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 By Neil B. Gailmard, OD, MBA, FAAO, Editor July 30, 2008 - Tip #339 
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More on Practice Culture


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Last week I wrote about the prevention of common service problems that occur in eye care practices. But we all know that no matter how much effort we put into staff training and customer service, we will still have patients who are unhappy. This is especially true if you operate an optical dispensary because the patient's perception of the rules is different for an organization that sells a product and could be interpreted as retail, as compared to health care services. Let's consider how we respond to unhappy patients.

The customer is always right?

In my experience, this is where eye care practitioners (ECPs) just don't get it. Most of us don't think of ourselves as "retail" and we want nothing to do with the rules of good retail business. In fact, many ECPs try to distance themselves from any perception of retail by completely rejecting the mantra of the most successful retailers: let the customer win. By doing so, ECPs hope to teach the general public that they are health care professionals and the retail rules don't apply. ECPs generally adopt an attitude that says the customer is not always right; we do things our way and you can take it or leave it.

The problem is that society is changing the rules fairly quickly and consumers today have little regard for the old standards. In my view, you can't train the public; it's simply too large and too powerful. Of course eye care is part of health care, but there are large differences among the various health care disciplines and we must accept eye care for what it is.

  • There is a large amount of free enterprise in eye care. Many people pay privately for eye care and even with vision plans and medical insurance, the consumer makes the buying decisions based on the services they receive for their benefits and they often must supplement their benefits out of pocket. It feels like shopping to the average consumer.
  • Most eye care practices sell products. The sale of the product is a bigger focus in eye care than any other health profession. Eyeglasses are definitely viewed by society as having some retail qualities because they are both health care devices and fashion accessories. That is not a bad thing in my view; quite the contrary, I love competing in a free marketplace for the private pay dollar.
  • There are generally a large number of ECPs in any local market. This provides many choices for consumers.
  • It is fairly easy to change eye care providers. Previous records are not generally needed to switch.

So, people shop for eye care more than they shop for brain surgery.

In my view, eye care is not really retail, but we would be smart to operate under the same rules. There are enough similarities between eye care and retail that the public expects the same treatment. Regardless of what we label our form of business, customer service is a huge factor in success. A practice culture that is built on a solid foundation of always trying to please the patient and going way beyond the call of duty is the key to success.

What's the advantage to your practice?

Adopting a customer is always right philosophy creates a practice culture that will guide your staff to the behavior you really want to see. The very difficult complaint cases that rise to the top and cause you stress are the ones that employees pay attention to and learn from. When you let the patient win, even when it's clear that you didn't have to, you send a valuable and positive message to your staff. Your action in such cases may make you feel like you were overly generous, but the resultant employee behavior, over time, will be excellent service and pleasant attitudes. Without occasional extreme examples of caring and giving from practice leadership, employees tend to be overly-protective of the practice and therefore too hard on patients.

The whole issue of the customer (patient) being right is really about looking at situations from the customer's point of view, rather than the ECP's. In free enterprise business models, the customer's point of view is always favored because he is just one individual going up against a big company (the doctor and the practice are always viewed as wealthy and powerful).

The customer is always right culture results in extreme patient loyalty that will create great demand for products and services. Demand is the factor that is sorely missing in most practices. Oh, we get used to low demand and the ECP will likely rationalize the situation and say he or she doesn't want a bigger practice, but great patient demand converts to great net income. It converts to higher fees, less dependence on vision plans, advanced equipment, better employees and a thriving optical. Patient demand is the key to the kind of practice you dream of owning.

Do we really want difficult people in our practices?

I've heard the concern that letting patients win (even when we think they are being unreasonable) will only cause the practice to gain a reputation as an easy mark for the public to take advantage of. The logic is that eventually the practice will be overridden with complainers and whiners who are difficult to deal with. Apparently there is quite a network of this ilk and they really spread the word when they find a business that gives in to their demands. The smart move would be to show this type the door or ignore them and hope they go away. The practice is better off without them.

I don't agree with that line of thinking. Those "complainers" are just regular folks in most cases who find themselves in a difficult situation. You and I have been there when we bought something we didn't like and wanted to take it back. Let's remember... we deal with the general public! There are all kinds of people out there and I say we should expect the difficulties and manage them to our own advantage.

Let's assume we have a practice culture that gives in to the complainers and makes them happy at any cost. From the patient's point of view, the practice reputation that would develop from this scenario is one of kindness and fairness. The story portrayed is one of finally being treated right for a change and how refreshing it is to find a doctor's office that actually cares about people. This kind of victory for the patient would likely result in telling many people about how great this office is. If that's the result of working with complainers, I'll take all I can get. I'll pay a lot for that kind of buzz.


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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