o.d. to o.d.
How can optometrists respond to lost
sales, reduced reimbursements and other variables that affect profitability?
WALTER D. WEST, O.D., F.A.A.O., Chief Optometric Editor
Historically, the business model of optometry has
been one of providing vision care including refractions, eye health evaluations
and along with it, spectacles and contact lenses. Optometry's past has been so
closely tied to the provision of spectacles and contact lenses that the majority
of the population saw an optometrist for their routine vision care, yet never
thought of going to an optometrist for eye pains or eye infections.
One of the reasons that the historic model was so
successful was convenience. Think about it: You could have your eyes examined
and purchase glasses and/or contact lenses at the same time, during the same
visit without having your eyes dilated. Profitability has been -- and is now --
largely a function of the sales generated in the optical dispensaries. A
practice generates some 42% to 54% of its gross income through the sale of
frames and lenses.
The model changes
Profitability in optometric practices has begun
to decrease as a result of fluctuations in the economy, reduced reimbursements
as a function of managed care, loss of sales in the optical, reduced contact
lens sales and other variables. Also, a lack of management skills certainly
If you'll allow a pun, optometry's focus has
changed. Optometry's attention has been turned from the business model of
providing glasses and contact lenses, which existed for more than 50 years, to a
model that has begun to focus more on the primary care opportunities that exist
in eye care, which generate 12% to 15% of a practice's gross income.
Although primary care is an important addition to
the optometric practice and it has been available from optometric practitioners
in some states for decades, most patients continue to see medical practitioners
for primary eyecare needs.
Some of these facts exist because the public is
unaware that optometrists can provide primary care, some because perhaps
patients have relationships more with general medical practitioners than with
optometrists. And let's not forget that ophthalmology has long been considered
the place to go if you really have a need for primary eye care.
Why not optometry?
So why don't more people seek primary care from
optometrists? Of the many reasons, the following identify but a few:
- Optometry doesn't have an eight- to
nine-decade history of providing primary eye care, as do the medical
professions. We as optometrists are the new kids on the block with West
Virginia leading in that experience. (The Mountain State's optometrists are
closing in on three decades of providing primary eye care.)
- The current patient demographics in most
optometric practices -- typically a younger, healthier patient base -- are a
function of the more vision-related care that those practices have
- A lack of education as to optometry's ability
to provide primary care exists not only among the general public but within
most optometric practices as well.
Get the message
So what's my message in all of this? Simply, we
as optometrists need to treat primary care as an important addition to an
already successful business model. We need to focus on providing, as well as
educating, our patients regarding our ability to provide primary care and to
continue to expand our ability as well as our responsibility in primary care.
Simultaneously, we need to direct, in proper
proportion, our time and attention toward that which has always been our core
business: optical and contact lens.
Optometric Management, Issue: September 2003