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Bird’s-eye view: Use these golf tips to control your misses


How taking a holistic, tactical approach into process improvement can drive even the smallest of gains for your practice

Editor’s Note: Welcome to “Eye Catching: Let's Chat,” a blog series featuring contributions from members of the ophthalmic community. These blogs are an opportunity for ophthalmic bloggers to engage with readers with about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Donna Suter, president of Suter Consulting Group. The views expressed in these blogs are those of their respective contributors and do not represent the views of Ophthalmology Times or UBM Medica.

“The experience at Augusta National is all about controlling your misses.” That, and commentator observations about not being afraid to “drive the golf ball” allow me to develop a mental image of the winner even before the first round of play is complete.

The man who wears the coveted green jacket signifies a winner who can perform under pressure. Confidence and focus are as iconic in running a successful practice as they are in winning the Masters. It's synonymous with becoming a champion, and among the many different homilies about practice success, having a confident, purposeful execution of the basics stands as a cornerstone.


Controlling your misses

Each and every day you and your staff take a mission statement of caring for the health of your patients’ eyes. You improve vision with optical products and use your own personalities to recommend a continuum of care, along with the right spectacle or contact lens technology. As a golfer, I can tell you that a lack of confidence or nerves translates into a poorly struck ball –it just doesn’t perform IRL (in real life) as it does in my mind’s eye.

In practice management, use the phrase “It’s all about controlling your misses” as a reminder to take a holistic, tactical look at how successful practices use process improvement as their secret to practice success.


Cancellations and no-shows

It's the same in every practice: patients call with little or no warning, and suddenly your perfect day of seeing a good mix of patients turns into a nightmare. Controlling your misses (missed appointments) with confidence means everyone who picks up a ringing phone (not just the appointment scheduler) knows how to turn a no-show or cancellation into a rebook.

The conversation

The patient doesn’t know your process and will seldom volunteer information about his or her availability. Use your personality to connect with patient-centered comments and your empty day will quickly rally.

Patient: “This is Donna Suter and I can’t make my tomorrow appointment with the doctor.”

Employee: “Thank you for letting us know. I hope everything is OK.”


Seeking to understand

The relationship-oriented employee who is comfortable in asking if everything is OK did not just ask for the patient’s life history. He or she is seeking to understand in order to:

  • Multitask while the patient is talking and pull up the appointment scheduler.

  • Book an appointment using the software’s shortcuts.

  • Establish rapport with the patient and reinforce the habit of calling before missing an appointment.

Your employee now has control of the conversation ball and guides the patient back to the task at hand.

Employee:  “I understand why you called. Again, Donna (or the more formal Ms. Suter) thank you for calling. It is important you take time to take care of your eyes and I can rebook that appointment for tomorrow at 2:00 p.m.”



Tactical tip: invite the patient

Confidentially presuming the patient feels that eye healthcare is important and that the doctor offers the best in care leads to the natural response to rebook.

  • Offer first available.

  • Do not book out more than two calendar weeks.

So why is offering the patient an appointment within the next two weeks such a winning tactical tip?

  • Today’s consumer is so busy that he or she is more likely to cancel when rebooked further into the future. (This consumer research is validated by my observations as a practice management consultant and analysis of big data streams collected by automated add-ons that text or call patients to confirm appointments.)

  • The employee said that the appointment was important. When the employee does not offer another appointment he or she is undermining the importance of seeing the doctor as recommended. (Consumers either think your practice cares about the health or his or her eyes and always recommends a course of action that will preserve sight, prevent vision loss and improve acuity or the consumer thinks the practice is like the TV exposes that position healthcare providers as “just out for the money” and “milking managed care providers who run up my premium and out-of-pocket expenses.”

Congratulations, you have just controlled your miss. Offering the appointment confirms that your practice is “one of the good ones.” It also reinforces that the patient is making a wise choice; the time he or she will spend in your office is not a waste of time; and you and the staff care about the patient.

Relationship logic

The above relationship logic shared with your employees who are more right-brained than left validates your office procedure to reschedule cancellations.

Why task-oriented employees may think returning patient calls wastes time

Your task-oriented employees will think the patient encounter is a waste of time. (The only reason the employee with this mindset answered the phone is because a ringing phone is annoying.)

Truth. The detailed, task-oriented nature of today’s office environment mean that many of your employees will not make outbound calls to patients not keeping appointment and generally define patient conversations as a waste of time or a necessary evil that “slows them down.”


Don’t fault this mindset. Endless details, letters, phone calls, emails, and interruptions have us all wondering, “Will I ever get caught up?”

Learning and mastering the essential skill of gracefully taking control of patient conversations will help these task-oriented individuals feel less stressed and frazzled. Best of all, the practice will have a robust reschedule policy that allows everyone to move toward your mission statement of providing quality care.

The bottom-line takeaways that resonate with these left-brainers are as follows:

  • The bottleneck of making an outbound call to reschedule is eliminated.

  • A simple word pattern forms a strong foundation for success.

  • A 50% chance of rebooking the patient who called to cancel not only means a quieter telephone but allows hi or her to short-circuit conflict when other employees’ goals (a full schedule) to compete with theirs (a coworker that supports and can help with a side project.)

  • Bringing existing patients back for needed care means taking better care of existing patients. Congress recognizes this with its proposed pay-for-performance initiative, which looks closely at whether patients with glaucoma and diabetes, for instance, are seen at regular intervals.

The financial impact

The golfer who earned the right to wear that green jacket took home a purse of about $1.9 million. The amount of business lost as a result of ignored opportunities to reschedule patients depends on the mix of appointment types and how far out appointments are scheduled before the rebook/recall process kicks in.

At a general ophthalmology clinic that schedules appointments 6 months out, the number of recalls typically equals 30% of total visit volume. This means that more than 15% of annual demand for visits is lost to ignored opportunities to invite patients back to the practice.

The financial impact of losing 15% of demand for visits depends on how busy a clinic is. If doctors are fully utilized, with no empty slots expiring unused, and the clinic cannot hire additional doctors because of space constraints, there is no financial impact (although there is still the troubling problem of patients not returning for needed care).

On the other hand, if a clinic has enough empty appointment slots to handle all this extra business without adding staff, the impact to profits might be as high as 75% or more because a 1% change in revenues typically yields a 5% change in profits. Most clinics lie somewhere between these extremes.

A common saying in competitive sports is: “If you can’t handle the heat, stay away from the fire.”


But if you’re ready, train your staff to support your patient care efforts. Get in the tactical game and add confidence by repeated trainings and recording inbound calls.  There are few opportunities that offer a payback of this size for so little effort and time. Training can be completed in a few hours, and aside from some additional time to manage the process and watch the results, only employees who answer the phones are affected by the changes.

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