By Daniel J. Vargovick, OD
April 4, 2018
Improving the recall of all patients is essential to providing good care and increasing profitability, but it’s especially important when the patient has been diagnosed with an eye disease. I’ve found that a key to practice success is ensuring my medical eyecare patients understand the importance of returning for care, and follow through on doing it.
Effectively recalling medical eyecare patients is essential because doing so aids patient compliance. By ensuring you see the patient back as planned, you lessen the chances of a lapse in the patient’s treatment plan, and a threat to the patient’s eye health and vision.
My practice, which I sold last year, is a large, two-doctor practice, practicing full-scope primary care optometry with a significant glaucoma population for the past 40 years. I continue to practice part-time.
A Two-Tiered Recall System
Over the years, my recall system has evolved considerably. I inherited a paper system from the previous owner, using 3 x 5 cards, filed in a drawer chronologically per month to mail a generic postcard. Now, it is more complex with checks and balances to more thoroughly notify and document the process, with two distinct systems, one for standard exam recalls and one for medical patient recalls, which require a higher level of care and documentation.
The standard recall system utilizes our practice management software, OfficeMate. When the patient checks out, the software is updated and the patient receives a postcard in a year notifying them they are due for their annual exam.
We developed a more robust system for medical recalls to both ensure patients get the proper procedures for their condition, and also to help our office run most efficiently. For example, when we monitor patients for glaucoma, they require specific tests at certain intervals for their best care and insurance compliance.
We schedule these tests at specific times during the day to efficiently manage patient flow, helping both patients and our team optimize time spent. This is where pre-appointing these medical patients is key, allowing us to achieve a much higher return rate, better staff efficiency and the ability to monitor and document no-shows. This last part is crucial at providing sight-saving treatment, as well as protecting the practice in our increasingly litigious society.
Higher Stakes When Medical Eyecare Patient Doesn’t Return
An important question I would ask anyone involved in medical eyecare: When a patient you are treating for a potentially blinding condition does not show up for their appointment, how are you tracking this to be able to get in touch with that patient, and how are you documenting this in the event the patient denies you informed them they could go blind? This is important because there is nothing more important than our patient’s vision, but also for the health of our practice.
When a patient doesn’t show up for a medical exam, or medical test, it is documented per our process. Then they receive a personal phone call to reschedule. If they cannot be reached, a letter is sent. If no reply, another letter is sent. These steps are all documented in their OfficeMate chart. I never wanted to be in a situation where a patient lost vision and would be able to say “why didn’t you tell me I had a problem?” Our unique process ensures that doesn’t happen, and double checks for success.
We send out standard recall cards for the previous 1-5 year anniversary of their visit. As is typical, the more time elapses, the less chance of that person returning (although some patients return even 4-5 years out because of an insurance change). It probably ranges from 10-50 percent return, depending on how many years.
Conversely, our medical recall rate is extremely high, closer to 90 percent, due to the pre-appointing required when these patients check out (described above).
Doctor Educates on Importance of Returning
After every exam, it is the doctor’s responsibility to recommend when the patient should return based on the standard of care. For a typical patient, it can be as simple as saying, “I recommend you come back in one year, even if you’re seeing OK, to make sure your eyes continue to stay healthy.” Talking about recall (in addition to documenting it) is important, so patients can ask questions and we can advise patients if they need HMO referrals for upcoming appointments.
A shortcoming of some recalls systems that work without doctor input is that patients (and the software) often confuse an eye-emergency appointment with a wellness appointment, and reset the recall clock. This level of automation can be costly as it pushes out a patient’s return. Our process ensures a patient’s wellness visit is kept on track, even if we see them in the interim for an eye issue.
Include Promotional Offer When Recalling Patients
In addition to wording that explains the importance of annual eye exams, our customizable recall card informs patients of monthly promotions that encourage patients to come in. For example, we will notify them of new frame brands carried, a trunk show happening, or a second-pair promotion.
The patient should understand from the doctor’s and staff’s education why it’s important to return for every visit the doctor recommends, but a promotional offer can give them the added push that’s needed to make an appointment.