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help you keep your patients in lenses, and in your practice.
A surprising number of practices have a fee that is charged to patients who fail to show up for
appointments. There are many variations on the exact policy – such as not really charging it
(but only threatening to do so) or giving a discount on the no show fee if a future appointment
We may have to agree to disagree on this, but I think these policies are damaging to the practices.
Further, it might serve as a sign of a customer-tough philosophy in general for any given practice.
I assume doctors who have these policies like the impression it gives the public – sort of a
“we don’t really need you” attitude. My way or the highway. Maybe these practices are so large
and successful and booked so far in advance that they truly don’t need patients. If that is the
case, then I have no problem with the tough-love policy. But I’ve seen a lot of practices, and I
hardly ever see one that could not use more patients. Lots more patients. In fact, I can’t
envision any practice that has enough patients. If demand is high enough, I’d hire more staff,
hire associate doctors and build new offices.
Understandable logic – but flawed
I think I understand why no show fee policies are developed. It seems unfair and inconsiderate
when a patient reserves the doctor’s time and does not use it. Income is lost. Time is wasted.
Expenses, like staff salaries, are still incurred. Another patient could have used that
Further, the irritated doctor reasons that he is better off without these people. If they pay
the fee, then fine, but if they don’t recognize the value of the doctor’s time, they can go
elsewhere. This is where we differ. If the primary goal is making a profit, I believe we are
better off letting the patient win. This is an example of customer service, which yields patient
satisfaction and loyalty. That is the single most important aspect of practice building.
When a patient misses an appointment, he invariably believes it is not his fault. And many times
it isn’t, but in any case, there is always an excuse. It’s human nature. Smart businesses don’t
worry about fairness; they look at everything they do from the patient’s point of view. Marketing
is defined as identifying and satisfying customers’ wants and needs. The patient’s perception is
all that matters and they never put the practice’s needs ahead of their own.
One final drawback to the no show fee is that to be effective, it must be stated in advance to every
patient, even though only a small percentage of people are guilty of the offense. This causes every
patient to perceive the practice as tough. I think it makes them easy pickings for another practice
which projects the high-service image.
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.