Vanguard Medical Group is a 50-provider multi-specialty practice based in Verona, NJ, known for its commitment to practice excellence. Vanguard was recently recognized by rater8 as one of its highest-ranked practices based on the patient ratings and reviews collected by rater8 surveys, with particularly strong scores (99th percentile) in the “check-in experience” category.
In a recent interview with Vanessa Marrero, Vanguard’s Primary Care Operations Manager, we delved into the importance of the check-in experience as a significant driver of overall patient experience, satisfaction, and retention.
“Our goal is to cultivate a warm and welcoming atmosphere where everyone feels seen,” Marrero explained. “Taking the time to build connections with our patients and ensure they feel heard and understood is what keeps them coming back.”
Marrero shared that staff onboarding, training, and support; leadership attitude; and patient communications are all key components of Vanguard’s superb check-in experience. Here’s what we learned.
Contents:
It Starts with the Staff
Hiring “People Experts"
Vanguard Medical Group firmly believes that smart hiring decisions aren’t just about roles people have held in the past. More important are an employee’s ability to empathize, communicate effectively, and create positive experiences for patients.
“Several of my best front desk employees had no prior healthcare experience at all,” Marrero shared. “Instead, they had ‘people experience.’”
Vanguard has always been open to considering candidates who may not have direct healthcare experience. Instead, they focus on individuals who possess valuable skills and qualities that align with the practice’s commitment to exceptional customer service. In fact, Marrero shared that she’s hired several front desk staff members who held a variety of service industry titles — from bartenders to waitstaff and more — prior to joining the Vanguard team.

Why service industry professionals? Because they know people! They understand the art of connecting with others and providing exceptional service in a fast-paced environment while multitasking. These skills are transferable to the front desk role where building rapport with patients and ensuring their needs are met is crucial.
By valuing expertise beyond traditional healthcare roles, Vanguard has assembled a diverse team that brings unique perspectives and a genuine passion for customer service.
Centralized Onboarding
At Vanguard, strong centralized onboarding processes aren’t just a box to check, but are indeed a vital part of the practice’s success. They understand the first impression is crucial, and strive to make it a memorable and positive one for their patients.
Marrero expressed Vanguard’s belief in the power of personalized learning experiences. By providing individualized attention and guidance, they can address specific needs and maximize the potential of each team member. This is why, toward the end of 2022, the practice developed a specific role whose sole responsibility is to train onboarding employees in a 1:1 capacity. This approach allowed Vanguard to create a hands-on learning experience where staff feel equipped and empowered to apply what they’ve learned.
“Even if you’re a front desk employee,” Marreo explained, “you are going to shadow medical assistants, sit with our nurses, and observe patient-provider interactions. You’re going to get a taste of every role in the organization to understand their experiences and have the opportunity to ask questions.”
Continuous Training and Support
One of the standout features of Vanguard’s approach is their consistent training across all of their eight practice locations. Every member of their team receives the same level of comprehensive training and coaching, regardless of location. By maintaining this high standard, Vanguard guarantees that patients receive consistent care no matter where they seek treatment.
Marrero shared that Vanguard takes great care in working to understand the patient perspective. This is integrated into training for front desk staff from day one.
“If a patient is upset,” she explained, “you have to coach your employee about why they could be upset. It isn’t about assigning blame, it’s about understanding the patient perspective.”
When it comes to front desk processes, such as accepting walk-ins or late arrivals, Vanguard’s culture centers on one thing: They’re always going to try.
Vanguard’s approach is to never say no, a method that has been wildly successful. No matter the situation, front desk staff are trained to make every effort to fit patients in, regardless of what the schedule looks like. Even when they’re unable to make an accommodation, the end result is still appreciation: patients feel heard and understood, and they’ve witnessed staff members do everything possible to help. A little effort goes a long way in fostering positive patient relationships.
“Life happens: traffic, wrangling kids, that sort of thing,” Marrero pointed out. “Why not give your patients the same grace you’d give your employees?”
A “Let’s Try It” Attitude
Enthusiastic Leadership
In meetings, when someone brings forth an idea, Vanguard’s leaders don’t dismiss it or brush it off. Instead, they embrace new ideas with open arms and respond with an enthusiastic “Okay, let’s try it!” This mindset creates a culture of innovation and experimentation where every idea is given an honest chance to succeed.
“I’ve been privy to office meetings where someone makes a suggestion,” Vanessa said, “and our leadership team will say, ‘All right, let’s give it a try. Let’s pilot it. Let’s see if this helps, and then expound on it if it’s successful.’”
The ultimate goal for Vanguard’s leadership is to continually improve the patient experience. To achieve this, they understand they must be willing to step outside their comfort zones and explore new possibilities. By embracing this “let’s try it” mentality, they’ve been able to roll out numerous initiatives that have had a significant impact on enhancing patient care.
Empowering Staff
Vanguard’s leaders know that feedback from their front desk staff in particular is invaluable in refining check-in processes and enhancing the patient experience. Marrero and her colleagues actively seek input from their staff on how they can streamline processes to be more efficient. This open dialogue fosters a culture of continuous improvement, where everyone’s voices are heard and valued.
A shining example of this commitment to listening and responding to staff feedback is when the front desk staff at one location requested a kiosk for quicker check-in. Rather than brushing aside this suggestion, Vanguard’s leadership took it seriously, evaluated options, and installed a kiosk system.
When making a change like this, one might expect the number of front desk staff to decrease as a direct result. Vanguard, however, anticipated the needs of their patients.
“We knew some of our more elderly patients would have trouble adapting to the new system,” Marrero explained. “To ensure all of our patients could be assisted through the check-in process, we actually staffed the front desk above the normal level.”
Not only did this successful initiative streamline the check-in process, it also demonstrated Vanguard’s dedication to empowering their staff by taking action on their suggestions, and showcased the practice’s proactivity in considering their patients’ needs.
Communication Eases the Patient Journey
Staff Know What Patients Need
Marrero believes the foundation of exceptional primary care lies in truly listening to patients. Effective patient communication goes beyond just medical expertise — it’s about creating an environment where patients feel heard, valued, and understood.
Vanguard is committed to ensuring no one feels like they’re just a number in a sea of patients. Their dedicated staff members take the time to build genuine connections with each patient, becoming familiar with them, their stories, and even their children. It’s these personal touches that keep patients coming back — and enable Vanguard to make an impact.
“Staff are in the trenches,” Marrero said. “They know what patients need. If patients are constantly asking for something, it’s the staff who are going to report that, and we have to listen.”

rater8 Engages Your Patients
Vanguard’s commitment to their patients is evident in their dedication to continuous patient engagement and practice improvement, made easier through their utilization of rater8, which Marrero says has far surpassed their previous SEO and reputation management service.
“We previously used a different company to get feedback on the patient experience,” Marrero shared, “but that feedback didn’t come through in real-time. rater8 gives us the ability to snip and send real-time feedback to our providers and staff so we can proactively resolve any issues.”
Engaging patients is crucial in the healthcare industry, and Vanguard understands this. Through rater8’s satisfaction surveys, they offer patients a fast and simple way to provide feedback, and with specific questions tailored to each area of their practice and member of their team, Vanguard also gains operational oversight. They know for a fact that each team and staff member is doing everything they can to enhance the patient experience, and they quickly identify and address concerns when they arise.
Embracing rater8’s cutting-edge solutions has helped Vanguard create a patient-centric environment where every patient voice is heard and valued.
Thank you again to Vanessa Marrero, Primary Care Operations Manager at Vanguard Medical Group, for providing valuable insights into Vanguard’s stellar check-in processes and overall practice excellence.