Rating Patients: ODs Voice Mixed Feelings
How do you define a true problem patient?
The next time your receptionist says, "Guess who’s in the waiting room complaining about their glasses?”
If the correct name rolls off your tongue without thinking, they might be a problem patient!
How Do ODs Feel About Rating Patients?
The concept is hardly original to me. Airlines and hotel chains rate you with frequent flyer programs. Even your labs and frame companies do it.
You’ll have to decide for yourself if the idea makes sense for your practice. Here is what some of your colleagues had to say:
Comments From ODs
While most respondents said they did not currently rate patients, they were open to the idea. Here were four key points offered by readers:
• Don’t rate patients solely on how much they spend. Take good and bad behavior into consideration. You might consider a system to rate both areas.
• One advantage of a rating system is that it could alert new employees to patients who might warrant special attention.
• One disadvantage of a rating system is that it could bias employees against patients that don’t have a high rating.
• Be careful not to make comments or use codes that could be used against you in a court of law.
Quotes From Readers
Dear Jerry,
I like the idea and have often thought about it. How much a given patient spends is only one consideration.
It would also be nice to know those who have been rude, missed appointments and problem patients versus those who have been accommodating, easy to deal with and a joy to have in the office.
Frederick T. Heller OD, FAAO
Dear Dr. Hayes,
Ratings are a way for a new employee, or one being cross-trained, to recognize those patients who are valuable assets to the practice.
As you know, it pays to take care of those who take care of you.
Regards,
Steve Tonge
Dr. Hayes,
We don’t currently use this technique, but I like the idea and would consider doing it in the future.
I wouldn’t rate patients on how much they spend, just on good or bad behavior.
James B. Mayer, OD, FCOVD
Dr. Hayes,
No formal system; I suspect having this info attached to a patient's record is a danger in a potential court case.
The Eye Center
Dear Jerry,
By no means is it formal in our office. It's all on the basis of who that patient is.
For instance, I have great friends who don't spend much at my practice but, I'd go the extra mile for them as well as a big spending patient.
In essence, I value each for what they bring to my practice… both in money and in character.
Robert Haws, OD
Dear Dr. Hayes,
My staff and I were recently discussing this very topic. How can a doctor deny he would not have his staff stay late for an individual who spends $5000.00 or more a year on care in your office?
But, what about the patient who complains to you that he cannot see well with the glasses he purchased at the local discount store?
We thought about creating a field on the patient’s pertinent information page that simply say ‘A’ ‘B’ ‘C’.
This does not mean we would treat the ‘C’ patient with less than excellent care. What it does mean is that there are few exceptions made or policies changed for the ‘C’ patient.
Dr. D
Dr. Hayes,
Because our office is small and we know many of our patients by name, we do go out of our way for our more loyal patients.
Conversely, we don't give prime appointment slots to patients who have a history of not showing up.
The practice of going the extra mile for our best patients just makes good business sense. We do not give poor or rude service to any of our patients, even if they have a history of creating problems.
Thanks, TS, OD
Dear Jerry,
We just started rating patients in 2009. It’s helpful, as I did not realize how many patients don’t purchase the eyewear I recommend.
Patients change their mind from exam room to optical, especially when money becomes an issue.
We hope to offer programs for our A/B patients in the future to build more of them.
Love the Blog! RR
Dr. Hayes,
This is a very intriguing idea. I think we would all like to say we treat everyone the same, but I’m sure that’s not always the case.
I feel that my staff and I give all new patients the “Royal Treatment” on the assumption they would allow us to be their total eye care and eyewear provider.
I have never thought about an actual rating system for chart notation, though. One point on the negative side might be having a new staff member prejudge the patient based on a poor rating.
I am sure there have been times where a patient has missed an appointment or taken their prescription a time or two and eventually came in and made a significant purchase. Had we not given them a second chance at the “Royal Treatment” we may have been the losers.
Maybe we should just rate the above average patients to make sure they are afforded the extra perks?
Rick Gilliam, OD
Hey Jerry,
Although I never trained my staff to do this, they figured it our on their own.
A quick look at a patient’s ledger — and it only takes a few clicks — can make those “gray area” decisions easy. We also track appointment no shows. Those are a real nuisance!
One very, very important item that just won’t work when “grading” a problem patient is that you can’t always track who they know, or who they’re related to. You could lose a whole family by not treating the black sheep well.
Dr. Hayes,
We don’t currently use this technique, but I like the idea and would consider doing it in the future.
I feel the best way to do this should include more than how much they spend in the office, but also include:
• How easy they are to work with
• How many people they refer
• How many family members they have and do they see us
• How often they visit us
• And also have a wild card, say for things such as personal friend, person of prominence (mayor, school nurse etc.).
Add the points up or weigh each question and then categorize them. Integration into our PMS of this would be great.
ODs need to think more in this direction or they/we will suffer. I suspect all docs do this to some degree, they just don't put a number in print.
Hi Jerry,
We do not deliver any different standard of care between any class of patients.
In thinking about the question, I look at how much a patient spends in our office just as another behavior that needs to be taken into account in order to service the patient properly.
Some patients require different treatment than others, like engineers or a person from different cultures. I think with any person who spends a lot of money in our office, or anywhere in the free market, there is going to be an expectation of better customer service.
If you accept a variety of insurance plans where patients will come to your office that have different access and attitudes about how much they will spend on eyewear, then grading patients will only help you deliver better service to each patient.
If you have developed a niche, then you have already sorted out many of those issues and have little issues with patient diversity or spending habits.
Steve
Dr. Hayes,
There is not a formal rating system in our office. That being said, each patient leaves an impression on me and on my staff. These impressions reflect how we behave toward the patient.
The results may not be so much economical as a true connection to those who are loyal and grateful for our services versus those who view our practice as an outlet for outrageous demand.
Perhaps this declaration is only the result of metacognition as I am sure that we all do this to a larger or lesser degree; it is human nature. I like the idea of a formal system and can see how identifying our ideal clients can help the business financially and emotionally.
Shaune
Agree with this blog? Disagree? Have a comment or question of your own? Click here to send me an e-mail.
Disclaimer: The information and opinions contained on this site are for discussion purposes only and are NOT intended to serve as legal, accounting or investment advice. ©2009 Jerry Hayes, OD. Not to be reproduced without written permission of the author.
Back To Top
We use to use tab codes to
We use to use tab codes to code patients. We use TAB products and used the following:
1. Every three letters of the alphabet uses a different color file to make it easy to find files.
2. Every file label has last name, first name and middle initial (since we have multiple patients with the same name), their office ph, cell ph, and home ph...we use to put their SS # on the file, but do not do so any longer
3. We used three sets of number codes on the edge of the file
a. one number to tell us whose patient they are
b. one number to tell us what patient type (insurance, private, hi-mid-
or low end...what they asked for)
c. type of patient (SV, BF, NL, CL, LSK, GLA, etc)
While this did give staff a heads up on who was coming in, it also was a detriment since staff would learn who to see and who to "pawn off" on the other employees.
We are doing better by not rating patients and just trying to do what is best for each patient every time in fulfilling their needs and desires...which changes over time. Never brand a patient or you will never meet all their needs.
I think when it comes down to
I think when it comes down to it, shouldn't every patient be treated the same. I realize some are buying products, and this comes into the retail arena as far as "customers" but ultimately they are all our patients. And we all long ago took an oath to take care of those patients, no matter their faults, issues, attitudes or financial status.
I hate when patients no-show, cancel at the last minute or show up late. I also hate when patients take their glasses prescription with them and only use my services. However, if I consistently give excellent care, no matter how much they spend, how nice the patients are, or who they are, my office will have a reputation of perfection in service. This will carry out in the future, and if someones status changes, I will be there ready for them.
Ultimately, rating patients will feel just as bad to them as it does when they rate us. Yes, I love to have a good rating, but, if I just visited an office, bought a value package frame for my kids and myself, since that was all I could afford, should I be either not rated or rated poorly? Remember what affect this system can have on those we dont rate, its possible that many more will take offense than those that we positively affect with our good ratings.