Optometric Management Tip # 148   -   Wednesday, November 17, 2004
What stories are your (former) patients telling about you?

I often hear colleagues discussing difficult patients who have unreasonable complaints about eye care services or products. The side of the story that I hear is the one about how absurd the patient was and how the complaint was completely unjustified. The patient is usually a real nut case. Ah, but you should hear the story the patient is telling and how many times heís told it! The story is completely different, of course. Itís a story about an optometrist who is incompetent and couldnít get the glasses right (insert contacts, insurance billing, diagnostic testingÖ whatever you want). Thereís also the part about the assistant who was extremely rude.

Is the customer ever wrong?

So whose side is correct? Well, thatís the whole point Ė itís not about who is correct; itís all about perception. In business, the only perception that matters is the customerís. The doctor can tell his side all day and it does not affect future business. But the patientís perception can cause the loss of that personís future purchases (and his familyís) and will create negative word-of-mouth thatís even more costly. When the old business axiom ďthe customer is always rightĒ is used, itís meant to imply that it doesnít matter who was REALLY right, but that even when the customer is wrong, successful companies treat him as if he were right.

You may be thinking you donít need complaining patients anyway and that youíre better off without them. First, I would disagree with that logic because every patient has a huge economic value, and second, that very attitude is what is creating an office culture that causes people to complain! I find it unfortunate that many optometric offices have what I call a ďlove us or leave usĒ attitude. Itís a practice philosophy that says: ďWe do things our way: take it or leave it.Ē Itís a culture that feels good to some doctors, but it kills business. In my opinion, this practice culture is the key to why a few practices have tremendous patient volume and revenue while the rest just do OK.

Office Policy

The undesirable approach to patient service occurs innocently, with a well-meaning doctor who is trying to be a good business person when crafting office policies and procedures. If you think about it, office policy is always written to aid the office Ė not the patient. No customer ever wants to hear about company policy in any type of business, because itís only invoked when the company needs to say ďNO.Ē Office polices are invariably decided on by looking at the doctorís wants and needs Ė not the patients. So staff members who are taught to carry and quote policy are invariably making some patients unhappy. Remember that marketing is defined as identifying and satisfying customersí wants and needs.

Often, the doctor/owner becomes detached from the front-line process of handling complaints and may think that all is well. After all, the policies are in place. The problem is that the vast majority of patients will not complain about office policy, because it wouldnít do any good anyway and no one likes a confrontation. They just go away, silently and invisibly, and thatís a huge loss over time. Acquiring a new patient is much more difficult and expensive than retaining an established one. My advice is to train staff members to use their judgment and to try to solve problems creatively, and to try to find a way to say ďYES.Ē Even when you have to say no, much depends on how itís said. Is it with compassion and understanding or is it cold? Do doctors and assistants ever apologize? Sincere apologies are extremely important and they should occur when things go wrong. Itís often all a reasonable person needs to hear when they PERCEIVE they were wronged.


Office policies are necessary, but so are exceptions to the policy, and keeping patients happy is crucial to your reputation. Ironically, policies are often developed to save the practice some form of expense Ė but losing a patient is way more expensive!

When patients do complain, often in anger, many doctors proudly ask the troublemaker to go elsewhere in the future. Iíll admit that this may be the best solution in very rare cases, but I would not take pride in it, and it should occur about once every ten years. Some doctors will fire a disgruntled patient very easily, but they will hang on to a rude staff member forever. They donít seem to care about the financial loss of the missing patient, but they lament the potential increase in unemployment taxes if the ex-employee were to file for unemployment benefits. It should be the other way around.

Your patients are going to tell stories about your practice and the sum total of these stories make up your reputation in the community. Itís up to you if they tell stories about how you let them down Ė or how you saved the day.

Best wishes for continued success,

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