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 By Neil B. Gailmard, OD, MBA, FAAO, Editor January 7, 2009 - Tip #361 
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Planning for 2009

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As we enter a new year, I always find myself planning and setting goals for my practice. This year, the economy has us all wondering what might lie ahead and many eye care practitioners are worried.

If we step back and take a simplified overview, you have three options for how to approach business in 2009.

  1. Make no significant changes. Just continue with business as usual and ride out the tough economy.
  2. Concentrate on reducing practice expenses to improve profitability.
  3. Invest in the practice and make proactive changes to stimulate growth.

There are certainly degrees within these three strategies and you could incorporate more than one, but I find it helpful to consider which strategy feels best to your business instincts. I don't have a crystal ball and there is some risk in any of the approaches, but I think number three has a lot of merit. It is very possible to make 2009 an excellent growth year in your practice in spite of the national economy.

Of course, the best way to go depends on your practice history and your current financial condition. The first option above feels safe, but it allows external events to happen to you without any control. The second option is how many business owners instinctively react when business slows down, but it can be dangerous because cutting costs often means cutting service which can drive away the few customers that are still coming. Option three gives you the ability to make things happen. You can stimulate productivity, office efficiency and revenue production. You can offer new services to create a new revenue stream. You can create a positive buzz about your practice that will generate new business and more repeat business.

Let's look at a few ways to invest in your practice with both time and money.

Practice management technology

2009 could be a great year to take the plunge and adopt a new practice management software system, including electronic medical records. Among the many benefits:

  • Impress patients with your state of the art facility as you and your staff record exam data on a desktop or tablet computer. Anything that gets patients talking about you to their friends and family is good for business.
  • Print walkout eye care reports for the patient to take home.
  • Easily send letters to other health care providers.
  • Improve efficiency for filing claims with vision plans and develop new ways to bill for medical eye care services.
  • Improve your accuracy with coding of procedures and diagnoses.
  • Use email to communicate with patients.
  • Track your frame inventory to facilitate smarter buying and restocking.
  • If business slows somewhat you'll have the time to integrate the new system and work with your staff.
  • There are many, many more advantages and efficiencies to be gained. Just research the websites of the leading eye care software providers.


I never look at an instrument as simply a way to generate income; it must have a valid clinical benefit for the patient, but there are many new instruments that provide both. Some instrument investments will provide an immediate positive cash flow for established practices while increasing the level of care you provide. Add the wow factor which can increase word of mouth referrals and investing in a new instrument becomes a great decision. Some instruments have the added benefit of stimulating professional referrals from local doctors who don't have the technology. Some of the hottest instruments right now are:

  • Fourier Domain OCTs. The diagnostic capability is amazing.
  • New macular diagnostic technology. There are several instruments that measure, monitor or assess risk of macular disease.
  • Computerized refraction systems. Whether used by a technician in a pretest area or by a doctor in an exam room, this is the most advanced instrumentation available for refraction. It is fast and accurate and very impressive to patients.
  • Computerized Snellen charts. While not new, I'm still surprised at how underutilized these digital acuity charts are. They provide a lot of bang for the buck.

Read about these advancements in professional journals and see them demonstrated by attending a major conference in 2009.

Adding an associate practitioner

A practice generally needs a surplus of patients to successfully bring in a new doctor, but if you are fortunate to have that, nothing adds more revenue than an associate. A great strategy is for the senior doc to reduce his or her patient care schedule, which naturally moves some of the patients over to the new doctor. The senior doctor can then spend more time on practice management issues and the practice becomes busier than ever.


The secret to developing an efficient practice is to delegate procedures before you actually have to. This allows the staff to become highly proficient and able to handle increased patient flow when the time comes. Consolidate your typical patient load into fewer days of the week and create free days that you can use for management. A fantastic side benefit is that your practice immediately appears busier! A successful and thriving practice is a great image to present to patients.

Customer service

This is most forgotten element of practice growth. Make 2009 the year for legendary patient service and satisfaction. I assure you that helping patients get what they want will not increase your expenses; it will increase your income.

I hope you have a very prosperous new year!

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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