Optometric Management Tip # 192 - Wednesday, September 21, 2005
A Sensitive Subject: Refunds
For many eye care professionals, the idea of giving a refund to a patient isÖ well, you pick the word.
Insulting, offensive, unfair, demeaning, upsetting, annoyingÖ whatever the word, it can ruin your day.
No business owner likes to take back a product or learn that a customer is unhappy with a service, and
doctors are even more sensitive about this, because they are professionals, not retailers.
Weíve all been thereÖ dealing with a very unreasonable patient who is making a demand that is completely
unrealistic, when the problem was not the fault of the doctor or staff. These situations can defy all
logic, which makes them very upsetting. Typically a staff member receives the complaint first, and then
may take it to an office manager, who may take it to a doctor. In the process, everyone feels the stress.
While these cases often have to be decided on a case-by-case basis, itís important to review how your office
typically handles them. It may be smart to hold a staff training session and develop new policies when the
topic is purely hypothetical and a refund request is not staring you in the face.
The way a practice deals with refund requests is often very telling about its patient service philosophy
overall, and that philosophy is the key to success and high revenue production. Realize that the revenue
you generate is dependent upon customers (patients) and the more of them you have and the more loyal they
are, the more revenue youíll gain. Contrary to how most practices handle a request for a refund; my advice
is to not fight it at all. This goes against the grain for many doctors, but trust me, letting the customer
win is a very smart business strategy. You may think that you can simply keep the group of patients that are
reasonable and let the others go, but sadly, there are too many to let go, and those that you do let go can
do incredible damage to your reputation.
Realize that the only personís opinion that really counts in business is that of the customer. No one elseís
opinion comes close. So if you hold your ground and refuse a request for a refund, or tell a patient that you
can only provide so many free remakes on a pair of glasses, the short term financial savings is greatly
overcome by the high cost of an unhappy customer. Maybe you feel like itís not the money, but rather that
you are doing whatís right. Perhaps you are simply sticking up for yourself and showing the patient that
they canít get away with unfair demands. To that I say, unless the patient agrees, you did not achieve your
goal. And the patient never agrees.
In fact, what is really aggravating is when you decide to give in and let the patient have the refund, or
whatever, and he is still angry! It certainly seems to me that when you go beyond reason to give patients
what they want, they ought to appreciate it. When they donít, you should learn how far apart you really were.
From the patientís point of view, even the refund did not make you square!
Doctors must act like businesses. Forget that you are somehow immune from societyís retail standards because
youíre a doctor. The public doesnít think that way and they will hold you to the standards of any other
business when a problem arises. Given that, how do you expect a business to behave? How do great businesses
behave? Strive to match that. It doesnít matter that the glasses are custom made, or that the professional
time was delivered and canít be taken back. Just guarantee satisfaction.
Here are a few practical factors to consider:
- You donít have to announce an open refund policy to everyone. You can even attempt to limit refunds to
materials and products only (not offering it on professional services), because many people will view that as
fair. But if a patient asks for a refund, Iíd listen to their complaint objectively, understand it, and
generally give the refund.
- Patients donít usually request refunds on amounts paid by insurance, but if push comes to shove, Iíd either
reinstate those benefits or simply give that part back in a check.
- Empower your staff to make a decision on behalf of the practice and train them to not take the problem
to the doctor! Keep the doctor out of it. If the doctor says no, the patient relationship will be damaged
forever, and if the answer is always yes, why ask? As long as my staff makes the patient happy, I completely
support the decision.
- Refund checks can usually be printed and mailed within a few days; patients generally understand that
there is an administrative office that handles such matters. But I like to empower an office manager to be
able to write a check against a petty cash account on the spot if needed.
- Donít take too long to tell the patient what youíll do. The longer a decision takes, the more tempers
brew and the bigger the issue becomes. Saying yes right away makes the problem minor.
- Let the patient win this time and learn from the problem for the future. Talk about it with your staff
and work on prevention.
- The right decision is really pretty easy. Pretend that you are the patient and adopt his complaint as
if it were valid. Just accept it as true. Then pretend that you are quite upset about the problem and
envision what you would expect the best eye care practice in the world to do about it. Consider being more
than fair; going above and beyond whatís expected. That is how great companies are built.
Best wishes for continued success,
Neil B. Gailmard, OD, MBA, FAAO
Chief Optometric Editor, Optometric Management