Asking the Right Questions Leads to Patient Retention

by Melissa Neill and Andrea Goodall

Before reading further, take a moment and think about a store you visit regularly, a family physician you never stray from, or a dentist you always refer to a friend. What keeps you going back? Is it the way they treat you when you go in for an appointment? Or maybe it’s what happens between appointments?

In general, health-related businesses thrive by acquiring new patients and retaining current ones. Dental care providers are no exception. All too often, however, efforts are directed at generating new inquiries that convert to new patients. It is important that dentists focus on current patients because understanding their needs is just as important — they can be advocates for your business and provide a steady stream of referrals and revenue.

Often, patient-focused businesses believe they understand patients and intuitively know how to communicate with them to maintain a meaningful relationship. What one thinks one knows, and what one actually knows, however, does not always align.

Where is the best place to start? One Minneapolis, Minn.–based dental practice with multiple locations — we’ll call him “Dentist X” — conducted a survey of current and lapsed patients to see why some patients stayed and why others moved to another provider. What follows is a simple example process for assessing and addressing patient retention for your business, similar to the process used by Dentist X.

Getting ready
First, there’s preparatory work. It starts with an internal brainstorming meeting, including all individuals with a patient touch point — i.e., doctors, front office staff, assistants, hygienists, and even accounting or billing representatives. Keeping this group small will help with moving decisions along. Appoint a facilitator or consider an outside resource to lead this session for an objective perspective.

This session is a conversation about current patient retention efforts, types of patient communication, goals for retaining patients, and desired outcomes of a survey. Things to talk about include:

1. How do we believe patients perceive us?
2. How well do we communicate with our patients? What kind of communication do we use? How often do we communicate between appointments?
3. What is the patient experience like?
4. What is our current patient retention status? What are our goals for patient retention?
5. What information would we like to gather from a survey?
6. How will this information work to help us retain patients? How will we use this information?

This is not an exhaustive list, but will help guide an initial discussion. For example, Dentist X wanted patients’ feedback regarding their experience with the dentist, the hygienist, and how welcome they felt overall when they arrived. He also wanted information on how much insurance influenced patients’ longevity with the practice.Following this discussion, review current and past efforts to retain patients; look at patient communication pieces including newsletters, appointment reminder voice mails, e-mails or cards; and review industry and competitive patient retention practices to help with question development (i.e., does this particular communication piece serve its purpose?).Creating the list and surveyWith a brainstorming session complete, background information gathered, and a clear idea of what a survey should accomplish, the next step is creating the survey. To start, look at your current and lapsed list of patients. If your practice is small, survey everyone. For a larger practice, the list should consist of enough participants to make data representative of current patients. While 1,000 to 1,500 respondents are necessary for a statistically valid sample of the entire United States, fewer are needed for a regional sampling. The Minneapolis practice had lists of thousands of current and lapsed patients, and set a goal of securing 100 total respondents. Look at the size of your practice and isolate what you believe is a sufficient number of patients to survey. Keep in mind that not all patients are willing to participate, so a larger list than the target number of respondents is important. Ultimately, you will need enough consistent feedback from your survey to implement changes in the way you run your practice, if needed.Next, develop the questions. Each question should help gather information to accomplish the initial survey objective. The best surveys include questions that can be answered on a scale of one to five, with a few open-ended questions. A sample one-to-five question may be: “On a scale of one to five, with one being ‘needs improvement’ and five being ‘extremely useful,’ how would you rate the content of our monthly newsletters?” An open-ended follow-up question might be: “What type of topics would you like to read about in our monthly newsletters?”Dentist X asked the following survey question:
I want you to rate the following on a scale of 1-5 in terms of how important they are to you regarding dental care where 1 means it is of no importance; 2 means it is of little importance; 3 means it is important; 4 means it is somewhat important; and 5 means it is very important:
• Evening office hours
• Weekend office hours
• Availability of appointments
• Length of appointments
• Convenience to work (or school)
• Convenience to home
• Insurance You can develop your own questions, or consider an advertising or public relations agency that is versed in survey question development to help determine if your questions will elicit responses so you can gather the information you need.Launching the surveyHow a survey is conducted depends on available information. Do you have e-mail addresses or just phone numbers for patients? Both methods have advantages and disadvantages.While the primary advantage of conducting surveys online is the relatively low cost for the quantity, some consider another advantage to be that it is less intrusive and respondents can complete the survey at their convenience. Don’t let this be an excuse to leave the survey active for months. A safe time limit is two weeks. A friendly second reminder after the first week will always encourage additional responses. Telephone is typically a more expensive option, but allows interviewers to probe and gather more in-depth information. This type of survey can cost upwards of $25,000 to capture 100 patient interviews. Don’t underestimate the time required for telephone surveys. Securing willing participants can take weeks or even months.For each method, several resources are available, all with different cost considerations. Survey Monkey and Zoomerang offer free basic versions and are often used by survey experts. Several market research firms offer telephone and online services for a fee. The intent of the survey should help guide the number of participants as well as the method used. Reviewing the survey resultsFollowing a survey, the most important aspect is review. Look for trends in information to determine the effectiveness of patient-retention efforts. Then, use insights to determine next steps — how information will be used to enhance patient communications and their experience in your practice.Most important to note, though, is that a survey is not done once, used for a period of time to determine necessary improvements, and then forgotten. To be effective, insights need to be measured on a regular basis to determine changes in attitudes and behavior. Dentist X based his survey questions on a previous questionnaire on patient satisfaction, wanting to explore how satisfaction and retention are linked.If your organization has never done a patient survey before, the first survey will be a starting point. Depending on budget, resources and usage, surveys should be conducted every one to five years. Just remember not to significantly change the questions. Keeping it consistent will allow you to see the changes in attitudes over time.Surveys are an easy and cost-effective way to learn more about current patients. They are more than just gauging satisfaction — a patient can be satisfied and not return. Insights gleaned from a survey will help you determine why patients stay or lapse, and put an action plan in place to retain more patients. Melissa Neill is an account supervisor at Risdall McKinney Public Relations, an integrated public relations firm located in the Twin Cities. Neill works on a variety of health-care and consumer-facing accounts. E-mail Neill at [email protected] or visit the company’s Web site at www.risdallmckinneypr.com.Andrea Goodall is an account supervisor at Risdall McKinney Public Relations, an integrated public relations firm located in the Twin Cities. Goodall has worked on several health-care accounts, including current work with “Dentist X.” E-mail Goodall at [email protected].