I know many successful optometrists who use
preappointing as the recall system of choice. Also, many respected practice management
consultants strongly recommend it as the most effective recall strategy.
I agree that it can provide a high recall
return rate, but I don't believe that it's the best program for my practice.
The way we do it
Don't get me wrong -- I'm in the business of
making appointments. They drive everything in my high-volume, five-O.D.
practice. I study how to maximize patient volume, and my staff is extremely
well-trained in efficiently scheduling appointments.
It's certainly possible to build a highly
successful practice without preappointing -- in fact, I believe preappointing
can actually be an obstacle to practice growth.
We preappoint follow-up visits and ongoing
medical eyecare visits, and we even preappoint patients who simply want to
schedule far in advance, but that's different than automatically scheduling all
patients for appointments a year or more in advance for routine eye care.
Except for a short period of time 10 years
ago, when I tried preappointing because it was "in vogue," my
practice has always used personalized letters and postcards for our patient
We send more than 1,500 recall notices every
month. They're easy to process with our office management software, laser
printer, window envelopes and postage meter.
Identify and satisfy
We ask patients if they'd rather we remind
them to make an appointment by mail or if they'd like to schedule their next
visit at the present time. We then do whatever they prefer. The vast majority
prefer mail reminders for long-term, routine care.
I built my practice by doing as many things
as possible the way patients want them done. It's simple marketing -- identify
and satisfy customers' wants and needs. This is the only business strategy that
Limitations of preappointing
I want the patient in my chair to want to be
there. Our doctor-patient relationship is more relaxed when we examine patients
who want or need to be seen.
Animosity can easily manifest when patients
return for eye exams primarily because of an aggressive preappointment system.
A recall system that boasts a "high
effectiveness rate" is, by design, actively working to schedule
appointments for people who wouldn't normally schedule at that particular time.
Some preappointing systems work by being a
little "pushy." Patients may schedule appointments to avoid
embarrassment or to simply go along with the office system -- but this can
cause some resentment, and even buyer's remorse later.
Through patients' eyes
I don't like the image preappointing gives
my practice. Your patients can easily spot a "business strategy"
aimed at selling more goods and services. Even if that's not the intent of a
patient recall system, perception is everything. An aggressive system where
appointments are automatically scheduled for the following year and reconfirmed
through a series of efforts can easily give the wrong impression.
And let's be brutally honest -- patient
recall systems in optometric practices are at least as much about marketing as
they are about public health policy. I want patients to perceive my practice as
caring more about their eye health than about repeat business.
Visits vs. revenues
From a business standpoint, I care about
productivity and gross revenues per patient visit.
Aggressive recall systems cause patients to
return with "no complaints," which often leads to "no
prescription changes" in contact lenses and eyeglasses. Increasing the
percentage of "exam only" visits in my schedule greatly reduces my
Preappointing systems lead to more no-shows
and rescheduling. It depends on the ability to confirm by phone, which actually
doesn't eliminate the increased no-show rate common with preappointing.
It stands to reason: People who have
appointments that they didn't voluntarily schedule for services they possibly
can't afford at the time are more likely to have something
"unexpected" come up at the last minute. They may or may not call and
cancel, but in any event, it's too late to fill the slot.
A good recall system is important to your
practice -- choose one that patients like and that's good for your image, and
the appointment book will fill up.
Dr. Gailmard served as benedict professor
of Practice Management at the University of Houston College of Optometry for
1999-2000. He may be reached at firstname.lastname@example.org.