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March 2010

Start with service

When starting or building a practice, one thing to keep in the forefront of your mind is customer service. Discover what to do, how to do it, and what to avoid by learning from the Customer Service Best Practices Survey.

By Monica Wofford, CSP

Delivering exceptional customer service, or not, can mean life or death to your practice.

While good customer service can catapult your practice into chiropractic stardom, bad customer service can shut your doors quicker than you can say, “subluxation.”

So, has the concept of customer service become so cliché that you overlook the obvious? Is it something you actually check on, measure, or reinforce?

According to the Customer Service Best Practices Survey, this is true for a few of the survey takers. Yet out of the 467 chiropractic practices nationwide contacted for this survey, some of the results uncovered may surprise you.

Initial findings         

An expected conclusion one might assume to be true in this type of study is an increase in customer service provided in correlation with an increasing number of years in practice.

An experienced chiropractor could be expected to have greater success in providing patient care and leading employees, simply because he or she is assumed to have developed and honed the skills to run a practice more effectively.

• Overall customer service. This increase in rating proved to be true, but with an overall increase of only 0.4 percent, indicating that service is perceived to be high in all number of years in practice (See Fig. 1).

Subjective ratings by the participating doctors (and one office manager) on the level of customer service their practice provides ranged from a perfect 10 down to a five, with one rating of a five and two ratings of six in the entire study.

Fourteen percent of all practices surveyed gave themselves a rating of 10, indicating no room for improvement in the area of customer service. All the remaining offices considered themselves to be worthy of a seven or higher in customer service.

• Adding more staff. Additional logic that might follow this line of thinking is the more staff members on hand to serve patients the higher rating of customer service would be present and could be provided by more “hands on deck.”

This “logic” proved not to be true as the customer service rating declined without exception when staff was increased (see Fig. 2). In addition, when staff increased the time in their role, or tenure, the customer service rating experienced a downward trend, indicating that more is not necessarily merrier (see Fig. 3).

• Patient complaints. When doctors were asked how many patients complained — about anything — 52 percent said less than 2 percent.

While 22 percent said between 3 percent and 5 percent complained, 6 percent of the practices reported percentages between 10 percent and 40 percent — with these latter practices also mentioning being a member of one of many chiropractic coaching programs and able to articulate the method by which they actually tracked numbers.

Much as the rating of customer service on a scale of one to 10 is a subjective measurement; without tracking, the percentage of customers who complain is also a subjective number and in some cases an educated guess.

However, in the same practices who sighted between 10 percent to 40 percent of patients complain, 50 percent also answered “no” when asked if they provided specific customer service training to staff members.

Thirty-five percent of practices shared that patients complain about billing issues, while 19 percent said customers complained of not understanding the bill once they received it.

Complaints from patients about wait time have been received by 25.3 percent of practices surveyed and 10 percent of doctors recalled customers complaining about a surprise in treatment or not having their expectations met in the office.

The good news is that less than 1 percent of practices reported patients complained about poor customer service, but many wondered how many of those patients may have voted with their feet and gone “missing in action.”

Customer service training

Customer service is defined as providing a high level of quality communication, assistance, and support to all levels of customers, including patients, colleagues, and employees.

The skills to provide this type of service to others, even when compensated in salary or bonus, are not natural for 75 percent of the nation’s population. Yet specific skills can be taught to those who are not naturally nurturing and supportive. The desire to care about people and a liking for people, it is argued, cannot be taught.

Training, similar to teaching, is the transfer of knowledge and skill. Whether a procedure course, training conference, CD series, or monthly meeting was used as the medium, 49 percent of doctors said they provided training specific to the topic of customer service.

The 51 percent who did not spend time on this type of training had an average employee tenure of 3.75 years versus those who spent 15 minutes or more on customer service training per week, whose average staff tenure was 5.7 years.

This data indicates that even minimal training doubles the amount of time a staff member will remain in the role. When the average cost of a new employee, from all who knew or kept a record of this number, is $5,205, training could be said to account for a significant long-term savings in hiring costs.

Business training

While it is widely known that little training is devoted to the subjects of running a business, developing a team, or developing skills performed by employees at most chiropractic colleges, this is also evident in the anecdotal data gathered on the subject of training.

When asked, “What training is missing that you would take or bring in if you had all the time, money, and resources needed?” 17 percent of the doctors surveyed said “None.” The remaining 83 percent of practices contacted, however, shared training needs that were missing.

The top  missing training needs reported from these practices are as follows:

1. Communication skills training. This training includes topics such as talking about money, handling follow-up calls, explaining finances, scripting for CAs, asking for referrals, ending a conversation gracefully, and handling conflict.

2. Leadership

of employees training. This includes topics such as dealing with attitude issues, delegating, sharing expectations, motivating employees, recognizing and incenting employees, training and cross training, and delivering employee reviews.

3. Running a business training. This includes topics such as marketing, time management, focus, and expense management.

4. Customer service training. This type of training includes role playing, dealing with difficult patients, maintaining a positive attitude, showing confidence and empathy, and keeping current patients coming back.

A question that inspired searching for calculators, longer to-do lists, and action on the part of some participants tied together the training aspect and customer service centered philosophy.

That question was “What financial impact would it have on your practice if you were able to improve your own perceived and subjective customer service rating and behaviors?”

The 21 percent of participants willing and able to answer that question said the average financial impact would be $186,000 in a potential annual revenue increase, with amounts ranging from $36,000 to $1,000,000 annually.

Recommended actions

The Customer Service Best Practices Survey includes compiled data from practices of all patient volumes, within rural and urban locations from Alaska to New York and Hawaii to Florida.

It takes into account answers and information from doctors ranging in practice time from one month to 45 years and who practice in offices of all sizes ranging from 204 to 5,000 square feet.

Some had other doctors who worked with them or staffs of up to 18 employees. Others had no employees or one spouse that ran the front desk, and a small number even operated out of towns of less than 50,000 in population.

With all these variables, what seemed to have the greatest impact on customer service was the doctor’s knowledge about his or her business and where it was going and with whom.

Those who tracked their numbers, such as average cost of employees, cost of a new patient, and revenue impact of better service, all had ratings less than 10 in customer service.

Those who participated in the above activities, all listed needing more help with employee leadership, as a training topic that was missing, and all made mention of the fact that there is “always room to improve.”

When leaders of chiropractic practices are able to assuage anxiety in staff members, by sharing expectations, providing adequate training and development (to not only perform, but excel), and are able to demonstrate service to all staff versus focusing merely in the treatment area, customer service and revenue will rise effortlessly.

The stress associated with trying to be the doctor, and the leader, and the manager, and the coach, and the counselor, and the billing agent, and the technician is what business owners’ deal with daily — yet it hampers communication abilities and workflow dramatically.

Those who grow a business beyond five years and those who are successful learn quickly to work on their business instead of in their business — performing every role needed.

Thus, though there is a clear need for customer service training — even being mentioned as one of the top topics missing — there is a more clear need for leadership and communication skills training beginning with those who are leading the business, from whom all other behaviors, philosophies, and performance extends.

Leadership, as well as customer service and how one communicates, is contagious.

Monica Wofford, CSP, is the founder of Contagious Companies, a Florida-based training and consulting firm. She is a business owner, coach, speaker, and author of Contagious Leadership and Contagious Chiropractic Customer Service. She can be contacted at 866-382-0121 or through www.contagiouschiropractic.com.

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Customer service training

When asked in the survey about training, there were some specific subjects provided by participating practices. Some of the topics included:

• Clinical and procedural training;

• How to handle discussions on money and billing;

• How to communicate insurance options;

• How to smile when answering the phone;

• Training staff how to help when wait times got long;

• How to effectively schedule;

• How to perform customer follow up;

• How to deal with difficult patients;

• How to provide a better patient experience;

• How to help customers feel special (i.e. provide bottled water, set up and clean up kids area, send thank-you notes, follow up with what was promised, ask about family members, remembering names, etc.);

• How to communicate better with patients;

• Role play on common and difficult situations;

• How to validate patient feelings without being a “doormat”;

 • How to listen and validate;

• How to explain procedures; and

• How to communicate effectively over the phone.

 

About the survey

The Customer Service Best Practices Survey was conducted during the first and early second quarter of 2009. This study served to indicate how much the chiropractic industry focuses on customer service as a means of driving, growing, and maintaining a healthy business.

With data gathered objectively by Contagious Companies, a Florida-based training and consulting firm, this study measured such customer, or patient, service attributes as the rating a doctor would give his or her own practice, the amount of time spent on customer service training, how many customers complain and about what, and the financial impact of an improved rating (should the resources for such an increase be made available).

Other factors considered were the years the doctor has been in practice, tenure of staff members, number of staff compared to office square footage, and amount of time spent on training as a whole, as well as data on patient retention efforts.

For a complete version of all results, go to www.ChiroEco.com/BestPracticesSurvey.

 

 

 

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