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 By Neil B. Gailmard, OD, MBA, FAAO, Editor January 23, 2008 - Tip #312 
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Lack of Patient Demand: Reasons? Solutions?


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I received several reader emails about Tip #310, which centered around three major management challenges that face most eye care practitioners (ECPs). The aspect that got the most attention was my statement that lack of patient demand is the biggest problem facing ECPs today. Here are some examples of reader sentiment:
  • Lack of demand is directly related to the total oversaturation of ophthalmic providers, especially in the northeast U.S.
  • Do you feel that there are too many ECPs for the demand, and if an oversupply of ECPs is not the reason, what would the reason be?
  • Fee for service patients are virtually nonexistent; after all, why would someone pay $100 for me to examine them when the guy down the street will do it for $59?
  • There is absolutely no patient loyalty - one either accepts their insurance or not. If the latter, they go elsewhere.
  • The days of patients flocking to an OD because he/she is a wonderful person who does a great job are long gone, and patients will leave a practice if they can save a mere $5.
  • I always enjoy reading your thoughts, even if they don't reflect the realities of practice in many parts of the country.
An oversupply of ECPs?

With the reality of three new schools of optometry in the planning stages, the supply of optometrists is an emotional question. Most practicing ODs would say there are too many ECPs in their community and they all could be busier, but some experts counter that argument by saying there are many unmet visual needs and if the public was educated about the eye care that is truly needed, there would be plenty of business for all. Would-be employers of ODs are certainly finding it more difficult to find job candidates, but many in the profession feel it's better for optometrists to own their practices rather than be employed.

The whole question of an oversupply of ECPs is too abstract to hold my interest for very long. Maybe I'm just too practical, but even if I could pin down the true reasons for why it seems that most ECPs lack sufficient patient demand, I couldn't do anything about it. It's too big and too complex for my short term needs. I support the organizations that can do the proper manpower studies and possibly affect public policy in a positive manner, but my bigger interest lies in my practice, right now.

What can you do about it?

While many practices suffer from lack of demand, anemic fees, and saturation by vision plans, let's be clear that not all practices have those problems. In every region of the U.S., in every type of market and in all kinds of local economies, we can find ophthalmic practices that thrive. These practices have full appointment schedules and they charge fairly high fees. They take some vision plans, but they are not dominated by them because they also have some private pay and they bill medical plans as well. They have a reputation as the best eye care provider in town. Practice owners really do have options for the destiny of their practices. There may not be enough patient demand for all practices to be busy, but there is enough for yours to be busy.

This model of excellence in eye care can be seen in virtually any other industry you wish to analyze. People from all walks of life and from a wide range of income levels will opt to buy nice clothes from a fine store, even though cheaper clothes are available. They will choose to go to an expensive hair salon and spa, even though they don't have to. They will pay $4 for a cup of coffee when they could have made their own. They will pay $50 for dinner in a nicer restaurant when they could have dined out for much less. They will take their car to an independent mechanic they trust and pay more than they would have at the auto department at a big box store. I could go on and on, but I'd rather you think of some more examples.

Why do people spend more than they have to? Because they perceive a value in the higher priced product or service that is worth more to them than money. Opting for better quality is not just for the wealthy; high quality goods and services transcend income levels if the desire is strong enough.

If you want to own the busy, high fee practice in your community, go about the business of setting your practice apart from the pack. It may take a few years to build it and develop it, but isn't it worth the trouble?


Best wishes for continued success,

Read Past Tips Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week


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Send questions and comments to neil@gailmard.com.

Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com.
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