Patient Pay, Patient Wait and the Customer Experience

As the cost of health care from the patient perspective increases, so will patients’ expectations of their providers. Out-of-pocket expenses have always been a point of contention in the health care industry, and this tension only increases as the field of health care takes a more dominant stance in what we talk about each and every day. Patients are very aware of how they are treated at every step of their journey through the doctor’s office, and they are expecting more from their experience as their personal costs continue to rise.1

Waiting is inevitable in eye care. Efforts should be made to turn “wait times” into something else entirely.

One of the key measures of patient satisfaction in the health care sphere is how long a patient’s wait time is before seeing his or her provider. Patients often cite their wait time as a measure of the quality of care and overall satisfaction they feel while in the doctor’s office. A recent study by Michael McMullen, MD, and Peter Netland, MD, PhD,2 correlation between the amount of wait time and patient satisfaction. In fact, the study authors found that satisfaction with the amount of time spent waiting was the strongest driver of overall satisfaction. This is keen insight into the minds of our changing consumer.

Patients are now paying more than ever for even simple things such as X-rays, routine exams, and follow-up care. Even if the visit is not associated in any way with an elective offering, they are paying more. Therefore, their consumer-like preferences will be even more acute. In addition, patient customers report that their strongest consumer-like preference is to “not wait.” With this in mind, it is helpful to look at your clinic environment through the lens of the patient and create for them an experience that can satisfy this key driver.

Setting Standards for a Better Customer Experience

Waiting is inevitable in eye care. Efforts should be made to turn “wait times” into something else entirely.

You can begin this review the same way a patient might come in contact with your health care system. First, evaluate your phone standards:

  • How long does it take before someone picks up when you call your own office?
  • How many dropped calls or calls where the patient hangs up before you answer do you have?
  • How many total calls do you receive a day?
  • Is there a call center you rollover to when the heightened call volumes occur?
  • What is your standard number of rings?

Many practices use a phone prompting, or a phone tree, system that can frustrate the patient customer. Although having one of these systems may allow for more modest staffing expense, it typically starts the relationship on a bad note. These systems are difficult to navigate, programmed too quickly, not revisited, and often lead to dead ends, where the caller is placed in the back of the queue or disconnected altogether.

After you have reviewed the standards of your phone team during the call, it is important to review the standards your team has before and after the call. Many practices believe that when the phone is hung up, the responsibility of the phone team is finished. Not so. Days and weeks before the patient customer appears in your office, it is nice to make a reminder call, pre-visit contact, to reiterate what was discussed on the phone, review any questions that may have arisen during the patient’s exploration of your offerings, and/or review any remaining materials or doctors’ instructions in preparation for his or her upcoming exam. It is also important to ask patients about their concerns regarding the exam.

This reminder call also serves as an opportunity to remind folks to bring a loved one or family member along to their visit. This can help the patient-customer to not only have a good experience but also properly make their educated decision while with the provider in your office.

The Day of the Examination

Now, it’s the day of the examination. Everything needs to be thought through, from how patients arrive at your center to how they’re escorted back into the diagnostic area after the check-in process. Let’s begin with how patients arrive. Every effort should be made to make this process as smooth as possible. Maps, GPS, radio signals, call-ahead reminders, and texts should be used to help patients feel like they’re on the right track when traveling to your practice. In the northern states, one of the number-one patient concerns during the winter months is road conditions. Patients worry about the drive to the center, if the sidewalks will be icy, and whether they can find a parking spot close to the front doors of your practice. While designing for the optimal customer experience in health care, heated sidewalks might be something worth considering if you live in a region that has inclement weather.

Customer experience: the welcome area

Words are important: use “atrium,” “welcome area,” or “lobby” instead of “waiting area.”

There is nothing more powerful than the first impression. The first time the patient-customer walks into your office or clinic will leave a lasting impression as to how he or she feels about your offering. Be very, very picky about what you allow on your walls and how you design your atrium space. (Notice I did not say waiting room. Words are important, so the terms atrium, welcome area, or lobby should be used instead of waiting area.)

Explain the process

Once it is time to have measurements taken of the inside and outside of your eye, the clinical team or technicians should be mindful not to use jargon that might leave patients wondering what is going on. Rather than simply doing advanced diagnostics, it is important to explain to patients what is happening at each stage of the process. We use a simple method of laminated sheets to articulate the three major points of any advanced diagnostic. With these sheets, whenever we’re doing a test, team members can explain the highlights of the technology being used, and this ensures that everything is explained in roughly the same way to each patient.

These first few stages and ideas only cover the first few areas of the customer experience in ophthalmology. We all know that there is a lot more to be done after the diagnostic work is complete. We still need to take the patient to the exam room, explain his or her surgery options, counsel the patient, and discuss different payment options. Finally, we need to cover what happens between when the patient leaves the office and later returns for surgery.

1. Bouchard S. Patient payment responsibility increases. Healthcare Finance News. June 11, 2013. Available at: Accessed March 21, 2013.

2. McMullen M, Netland P. Wait time as a driver of overall patient satisfaction. Clin Ophthalmol. 2013;7:1655-1660.

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