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 By Neil B. Gailmard, OD, MBA, FAAO, Editor August 13, 2008 - Tip #341 
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Is the customer always right? Where do we draw the line?


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My last few articles focused on patient satisfaction and customer service. It's one of my favorite topics because it's the main factor at the core of every highly successful eye care practice. Whenever I write about extreme examples of letting the patient win, even when not truly necessary, it sparks an emotional response from eye care practitioners (ECPs).

The email I received following this series is no exception. Most ECPs agreed with the concept of practice building based on legendary service, but many shared specific examples of incidents in their offices which proved challenging. I love real case examples like those because it goes beyond generalities like "we'll do whatever it takes." We can all learn from examples of service challenges and it turns out there are some very creative ways to manage them.

Is the customer literally always right?

No, I don't mean it literally. There are always extreme situations where you just can't say yes. I'm the first to say we must run our practices like a business. That means we need to be paid for our services! We need to make a profit. But how we say no is critically important. If you listen to patients on a case by case basis, and if you really try to help them within the limits of good business policies, you can make 99% of the people happy. You can be sincerely empathetic and still stick to your policies.

One of the best responses when you can't give a patient what he wants is to say "in order to be fair to everyone..." Another important guideline is to simply be honest and upfront. When confronted with a complaint like: "You used to give me a discount if I paid cash, why didn't I get that today?" a good response is honest: "I'm sorry we had to drop that program due to our own cost increases, but we try hard to keep our fees in line with the high quality we provide." People may be disappointed a little, but they really just want to know what happened. Did you forget the discount he was entitled to?

We can reduce the occasions where we have to say no if we tell people what to expect in advance. Smart business owners work on this. Anything that can be a source of problems, such as fees, payment requirements, vision plans, warranties, appointment times, return policies and more, is best disclosed in advance. This may be done verbally or in writing. It doesn't solve all the problems, but advising in advance prevents most of them and it helps to be able to point out the advance notice when a problem arises. Since fees and payments are a big source of misunderstanding, just think how much easier life would be if your staff told every patient what the fees would be in advance and when payment was expected.

It's all about making money!

Some of the reader emails I get on this topic seem a little antagonistic; like the ECP is annoyed with me for advocating that we are nice to patients even if they are wrong. These ECPs think it's wimpy to give in to patients or to go above and beyond the call of duty. Let me be very clear, this whole approach of catering to patient's needs is anything but wimpy! It is clearly designed with the goal of making the practice owner wealthy! It's a business strategy and it works.

We have to draw the line somewhere on how much we can give in to a patient's wants and needs, but in my analysis most ECPs and their staffs draw the line much too soon. More damage is done by drawing it too soon than too late.

What if vision plans are involved?

Many of the examples of frustration sent in by readers revolved around patients with vision plans. The essence is that under normal circumstances with decent profit margins, one could afford to let the patient win. But with the steep discounts required by vision plans and with some of them forcing the ECP to use a sub-par lab, it can be hard to practice good customer service. I understand that having a third party involved between the buyer and seller can create difficult and unusual circumstances, but I hate to give excuses to my patients and I won't sacrifice my principles of excellent service. We must look at the big picture in these cases. If a vision plan does not allow you to practice the way you want, you may not be able to participate. But if you do choose to participate, there must be enough business advantages to overcome the disadvantages.

Should the squeaky wheel get the grease?

I think some ECPs are troubled by the thought that it's simply not fair for the complainers to get special breaks. Why should we give in just because someone complains loud enough? This does not bother me and here is how I justify giving in. First, it's good for business and that is of overriding importance to me. Second, I really do treat all patients the same. I'll give anyone who is unhappy with my services the same consideration. My policy is to guarantee satisfaction and I admit that achieving satisfaction occurs in various degrees among people. Most are easy to satisfy; a few are not so easy. One final benefit: life in the office is much less stressful. Employee attitudes improve as a result.

An example of high standards

A colleague emailed me with a great story from his practice. He was trying a new optical lab and it became evident that they provided very poor work, took too long and did not communicate well. One patient's eyeglass order had several problems in a row and was rejected multiple times. Mistakes were made and promises were broken. The job took much longer than it should have and the patient was obviously upset. When the glasses were finally ready, the ECP had prepared a check for the amount paid toward the glasses and the optician presented it to the patient with an apology and then dispensed the eyewear. The doctor said he may have still lost the patient, but he felt he did the right thing and at least he avoided bad word of mouth. I agree and I also think the staff learned a valuable lesson about how important excellent service is in their practice culture. I also think the chances are very good that he'll keep the patient for life. It was not a waste of money; it was a smart investment in the practice.


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.

Please Note: The views expressed in Management Tip of the Week do not necessarily reflect those of the sponsor.

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