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 By Neil B. Gailmard, OD, MBA, FAAO, Editor September 25, 2002 - Tip #36 
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Prescribing and dispensing more to each patient

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Last week's tip focused on seeing more patients per day, and I mentioned that there are three basic ways to increase practice revenue. Those are: (1) raising fees, (2) seeing more patients per day, and (3) "selling" more goods and services to existing patients. This week I'll focus on the third factor: selling more to each person. I know selling is not a popular word for what optometrists do - but in a general sense, we are always selling ourselves, our practices, our treatment programs, and when a patient walks into the dispensary... our products. We generally substitute the word prescribed or dispensed, but in business terms, it is all the same.

I do not believe in a hard-sell approach in my practice, and my staff supports this philosophy completely. I do not pay any commissions or bonuses or spiffs - just good wages and benefits. I believe that selling in a professional office occurs through patient education. If we explain the features and benefits of our services and products... they sell themselves. Even with this low-key approach, we are pretty successful at selling more to each person we see.

An important step in achieving a goal is measuring, and we do this with an important statistic called gross revenue per patient (GRP). It is easy to track - just take your monthly gross revenue and divide by the number of patients you saw that month. I use only comprehensive exam patients for simplicity. As long as you always use the same terms, the stat allows you to chart your progress. This number is directly related to how many goods and services each patient consumes. Do you know what your GRP is?

Here are some examples of what drives the GRP up.

  • Prescribing contacts and new glasses at the same visit
  • Fitting specialty contacts - like bifocals
  • Monitoring and treating eye disease, as you provide optical eye care. If you invest in instrumentation, this results in visual field exams, nerve fiber analysis, retinal photography, corneal pachymetry, gonioscopy, corneal topography, etc.
  • Performing a low vision exam (higher fee service) and prescribing advanced aids like closed circuit video magnifiers
  • Providing high quality non-Rx sunglasses as you dispense new contacts
  • Co-managing LASIK patients
  • Patients frequently order two pairs of glasses at once, like one regular progressive and one computer progressive
  • Patients order a high end frame for their new glasses
  • Patients order lots of lens options, like A/R coatings, high index lenses, edge polishing, etc.
So what causes a practice to excel at these multiple services? I think the biggest factor is developing a relationship of trust between the patient and your practice. It is providing an overwhelming feeling that what you are recommending is in the patient's own interest, far more than yours. This becomes part of your practice culture and it is intangible.

It also comes from being in a position to offer the higher-level goods and services, and recommending them. You can do a high fee low vision exam and prescribe the high tech aid... if you have the equipment and have created the procedures. You can sell non-Rx sunglasses... if you have a great selection of top name brands. I find people don't have to be wealthy to want these extra services - just ordinary folks.

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.

Please Note: The views expressed in Management Tip of the Week do not necessarily reflect those of the sponsor.

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