• Fill out your intake forms. Are they current? Are they easy to complete? Is there enough space for the answers? Is there anything that should be changed?
• Enter your office with fresh eyes. Is it clean and organized? Is it well lit? Are there materials available? Is the bathroom spotless and stocked with enough supplies? Is there enough seating or too much? Side note: too much seating sends the message that you don't run on schedule and patients need to wait.
• Note what things look, smell and feel like. Is it quiet? Does it smell of any odors that might offend someone? Are there stains on the chairs, walls or carpet? Are there fingerprints or scuff marks on the walls? Are the magazines tattered, out of date and irrelevant?
• Lie on your exam table and look at the ceiling and under the table. Do you need to dust or paint or replace the carpet?
• Use all the facilities/equipment at your office. Is everything in working order?

This is not an exhaustive list, but gives some ideas to get started.

Mystery Shopper

You can also elicit the help of a good friend, family member or colleague and ask them to run through the process from beginning to end. Sometimes called a "mystery shopper," this person goes undercover to find pitfalls or accomplishments. Choose someone who will be brutally honest with you. The point is to learn possible areas of improvement, not to learn how wonderful you already are. Have them call for an appointment at some random time. See the process through, all the way to rescheduling another appointment. Once completed ask them:

• Was your call returned promptly?
• Were the directions to the office clear?
• Did you find the information you needed on the website?
• Were you greeted in a professional manner?
• Did you know what to do once you entered the office?
• How long did you have to wait to be seen?
• Did you and your time feel valued?
• Was the facility clean and uncluttered?
• Did everything smell and look clean? Was the temperature of the office comfortable?
• Did you feel comfortable with the entire process?
• Did you feel "listened to?"
• Was there a place for your belongings?
• Was there anything that made you feel uncomfortable or uneasy?
• Is there anything I could have done to improve the experience?
• Did you think the pricing was appropriate?
• Was there inherent value in the experience?

Note that neither of these lists has anything to do with your technique or the hands-on experience. These are business applications that can make a patient's experience wonderful or miserable. You have the power and if you take the time to test the waters, you can learn and make the necessary adjustments.

It's Competitive Out There

When you think of your own experience with health care professionals, I am sure you can conjure up a good memory and a bad one. With a myriad of health care professionals to choose from and competition being stiffer than ever, the average patient won't stick with someone if they've had a bad experience. I waited for a medical consultation for 3 hours ... once. I never saw that doctor again and in fact, never went back to that group practice. The staff was unapologetic and the doctor made me feel like his time was more valuable than mine. He was a world-renowned surgeon and I didn't care. He wasn't getting a piece of my shoulder.

Conversely, my chiropractor makes me feel like she has no one else to care for except me. She tends to run a little late, but it is okay with me because I know she will give me her undivided attention. Her staff is fun and it is always joyful to go to her practice. Take a minute now and consider your own experiences with health care. Recall the one that you liked and think about why you liked it. Do the same with the negative experience. Now take this information and duplicate it in your own practice.

Annual analysis of your practice is a must. More frequently is fine, but at least yearly, try to be your own patient. This is even more important and valuable if you have staff. In fact, if you have staff, a semi-annual review is imperative. All of this takes time and doesn't actually make you money, but the importance can't be under-estimated.

Retention is the name of the game and if you would return to your own practice, chances are your patients will feel the same way. When I look at everything that goes into a successful appointment, I realize that the comparison to Maryann had little to do with my hands. Our demeanor, office set up and business acumen are very similar. Being compared to her is actually a compliment, and nothing for which I should be disappointed.

Jenn Sommermann is a licensed massage therapist, educator and business consultant. She practices in New York and is owner of Massage by Land & Sea. Jenn continues to reach a broader audience offering continuing education in Practice Management and Ethics throughout the country. She can be reached at http://www.jennsommermann.com