November 2018


To the point: simple practice tune-ups for complex times
How to boost and improve each patient’s experience

by John B. Pinto and Corinne Wohl, MHSA, COE

“Southwest Airlines is successful because the company understands it’s a customer service company that just happens to be an airline.”
—Harvey Mackay

Few patients have a background allowing them to gauge the objective quality of the eye care they receive. But every one of your patients is a perfect instrument when it comes to measuring the caring and value they receive from your practice. They know “20/happy” when they get it.
Although doctors are at the heart of providing ophthalmic care, your management team is the front line for assuring a high level of customer satisfaction.
Here’s a quick assessment you can take to determine how your managers—and the overall practice enterprise—are doing in fostering patient contentment. Below are 20 activities and attributes that help to drive higher levels of patient satisfaction. Rank each on a 0 to 5 scale (where “0” means your practice does this poorly or not at all, and “5” means your practice excels at this.)

___ 1. We have formally designated a member of our practice to be in charge of monitoring and improving each patient’s experience during his/her visit with our practice. (This can be the administrator, a department head, or a provider.)

___ 2. We have agreed on and written out the hallmarks of what we think it means to deliver an excellent experience for patients, including such things as maximum waiting and total visit time, addressing each patient’s chief complaint specifically, making sure the patient leaves knowing what he/she should do next about any medical condition, etc.

___ 3. In our practice, we consider a complaining patient an early warning sign of something we could be doing better because we know that for every patient who complains about something there are probably many who suffer in silence.

___ 4. We have a formal, written process for logging and responding to patient complaints. Once a problem has been logged, a manager or the practice administrator has to formally “close the case” and sign off that the patient’s concerns have been appropriately addressed.

___ 5. Our practice has training materials for teaching both staff and providers how to provide a more caring, patient-friendly environment and how to respond to everything from minor grumbles to major service mishaps.

___ 6. Our administrator and mid-level managers receive ongoing, specific training not only on customer care, but on how to train staff on the elements of providing superior customer service. We “train the trainers” so that our customer service mission is constantly improving for the better.

___ 7. During staff meetings we often bring up examples of good and poor customer service, so that our team over time develops widely understood standards for patient care and caring.

___ 8. At the time of our annual staff and doctor performance reviews, each member of our practice is graded (among other things) on their sensitivity to and success at providing each patient with a great experience in our practice. If the performance score is low, we initiate remedial training and subsequent oversight.

___ 9. We manage patient expectations so that they match what we can reasonably deliver. An example would be to tell a patient at check-in if the practice is running on time, or advising a new surgical consult patient that their appointment will involve extra testing that will be more time consuming.

___ 10. During the course of a patient’s visit to our office, we ask a lot of “checking in” questions: “Do you have any special needs or questions during today’s visit?” “Are you comfortable?” “Do you have any questions about what I have just described?” “Before we wrap up today do you have any final questions for me?”

___ 11. Because we know it is sometimes uncomfortable to have an eye exam, and some patients are especially apprehensive, we work hard to comfort and soothe anxieties. We do this by things such as our tone of voice, not rushing, and letting patients know ahead of time when something uncomfortable (a bright light or needle stick) is about to happen.

___ 12. We formally measure and report on patient satisfaction. (There are numerous ways to do this: written surveys, phone surveys, focus groups.) We track our progress over time, and have agreed on an objective, minimum score that we work to consistently exceed.

___ 13. Our administrator routinely gets up from his/her desk and walks the clinic floor, first to directly observe and assure that the practice is running smoothly and second to engage patients in a friendly conversation about how their visit is going. An example (spoken to a patient in the sub-wait/dilating areas) is: “Hi, I’m Anita, the practice’s administrator. How are we doing for you today? Is there anything we could improve today or on future visits?”

___ 14. The first staff that most patients meet are our operators and receptionists. Because these workers set the tone for how the rest of the visit will go, we hire and train for exceptional warmth and friendliness in these roles. We only pick staff who can be cheerful to the grumpiest people over and over again throughout the day.

___ 15. Because patients spend more time with technical staff than with any other workers in the practice, the head technician is our most vigilant customer satisfaction monitor. He/she questions techs and scribes closely for any evidence of service gaps, adverse patient-doctor interaction, a lack of gentle treatment or a kind word.

___ 16. We know that for most patients, their chief complaint in the clinic is not “dry eye” or “blurry vision,” but “excess waiting time.” Accordingly, managers in each department conduct regular time studies and have not-to-exceed standards their team needs to hit.

___ 17. We observe the basics of being a good host to our visitors: a scrupulously clean facility, enough space and seating so that everyone is comfortably accommodated, handicapped patient access, refreshments, calming background music, and interesting reading material to help pass the time.

___ 18. In addition to paying attention to complaints, we listen carefully to patient compliments, and use these to better understand what patients like and how we can deliver more of that.

___ 19. One of the most important traits we look for when hiring new staff and doctors is their friendliness and empathy for the feelings of our patients. We can teach anyone how to answer the phone or run a visual field, but it’s hard to teach someone how to like people and serve them in a manner that leaves them delighted with the care they received.

___ 20. We briskly remove or reassign staff who are not patient-friendly. In addition to knowing how to consistently perform the technical components of their job, every staff member needs to know how to delight patients. We have dismissed staff who complete their core job functions well but who didn’t meet our standards of customer care.

The maximum potential score on this is 100 points. Add up your practice’s score. Note any especially weak areas for priority attention. Hold a group discussion with your management team.
Remember that a patient’s level of satisfaction is simply the comparison between their expectations and their experience. In all service sectors, customer expectations are rising, at the same time that your patients have the ability to very publicly score their perception of the service you provide. In addition, third-party payers commonly make their panel decisions as much on patient complaints as they do on adverse utilization or outcomes. In an increasingly transparent and judgmental world, managers are as much a determinant of practice success as the surgeons they serve.

About the authors

Mr. Pinto is president of J. Pinto & Associates Inc., an ophthalmic practice management consulting firm in San Diego. His latest ASCRS•ASOA books, Simple: The Inner Game of Ophthalmic Practice Success, and the fifth edition of John Pinto’s Little Green Book of Ophthalmology, are now available at He can be contacted at or 619-223-2233.

Ms. Wohl is president of C. Wohl & Associates Inc., a practice management consulting firm. She earned her Masters of Health Services Administration degree at George Washington University and has more than 30 years of hospital and physician practice management experience. She can be contacted at or 609-410-2932.  

How to boost and improve each patient’s experience How to boost and improve each patient’s experience
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