Five Ways in Which Patients Stunt Your Practice Growth

Bad patient habits can mean either a habit that we allow our patients to form or ones that we subject onto our patients. Both of these can negatively impact overall patient satisfaction and our ability to grow our practices.

We are all aware that patient to patient referrals are among the top ways to promote our business. A Nielsen study found that 92% are more likely to heed a friend's suggestion than an advertisement. How do we keep our patients happy enough, so they act as marketing for us yet break the habits that stall out our growth?

1. Tardiness and No-Shows

I start with this, as it is a huge pet peeve of mine. We all have those patients. Those patients who haven't been on time for an appointment in years, or those patients who will "No-Show" to an appointment, even one made that same week. When this happens, we all know the frustration. Now, because that one patient was late, we either make our punctual patients wait or fit the tardy patient in later, which puts the rest of our schedule out of whack. That No-show patient just wasted an appointment slot that could have been used by somebody else. We need to cut it off.  

Set a standard and make it policy, written in stone across the board. You decide among your practice what the standard is: maybe 10 minutes, maybe 15 minutes...but make it clear if they are 'X' minutes late, they will not be seen, and will be asked to reschedule. If they No-Show, call them with a reminder that they missed their appointment and ask if they would like to reschedule. But set a standard. After one no-show? Or after three? Pick a number, and then they can no longer be seen. 

It isn't fair to punctual patients to have to wait or to schedule weeks or months out because the book is filled with historical no-show patients. You decide which standards work best for your practice but set them firmly and stick to them. Keeping your appointments running as smoothly as possible will make the patient experience that much better. If your bookings are being executed as efficiently as possible, this can open the possibilities of seeing more patients in the end.

2.  Non-Compliance

This issue is two-fold on our end, and our patients end. Patients seem to be more non-compliant with us than with their primary care physicians. How often have you been asked, "Is it really that important for me to take those drops every day?" Or "Didn't we just do those tests last year? I don't want to do them again" and "Why do I have to come back every six months?”. These patients don't follow-through with our treatment plans or recommendations, which leaves their issues unresolved. If a patient comes in for blurry vision, and we determine that it's related to Dry Eye, but they refuse to follow our recommendations, their impression will be that we did not fix their problem. Why would a new patient return, or an existing patient recommend a mediocre eye doctor who didn't address their complaints?

A significant reason for this habitual combative attitude and outright non-compliance is due to a lack of education. Yes, the patient is noncompliant...but we are the reason for this one. A patient won't follow directions or buy those expensive drops, or come back for that pressure check if they don't understand 'why.' To the patient, this all seems like a way that we are trying to line our proverbial pockets. Take the time to truly educate your patients. Explain precisely what their diagnosis means, why we recommend a specific therapy or treatment, and what we expect from it, explaining the importance of special testing and follow-ups. 

If our patients understand, they will feel more empowered, like they have a hand in their own care. This can make them more likely to comply with our orders. This does help with medically-billable tests and follow-ups on our end, but also higher success rates of treating patient issues will lead to happier patients. Happier patients schedule back with your office.

3. Reluctance to Pay and Optometry Guilt

From medical co-pays to hi-index progressive lenses with AR, sometimes patients don't like their total at the end of a visit. They will fight, sometimes every single year, about paying for their Optomap or their new eyewear, or whatever fees are accrued. As eye care professionals, we seem to get lumped into some non-necessary category of finances for our patients. Again, this can be tied back to patient education. However, we all seem to suffer from some universal guilt over our goods and services' costs. I've seen techs and opticians, even doctors, question totals after insurance. Then we feel guilty for charging our patients. Why? Do you think that orthodontists feel guilt over the cost of braces? Or that the patients argue that cost with them? Why do we feel such unique guilt over the value of our services? Allowing our patients to feel they've been had or bamboozled and then apologizing for the cost needs to stop. We are providing a high-quality medical service or device from trained professionals. Own it.  

I'm not saying to not compete in the market, but don't feel like you are overcharging your patients. If you think your office is being overcharged, then switch vendors. But let’s not cower behind our prices. We are providing specialized care and services and deserve to be compensated for our efforts. Stop allowing our patients not to see the value of what they are spending their money on. 

Compare your office prices to similar practices in your area. Either you'll see that you have nothing to hide and are priced competitively and reasonably, or that you are at a higher price point...and that isn't a bad thing! This is a business, too. Let’s not forget. 

4. Taking Advantage

There are instances in which a patient may misunderstand what they are being seen for that day (just a follow-up or pressure check, routine exam, etc.) They may not be aware of the limitations put onto a technician or optician when changing prescriptions. Sometimes, however, it seems that they do know and just don't care. Most offices book appointments in different time slots or by other appointment types depending on their needs (like a full 30-minute slot or a short 15-minute slot, for instance). Keeping a schedule well regulated, as mentioned before, can help to maximize efficiency for the office, but also allow for enough time to spend with each patient educating them. 

We must keep our patients accountable for the type of appointment they schedule with us. If Mr. Smith calls in for redness in his eye and we get him worked in for an " Emergency Exam," then that is why he is there. If, during the pretest, he says, "yeah, my eye is red, but I think I need a new glasses prescription, as well" don't fall into that trap. Explain to him, "Okay, we can get you scheduled for a refraction or routine exam to address your vision concerns, but today let's focus on your red-eye."

Another way we get taken advantage of is by a patient's unrealistic expectations, which ultimately hurts our bottom line. If a patient's best-corrected vision is 20/40, we need to explain this to them. Otherwise, once they get to the dispensary stage of optical if they expect 20/20 with their new glasses, then that is a remake waiting to happen. You've had those patients who, after however many remakes they still want a refund or just quit your practice entirely because they are unsatisfied with their prescription. Again, patient education is critical. If they know what to expect, it will cut down on issues in the future.

5. Bad Attitudes Are Contagious

Let's be honest. We all love our patients. We all have individual patients whom we can look forward to seeing, ask about their family, and generally enjoy. And then there are those other patients. We all have at least one—the rude for no reason, difficult, condescending, and just plain unpleasant to be around. And then sometimes those patients cross a line. Being profane, berating staff, and being impossibly rude. This is unacceptable. These patients need to be fired. Yes, this seems harsh and extreme. But I am not talking about the generally rude or impossible to please patients, as they are a natural and unavoidable factor of working in the healthcare industry. I mean the truly horrible ones. Do not tolerate that. If you permit this type of behavior towards your staff, it will demoralize them fast. Stand up for your employees and make sure they know that you have their back. Tell them that they do not have to tolerate being treated like that. That patient's money isn't worth losing staff. A skilled, cohesive, dependable, and hardworking team is the key to growing your practice. They will not only make your job easier, but they will take care of your patients, and that is the foundation of a successful and prosperous practice.

In the end, it can all be boiled down to excellent patient education, setting policies and abiding by them as law, and running our office like the businesses they are.