Article Date: 4/1/2001


Achieving Patient Retention
How you can use modern business practices to develop long-lasting patient relationships and a strong image for your practice.
By Peter G. Shaw-McMinn, O.D., Riverside, Calif.

We're in the business of eyecare, and just as anyone who runs a business, we must take stock in our greatest assets to help ensure our future success.

In our "business" the most valuable assets we have are our practice identity, our patients and our staff. How these factors interplay form the cornerstone of every successful service-oriented business.


What Makes an Effective Team?


  • Members are clear about their roles and the roles of all other team members.

  • They have a sense of ownership and accountability.

  • They're confident that they can communicate openly and honestly and share ideas, opinions, disagreements and feelings.

  • They're able to resolve conflict quickly and constructively without waiting for the boss to take action.

  • Members of an effective team are capable of initiating decision-making and solving problems on their own.

If asked, how would you answer the following two questions?

1. How do your patients view your practice overall?
2. Is your practice the Cadillac of eye care -- or something else?

Here, I'll explore the optometric practice wholly from a business standpoint and discuss how you can strengthen your practice and reach a new level of success, including:


A practice brand is the "trust" you create between your patients and your practice. The experience is enhanced by interactions with staff.

A brand consists of pricing policies, quality of service and products dispensed, staff interactions with patients and the overall appearance of the office and equipment.

The value of a brand is how successfully you differentiate your services from the competition.

W. David Sullins, Jr., O.D., F.A.A.O., of Athens, Tenn., past president of the American Optometric Association, found his niche developing a strong practice brand.

"The best way we found to build our practice was focusing on children. Interestingly enough, we're now recommitting that interest in infant eye care and have developed the program Operation Bright Start.

"We learned that nationally 86% of children receive no eye care of any kind when they enter the first grade. We've agreed to provide eye care to infants in their first year of life without charge for our services.

"We feel we must introduce parents and grandparents to eyecare as a most important part of infant and child development. Parents and grandparents naturally follow the lead of their infants and children."


When marketing your brand, a name, logo, slogan or other mechanism can help you enhance your message. Various media including signs, print (brochures, letterhead, newsletters), visual symbols, staff uniforms and mass media help establish and reinforce your practice's brand. To get your message across as you intend, make it uniform throughout all media used.

What you want your practice to represent becomes the "promise" you intend to deliver to patients. To gain the most benefit from a brand identity, patients should highly value this "promise," and it should be unique from your competitors and compatible with your practice's capabilities and strengths.


The first step in building a strong brand identity is finding your own answers to the following questions:


Your biggest goal will be to determine how you want patients to perceive your practice. One concept you can use is the "moment of truth" analysis suggested in the late 1980s by Jan Carlson, former CEO of Scandinavian Airlines.

The moment of truth concept describes critical encounter points within a practice that can influence patients' impressions. You can tilt these moments in your favor when you've identified and defined what you think is the ideal outcome.

Carlson estimated that at Scandinavian Airlines there were 50 million moments of truth -- the annual number of passenger and employee interactions.

How many moments can you identify in a typical patient visit?

Start by analyzing the patient office visit cycle from start to finish.

During this patient encounter, several significant "moments of truth" present opportunities for you to reinforce your practice.

For example, critical moments occur when you present case findings, make recommendations and present the patient to a staffer for eyewear dispensing.

These moments signify when the patient encounter transforms from a service-oriented to a product-oriented experience -- an encounter that could result in negative consequences to the practice and to revenue if it's not handled properly.

That's where your staff comes in. They can make the moments of truth good or bad for your practice. You need them all to work with you to establish your practice brand and leave lasting good impressions on your patients.


Once you've determined your practice brand and pinpointed critical encounter points during the patient visit, you need to get your staff on board with the message you want to send to patients.

However, finding the right people for your team is a growing challenge. Arguably, the number-one complaint by optometrists today is finding competent, loyal staff.

In the words of Dr. Denise Howard, of Bloomington, Indiana,

"My success has been a result of my investment in a great staff and up-to-date technology. I hire the friendliest, nicest people I can find even if they have no healthcare or optical experience. Good people can learn skills, but you can't do much to change difficult personalities."

Successful large companies can teach us a lot about how to apply the concepts of teamwork and purpose. Before you dismiss the thought of your office having similar characteristics of a big business, keep in mind that a big business's success has been achieved by dividing the company into teams ranging from five to 10 members. Optimal group size, in most studies, is seven."


A team is a group of people working together to achieve a common goal or business objective; in this case, the objective is patient retention. Research has shown that high-performance teams share certain characteristics:


Your role as the formal leader is to coach and mentor the group. A coach works tirelessly to free the team from needless restrictions on performance.

But your team needs to share common goals, and all team members must take responsibility for the team's effectiveness.

To help your staff become a more cohesive team, ask each one to complete the Practice Brand Identity exercise. Do they agree that you're conveying the image you thought to patients? If not, discuss how you can become more consistent as a practice in projecting your image.

Ask each staff member to identify "moments of truth" and describe how to use them to convey your brand to the patient. For example:

Remember to analyze why patients leave your practice and give a report during your office meetings. Use the findings from this report to help you and the team set objectives to improve the practice.

Most importantly, don't forget to reward the team.


Once you have identified your practice brand, and you have a good team in place, turn your sights toward developing stronger patient relationships.

First, though, remember that not all patient relationships are equal. The most valuable patient in any service-oriented business is one who offers greater potential revenue and profit by returning more often and exhibiting greater loyalty.

Consumer research shows that the top 30% of customers contribute 70% of revenue, while the bottom 30% contribute just 3%. These "select" patients from the top group are more likely to recommend your practice to others, cost less to maintain and are willing to pay premium fees recognizing the benefits your services offer.

Many practices direct the majority of their attention towards attracting new patients at the expense of fostering heightened relationships with current patients. The risk of this strategy is known as the 'leaking bucket' effect, where current patients abandon the practice due to inadequate ongoing communication with the practice.

Keep in mind: The number-one influence on choosing a healthcare provider is recommendations from family and friends.


In the world of marketing, bonding relationships are categorized into three levels.


We all face a range of growing competitive pressures, but these outside influences don't need to have an adverse affect on us. If we're sending the right message to patients, then it shouldn't matter.

Develop a strong practice brand, get your staff on board to help efficiently and uniformly reinforce it, and work on developing stronger patient relationships to create a winning formula. 

Dr. Shaw-McMinn is in private practice in southern California. He's also an assistant professor at the Southern California College of Optometry. Along with Dr. Gary Moss, Dr. Shaw-McMinn is co-author of the new book Eyecare Business: Marketing and Strategy. You can contact him at

Optometric Management, Issue: April 2001