STRATEGIC SKILL BUILDERS: Continuing Educations
BRANDING YOUR PRACTICE
Achieving Patient Retention
How you can use modern business practices to develop long-lasting patient relationships and a strong image for your practice.
By Peter G. Shaw-McMinn, O.D., Riverside, Calif.

We're in the business of eyecare, and just as anyone who runs a business, we must take stock in our greatest assets to help ensure our future success.

In our "business" the most valuable assets we have are our practice identity, our patients and our staff. How these factors interplay form the cornerstone of every successful service-oriented business.

If asked, how would you answer the following two questions?

1. How do your patients view your practice overall?
2. Is your practice the Cadillac of eye care -- or something else?

Here, I'll explore the optometric practice wholly from a business standpoint and discuss how you can strengthen your practice and reach a new level of success, including:

• developing a strong practice identity (branding)

• reinforcing your brand through cohesive staff interactions.

• developing stronger patient relationships to solidify the brand.

BUILDING LOYALTY WITH A PRACTICE BRAND

A practice brand is the "trust" you create between your patients and your practice. The experience is enhanced by interactions with staff.

A brand consists of pricing policies, quality of service and products dispensed, staff interactions with patients and the overall appearance of the office and equipment.

The value of a brand is how successfully you differentiate your services from the competition.

W. David Sullins, Jr., O.D., F.A.A.O., of Athens, Tenn., past president of the American Optometric Association, found his niche developing a strong practice brand.

"The best way we found to build our practice was focusing on children. Interestingly enough, we're now recommitting that interest in infant eye care and have developed the program Operation Bright Start.

"We learned that nationally 86% of children receive no eye care of any kind when they enter the first grade. We've agreed to provide eye care to infants in their first year of life without charge for our services.

"We feel we must introduce parents and grandparents to eyecare as a most important part of infant and child development. Parents and grandparents naturally follow the lead of their infants and children."

CONSISTENT MESSAGE

When marketing your brand, a name, logo, slogan or other mechanism can help you enhance your message. Various media including signs, print (brochures, letterhead, newsletters), visual symbols, staff uniforms and mass media help establish and reinforce your practice's brand. To get your message across as you intend, make it uniform throughout all media used.

What you want your practice to represent becomes the "promise" you intend to deliver to patients. To gain the most benefit from a brand identity, patients should highly value this "promise," and it should be unique from your competitors and compatible with your practice's capabilities and strengths.

CREATING YOUR PRACTICE BRAND

The first step in building a strong brand identity is finding your own answers to the following questions:

• What's important to patients in selecting an eyecare professional?

• How do patients compare different doctors?

• What's most important to patients about obtaining eye care?

• What eyecare benefits do patients value the most?

MOMENTS OF TRUTH

Your biggest goal will be to determine how you want patients to perceive your practice. One concept you can use is the "moment of truth" analysis suggested in the late 1980s by Jan Carlson, former CEO of Scandinavian Airlines.

The moment of truth concept describes critical encounter points within a practice that can influence patients' impressions. You can tilt these moments in your favor when you've identified and defined what you think is the ideal outcome.

Carlson estimated that at Scandinavian Airlines there were 50 million moments of truth -- the annual number of passenger and employee interactions.

How many moments can you identify in a typical patient visit?

Start by analyzing the patient office visit cycle from start to finish.

• It begins when the patient first calls for an appointment. What's your staff's attitude on the telephone? Does your receptionist make a positive first impression by being kind, sincere and helpful? Can the patient "hear" her smiling during their conversation? How long before the phone is typically answered? How long are callers on hold?
  If you find that your office receives an inordinate number of calls from patients waiting for glasses or contact lenses, your staff might suggest it would save time to send patients postcards or phone them when products are ready.

• When the patient arrives. Does your staff greet a patient within 30 seconds, or does a patient wait 2 to 4 minutes at the front desk before he's acknowledged? Does your staff create a caring atmosphere by addressing the patient by name? How user-friendly is your reception area? Are all of the office policies and forms explained to avoid possible misunderstandings about insurance coverage?

• The wait. When the patient waits more than 15 minutes, do you give a free lottery ticket with a comment such as "Thanks for your pa-tience . . . maybe thanks a million"?

• Is this area spotless, modern and updated with appropriate reading materials and informative signs pertaining to patient well-being?

• The exam. After the patient is escorted to the exam room, is infection control emphasized? Does a staffer wipe surfaces with a disinfectant? When you enter the exam room, do you first wash your hands in view of the patient to reinforce infection control?

• The end of the visit. When you've completed the case summary presentation, how are billing procedures explained? Before leaving, does the patient get a re-appointment with a proper explanation?

During this patient encounter, several significant "moments of truth" present opportunities for you to reinforce your practice.

For example, critical moments occur when you present case findings, make recommendations and present the patient to a staffer for eyewear dispensing.

These moments signify when the patient encounter transforms from a service-oriented to a product-oriented experience -- an encounter that could result in negative consequences to the practice and to revenue if it's not handled properly.

That's where your staff comes in. They can make the moments of truth good or bad for your practice. You need them all to work with you to establish your practice brand and leave lasting good impressions on your patients.

CREATING A WINNING TEAM

Once you've determined your practice brand and pinpointed critical encounter points during the patient visit, you need to get your staff on board with the message you want to send to patients.

However, finding the right people for your team is a growing challenge. Arguably, the number-one complaint by optometrists today is finding competent, loyal staff.

In the words of Dr. Denise Howard, of Bloomington, Indiana,

"My success has been a result of my investment in a great staff and up-to-date technology. I hire the friendliest, nicest people I can find even if they have no healthcare or optical experience. Good people can learn skills, but you can't do much to change difficult personalities."

Successful large companies can teach us a lot about how to apply the concepts of teamwork and purpose. Before you dismiss the thought of your office having similar characteristics of a big business, keep in mind that a big business's success has been achieved by dividing the company into teams ranging from five to 10 members. Optimal group size, in most studies, is seven."

HIGH-PERFORMANCE TEAMS

A team is a group of people working together to achieve a common goal or business objective; in this case, the objective is patient retention. Research has shown that high-performance teams share certain characteristics:

• They share a common vision and purpose. Successful team members have a shared vision that translates into specific goals and objectives. They know what they're doing and why it's important.
  I once asked one of my receptionists, "What's your job? What do you hope to do here?" I expected her to say, "Answer the phone, make appointments, greet patients," but she surprised me by saying, "My job is to get patients to like me. I don't believe I'm just a receptionist. I'm more than that."
  She understood the importance of patients bonding with her. Now her job is to make our patients as comfortable as possible in the office and get them to like all of us. Her title is now patient manager.

• They communicate openly and honestly. They say what they think and respect the right of others to have different views. Open and honest communication provides caring feedback, which enables everyone to learn and improve.

• They show trust and mutual respect. When preparing to write this article, I asked my staff what they thought about team building. They said that one reason they work well as a team is that they genuinely like each other.
  Then they said that being friends isn't necessary for working well as a team -- respect for each other and each another's abilities is most important. They explained that they thought either myself or the office manager is responsible for assuring that each team member knows enough about the others to allow the respect to develop.

LEADERSHIP SHARED

Your role as the formal leader is to coach and mentor the group. A coach works tirelessly to free the team from needless restrictions on performance.

But your team needs to share common goals, and all team members must take responsibility for the team's effectiveness.

To help your staff become a more cohesive team, ask each one to complete the Practice Brand Identity exercise. Do they agree that you're conveying the image you thought to patients? If not, discuss how you can become more consistent as a practice in projecting your image.

Ask each staff member to identify "moments of truth" and describe how to use them to convey your brand to the patient. For example:

• Does the staffer who's pre-testing explain the reason for the tests and relate them to procedures planned for future examinations?

• Do you explain what you're doing during the eye examination and relate it to annual eye exams?

• Does the receptionist explain the recall purpose and procedure?

• Does the optician discuss the life-expectancy of products and the need to return for adjustments?

Remember to analyze why patients leave your practice and give a report during your office meetings. Use the findings from this report to help you and the team set objectives to improve the practice.

Most importantly, don't forget to reward the team.

YOUR TOP PATIENTS

Once you have identified your practice brand, and you have a good team in place, turn your sights toward developing stronger patient relationships.

First, though, remember that not all patient relationships are equal. The most valuable patient in any service-oriented business is one who offers greater potential revenue and profit by returning more often and exhibiting greater loyalty.

Consumer research shows that the top 30% of customers contribute 70% of revenue, while the bottom 30% contribute just 3%. These "select" patients from the top group are more likely to recommend your practice to others, cost less to maintain and are willing to pay premium fees recognizing the benefits your services offer.

Many practices direct the majority of their attention towards attracting new patients at the expense of fostering heightened relationships with current patients. The risk of this strategy is known as the 'leaking bucket' effect, where current patients abandon the practice due to inadequate ongoing communication with the practice.

Keep in mind: The number-one influence on choosing a healthcare provider is recommendations from family and friends.

DOCTOR-PATIENT MARKETING BONDS

In the world of marketing, bonding relationships are categorized into three levels.

• Level one. Referred to as "frequency or retention" marketing, it only uses financial incentive to strengthen the relationship. Price cutting, such as special short term sales or the buy one get one free (BOGO) tactic, are the methods of choice. However, this approach offers only limited short-term advantages over the competition.
  It may drive revenue up in the short term, but it won't create a lasting bond with your practice. Also, this is the easiest marketing strategy for competitors to copy.

• Level two. This is a more developed relationship that adds a social bond by personalizing patient communications and stressing the concept of the "patient as a person," rather than a uniform message to all patients.
  Marketing tactics commonly emphasize staying in touch with patients through various communication media and learning the specific needs of targeted groups.
  Once you've established this type of relationship, patients will be more forgiving of problems, giving you the chance to rectify them before they abandon the practice.
  Dr. Craig Hisaka of Stockton, Calif., calls this making the human bond before the business bond. During the patient history he learns about the patient as a person, keeping notes about what the patient does and doesn't like, what's important to him, etc.
  He records this information in the "green book," which he reviews before each patient encounter. He re-bonds with patients by asking about their golf game or how their Scottish terrier Winston is doing. Patients are impressed by and appreciate this caring individualistic approach.

• Level three. This level is characterized by a structural bond formed as a component of the service delivery process, rather than evolving from personal relationships or business strategies.
  You can achieve this level by providing patients with services not offered by your competitors. Often, these are technology related.
  Internet and database marketing can enhance level three patient relationships. Market your Web site and e-mail address every chance you have. Send occasional Internet communications or newsletters.
  For the eyecare setting, ocular health e-letters, online illustrated eyewear and contact lens ordering are all forms of level three marketing that could offer competitive advantages.

MAKING IT ALL COME TOGETHER

We all face a range of growing competitive pressures, but these outside influences don't need to have an adverse affect on us. If we're sending the right message to patients, then it shouldn't matter.

Develop a strong practice brand, get your staff on board to help efficiently and uniformly reinforce it, and work on developing stronger patient relationships to create a winning formula. 

Dr. Shaw-McMinn is in private practice in southern California. He's also an assistant professor at the Southern California College of Optometry. Along with Dr. Gary Moss, Dr. Shaw-McMinn is co-author of the new book Eyecare Business: Marketing and Strategy. You can contact him at shawmc@inland.net.