Addressing the weakest link in refractive surgery
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1) A study analyzed telephone calls from potential refractive surgery patients to 77 practices across the US to assess counselors' phone skills. Calls were scored on 13 topics including greeting, qualifying needs, differentiation, and call to action. 2) Counselors generally scored poorly, averaging 49/100 points. The weakest areas were qualifying needs, differentiation, and call to action. Only 19 practices met the benchmark score of 57 points. 3) The study suggests telephone conversations are an underappreciated weakness for many refractive practices and an area needing improvement to better convert callers to consultations.
Addressing the weakest link in refractive surgery
- 1. TODAY’S PRACTICE Addressing the Weakest Link in Refractive Surgery Measuring and assessing telephone skills. BY SHAREEF MAHDAVI This is the first in a series of articles that highlights results from market studies on topics of interest to refractive surgeons. These studies comprise original research conducted by SM2 Consulting of Pleasanton, California. Ten years after the first excimer laser was approved in the US, there is enough industry experi- ence in marketing laser refractive procedures to identify the weak links in the process. Procedural advertising, although expensive and often subpar in quality, has created con- Figure 1. SM2 Consulting analyzed 13 different aspects of a sumer awareness and can make the telephone ring with phone call for a refractive surgery inquiry. inquiries. Fast forward to the consultation: once inside the practice, the majority of qualified candidates move forward the call. This survey tool was reviewed by an independent to undergo surgery. Between the ad and the consultation, group of ophthalmic administrators and validated in a pilot however, is the patient’s initial telephone call. My group’s study of six centers from around the country. research hypothesis has long been that this second step in Seventy-seven practices nationwide volunteered to par- the process has proven the most difficult for providers. ticipate in the study. They were spread evenly across the Virtually every surgeon with whom I speak has an inflated country and represented modest-, moderate-, and high-vol- view of the actual skill of their phone answering team. In ume LASIK practices. All of them signed an informed con- reality, most telephone counselors struggle with being able sent authorizing the placing and recording of phone calls. to effectively convert a caller’s initial interest into a sched- We used a “mystery shopper” technique in which each uled consultation. Any improvement in this area would phone call was made by a person posing as a consumer directly benefit the refractive practice. interested in LASIK. Employees of Opticall (Sarasota, FL), a SM2 Consulting conducted a study funded by Carecredit professional call center that provides call coverage for (Costa Mesa, CA) to independently assess and measure the refractive practices, made the calls. Opticall’s employees are current abilities and skills of personnel in refractive prac- professionally trained and skilled in handling incoming calls tices when answering consumers’ telephone inquiries. The from interested patients and are thus well suited to playing data collected in the study may be used in two ways: (1) as the role of a mystery shopper. objective feedback that practices may use to improve their The callers graded the phone counselors on each of the service and (2) as a survey tool and industry benchmark of 13 topics on a scale of 1 (poor) to 5 (excellent). They used phone skills across a large sample of practices from around specific criteria to define a score of 1, 3, or 5. Figure 2 pro- the country. vides an example of these criteria. The caller would give a score of 2 or 4 when he or she believed that the counselor’s METHOD OLOGY effort fell in between the defined criteria. Our firm developed a survey tool that covers 13 aspects The callers attempted five separate phone calls for each of a phone call between a potential refractive patient and a practice participating in the study. They made the calls at refractive counselor (Figure 1). The topics cover everything different times of the day and week to eliminate possible from the counselor’s initial greeting when he or she first bias. On the data collection form, we recorded the length of answers the phone to the skill with which he or she closes the call and any comments from the mystery shopper. AUGUST 2005 I CATARACT & REFRACTIVE SURGERY TODAY I 83
- 2. TODAY’S PRACTICE phone was answered (mean score = 3.6), the time it took to reach a LASIK counselor (mean score = 4.2), and the ability of the counselor to control the flow of the con- versation (mean score = 3.1). The ability to qualify the needs and interests of the caller was the topic on which counselors scored the lowest, with a mean score of Figure 2. For each topic, the researchers developed specific criteria in order to assign a score 1.8. We rated fully 60% of on a five-point scale. the phone calls as poor in this area. SM2 Consulting collected and independently analyzed Two other very important elements of the phone call the data from 304 completed calls made to the 77 partici- also scored below expectations. More than half of the pating practices. We excluded calls that were sent to voice- calls (57%) were rated poor on the counselor’s ability to mail or placed on hold for longer than 3 minutes from the differentiate the practice’s offering from those of other data analysis. Finally, we gave each practice a detailed providers (mean score = 2.1). Similarly, 46% of calls were report with the scores for each phone call and their com- rated poor in the attempted call to action, a measure of parison with the average across all participating practices, the counselor’s effectiveness in moving the caller to the as well as an audio CD with recordings of each call made to next step in the process (eg, signing up for a consultation, their practice. attending a seminar, or viewing a surgery). In only one of every three calls did the counselor ask the DATA ANALYSIS AND RE SULTS caller how he or she had heard about the practice (Figure 4). We calculated average scores for each topic, each call, Similarly, counselors offered callers additional resources to and each practice. We determined a score of 3 to be learn about the LASIK procedure only approximately half of good, its being midway between poor and excellent using the time. the five-point scale. In addition to the raw scores, we cre- Consequently, the low raw scores, when translated into ated an indexed total call score of 100 possible points that total scores, yielded an average call score of 49 (out of 100 gave more weight to certain topics that we deemed more possible points). The benchmark for a good total call score advanced (eg, the ability to differentiate the prac- tice’s offering) than basic ones (eg, the amount of time it took to reach a counselor). We also analyzed the data for any differences between high- and low- volume practices. Figure 3 shows the average raw scores by topic for all phone calls to all practices. An aver- age score of 3 or higher was achieved in only three of the 13 areas measured on the phone call: the warmth of the Figure 3. This chart shows the average scores for each of the topics measured on the phone calls. greeting when the A score of 3 was considered good. 84 I CATARACT & REFRACTIVE SURGERY TODAY I AUGUST 2005
- 3. TODAY’S PRACTICE was 57 points, which the counselor would achieve by receiving a score of 3 for each of the topics measured. Only 19 of the 77 practices achieved an average call score that met or exceeded this benchmark for a good average score of their phone calls. ADDITIONAL ANALYSES Length of Call Practices with an average call length that was longer than 5 minutes had average call scores that were signifi- cantly higher than those of practices with calls shorter than 5 minutes. Based on the data, the optimal length of a phone inquiry appears to be between 5 and 8 minutes. Conversely, practices with an average call length of under 1 minute (presumably due to a desire to schedule a con- sultation with the caller and withhold all information until that event) scored significantly lower. Incomplete Calls Twenty-six percent of all attempted calls were put into Figure 4. Only one in three callers was asked how he had voicemail, and 2% of them were placed on hold for longer heard of or learned about the practice. than 3 minutes. presumably to leave all the “heavy lifting” until the pro- DISCUSSION spective patient has come into the office. In an emotional- This study is the largest assessment to date of coun- ly laden decision-making process, that simply is not an selors’ telephone skills across a wide range of providers of optimal means of building rapport and trust with poten- refractive surgery in the US. For many refractive surgeons, tial customers. this has not been an area of great attention or focus. The encouraging news is that each one of the participat- Most of those with whom I speak assume that phone ing practices now has objective data that it may use to calls in their practices are handled adequately and are better educate and train those staff members responsible shocked when they hear (via recorded calls) what is actu- for providing the first impression of callers into the prac- ally happening. tice. The recordings have become an invaluable teaching The low scores confirm our hypothesis that the tele- tool, allowing all personnel to hear exactly how questions phone is an area of weakness on the business side of are being answered during inquiries. refractive practices and that it is in need of great improve- As an industry, we now have a way to measure coun- ment. The most distressing findings were counselors’ selors’ phone skills and monitor their improvement over inability to differentiate their practices and the lack of time. The incentive for providers and manufacturers to uti- information they collected to determine the source of lize such assessments is strong: better phone skills will callers’ awareness of the practice. Differentiation is the key translate into a higher percentage of callers scheduling to giving prospective patients a reason to select a particu- consultations. Even if conversion rates from consultation lar practice. Without it, all providers look the same, and to surgery stay the same, more refractive surgery will be refractive surgery risks becoming viewed as a commodity. performed. ■ “How did you hear about us?” is one of the most basic pieces of data required to help any small business decide Shareef Mahdavi draws on 20 years of medical device how best to invest precious marketing dollars. It was sim- marketing experience to help companies and providers ply astounding that this question was asked in only one- become more effective and creative in their marketing and third of all completed calls. sales efforts. Mr. Mahdavi welcomes comments at (925) 425- Additionally, an analysis of the average call length 9963 or shareef@sm2consulting.com. Archives of his monthly revealed that certain practices strive to keep the phone column may be found at www.crstoday.com. calls as short as possible. Listening to those calls makes it Practices interested in having their counselors’ phone skills clear that their sole objective is to get the patient to sched- assessed may contact Kim Gibson at Carecredit at (800) 300- ule a consultation in as brief a conversation as possible, 3046, ext. 4133; kgibson@carecredit.com. 86 I CATARACT & REFRACTIVE SURGERY TODAY I AUGUST 2005