Managing patient expectations means that you provide patients with information so that they have an appropriate understanding of what to anticipate with regard to their care and treatment. While this may appear to be a relatively simple concept, due to various factors, it can often be difficult to achieve. It should be a part of your overall communication strategy with your patients, as it can lead to a greater level of patient involvement and compliance. It is also way to reduce medical errors and to liability exposure, as communication issues are often what lead patients to plaintiff’s attorneys, as they are looking for answers to unanswered questions or expectations.

Knowing what expectation management strategies to use and how to use them effectively is essential.

Understand each patient individually. Different strategies may work for different patients. Overall, understand your patient’s expectations. Take a walk through your office in their shoes. Often outside consultants can be effective in tackling this issue for you as a type of "shadow." Also, survey your patients.

Miscommunication or failing to communicate can greatly affect your patient’s understandings, or misunderstandings, as to their care and treatment. When there are gaps in their understandings, they will fill them in on their own by listening to others, or through other informational sources like the Internet, which may not take into account all of this patient’s variables in their individual health and may lead to shock and anger when a different outcome occurs than what they had anticipated.

Communicate verbally to the patient their current condition, any variables, your plan for care and treatment, what they need to do, and what will, and may, occur next. Ask the patient if he or she has any questions about what you have discussed and what they need to do. Provide him or her with contact information if they should leave the office and thereafter have any questions. Surgical practices often follow up with their patients post-surgery to see how the patient is doing and if they have any questions.

Provide educational handouts and/or brochures that reinforce what you have already explained, and which include frequently asked questions, having the added potential of freeing up your staff’s time and resources.

Use the informed consent process as a way to manage patient expectations, including communication to the patient about the proposed procedure, its potential risks\ complications, potential benefits, and alternatives. Procedure-specific informed consent forms should be used to reinforce what you have explained to the patient. The form should include language that explains to the patient the importance of understanding what is contained on the form. Using a different type of witness verification can be effective: instead of the witness merely signifying in writing that the patient has signed the form, use the witness as someone who can verify that the patient read and understood the form, had the information on it explained to him or her, and that the patient had no more questions – all of which can be incorporated onto the form. Use videos, DVDs, and/or handouts to manage patient expectations during the informed consent process. Be sure to use common, plain language to explain medical terms, e.g., "stomach" instead of "gastric."

Be sure to set forth realistic expectations in your marketing materials – office brochures, advertisements and your website. Remember that these materials do impact expectations and also do show up in court.

Identify at-risk patients. There may be times when patients, despite your insistence, refuse to follow through with your recommendations. Appropriate documentation of your discussions with the patient and their responses should be done in the medical chart. In appropriate instances, send the patient an "at-risk" letter that documents your recommendation, the patient’s non-compliance, why it is important to follow your recommendation, and what could occur if the advice is not followed. This is a valuable documentation tool to reduce liability risk, and it can prevent a patient from later saying that, had they known of certain risks or why they needed to follow the advice, they would have done so.

Despite our best efforts, certain events will occur where we will have an unhappy patient, a patient complaint, or even an adverse outcome. When events occur, it is essential to manage these events while simultaneously managing patient expectations. You should have in place, and follow, an appropriate patient compliant process, including steps such as contact with the patient, investigating the complaint, notifying the patient of an investigation, and follow-up with the patient on the outcome of the investigation.

While not traditionally seen in the physician office setting, an event management program can be effective in managing events and preventing future events. This is key to understanding areas of risk and developing strategies to prevent risk at the same time that you manage patient expectations.

Expectation management is essential to reducing liability risk. It is a concept that is not as easy to do as it may sound, as many variables affect the efficacy of managing patient expectations. However, by instituting certain strategies, one can increase patient understanding, increase patient compliance and increase better outcomes, all at the same time that liability risk is reduced.