Creating patients for life: Part 2—Care during the appointment

Step 3: In-office care 

Patients want to feel good about their examination experience and about the dollars they spend in the optometrist's office. According to Daniel Abramson, work performance strategist, it's critical to remember, “today's customers want results, not effort; solutions, not idle chitchat; value, not promises. You determine the price, but it is the customer who determines the value. Value is a perceived issue—and perception is reality.”5 It is the goal of the optometrist and the staff to make each patient's perception a reality throughout every aspect of the in-office care process.

The good news is that optometry clearly shines in this aspect of the eye care experience. Patients regularly rate the thoroughness of the examination they receive from private practice doctors as excellent.

That said, if an optometric office has already delivered a stellar appointment scheduling and check-in process, by the time patients complete their examinations, they will be well on their way to singing the practice's praises to friends and family.

So what do patients want during their examination? Patients want their eye doctors to take their time during the examination, to explain the “whats and whys” behind the tests that are being performed, and then to make eyewear recommendations that are based on their personal health history and lifestyle information (see Figure 2). Also, when receiving eyewear recommendations, patients want the doctor to keep their best interests in mind and to recommend only those items that are right for them.

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Figure 2. Lifestyle questionnaire.

Finally, once the exam is over, patients want a seamless transition to the dispensary and check-out. In short, staff should know what the doctor has recommended and should reinforce those suggestions during the eyewear selection process. Consider using an eyewear recommendation form as shown in Figure 3. For additional tips on in-office care, see Table 1.

Table 1. In-office care

	What patients want…	Need to improve? Do this first
	•Provide a thorough exam using a personal history and lifestyle information. •Explain tests and make eyewear recommendations, keeping the patient's best interests in mind. •Provide a seamless transition to staff, making sure the staff knows the doctor's recommendations and are reinforcing those recommendations during the eyewear selection process. Key Points to Remember •Thoroughness •Explanation •Patient focus •Considerate •Smooth handoff	Provide a seamless transition between doctor and staff following an exam. Start by instituting a clear communications process for doctor and staff. This involves the doctor filling out an eyewear recommendation form and going over the suggestions with each patient in the exam lane (for a sample eyewear recommendation form, see Figure 3 View Large Image Download to PowerPoint Figure 3. Eyewear Recommendation Form. The form should be completed while the optometrist and the patient are still in the examination room. The optometrist uses the form to note the product recommendations, by category, that have been discussed with the patient. Completion of more than one complete set of recommendations indicates the patient may need to purchase multiple pairs of eyewear. The optician and dispensary staff should refer to the form when making eyewear recommendations. ). View Large Image Download to PowerPoint Figure 3. Eyewear Recommendation Form. The form should be completed while the optometrist and the patient are still in the examination room. The optometrist uses the form to note the product recommendations, by category, that have been discussed with the patient. Completion of more than one complete set of recommendations indicates the patient may need to purchase multiple pairs of eyewear. The optician and dispensary staff should refer to the form when making eyewear recommendations.
		It's a great idea for doctor and staff to jointly discuss any recommendations in front of the patient to transfer the doctor's authority and reassure the patient that the doctor's recommendations will be acted upon. This can be done either in the exam room or after the doctor escorts the patient into the dispensary.
		Note that some offices use a paper eyewear recommendation form, whereas others do so electronically through their office system. Either method works well as long as doctor and staff embrace it fully.
		F. Mason Smith, O.D.
	Other improvement suggestions from the experts
	•Getting to know the patient
	Use a lifestyle questionnaire form (for a sample lifestyle questionnaire, seeFigure 2) or ask appropriate questions (e.g., occupation, work environment, activities) to ensure that the patient's visual demands and lifestyle preferences aid in the eyewear selection process.
	•Patient Point of View
	During the exam, talk benefits, not features. Although an optometrist may be tempted to talk about the latest “high-index progressive,” remember that patients only care about the fact that the lens being recommended is lighter, thinner, and has no lines, meaning they'll “look younger and feel more comfortable” when they are worn.

Step 4: The “shopping experience” 

Of all the steps during a visit, research shows that the “shopping experience” rates among the most important in a patient's mind.1, 2, 3, 4 Unlike the exam, where the patient relies on a general sense of examination thoroughness and competency of the doctor, most patients are skilled shoppers and judge this aspect of their visit with a critical eye.

It all starts with staff. Often bewildered by the many lens choices and concerned about their fashion needs, patients look to dispensary staff as advisers. They want staff to support the doctor's recommendations and to educate them on the benefits of their lens choices. They also want help in selecting frames that meet their fashion needs. The staff should explain the benefits and features of eyewear options using “benefit-oriented” language such as that suggested in Figure 4.

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Figure 4. Benefits and features chart/planner.

“Take the time to teach,” said Joseph T. Barr, O.D., and echoed by Timothy B. Edrington, O.D. “It's critical for you and your staff to make a greater effort in educating your patients about eye care and eyewear options. If you don't, your competition will.”6

In addition to staff training and knowledge, physical layout is another key factor, as patients like easy-to-navigate dispensaries. Patients want the frame board categorized so they can browse quickly (e.g., by gender, brand, or price point). Access is critical as well; patients want to touch, feel, and try on several models to make a final selection.

Finally, selection and affordability are important. The good news is that patients do not expect thousands of frames at their fingertips, but they do expect a good mix that meets their personal needs. This ultimately means having an understanding of patient demographics, so each office should offer the right mix of frame lines and price points to meet the needs of its customers. Practices can objectively measure their success in this phase of the patient visit by compiling a sales capture rate using the type of form illustrated in Figure 5. For additional tips regarding the patient's “shopping experience,” see Table 2.

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Figure 5. Capture rate form.

Table 2. The “shopping experience”

	What patients want…	Need to improve? Do this first
	•An eyewear consultant who takes the time to support the doctor's recommendations and explain the benefits of eyewear being selected. The staff person also should help the patient select the right frame to meet fashion needs. •Make your dispensary easy to navigate. Categorize frames in a way that makes sense to me, like by brand, gender or price point. •Have a good mix of brands and frame styles that fit me and my budget. I don't need thousands of frames as long as you have what I need. Key Points to Remember •Consultative •Caring •Good display merchandising •Mix of styles and prices	Use the practice's daily sales capture rate and frame sales history to help monitor and adjust the type of frames being offered to patients.
		Any practice that is not yet compiling a sales capture rate should start. It is easy to do (see sample form, Figure 5). Simply recording the daily capture rate and monitoring results will typically cause an increase in productivity throughout the practice and will allow the optometrist to hone in on why some patients choose not to buy from the practice. When patients do not purchase, ask them why. Here's how: “We're interested in making it a better shopping experience for you and other patients. Would you mind sharing with us why you elected to go elsewhere to purchase your eyewear? We want to make changes in the areas where you were less than satisfied. We'd appreciate your feedback and help.”
		Walter D. West, O.D.
	Other improvement suggestions from the experts
	•Build Credibility
	Establish credibility with patients through education-based selling. Go through the doctor's recommendations and teach the patient about the benefits (for a sample of benefit-oriented language, seeFigure 4) of the doctor's suggestions based on that patient's health needs and lifestyle. For example, “I see that you work in an office; the doctor's recommendation for anti-reflective coating will really help cut glare when you're working.”
	•Get an outside opinion
	Conduct a walk-around in the dispensary, or better yet, ask a friend or relative to do the same. Is it easy to shop the frame board? Can someone easily find the right frames in the style desired? Can the patient find pricing?

Step 5: Check-out 

The conclusion of the patient's visit, after the patient has made selections in the dispensary, is the check-out. Value is critically important to today's patient, and the check-out gives the optometrist the opportunity to cement the entire experience with a few important steps.

When asked about this stage of their visit, patients say they want to understand how their dollars are being spent and want to know about any savings received. Furthermore, patients with insurance want to understand how their benefits are being applied.

Patients also expect a receipt, which serves as an important confidence-building reminder that they are getting a great value. They want an easy-to-understand, itemized document that covers charges, savings, and the application of any insurance benefits (see Figure 6). This is important not only to the patient during the visit, but also when that patient goes home and must explain any charges to a friend or family member. For additional tips regarding check-out, see Table 3.

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Figure 6. Savings statement form.

Table 3. Check-out

	What patients want…	Need to improve? Do this first
	•Verbally discuss charges and any savings the patient has received. Be sure to show how the patient's insurance benefits have been applied. •Provide an easy-to-understand, fully itemized receipt that explains all charges. Key Points to Remember •Review insurance coverage •Explain charges •Create an informed consumer	Escort the patient to the check-out area.
		If a separate staff member handles payment, be sure that the eyewear consultant escorts patients to that individual and introduces them.
		Make it a rule in your office to provide all patients with an itemized receipt. Use it as a tool to verbally go over charges and any savings and to show how any insurance benefits have been applied.
		For Vision Service Plan patients, use the Vision Service Plan Savings Statement (for a sample statement, see Figure 6).
		F. Mason Smith, O.D.
	Other improvement suggestions from the experts
	•Create a take-home packet
	Give patients a portfolio and place their receipt and any other documentation from their visit inside. If they have purchased special lens options, provide educational materials on those items. Practices that want to provide a specialized portfolio can have some printed at a local printer; otherwise, many office supply stores carry generic folders that will do the trick.
	•Say “thank you”
	Thank patients for choosing the practice for their eye care and eyewear needs and verbally re-emphasize the value of the eyewear choices the patient has made, if any.

At the end of such a visit to an optometrist's office, patients will feel they have gotten real value for their money, obtained useful information, and, above all, feel they have been well taken care of. The concluding article of this series will discuss how to continue that feeling through product delivery and how to maintain those positive feelings through ongoing communication.