PRACTICE MANAGEMENT
Thar's Gold in Them Thar Files!

Here's a cheap yet effective way of building patient volume in your practice. Just reach out to your long-lost patients.

by Gary S. Gerber, O.D., Westwood, N.J.

When you want to in-crease your patient base, the first thing you might think of is to let your fingers do the walking. Most optometrists do. They typically advertise in the Yellow Pages, or local newspaper, radio and even direct mail. Yet, when you calculate the cost of one of these conventional forms of marketing, you could be spending up to quadruple what it costs to bring a former patient through the door. That's a lot of gold!

Doctors often ask me in my seminars, "What's the single best way to get more patients to walk through my door?" My answer never wavers: Take care of the ones you already have. There's a veritable gold mine in your patients' files, and you should take advantage of this resource.

Here's how you can mine those inactive patient files for gold and  save costs by breaking that expensive, and often ineffective, impulse to let your fingers do the walking. It's a process I've also called "farming" because it involves plowing through your old files and finding seeds that can grow into active patients.

What's a Patient Worth?
When you see a typical patient for an examination and a pair of glasses, how much is that patient worth to your practice? $100? $250?

My research shows that even if you're the worst doctor in the world, 20 percent of your patients will still refer someone to you. So, if you're currently getting a referral rate of 20 percent, don't get too excited. You get that just for showing up.

Similarly, in most U.S. markets, a patient stays with his or her O.D. an average of eight years. So, that patient is actually worth at least six to 10 times what they spend on their first visit. I call this concept the "Residual Value of a Patient," or RVP.

You have to stop thinking of how much a patient will spend in your office on any given exam day, and start thinking in terms of what that patient is worth to your practice over the course of his lifetime.

Sowing the Seeds
There's one particular favorite "farming" project of mine that I've dubbed, "Resurrecting Dead Patients." For example, if your practice is more than 10 years old, you may already have a stack of so-called "dead files" for patients who haven't returned for many years. We all know that a lot has changed in optometry over the past decade, but it's likely these patients don't know that.

New contact lens products and modalities, your TPA certification, dry eye treatments, nutritional supplements, diagnostic technologies, and even new managed-care plans are all things your "lapsed" patients might not have a clue about.

Have employees pull these inactive charts and start calling these patients. A phone call works infinitely better than a letter, and is much more personal. Offer these patients something they're not likely to get elsewhere, such as a discount or free service. Why offer something for nothing, especially to a patient who hasn't returned in a long time? Bear in mind that once you've reactivated this patient, he'll be back in the fold. You may need to go through 20 charts before you hit on one that applies to the current promotion you're offering, but the payoff is usually worth the effort.

Read the Script
When your employee calls a patient, have him or her open the conversation with something like this: "We'd like to reintroduce you to our office and bring you up to date on all that's changed in eye care since we last saw you." Then the employee can follow through with your promotional offer.

Always remember to leave that person with a piece of new information helpful to them: anti-reflective coating for spectacles, daily disposables for contact lens wearers or new medications for glaucoma patients. Once you've made a few calls and recaptured a few patients, you'll understand how powerful this technique can be.

I also recommend rewarding employees with a bonus for the number of patients they succeed in reactivating. This might add to your cost, but it's still much less expensive than external advertising. If office space or phone lines are limited, consider hiring someone to make calls from their home.

Instead of a "global" farming effort like the one I've just de-scribed, you can cherry-pick certain charts to increase your odds of success. For example, pull old files of patients who dropped out of contact lenses because they had problems with lens deposits. Offer them a free consultation to see if daily disposables are right for them. Similarly, offer dry eye patients a free consultation to see if punctal occlusion will work.

Call patients with high cylindrical corrections and discuss what's new with soft toric lenses. And your bifocal wearers might be interested in learning about the new progressive addition lenses. Indeed, if you go through these charts, you'll probably find something new to offer almost every patient.

There's also a good chance that patients might have stopped coming to you because you weren't on their health plan. Over time, patients change jobs and sign on to new insurance plans. Make sure your callers have a list of all your current health plans and can explain how these plans work. Many of these patients might now be with a plan you carry.

Surf the Net
Ten years ago, few patients were on the Internet or had e-mail access. Today, many do, and you can use that to your advantage. A number of free web sites list e-mail ad-dresses just by typing in a name, city and state. Research your own patients and start building a database. E-mail these patients and direct them to your web page. Other than labor costs, this technique is essentially free.

A word to the wise regarding e-mail, and any written communication, for that matter: Take care in phrasing your letter. Your correspondence should be informational, rather than advertorial. You don't want electronically savvy patients to think you're "spamming" them ("spam" is a term for junk e-mail). Focus your message on what's new in eye care: new contact lenses, diagnostic technologies, or that you comanage refractive surgery. The possibilities are endless.

Don't worry if patients don't respond immediately. It's like prospecting: You don't always strike gold right away. As with any marketing effort, consistency and repetitiveness are crucial to success.

Plan your e-mail messages in "threes." For example, compose one message and send it, and have two other contingency messages ready to go in subsequent months to those who haven't responded. Again, there's no outside cost to do this.

Hey, How Ya' Doin'?
Another approach, and perhaps the simplest and most effective way to get patients back into the fold, is to telephone them and check on how they're doing. Your staff can open with: "Dr. Jones hasn't seen you in a few years and was concerned about how you're doing." Since your callers will have charts in front of them, they can customize the calls by adding, "The doctor also wanted me to check and see how your invisible bifocals were working and if your blood pressure has been under control." Patients will appreciate the concern and personal touch.

Have your callers prepared to take notes. They'll start to track certain patterns about why these patients haven't returned. Typical reasons: inconvenient hours, personality conflicts with staff, changes in insurance coverage and dissatisfaction with a product. Very often patients simply feel they don't need to return because they "can see fine." Your caller can educate these patients that regular optometric care encompasses more than visual acuity. More importantly, use this as a wake-up call that perhaps you didn't educate these patients well enough in the first place about how important it is that they keep coming back. Then you can set to work on improving your and your staff's patient communication skills.

Often, one family member returns at regular intervals for eye care while the rest of the family doesn't. Target this person as your messenger to that family. Each afternoon have your staff draw up a list of those "messengers" who will be coming in the next day. Put together a personalized form letter with a list of each messenger's family members you haven't seen for some time. Give this letter and your business card to the messenger, together with a refrigerator magnet (if you have them), and ask him or her to deliver your eye care message to the family. Follow up in a few days with a phone call or e-mail.

These suggestions will not only help bring long-lost patients back to your practice, but you'll do it with little expense. Remember, it costs more to get a new patient in the door than it does to keep an existing one. So, when there's a slow day at the office, avoid the impulse to start advertising. Instead, start finding those golden nuggets in your inactive patient files.

Dr. Gerber is a practitioner, consultant and producer of The Power Practice Video Package and Eight Power Steps to Making your Practice Succeed! You can e-mail him at DrGerber@PowerPractice.com or call him at 1-800-867-9303.

Harvesting the Yield
Whether you call it farming or mining, bringing back long-lost patients really does pay off. Here's one example.

One client of mine was spending about $300 a month for Yellow Pages. For that, he was getting about three new patients a month—at a cost of about $100 a patient. So he tried the "farming" method.

He took that $300 and instead paid someone to weed through his old patient records for about 10 hours a week, call patients and offer them free exams. This generated about 400 calls a month; about one in 10 came into the office that first year.

The next year, this doctor retained about 82 percent of those lapsed patients who had come in the year before. That's about 32 additional patients a month vs. the three new patients a month his advertising brought in.