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 By Neil B. Gailmard, OD, MBA, FAAO, Editor May 19, 2004 - Tip #122 
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Office Polices for Remakes and Refunds

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Continuing with our series on patient satisfaction, following last week's tip on warranties and the previous tip on service recovery, let's talk about a fun topic: remakes and refunds!

Remakes and Rechecks

Most optometrists understand the need for remakes and do so willingly. The nature of our work and the conventions that exist in our society make it best to offer complete satisfaction. This would include a no-charge recheck by the optometrist, if needed, to resolve a problem.

In argument, one can offer the analogy of a physician who prescribes a drug that doesn't work; noting that the doctor does not pay for the ineffective medication, or waive the office visit fee for continuing to work on the problem. But it's different with optical than it is with medicine, because optical is close enough to retail goods that those rules apply. Optometrists get to follow the medical tradition when prescribing a drug that does not resolve a keratitis, or reduce IOP enough in glaucoma. We do make a profit on the sale of optical products, but not on the sale of a drug. If the complaint is about eyeglasses, and if we look at what is best for the practice and its reputation, the no-charge trouble-shooting visit is essential to good will. I view these visits as an opportunity to create a powerful bond by sincerely helping a patient who has a problem. How you approach these can set your practice apart from others and relieve considerable stress for the patient, who is likely to be worried over the confrontation.

As for the remake, my advice is to just do whatever it takes to make the patient happy. The tough part is often figuring out what that is... but if you know, or if the patient tells you, it's easy. Another tough part involves the time line. How long do you offer the free remakes and rechecks? Here are a few rules and tips I've found to be helpful for me and my staff.
  • I will often provide some kind of remake, even if I'm not sure what is causing the complaint. I demonstrate my desire to help, and it often does solve a vague problem, or a problem that is in disguise when the patient really wants to choose a different frame.
  • While I empower my staff to fix problems themselves without my input, I discourage them from guessing at the cause of a problem. A 2mm change in the PD is not going to resolve a visual complaint in most cases, and the patient ends up having to come back again. Multiple attempts at remakes is very inconvenient, costly and undermines the patient's confidence in our practice. I'd rather see that patient myself and re-refract.
  • One of the clues I listen for, which can change how I resolve a problem, is when the patient states: "these glasses were never right". That is quite different than glasses that were once just fine, and something happened to change the fit or the vision. If they were never "right", and if the time frame is not too unreasonable (like years after dispensing) I'm likely to remake them at no charge.
  • It's frustrating when people wait what seems to be an unreasonable time period before bringing up a complaint. My response to this helps me deal with the problem appropriately. I ask the patient, in a nice way, "what took you so long to bring this to my attention?" Then I listen. The answer will vary, but it does two things: first, it gives me some insight into why it took so long, which can be legitimate ("I was in the hospital") or lame. Secondly, it lets the patient know that they took too long and whatever we do for them is really nice.
  • After listening carefully (and empathetically) to a complaint, if the resolution is not obvious, a very effective question to ask the patient is "what would you like us to do?"
  • I apologize. I'm not sure why so many eye care professionals have learned to remove the words "I'm sorry" from their vocabulary, but it is often all any of us really want to hear when a business lets us down (patient perception is all that counts here). I have no problem apologizing for the patient's inconvenience for having to return, or for making a mistake in the lens design or prescription. I don't worry about who I can blame - I'll take the blame. I also thank the patient for bringing the problem to my attention.
  • I think it's smart to print all office polices about rechecks, remakes, refunds etc. on the back of your superbill or walk-out statement. Patients will read this and most will follow the rules.
  • Don't forget that you can put returned frames that have not been worn back on display. I have my in-office lab make new plano demo lenses for them and put the frame back in standard adjustment.

The topic of refunds can trigger emotions in practice owners that run very deep. Opinions vary widely on how to handle them, and all I can do here is share my views.

I will try to resolve complaints and fix problems through remakes first, but if the patient wants a refund, I'll give it with no hard feelings. It does not ruin my day. We try our best and we learn from our mistakes, but no one is perfect and we know we can't please everyone. I don't take it personally. I've learned that we often retain the patient, keep a good relationship, and provide services and products for many years to come.

Our policy, which is printed on the back of my superbill, states that refunds must be requested within 30 days of dispensing. This is reasonable, but rules can be bent when circumstances warrant it.

I would typically offer a refund only on materials, keeping examination fees totally separate - which indeed they are. If a patient requested a refund on an eye examination, I'd politely make the point that exam fees are for work that was performed in good faith, and that no one works for free. But if the patient continued to request the exam fee, I'd realize that I was dealing with an irrational person and I'd refund that fee also. This happens so rarely that it's not worth worrying about. I don't stew over the incident - just move on.

Why do it?

One very valid reason to have patient-friendly policies is to make life more pleasant in the office for you and your staff. It reduces stress when you can make patients happy, and the pleasant working environment breeds many important intangibles in the practice culture! Providing the remake or refund without a fuss even allows you to save face in the patient's eyes, because if you don't make an ordeal out of it, it's not perceived as an ordeal. But the biggest reason to have lenient policies is that you will make more money. Your practice will grow and become one of the most successful in the community. It will take a few years, but time passes. You wouldn't think giving refunds or doing more remakes would make you more money, but it's a paradox.

Best wishes for continued success,

Read Past Tips Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week

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Send questions and comments to neil@gailmard.com.

Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com.
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