Recognizing the value of a new patient kept

'Catch and keep' is the key to practice success.

Issue: March 10, 2018

ByJohn B. Pinto

“By putting the employee first, the customer effectively comes first by default, and in the end, the shareholder comes first by default as well.”
– Richard Branson

“The purpose of a business is to create a customer.”
– Peter Drucker

Early in its corporate life, now-ubiquitous shipper FedEx hired high school dropouts to make the rounds of office buildings and businesses, picking up and dropping off what were then mostly $11 packets of urgent correspondence, contracts and payments. The logic was, “It’s an $11 sale. We don’t need — and can’t afford — anyone all that smart or polished.”

And then Mr. Consultant came along.

“You know, guys,” said Mr. Consultant, “That high school dropout driving for you is picking up and dropping off a few hundred envelopes and packages a day. He’s doing that every weekday for a year. He is actually managing a million-dollar book of business. Are you sure you want to save $20,000 a year in labor costs by hiring at the bottom?” FedEx went on to hire college grads, put them in snappy uniforms, and the rest is corporate history.

Realizing that every delivery route was a big deal was paired with the reality that every individual customer — every law firm receptionist and dental office clerk — was also a pretty big deal. They were not just an $11 grab-and-go customer, but someone to say hello to, chat with for a moment and remember their name. They were the gatekeepers of FedEx’s corporate success.

In a busy office, such clerks might have 10 envelopes a day to send out, maybe $25,000 a year in work for FedEx — in 4 years, $100,000. So that customer wasn’t an $11 nobody, she was a $100,000 goddess to worship.

How does this relate to ophthalmology and our customer-patients?

In the ophthalmology realm

Consider that the typical new patient entering your geriatric-based practice may be in his early 60s. He has the potential to be a customer for 20 years or more.

If he is like most patients, he is going to spend about $200 for professional fees on average every visit — much less for a postop visit, much more if his surgical needs are great. But the average is around $200 per visit in most practices, and this patient is going to see you at least annually. So that is 20 visits in 20 years times $200, or $4,000. If you dispense, he is going to spend another $500 or more on glasses, let’s say every other year. That’s another $5,000 over 20 years. So one new patient may be worth $9,000 or so.

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But does it end there? No.

If your practice is efficient, effective and likeable, this patient will refer a friend every couple of years to the practice, and more than that if you simply ask each patient at every visit to support your practice with referrals. So that is 10 patients referred to you in 20 years, and each of these patients is worth $9,000. So now we’re up to $99,000.

Let’s leave it at that, a nice, round $99,000, and not flog the point by adding in the second-, third- and fourth-order derivative referrals from referred patients who refer — a virtual pyramid of patients descending on your practice simply because you have delighted the first patient.

If you follow my thinking, about now you should be saying, “I guess we should delight each of these $99,000 customers. How?”

The short list

Be amazing on the phone. Phone work is often an afterthought, but it is the lead-in to every new $99,000 patient. Record and listen in to the phone service your patients get.
Use a roving volunteer or paid concierge senior to greet patients and direct them to the reception desk.
Remember that the way you treat staff is the way staff will treat patients. Be kind, encouraging and generous in your praise.
Spend a few dollars to make each patient’s experience the best trip they have ever taken to a doctor’s office: Kind staff. Scrupulously clean and well-kempt furnishings. A pleasant smell. Gentle music. Ad lib snacks (even if some are snitched). Free water and juice in a glass-fronted refrigerator. Fascinating reading materials — coffee table books instead of dreary news magazines.
Make sure staff are as well-groomed as Disney and Ritz-Carlton staff. This goes double for the doctors.
Write out and have staff memorize answers to the most common patient questions so that everyone is on the same page.
Be intensely present. Look at the patient when speaking to him and listening to him. Intense communication will not only save you time by reducing repeated instructions, but will convey to the patient a sense of deep interest and regard.
Recover from errors. When waiting time is excessive or a procedure is surprisingly uncomfortable or your clinical bluntness has been taken the wrong way, apologize abundantly.
Apply Southern hospitality, even if you are a Yankee. Speak respectfully to every elderly patient as though they were your own frail grandmother or grandfather, and nothing you could do for them would ever be enough to pay them back.
Have enough staff so that every patient, in the course of his visit, is asked three questions twice each: “How is your day going? Can I make you more comfortable? Is there anything I can explain for you?”
Say it and then summarize it. The goal of every patient interaction is not to wow the patient with your technical intelligence, but to assure that he understands what he should do next to advance his care.
Have every doctor, at the conclusion of every visit, say to every patient, “Please tell your friends about the importance of regular eye care.” And hand the patient three cards. This feels embarrassing if you have not just delighted the patient, but feels very appropriate if you have.
At checkout, ask patients who look over 60 if your concierge can help them to their car.
Have an especially pleasant staffer call every new patient within 72 hours of the appointment: “How are you feeling? How did we do? Did the doctor answer all of your questions? Are doctor’s orders about medications and your next appointment clear?”
Handwrite a thank you letter every time a patient refers to you. Have the doctor call the patient after three referrals have been made. Send flowers after five.

For more information:
John B. Pinto is president of J. Pinto & Associates Inc., an ophthalmic practice management consulting firm established in 1979. John is the country’s most-published author on ophthalmology management topics. He is the author of John Pinto’s Little Green Book of Ophthalmology, Turnaround: 21 Weeks to Ophthalmic Practice Survival and Permanent Improvement, Cashflow: The Practical Art of Earning More From Your Ophthalmology Practice, The Efficient Ophthalmologist, The Women of Ophthalmology, Legal Issues in Ophthalmology, Ophthalmic Leadership: A Practical Guide for Physicians, Administrators and Teams and a new book, Simple: The Inner Game of Ophthalmic Practice Success. He can be reached at 619-223-2233; email: pintoinc@aol.com; website: www.pintoinc.com.