The Paradox of Disappearing Patients

By Stewart Gandolf, Chief Executive Officer

Magic hat with gold coins in it against white backgroundThe surprising reason why patients leave and the impact to your bottom line.

Most say nothing at all...they just don't return. Patient satisfaction is the cornerstone of patient retention. It's difficult to detect, but It is a perception of indifference that causes most people to quit coming back. And the financial loss to your business is nothing to take lightly.  

The perplexing thing about "disappearing patients" is that they're not around to ask why they aren't patients any more. Patients leaving a business rarely complain to you (less than 4%). Most say nothing at all...they just don't return.

With charts packed to the rafters, you may not even know which ones have disappeared. It's next to impossible to tell which individuals are still "bonded" to your organization (and likely to return), and which charts are ready for the recycled paper bin.

You can guess some of the reasons...perhaps they were attracted by the competition; they acted on a trusted referral; they have no current need; they moved, they died...or maybe their son-in-law went into practice. Intuitive or obvious, all these are just the minor issues.

The biggest reason that people take their business elsewhere is they perceive an attitude of indifference–meaning how they felt about the experience. "Indifference" wins by a staggering 68%...that's nearly 7 out of 10. And the categories aren't even close:

  Why customers stop buying:

Die 1%
Move Away 3%
Formed other relationships 5%
For competitive reasons 9%
Due to product/service dissatisfaction 14%

And 68% Quit because of an attitude of indifference by one or more
persons representing the business.

Although not specifically about healthcare, the results of this well-respected business survey1 have been validated in many service areas including healthcare, hospital and patient satisfaction surveys. (Other surveys say as much as 80 %.)

"That's not my organization!"

Healthcare is a caring profession–and in our experience, service is delivered by caring professionals and staff. But feeling an "attitude of indifference" is not the same as quality of care or even cost.

In the total patient experience, indifference could come from how the phone is answered, enduring delays in the office schedule, or even the cost and convenience of parking. The process of building and maintaining rapport and achieving satisfaction is all in how they were treated.

Even more challenging is what the business does not do–such as no friendly greeting, a lack of appointment reminders, after-care calls or other routines to keep in touch with patients. Often it's the small things that make a big difference.

The loss of one patient is large and far-reaching.

Of course, every patient is important...but avoiding the disappearance of even one patient is financially significant to the business. High patient satisfaction is a primary ingredient in patient loyalty or bonding with the organization. Here are six basic business reasons to make patient retention a high priority.

● Lost future patient care opportunity. In the retail world it's called "repeat business," and when a patient leaves the practice or organization they're likely to be lost forever.

● Lost patient referrals. Even satisfied patients may leave your organization, but devoted patients will refer to you. In most organizations patient referrals produce a high Return-on-Investment.

● Risk to reputation. Dissatisfied individuals not only don't make referrals, they may tell others about their concerns (even when they are minor.) This negative word-of-mouth can influence others, and potentially reach professional referral sources as well.

● Possible loss to the competition. Patients that are strongly bonded to you tend to ignore competitive marketing messages.

● Lost acquisition investment. Attracting patients typically requires an initial marketing investment. When they leave the long-term value of that patient is cut short.

● Replacement costs are higher than retention costs. It is far more costly to attract a (replacement) patient–anywhere from 4 to 100 times more expensive.

Patient satisfaction. Patient retention.

Most patients are not medically trained and have little or no clinical basis to evaluate a professional or the quality of care. Their value system is usually personal–how they felt about it all–the total "patient experience."

The key to retention is satisfaction. Clearly high quality medical care comes first, but cultivating a positive and caring personal relationship with patients is also critical. It is good business sense to build, preserve and protect against the loss of patients. It can be relatively easy and inexpensive to keep satisfaction high.

Click through on the link below for another helpful article.


A patient satisfaction survey can reveal important issues for resolution or training:

How to Improve Patient Satisfaction and Win Patient Referrals
What's important to patients and three easy ways to measure approval

1. Rockefeller Corporation survey; published in the US News and World Report and elsewhere.

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