Many audiologists concentrate the preponderance of their resources and energy on searching for new patients, while often ignoring the opportunities that exist within their current patient base. Patient retention is vital to the success of any business. In an industry that grew a mere 2% in 2009, patient retention can be the silver bullet that a business needs to increase profitability.
According to Frederick Reichheld (2003), an expert in patient loyalty, a typical business loses 10-30% of their customers per year. While some patients leave an audiology practice because they relocate or pass away, the majority of them leave because of a perceived attitude of indifference. Feeling ignored when entering the office, being rushed through an appointment, leaving without having questions answered, or not having a problem solved in a timely manner may be sufficient to cause a patient to find a new audiologist. Since the cost for acquiring a new patient is almost five times more than that of retaining a current patient, it's critical to the profitability of a practice to maintain a strong relationship with a patient for as long as possible.
Developing a relationship with a patient may be the best way to maximize patient retention, and furthermore, patient satisfaction. Some evidence reveals that an overwhelming majority of consumers, slightly over 90%, make important purchasing decisions based upon relationships, and we have no reason to believe that hearing healthcare decisions are any different. Paul Wang (2010), an expert in database marketing, contends that there are two types of consumers - relationship consumers and transactional consumers.
"Relationship buyers are customers who like your products and services. They build a relationship with your employees and they think of your company as their primary supplier of your category. They do not want to be bothered to have to shop around every time they make a new purchase. They look for quality, good service, helpfulness, friendship and information. If you can supply these things, they will stick with you when your competition is on sale. If you have a new product, they will be the first to want to hear about it. However, transactional buyers base their purchasing decisions on price alone. They are willing to shop around for every purchase and actively compare prices. Loyalty is almost unknown to transactional buyers."
This information supports the idea that developing meaningful relationships with patients helps ensure the longtime success and viability of an audiology practice. Instead of focusing on how to increase the number of new patients, the focus should be on keeping current patients longer and getter more value from that relationship over a period of time. Gathering personal information about a patient's life and interests is key in developing a relationship, so take every opportunity to listen and gather information and record it in the patient file to refer to in the future.
Sergei Kochkin (2005) reported in his MarkeTrak study that 55% of patients will not repurchase a hearing aid solely based on the brand they had purchased before. Since there seems to be very little brand recognition or preference when it comes to technology, patients may associate audiology services with the provider and the brand created by the audiology practice. Therefore, a practice that focuses on capturing patient loyalty may not want to market to transactional buyers, but rather choose to focus on the patients who value exceptional service and the patient experience and those who are willing to pay for it. Therefore, advertising based upon price alone may be sending the wrong message to your target audience. Marketing messages should promote the unique brand of your organization rather than advertising a specific product.
A review of recent healthcare trends indicates that there is a growing interest in the value of the patient experience and how it affects patient satisfaction. The newfound attention is emerging in all facets of healthcare, even forcing physicians and hospitals to reexamine their traditional practices and provide a greater emphasis on the patient experience. A recent survey on the impact of the customer experience conducted by Harris Interactive (2010), a global market-research company, supported the idea that the patient experience is becoming more important as consumers continue to demand more from their service providers. A poll of 2,112 United States consumers (age 18 and older) concluded that:
- 87 percent will discontinue business with a company after a negative customer experience, which is an increase of 7 percentage points from 2007;
- 58 percent will "always or often" pay more for a better experience during a down economy;
- 84 percent of those polled will tell others about a bad customer experience, which is up 10 percentage points since last year.
A study conducted by Wong and his colleagues (2009) concluded that patient satisfaction ratings were influenced more by how a patient was treated than by the sound quality and intelligibility of the hearing devices.
The patient experience may even have the potential to affect future reimbursement rates in healthcare. In February of 2008, Blue Cross Blue Shield of Massachusetts (BCBSMA) announced that it was testing an innovative reimbursement approach to improve the quality of care for its members. They attempted to incentivize optimal patient outcomes by combining two kinds of reimbursement for physicians and other health care providers: a global, risk-adjusted, fixed payment per patient, with annual increases in line with inflation, and a performance-based incentive linked to nationally-recognized measures of quality, efficiency and patient experience. Spectrum Health, a major healthcare system in Michigan, is also attempting to develop a unique patient experience to capture a greater share of their market. An interactive Care Console designed to enhance patient communication has been installed at patients' bedsides. The system integrates medical information with customizable features that enable patients to learn more about their medical conditions, and it also serves as a tool to help patients follow recommended treatment plans.
First impressions are lasting ones, so care should be taken to ensure that a patient's first impression of the office is a favorable one. What a patient sees when entering the office can be perceived as an indicator of the level of care and service that will be provided in the practice. While "shabby chic" is a trendy form of decorating, it shouldn't be a term that patients use to describe the office. The waiting room should look and feel warm and inviting. Simple, inexpensive changes like a fresh coat of paint, especially in a warm color, can brighten an office and give it a fresh look. The furniture should be comfortable and easy for patients of all sizes and ages to get in and out of. Since many potential patients are elderly, plenty of parking spaces should be available as close to the front door as possible with appropriate handicap parking spaces per each state's regulation. Sound rooms should be equipped with ramps for wheelchairs. Assistive devices can be installed in the office so patients can actually experience the benefits of their use. Creature comforts such as flavored coffees, bottled water, and even freshly baked desserts can add a special touch to the patient experience that your practice provides.
The way a patient is greeted when they enter the office is a critical, and often underestimated, component of the patient experience. Never minimize the importance of a good and friendly receptionist as he or she can make or break a relationship with a patient. Patients should be greeted by name within seconds of arriving. Ongoing training for front desk personnel is essential to maintain the level of competence that is required to correctly answer patient's most commonly asked questions. Every member of the staff should ensure that the patient experience accommodates the specific needs, wants and expectations of a patient.
People dislike having to wait an excessive amount of time for their appointment to begin, especially if they are not kept informed as to the reason for the wait. Long wait times show a lack of respect for a patient's time. When running behind schedule, make sure the staff informs the patient of the reason for the wait when appropriate, apologizes for the delay and gives an estimated waiting time. The patient should be given the choice to reschedule when the wait becomes excessive.
When considering the value of the patient experience, audiologists should include the capability to demonstrate the benefits of better hearing in real-world environments in their practice environment. Patients who have lived with the gradual onset of hearing loss may have a difficult time understanding what it will be like to hear well again. Demonstrating the actual benefits of improved hearing can be a very effective way to convince a patient to do something proactive about their problem. Hearing loss occurs gradually over a long period of time, and patients really do not understand what they actually miss hearing. Discrimination testing presented at a normal listening level (45dB HTL) comparing a patient's ability to understand speech in the aided versus unaided condition can be an effective way of demonstrating hearing handicap and the potential benefits of amplification to a patient. In fact, including multi-media environments can be a possible way of actually evaluating a patient's potential performance in the real world, and the virtual fitting environments can be used to demonstrate to patients how technology can improve their ability to hear in a diverse group of listening situations.
Industry statistics indicate that approximately 60% of revenue in a typical practice is generated by current patients, so marketing to current patients is an appropriate way to increase revenue. Industry statistics indicate that patients replace their hearing aids on an average of every four to five years. Therefore, an adult patient may purchase hearing aids from you as often as five or six times during their lifetime. When a new technology is released, invite current patients to be part of a focus group that is the first to evaluate the new product. Plan upgrade programs for your patients at least twice a year, and consider offering financial incentives for your patients to trade in their older hearing aids for the benefits of better technology. While every patient may not be willing to invest additional financial resources in their hearing, experience consistently proves that patients want to hear better and many will upgrade to newer or better technology when given the opportunity. Your competition is consistently reaching out to your patients with information on new technology so you want to be the one that sends the word to your patients that you have the latest technology, and they should return to your practice when they want to hear better. Never underestimate a patient's ability to consume. Everyone wants to hear better.
A basic rule of thumb is to communicate with your patients at least four times a year. Whether it is an e-mail newsletter, monthly flier, a reminder card for an annual hearing evaluation or a holiday greeting card, reach out to your patients and let them know that you care and want them to come back. When patients are not happy with your business they usually will not complain directly to you. Instead, they will probably complain to just about everyone else they know and take their business to your competition next time. Take steps to ensure that patients are satisfied by making follow-up calls or mailing satisfaction questionnaires after the patient has visited your office.
According to a recent article by Don Marsh (2009), as few as 3% of tested-not-sold (TNS) prospects return to that same practice when they decide to purchase hearing aids, and 30% will eventually decide to buy elsewhere. As a result, it is important to follow up with TNS prospects immediately following the initial contact, with another contact 10 to 14 days after that, and then at 30-day intervals. Try to create a "speed bump" that will cause the patient to reconsider you and your practice. For instance, I read that someone sent a lottery ticket with a letter stating, "Take a chance on better hearing." The tactic isn't as important as the effort and letting the patient know that YOU want to be the one to help them with their hearing loss. TNS prospects have the greatest potential for adding value to your practice, so take some time to create targeted campaigns that will encourage these patients to return to you before they visit your competition.
Building patient loyalty will be easier to accomplish if you have a loyal workforce. It is important to retain the employees who interact with patients on a regular basis. Employees have the potential to build relationships with patients that keep them coming back for a lifetime. Make sure to appreciate good employees and reward them for being loyal to you and your organization. In addition, empower employees to make decisions that benefit patients and encourage them to solve problems or complaints as quickly as possible. Excuses such as, "That's the boss's policy", or "Sorry, I am not allowed to do that" may turn a patient away permanently.
While every patient should be treated with courtesy and respect, there may be some patients who actually deserve special treatment. Most of us can recall an experience with a patient who spent the least but expected the most and actually cost the business money. Identify the patients who have been the most supportive of the practice and possibly invested the most in the practice and consider offering them special treatment such as executive hours, no charge service on minor repairs, extended payment plans and/or trials on new products before they are released to the public.
Marketing efforts to attract new patients are unpredictable and expensive. However, happy patients are more than willing to tell their friends about you - if you ask them to. A patient referral program can be a time-efficient means to develop new business through your existing patients. While many practitioners focus on getting new patients, it may be the most difficult way to increase revenue. A formal patient referral program costs little to establish and is a good way to remind patients that they need to spread the word about the practice.
The more a patient knows about you and your accomplishments, the more they will see you as a professional they can trust. Let patients know when you or a member of your staff completes an educational course. The strategy for creating "patients for life" can be quite simple. When patients receive the best quality of care and feel like their hearing needs are being met and perceive that people in the practice really care about them, they are more likely to return to the practice for care in the future. While there is no such thing as a silver bullet when it comes to business, satisfied patients will stay loyal longer, talk favorably about the organization to others, pay less attention to the competition and are less likely to be price sensitive. It makes good business sense to concentrate on making every patient a patient for life. The task requires constant and consistent effort but the rewards will be worth that effort.
References
Harris, T. (2010). Harris Interactive. Retrieved September 2, 2010, from www.harrisinteractive.com
Kochkin, S. (2005). MarkeTrak VII: Consumer satisfaction with hearing instruments in the digital age. Hearing Journal. 58(9), 30-43.
Marsh, D. (2009). 10 Pathways to Marketing Success in Challenging Times. Hearing Review, 6(6), 32-34.
Reichheld, F. (2003). Loyalty Rules: How Today's Leaders Build Lasting Relationships. Boston: Harvard Business Press.
Robinson, J., Russ, D., & Siu, B. (2002). Effect of a multimedia fitting tool on final gain settings. Hearing Review, 9(3), 42-45.
Wang, P. (2010). Database Marketing Institute. Retrieved September 2, 2010, from www.dbmarketing.com/about/paul-wang/.
Wong, L.L.N., Hickson, L., & McPherson, B. (2009). Satisfaction with hearing aids: A consumer research perspective. International Journal of Audiology, 48(7), 405-427.
