Category Archives: Patient Experience

Keep Calm and Show Photos

Everyone loves a good before and after photo, from kitchens, to cars to plastic surgery. It’s really fun to see the transformation.

before after

Many practices overlook the impact these photos have on the consultation experience. Photos play a starring role in your marketing and sales management processes; our data shows a 26% increase in same day scheduling rates when they patients find the before and after pictures useful.

But patients take notice when photos are missing, as evidenced by this recent review: review-1

Does this office use before and after photos during consults? Yes.
Were they available to the patient? Yes.
Was there something different about this particular consult day? Perhaps.
Was there a change in staff involvement in the consultation? Possibly.

In this case, a 4 star review provides a clear opportunity to increase treatment or surgical volume. RealPatientRatings survey data helped the practice gain insight to the areas of greatest opportunity to improve patient satisfaction, and with it the corresponding increases in conversions and revenue.

It’s a challenge to provide a consistent consult experience, but you can save the show regardless of the players involved by using a standardized process that produce more consistent results. Surveys and reviews provide practices with the opportunity to validate your service delivery model and ensure you are focusing on what’s most important to your patients.

Patients have been very vocal related to the usefulness of before and after photography in their decision-making process. Our results from surveying more than 80,000 patients shows a 26% increase in same day conversion rates when patients find the before and after pictures useful.

same day conversion

Managing the process delivers predictable results

Before and after pictures should be shown to patients so that they can visualize their potential results. When before & after photos are thoughtfully presented during consult, you help your prospective patient by personalizing the experience and differentiating your practice.

Ideally, at the end of the consult, your use of photos helps patients validate their personal goals and move more confidently toward a buying decision


Best practice standards for before and after photography are as follows:

  • Have a large variety of results
  • Tell a story with each example, make sure the pictures are labeled
  • Organize your photography by procedure and within the procedure by size, gender
  • Continually update your photography
  • Considering using technology such as 2D or 3D options
  • More is more, there is no such thing as too many before & after photos

Every practice has a process that they think is being implemented on a daily basis. The value of feedback and reviews is that you can quickly determine if your process is being executed and more importantly, how effective that process is in the eyes of your patients.

Implementing a 5-Star Patient Education Process to Drive Retention

Part 1: The Coordinated Pre-Op Visit

love-nurseImplementing a patient-centric, high touch pre-op visit can result in a 53% increase in patient satisfaction and a 37% increase in patient’s likelihood to return.

For plastic surgery patients, nursing plays an integral role in the delivery of care and has a direct link to patient satisfaction, which is the ultimate measurement of a successful outcome. Effective communication protocols improve outcomes and expedite the recuperation process.

Implementing a thoughtful and consistent patient friendly peri-operative education component and communication process increases satisfaction and dramatically decreases post-op calls. This plan consists of a coordinated pre-op visit, personalized pre-op materials and a proactive post-operative communication strategy.

More often than not, patients are confused about the surgery process, their specific procedure and have important questions to resolve. Nurses must display empathy and patience regarding their mental state.

To further complicate matters, the human brain forgets 90% of what is learned within 1 week. When we consider that patients will only remember about 10% of the information provided to them, it is clear that the pre-op visit must be a carefully planned process and include effective supporting

The best practice standard is to schedule a 1-hour pre-operative visit 2 weeks prior to surgery.

1. Prepare: Send the patient the personalized education materials in advance with a note encouraging them to review prior to their appointment and place sticky notes on any sections that are unclear.

2. Educate: At the visit, the nurse should review the relevant informed consent materials, and pre and post-op preparation instructions.  In this teaching role, the nurse educates and prepares the patient for the pending surgery process which sets the stage for a successful post-op recuperation and healing process.

3. Review: Next, the patient should be given the opportunity to address all of the items that they have flagged for review.

4. Confirm: As a last step, the nurse should inquire with the patient, “Did this visit cover all of the information that you anticipate needing as you prepare for and recover from surgery? Are there any remaining additional questions or concerns?” The nursing staff must confirm they have met the patient’s needs before they conclude the pre-operative

With proper pre-planning, the visit will be much smoother and meet the patient’s need for information.

This article is part one of a three part series based on a poster presentation delivered at the American Society of Plastic Surgery Nurses (ASPRN) Meeting in Boston, on October 18, 2015.


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Service Recovery: Why Early Warning Systems Aren’t Optional

Concerns about on-line reputation and strategies for reputation management are regular topics at Society meetings. Virtually every physician has experienced at least one harmful review. Negative reviews impact our reputations and, in the extreme, can stifle business growth. Despite the danger, very few practices institute early warning systems to decrease the likelihood of negative reviews.

A smaller subset of physicians who use ratings and reviews to market their practices tell a different story. These practices verify their own quality and use it to attract consumers to their brand. They can attest to the incredible sales and conversion benefits of proactively providing ratings and reviews to consumers for use in their buying process.

Regardless of your perspective on the ratings and review phenomenon, it’s time to adopt an unheralded methodology, service recovery. Viewed through the service recovery lens, a negative review reflects the organization’s failure to ferret out discontent and resolve it internally before it goes viral. Service recovery provides an early warning system that enables practices to resolve service issues privately and internally.

What is service recovery?

“Service recovery refers to the actions a provider takes in response to a service failure.[1] A failure occurs when customers’ perceptions of the service they receive do not match their expectations. By including also customer satisfaction into the definition, service recovery is a thought-out, planned, process of returning aggrieved/dissatisfied customers to a state of satisfaction with a company/service.”[2]

What are the effects of service recovery?

“A growing body of literature on service recovery suggests that a good recovery has a positive impact on satisfaction, recommendation intention, word-of-mouth, loyalty, image, and trust.”[3][4][5][6]


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“Some even argue that a good recovery can increase satisfaction to a higher level than if nothing had gone wrong in the first place, which is referred to as the service recovery paradox.[7][8] See chart showing the increase in customer loyalty after problem resolution.”

How do you start a service recovery program?

Go the source, your patients. Embrace feedback and use their disappointments as opportunities to improve your practice and your reputation. In this digital age, you must follow up to resolve the often justifiable concerns of your patients.

  1. Survey all patients post consult, post treatment and post op.
  2. Rate satisfaction using 5 point scale similar to ratings and reviews. Your internal scores provide insight into what public scores should be from verified patients.
  3. Follow up with individual patients who indicate they have an unresolved problem. Work with them to deal with the issues of concern. The higher the patient’s satisfaction with the outcome, the better it is for your reputation.
  4. Identify and resolve process issues which are reflected in low satisfaction scores of many patients, i.e., late clinics, lack of responsiveness or poor preparation for recovery. Low scores at consult impair conversions. Low scores post op reduce retention and referral.


Wise practices recognize the value of proactive customer service and responsive customer complaint systems. Service recovery processes can harness patient feedback and turn it into a valuable and profitable asset. The stakes are much higher among today’s perpetually-connected consumers, a reality smart practices should not ignore.

Marie Olesen
Founder, RealPatientRatings®
Advisory Board, Center for Services Leadership, W.P. Carey School of Business at Arizona State University

Note: Service recovery is an established methodology in the business environment. I’ve cited these studies because it is important that those of us in medicine adopt these processes rather than question the validity of the concept.

  1. Grönroos, Christian. “Service Quality: The Six Criteria of Good Perceived Service Quality.” Review of Business 9, no. Winter (1988): 10-13.
  2. Lewis, Barbara R. “Service Promises, Problems and Retrieval. Working Paper.” Paper presented at the QUIS, Karlstad, 1996.
  3. Maxham, James G. III. “Service Recovery’s Influence on Consumer Satisfaction, Word-of-Mouth, and Purchase Intentions.” Journal of Business Research 54, no. October (2001): 11-24.
  4. Spreng, Richard A., Gilbert D. Harrell, and Robert D. Mackoy. “Service Recovery: Impact on Satisfaction and Intentions.” Journal of Services Marketing 9, no. 1 (1995): 15-23.
  5. Smith, Amy K., Ruth N. Bolton, and Janet Wagner. “A Model of Customer Satisfaction with Service Encounters Involving Failure and Recovery.” Journal of Marketing Research 36, no. August (1999): 356-72.
  6. Tax, Stephen S., Stephen W. Brown, and Murali Chandrashekaran. “Customer Evaluations of Service Complaint Experiences: Implications for Relationship Marketing.” Journal of Marketing 62, no. April (1998): 60-76.
  7. Hart, Christopher W. L., James L. Heskett, and W. Earl Jr. Sasser. “The Profitable Art of Service Recovery.” Harvard Business Review 68, no. July–August (1990): 148-56.
  8. McCollough, Michael A., and Sundar G. Bharadwaj. “The Recovery Paradox: An Examination of Customer Satisfaction in Relation to Disconfirmation, Service Quality, and Attribution Based Theories.” In Marketing Theory and Applications, edited by Chris T. Allen, 119. Chicago: American Marketing Association, 1992.

5 surprising things we learned about your patients in 2013

1. Time-related concerns are the #1 complaint in plastic surgery patient reviews

clockMost bad reviews are not complaints about the quality of results, but about the patient experience. Patients most often express sentiment within themes of time, communication, and money. They are frustrated by service and communication failures and their negative reviews focus on these issues.

But in 5-star (highly-satisfied) reviews, patients focus on their positive emotions, i.e., comfort, outcomes and next steps. They are happy and satisfied. They plan to stay in the practice and help it grow.

What to do: If you want to change the tone and content of future reviews, then you need to attack service problems at the source.

2. After restaurants, consumers read reviews of doctors and dentists more than any other category.

Most people read less than 10 reviews before forming an opinion of you, and they read less reviews before forming an opinion than they did a year ago. Nielsen recently reported that 68% of consumers trust online review content, and an astonishing 70% take action after reading consumer opinions posted online.

The only type of advertising to inspire more action than online reviews is a recommendation from a friend. Reviews are more powerful all other media including TV, websites, newspaper ads, email marketing, print ads, and billboards.

What to do: You need trustworthy, relevant, recent reviews. A lot of them.

3. Consumers require negative reviews to believe positive reviews

Thumbs-Up-Thumbs-DownPatients who rate their experience as neutral, dissatisfied, or highly dissatisfied represent only 4% of the survey totals for overall satisfaction.

A number of studies have determined that consumers require a small amount of negative feedback in order to confidently believe positive feedback.

What to do: Stop freaking out about negative reviews! (Easier said than done, we know…)

4. Proactive price education = stronger SEO, more leads, better consults, and more cases

Patients who are prepared for the cost are 21% more likely to schedule on the spot, at the end of their consult. Rather than worried about a financial surprise at the end of the consult, they are focused on absorbing your expertise about the procedure.

“Cost” and “Price” are two of the strongest keywords there are! Neglecting to include them on your website is costing you a pretty decent amount of web traffic. Just like in the consultation, a prospective patient visiting your website looks for cost information in order to move forward in their research process. If you answer their question, they can move on to learn about the procedure, look at your beautiful photos, and contact you for a consultation.

What to do: Put general price ranges on your website and share cost information over the phone before the caller asks.

5. Prospective patients who read reviews are ready to buy

A year’s worth of data gathered from 14 plastic surgery practice websites shows these visitors who read reviews at part of a visit convert at least twice as often as those who don’t. (In this case, “convert” simply means they completed a form on a website.)

What to do: If you want more leads, consults, and cases, add reviews to your own website.