Sight for Sore Eyes

July 2008
By Marsha Canright

Why ophthalmology chair Bernard Godley decided to clean his patients' glasses-and how he aims to make his patient-centered department the provider of choice for the UTMB community

Four years ago, soon after he entered a private ophthalmology practice in Dallas, Bernard Godley, a highly skilled retina surgeon, experiences an epiphany. "I knew I was providing excellent clinical care, but my patients were not truly satisfied with my services, and I had to ask myself why," said Godley, who earned a bachelor’s degree with honors from Brown University in 1980, a Ph.D. from MIT in 1987, and an M.D. cum laude from Harvard in 1989. He subsequently interned in medicine at Brigham and Woman's Hospital in Boston and completed a residency in ophthalmology at the University of Iowa Hospitals and Clinics, followed by clinical fellowships at Moorfields Eye Hospital, London, and the Retina Institute of Maryland and a five-year tenured associate professorship with UTMB’s Department of Ophthalmology and Visual Sciences ending in July 2001.

Change agent: Professor and Chair of Ophthalmology and Visual Sciences Bernard Godley, right, visits with, from left to right, Claudia Salinas, ophthalmic assistant; Tekeema Franklin, surgery coordinator; Donna Ketchens, certified ophthalmic technician; John Horna, former ophthalmic photographer; and Amber Crocker, certified ophthalmic technician.

Shifting from academia to private practice, Godley encountered a sea change in institutional cultures. After arriving in Dallas, "I found myself thinking, 'I'm a scientist. I'm a retina specialist. I don't clean glasses,'" Godley noted. But he soon sensed that his patients, who actually appeared to feel nurtured when their doctor cleaned their glasses, perceived this hierarchical attitude as telegraphing that he was egotistical and aloof.

Discovering how patients felt about him "was my awakening," said Godley, who was named last December as professor and chair of UTMB's Department of Ophthalmology and Visual Sciences. Being a successful practitioner "wasn't just about my level of skill or how many degrees I had."

Medical practice is fundamentally about the patient and the patient's needs, observed Godley, who at the time of his great awakening was the director and senior scientist at the Sybil B. Harrington Molecular Ophthalmology Research Laboratory, Retina Foundation of the Southwest, and an active partner in Vitreoretinal Practice of Retina Specialists, in Dallas.

"Everyone is our customer, and it's our responsibility, each of us, to understand and serve the needs of every customer."

- Bernard F. Godley, MD, PhD, FACS

Initially humbled, Godley soon began to conceive a vision of what he needed to change and how to do it. He began to listen more closely to his patients, making an effort to keep track of the patient's expectations and figure out how to meet them. He still delivered excellent clinical care—but with a difference: If a patient wanted to talk about his or her dry eyes, a subject Godley formerly considered trivial, Godley talked about their dry eyes. He even cleaned his patients' glasses.

Suddenly patient satisfaction soared. His practice blossomed and prospered.

This patient-centered approach seems to be serving him well at UTMB, too.

Engaged and energetic, Godley has met individually with all sixty-six members of his staff to stress the need for improved customer service. He said every staffer was "willing to set a new course, willing to set a high standard, and eager to succeed." He also organized a new management team with ophthalmologists Eric van Kuijk as vice-chair for clinical services and Brian Wong as the resident training program director.

"We've spent a lot of time talking about the characteristics of good service and poor service with examples," he said. "Everyone is our customer, and it's our responsibility, each of us, to understand and serve the needs of every customer."

Is it working? It seems to be: In his first sixty days as chairman, patient satisfaction soared by ten percentage points in such key areas as speed of registration, courtesy of registration staff, and courtesy of care providers. The likelihood that a customer would recommend the practice to others also jumped ten points. The turnaround happened so fast it surprised even Godley. Despite a few bumps in the road here and there, the numbers continue to rise.

Whatever makes the customer more comfortable, more welcomed, more secure—that is what Godley practices and preaches. With staff assistance, he has redesigned the formerly confusing traffic flow of the clinic to give patients the sense that they are progressing through the logical stages of their appointments. And in a clinic where patients once had to wait for several hours, he has set a goal that no patient’s visit should exceed one hundred minutes. Meanwhile, he has cross-trained technicians to speed serving the patients, and he has set up a dedicated telephone line reserved for referring physicians so as to expedite their calls. Prior to appointments, a letter now goes out to patients describing exactly what to expect during the upcoming visit. Godley encourages staff to spend more time concentrating on what they can do for patients and less fretting over what they can't.

Godley doesn't try to manage all this change from his second-floor office in the University Eye Center at 700 University Boulevard, halfway between Seawall Boulevard and UTMB. Instead, he works in the clinic alongside fellow care providers, modeling the positive behaviors he wants his staff to emulate. He freely hands patients his business card, including his cell phone number, and he encourages them to call if they need him. Although he says he has gotten only one call in six months, he thinks the gesture coveys a valuable and not-so-subtle message—that he considers them "important and that taking care of them is a high priority" for him. He likewise requires all his managers to work the line.

"I want people to know I have skin in this game," he said.

"We have a clear vision of where we’re going," Godley said.

"Within five years, and hopefully long before that, we will be among the best ophthalmology departments in Texas, with an outstanding customer service rating. We'll be the provider of choice for our UTMB community. We will be training national leaders in visual science, and our clinical practice will be generating a positive cash flow."

Another goal, an important one to Godley, is to create a world-class center at UTMB to treat age-related macular degeneration. The first step in realizing such an undertaking was his success recruiting an internationally renowned expert in the field, Michael Boulton, from the University of Cardiff, Wales, who will lead this effort.

"Our faculty members are excellent, with diverse talents ranging from bioengineering to molecular biology," Godley noted. "We have leading-edge imaging equipment and everything we need to build a center of excellence."

Finally, he says, he is committed to financially rewarding staff members who become "customer service stars." For this initiative and for his patient-centered approach, he has the full support of Dean of Medicine Garland Anderson, whom he said understands what it takes to create a culture of caring for one's patients. For his part, Anderson sees Godley as a "person to lead us into the future—a rare 'triple threat'—a compassionate human being, clinician, and researcher. Dr. Godley has set very high goals for his department, and I'm confident he will achieve them."

Said Godley: "UTMB hasn't always focused on customer service, but it’s not too late to start. I'm happy to be an agent of change. Great things are going to happen."