Abstract

You have accessThe ASHA LeaderFeature1 Feb 2003Using Patient Newsletters in an Audiology Practice Dennis Hampton Dennis Hampton Google Scholar More articles by this author https://doi.org/10.1044/leader.FTR2.08022003.6 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In About 15% of patients will leave a practice each year because of death, relocation, or dissatisfaction—with the last reason being the most common cause. According to a Rockefeller Foundation study, 68% of those who leave their health care practitioner do so because they didn’t feel cared for, the practice did not stay in touch, or they felt they were taken for granted. Patient satisfaction and loyalty are crucial to the health and development of any professional practice. Excellent patient satisfaction and loyalty help ensure steady growth through repeated visits and new referrals. Loss of patients because of dissatisfaction may be greater in dispensing audiology practices. According to MarkeTrak III, a survey of more than 2,000 hearing aid users, about 20% of this group are dissatisfied or very dissatisfied with their hearing aids. Of these, two-thirds would not recommend hearing aids to their friends. Post-fitting care was the dispenser service ranked lowest in consumer satisfaction. This follow-up service, then, is the area most critical for patient retention. How costly is it to replace patients who leave a practice? How costly is it to the profession to have significant numbers of dissatisfied consumers? And, despite the importance of patient loyalty and satisfaction, how many audiology practices have specific programs to increase patient satisfaction and loyalty? The Uses of a Patient Newsletter A patient newsletter is an easy, effective, and economical way to increase patient satisfaction. A newsletter can provide an important audiologic rehabilitation service, keep patients satisfied and loyal, and increase referrals and office revenues. • Follow-Up Audiologic Rehabilitation In almost all cases, hearing loss is a chronic disorder that will be significantly helped, but not cured, through the use of hearing aids. Because the problems of hearing loss are permanent, people with hearing loss need to be as involved as possible with their own hearing health care. Consumer education can be an important part of the rehabilitation process, and there is evidence that such education and involvement improves hearing aid use. For example, a patient newsletter can help the patient understand why hearing aids don’t cure hearing loss, how hearing problems are different from vision problems, why background noises make understanding speech more difficult, and why loud sounds may be a problem. The newsletter can suggest specific strategies to improve hearing ability, such as the use of speechreading, the benefits of assistive-listening devices, and the advantages of binaural hearing. Other contents of a newsletter may include such benefits as travel tips for people with hearing loss and how to cope with noisy restaurants and telephone use. By providing information about hearing loss, hearing aids, and hearing health care, a patient newsletter can be a valuable component of the audiologic rehabilitation process. • Improved Patient Satisfaction We know the greatest patient complaint about dispenser service is the lack of follow-up care. Although a newsletter service certainly does not replace face-to-face follow-up care, it can reinforce and become a vital part of that care. That is, if the audiologist is in contact four times a year, the patient cannot say, “They fit me with hearing aids and I never heard from them again.” The newsletter is concrete evidence of the intent to provide a high level of service. A newsletter can thus improve patient satisfaction simply by providing regular contact with the patient. But satisfaction also can be improved in specific ways. For example, by providing the travel tips mentioned earlier and suggestions for speechreading, using the telephone, and coping in noisy restaurants, the information in the newsletter can allow the person with hearing loss to do better in those settings and understand why he or she continues to have hearing difficulties. By shifting the “blame” away from the hearing aids, the patient is likely to reach a higher level of satisfaction. • Increased Patient Loyalty The most common reason patients give for leaving a professional practice is that they “don’t feel cared for.” A patient newsletter targets that reason directly because patients are “cared for” at least four times a year. Furthermore, in a service profession, consumers report that they develop loyalty based on familiarity and trust, not technology or brand. Regular communication, such as that provided by the periodic contact of a newsletter, is crucial to establishing client familiarity and loyalty. • Referrals From Patients It does not always occur to patients that their provider values their referrals. A program to encourage patient referrals can develop this valuable resource; newsletters can be a part of such a program. A patient newsletter is a concrete demonstration of the provider’s professionalism and willingness to provide “extra value “ service. The newsletter also provides a regular reminder to patients about who their provider of audiology services is and where the provider is located. Finally, the newsletter itself can be passed on to family and friends as a way to learn about the practice. • Increased Office Revenues The most valuable market available to any dispensing audiology practice is its own group of current patients. This group consists almost exclusively of individuals who have hearing loss, use hearing aids, and have identified the practice as their source of hearing health care. This is a highly focused and motivated “market segment.” Yet, how many practices spend thousands of marketing dollars on mass marketing (e.g., newspaper advertising and direct mail)? Such marketing predominantly reaches individuals who may not have identified themselves as having hearing loss. If they have a hearing loss, they have not acted on it. If they have acted, they may not have identified your practice as their source of hearing health care. The most cost-effective marketing an audiology practice can perform is direct marketing to its own patients. In most cases, however, this market goes ignored and untapped. For example, according to a survey of dispensing practices (see Strom, in references below), most dispensers believe that about 50% of their hearing aid users purchase batteries from them. In fact, when practices actually measure battery purchase, the typical office sells batteries to only about 30% of their hearing aid users. That number can easily be doubled through use of a battery-marketing program incorporated within the patient newsletter. The increase in battery sales alone can easily pay for the entire cost of a patient newsletter. But battery sales are only a small part of the large market untapped by the typical audiology practice. Regular audiologic examinations can be both a valuable patient service and an important source of revenues. Again, most practices do not have a formal re-call program, and only a small number of the current patient group is seen for regular checkups. When a formal re-call program is instituted and the patient newsletter is used to monitor visits as part of that program, revenues from the visits can be increased significantly. Increased sales of hearing aids and assistive-listening devices promoted through a patient newsletter can increase office revenues far more than battery sales and annual visits. Indeed, at a typical newsletter cost of $4 per patient, per year, the sale of a single hearing aid returns a significant part of a practice’s entire patient newsletter program. An informal survey of several offices found an estimated return on investment of at least 18:1 ($18 returned for each $1 spent) for a patient newsletter program when increased battery sales, annual visits, hearing aids, assistive-listening devices, and referrals by current patients are combined. Making a PatientNewsletter Work Newsletters come in a variety of formats and styles, from the basic black-and-white version prepared on a word processor to four-color newsletters printed on glossy paper. Following are some areas to consider. • Substance The key to a specialized newsletter that is valued by readers is substance, not style. The substance or information should be of benefit to the reader, not the practice. Individuals with hearing loss have a particular need to learn and understand as much as possible about an often-misunderstood problem. The newsletter can include substantive articles about such topics as medical aspects of hearing loss, communication strategies, hearing aid care, and general information about hearing and hearing loss. A newsletter that only advertises services and products will probably be seen as direct-mail advertising rather than a valued service. However, information about services and products can be an important part of more comprehensive information. Information about office hours, staff news, and continuing education activities keeps the patient informed about the office and helps develop the long-term relationship. • Style Although not as important as substance, style is still an important area. Type size, ink and paper color, and the use of graphics all contribute to the attractiveness and readability of the newsletter. Many readers will be older adults, so type size and style should be chosen accordingly. As a minimum, 11-point type with slightly larger line spacing allows for good readability. Heavyweight paper provides a more substantial feel to the newsletter. Many newsletters are printed in the four-page format (a double-folded 11“-by-17” sheet). A two-sided standard or oversized sheet also can provide a great deal of information with reduced printing costs. Graphics can improve the visual appeal of a newsletter, but they use up a great deal of space. Some patient newsletters are very attractive and appealing to look at, but have so little space left for written text that there is little useful information. Since our readers are highly motivated (the information is of direct interest to them), useful, specific information is probably more important than visual effects, but obviously a balance should be reached. • Schedule A newsletter should be delivered on a periodic basis. An annual or biannual mailing may be perceived as occasional direct mail rather than a newsletter service. At a minimum, a patient newsletter should be mailed three times—and preferably four times—a year. But whatever the schedule, if patients are told they will be receiving a patient newsletter, it should be delivered. Occasionally practices start a patient newsletter and fail to provide more than one or two issues, so a promise has been made and not kept. • Cost There is a misconception that providing a patient newsletter will cost the practice money. In fact, the opposite is true. A patient newsletter can generate significantly more income than it costs, and it is not difficult to achieve a high return on investment. Costs include printing and postage. Printing costs will depend on paper stock, the number of ink colors, and the number of copies, but average about $1.50–$5 per year, per patient (for four issues), with the lower end of costs for practices printing more than 2,000 copies. Postage costs (for four issues) range from about $1–$1.50 per year, per patient, based on first-class or bulk-rate mailing. An additional advantage of bulk-rate mailing is that the post office indicia can be imprinted and no stamping is required. A disadvantage is that such mail has to be delivered to the post office already ZIP-code sorted and bundled. Thus, printing and postage costs for a quarterly newsletter range from about $2.50–$6 per year, per patient, with the lower costs due to reduced per-copy costs when printing larger print runs (patient lists over 2,000). It is certainly not difficult to recover those costs. Regardless of the return on investment, many audiologists view the annual cost as an investment in long-term patient loyalty. In short, consumer satisfaction and loyalty are crucial, both for the individual practitioner and for the profession of audiology. A patient newsletter is an easy and cost-effective method to improve both satisfaction and loyalty, while generating additional revenues for the practice at the same time. References Hampton D. (1992). Internal marketing for the established audiology practice.American Journal of Audiology, 1(3), 57–60. LinkGoogle Scholar Kochkin S. (1992). MarkeTrak III identifies key factors in determining consumer satisfaction.Hearing Journal, 45(8), 39–44. Google Scholar Levinson J. (1984). Guerilla marketing. Boston: Houghton Mifflin. Google Scholar Strom K. (1995). Give your hearing care business a battery boost.Hearing Review, 2(2), 12–15. Google Scholar Author Notes Dennis Hampton, has been in private practice since 1976. He is also founder and editor of Hearing HealthCareNews, a customized patient newsletter used by audiologists throughout the United States and Canada, and Audiology HealthCareNews, a physician newsletter. Contact him by e-mail at [email protected]. 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