Readers Voice their Opinions
Underestimating the benefits of medical optometry?
To the editor: I'm sure that Dr. Gary Gerber's recent column, "Medical Optometry vs. Eyeglasses" (OM, April, page 20) will spark much interest and debate regarding the direction optometrists should take in their practices.
What makes optometry a great profession is that most of our practices have multiple streams of revenue and profits. To accurately evaluate the relative importance of optical vs. medical, we have to look at actual profit, not just revenue.
In my practice, for example, we monitor our revenue and profit from these profit centers. Only when you attribute all the costs of running the optical center can you accurately assess its profitability as compared with medical services.
I feel Dr. Gerber is right: If you have a retail optical in your practice, make the most of it. In fact, we, as optometrists, are probably less prepared to handle this area than the medical practice due to poor business training in school and lack of skills in purchasing, production and controlling costs. So by all means, we should do everything we can to increase sales and boost the profits of our retail/optical profit center. In my practice, profits have grown as a result of remodeling and re-merchandising even in the midst of the recession.
That being said, I would not underestimate the potential of increasing our medical services. Increasing our medical services has nothing to do with being more attractive or seeming more intellectual to current and perspective patients, it's about profit, not to mention good patient care. If our revenues from medical optometry really are close to 6%, as Dr. Gerber says in his column, then we have a serious problem.
In your February issue, you offered a revealing look at how incomes are related to care. The article "Targeting Ocular Surface Disease" (OM February) offers a how-to look at medical optometry. It begins: "The average optometric practice acquires 80% of its revenue from goods and services related to glasses and contact lenses, according to the American Optometric Association. Among practices in the top 5% income bracket, however, that figure is less than 50%, with their remaining revenue deriving from medical services."
The article goes on to state that 40 million Americans have dry eye syndrome, half of them undiagnosed. It seems to me that the untapped potential for increased revenue could be on the medical side of our profession. It may require more technology and training but it can be done.
We earn our living taking comprehensive care of our patients. Regarding refractive eye care, Dr. Gerber says that we "own this position," but I'm not so sure this will last forever. Our competition now includes online sellers of eyewear. But when a patient in our exam chair has dry eye syndrome or posterior blepharitis, we can create a win-win situation by treating that patient and billing for our services.
Let me ask this question: If you analyze an optometric practice and medical billing is below average, why is the solution to "sell more glasses?" I think the solution is to get credentialed with medical plans, verify the patient's coverage and learn to code and submit claims.
I've learned that there are good people who can help us implement medical optometry, as well as, increase optical revenue. For instance, I'm proud that our state organization in Georgia has retained a coding specialist for our benefit and facilitates healthy discussions on coding and patient care between doctors by e-mail.
I know Dr. Gerber would agree that medical optometry is important. In fact, he is one of many who have helped the success of my practice by promoting the use of technology in medical optometry.
It's certain that we will continue to face challenges in remaining profitable. For now, medical opportunity still spells opportunity. OM
Matt Dixon, O.D.
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Optometric Management, Issue: September 2010