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 By Neil B. Gailmard, OD, MBA, FAAO, Editor March 11, 2009 - Tip #370 
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Not busy enough? Look within.


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Insufficient patient demand is an ongoing problem that plagues most eye care providers. There are exceptions; we all know of a few practices that are incredibly busy, but the vast majority are not. Many practice owners have rationalized this sad state of affairs by adopting a convenient philosophy that the current patient flow is desirable. Doctors may profess that they don't want to be any busier or they don't want to hire more staff, but I would respectfully challenge that. Greater patient demand creates a wonderful chain of events in a practice with the most profound result being great income levels.

Oddly, owners of practices that aren't very busy don't often look at their own procedures and policies as the probable reason. Maybe it's too uncomfortable or too personal. There are usually all kinds of outside factors that get the blame for mediocre production. There is actually a very direct connection between your office operations and how busy you are! If you need more patient demand, don't look to advertising or promotional efforts; look to how you do business.

A restaurant analogy

The basics of good business become clearer if we remove ourselves from our own practices and even from eye care for a moment. Let's consider your own experience when dining out at restaurants. As consumers, we all tend to evaluate the performance of a business as we patronize it. Here are a few dining experiences you may have had to which you can relate:

  • The food is just not that good. This is a restaurant that you want to like, because it is in a good location or it looks nice, but on repeated occasions you have found the food is not all that great. You may find yourself wondering if the owner ever eats this food and why can't they figure out the shortcoming? You think: this could be a booming business.
  • The service is terrible. This place may have good food, but you repeatedly have to wait to be seated, the meal takes too long to arrive, the waitresses are all rude and not readily available and it takes forever to get the check. If the food is really, really great, you may put up with the abuse, but only if there is nothing comparable in the area.
  • The décor is shabby. This is not a good thing, but depending on the kind of restaurant it may not be a deal breaker. If the food and service is great, you may decide that the hole in the wall place is kind of like a well kept secret and it's worth it. But it must be clean or forget it.
  • Prices are very high. Price is part of a value equation. High prices on the menu will not necessarily stop you from choosing a restaurant, but you are going to evaluate the food, service and décor to judge for yourself if it's worth it. You may even use the price level as one of your tools to position the restaurant in the marketplace and the initial assumption is that an expensive restaurant will be very good. You may even seek out the expensive restaurant at times.
  • Prices are very low. Low prices are always welcome and you're happy if you feel like you got a bargain, but it's kind of a bonus. When I eat at a busy restaurant with excellent food and low prices I sometimes find myself wondering if the owner knows he could charge much more and still do the same business. I can just tell by the other patrons that we would all keep coming even if the prices were raised 50%. No one shares this valuable tidbit with the owner, however. I can usually tell that these well-meaning owners are not good business men or women. They are middle class, hard-working folks who know how to cook! They set their menu prices based on their own financial means, which is not real high. They don't see the perception of value in their product the way their patrons do.
  • If food and service is mediocre we rarely say anything to the server or manager. We just don't return very often and we certainly don't recommend the place to our friends. In fact, if food or service is poor enough we may tell our friends to avoid the place!

The eye care counterparts

I think it's pretty easy to see how your practice relates to the restaurant analogy. The food is akin to the eyewear and contact lenses you dispense, as well as the clinical treatment of eye disease. Customer service and décor relate to the same factors in your office.

Notice that the perception of food quality can be heavily influenced by the other factors and by the reputation of the restaurant. The same goes for how eyeglasses are judged by your patients. A hamburger served with excellent presentation and well garnished on nice china with white linen tablecloths is simply perceived better than the same burger served alone on a paper plate at a stand-up counter. The former could be priced at $20 and the latter at $5 and both could be quite popular.

So how does a great restaurant become popular?

It's often surprising how quickly a great restaurant can become busy. I mean really busy! It's a testament to the power of word of mouth. When we come across a truly great restaurant we want to go back and take a friend. We can't wait to tell others. The business success is directly related to the quality of the product and service. I guess this is so obvious we could insert a "duh!" here, but there are a huge number of restaurants and eye care practices that apparently have not discovered the relationship.

Word of mouth is the most powerful marketing tool there is in business and it works fairly quickly. Make sure it is working for you.


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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