Optometric Management Tip # 236   -   Wednesday, July 26, 2006
Jump-start Your Practice: Part 2

This series on jump-starting your practice is based on the premise of making your practice appear to be the way you hope it will become. Act now as you mean to go. Visualize the practice you want to build and make your present office look and act like that in every way possible. This strategy involves doing things before they seem necessary. By emulating the high-level practice, your practice will become one. Itís not hocus-pocus; high-powered practices have certain traits that generate more business. These traits may involve excellent customer service, an outstanding professional image or other competitive advantages.

Jump-start #2: Raise your exam fees

Once again, Iím advising taking an action that, on the surface, seems contrary to what you might do if a practice was not busy enough. Why would more patients come to your office if you raised fees? Most ODs worry that a fee increase will drive away the few loyal patients they have. Here is why a fee increase will help grow your practice. How much to raise them

I have successfully raised fees in my own practice and in clientís practices in fairly large increments. Very few patients really keep track of what your exam fee was last time they were in, and even if someone does, so what? Fees are like prices on anything Ė they go up! How much to increase exam fees depends upon how woefully off-base they are. I have known doctors who feel a 10% increase in fees is a very large increase, but they are charging $60 for an exam with refraction. That increase is a whopping $6 bucks! It will still help the bottom line, but itís a missed opportunity to do something that will really make a difference in the practice. That fee will likely not be raised again for over a year; maybe not for two or three years. Since youíre raising it, why not raise it $25? At $85, the exam you are providing is still a great bargain! The vast majority of patients still wonít notice and even those that do notice wonít leave.

How to raise them

Just do it... with as little fanfare as possible. You are allowed to raise your fees without notice. What good would it do your practice to make some announcement? Sending a message that you and your staff are defensive about fees or that they may not be justified is the one action that will make a patient balk at the fee. Act as if itís business as usual and no one pays any attention.

Erase any feelings you may harbor that your services may not be worth a high fee and talk with your staff about it. After all, you provide the very best exam technology and patient care, donít you? And your customer service is second to none, right? If so, trust that there are many people willing to pay for that excellent care.

I strongly believe that the exam fee should be stated over the phone to every person who schedules an appointment, even if they donít ask. Your staff need not say that the fee went up, just say what it is and discuss if insurance will be accepted or if payment will be due at the time of the visit. If your fee structure is so complex that you canít quote the fee without seeing the patient first, I think thatís a problem. Quoting the fee and explaining the payment policy in advance is a major step in achieving patient satisfaction. Patients want to know and they deserve to know.

On the day you raise the fees, you might tell your staff that if any patient responds by saying they were quoted a lower fee than what is being presented, the staff is empowered to explain that there was a fee increase, but that the office will substitute the old fee since that was quoted. I doubt that anyone will respond that way, but itís a good policy just in case. That policy can end after about two weeks.

But it will make no difference with vision plans

This may be the ODís favorite reason for not raising fees; it wonít make any difference anyway. Well, if it wonít make any difference then why not raise them? You certainly wonít hurt anyoneís feelings at the vision plan headquarters if your usual exam fee is much higher than their maximum payment. They wonít complain or even notice. Most practices do have some private pay patients and the owner is worried about offending them, or thinks it would not be fair to charge so much more to this valuable patient group.

What about fairness to you? You probably believe that your professional judgment, your staff and your physical facility is worth much more than your current exam fee. Sure, the private patient is valuable, but why should he or she pay so much less than you are worth? I can see why a vision plan should get a discount on your fees (assuming they deliver patient volume or potential volume), but why should all private patients get a discount? You canít give everyone a discount.

The volume discount you grant to vision plans is a business decision that should not relate to your usual fee. Just because some vision plans pay ridiculously low fees and you accept them does not mean that is what your services are worth. It only means that you feel the volume of patients the plan delivers is of sufficient value that you are willing to accept a huge discount for that group. If you no longer feel that way then drop the plan.

My friend Jerry Hayes sums up fee levels in a very clever way as he makes the point that fees are not the most important criteria when patients choose an eye doctor. He starts by asking if there are any practices in your area that have lower fees than you. Generally the answer is yes, there are lower fee providers. He then asks ďWhy donít they have all your patients?Ē


Best wishes for continued success,

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