Moving on: The road ahead

In most cases, the conclusion we come to is that we need to make changes to guide us forward and to prevent us from making the same mistakes. What happens if we have no idea what happened to us-or did we miss the point of the lesson? Realizations are great as long as you are attuned to them and get the message.

Let's use this example. Over the past year, we all have experienced a decrease in patient loads. Because of that, some offices have been forced to take the unpleasant step of either reducing staff or enforcing furloughs to reduce the cost of staff hours.

The hard lesson is that volume is down because the United States had a 10% to 14% unemployment rate in 2009. People are not going to the doctor, especially for new glasses. They are making do with the old pair.

Instead of looking for lessons, I have spent a lot of time dealing with realizations. Realizations are more subtle. They sneak up on you when you don't expect them. They are not hammered home in lesson form.

I'd like to share some of these realizations. Maybe you will recognize them as your own.

1. Patient complaints are up. As a clinical services manager, part of my job is to work with patients when they have a complaint.

Patients realize that they are a hot commodity now, and they are voicing their concerns over poor "quality" of care. Not poor care, but poor quality of care.

These complaints start with poor bedside manner, poor listening skills, and number one: the doctor did not spend any time with me. They didn't pay attention to me.

2. Patient care is a business. In the past, HMOs and hospitals spent a great deal of time and money training their staff in customer service. Many of us old timers were incensed at the thought that patients were being categorized as customers. Patients weren't a business, they were people (patients) to be cared for. Well, that utopia is long gone.

Your patients ARE consumers. They are shopping and marketing your practice every time they have a poor experience in your practice. If you aren't paying attention to patients when they do come in your door, they will find someone who will.

Increase your budgets and advertising focus? How you treat your patient is the message that that patient will share with others. If it was an unhappy experience, no amount of advertising is going to change that.

The next time a patient transfers care to you, ask the technician that spent 20 minutes with the patient why the patient decided to change from the last doctor to you. Patients aren't going to tell you why they changed, but they will give the tech an earful. Use the information to make sure you are not behaving in the same way.

3. Educate patients. Patients cannot come to your office for an eye exam because they cannot afford new glasses. That's why you wanted to see them yearly. Right? Wrong.

You wanted to see them because they have diabetes and need to be followed routinely. It's not about selling them glasses (sure, at some point it eventually is) but that is not what you want your patients thinking is the sole reason you see them.

They think the reason you want to see them is to make money. You need to be talking to them about their eyes, the course of action you and they will be taking, and when you want to see them again, not when you need to see them again. Seems like a play on words, want versus need? Not to your patient.

4. Patients are paying their bills . . . $20 a month. We sat down and looked at our patient billing trends. We were concerned that due to the poor economy, potentially patients were not paying their bills. But, overall, what we found was that patients were paying their bills . . . just $20 a month! This caused us to have to re-bill them more often.

Looking back, some realizations appear crystal clear when just 6 months ago we couldn't see them at all.

The following quote has been attributed to many people, but I remember it being said best by George Burns:

"When it comes to the future, there are three kinds of people: those who let it happen, those who make it happen, and those who wonder what happened."

If you spend all your time focusing on the past, you will never get to the future. Use your realizations wisely, and move on.

Dianna Graves, COMT, BS Ed, is clinical services manager at St. Paul Eye Clinic PA, in Woodbury, MN. Graves is a graduate of the School of Ophthalmic Medical Technology, St. Paul, MN, and has been a member of its teaching faculty since 1983. She can be reached at dgraves@stpauleye.com
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