Practice Management

Introducing Insights to Impact: 6 Guides to Bouncing Back Stronger from the Pandemic

By Mark Wright, OD, FCOVD

Professional Editor, Review of Optometric Business

June 16, 2021

The last year changed how we approach the patient experience and office safety protocols. Some of the lessons we learned during the pandemic will stay with us long after Coronavirus ceases to be a threat. To help eyecare providers create a strong recovery and a more resilient practice, we will be presenting the CareCredit-sponsored six-part series, Insights to Impact, over the next several months.

The series, which includes podcasts in which I interview the authors of each article, will show you actions you can take now that will have a positive impact on your practice and the profession as a whole as we move into the future.

Here is a preview of the six upcoming articles.

Powering the Growth of Medical Eyecare Services
The Baltimore Eye Survey showed that 56 percent of patients with glaucoma were not diagnosed. Said another way, 56 percent of people with glaucoma are walking around without being treated for an eye disease that is slowly stealing their vision. Each day, the glaucoma is doing increasing damage. Damage that is permanent.

Estimates are that 6 million people in the U.S. have dry eye symptoms, but have not yet been diagnosed, and therefore, not in active treatment. We need to fix this. We are in the business of helping people to have a better life through better eyecare. We have our work cut out for us.

One area of practice that has grown consistently over the last decade within optometry practices is medical care. Matthew Ward, OD, will show us how we can do this even better. He discusses how to create a practice that can withstand marketplace challenges, how to grow the opportunity for enhanced care, how to help patients pay for the care they need, how to establish practice differentiators and how to market effectively to patients.

Creating a Winning Patient Experience
Throughout history one key business principle exists. That key principle can be described this way. If one business provides something people want, something others can’t provide, then that business has a competitive advantage. The moment other businesses start providing the same product or service – or better – the competitive advantage is lost.

Businesses evolve. The industrial revolution brought the ability to produce unique products in mass quantities creating competitive advantages in both selection and price. But that did not last long. The world quickly moved from an industrial economy to a service economy as the competitive advantage of selection and price disappeared.

We can see this in contact lenses. How are the contact lenses offered in your office any different from the contact lenses offered in the practice down the street? They are made by the same companies. The way you position your practice as different from the practice down the street (or the internet seller) is to offer services they do not. The most common reason why people purchase contact lenses on the internet rather than in your practice is not price. It is convenience. (Is it possible to purchase contact lenses from your practice at 8 p.m. on a weekend?)

The world did not stand still. Businesses continued to evolve. Businesses moved out of a service economy and into an experience economy. We are currently in an experience economy. In fact, we’ve been in an experience economy since at least 1998.

The experience economy is based on improving the patient journey. A helpful way to think about the service economy and the patient journey was described by the Danish researcher Rolf Jensen as the commercialization of emotions. Putting this another way, patients don’t always remember what you say, but they always remember how you made them feel.

The pandemic focused our attention on maximizing the patient experience. One of the first actions most practices took during the pandemic was to retool the patient journey to make sure patients felt safe and secure while we delivered a memorably pleasant experience. Through trial and error we refined this process until we found what worked the best. We all have room to improve our patient experiences.

Justin Manning, OD, MPH, FAAO, will drill down on this topic and show how the patient experience can be used to build patient loyalty. He will discuss how to bridge the gap between prescribed treatments and care received, how to stay attuned to our patients’ emotions, how to show respect to patients by answering their questions before they are asked, how to create a team that thinks in terms of solving patient challenges rather than solely on making the sale, how to empower patients to receive continuity of care and how to manage the emotional element of the patient experience to make treatment and purchases more manageable.

Boosting Revenue-per-Transaction
There are a finite number of examination slots available in any given day due to the new safety protocols implemented in our practices. We are carefully controlling patient flow to keep our patients, staff and doctors safe. Gone are the days of standing room only in our reception areas. Two problems created by this new normal are (1) our expenses are still the same or slightly higher than before the pandemic and (2) the damage inflation does to our purchasing power is both constant and ongoing.

Rent has not changed, payroll is back up to pre-pandemic levels as most practices are at 90 percent capacity or higher, what laboratories charge us for frames, lenses and contact lenses has not decreased and equipment manufacturers have not lowered their prices for product or maintenance contracts. All of that means our practice expenses are the same or slightly higher than before the pandemic.

Inflation is moving toward 3 percent and is predicted to get as high as 4 percent this year. The year-over-year April inflation rate was 4.2 percent. The purchasing power of a dollar is only really worth 95.8 cents this year. If the practice did not grow 4.2 percent this year over last year, then the practice is losing ground. The scary scenario is if the practice gross revenue collected is down 5 percent over last year, then the practice is really down 9.2 percent (5% + 4.2%). A practice with an almost 10 percent decrease is screaming for emergent actions.

Dave Anderson, OD, shares how his practice optimizes the use of patient financing, along with other measures, to ensure a strong revenue-per-transaction.

 Growing Capture Rate
A high capture rate is essential in a practice. The reality is that in some practices, as high as 40 percent of patients go somewhere else to get their prescriptions filled. That results in a capture rate of 60 percent. Is that number high? Well, rather than feel good about having 60 percent of patients who purchase from us, we need to drive that 40 percent number to as close to zero as we can get it. The reality is that we will never probably be able to get that 40 percent number to zero, but we should be able to get it to 10 percent, which gives a capture rate of 90 percent.

From a practice management perspective, it is a better use of time and resources to capture as much of the 40 percent lost sales than it is to spend the same time and resources to go out and try to convince more new people to become your patients.

Step 1 is to find out why patients are going elsewhere to make their purchases. The best way to do this is to ask patients directly. You can use a script like this, “We want to be the best practice in town. Since you are planning to buy somewhere else, please let me know what you think you can get somewhere else that you can’t get here.”

Write down exactly what patients say. Do not edit their words. They are giving you their perception of your practice. You will probably find some of their answers surprising. This information is valuable. Take the feedback and make changes to your practice, so patient perceptions of you are also changed. Your patients may have misunderstandings about who you are and what you offer.

Examples of misunderstandings could be that you are too expensive when you have value options that the patient was not exposed to. It could be that in the sea of frames the patient could not find the brand line they wanted, so they believe you did not carry that line. Or because they did not see the brand line they wanted, they perceived you could not provide that for them. Both of these examples are easy fixes. And if one patient is perceiving your practice this way, you can be sure that 10 more perceive it the same way, but are not telling you.

Step 2 is to teach doctors and staff how to ask for the sale and overcome objections.

Step 3 is to make it easy for patients to pay.

James Step offers the following advice: “Stick to your guns by offering premium products like Varilux and Shamir or Heritage Plus and Legacy Pro. You should also have a value alternative such as Shoreview, Hoya Amplitude, or Heritage, ready to save a sale.

Smaller sales are better than no sale at all. Often with the pricing on these value PALs, your margins will not change that much, but it will help your bottom line tick upwards.”

Patty Casebolt, chief quality officer for a large optometry-ophthalmology practice and surgery center, will show you how to increase your chances of having the vast majority of your patients fulfill their prescriptions in your office.

Leveraging Specialized Care
Why should a patient come to your office rather than the practice down the street? This is a core question that you should be able to answer in a 10 second elevator speech.

Here are eight ways to make your practice stand out:
1) Narrow your target market.
2) Focus on superior customer service.
3) Solve a problem.
4) Be innovative.
5) Create offers that are too hard to ignore.
6) Be known as the expert in your field.
7) Make it easy to do business with you.
8) Create a unique business model based on your values

Miki Lyn Zilnicki, OD, FCOVD, and Jessica Licausi, OD, FAAO, FCOVD, the owners of a vision therapy-focused optometry practice, show you how they have differentiated their practice by offering specialized care, and how this practice differentiator makes it easier for them to survive, and bounce back from, hard times like the past year.

Maintaining a Strong Cash Flow
A core concept in business is to make it easy for patients to pay. It is important to put this concept in context. Here is the need. Some 31 million Americans were uninsured in 2020, according to the Congressional Budget Office. This number is expected to increase this year. But even patients with third-party coverage have deductibles and co-pays that need to be handled.

When patients cannot afford care, they often will not seek care, or refuse, care. This is compounded by rising healthcare prices and patients who are increasingly purchasing high-deductible health plans. According to one study, 64 percent of patients reported they have delayed or neglected care because their medical expenses would be too high.

Roxanne Achong-Coan, OD, FAAO, FIAOMC, FSLS, will use her 20 years of patient experience to discuss specifics on how to help patients receive their full treatment plan while maintaining a strong practice cash flow even through turbulent times. She will share the numbers – what per patient revenue is with and without a solution such as CareCredit credit card.


Mark Wright, OD, FCOVD, is the CEO of the practice management consultancy Pathways to Success and is the professional editor of Review of Optometric Business, along with Carole Burns, OD, FCOVD. He was the founding partner a nine-partner, three-location full-scope optometric practice. To contact

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