Practices Don't Always Get a Second Chance


Proactive Patient Retention Can Pay Large Dividends

Phyllis Blount remembers when her elderly mother was in the emergency room after a fall. Blount didn't call Dr. Vincent Smith, her mother's primary doctor, but he showed up anyway to check on her. On a Saturday.

Mary Jehl Kenner recalls a time 25 years ago when she sat for three hours in a waiting room with her daughter to see an eye doctor. Kenner, a single mother, who took off work for the appointment, complained to the doctor.

"Make an earlier appointment next time," he said.

There was no next time. Kenner never went back. It still makes her mad, 25 years later.

Sometimes patients leave for reasons beyond a medical practice's control, such as a change in health insurance coverage, the patient moves away, or their doctor is leaving or retiring from the practice.

But there are plenty of proactive patient retention steps in a practice's control that can keep their patients happy and connected. Most medical practices use technology, training, social media and old-fashioned attention to patients as part of proactive patient retention. The practices contact their patients through texts and emails. Patients can log into their patient portals to see test results and summaries of their office visits.

"We send reminders by text, said Shanna Smith, director of payment services for OrthoOne. "We call them two days prior and send the text the night before. Our no-shows have decreased. They've gotten so used to our contact, that if we somehow forget to call or the text doesn't go through, they get anxious and call to make sure they have the right day. They like the reminders."

Levy Dermatology also sends texts and emails, and they email a patient survey right after a patient leaves. The practice, which averages about 200 patients a day, gets between 20 and 30 surveys returned them that day.

A negative comment is immediately addressed by the office manager or Shira Levy, the chief operations officer.

"We listen, we apologize, we offer them a free visit," Levy said. "We deal with the issue."

Other ways in which the clinic practices proactive patient retention includes: Continuous training of staff on customer service, social media games on Facebook such as Bingo for Botox, Instagram giveaways, charity events that patients are invited to attend, an open house, free consultations and free cancer screening.

"Our retention rate is directly tied to our attention to detail and emphasis on the customer experience," Levy said. "What we hear most often that keeps patients coming back is the high efficiency of patient flow, the friendliness of our staff, attentiveness of our providers and the cleanliness of the clinics."

Jennifer Goodfred, DO, medical director of the University of Tennessee Health Science Center (UTHSC) University Clinical Health Family Medicine said since the clinic treats a range of patients, from infants to geriatric people, and provides a continuity of care not found with other practices.

"Patients feel they are getting excellent continuity of care," she said. "They want to know if I'm going to still be their doctor (when they get older)."

The biggest reason patients leave a medical practice is because they are upset with how they were treated, said Stewart Gandolf, the chief executive officer of Healthcare Success, a California-based marketing and advertising agency.

"In business in general, upwards of 70 percent of people who take their business elsewhere do so because they perceive an attitude of indifference," he said. "Admittedly, their perception may not have been due to a deliberate slight or discourtesy, but the result is staggering anyway."

Goodfred says that is something her practice takes seriously.

"The behavior and attitude of the staff is a reflection on me, said Goodfred, "We are part of a team that takes care of our patients from the person who greets them when they walk in the door. It's very important for patient retention."

Gandolf said successful practices maintain a culture of respect and attention to patients' needs and concerns, even if it's something like the long walk from the parking lot.

"A practice should leave no room for anyone to feel that they (the patient, visitor, family member) are an intrusion or interruption to the busy office environment," Gandolf said. "Doctors and staff have to pay attention to patient needs, and to hear them when they share their concerns. Even if the issue seems trivial or out of your control . . . listen."

The other big reason patients leave is because of wait times. The University Clinical Health clinic offers a half hour each morning at 7:30 for walk-ins, which addresses some of the wait time issues. But since the clinic is a residency teaching practice, there will be some delays, Goodfred said. Their goal is to give each patient their full attention.

OrthoOne has patients back within 5 to 10 minutes of their arrival, Smith said. They are usually finished within 30 to 45 minutes, unless it's a complicated issue.

"Staying on schedule (or close to it) is a major factor in retention; perhaps one of the biggest," said Smith. "There is a clear message of 'indifference' that flows when people frequently experience long wait times."


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