How to be a great DO Part 3

Measures of happiness describe the experience in the moment

In practice we all have the usual numbers we pay attention to; number of eye exams booked, number of spectacles dispensed, conversion rate and average order value just to name a few.

These are all valuable metrics that help the business understand performance and they make comparisons possible. Yet the things we say we want for the business don’t always show up in these metrics; namely loyalty, advocacy, referrals, long-term brand strength and emotional attachment.

We often end up treating the numbers as the achievement itself: “We got x conversion rate and x average order value today”, but most of the measures are proxy ones. Meaning they are not the thing we ultimately want, they are the indicators we hope point to something bigger.

We assume that if conversion rate is high, patients must be happy. Yet a practice can hit high conversion whilst at the same time eroding distinctiveness. A practice can also increase average order value (AOV) whilst at the same time making the experience feel transactional rather than relational.

The numbers we measure don’t lie, but they also don’t tell the whole story. They help us run the business, but don’t necessarily tell us whether the business is working the way we hope it is.

Patient happiness: the missing metric

Many practices already use tools such as satisfaction surveys or Net Promoter-style questions to understand how patients feel about their experience. These measures are valuable; they offer a quick sense check, help identify obvious issues, and provide reassurance that the basics are being delivered well.

Where they tend to reach their limit is not in what they capture, but in what they predict. A patient can report being very satisfied without that feeling translating into loyalty, advocacy or a desire to return.

In optics, ‘happy’ often reflects a smooth, comfortable appointment; important, but not always distinctive. This creates a small but significant gap.

Measures of happiness describe the experience in the moment, while many of the outcomes practices care about most (repeat visits, recommendations, long-term attachment) show up later, through behaviour rather than feedback.

Rather than replacing these tools, the opportunity is to build on them by paying closer attention to what patients do next. Instead of measuring happiness directly, it might be useful to measure the behaviours that only happen when happiness is real. Because if patients are genuinely happy, not just satisfied, it will show up elsewhere without us needing to ask.

Three ways to measure what matters

Here are three ways we can measure what matters beyond average order value:

1. Advocacy

Advocacy goes beyond a patient saying they were happy. It appears when someone actively recommends the practice to another person; by naming it, directing someone to it, or speaking about it publicly in a way that goes beyond a generic review. What makes advocacy such a strong signal is that it carries a cost. When people recommend a practice, they are putting their own reputation on the line. If the experience falls short, it reflects on them. As a result, recommendations tend to be selective and considered, not casual.

Tracking ‘return without need’ can provide valuable insights

This makes advocacy a more meaningful indicator than satisfaction alone. It suggests trust, confidence, and a belief that the experience will stand up when passed on to someone else. It’s happiness with a cost attached, which makes it meaningful.

How to track:
• Ask “Did someone recommend us?”
• Named referrals per month
• Not just the number unprompted of reviews, but the quality of language in them

2. Return without need

Many return visits in practice are driven by clinical need, perhaps an eye exam reminder, a prescription change, or a broken pair of spectacles. These are important, but they don’t necessarily tell us how strongly a patient feels about the experience.

Return without need looks at something different: patients who come back before they have to. This might be for a second pair, sunglasses, or simply because they want to explore options that suit their lifestyle, not because their eyes demand it.

When someone returns by choice rather than obligation, it suggests the practice holds emotional as well as clinical value. It indicates that the experience was memorable, enjoyable, and worth repeating – not just effective.

How to track:
• Percentage of purchases not linked to an eye exam
• Time-to-return without clinical need

3. Language as a signal of emotional value

The words patients use to describe a practice offer another useful signal. Language often shifts as experiences move from competent to meaningful. Comments such as, “It was easy” or “They had nice frames” tend to describe a functional service. Phrases like, “They really understood me” or “It felt different” point to something a little more personal.

This kind of language matters because it reflects how the experience has been positioned and received emotionally by the patient. When patients describe a practice in their own words, particularly using identity-based or emotive language, it suggests a deeper connection than satisfaction alone.

Paying attention to repeated phrases, rather than isolated comments, can reveal whether the practice is becoming more distinctive in the minds of the people it serves.

Summary

These kinds of measures can feel harder to track than the traditional performance metrics we’re familiar with. They are less tidy, less immediate, and don’t always sit in a spreadsheet. But they are often closer to the outcomes practices say they care about most, because they reflect real behaviour rather than reported sentiment.

When we only measure what’s easy, we optimise for efficiency. When we measure what matters, we build something people choose to come back to and talk about.

One to read
The Power of Moments – Chip & Dan Heath explains why certain experiences stand out, get remembered and talked about; useful context for advocacy and word-of-mouth.

Rebecca Thompson FBDO is a dispensing optician, eyewear strategist, founder of Eyestyle Studio and writer of Eye Style, a weekly journal exploring the business, design and the future of optics.