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What to Do When Your Patient Volume is Down

04/24/2019

From time to time, I’ll have a call that goes something like this: “Help!  My revenues are down, and I don’t know why!”

If this happens to you, it’s useful to remember that your collected gross revenue is a function of three variables, which we could express in a formula that looks something like this:

Collected Gross Revenue = # of Patients Seen x Revenue Per Patient Visit x Rate of Collections

In benchmark terms, you might think of patient counts as comprehensive exams and revenue per patient visit as revenue per comprehensive exam.

Let’s consider a couple of ways to triage the first issue: revenues are down because of decreased patient volume.  One of the most important things you should do is to explain why your practice achieved its results – good or bad.

Doctor Time is Down
Did you take a vacation last quarter?  Get injured and were unable to work?  In single-doctor practices, sometimes this is the simplest explanation for why revenues are down.

How to avoid this issue? Either hire a fill-in OD while you’re away, or just front- and back-load your patient load on either end of your vacation.

Recall Is Broken
It’s possible that something has gone wrong with your recall.  If you pre-appoint your patients, make sure your confirmation process starts early and doesn’t end until your patients actively affirm that they will make their appointments.

If you’re doing mail, email, or text recall, consider pairing that with phone calls to schedule annual exams for your existing patients.  Patients are the life-blood of your practice, and private practices are going to deliver the highest level of care to their patients.  Don’t be shy about asking your patients to come back.

New Competition
A big box retailer or corporate chain store has moved in next door.  Now what?

First off, you will have patients go dip their toes in the water. Most will come back sheepishly 18 months later and tell you how much better your practice is.  So, don’t panic.

Second, you’ll want to take this opportunity to refine your brand and be sure you’re differentiated from your competitors.  Articulate your standard of care and specialty services that your patients can’t get at the ‘new guy in town’.  And how the glasses you sell are higher quality and will have better fitment because of your opticians’ prowess.

And here’s a bit of counter-intuitive advice: if your new competitor has a low-cost strategy, raise your prices.  And then script out for your team all the ways an exam in your practice and the products you sell ARE better, charge more.

Negative Online Reviews
If you’re not keeping track of what’s being said about you online, start now. Read all reviews out loud in your staff meetings and debrief them with your team. What went right?  What can you and your team do better the next time.

Most new patients will strongly consider online feedback on a business before going, so this is mission critical.  And while you will get the occasional ‘crazy’ patient leaving an off-basis review, if you get consistently mediocre or negative feedback – hard as it is to admit it – the problem is probably your practice.  Always ask how you can put customer service ahead of ‘what’s convenient’ for you and your staff.

Patients First, Always
Fundamentally, a business that isn’t growing its customer base isn’t healthy.  Track your patient volume regularly and remember that the best way to keep your current patients and grow your practice is to deliver a uniquely friendly patient experience and just be kind.

Finance

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AUTHOR

IDOC Optometry - Color Bar
Nathan Hayes

Nathan Hayes

Nathan serves as IDOC’s Practice Finance Consultant and developed the unique 3-Year Growth Plan, as a benchmarking, planning and decision-making tool for ODs. He also writes and lectures on various practice management topics. Nathan graduated from Vanderbilt University in three years, with a degree in Spanish and a minor in mathematics. After graduating, he spent a year working abroad. During that time, he worked for two firms in San Jose, Costa Rica. He interned with Grupo Juridico de San Jose, working in environmental policy to protect a threatened parcel of land, then he worked as a project manager for a US-owned precision machining shop, Olympic Precision Machining. Nathan then spent 6 months working with street children and orphans in Mexico. Before getting into the healthcare industry, he was an Assistant Store Manager and completed the Corporate Training Program with Haverty's Furniture Company in Atlanta, GA. Nathan serves on the advisory board for the Hayes Center for Practice Excellence at the Southern College of Optometry.