I’m very proud of the progress optometry has made in medical eye care over the past 40 years. As professional evolution goes, our advancements in the diagnosis and treatment of ocular disease have actually occurred fairly rapidly, although it has not always felt that way to those of us who see patients.
There is no doubt that medical eye care is good for the business aspects of optometric practice. By embracing our expanded scope of practice, we diversify the services we offer and we become less dependent on selling products. My own practice provides full scope medical eye care to the maximum allowed by our state law. This segment of patient care is growing nicely and it is profitable.
Most optometrists I know enjoy providing medical eye care and they are continually taking continuing education courses to improve their skills. Optometry schools are providing better training than ever in this specialized field. So, it is only natural that optometrists who own practices are influenced by what they see in the practice of medicine. Increasingly, we run our practices in very similar ways to how medical clinics operate. While we can certainly learn from other health care providers, I caution ODs to not emulate everything they do.
Patient demand differences
My concern is that well-meaning ODs will adopt some of the very bad habits I see in many medical offices (especially family practice or internal medicine). Customer service is one of the most important aspects of practice building for optometry and that can be virtually non-existent in many primary care MD practices. I think independent optometry has always been pretty good in this area (relatively speaking), but I don’t want to see us decline.
The major reason why customer service lacks in many medical practices is that they have more patients than they know what to do with! Optometry is not like that. We can all wish it was like that, but it isn’t. Any business that has more customers than it needs will drift away from great service. The incentive is gone. Think about the local branch of the department of motor vehicles or your local post office if you want examples. I don’t like the poor service, but I totally get why it becomes that way. Most optometric practices still need more patients and excellent service and convenience is the most important way we overcome that obstacle.
I must include some disclaimers: there are some medical practices that deliver excellent customer service. And there are some optometric practices that are extremely busy and have excess patient demand. I am painting with a broad brush to give us a very high-level view.
How medical practices drop the ball
Here are a few specific ways that medical practices disappoint their patients and optometry is not far behind.
• Office policies. There are hundreds of business and clinical procedures that are decided upon by a practice owner or manager. They can go the patient’s way or the owner’s way.
• Waiting time. How long does the average patient sit in the reception area? Some practices overbook just to be sure the physician is never waiting for patients.
• Office hours. Why make them convenient for the public? If you have tons of patients needing to get in, they will come whenever you want. There is certainly no need for evenings or Saturdays. Some offices close for lunch because it is easier for staff that way.
• Voice mail or answering services. Why bother with live staff members answering phones?
• Staffing levels. Why not cut some employees? It saves on payroll.
• Attitude. When a business has a never-ending supply of customers, the employees begin to focus on themselves and their needs. They are usually not kind or friendly.
Optometry still provides routine care and products
As much as we may like providing medical eye care, there are very few practices that can limit themselves to that. There are simply not enough medical patients to go around for all the eye doctors in practice. We need to provide routine exams, refractive care, contact lenses and eyeglasses. But, when we do that, we add in more layers of competition: retail optical, big box optical, online vendors, boutiques, optician-owned stores, plus all the traditional eye doctors. In any case, we still need more patients.
If we want to emulate other health care professions, I recommend we watch dentistry. Or medical specialists that provide secondary care and still need more patients.