Fix This Practice
Improving Recall Efficiency
Don't settle for low recall percentages; take these steps to increase them.
By Richard Kattouf, O.D.

Q: For years I had no idea how many patients responded to our recall system. So for 6 months, I tracked our recall efficiency and found that it was only 15% to 20%. What can I do to improve this?    

- Dr. A. L. Sorowski

A: Dr. Sorowski, without knowing your recall efficiency calculations, your figure is typical for what my management companies have calculated for optometry in general by gathering recall data from hundreds of offices.

For starters

Recall efficiency is the percent of patients who respond to recall notification in the time frame that your office requests. Postcard, letter or computer-generated mail-outs are examples of standard recall methods. However, these methods have a low recall efficiency.

But before we talk about recall methods, there's something you should know -- patients who wear visual aids (i.e., contact lenses or spectacles) seek the care of their eyecare practitioners every 2.9 years. (My firms came up with this number after surveying patients in several different offices. I've also seen similar numbers in the literature.) The reason for this horrible statistic is that we don't educate our patients about the importance of eye exams as a preventive health evaluation.

If you educate, they will come

Dentistry has done a wonderful job of educating the masses that dental visits are both medical and preventive. Eyecare patients have the following attitude: "My glasses or contact lenses work fine, so I'll notify you when I experience blur."

So why is it that dentistry enjoys such a high recall efficiency (70%) and,at best, the eyecare industry's is 20%? Can we attribute this solely to patient education? The answer is that dentistry, with the aid of the toothpaste companies, has succeeded in educating the American public about preventive dental care. Ophthalmic professionals, their associates and suppliers haven't taken on this task.

There's no evidence to support any such educational venture in the future. It is, therefore, the obligation of each eyecare professional to educate, motivate and make patients enthusiastic about their experiences during their examinations. Accomplish this, and you'll see an improvement in your recall rates.

Tips for taking charge

For O.D.s and M.D.s to achieve at least a 60% recall efficiency, the following steps are critical:

• pre-appoint patients
• offer proper intra-office education (medical scripting) to staff
• offer staff training about office language and proper attitude regarding preventive eye care
• use a checks-and-balances system to ensure staff implementation.

Case in point

Dr. Wells called my company complaining about a decline in gross income and a slow decline in net income. Also, his recall efficiency was only 12%.

I performed an on-site consultation for Dr. Wells in which I dedicated the first part of the visit to a 4-hour business meeting with him. At this time, I mapped out the direction that my consulting program would take to stimulate gross and net income in his practice.

Getting to work

During our business meeting, Dr. Wells described his office protocol from the moment a patient entered the office to the time he left. I realized that his office ignored all four of the critical points that I mentioned earlier. In observing him and his staff in action, I noted that their level of care was fine, but they didn't educate, motivate and influence enthusiasm in patients.

I asked Dr. Wells and his staff to visualize the patients they serviced that morning. Did they leave the office thinking they just left a preventive medical exam, or a visit that simply led to a contact lens or spectacle fitting? Unanimously, the staff answered, "The visit was all about spectacles or contact lenses."

Implementing change

I explained to Dr. Wells and his staff that, carried out correctly, pre-appointing shows patients how much you care about them, but that it doesn't work without proper intra-office education. I instructed them to explain the following three points to the patient each time any of them performed a procedure:

1. What you're doing to him.
2. Why you're doing it to him.
3. Why you perform this procedure annually.

I developed scripts for all of their procedures and methods that made it simple for Dr. Wells to ensure that all of these new changes were implemented.

One year after my consulting, the new system exhibited tremendous changes:

• Recall efficiency jumped from 12% to 60%.
• Gross income increased by more than $100,000.
• Net income increased by 7%.
• Patient perceptions changed -- they realized that they were in the office for preventive medical care.

Many ophthalmic professionals tell me that they've attempted some of these measures with no success and much frustration. The key word in this paragraph is some. To increase recall efficiency, doctors and staff must focus on all four points.

Details and diligence

Modern-day management requires a detailed method followed by tremendous awareness. Without diligence, though, you won't be successful with any management method. 

DR. KATTOUF IS IN PRIVATE PRACTICE IN WARREN, OHIO, AND HE'S PRESIDENT AND FOUNDER OF TWO MANAGEMENT AND CONSULTING COMPANIES. FOR INFORMATION, CALL (800) 745-EYES OR E-MAIL HIM AT ADVANCEDEYECARE@HOTMAIL.COM. THE INFORMATION IN THIS COLUMN IS BASED ON ACTUAL CONSULTING CASE FILES.