Do Your Patients Come Back? Part 1

Do Your Patients Come Back? Would You Know When They Don’t?

I am a data nut. I analyze data. I can tell a physician where they are losing money within 10 minutes of looking at their procedure reports. I can tell them where they are failing to provide comprehensive care. The number one reason for lost revenue across all specialties: Patients not returning.

The main reasons patents don’t come back include:

1. Patients never schedule their return appointments.
2. Patients don’t understand why they need to return and therefore do not return.
3. Lack of recall campaigns.
4. Patients cancel their appointments.

How Many of the Following Scenarios Happen at Your Office?

(I guarantee it is more often than you think)

• Mrs. Jones comes in to see you for an appointment. She is in a hurry. You, as a physician, tell her to return to the clinic in two weeks. She goes to the checkout desk and sees a line, so she decides she will call later and make an appointment but never does.
• Mrs. Smith comes in for an appointment. The doctor tells her to come back in if she is not feeling better in a couple of weeks. In a couple of weeks, she feels a little bit better, so she doesn’t know if she should come back or not.
• Mr. Johnson is told to return to the clinic in one month. He doesn’t hear you and goes to the checkout desk. The receptionist does not know when he needs to return, and neither does he. So, they both assume it is not needed.
• Mr. Lee knows he owes money, but he forgot his wallet, so he sneaks out and never pays or schedules a return appointment.
• Mr. Beck is doing better now, and the physician tells him to come back PRN. Mr. Beck has no idea what this means.
• Mr. Call is a diabetic and comes in for a yearly exam. Mr. Call does not want to schedule a year out, so he says he will call you later. He never does.

How Can You Encourage Patients to Schedule Return Appointments?

1. Set Protocols

When a patient comes in for heel pain, wound care, an ingrown toenail, surgery, etc., you need to have mandated protocols that allow your entire staff to know when to have a patient return. If the doctor forgets to tell the patient or write it down, the receptionist or MA should know when to have the patient return. There should be no running around to find the doctor or just assuming the patient does not need a return appointment.

If a patient comes in with a wound, the receptionist should know to schedule once-a-week appointments for the next four weeks and an appointment in 31 days to refill their wound care supplies. If you have set wound care protocols, your receptionist already knows that these five appointments must be scheduled.

2. Be Clear with Patients on When They Must Return

Stop letting the patients make decisions on their medical care. If a patient is not 100% healed when you see them, you need to continue to see them until they are. You are the physician. You know when your patients are healed, they don’t.

If I am a patient and a doctor has told me to come back in as needed or if the problem gets worse, or if I don’t get better, then I feel abandoned and confused. When am I better? If I am only 10% better, do I make an appointment? Am I ever going to get to 100%, or do I just need to live with it? Maybe I should see another doctor that has more definitive answers; this one doesn’t seem to care.

3. Set Follow-Up Appointments Before the Patient Leaves the Office

Schedule appointments in the room or have the MA walk the patient up the checkout counter to be sure that both an appointment is made, and money is collected.

4. Don’t Use Jargon or Ambiguous Language

Using words such as PRN or phrases like “come back when needed” can confuse your patients. What determines “need?” What is PRN?

Your patients are not physicians. If a patient has seen you for the last five months for an ulcer and it has healed, don’t tell him to come back PRN. Tell him to schedule a return appointment in a couple of months.

5. Always Follow-Up

What about dispensing orthotics or DME? You need to schedule follow-up appointments to make sure those devices are still working.

If you need to schedule a follow-up appointment for a year from now, and patients don’t want to schedule appointments a year out, make reminders in your EHR. Call the patients closer to the date and reschedule those appointments.

In Conclusion

Remember, it is much more expensive to acquire new patients than it is to keep the ones you already have. It is also poor medical care to not actively follow-up with your patients.

In next month’s blog, we will discuss the lack of recall campaigns and patients who cancel their appointments.