Article Date: 5/1/2013

Bring Back �Lost� Patients

Bring Back “Lost” Patients

Use a three-step approach to keep patients in your practice.


A huge number of potential patients are waiting for you in your practice management system (PMS). Let them out. Here’s how:

Start by dividing your patients into two categories: active patients and “lost” patients, or those who have not visited your office for 30 months or more.

Most practices have a one-size-fits-all recall campaign. They send one recall postcard and try to follow-up with one phone call if the patient doesn’t respond. Let’s see what a more robust system looks like.

Good housekeeping

An effective recall system starts with good housekeeping. After each comprehensive exam, place a recall date into the proper field in your PMS. Most systems have a preference you can set to either remind you to set the recall date, or it sets it automatically, depending on the type of exam. Once you’re properly using the recall date field in your system, you’re on your way to long-term success with getting patients back.

The objective of your recall system is to maximize the number of patients returning while minimizing the cost per communication. The methods in order of least to greatest cost:

1. Electronic communication: e-mail, text messages.

2. Standard U.S. Postal Service mail: postcards and letters.

3. Human interaction: phone calls.

4. Knocking on the patient’s door. (Forego this one … it’s called stalking).


Each time you communicate with a patient, and he/she doesn’t respond, go to the next level. Because this method increases expenses, leverage technology first.

Many products or services within the industry manage part of your recall system. (See page 56 for a list of these patient communication systems.) These typically focus on e-mail and text messages and all have the capability to automatically choose which patients to contact by looking at the recall date or last exam information.

It is imperative to assign one person to use the system as if it were his/her own business. He/she should review the results and campaigns every week.

Most doctors use electronic communication as their only method of recall. Though it is the easiest and most cost effective way to communicate with patients, many still fall through the cracks and eventually end up as “lost” patients.

Postcards and letters are the next step. Use the reporting system in your PMS to identify which patients to send communications. Identify these patients by the recall date or, in some cases, by last exam date.

Lastly, are phone calls. You can use the same reports in your PMS to identify which patients to call. Patient reactivation software helps identify patients and manage the phone calls as they are made. Use your staff to make these calls, or hire an outside phone recall company.

Identifying lost patients

There are typically two ways to identify active and “lost” patients within your PMS: First, you can run a report by “recall date” or by “last exam date.” Last exam date is less accurate because you may call patients back for follow up after a specific amount of time that differs from their regularly scheduled examination — for example, six months, one year or 24 months. But at this stage, any patient who has not returned for more than 30 months is already “lost,” regardless of recall frequency, so we want to cast a wide net while searching.

Identify lost patients by searching either “last exam date > 30 months ago” or “recall date > 18 months ago.” (We use 18 months because it equals 30 months from the patient’s last exam date minus the 12 months from the initial recall date.) Once you identify “lost” patients, begin your communications efforts. (See “Positive Steps to Re-Activate ‘Lost’ Patients,” page 23.)

STEP 1: Reach out electronically

Send electronic e-mails to “lost” patients once a month. If you have patient communication software, sending out e-mails is essentially free. So don’t be afraid to use it. Create up to 12 unique e-mails. Then repeat them. Include these topics:

► Eye health education.
► Fashion trends.
► Importance of sunglasses.
► New technology in the office.
► Events or special announcements.

Each e-mail should have a call to action, such as “Schedule an appointment today,” and should include your phone number. If you can customize the e-mail, due to the patient’s diagnosis, it’s more likely that he/she responds.

Unfortunately, you may not have an e-mail address for most “lost” patients, and if you do, it may have changed. Also, e-mail is the least effective communication. Does the patient open the e-mail, or does it go to spam?

STEP 2: Reach out through a postcard or letter

Postcards or letters should be sent quarterly. Topics include:

► Eye health.
► Eyeglasses.
► Contact lenses.

Remember: Each time you receive a “wrong address” postcard, update your PMS system.

To save time and money, take advantage of vendor programs that allow you to customize and send postcards right from their sites. This is a huge time and money saver.

STEP 3: Reach out with phone calls

Phone calls are the most expensive, but most effective, communication. Therefore, this method should go hand in hand with tracking.

► Update the recall date if the patient asks to be called in a few months or contacted again.
► When a patient asks not to be contacted again, mark them as inactive.

Positive Steps to Re-Activate “Lost” Patients

1. Take action

a. Once you get started, momentum builds and helps you do more and more.

2. Don’t give up

a. Just because you have not seen a patient in a few years, doesn’t mean he/she is gone forever.

b. The patient’s situation may have changed.

c. You may not have found the right way to connect with him/her yet.

3. Be consistent

a. Create a follow-up schedule, and don’t stop.

b. Measure the results.

c. Update your PMS.

d. Reward your staff for success.

4. Include a special offer

a. $35 off.

b. Buy one, get one free.

c. Use the time of year to customize special offers.

5. Always send information about trunk shows

a. Use a trunk show to display an entire branded collection of frames in your practice. Trunk shows can include a discount on eyewear or special giveaways. When done correctly, trunk shows can be a great event for your practice and the surrounding community.

b. “Lost” patients may now be in the market for eyewear, and trunk shows are a good way to attract them.

6. Send an announcement if you are on any new insurance panels

a. Many patients don’t come back because their insurance changed. If you get on a new insurance plan, make an announcement, so patients are aware of it.

b. Create a press release, or send a letter to all your lost patients letting them know.

c. Include all the plans you take, not just the new one. Sometimes, patients don’t realize you are a provider for their plan.

Also, a phone call is the only method that encourages patients to give you feedback about why they left the practice. If the patients don’t want an appointment, ask about their experience and their opinion of how the practice can improve. Thank them for their opinion, and invite them back to the practice. Perhaps, you can give them an incentive to return (see “Positive Steps to Re-Activate ‘Lost’ Patients, left.)

Ultimately, phone calls have the highest percentage chance of re-activating old patients.

Recall: the bottom line

We, as optometrists, spend a lot of time and a great deal of money bringing new patients into our practice, but we rarely spend enough of these things to keep them coming back. This damages the overall business health of our practices. A robust recall and patient education system during the office visit helps keep “lost” patients to a minimum. In addition, it keeps your practice in the minds of your patients, which instills patient loyalty and helps your practice to grow. OM


Mr. Kestenbaum is co-founder and chief information officer of GPN and co-owner of Optix Eyecare Center in New York. He received his M.B.A. from SUNY Binghamton. He leads the development team of GPN’s EDGE online technologies and data-based services. His involvement with practices has supported the development of corporate strategies and business philosophies for independents.

E-mail him at, or send comments to optometricman

Optometric Management, Volume: 48 , Issue: May 2013, page(s): 20 21 23