Article Date: 6/1/2012

HAPPY PATIENTS: The Foundation for a Growing Practice

HAPPY PATIENTS: The Foundation for a Growing Practice

Simply put, happy patients refer others, and referrals are the key to growth. Learn more about this and how you can tap into its power.

Kim Castleberry, OD • Kerry Pearson, OD

Dr Castleberry: Each doctor on our panel has taken a slightly different path to success, and we're here today to share our insights and experiences. First, let's explore what we can do to ensure a steady stream of referrals.


Dr Castleberry: The most important thing we do as optometrists is find out why a patient has come to see us and then resolve that issue. By doing that, we're meeting the patient's expectations, but that alone won't necessarily generate a referral. What more do we have to do?

Dr LaHiff: We must go above and beyond meeting expectations. Many patients don't really know what they need, but they know they want comfortable eyes that they don't have to think about during their busy days. They may come into our clinic with a particular complaint but there may be other unrecognized problems we can address that, if left uncovered, could cause problems down the road.

Dr Castleberry: We do much more than address the chief complaint in a comprehensive eye examination, but it's easy to get distracted. That's why I always look back at the chief complaint at the end of the exam to make sure I addressed it.

Dr Brujic: A challenge we often face is patients — especially contact lens patients — who aren't totally up front with us about how they're feeling. They're worried we'll tell them they can't wear their contact lenses. If I suspect all is not well, I plant a seed of hope by mentioning that we have new contact lenses designed to be comfortable all day, even toward the end of the day. Then I ask, “Is that something you might like to try?” Hopefully, this starts a dialogue, because the patient realizes he can talk openly to me, and I may have a solution to his problem that won't require giving up contact lens wear. In these situations, we have the potential to generate loyalty and relationships that go deeper than just being the doctor who accepts their insurance.

Dr Pearson: It's also important to put patients at ease. When I ask a patient what kind of contact lenses he wears and how often he replaces them, I reassure him I'm not going to scold him. I explain that I need to know what he's doing, so I can help him. People tend to say what they think they're supposed to say. For us to properly take care of them, we have to get past that barrier and promote open, honest communication.

Dr Brujic: Many of us are in the habit of asking patients what time of day they start to notice their contact lenses. Often, the same people who say they have no problems tell you they can't wait to remove their lenses at 5 o'clock. That's a problem you've gently massaged from the history and can now address with new contact lens options.

Dr Castleberry: I verbally poke and prod gently throughout the examination based on what I find. If I see jelly bumps on the contact lenses, for example, I'll ask if the lenses get sticky toward the end of the day. If I see a cataract, I'll ask if driving at night is troublesome. As I start to uncover these issues, I can explain what's causing them and how they can be treated. Being able to solve problems that patients won't admit to creates a better experience for patients.

Dr LaHiff: I think the take-home message is: We don't want patients to feel their eyes or even think about them. If they're dry, that's a problem. If vision is poor, that's a problem. Just as you never want to think about your shoes because they're hurting your feet or your watch because it's not working, patients should never have to think about their eyes.

Dr Castleberry: Surprising patients with solutions to problems they didn't know they had, or didn't think could be resolved, creates happy patients. Let's discuss the results of a recent study that links happy contact lens wearers to referrals.


Dr Castleberry: The 2011 CWatch Referral and Return Study polled 1,086 patients. People were asked to grade on a scale from 1 to 5 how happy they were in their contact lenses. Later in the survey, they were asked to grade how likely they were to recommend their eye doctors to others. The survey found that patients who are happy in their contact lenses are nearly twice as likely to recommend their eye doctors as those who are unhappy in their contact lenses. Let's discuss what this means to us.

Dr Brujic: The more I analyze these statements, the more I realize how powerful they are. Unhappy contact lens wearers fall into several categories. For example, you may have spent significant time and tried numerous options, searching for the best lens for a patient but achieved only moderate success. She may not be entirely happy in her lenses, but she appreciates that you worked hard for her, and she still may recommend you. If she were totally happy, however, she'd be twice as likely to recommend you.

Dr Pearson: We also need to remember that people who don't complain aren't necessarily happy. They may not be unhappy, just neutral, so we still have an opportunity to make them happy.

Dr Brujic: Exactly! Our goal is to optimize the contact lens-wearing experience. Most often, that means improving comfort. If I can take a patient's comfort level from a five out of ten to a seven or eight, I've improved his comfort. We also shouldn't forget vision. For instance, we can often improve vision for patients with astigmatism by prescribing a toric contact lens. I honestly don't know why anyone wouldn't reach for a toric lens for a patient who has three-quarters of a diopter of astigmatism. That's an opportunity to take someone from neutral to happy.

Dr Castleberry: We know referrals are important to our long-term growth and success, and we know happy contact lens patients are twice as likely to refer people to us. We've also learned how our panelists find out if their contact lens patients are not happy in their lenses, and we've discussed some things we can do to make them happy. Now, all we need to do is ask for referrals. Is it as simple as it sounds?


Dr Castleberry: Asking for a referral does take some finesse. You need to know when and how to ask. Let's discuss what we do in our practices.

Dr Brujic: When a patient has had an exceptional experience in our practice, we let him know we're always accepting new patients, and we encourage him to recommend us to friends and family members. I have no qualms about telling people in my exam chair, “I'm glad you had a great experience, and if you know anyone who would benefit from our services, please let them know.”

Dr Castleberry: Do you ask your own family and friends for referrals?

Dr LaHiff: Yes. In fact, I get most of my referrals from my family and friends. My mom is one of my best advocates. She works in a credit union, so she sees many people every day. She wears the craziest, coolest eyewear, and people often comment on it, which opens the door for her to recommend my practice. It's the same with our staff. When they're wearing our products, they're excited to talk about them with their friends.

Dr Brujic: Asking for a referral is the culmination of everything we do in our practices to create a positive experience. Not only does that experience generate loyalty, but it also gives patients the confidence to encourage others to see us.

Dr Castleberry: Are any specific types of patients particularly important referral sources?

Dr Pearson: Never underestimate the power of moms. They've been called the chief medical officers of the family, being primarily responsible for making healthcare decisions for their kids and spouses. That is a huge driver for referrals within their sphere of influence.

Dr Castleberry: How do you engage the moms?

Dr Pearson: I proactively talk to them about eye care for their kids and their husbands. We don't just let our relationships with moms grow organically but actively nurture them, and we've seen results. We often hear men say, “My wife sent me.”

Dr LaHiff: When a child accompanies his mom to her appointment, I encourage my staff to ask if the child has had an eye examination. If he hasn't, we offer to make the appointment right then and there.

Dr Pearson: We treat all of our patients really well, but moms are our VIPs. Whatever we can do to make their experience in our office pleasant — minimize paperwork and waiting times, for example — will come back to us in referrals.


Dr Castleberry: It's been interesting to focus on what I consider — even after 28 years of practice — the most difficult task we have: Making patients happy. Happy patients are at the core of a successful practice that endures, because they share their positive experiences with others. We've learned that happy contact lens patients are twice as likely to recommend us to others, and we know the more frequently a patient applies a new lens, the more likely he is to recommend his current doctor. These are opportunities we can't afford to ignore.

Now, let's review five key steps you can take to maintain a solid patient base. ■

Dr Brujic: Have you ever noticed how some successful companies create a mystique around their products, so their customers feel like members of an exclusive club? Apple comes to mind. People who own Macintosh computers tend to feel connected. I may not know anything about you, but I think you're cool because we use the same type of computer. It's the same reason so many people have iPhones and iPads.
I want my patients to feel that same type of loyalty to my practice — that it's the “cool” vision center — and share their excitement with the people in their social circles. The challenge is to generate that level of enthusiasm for what is essentially a necessity — eye care.

Dr Pearson: It's important to find a niche and become the expert. When you're an expert in contact lenses and you have a reputation for always offering the best products, you're creating that special club. Thanks to social media, such as Facebook, Yelp and LinkedIn, our patients have an ever-expanding circle of influence.

Dr Brujic: I've used the concept of being part of a club to support some of my recommendations. I tell patients, “Most people with your prescription who are candidates for daily disposable contact lenses go with these.” It's an easy, fluid communication point. It makes patients feel comfortable that they're not the only ones wearing this lens, even though they may not have heard of it before coming to see me.

Dr LaHiff: I'll also mention to patients that the lens I'm prescribing for them is the most commonly prescribed lens in the United States. People like doing what other people do, not only because of the cool factor but to be confident they're using a product that has high marks from many other patients and practitioners.

Optometric Management, Issue: June 2012, page(s): 3 - 5