My community eyecare practice has been open for about 2 years and things are going well. I have noticed though that some of the patients I examined when the practice opened have not come back for their yearly or two yearly examinations. I’ve lost about 20% of the people I saw in the early months. It’s crucial for the long-term success of the practice that I reduce this loss of repeat business. Do you have any suggestions?

This is a problem for many practices. Repeat business is the lifeline of all practices and we need to take care of this element of our work.

There are many ways of improving the return rate of patients but I will focus on the eye health side of things here.

It’s my experience that people who change eye care specialists by moving from one practice to another think that the new eye care specialist has access to their previous clinical records. Many people think that their community eyecare records are stored on a central computer and the new eyecare specialist has access to this computer and can see the results of their previous eye examinations. In those countries where I have experience or knowledge of working practices, the new eye care specialist does not have access to the clinical records completed by the previous eye care specialists.

In my practice, I have access to a handheld retinal camera which I use a lot. Often on undilated pupils. Once I have taken photographs I show one of them to the patient and talk briefly and simply about the optic nerve, the blood vessels and the retina, and any abnormalities that may be present.

I then say ‘It’s good to have these photographs. I’ll save them on the practice computer so the next time you have an eye examination here I can take more photographs and then compare them to the ones I have just taken. That way it will be a lot easier to see if anything has changed.’

People often tell me that they have never seen a photograph of their eye and thank me for showing and explaining it. They also see the sense of taking photographs the next time and comparing those to these.

If you don’t have access to a retinal camera you can say the same thing about the clinical records you have made:

‘I’ve made a note of your vision and lens powers along with your eye health. I’ll keep these on file until your next eye examination and can then compare how things are next time with how things were today. It’s the best way to see if anything has changed.’