Article Date: 1/1/2001

Patients Don't Grow on Trees

An unfriendly staff may put you out on a financial limb.
By Jerry Hayes, O.D.

Have I ever told you about the time when Betty, my first full-time assistant, chased away little Bobby Curatt and cost me $25,000 in lost fees? Well, it's definitely a story I won't ever forget.

The Curatts were a nice family. There was the mother, father, two teenage daughters and 10-year-old Bobby. They all wore glasses -- and best of all, they all came to me for their vision care. This was very important to a young O.D. just getting his practice started.

Wearing thin

Unfortunately, Bobby, a -2.00 myope and typical little boy, was a holy terror on glasses. He bent them, he smashed them and he knocked the lenses out. It was amusing for a while, but adjusting those frames got old after the first half dozen times. I didn't really mind though, because I liked the Currats, and they were great patients.

Betty, however, forgetting that her sole job was to serve patients, got sick of working on little Bobby's glasses and made a comment to that effect to Mrs. Currat one day when I was out of the office.

It didn't take long for me to notice that the Currats weren't coming in anymore, and I soon found out through some mutual friends that I'd lost a great family of patients because of Betty's rude behavior.

Numbers don't lie

Just how much did losing the Currats cost me? Using conservative numbers, at least $25,000 over the lifetime value of those patients (LTVP).

To a young O.D. looking ahead to 30 more years of practice, the typical patient will come to see you an average of once every 2 years. Assuming an average fee of $200 adjusted for 3% annual inflation, that one patient will see you 16 times and spend about $5,000 over the lifetime of your practice. In Bobby's case, the figures would've been much higher because he was a progressive myope who came in on a regular basis.

As healthcare providers, we always want to look at our patients as real people with feelings and needs, not as eyecare problems with money to spend. Having said that, it's funny how your perspective can change when you think in terms of each patient in your exam chair as having a lifetime value of $5,000 rather than being a $50 eye exam.

And, that LTVP can skyrocket from $5,000 up to $100,000 if they like you enough to refer just 10 or 20 other patients over the course of your practice. It can also cost you much more than that if a staff member, like my Betty, is chasing patients away.

Because a vision care consumer goes through a cycle of trying you and then returning for repeat care before she's really somebody's patient, it's important for you to recognize that patient retention, not new patient acquisition, is the key driver in the long-term success of your practice. Only when a patient makes the decision to come back for repeat care can she be considered your patient.

Get them coming back

The trick that many healthcare providers, including some optometrists, never fully learn is that getting patients to come back on a regular basis requires more than just providing good basic care. That's the minimum people expect.

A number of other things go into determining whether patients will stick with you, such as marketing and the appearance and location of your office. But mostly, it's the friendliness and efficiency of your staff and how they feel about you as a doctor that'll keep people coming back, again and again, for repeat care.

In the end, the ultimate goal is to create a bond between you and the patient for a lifetime of practice. That's where the payoff is -- for both you and them.

So, are you wondering whatever happened to my assistant, Betty? I'm sure you'll get a kick out of this. Betty eventually drifted off to another job. The reason she gave for leaving? Strangely enough, it seems she didn't like working with the public.

Dr. Hayes is director of the Center for Practice Excellence. You can direct practice finance questions to him by fax at (904) 273- 1224, or by e-mail at

Optometric Management, Issue: January 2001