Article Submission Guidelines for Practice Management, EHR, Glaucoma, and Managed Care

Exclusive Date: July 24, 2013

How Can You Think Big?

 Sponsor: AIR OPTIX® for Astigmatism

Many optometrists wish their practices would grow faster. Many are stuck in a mode that has average production and average profit, but they are not sure what to do about it. After trying a few marketing ideas that don't work very well, most ODs just assume there is nothing they can do. They hope for business to improve, but unless there is a change in strategy, the chances of significant growth are highly unlikely.

If the approach you have taken to date has produced results that you feel are less than stellar, why not try something different? Why not try something big? Your career is flying by. Life is short. If we look at the areas of your practice that you can control, there are only a few that produce very strong results. Read on and decide which ones you want to implement.

Raise your fees
Raising fees is one the easiest big things you can do and it can provide the instant resources to do other big things. Many strategies that are really productive require a financial investment first and a fee increase can provide that. Yes, even in this era of managed care, fee increases still work. Here are some important points on why fee increases work and how to implement them.

  • It is extremely important to realize that the vast majority of patients are very loyal to your practice and they won't leave you over a fee increase. Most patients have insurance anyway and they don't even pay the basic fees.
  • Your staff may resist fee increases. They mean well, but staff members are not experts in this area. They react with emotion and they sympathize with the patient. This is an area where the OD/owner needs to be the leader and run the practice. Don't ask for input about fee increases, just announce them.
  • As you evaluate the effect of a fee increase, do so with a scientific approach. Anecdotal reports from your staff are not good enough. Measure your Rx retention rate (see tip #590).
  • Many doctors tell me they don't bother raising fees because most of their patients are on vision plans and it will not make any difference. That is not true at all. Many vision plan patients buy products or services that are not covered by vision plans or only covered in part. If you increased your frame mark-up formula, more patients would pay a higher overage. If you raised your contact lens evaluation fee, many patients would pay more after their allowance was applied. These are just examples; there are many areas where optometric fees are vastly too low.
  • Do you offer retinal photo screenings as an optional test for an additional fee? Do you perform macular pigment testing and prescribe nutraceuticals? Do you prescribe a high percentage of digital progressives with premium antireflective lenses? There are untapped opportunities galore in optometric practice.
Hire another employee
Many ODs will not hire more staff members because a) they view staff as more headaches to manage and b) they are concerned that their payroll costs are already higher than the national norms. This is small thinking and we are now thinking big! You can't do great things in your practice if the doctor has to do everything. Delegation is the key to growth and it can be dramatic. Make one of the new staff appointments an office manager and she/he can take over most of the headaches of managing the others. Don't worry about the metrics such as staff expense as a percentage of gross or gross production per full time equivalent (FTE) staff member. Those metrics often improve with additional employees because revenue goes up much more than their salaries!

Many good things happen when you hire more staff:
  • Customer service improves because there are more staff members to answer phones and take care of people. That is the key to growth and word of mouth referrals.
  • Production increases because staff and doctors have time to recommend treatment options.
  • Doctors delegate more because there are staff members to delegate to.
  • Existing staff often improve their performance because they see other staff capable of doing their jobs.
  • Stress levels decrease because staff members are not rushing all the time.
See patients faster
It may be time for a major change in your clinical routine. Push out of your comfort zone and try seeing patients at a faster pace. With more delegation and data collection, clinical quality does not need to drop at all. Many doctors take great pride in how much time they spend on patient education but most patients really wish they could get through the eye care visit faster. Even if they tell you how much they appreciate all the time you spend, most are really not having that much fun in your exam room. Delegate more and shorten your appointment slots.

Move to a larger office
Most doctors don't even consider moving unless the practice is bursting at the seams with patients, but a large nicer office can be a great marketing strategy that will get you noticed in the community and will drive more patients. The more impressive your office, instruments and optical... the faster your practice will grow!

Join more vision plans
I realize it is in vogue to talk about dropping vision plans, but many of those doing the talking don't actually own a practice or if they do, they have a small one that does not produce big profits.
  • Vision plans are very strong and they provide routine eye care benefits for huge numbers of patients in the U.S.
  • It is quite possible to make a nice profit with any vision plan.
  • Many people with vision plans also need medical eye care.
  • It is very difficult to grow a large, successful optometric practice while not accepting vision plans.
  • Joining a new vision plan can quickly increase the number of patients a practice serves.
Remodel and expand the optical
The optical dispensary in your office is responsible for a huge amount of revenue in your practice, yet most offices have a fairly small, modest optical. Many appear outdated. Optical consumers today are willing to spend big money for the right products and service. And they have many vendors who are vying for their business. The patient is yours to lose and you can retain at least 90% of them if you have a great optical. It needs to be larger in space and in frames on display. It has to be fantastic! Invest in your optical.

Best wishes for continued success,

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