When Loyalty Crosses the Line

Andrea (00:04):
Well, hi there. I am Andrea Watkins, and if you're listening to this while juggling three patient calls, checking in a couple patients, taking a payment, selling skincare, and trying to catch your doctor in between procedures, you might be working in an aesthetic practice.

Blake (00:18):
And I'm Blake Lucas and this is Practiceland. This is not your doctor's podcast. Welcome back to Practiceland. Thank you so much for tuning in. Appreciate everyone out there that's listening, and please remember to share Practiceland with your friends and coworkers. Really excited of course to have one of our favorite guests back today. Heather Hughes Hardy is a former COO registered nurse who partners with practices to take big ideas and make them work in real life and ultimately drive profitability that lasts. Heather, so happy to have you here. Hello.

Heather (00:53):
Hello. Thanks for having me. I'm excited to be here.

Blake (00:56):
Really interesting topic today. We're talking about valuable but probably a problematic patient type. We're coining it, the frequent flyer. Who is this person, Heather, and why can they be challenging?

Heather (01:10):
For sure. I mean, we all value our long-term patients, right? It's so nice when you have someone that just knows the flow, they know the staff, they come in and you can really count on them to be in there every month or every couple of months. But there's a subset of that patient population and hopefully, and most of the times it's quite rare, but you get that person that even though they're there every couple of months, it's almost a little bit painful when they come in because they have this new sense of expectation that because they have been a long time patient and they've been so loyal that there's some type of entitlement that kind of comes along with that. And we never want to feel like a patient doesn't get a good experience. We definitely want our long-term patients to feel really valued, but we don't necessarily want for that gray area to start to develop where they feel like maybe they can take a little bit more than what's appropriate.

Blake (02:08):
I think all of us listening to that right now just envisioned a patient's face. I have a name in our head that just popped up and we're like, oh yeah, but maybe take us through a real life example maybe of someone, a story you have of a patient like this to help us maybe better define it for those that maybe haven't dealt with it yet.

Heather (02:26):
Yeah, no doubt. I have a patient that comes to mind pretty quickly when I was going through and thinking about this topic. She was a really sweet patient and we'll call her Diane for all intents and purposes, not her real name, but she was a long-term loyal client. She spent a lot of money with the practice. She spent a lot of time coming into the practice, and honestly, it was really enjoyable to spend time with her when she would come in, she knew people, she would come say hello, and it was kind of fun to have that interaction.

(03:00):
She started to go into that gray area where she was like, I'm going to book a surgery. Wonderful, that's great, but then I'm going to talk to my injector and see if she can't just move it around a couple days for me. Well, that's completely outside of the process. You have to go through your patient care coordinator to do those types of things, but it creates that sticky situation, this injector who's been seeing her for years feels obligated to be like, yeah, let me see if I can pass that message along. And then she started texting some of the staff, not through their personal lines, but through their CRM numbers, but kind of knowing who she was talking to, Hey Heather, not just someone on the other line that is somebody that works there. She's directly reaching out to a person there and saying, Hey, I talked with my injector. She said she was going to let you know that I need to move my surgery. And just starting to cross these weird boundaries that you're like, well, that's not really how it works, but you've been here so long. Let me see what I can do. I do want to make this a good experience for you. And so for this patient specifically, I crossed into that area. I was a patient care coordinator at the time of feeling obligated to see what I could do to make her happy, and it led us down this really sticky path because then she started taking more and more leverage and asking for more and more things that ultimately I had to address. But at the time, it felt really new to me. It was my first experience with a patient doing something like that, and so it snowballed quickly.

Blake (04:31):
Wow. And that's so hard too because such a, you've kind of outlined it. This is a patient that everybody enjoys working with and is there so often, and it becomes kind of the regular that you really create almost a real friendship with these type of customers or patients I should say. And all of a sudden now that starts to change that they start to get a little too comfortable and they start to ask for things or do things you're like, that would never fly with a brand new patient. We would absolutely squash that right away.

Heather (05:03):
Exactly.

Blake (05:04):
So how do you deal with that type of patient or what was next for this patient or were you able to rectify this without ruining the relationship?

Heather (05:14):
So looking back, I would handle it a lot differently. With that patient specifically, like I said, I kind of let it snowball to a point where I was like, well, now I've let us enter into a gray area. And I kind of bent policy a little bit, not in a way that was hurting the practice necessarily, but now it's like, what I can't do for all I shouldn't do for one, I should say.

Blake (05:36):
Yeah. Yeah. No, that's a great way of putting it. It's very succinct.

Heather (05:39):
So sitting down with her, what I should have done is said, Hey, Diane, I so appreciate that you feel comfortable talking with our staff. Everybody here certainly wants to help you, but when it comes time to making changes to your procedure date and anything that has to do with your surgical arrangements, that really has to go through this line. And so I know your injector wanted to pass that message along, but I really need you and I to be on that same page, and I did tell your injector moving forward that she does need to pass that to me. And that's a big point too, right? Because the patient will come in and talk to different people within the practice and get different answers. So everybody needs to know how to direct a patient to the appropriate person to speak with, but handling it directly when it does happen and not letting yourself get down that sticky slope.

Blake (06:29):
Yeah. Take me through that a little bit. What were you feeling going into that conversation and how did you feel coming out of it?

Heather (06:37):
Yeah, so for her specifically, I felt extra tense because I had already gone through it. And so for someone that you've already started to bend the rules, truthfully, in my opinion, you just need to be honest and candid with them, very authentic, and be like, Hey, I kind of bent the rules here because I so value you as a patient, but now it's led to a lot of extra loops that I've had to go through on my end that started to create some administrative chaos, and my team we're just not equipped to handle it, going about it in this way. And so what I really need for this to happen moving forward. And then I set out those expectations for her specifically. And so I let her know, Hey, I did this and that's on me, but now I've kind of created a mess. And so I didn't make it feel like, oh, you did this whole thing and it's all on you. It's like, Hey, I kind of did this thing and now I need you to help me get back on track.

Blake (07:34):
Yeah, I mean, obviously we create these processes and these flows and standard operating procedures or SOPs to make sure that we're all creating this amazing experience for every patient that we see. Many times, I don't think these patients realize what they're doing. They don't know what those things are. They know everybody at the practice and they're comfortable and they're going to have that conversation or they're going to make those requests without everybody really knowing what's going on. Maybe let's talk about the logistics of a conversation like that. Where did you have this conversation? Was it over the phone or in person? And maybe talk me through if you had a strategy for that.

Heather (08:15):
Yeah, I think it's most ideal when you can to sit down with someone face to face because body language plays such a key part in these types of interactions where you are having a little bit more of a tense conversation or a potentially tense conversation where a patient might start to feel some type of way about what you're saying. And so that's not always the case. So for this patient specifically, again, I had already kind of done all the wrong things. And then on top of that, she was a patient that flew in for her appointments. And so when it came time to address it, what I did for her specifically is I said, Hey, when you're coming in for your next appointment, how about you and I sit down and have a little chat? We'll catch up. We already had that rapport there, and so I made it possible for us to sit down. Ideally, you wouldn't have that type of conversation over the phone just because you don't necessarily know that it's going to come off the exact same way that it would in person, so ideally in person, but if you need to do it over the phone, just being very light with them and giving them the opportunity to have plenty of time to give you feedback to speak about what they're feeling about the situation as well.

Blake (09:21):
Definitely don't do it through text message.

Heather (09:23):
Definitely not. I would not do that.

Blake (09:25):
Absolutely not. I've been in these situations before where you create this kind of rapport and all of a sudden maybe a line starts to get drawn between what is great customer service and what is letting the patient take too much control. So how would you define that or how would you differentiate between that's great customer service or no, you're giving away too much.

Heather (09:56):
Yeah, it's kind of funny. I sat in on a Ritz Carlton course because they are well known for their customer service.

Blake (10:04):
Absolutely.

Heather (10:04):
And honestly, the course was really great, but I think that there's something that people kind of forget when it comes to customer service when you're working within the medical field, and that's that you can't always prioritize customer service over safety, or even one of the surgeons that was sitting in on this training with me was like, if a patient comes in for a facelift and they're unhappy with it, Ritz Carlton, it sounds like from the training is saying, well just refund them. Well, it doesn't work necessarily the same way in plastic surgery, right? Because they're not going to come back for 50 different facelift trips like they would a Ritz Carlton trip, and so how are you going to handle it within the medical kind of setting? And so I think it's setting clear expectations upfront and holding up those expectations throughout the patient's journey with you. There's policy and procedure for a reason, and you need to abide by that to give the patient the best experience. When you start to bend the rules, it actually creates all of this gray area that ends up hurting the patient a lot later on.

Blake (11:11):
So I think that can be really difficult with patients to reset expectations without damaging the relationship that you have with them, the trust that you have with them all this time that you've spent, all this work that you've done to build that relationship. So how do you reset expectations without breaking that down, especially with someone that's been loyal for a long time?

Heather (11:34):
Truly, I think it's all about just having a really authentic conversation person to person and letting them know, Hey, this is where we're at. This is how we got here, and this is how we're going to do this moving forward. And if you just give them that opportunity to sit down and really go through it line by line, I think that's the best approach.

Blake (11:53):
Yeah. Thinking about it now, looking back, what maybe would you have done different with our Diane patient?

Heather (12:00):
Yeah, I think just as soon as that injector had come to me, letting me know what it is that we were trying to do, I think I should have addressed that situation right then and there, had that conversation with the patient and let them know, Hey, moving forward, I really need you to go through X, y, z step. Instead of what I did at that time was I went and looked at the schedule, I saw what I could do, and then I reached out to the patient and said, here's what I've looked at. Here's what we could potentially do because your injector told me all of these different things, and I kind of just indulged it. What I should have done is set a hard boundary and then collected more information from the patient at that time.

Blake (12:35):
I always love doing this at the end. To wrap things up, what is one thing that we can take away from our discussion today or that you'd want people to take away from our discussion today that they could put into action maybe even in their next consultation?

Heather (12:49):
Yeah, for sure. I think that kind of what I've learned thus far in my career, especially working in an area of it is elective services and cash pay, but it is a mix of medical that you do need to rely on and lean in on your policy and procedure just a little bit more heavily because while we want to provide a great customer experience, what we really want to do is make sure we're able to provide an experience that every single client and customer can expect every time that they come in.

Blake (13:18):
Yeah, amazing. Love it. Heather, thank you so much for joining us again today and dropping your dimes of wisdom on us. It's always a pleasure to have you on the show. Remind us where can we follow you online or get to know what you're working on?

Heather (13:34):
Yeah, absolutely. You can find me on Instagram at Heather Hughes Hardy. I'm also on LinkedIn, Heather Hughes Hardy, or you can find my program at thecoreitmethod.com.

Blake (13:44):
Fantastic. And of course, listeners, if you've got a question for Heather and would like her to answer on the show or a future episode, send us a message at practicelandpodcast.com. Thank you all for joining us in Practiceland today. Have a great rest of your day, and join us next time. Take care. Got a wild customer service story or sticky patient situation? Send us a message or voicemail. If your tale makes it into our "She did what?" segment, we'll send a thank you gift you'll actually love. Promise no cheap swag here.

Andrea (14:14):
Are you one of us? Subscribe for new episode notifications and more at practicelandpodcast.com. New episodes drop weekly on YouTube and everywhere you can listen to podcasts.