Many things go into building a large and profitable practice, but if I had to pick one factor that has led to success in my practice, it would be delivering excellent customer service, even when it is difficult. One of those times that it is difficult is when patients arrive late for an appointment or when they call our office to let us know they will be arriving late.
My staff and my associate doctors have wanted me to take a hard stand with these patients from time to time. They would like me to set some number of minutes, after which, we would refuse to see the patient that day and we would reschedule them. Rescheduling may be the best answer, but I insist that we decide that on a case by case basis with the late patient. It is not a mandate based on policy.
The last time we discussed this issue at a staff meeting, I asked my staff members to consider how they would feel if they arrived late for a doctor’s appointment, due to some factor that was beyond their control. Maybe they had trouble with child care at the last minute or perhaps traffic was very heavy due to an accident. Let’s assume they really needed to be seen and delaying the visit a week or more would have caused a real hardship. How would you like to be treated by the person at the front desk? How would you feel if she was very understanding and wanted to find a way let you see the doctor?
A memo to my staff
As part of staff training in my practice, I often put my thoughts in writing and pass them out to all for discussion at a staff meeting. It keeps me organized and it helps staff members to remember the key points. Here is a handout I wrote for my staff on the topic of late patients:
Our primary goal is to provide great service for the patient, not to do what is most convenient for us. Look at the situation from the patient’s point of view first.
We don’t usually have to stay much past quitting time, but we will have to sometimes. That is the nature of our work. We stay until we are done with patients.
Setting an exact number of minutes for which we will turn a patient away is not advisable. We will handle each case as it arises after looking at various factors such as:
The nature of the patient’s needs. How urgent and serious is the eye problem? How important does it seem to the patient that he/she be seen today?
How much past the original appointment time will the new time be?
How close will the new time be to quitting time?
How busy are the doctors expected to be at that time based on the schedule?
It is fine to ask for input from the doctors or the office manager about the situation, but I expect them to follow these principles and guidelines as well.
If the new start time seems difficult for our office to manage, offer to reschedule or ask if the patient would rather reschedule given the circumstances. Do not dictate that we must reschedule. Work with the patient.
We will not inconvenience other patients who are on time for appointments. They will be given priority and if the late patient will truly impact others, we just explain to the late patient that there will be a wait until we can see them due to other appointments. This may make the late patient choose to reschedule for their own convenience.
If a different doctor has an opening or has faster patients, the late patient may be asked to see the other doctor.
Many late situations are pretty easy to decide if we should see the patient today or not. But if the decision is borderline or hard to decide, then go ahead and see the patient. That is always the right decision and we can often improve the situation if we spend less time thinking, talking and worrying about it and just get started. If the patient wants to be seen, we will usually do so unless circumstances are extreme. We can see a patient in 15 minutes or less. Don’t make it a big deal.
When we see a late patient, receptionists, technicians and doctors should consider changing our usual office routine to be more efficient. Possible examples: Skip the history form for now (we can do it later and take it verbally). Start the pretesting faster (don’t stand there and read the previous exam data, just call the patient in). Let the doctor see the patient without pretesting (especially if no tech is available and if it’s an established patient). Do frame selection before the exam if the clinic side is busy. Just see the patient and figure it out as we move forward. Once we begin working with the patient, you will find the situation will get easier. The patient will know he is late and will be accommodating to us. Some services can be reappointed as needed if there is a time issue. This includes frame selection, which can always be done with no appointment needed. A practical solution can be found once we talk to the patient.
I realize that my patient-friendly approach will not be well-liked by some optometrists. It is, however, very well-liked by patients. Some ODs feel that letting patients win in cases like these just enables them to take advantage of us. I have not found that to be true, but even if it were, I wouldn’t care. The practice-building power is simply too great to pass up.
Best wishes for continued success,
Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week
Dr. Gailmard's new book, Practice Management in Optometry: A Blueprint for Success Based on the Optometric Management Tip of the Week, is now available on Amazon.