Article Date: 4/1/2013

Managed Care Migration
practice profile

Managed Care Migration

Our practices opted out of insurance-only patients to provide quality vs. quantity care.


A quarter-century ago, my partner and brother, Tom, and I decided to go concierge. We felt managed care hindered us from providing a high level of care and often dictated choices based on coverage issues.

Today, 85% of our practice is concierge. We are able to provide much higher-quality (and profitable) care to a stable group of patients who value us and understand their eyesight is worth an extra investment. Hundreds of times, our patients become “raving fans,” who refer others.

Here’s what we did and how:

We differentiated our practice.

To successfully go concierge, you must provide an unparalleled level of service, and become your patients’ trusted and reliable advisors. Otherwise, patients won’t pay out of pocket. Our practice offers caring, experienced, detail-oriented and well-educated staff and doctors who devote ample time to each patient. We offer extensive education, closely monitor progress and are available 24/7.

We prioritized quality vs. quantity.

We shifted our focus to care quality vs. patient quantity, concentrating on contact lens and dry eye disease patients. This enabled us to treat fewer patients more comprehensively, regularly and profitably.

There is no “magic” number of concierge practice patients. Much depends on how much testing, education and consultation is done by doctors vs. technicians. (Technicians handle our testing; Tom and I provide education.)

Dr. Azman enjoys providing concierge care.

We raised our fees.

To more than compensate for fewer patients, we raised fees 50% to 60%, explained by our receptionist at appointment time as a move to a higher level of care.

For resistant patients, Tom or I addressed the issue privately. To alleviate a financial burden, we offered to accept the former fee at the present appointment, noting that future appointments would be at the new rate. We added that we would understand if the patient decided to go elsewhere. (Never blame managed care. Many patients love their insurance; if you insult it, you’re insulting them.)

During the first three years of our transition, we retained roughly 60% of our patients.

We networked with other eye doctors.

To grow further, we visited local O.D.s and ophthalmologists, encouraging them to send us their “nuisance” contact lens and dry eye disease patients. This has provided a nice patient influx.

The end result

Tom and I greatly enjoy the freedom and profitability our concierge practice has given us. Our patients are loyal and appreciative. OM

Dr. Azman and his brother, Tom, launched Ophthalmic Practice Transformations ( last year to help others make the concierge transition.


Optometric Management, Volume: 48 , Issue: April 2013, page(s): 64