For many patients, problems getting appointments and care when needed and interactions with physician office staff are bigger concerns than physician-patient communication. In fact on the Clinician/Group CAHPS surveys, physicians and their staffs rate lower on these matters than on communication issues. As noted elsewhere on this website, a 2007 article in The Joint Commission Journal on Quality and Patient Safety stated that "delays for appointments are prevalent, resulting in patient dissatisfaction, higher costs, and possible adverse clinical consequences."

Physicians can affect these aspects of care with decisions on staff hiring and on design of office systems and procedures. Decisions have to be made about how to handle phone calls, about the use of e-mail for communicating with patients, about appointment scheduling systems, and other matters. Medical office management consultants can be helpful in designing and implementing office practices. Other organizations can also help. For example, the American Academy of Family Physicians (www.aafp.org) has various resources that bear on these questions. AAFP's Family Practice Management magazine includes articles on such topics as "Reducing Delays and Waiting Times with Open-Office Scheduling," "Making the Case for Online Physician-Patient Communications," "Same-Day Appointments: Exploding the Access Paradigm," and "Reducing Waits and Delays in the Referral Process." Similarly, the American College of Physicians (www.acponline.org) offers various resources, such as its "Patient Satisfaction Tip Book--Improving Patient Perceptions."