It seems to me that one of the biggest problems facing optometric practices today is lack of patient volume. We could solve so many problems if we just had enough demand for our services (at usual fees). Of course, building volume through managed vision care plans is generally not a good strategy, because the low fees and required discounts severely limit the profit potential on each patient seen. Most practices need to increase the number of private pay patients, or patients who use plans that pay near normal fees - like Medicare.
There are many facets to the challenge of increasing patient volume - and I'll cover more of them in weeks to come, but a basic way is to look within the patient base you already have. What new service could you provide that would be largely private pay or full reimbursement? These are optometric sub-specialties - and there are many to choose from - including sports vision, computer vision, pediatric eye care, advanced contact lens services, dry eye therapy... and low vision. Let's look at low vision as one example.
I believe every optometrist has the basic training to begin a low vision practice - we all know optics and refraction and the visual system very well, and that is what it takes to get started. Of course, any new low vision practitioner should take CE courses in the field and further their skills, but the important thing is get started! In addition to your knowledge of optics, you need patience. Low vision care is at a slower pace than routine optometric care. Here are some basic things to consider in opening a new low vision practice:
You can follow the above strategy with any specialty area - but the key is to do it. Develop something - make something happen - invest in your practice. The excitement is contagious from you to your staff to your patients.
- Develop your own LV exam form - with lots of places for history, distance and near low vision aid testing and acuities.
- Order a set of basic diagnostic low vision aids to use as trials. We placed ours in a mobile tool chest with drawers from Sears Hardware.
- Order a good low vision acuity chart on a stand for distance and a special near point card.
- Have a very good light source near your exam chair - and be able to provide special reading lamps for your patients.
- Discuss the low vision exam with your staff. Plan to allow at least one hour in your appointment schedule (with the doctor). This means your low vision exam fee will have to be at least double your usual exam fee - maybe triple. Low vision patients need a practitioner who has time to work with them and talk with them. I have a full pre-test battery performed by my techs before seeing a low vision patient - including auto-refraction and field screening.
- A low vision dispensing visit is needed to instruct and train patients with their new aids.
- Reappoint appropriate patients you see in your practice for low vision exams - and let local ophthalmologists know that you accept referrals for low vision care. Their waiting rooms are usually filled with low vision patients who are not receiving care.
- Be ready to adapt to a different type of care from the rest of your practice. People will return low vision aids - it is a fact of life. Don't let it upset you. We just issue a refund when the patient requests it. You may require that aids be returned within 30 days in perfect condition.
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