Optometric Management Tip # 121   -   Wednesday, May 12, 2004
Patient Satisfaction

Last week’s tip on service recovery prompted quite a bit of reader interest and several requests for more information, so I’ll write more here. In fact, this topic is big enough and important enough that I’ll cover it in the next couple of tips.

It seems like many eye care professionals struggle with deciding what to do when it comes to patient complaints. It seems that most of us want to do what’s right – but that’s not always so easy to determine. “What’s right” needs to reflect what is fair to the patient who has a problem – and also to the business side of the practice. There are indeed many gray areas when a doctor or staff member actually must apply office policies in the real world.

The Cost of Dissatisfaction

This subhead title could just as well be “the value of satisfaction”. As we formulate policies for handling complaints, we should start by truly recognizing the importance of this point. In my opinion, there is nothing more important in building a professional practice than patient satisfaction. We are in a service business that depends on word-of-mouth referral for growth far more than any other factor. Our reputation in the community is paramount to our success, and it is not solely dependent on clinical skills! In fact, when it comes to practice-building, our clinical reputation is probably less important than our reputation as a fair and caring business person. Patients can’t really evaluate clinical skill anyway – but they can and do evaluate customer service issues as they perceive them. Note that I said as they perceive them. What a “customer” (purposely using this term, rather than patient) perceives as fair can often be quite different from what a business owner perceives as fair.

The point of this review is to realize that the cost in dollars of a remake or refund is actually very small when you think of the goodwill value that is created. Or conversely, the cost of leaving a patient unhappy and with problems unresolved is extremely high when viewed against the damage that can be done by negative word-of-mouth comments, not to mention the loss of future years of revenue by this patient and family. So, doctors who think they are getting ahead by withholding a remake, or a refund, are actually invisibly paying much more. I’ve had a few colleagues tell me they dropped the follow-up phone call after dispensing new eyewear, because it resulted in people wanting trivial remakes or even refunds. I say we want to find these people and take care of them! A patient with a $400 pair of glasses, which are in a drawer because they can’t be used, is likely to share that experience with dozens of people. That’s costly!


A practice can make its eyeglass warranties whatever it wants, and it can make the warranty included at no additional charge (built into the optical cost structure), or charge extra for it. The important point is to have the warranty clearly explained and in writing. This helps your staff handle remakes and repairs, which may be handled differently at 1 week, 1 year or 3 years from dispensing. I recommend having the eyeglass warranty printed on 2-part NCR paper, giving one copy to the patient and placing one in the file. Some practices have the patient sign the warranty form to indicate they received it.

Keep in mind that warranties from frame manufacturers, lens labs, anti-reflective labs, etc. are all made to the practice – not to the patient. The practice is free to set its own warranties to the patient, and can choose the time span to cover, or even if a warranty is provided at all. You can set a 1-year warranty on all frames, even if some frame lines offer a 2-year warranty.

It is certainly acceptable to have a limit on the number of free replacements that exist under warranty – like 1 remake due to scratches during a 1-year period. This avoids the potential for abuse where a patient expects free lenses every month for barely visible surface scratches.

Having said all that, warranties are a strong selling point and they should be designed to provide security for consumers and promoted at the time of the sale. I like to remove the “fault” aspect of any future eyewear breakage. It is too difficult to separate a manufacturer’s weakness from a patient’s neglect. Patients take great comfort in a warranty that is “no-fault”.

It seems to me that we really can have two types of warranties on our optical goods: a satisfaction warranty (or guarantee), and a longer term mechanical warranty. The satisfaction warranty promises to deliver a pair of glasses free of any defects, that the patient likes. The “patient liking it” part can cover everything from vision to fit to appearance. This satisfaction warranty should be resolved within the first couple weeks of dispensing. The mechanical warranty covers break-downs for a future period of time.

Getting our credit

It should seem obvious, but we need to always be vigilant about getting the credit for returned merchandise when it is covered by a warranty from our suppliers. It’s very easy in a busy office to become lax with collecting the returned items, finding the invoice, packaging the item up, and sending it back. Then we must watch for the credit memo that should eventually arrive by mail, signaling the credit on our account. Do you have a box or a drawer with returned frames and contact lenses waiting to go back? Assign a capable employee to be in charge of this entire task, and then supervise it closely enough to be sure it’s being done well.

Many patient satisfaction issues are not covered by manufacturer warranties. Stay tuned for polices on remakes and refunds – next week.

Best wishes for continued success,

Neil B. Gailmard, OD, MBA, FAAO
Chief Optometric Editor, Optometric Management