By Mary E. Boname, OD, MS, FAAO
I like to think of my practice as having the concierge approach—low volume but high attention paid to each patient. On a typical day, I see eight to 10 patients for a combination of needs including follow-up visits and full comprehensive exams. A very busy day for me would be 10 full comprehensive exams. I have a staff of five including myself as the sole doctor, so on days when one or more employees is out of the office, a patient might find me at the other end of the line when they call to book an appointment. In addition to conducting exams, I do all pre-testing myself and offer each patient a detailed summary of my findings at the end of each exam.
Dr. Boname’s grandfather, Mat G. Boname, MD, in one of his formal graduation photos from Syracuse Medical School on June 14, 1926.
This low volume/high-touch approach to healthcare is something that I witnessed firsthand as a child visiting with my grandfather, the only doctor for many years in the tiny town of Oxford, NY. Graduating from Syracuse University’s medical school in 1926, my grandfather, Mat G. Boname, MD, practiced family medicine until a year before his death in 1996. He practiced out of a house with the office located on the first floor and a separate entrance for the private residence.
Like me, my grandfather often answered the phone himself and spent enough time with each of his patients to know not just their heath history and current conditions, but who they were related to in the town, what they did for a living and what they enjoyed doing in their leisure hours. In other words, none of his patients were just medical files of health information—they were all complex human beings to him with individual needs. As the doctor who often delivered a town resident at birth, gave them their blood test prior to getting married, and then presided over the birth of their children, he knew who his patients were and took the time to engage each of them in conversation about their lives.
That practice of caring enough to spend a little—and sometimes a lot—of extra time chatting with patients and inquiring about their wellbeing is something I take seriously. It is not unusual for me to take a patient back to the exam room, and when I shut the door and ask them how they are doing, to have them burst into tears. It seems to be a relief–and something out of the ordinary these days–to have a doctor who wants to know more than your test results. The easiest route for a doctor to take is to focus entirely on the clinical and avoid relationship-building with patients. But that approach isn’t the most effective as the expression on someone’s face, or especially as optometrists, the look in their eyes, often is more important than the data listed in their medical record.
Like my grandfather, who was available to patients regardless of the holiday, I make patient access to me a priority. I provide each patient with my personal cell phone number and have found that they appreciate my availability and only call for true emergencies.
Mat G. Boname, MD, in his doctoral robe & mortar board. June 14, 1926.
The town I practice out of, Skillman, NJ, is larger than Oxford, NY, but, following my grandfather’s example, I have become a part of the community sponsoring local sports teams and charities. I also reach out to nearby schools, often purchasing ads in high school yearbooks.
The personalized approach I inherited from my grandfather comes at a cost. It requires additional chair time, which results in a smaller patient base. For that reason, I made the decision when I opened my practice more than 13 years ago to only accept Medicare and Blue Cross/Blue Shield insurance. Most of my patients pay out-of-pocket. The patients who stick with me are the ones who want a caring touch more than just a bargain, or maybe they feel a cheaper visit with the eye doctor often delivers a cheapened level of care. One thing I do know for sure: If I am providing an exceptional experience, and patients go somewhere else, they will come running back.
High-touch healthcare practitioners, who treat each patient as an individual they are excited to get to know, is as uncommon today as the small town doctor who provides care out of his house. I’m glad my grandfather gave me the opportunity to see this rewarding approach to healthcare in action.
How much time do you spend getting to know each patient and your community? What do you do to build relationships with your patients?
Mary E. Boname, OD, MS, FAAO, is the owner of Montgomery Eye Care, P.A., in Skillman, NJ. To contact her: mboname@mecnj.com.
