Optometric Management Tip # 87   -   Wednesday, September 17, 2003
A Few Thoughts on Patient Recall

I get many good ideas for Tip of the Week topics based on reader's requests, including this week's. I have not written much on the topic of recall systems, so it's time to dive in. I know my philosophy on recall may differ from many leading management consultants. There are many different points of view on this subject, and I respect the fact that there is more than one way to do recall successfully.

Pre-appointing seems to be the buzzword in recall, and there are many loyal and sometimes passionate followers of this method. I don't use it in my practice, but I acknowledge that, when designed properly, it can work well. I believe that if one tracks the percentage of patients who return within a few months of the recommended re-exam date, the recall success rate is highest with the pre-appoint method (also called long-hop appointments). But there are some other considerations before you decide on this important practice management procedure.

By the way, when I refer to recall systems, I'm considering patients who are released from eye care for a year or longer, and whose next exam would be considered routine. Patients who need more frequent follow-up visits, such as the 1-week follow-up on infection or the 3-month glaucoma visit or even the 6-month cataract check, would simply receive a specific appointment date while in my office.

The main thing I look at whenever I'm communicating with my patient base is: what effect does it have on my practice image? Many invisible messages can be sent whenever a practice communicates with the public, and I think we often don't study that effect close enough. Lets look at a hypothetical, ideal, super-successful practice and work backwards. If you had such a practice, it would be very busy because patient demand would be high, due to high levels of patient satisfaction and numerous referrals of new patients. It would provide some type of recall service as a courtesy reminder to patients when they need care again, as advised by the doctor, but this service would not need to be very complex or aggressive. It would not need to be a long letter extolling all the virtues of the practice (that is good for a newsletter). It would not need to resort to scare tactics about how precious sight could be lost if regular check-ups are not maintained (patient education is good, but I don't believe in scare tactics). It would not insist on scheduling an appointment one year in advance for a routine exam before the patient leaves the office. It would simply notify the patient that they are due for an exam, and leave the rest to the individual. When I think about the way I would like to be treated by a service provider, this is what I would prefer.

I believe patients are much smarter than many optometrists realize, and I believe they can spot a business strategy a mile away. I think it's in the best interest of my practice to never let them spot a business strategy. There is a perception that if a doctor is really good, his or her reputation will attract plenty of business. If a business strategy becomes apparent, it hurts the practice image because the apparent focus shifts from patient well being to financial interests. In reality, both can coexist quite well and optometrists are very good at balancing both interests ethically. Even if I need more patients, I don't want the public to know that. The more aggressive and complex the recall system is, the more it looks like the practice needs the business.

I have another reason for not liking recall systems that aggressively achieve a high success rate. They result in more visits that do not need an Rx change. I recommend that patients receive regular eye exams purely for eye health reasons, but some self-selection by the patient works in my favor. I only have a certain number of appointment slots available in a given day and I can help more people (and produce more revenue) if I see more people who are having vision problems and less people who are only in the chair because of an aggressive recall system.

So what type of recall system do I use? A simple postcard.

Best wishes for continued success,

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