Dr. Foster’s optical dispensary. Dr. Foster says that having a more unique inventory was one of the improvements that made a huge difference to patient experience and profitability.
Improving patient experience and profitability in optometry by correcting practice management mistakes.
By Kara Foster, OD
Nov. 6, 2024
When starting out as a practice owner, making mistakes is expected. How you recognize and turn those mistakes around is what counts.
Here is how I figured out what was going wrong and course-corrected to create a practice with a per-patient revenue of $634.
Hiring People Solely Because They Had Optical Experience
I unknowingly hired employees who were burned out on eyecare, who were bouncing around different local practices, and never happy. That discontent showed in the low level of patient service they delivered.
To correct this mistake, we first spent a great deal of time and resources training support staff.
However, when I was certain that it wouldn’t work out, I spent significant time revamping my hiring process. That meant spending a lot of time with job candidates to see their true personality before hiring them.
We were rewarded with a happier work environment for putting this extra time and effort into the hiring process. We no longer had bad apples poisoning everyone’s thoughts and affecting the mood of the office.
Having upbeat employees flows through to patient care. When our team is happy because we like each other, and everyone pitches in without asking, patients can see and feel a more positive atmosphere.
When I hired for personality, I found that I could give my team much more autonomy, creating a healthier work environment and less mental stress on my part.
I base a lot of my practice decisions on Simon Sinek’s book about leadership, “Start with Why,” and I found that going with my gut on hiring decisions is hugely beneficial.
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I hire people who are happy to jump right in, but I tell my employees, I will stand behind whatever decision they make in the moment to make a patient happy. I can trust my team to take care of patients and situations without having to default to me, and they know that I’ll support their decision.
I also want them to treat our patients like they would a guest in their home. I focus on the feeling I want patients to have when they are in our office.
Having an amazing team is 100 percent the reason I’m able to successfully practice without taking insurance.
If I didn’t have a team that could jump in and take care of patients, and also explain the benefits of direct care, I wouldn’t be able to practice this way because I wouldn’t have any patients coming through the door.
When you’re in a bind, it seems like a good idea to hire someone quickly who has experience, but taking time and hiring for personality and training for skills is so worth it.
Hiring for personality gives patients a great in-office experience. Doing so helped me to have more time to work on advancing the profession of eyecare by continuing to work on improving direct care.
Accepting Vision Care Plans
I assumed I had to be in-network with vision care plans to attract patients.
But being in-network with vision care plans meant too much staff time chasing limited insurance reimbursements, causing decreased employee morale. This translated into a diminished patient experience.
I made the decision to drop vision insurance plans. We were able to keep our longer exam times, and work to improve patient experience and care versus having to shorten our exam times to see more patients.
Our patients appreciate having more exam time with the doctor to be able to troubleshoot their concerns and also not having to pay for additional for photos and OCT scans. Patients also get better-quality products in our optical because we can offer products that aren’t restricted by insurance companies.
The biggest benefit to my practice is our happy work environment. My team is happy and our patients appreciate their attitude.
Financially, dropping vision care plans hugely benefited our practice. We went from a revenue of $264 per patient while on insurance plans to a current revenue per patient of $634 in 2023 while simultaneously improving our costs of goods since we can use our own labs.
During the pandemic, I heard so many fears and concerns from other ODs about the future of optometry being so dependent on insurance plans.
I decided to start working on a program to educate ODs to move their own practices to a direct care system. I want to advance patient care and optometry in general by going to a direct care system.
I wrote a book that’s available on Amazon to help OD’s learn how to be successful dropping insurance plans and also have a training plan on my website at directcaredifference.com.
Click HERE to watch videos in which Dr. Foster and Laura Americo share how they dropped managed care plans, and the impact of doing so.
Not Having Enough Variety in Optical
We made the mistake of not having a large and diverse enough frame selection and being limited to insurance company frames and lenses.
We experienced low sales and lower capture rates because we didn’t have unique product to be able to appeal to a diverse patient base.
We expanded our frame lines to offer a range of eyewear packages that could compete with big-box stores, but applied our warranty and service to fun, unique frame lines.
Plus, after dropping vision plans, we were able to offer a much bigger selection of lenses and our labs were able to work with us to give us competitive pricing.
We were more competitive as an office as a result of changing our frame inventory. We also brought in patients with outside prescriptions who were looking for a smaller office with more individualistic frame lines.
Patients got higher-quality products, including frames that were more durable and longer lasting and lenses with superior optics to maximize their day-to-day vision.
As a result of correcting this mistake, we increased our capture rate and improved our cost of goods.
Our cost of goods went from 36 percent while using insurance company products (with more remakes due to poor lens design) to 30 percent using our preferred labs and lens manufacturers.
Having independent frame lines and quality lenses doesn’t necessarily mean being a boutique shop. We have a range of eyewear options to meet everyone’s needs. And when we explain our merchandise selection that way, patients seem to appreciate our approach.
Kara Foster, OD, is the owner of EyeCare for You in Apex, N.C., and now also helps other practices reduce, or eliminate, dependence on managed care. To contact her: drkara@directcaredifference.
