The single biggest problem with communication is the illusion that it has taken place.
— George Bernard Shaw
A CRITICAL COMPONENT OF having satisfied patients is good communication. We use specialized software to keep everyone on the same page, even to the point of overcommunicating. Otherwise, a patient can have a very different recollection of a conversation than the doctor or refractive counselor might.
During the COVID pandemic, we started having virtual consultations with our patients. Because we found it so useful, we’ve continued to do so. These consultations occur both before and after an operation.
In the past, patients would hear about us and have to pick up the phone and connect with our refractive counselor. They would have a conversation and then book a visit to see the doctor and undergo appropriate preoperative testing to determine the vision correction solution for which they were best suited. However, almost half of them just wouldn’t come in or would reschedule several times before seeing us.
During the pandemic, people didn’t want to come in, so we began using a telemedicine platform—doxy.me —which allowed us to offer in-person visits with our counselor virtually. With this system, the patients don’t have to download anything, and there’s no signup.
It’s Very Simple
Patients can select a timeslot for the refractive counselor to visit with them. The counselor sends a text message to the patient’s phone, and all the patient has to do is click on a link in that text message, and he or she is immediately brought into our virtual waiting room. For the initial online consult, the patient and refractive counselor routinely will have a 20- to 30-minute conversation about all the different options—custom lens replacement, blended vision LASIK, maybe the new Vuity drop from Allergan—all the possibilities.
From this consultation, the counselor is able to place patients into categories based on their ages and what they use glasses and contacts for right now vs how much they want to use glasses after surgery. For example when a 55-year-old comes in and says, “Hey, when I take off my glasses, I can’t see anything, far away or up close,” our counselor knows that’s a patient who’s going to need a custom lens replacement. However, if a patient is 43 and says he or she can see pretty well up close after taking off his or her glasses, maybe that’s a blended vision LASIK patient, so the patient goes into that category.
Stronger Engagement From Video
As we started doing these consultations, we found that patients that chose the virtual visit were much more likely to come in for their in-person examination by the surgeon. We believe this difference is due to the face-to-face interaction you get on video that you do not get on a phone call. There’s a little more buy-in; patients get a better sense of my refractive counselor’s personality, and because of that, they seem to be more likely to keep their in-person visit. This process has been very helpful for us, especially as we continue to experience great growth in refractive surgery since the pandemic.
Teleconferencing is much more personal than a phone call. You can see someone’s face and read their nonverbal cues, and you can see them smile and laugh. And they’re not wearing a mask. No one really did video meetings before the pandemic; it was seen as a difficult thing to do. Now, we all do them routinely, and it’s a much better way to have that additional online consultation – really the triaging that our counselors need to do.
Moreover, teleconferencing gives our counselor visual cues as well, just from seeing patients in their homes, what’s in the background, and how they behave. Do they seem to be mild mannered and easy going, or are they perhaps more type A? Another wonderful benefit is that the patient’s spouse or other loved one will routinely participate in the visit. On a phone call, it’s rare that another person would be listening in. But since it’s video, and they’re right there in the living room or kitchen, oftentimes they hop on. And nearly 100% of these patients come in because now you have the whole family engaged.
Postop Day 1
We also use doxy.me to do virtual 1-day postop visits. Our LASIK patients who don’t want to return the next day can choose an in-person video consult the day after, which spares them that 1-day postop visit.
Following surgery, we follow up with our patients with patient engagement software from Experity Health. We like to capture our happy patients and direct them to social media so they can talk about our presbyopia-correction solutions and bring in more patients. We also reach out to our less happy patients to see what we can do to help.
The Experity system sends out a text message to patients when they leave my office, asking them to rank their experience with us on a 1-10 scale. Anyone who ranks us with an 8, 9, or 10 is considered a “promoter.” These people are immediately sent a message asking them to please share their positive experience, and the message includes a link, to a Google review page, a Facebook review page, or whatever social media channel we want to boost that month.
This process is very helpful and works well. In the past, you could ask a patient for a review, but it wasn’t a simple process, so almost no one would do it. But with this system, approximately 35% of our patients now take the time to leave us a review.
We know that word of mouth is still king as a way to let others know of our services, especially for refractive surgery. So the Experity system gives us an opportunity to capture these happiest patients and makes it really simple for them to leave feedback and reviews online to amplify their voice.
In contrast, if patients score the experience as a 6 or less, they are considered “detractors.” In this case, a message goes straight to my manager, who reaches out to the patient. This process allows us to get to them before they get to social media.
This matters because it’s no longer that unhappy patients tell 2 or 3 people. With social media, they can easily tell everyone they know. Therefore, it’s critical, especially with vision correction patients, who are paying a lot of money out of pocket, that you capture those unhappy patients and talk to them. And 9 times out of 10, there is something you can do for them to make them happier.
Often, the very act of reaching out to patients makes them happy, letting them know someone’s actually paying attention and cares about them. Usually, the dissatisfaction was something simple like the wait time or that the prescription that the doctor sent in was not at the pharmacy when the patient went to pick it up.
Then, there are a few patients who didn’t fully understand their preoperative counseling, so their expectations weren’t met. For those people, I’ll get a text message of what they said, and I’ll reach out to them personally. Most of the time, a personal phone call from the physician and a willingness to see them that day, or the very next day, provide the opportunity to re-explain what the expectations are and what normal healing is, as well as anything else that needs to be discussed. Doing so elevates the level of communication and lets the patient know someone is listening and someone cares. ■