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 By Neil B. Gailmard, OD, MBA, FAAO, Editor August 6, 2008 - Tip #340 
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Service Recovery

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The last two tips have been about patient satisfaction and practice culture and I stressed how important it is to believe in the philosophy that the patient is always right (at least 99% of the time). In this tip, let's take a close look at how your office handles situations when things go wrong. And let's face it, things will go wrong. I do wonder though, why it seems that multiple things have to go wrong with the same person on the same job! Does that happen in your practice, too?

The initial response is key

The perception of quality and integrity of your practice is largely determined by the first few words out of an employee's mouth (and the supporting body language) when initially confronted with a complaint. It's so important that you should have a staff meeting to work on that issue alone. Well-meaning employees may try to mitigate the "damage" by trying to explain why the problem occurred or worse, trying to make a case that there is no problem.

The correct response to a patient complaint is one of complete understanding and agreement that the situation is intolerable and that a sincere effort will be made to correct the problem or at least learn
from it.

A good response from a staff member to a serious complaint would be "Oh, that's terrible."

As customers, we all know that things will sometimes go wrong; what we judge closely is what will happen next.

Unresolved problems represent a huge hidden cost

It's short-sighted to look at the immediate lab costs that may be incurred by fixing a problem with glasses or contact lenses or at the lost sale that occurs with a refund. And fixing a problem begrudgingly, while letting the patient know that you are not happy with the situation, is a double loss: you incur the immediate cost and still lose the patient goodwill. Realize that the public relations damage done by a patient who feels they were not treated fairly can be severe and long-lasting. Picture the patient who spent hundreds of dollars on glasses at your office but can't wear them for some reason. They sit in a drawer. That person will retell his story over and over every time eye care comes up in conversation. The damage to your practice reputation will be fairly invisible to you, but none the less real.


An important step in the service recovery process is to listen to the patient. Provide reassurance up front that you will resolve the problem, take him to a private area of the office and ask him to tell you about the problem. Don't cut the patient off. Make eye contact and nod in an understanding way. Take notes for the record if appropriate. You will be surprised at how easy it is to disarm a person's anger once you show support.

Empower staff

Make it easy for staff to fix problems. Be sure to train staff on how to troubleshoot a problem and to do whatever it takes to make the patient happy.

Don't make the doctor inaccessible

Remember that it's important to get the problem corrected on the first try. If your staff member attempts to solve a problem but does not have the knowledge to diagnose it properly in the first place, a wasted effort will be the result. When you have to get involved after two or more unsuccessful attempts, the patient will have lost confidence by then and will be losing patience as well. Be willing to get involved early with a no charge office visit, or with a behind the scenes review of the issue at hand.

Don't worry about blame

Resist saying the problem was the lab's fault. It's your lab and the patient is dealing with you! They don't want to hear about the problems you encounter in running your practice. Train your staff to not display anger or frustration at co-workers when faced with having to correct a mistake. Just admit the error and accept the blame on behalf of the office. Even doctors may have to check your ego at the door. Patients don't want to hear long-winded excuses about why the Rx didn't work.

Use the words: I'm sorry

It is extremely rare for eye care staff or doctors to say I'm sorry - but that is exactly what is needed in most cases to reach a successful resolution. You may never reach complete patient satisfaction without it. When things go wrong, most of us just want to hear a company representative admit that a problem occurred and express an apology. Once we get that, attitudes change instantly! Even the toughest meanest person will soften. What's the big deal about saying I'm sorry? Are we afraid it is an admission of fault? It may be helpful to actually rehearse saying it out loud.

The late complaint

How do you handle the patient in your chair who says her glasses have never been right and it's eight months after dispensing? Most of us are happy to resolve issues, but we expect the patient to be reasonable. When I'm faced with this I say: "I'm sorry to hear you're having problems with the glasses; why did it take you so long to let me know about this?" The response to this key question will lead you to the right resolution and just asking it lets the patient know, in a nice way, that she had some responsibility in the matter. The patient will typically soften up. Consider a few example responses and how it will change your point of view:

  • I did let you know four times but your staff refused to correct the problem.
  • My husband has cancer and I was just too distracted to take care of it.
  • I really should have come in sooner but I wasn't sure if there was a problem or not.
  • I just noticed the problem last week.

In some cases, a compromise may be reached that will be fair to all. You might say: "Of course, your prescription may have changed in eight months time, but I'll recheck it today at no charge and if we have to make a change in your lenses I will reduce the cost by 50%."

Ask the patient what to do

Sometimes I find I would be happy to fix a problem if I only knew what the problem was! In cases where nothing more can be done it's best to explain that to the patient. Often, that may be all that's needed. If you can't resolve a problem and the patient is still unhappy, it may help to ask him what he would like you to do. Listen and comply.

Refunds are allowed

Refunds are a sensitive topic among eye care practitioners, with some vehemently refusing. My philosophy is of course to try all other remedies first, but if a refund is requested, I grant it right away. I may even proactively offer a refund if I know I can't make a situation right. But refunds are extremely rare. I believe refunds should be limited to products and not professional fees since the service was provided, but if a patient did not agree with that, I would refund professional fees as well. Life is too short to worry about it and I stopped letting these matters upset me or my staff long ago. We simply move on and feel good about it. Don't sweat the small stuff.

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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