Managing Your Practice

Four pillars of a successful practice: 1. Keep your current patients happy

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The cost of maintaining an existing customer is one-fifth the cost of acquiring a new one. Here are a few easy, inexpensive strategies to ensure patient satisfaction and loyalty.


The medical landscape has changed. No one is quite certain what the future will hold. One thing we do know: 20 million more Americans, half of them women, will enter the health-care system in the very near future, as the Affordable Care Act continues to unfold. This flood of new patients will affect nearly every ObGyn practice in the country because we lack an adequate increase in the number of physicians to care for them. In the meantime, what can you do to ensure the continued success of your practice? This series focuses on four key areas. I call them the “four pillars”:

  • Keep existing patients happy
  • Attract new patients
  • Nurture relationships with your medical colleagues and other health-care providers, such as physician assistants and nurse practitioners
  • Maintain the morale of your staff.

No pillar is more important than the others; all four are necessary to guarantee success.

It is more cost-effective to keep an existing customer than to attract
a new one

In this article, I explain why it is vital to ensure that every patient has a positive experience of your practice, from the moment they make their first telephone call for an appointment, through their wait in the reception area, to the moment they are seen by the staff or the physician, and beyond—when they tell others about their stellar experience.

It’s nice to get new patients, but it is more important to keep the ones you already have. In most professions and businesses, the cost of keeping an established customer is one-fifth the cost of acquiring a new one. Medical practices are no exception. If you are not doing a good job with the patients you already have, spending thousands of dollars on a marketing plan to bring in new patients is pointless. The patients you have right now are the backbone of your practice.

Give your practice a checkup

Look at your practice from your patients’ perspective

Today, it is critical to know the needs and expectations of your patients and referring physicians. The best way to do this is to ask your patients what they think, which also will reveal your practice’s strengths and weaknesses. This information can be obtained easily by surveying patients about various aspects of your practice. (Even practices that are full or closed need to evaluate their services periodically and listen to their patients. Changes always occur, and the cup may not “runneth over” forever.)

Tom Peters, the nationally renowned author of In Search of Excellence, has described two keys to success in business:

  • Find out what the customer (patient) wants and give him or her more of it
  • Find out what the customer (patient) does not want and be sure to avoid it.

Techniques to gather the patient’s perspective

There are five effective techniques for determining how patients perceive your practice and for evaluating your performance and reputation:

  • Conduct personal interviews
  • Conduct patient surveys
  • Create a focus group
  • Use a suggestion box
  • Commission evaluation by a mystery shopper.

Although I have used all five techniques, my favorite and most cost-effective involves a survey card that is given to every patient on every office visit (FIGURE 1). The card is given to the patient when she checks in, and she can complete it in the reception area or exam room and return it to the receptionist before leaving the practice. The cards are reviewed by a nurse, who addresses positive and negative comments. Most negative comments are addressed with a phone call. If necessary, I respond to the patient’s complaint.

FIGURE 1: Patient survey card

There is another benefit to the survey card. The flip side of the card prompts the patient to write down the three questions she would like you to address on her current visit to the office (FIGURE 2). Conducting the appointment according to these concerns can help keep patients from initiating a last-minute discussion, often after you have closed the chart or electronic medical record, that you don’t have time to address adequately. Since my office has implemented use of this survey card, we seldom get follow-up phone calls from patients about issues they forgot to ask about. The survey card demonstrates that we are listening to the patient and want to be certain that all her questions have been answered at the time of her office visit.


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