Practice Management

How I Moved Past My Practice’s Growth Hurdles

By Susan Resnick, OD, FAAO, FSLS

Oct. 14, 2020

As many practices struggle to get back to where they were pre-pandemic, it’s worth looking ahead past the crisis, to when your eye will be back on growth. Over the years, I have noticed certain keys to identifying and surmounting practice growth obstacles. Here are approaches that will ensure your practice keeps on track for long-term growth.

Common Roadblocks to Growth
Over my many years in practice I have come to learn that the most significant roadblock to growth is not external market “disruptors” or even financial investment, but failure to follow through with the commitment to new investments and growth.

The typical path to profitability when acquiring new technology or introducing new procedures involves three steps: establishing clinical need and assessing potential return on investment, comprehensively training and engaging staff, and strategic clinical integration and implementation.

Eyecare professionals spend significant time contemplating the patient care benefits and profitability potential, but all too often, after the acquisition is made, there is a lag or failure in staff training and execution. It’s easy to understand why: day-to-day patient care and practice management tasks are, in and of themselves, time consuming and can significantly delay the start of new projects.

Keep the Momentum Going After Investing
There have been many times over the years when a new contact lens fitting set sits on a shelf collecting dust, to the point where we forget it’s there. Or we conduct dry eye surveys with patients and forget to review the responses. On our patient history form we always ask what technologies or products the patient is interested in discussing. But we frequently get too busy to pay attention. All of this leads to significant loss of opportunity.

To overcome these roadblocks to success, implement a well thought out and methodical strategy. First, decide upon the method for recruiting patients for new services. That can occur via intake forms, technician inquiry during pre-testing or in the exam lane. Often, a combination of all three ensures no patients slip through the cracks.

Second, it’s imperative ALL staff be educated on the technology or procedure, as well as the proper verbiage, so that the value of the service can be reinforced at each patient touch-point. Leadership here is key. The team must understand both the clinical need and the value to the practice. Arrange for periodic re-training through vendor reps. Appointing a lead staff member is a good way to foster enthusiasm and demonstrate confidence in your team, as well as providing the patient with a liaison.

Identify Potential Care Improvement & Growth Opportunities
Examples of procedures and technologies that offer growth opportunity include specialty contact lens fitting, myopia management, AMD management with genetic and nutritional counseling, neuro-optometric rehabilitation, ocular surface health management, and cataract and refractive surgery co-management.

I define a “profit center” as one which delivers a minimum of $10,000 gross annually. I look toward procedures and technologies that do not add significant chair time; in other words, those that can largely be delegated to well-trained technicians. I aim for a mix of products and services that that both draw on the clinical interests of our doctors and offer freedom from third-party payers.

To ensure successful planning, implementation and refining of each new clinical procedure and service, it’s best to allow 4-6 months per project. Overloading staff can cause a backlash and it’s important that depth, not breadth, be a priority. Set timelines and goals and periodically evaluate progress.

Gauging Success at Pursuing Growth Opportunities
Look at the interim profitability of new investments. A first look should occur at six-months post-implementation. Metrics to review include number of patients treated or number of procedures performed, gross revenue and per-patient net profit. The same should be repeated at the 12-month mark for annualized data. A second level of analysis looks at net promoter scores, clinical success and lead generation (referrals). To gather this data, careful tracking and follow-up is necessary. The global return on investment will reflect both levels of analysis.

Roughly a year and a half ago, my practice purchased a new MGD treatment device, TearCare. Our first step was to educate our entire team on the clinical aspects and the why and how we were going to incorporate the procedure into our existing dry eye protocols. We then trained our technical team to perform the patient preparation and lid warming component. With diligent patient screening, recruiting and exam lane education we performed over 100 procedures within the first few months.

Identify Ways Of Doing Even Better In Capturing Growth Opportunities
We have gone back and reevaluated our utilization of a couple of earlier instrument and technology acquisitions which had languished. One is our attentiveness to screening for risk factors and early signs of AMD. We have redoubled our point-of-care testing to assessing macular pigment density and to prescribing lifestyle and nutritional support.

One positive outcome of the changes we made due to COVID-19 was the increased spacing between appointments and increased time spent with each patient. That has taught us that better patient care, as well as profitability, are generated when we devote the needed time and attention.

Susan Resnick, OD, FAAO, FSLS, is president of Drs. Farkas, Kassalow, Resnick & Associates in New York City. To contact her: sresnick525@gmail.com

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