Do you want to change your snail-mail recall system over to email and text messages? What if you changed your phone reminder system to pre-appointments and added text messages? Or suppose your practice notifies patients by phone when their glasses are ready to be picked up, but you want to change this to appointments for pick-ups?

There are many examples of, “That’s the way we’ve always done it in our office” used as justification, be it recall or notifying patients about their glasses. Are the ways you do things in your office working optimally? And, more to the point: If you want change how you do things, how do you modify a process that has multiple steps?
Start with a baseline. Before you make any changes, you need to document how the current system performs.

One Change at a Time
Let’s use recall as an example. Suppose your current recall system involves a postcard sent 11 months after the patient’s last exam. Now, if you mail 100 cards to patients who were examined in July 2012, how many will come back in July 2013? I’d use at least three months of data to get this baseline number.

Once you have that data, then you can start to try to improve things. Any changes are fair game (content, font, card stock, ink color, formatting, whatever), and the best way to change a multi-faceted program is usually to change only one thing at a time. So, in this example, if you want to change from a postcard and add a phone follow-up, and then move to texting, try the addition of the phone call first.

As above, stick with the new change for about three months and track your results. Then, add texting and measure again. Carefully “titrating” the changes this way accomplishes two things:

First, it assures that any changes you make will be positive ones. For instance, if adding the phone call caused a decrease in response rate for some reason, you’d know that you can safely stop making the calls.

Second, you can control costs. If the phone calls didn’t work, you would stop them after your three-month test. From there, you’d have the extra money to put toward trying texting.

Making Recall a Priority
Here’s a great example of the importance of testing a change to an established system: A practice we worked with was using snail-mail recall with fairly good success, but still wanted to see if there was room for improvement. Because the response rate was already high, the practice owner was hesitant, as was I, to make any changes. However, we agreed that if first-class snail mail worked well, then the more expensive option of Priority Mail ($5 additional for each piece we mailed) might work even better—hopefully better enough to at least cover the extra incremental cost. We figured that the Priority Mail envelope would incite more envelopes to be opened, fewer would be thrown away compared to first-class mail and, as a result, more patients would come back.

So, we tested this for three months… and we were wrong! The bigger, more expensive, more urgent-looking envelope had no effect on the ultimate patient response rate. But, the point is, if we didn’t have a baseline before testing, and didn’t continue to measure results afterward, then we could have easily spent an additional $5 per patient per month ad infinitum.

Does this mean that Priority Mail won’t help your snail-mail recall system? No. It means the only way you’ll know is if you test it. Your patients might be more willing to respond to such a change than the doctor we tested this with. But, test you must, or you run the risk of haphazardly making changes at your own peril, or doing nothing at all and hoping “the way we’ve always done it” is the right one.