Article Date: 3/1/2004

market research
A Little Research Can Benefit Your Practice
Simple, low-cost market research tools can help you obtain valuable patient information.
BY BOB LEVOY, O.D., Roslyn, N.Y.

Do you know what patients most like about you, your staff and your practice in general? Do you know what they most dislike? Or why some patients switch to other practices in your area? Obviously, such information holds the key to improved patient satisfaction and practice growth.

Unfortunately, several obstacles stand in the way of obtaining such information. Unhappy patients rarely complain. They either endure the minor annoyances of dealing with your office or, if these annoyances become major, they leave your practice. At the other extreme are the pleased patients who have the highest regard for you and your practice but rarely tell you.

The absence of patient feedback in both cases leaves you in the dark about what you need to do more of, less of and what, if anything, you need to change. The solution? Market research. Here are some simple, low-cost, market research tools to help you obtain patient feedback.

Use a simple survey

An outpatient survey from a hospital in Pennsylvania asks, "Have you used the Hospital's services before? If yes, has the quality of the services improved, remained the same or declined?"

How would your returning patients answer such a survey?

Get focused

Healthcare providers are increasingly using focus groups to view their practices through the eyes of their patients. Other groups have used focus groups in qualitative market research about consumer products.

A typical focus group consists of eight to 10 invited patients who meet for an hour to an hour-and-a-half to talk specifically about your practice. The preferred setting is a small conference room in a hotel or a private room in a restaurant. Hosts typically serve light refreshments, such as coffee and cake or fruit and cheese.

Many patients are pleased to participate without compensation. Others are more interested when you offer an incentive such as a credit against future services or purchases.

The ideal person to conduct the session is a professional focus group facilitator, who, by definition, is neutral about the practice and more likely to make the participants comfortable enough to express their true feelings, for better or for worse. To locate such a facilitator, contact the school of business at a local college. A professor or perhaps a graduate student may be available. Or look in the Yellow Pages under "Marketing" or "Marketing Research."

The facilitator should have strong interpersonal skills and be able to start the discussion and then listen without interrupting or getting defensive. The facilitator should also be strong enough to manage the direction of the discussion while making sure that low-key individuals aren't overwhelmed by more outspoken participants.

Use the following types of questions to start the discussion:

► In your experience with the practice, what have you liked? (It's best to start with a question that everyone will find easy to answer.)

► What, if anything, have you disliked? (Participants may at first be hesitant to answer. Be patient: Someone will speak, and others will follow.)

► What are some of your pet peeves about the office?

► Why did you choose this practice above all others?

► Can you think of specific situations you wish the staff had handled differently?

► Have there been situations that you wish the doctor had handled differently?

► How do you feel about the office environment? Could we improve it in any way?

► How about the office hours? Appointment scheduling?

Suggestion: You'll get better results if the group is homogeneous in terms of education and socioeconomic status. People will be more at ease with each other and more willing to participate in the discussion. Without demographic information, of course, you can't be sure as to a group's homogenity, but presumably, you and your staff know patients of record well enough to make an educated guess.

Periodic focus groups will enable you to obtain valuable feedback about how patients perceive your practice and will perhaps reveal that you're doing far better (or worse) than you realized. Equally important, these surveys will alert your staff to the importance you place on patient satisfaction and their role in achieving it.

Stay on good terms

The average practice loses 10% to 30% of patients each year. Unfortunately, many of those who defect leave quietly, never stating their reasons for doing so. On those occasions when a patient announces his departure by chance, or when you or a staff member learns of it, consider sending the letter in the sidebar (above left).

This letter "leaves the door open" in case patients find the quality of care and service they receive elsewhere unsatisfactory. Failure to meet expectations is the most common cause of patient dissatisfaction. In many cases, it can be traced back to a badly managed interaction between either the doctor or a staff member and the patient. An apology may provide a simple remedy to the situation. If so, this short and sincere letter may convince the patient that you're truly sorry and have earned another chance. It's worth a try.

If such a letter could retrieve only one or two patients who made the decision to leave your practice, it would be well worth your efforts.

You asked for it

Another low-cost way to undertake marketing research and identify your practice's strengths and weaknesses is to ask your staff. Staff members frequently hear patients' comments about the practice but may not share such information because the optometrists with whom they work never ask.

To tap into this resource, distribute a list of questions to your staff. Then schedule a "no-holds barred" meeting to discuss their responses. Sample questions might include:

► How would you describe our practice to an outsider?

► What compliments about the practice do you hear most often from patients?

► What complaints do you hear from them?

► Where, when and why do misunderstandings with patients most frequently occur? What are your recommendations?

► Is there anything patients have been consistently asking for that we should consider offering?

► What changes will improve patient satisfaction?

► What is it about the practice that gives you the greatest pride?

Staff members tend to be more objective about a practice than are doctors. They also view patients from a different perspective and see and hear things that doctors don't. Listen to their ideas and insights. They may open your eyes to opportunities for improved patient satisfaction and practice growth.

Make them feel important

The post-appointment telephone interview is a type of market research typically done with 10 or 15 patients representing a cross-section of your practice, two to three days after their appointments. An office manager and/or staff members (on a rotating basis) often conducts the interviews. The premise isn't only to obtain patient feedback, but also to sensitize staff members to the importance of patient satisfaction.

To expedite the interviews, have a staff member make advance arrangements with pre-selected patients at the conclusion of their visits. For example:

"Mrs. Carlson, we plan to call a few of the patients seen this week to ask about their experiences in our office. We'd very much like your opinion on this topic. Would you be willing to be interviewed for just a few minutes later this week, at any time that's convenient to you?"

Most patients are agreeable, if not flattered. The following are some questions to ask patients during these interviews:

► How did everything go during your appointment?

► Were all your questions answered?

► Was there anything that bothered you in any way?

► Is there anything we could have done to make your visit a more positive experience?

► If a friend were looking for an optometrist, would you be comfortable in recommending our practice?

Tested tip: As in any interview, the more you draw the person out, the more you learn. Phrases such as "that's interesting" and "tell me more about that" let patients know the interviewer is truly interested in what they have to say.

An alternative to the post-appointment telephone interview is simply to have the receptionist ask patients as they are paying their bill at the conclusion of the visit, "How did everything go today?" In asking such a question, it's important to hold eye contact with the patient and look genuinely interested. Otherwise, the patient may not attach any importance to the question and simply say "fine."

Regardless of what you hear, the feedback you obtain from such interviews will help you identify hidden "blind spots" about your practice.

Get outside the box

Ralph Waldo Emerson observed, "The field cannot be seen from within the field." This sampling of market research techniques will enable you to get that all-important outside view of your practice through the eyes of others. Armed with this information, you'll have a veritable blueprint to improve patient satisfaction and practice growth.


Bring 'em Back

When patients quietly decamp, try the following letter to get them to reconsider your services.

Dear (patient's name),

I'm sorry to learn from (employee's name) that you've decided to leave our practice. If we have failed to meet your needs or expectations in any way, we'd like to know about it, make amends if possible, and have another chance.

In any event, if we can be of service to you at any time in the future, please don't hesitate to call us.


(your name)


Dr. Levoy's newest book, "201 Secrets of a High Performance Optometric Practice" is now in its second printing by Butterworth-Heinemann. You can reach him by e-mail at



Optometric Management, Issue: March 2004