It's not lost on me that if I consider myself an expert with vast experience at handling patients with eyeglass complaints, then it follows that perhaps I'm not a very good optometrist. But the fact is that I am a very good optometrist, if I do say so myself, but all ODs who see many patients over the course of their career will have quite a few who are unhappy with some aspect of their new glasses. It happens to all of us.
Here is a guide to efficiently correcting the problem, keeping the patient happy and loyal, and not losing any sleep over it.
An attitude adjustment
To be completely successful in managing an Rx problem, you may want to examine your own attitude about it first. It is easy to become a bit apprehensive when you first learn that a patient you recently examined is unhappy with the product you prescribed. You really must get over that feeling… that is for complete rookies with no self-confidence! Realize that the vast majority of these patients are as nice as can be and as soon as you show that you are concerned and want to help, they are like putty in your hands! So eliminate any stress or dread and know that these office visits are usually not bad at all.
This change in attitude should carry through so that you let your staff know that you do not mind seeing these patients at all. It is actually best if you see them as soon as possible with little inconvenience. It is OK to see these patients by appointment if you must, but if a patient with a problem is in your office and you can find the time, it is best to just see them right now. After all, you have no apprehension, right? And if you save the patient a return trip and get it over with, you will have a big advantage.
Train your staff to handle these cases properly before you even see the patient:
When the patient states a complaint, immediately show great concern and agreement that the problem must be corrected. Ensure the patient that you will find the cause of the problem and fix it.
It is usually appropriate to apologize. At the very least, apologize for the patient's inconvenience and if you find that your office made a mistake, admit it and apologize for that as well. An apology immediately makes most people more tolerant and understanding. It is what we all want to hear when we are inconvenienced or wronged in some way.
Forget about trying to blame others. Go ahead and accept the blame if it will help get to the issue.
Staff should know when they can fix a problem on their own and also know when to ask the doctor or senior optician to get involved. Taking a weak stab at the problem and not really fixing it only makes the issue worse. It is far better to solve the problem right the first time.
A scientific approach
Okay, let's get on with identifying and fixing the eyeglass problem. That is not always as easy as you might think. There can be many factors for an eyeglass complaint, including buyer's remorse. Remove the emotion and follow a specific scientific protocol like this:
Do it yourself. As much as I believe in delegation, I prefer to handle complaint cases myself once my staff feels they need my input. These cases are very important and can go very wrong if not handled perfectly. I have many excellent staff, but I'm in the best position to put together all the variables of eye health, refraction and optical correction.
Meet and greet the patient is a compassionate way. "I'm so sorry to hear there is a problem with your new glasses, Mr. Jones. I'll do whatever I can to take care of it. Tell me about it."
I begin by listening very carefully to the patient. Look him in the eye and understand what he is saying. Nod in a supportive way. Don't interrupt. Ask questions to be sure you understand and enter this history data into the patient record.
Recheck everything. Don't assume you know things; take a very scientific approach. Review the previous case history and any visual complaints that led you to prescribing the new glasses. Confirm these original factors with the patient. Verify all the prescription lens parameters, retest the subjective refraction and recheck visual acuity. Compare the new Rx with the old glasses subjectively, if appropriate.
I like to do lensometry on the problem glasses myself, not give them to a staff member to check. I need to know exactly what the readings are. Don't use an auto-lensmeter unless you paid over $10,000 for it. These $3,000 auto-lensmeters are not accurate enough. A manual lensmeter is actually better for troubleshooting. Spot the PDs. Spot the PAL markings on the lenses and draw the seg location. Put the glasses back on the patient's face and check the alignment.
Consider lens materials and base curves and review the previous lenses. Polycarbonate has some advantages over CR-39, but optics can still be a problem.
Be sure that visual acuity is as good as previously recorded and if not, suspect a change in ocular health status. Examine the eye as needed. I've seen Rx complaints turn out to be a fresh retinal hemorrhage.
Explain and fix the problem
In most cases, the process above will lead you to an obvious cause for the complaint. It should make sense; there should be a cause and effect relationship. In that case, just explain what happened in simple terms to the patient and proceed to fix the problem by remaking the lenses or whatever you have to do. Do not spare any expense at this point. The lab may make new lenses at no charge, but worry about that later. The cost is very minor in all this. It is part of the cost of doing business.
Unfortunately, there are plenty of times you won't know for sure what is causing the problem. The Rx and the optical measurements all seem perfect. In those cases, you might try just starting over. Ask the patient if she loves the frame or if she would be willing to choose a new one. The response can tell you quite a lot. I'm extremely easy on patients. If the new glasses are within 30 days from dispensing, I am happy to select a new frame and make new lenses.
Complaints cases can bruise your ego and they can become emotional, but resist the urge to blame others. If you handle the customer service aspect well, you can come off as a hero. Once you show a patient that you truly care and you go the extra mile for them, they become extremely loyal. Many of these complaint cases can turn into your very best patients.
If I feel like we dropped the ball in some way, or the patient thinks we did, I like to give a small gift as a goodwill gesture. It might be a coffee mug with the practice logo, a $10 Starbucks gift card or a $50 gift card to our eye center. We have all of them on hand.
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.