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I find it helpful to step back and see the big picture sometimes. We can become so busy with our day-to-day operations that we can easily overlook some potentially big opportunities to increase production.
There are only five ways to increase your practice net income. That's all I can come up with, but let me know if you can think of any more. What changes can you implement in your practice to improve these factors? Can you improve all at once?
See more patients per day
This concept is often not received well by ECPs or staff members. Basically, the objection is that it sounds like more work and stress, but it really does not have to be! With automated instruments and delegation of more duties to staff, it's easy to see more patients per day. I actually enjoy clinical eye care more with more support because I spend less time collecting data and completing exam forms and more time talking with patients. And the cash flow increases dramatically with the higher production, so you can easily afford the staff and the technology and still increase your profit.
It is reality that many eye care offices are seeing an increase in patients with discount vision plans. It's an old joke, but since these plans cap our fees, we really do have to make it up on volume. I think we should reject plans that are not reasonably profitable, but seeing patients more efficiently is definitely a smart move.
The first step is to consider if your practice has unmet patient demand or not. Simply put, are you booked with appointments more than a few days in advance? If so, you can just proceed with hiring more staff and reconfiguring your exam rooms and then change the appointment schedule. If you don't have the patient demand, you should be working on a plan to increase that. Make sure your customer service is top-notch because word of mouth referral is the best way to build your practice.
Sell more things to each patient
Selling certainly includes optical products, but I mean it in a very general way in this case to include selling services as well. A great statistic to track is your average gross revenue per exam (or average sale per patient). Simply take your collected gross income for the month and divide by the number of comprehensive exams performed. You can see that everything you sell increases your average. Consider these ways of increasing your average gross per patient:
Reduce Rx walkout. Be competitive with contact lens prices and make your optical truly spectacular. Expand it and remodel it.
Increase your use of medical testing procedures. Take continuing education courses and invest in advanced technology such as a retinal camera or an OCT.
Teach your staff to sell multiple pairs of glasses and take a role yourself in prescribing them. If you struggle with this, change your office policy to offer 50% off the second pair all the time.
Suggest contact lenses to your eyeglass wearers. Remove the barriers to trying them – simply put a trial pair on more people in your office just for fun. Don't worry about the fitting fee; it will only take about two minutes of your technician's time. Charge the fees if it goes further.
Add specialty services like low vision or vision therapy. The bonus is that these services are usually not covered by vision plans.
What is the high end price point for frames in your office? Are you really sure that‘s the high end?
Raise your fees
Raise your fees or reduce the number of discounts you offer and the number of vision plans you accept (all of these have the same effect). We all know that our fee increases in the past have virtually never resulted in a loss of patients, so what's stopping you? If you think your high concentration of vision plans makes the effort moot, then I really have to ask what's stopping you? Most ECPs currently have their services and products undervalued in my opinion. Raising fees has an immediate positive impact on your bottom line because your fixed and variable costs stay the same.
Avoid costly errors
This refers to stopping the waste that exists in most practices, such as:
Not keeping up with sending billing statements or recall notices.
Forgetting to return products for credit.
Allowing accounts receivable from insurance plans and patients to run beyond 30 days without checking into it.
Forgetting to enter charges into your office management system.
Reducing your expenses
Keeping overhead costs low is a basic tenet of good business management, but I actually advise caution in exercising this method of increasing profitability. Of course, you should always buy smart, but most doctors and staff do a good job of this. And cutting costs often means cutting service and that is shortsighted. Holding back on staff to save payroll or putting off some remodeling actually has hidden costs because you can't stimulate word of mouth referrals with a mediocre office. You can't cut your way to prosperity!
Best wishes for continued success,
Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week
Dr. Gailmard's new book, Practice Management in Optometry: A Blueprint for Success Based on the Optometric Management Tip of the Week, is now available on Amazon.