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 By Neil B. Gailmard, OD, MBA, FAAO, Editor November 17, 2004 - Tip #148 
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What stories are your (former) patients telling about you?

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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 he's told it! The story is completely different, of course. It's a story about an optometrist who is incompetent and couldn't get the glasses right (insert contacts, insurance billing, diagnostic testing... whatever you want). There's also the part about the assistant who was extremely rude.

Is the customer ever wrong?

So whose side is correct? Well, that's the whole point - it's not about who is correct; it's all about perception. In business, the only perception that matters is the customer's. The doctor can tell his side all day and it does not affect future business. But the patient's perception can cause the loss of that person's future purchases (and his family's) and will create negative word-of-mouth that's even more costly. When the old business axiom "the customer is always right" is used, it's meant to imply that it doesn't 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 don't need complaining patients anyway and that you're 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 "love us or leave us" attitude. It's a practice philosophy that says: "We do things our way: take it or leave it." It's 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 - not the patient. No customer ever wants to hear about company policy in any type of business, because it's only invoked when the company needs to say "NO." Office polices are invariably decided on by looking at the doctor's wants and needs - 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 customers' 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 wouldn't do any good anyway and no one likes a confrontation. They just go away, silently and invisibly, and that's 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 "YES." Even when you have to say no, much depends on how it's 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. It's 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 - 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. I'll 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 don't 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. It's up to you if they tell stories about how you let them down - or how you saved the day.

Best wishes for continued success,

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

A Proud Supporter of

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.
Advertiser Disclaimer: ACUVUE® and ACUVUE® 2 COLOURSTM are registered trademarks of Johnson & Johnson Vision Care, Inc. © JJVCI 2003. All Rights Reserved.

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