I was wondering if you have any information on doing a focus group. I have your sample letter "focus group invite". Do you have list of questions we should ask? Any help would be appreciated.

My Response:

The process of developing the questions you ask the patients is often as valuable as the answers you get. Every office faces a different set of challenges. The introspection required to create your questions is the first step towards the accountability that patients find so attractive. Tailor the questions into an "open probe" format for optimum results.

An open probe is a fancy name for an essay question. The question is asked in such a way that you do not impose the way in which it is answered. Try to avoid asking questions which patients would answer with a yes or no. In fact, sometimes a leading or provocative comment works better than a question. Here are some examples of closed and open probe questions/comments:

Closed probe: Do you like our hours?
Open probe: How could we make our hours more convenient?

Closed probe: Do you find that there is a lot of waiting?
Open probe: Tell me about waiting to see the doctor.

Closed probe: Are our fees fair?
Open probe: What are some ways we could make our fees even more affordable?

Closed probe: Is Barbara doing a good job at the front desk?
Open probe: Describe what you like and dislike about our staff.

ACTION: Come up with about 20 questions, based on your own agenda or stimulated by the following "moments of truth." During the course of a typical luncheon focus group it will be almost impossible to cover all twenty questions. However, with the list next to you, you'll feel comfortable that you'll be able to fill the allotted time effectively.

ACTION: Once you've developed your list of 20 questions, arrange them in order from least important to most important. Jump ahead, if
necessary, and ask the most important questions towards the end of the session when patients feel safest revealing their true feelings.

Moments of truth

Use this list to prompt questions unique to your particular office and routines:

Adjusting technique
Appointment setting process
Associate's report of findings
Bedside manner
Billings
Breath
Brochures
Children's area
Clinical routines
Dismissal
Doctor's appearance
Environment
Examination process
Fees
Financial policy presentation
First impression of the office
Front desk
Hours
Lay lecture
Magazine selection
Music
New patient procedure
Newsletter
Office brochure
Office capacity
Office location
Office procedures
Paperwork
Parking
Patient education videos
Paying the bill
Personalities
Recalls
Reexams
Report of findings
Reception room
Rewarding referrals
Scheduling
Signing in process
Staff
Telephone procedures
Therapies
Vitamins and supplements
Waiting time
Why haven't referred
Willingness to listen
Yellow page ad
X-ray procedures

Sample questions

The process of developing questions can be as valuable as getting the answers to them. There is no substitute for this introspective process. However, here are some general open-ended questions you might like to add to your own unique list:

Out of all the offices in our area, why did you select this office?

On a percentage basis, how full do you perceive the practice to be at the time you usually receive your care?

What are some of your "pet peeves" about the office?

If it were your practice, how would you increase the number of new
patients?

If money were no object, how often would you like to receive care?

When you were a new patient, what was the most frustrating aspect of those early visits?

What made you the most nervous on your first visit?

What could we do to our office to make it more comfortable for our
patients?

What's been your greatest disappointment since beginning care and what could be done to prevent that disappointment with future patients?

How could the staff be more helpful to our patients?

What tools could the office give you that would make it easier to refer others to our office?

Revealing a Flaw

The fastest way to put the focus group participants on notice and prompt them to honestly reveal their true thoughts and feelings is for the facilitator to reveal a flaw about the doctor or practice.

At first, some patients may be reluctant to share their perceptions about the office. Let's face it. Few businesses these days expose themselves and actually invite criticism! So this process is somewhat new territory for most people. No need to rush it.

Others, even the office staff, are accustomed to having their criticisms of the office or procedures rebuked. If the doctor takes a defensive posture or staff members are perceived to be disloyal because of their opinions, this valuable feedback loop is shunted. When the staff learns the emperor doesn't want to be told he or she isn't wearing any clothes, the staff quickly learns not to volunteer such information. The symptoms of this appear as lack of motivation, a loss of attention to detail, and a detachment that turns a career opportunity into merely a job.

This can happen at a patient focus group too.

It's important to put patients on notice that there aren't any sacred cows or unapproachable topics. The first step towards achieving this openness with the patients attending your focus group is to begin coalescing the group by revealing what they have in common. Focus groups are productive because they create a safe environment. Give patients this safety by explaining what they all share in common.

"Good afternoon, and thank you for attending Dr. SoAndSo's focus group. You probably don't know this, but all of you share something in common. You represent the doctor's Ideal Patients; patients he/she would like to have an entire practice full of..."

This usually puts patients at ease and serves as a compliment that affirms the patient's decision to attend. Patients feel safe because they know they are among like-minded individuals that probably share their same concerns.

The second step is to reveal a flaw. Discuss a seemingly sacred cow.

"I know that some of you probably have some great ideas on how we can improve the service we provide to our patients. I suspect one of the things we need to address today is the waiting time some of you experience at peak hours of the day..."

It doesn't matter too much what flaw you reveal, however the more
intimate or personal it is, the quicker you put the participants on notice it's all right to share similarly sensitive subjects or concerns. The flaw can be anything from something about the turnover of office staff to poor parking arrangements. Go through the list of Moments of Truth to get ideas about what you want to reveal.

The third step is to take a non-defensive posture. Patients may observe or comment on procedures or situations which exist for reasons not understood by patients; perhaps to avoid malpractice lawsuits, increase efficiency, etc. Unless there is a great uproar or participants are going after a red herring, avoid defending any comment or observation made by patients. Bite your tongue. This is a time to listen, not defend. It is not a time for a treatise on practice management or give a spinal care class. Even a modest effort to defend why something is the way it is will result in a shut down of the patient's willingness to volunteer ideas openly. Scolding patients or being ultra-sensitive about some issue will put patients on notice that the facilitator is not truly interested in constructive criticism.

Bill