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 By Neil B. Gailmard, OD, MBA, FAAO, Editor April 3, 2013 - Tip #577 
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How to Handle Late Patients

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I received some nice comments on last week's tip about staff members who frequently show up late for work, but several readers asked me to expand on the side point I made about patients who arrive late. I'm happy to tackle that topic here, but be forewarned: many readers of this column will not like my answer! Read on anyway. I might change your mind on this and there is one gem in here that almost every practice will like and use.

My philosophy
My method for handling late patients is based on an assumption that you want to grow your practice into a huge success and you want to make huge financial profits. I realize that financial gain is not important to everyone, so if you are not that interested in profit, I can understand that you might respond differently.

If you are interested in maximizing revenue and profit as fast as possible, then understand that my approach to late patients is one part of a larger philosophy of excellent customer service. Most ODs only get that to a point and most are not willing to go far enough to make customer service a marketing strategy. The late arriving patient is just one excellent example of how you could drive huge numbers of patients to your practice.

My strategy
My staff makes a strong attempt to confirm every appointment two days in advance, but in spite of that, we know that some patients will arrive late. Here is the part that many ODs and staff won't like: When a patient shows up late in our office; we are extremely understanding. If the patient offers a reason for why they're late, we're very sympathetic. We generally see the patient even if they are quite late, unless we are about to close the office for the day.

I realize that arriving late is disrespectful and disrupts our schedule. But I don't look at this event from our point of view. I look at it from the patient's point of view. From the patient's point of view, he could not help being late and it was not his fault. I don't get caught up in trying to judge whether that is actually true or not. That seems like a waste of time and I can't really be sure, so I just accept it at face value. I prefer to resist trying to teach the patient a lesson in life. I prefer to take advantage of the situation and show the patient how easy we are to do business with.

Moments like this can actually shock a patient, but it causes them to love our practice. As staff members provide this high level of service, it builds our office culture and they can feel that we are different and special. A situation that could easily have caused some anger ends up becoming a moment of kindness.

My tactical approach
We handle late patients one case at a time, but in general we try to see the patient as fast as we can while minimizing the impact on other patients. If we can't do a good job with both, the late patient has to wait. But we take pride in being able to provide an eye exam quickly and with flexibility. We simply make it work and we don't waste more time worrying about it.

Here are some tips that will make dealing with the late patient easier:
  • We train our front desk staff to be aware of the current time and if a patient checks in more than a few minutes late, we politely get it on record by mentioning it. The greeting is really the only time we have to let the patient know that we know he is late. It is to our advantage to work from that fact because if we have to make the patient wait longer than our usual high standard, it is because he was late. We just say: "Hi Mr. Smith. So glad you're here. Your appointment was at 3:00 and I see it is now 3:25. We will get your exam started just as soon as possible..."
  • A manager or an experienced staff member should look at the schedule and make a decision about when to start the visit and what procedures to do. The doctor may want to be consulted as well. If everyone works together, a solution can usually be found. I love it when the optometrist can be flexible and may take a patient without the usual pretesting. Or can see the patient briefly and then start him dilating. Whatever it takes.
  • My staff would like me to set a specific number of minutes, beyond which we can tell the patient that we won't see him. I won't do it. I want to handle these on a case by case basis as we look at the situation.
  • If we are near quitting time or lunch time or if there is some unusual circumstance, we just talk to the patient. We are simply honest, but very kind and understanding. We may let the patient know that because of other appointments in progress, there may be a significant wait and he may prefer to just reschedule. Or we will say that our office closes soon and we won't have time to do the exam, but our optician will be happy to help you look at a few frames today.

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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