Optometric Management Tip # 492   -   Wednesday, July 27, 2011
Not enough patient demand? How to make a huge impact

Many optometrists are simply not busy enough.  I think the biggest problem facing optometry today is lack of patient demand.  I'll present some strategies to attack this problem over the next few weeks, but most of them will not result in a quick, sweeping change.  The approach I will share in this article, however, offers a very quick remedy.

Sufficient demand, defined
How many patients an optometrist should see per day is subject to opinion, of course.  It varies based on many factors, but considering the impact of vision plans on fees, I think we need to see about 24 patients per eight hour day.  Many ODs see many more than this and I won't quibble with a few less, but let's analyze it a bit closer.  If you divide 24 patients by eight hours, you get about three per hour.  That's 20 minutes per patient and it is certainly reasonable in my view.  I like to remind ODs that as much as your patients may love you, they don't really want their eye exam to take a long time.  It is not really all that much fun in your exam room!  If you could do a great exam in less time, patients would actually pay more for it!

I realize there was no lunch break in my example, but you should be able to see four additional patients throughout the day and you may have a no show or two, so you can certainly take an hour for lunch.

To keep my example simple, I would like to just accept any type of exam in the eight hour day.  So the 24 patients will be a mixture of comprehensive exams, progress checks and office visits.  Of course, to achieve this time frame, the OD would have to delegate pretesting and optical dispensing to staff members, but I'm going to accept this as preferred clinical operations.  If you think about any medical specialty, 20 minutes with the doctor is a long visit.

So if we accept 24 patients per day as the norm, how are you doing on average?  Rather than overestimate, you might want to actually count the exams on days past.  Or track the total number of exams seen in 2010 and divide by the number of patient care days on the schedule.  The real number is often less than ODs think they see.  If you see patients at the rate of 24 per day and if you have appointments booked more than a few days ahead, you are doing very well.  If you are seeing fewer than 24 per day, you are closer to the norm and you could see more.

You are in control
Let's assume that you can't immediately generate more patient demand.  I will present some ideas in the next few tips that will go against that premise, but if I were faced with low patient demand, I would compress the patients I have into fewer days.  Even if you can't control your patient demand, you can control how fast you see them.  Rather than seeing 12 patients per day over five days per week, I would see 24 per day in two and a half days per week.

There are several huge benefits to this approach:

Success breeds success
By emulating the schedule of the busy optometrist, you and your staff begin to think that way.  Instead of the usual slow (boring) pace that contributes to small thinking, you will function as a busy practice when you are there.  Don't be comfortable with a slow pace where the doctor does everything.  Structure your office procedures so you are efficient when you are in the clinic.

Patients will respond to the new busier appearance with the conclusion that your practice is extremely successful.  It is obviously the place to go for eye care.  They will talk about your practice and refer others based on that assessment.

You may have to rearrange your staff members and even hire an additional employee to make this happen.  You will need several staff members on patient care days and maybe only one on the other days when you are not there.  You may need to hire some part time staff.  But let's remember the benefits of creating a day or two or three of free time each week.  That's worth a lot and you can use it to build your practice. 


Best wishes for continued success,

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