  6. Ciotti G. 16 customer service skills that every employee needs. HelpScout. March 7, 2018. . Accessed July 24, 2018.

  7. Hills L. Teaching your staff to reframe negatives into positives. J Med Pract Manage. 2018;34:95-99.

  8. Hills L. How to develop patience in your medical practice staff. J Med Pract Manage. 2018;34:40-45.

  9. Lorette K. Customer service characteristics. Chron. . Accessed July 24, 2018.

  10. Landsman I. The top personality traits for successful customer service. HelpSpot. April 26, 2016. . Accessed July 24, 2018

The CARP Method: Handling Customer Complaints in Four Steps

Good customer service relies on giving attention and credence to every customer complaint you receive. Here is a four-step method that you can use to be sure that you are consistent in how you process customer complaints. You can remember it with the acronym CARP:

C: Control the situation: Let the complaining customer know that he or she has your full attention and that you want to help. However, don’t take the customer’s bait. Assert your control by behaving in ways that demonstrate that the customer’s attempts to provoke you or to make you angry or defensive will not work with you.

A: Acknowledge the situation: It is important that the angry customer see that you understand both his or her emotional state and the situation. Two techniques to apply here are empathy and active listening. Repeat what the complaining customer has told you to be sure you have everything right. Let the customer know that you do indeed understand what he or she is telling you.

R: Refocus the conversation: Sometimes angry customers simply want to vent. Once you feel they’ve done enough of that, help them to transition from dealing with their emotions to dealing with the actual problem at hand.

P: Problem solve: Problem solving can be fostered by getting and giving information, suggesting possibilities, offering choices, appearing to be helpful, and following through.


Bacall R. What is the CARP system for defusing angry customers? Customer Service Zone. . Accessed July 24, 2018.

Twenty-One Tips for Excellent Customer Service

What exactly does good customer service look like in action? Here are 21 tips for providing good customer service in your medical practice. See how many of them you are currently implementing, and which ones you can add to your personal customer service repertoire.

  1. Smile: Smile when you greet your customers in person. But also smile when you greet them on the phone. Callers will hear the smile in your voice.

  2. Greet appropriately: Use age-appropriate greetings. Err on the side of formality when you don’t know the person or his or her greeting preferences. Avoid calling your customers guys when you don’t know them, as in, “How are you guys doing today?”

  3. Be proactive: Don’t wait in silence or look blankly at a customer. Ask how you may be of service.

  4. Stay visible and available: However, don’t hover over your customers if they need space to complete paperwork, talk privately with a family member or friend, or do other things.

  5. Don’t avoid customers: Don’t turn away, walk away, begin to make a phone call, or duck beneath your desk when a customer approaches you. Make eye contact, even if you must end a conversation with a colleague, put aside paperwork, or step away from a computer screen to do so.

  6. Prioritize: Patients are the customers who always come first in the medical practice. As well, the patient standing in front of you takes precedence over the one who calls you on the phone.

  7. Don’t judge a book by its cover: All of your medical practice’s customers deserve good customer service from you, regardless of their age or appearance.

  8. Be professional: Leave food and beverages in your office’s break room.

  9. Be discreet: Customers don’t want to hear about your personal problems or your complaints. Don’t overstep the boundaries of your relationships with them.

  10. Remove yourself: Make personal calls only when you are on a break and out of customers’ earshot.

  11. Own the answer: The correct answer is never “I don’t know” unless you immediately add to it, “but I will find out for you.”

  12. Get them what they want: If a customer asks you for a brochure, paperwork, or something else that is not easily at hand, excuse yourself and go get it. If you can’t at that moment, get it later and follow up. Don’t tell a customer to get what she wants herself or to pick it up on her way out.

  13. Track it down: If a customer needs something that you don’t have in stock in your office, get it for him or her.

  14. Pay attention: Learn to read body language and also to read between the lines when a customer speaks or writes to you. Notice when it looks or sounds like the customer can use your help. It’s always better to ask if they do rather than to leave them struggling on their own.

  15. Politely move forward: Don’t let chatty customers monopolize your time if other customers are waiting for your attention.

  16. Get help: Ask your colleagues for backup support if you have many customers who need your attention at once.

  17. Be sensitive: If a customer’s credit card is declined, ask if there is another form of payment he or she would like to use. Don’t discuss a patient’s payment issues, finances, or medical issues with him or her in front of others.

  18. Guard confidentiality: Never discuss customers in front of other customers, or even in front of other staff members who do not need to be privy to the information.

  19. Assure quality: Inspect paperwork and anything else you give to a customer to be sure that it is correct and complete.

  20. Ask: Make sure customers have everything they need before they leave your office or hang up the phone.

  21. End well: Smile again as you are saying goodbye. When appropriate, thank the customer. Make sure the customer leaves feeling good about his or her experience with you.


Business training works. Top customer service tips. . Accessed July 24, 2018.

Laura Hills, DA

Practice leadership coach, consultant, author, seminar speaker, and President of Blue Pencil Institute, an organization that provides educational programs, learning products, and professionalism coaching to help professionals accelerate their careers, become more effective and productive, and find greater fulfillment and reward in their work; Baltimore, Maryland; email:; website: ; Twitter: @DrLauraHills.

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