Optometric Management Tip # 219   -   Wednesday, March 29, 2006
Medical Optometry: Is There a Downside?

Talk with a group of optometrists today about the latest trends in the profession and youíll hear about the increased emphasis on medical eye care. New grads and seasoned practitioners alike; everyone is embracing diagnosis and treatment of eye disease; in some cases as if it is the savior for all of what ails optometry.

My personal position on medical eye care in my own practice is very positive. I became certified to treat eye disease in my state when the legislation was passed many years ago. Iím in group practice with three other doctors and we all actively diagnose and treat everything from infections to glaucoma. We all obtain a considerable amount of continuing education in this field. No doubt about it, prescribing pharmaceuticals for the eye is an important part of optometric practice.

From a business standpoint, medical eye care can be a financially rewarding addition to our other services, but there is also a potential drawback.

Driving the medical trend

There are many good reasons why optometrists are increasingly pursuing management of ocular disease. So what?

So, is there a downside to medical optometry? Not directly maybe, but concentrating on eye disease can pull your focus away from optical dispensing and that can lead to a loss of significant potential revenue. Revenue is not everything, of course, and each practitioner must do what makes him or her happy, but our premise for this article is the business standpoint and the primary goal in business is revenue. If weíre honest, personal income is a very strong goal for most of us.

Many ODs think they can practice both medical and optical care, and some actually do it. That would be ideal. Unfortunately, as is the case in any business, it is difficult to pursue two diverse services and do both well. There is only so much time and the CEO can only work on so much.

Optical suffers

In many cases, the optical department in a medically oriented eye practice is mediocre. There is often a lack of attention from the top and the staff develops a complacent attitude about customer service. Optical is not fun and exciting, but it is a medical adjunct to functional vision. A necessity. The doctor who loves treating eye disease usually could care less about the latest designer frame style or about policies to create sales of second pairs. In some cases, the doctor proudly states that he has no interest or knowledge of optical dispensing, preferring to delegate all aspects of that to the staff. Iím big on delegation, but that approach severely limits practice growth and revenue.

Big revenue

Optometric practices that earn top revenue have great optical departments and generate an amazing amount of revenue from eyeglasses. Without surgical fees, a primary care practice is limited to what it can bill for diagnostic procedures alone. That may seem like good revenue, but it pales when compared to what a practice can produce when it offers excellent clinical and optical service. Consider what you get paid for procedures like office visits and visual fields. Itís satisfactory, but itís not big money and it all depends on you to do the work.

Vision plans may be so dominant that it can affect the philosophy of the doctor and staff. You may feel like medical procedures produce excellent revenue because you compare it to the exam fees paid by vision plans. You may feel like optical is not that profitable because you have not broken away from providing what the plan covers. What many ODs donít seem to know is that patients will still pay for services and products that they really want, even if itís not covered by a plan. We have to make those services and products available and attractive.

Donít place all your energy into eye disease and billing and coding. Embrace optical as well.


Best wishes for continued success,

Neil B. Gailmard, OD, MBA, FAAO
Chief Optometric Editor, Optometric Management