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 By Neil B. Gailmard, OD, MBA, FAAO, Editor May 14, 2008 - Tip #328 
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A New Concept: Reduce the Time Patients Spend in Your Office

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Here's an idea that many eye care professionals (ECPs) have never thought to work on: find ways to reduce the total time patients spend in the office. Achieving that goal is really a win-win situation because (a) patients actually love a shorter visit. Their satisfaction with your practice greatly increases if you get them in and out quickly. And (b) practice profitability increases when you spend fewer resources, like staff time, on each patient visit. If all visits are quicker, the practice can see more patients per day.

Total patient time

While I'm sure most ECPs try to be economical with their own time (although, amazingly many don't think about it at all), I'm recommending that you reduce the total time spent in the office by patients. Total patient time is different than doctor time because the former includes things like completing forms, waiting, pretesting, patient education, eyeglass selection, and so on. Ironically, many ECPs think they will impress patients if they make the typical visit fuller. They reason that if more things are happening, perhaps the patient will perceive greater value. This kind of thinking is even more prevalent in practices that are not extremely busy. It's false thinking. Who ever said patients want an eye exam to take a long time?! They don't. It's really not that much fun. Patients have busy lives and the eye exam is just a necessary task that most people would really rather not have to endure.

Of course, we should make the visit as enjoyable as possible and we can give patients a pleasant surprise by making the visit more interesting, but making the visit short is an important way to make it enjoyable. Don't wear out your welcome!

The new value of personal time

The practice that works to reduce wasted time, while still being thorough and delivering high quality, wins. Patients who think back about their eye care visit and realize they were able to get in and out with amazing efficiency will love your practice! They will refer more friends and relatives. Convenience and personal time is valued so highly today that people will actually pay higher fees if they can spend less time with you!

What can be done?

Here are some time consuming factors that can often be made more efficient.

  • Reduce the wait in the reception area. It's easy to become complacent about the initial wait time. After all, it has become quite common in all health care, right? It behooves you to be the exception. Review your appointment scheduling system and your operations to eliminate reasons why you run late.
  • Reduce the time at check in. Having a staff member at the front desk at all times can make the welcoming greeting more efficient and it gets the process started immediately. Have staff members complete most of the records and paperwork the day before the visit so there is less to do when the patient arrives.
  • Reduce the number of forms for the patient to fill out. Don't overdo the history form, lifestyle questionnaire, various disclaimers, insurance forms, retinal photo approval, pupil dilation form, etc. I don't think established patients need to complete another history form; we just update the original one in person.
  • Reduce delays waiting for technicians to review the record and call the patient into the clinical area. Some employees simply procrastinate. Maybe the tech likes to chit-chat with the receptionist before calling the patient. I realize the tech needs to review the history form or the last exam results a bit, but train staff to move things along.
  • Reduce unnecessary pretesting. There is a balance between being thorough and being wasteful. It is efficient to delegate data collection, but don't run tests that don't yield valuable information and don't duplicate tests. For example, it makes no sense for the technician to spend time on a subjective refraction with a digital refraction system if the doctor is going to repeat the refraction anyway.
  • Reduce the inner wait. Patients don't just wait in the reception area; they wait again in the exam room. Develop a system so the doctor knows when there is another patient waiting.
  • Be flexible with your exam routine. Can you change your process on the fly and shift when some procedures are done in order to stay on schedule?
  • Reduce unnecessary tests by the doctor. It is never impressive for the patient to sit behind the phoroptor; the novelty wears of in about 60 seconds. Are there any tests that you do routinely, but don't really need?
  • Reduce the wait for dilation. Beyond the actual time needed for the drug to work, dilation is a huge drain on time in many ways. It's easy to put the drops in and say "we'll call you back in when you're ready", but do staff members let the time run over by several minutes? Are the exam rooms tied up and there is no place to go? Is the doctor too busy to see the dilated patient? Review your process with your staff and make this more efficient. Consider when the drops are instilled and what kinds of drops are used. Try to avoid having patients return on a different day for dilation (a huge time drain) or frame selection (a potential loss of business).
  • Be economical with your patient education time. Choose your words carefully and get to the point. Don't over-explain and don't be too technical. Ask the patient if he wants to hear more on a topic. Computerized education video clips can be great, but don't hold people captive watching commercials that they are not interested in. It can backfire on you.
  • Use a scribe in your exam room. Having a technician record data and make notes as you talk to the patient is the ultimate time saver.
  • Don't waste time walking patients around the office and waiting for a staff member. Scribes eliminate this.
  • Reduce the time spent at checkout. At this point, the patient usually really wants to leave. Streamline the process and don't make patients stand around very long.

There is a fine line between providing advanced services, new technology and personal care, and going on too long to point of being boring. Choose your procedures carefully and spend your patient's precious time on things that deliver maximum punch. Remember that the time spent in the optical dispensary or trying on contact lenses is a very profitable part of the visit. The less time spent in the waiting area, pretesting and exam rooms; the more time available for optical and contact lenses. Patients will only spend so much time in your office; use it wisely.

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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