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Optometry and the law of reciprocity: does it really exist?


Doctor: Would you like to order your contacts today, Mrs. Smith?

Mrs. Smith: That’s OK.  I’ll just take the prescription and get them online.

What happened here?  You just did a thorough, high-tech eye exam on Mrs. Smith, addressed all her complaints, answered all her questions, and then without hesitation she informs you that she will be taking her business elsewhere.  Let’s rewind 20 minutes and see if there’s anything we could have done to elicit a different response.

In the book Influence: The Psychology of Persuasion, Robert Cialdini takes an insightful look at the power of persuasion and what causes people to say yes (or no) to what you are offering.  According to Dr. Cialdini, one of the most potent weapons of influence is reciprocity.  Reciprocity refers to responding to a positive action with another positive action. In other words, when somebody does something nice for us, we feel an obligation to return the gesture.

Some of the experiments involved offering someone a soft drink and then later asking the recipient to buy raffle tickets. The subjects who were offered the drink bought twice as many raffle tickets as the control subjects that were not offered a drink. In another experiment, tips increased significantly at a restaurant when the waitress left a complimentary mint with the bill. Tips increased even further when two mints were left.

Some ”acts of kindness” we might offer our patients:

  •  Offer to clean and adjust glasses for people who are just browsing
  •  Gift box with free solution, cleaning towels, etc.
  •  In-office coupons or discounts
  •  Free brochures and literature
  •  Starbucks gift cards
  •  Free Wi-Fi
  •  Complimentary coffee
  •  Give eye related toys to the little ones
  •  Walk an elderly patient to his/her car

It’s important to discern that while there is a strong cultural pressure to reciprocate a gift, there is no such pressure to purchase an unwanted commercial product.  Although we give a great deal to our patients, if our presentation communicates standard operating procedure instead of selfless generosity, our patients will see it that way also.  If our patients don’t perceive our actions as altruistic, from a social behavioral standpoint there exists no perceived obligation on their part to reciprocate.  I’m not suggesting anybody take this approach for strictly self-serving reasons.  If you approach this with exploitative motives, your patients will likely see through the facade and turn away.  While the law of reciprocity can be exploited and used to manipulate, you probably won’t find long-term success in that approach.  As health care providers, we routinely give to our patients in a spirit of altruism for the same reason we became optometrists: we like to help others.

Is there anything wrong with giving with no expectation of receiving anything in return …and the recipient responds by giving back?  I don’t think so.  I think this exchange appeals to the positive side of human nature. If you take this approach, maybe next time the previous exchange will go something like this:

Doctor: Would you like to order your contacts today Mrs. Smith?

Mrs. Smith: Sure. That would be great.


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Steve Vargo

Steve Vargo

Steve Vargo, OD, MBA is a 1998 graduate of Illinois College of Optometry. After working in clinical optometric practice for several years, Dr. Vargo pursued his passion for practice management by earning his Masters of Business Administration (MBA) degree from the University of Phoenix in 2008. A published author and speaker with 15 years of clinical experience, he serves as IDOC’s Optometric Practice Management Consultant. Dr. Vargo advises optometric alliance members in all areas of practice management and optometric office operations.