Practice Management

4 Practice Investments Generating $200,000+ in My Practice Annually

Dr. Rhue and her staff in their office. Dr. Rhue says targeted technology investments have made the practice better for both patients and profitability.

By Brianna Rhue, OD, FAAO

Jan. 12, 2022

Technology investments can greatly enhance care. To ensure these investments are also a boon to profitability, you must carefully consider your return on investment. If you calculate that the ROI on new technologies will be significant, you can make even an expensive investment with confidence. Here are a few technologies that are improving our patients’ experience with our practice while stoking profitability.

Text to Patients & Appointment Reminders
Missed appointments cost the healthcare industry $150 billion a year, according to a study by SCI Solutions. Each patient appointment lost to an OD is worth $300, which translates into $1,500 per week. If one lost appointment per day equals $1,500 per week, then that comes to $6,000 a month lost and $72,000 per year lost.

The good news is that you can avoid losing many, if not most, of those appointments if you text appointment reminders to patients one week, one day, and one hour, prior to their scheduled appointment. To enable my practice to do this, I invested in Weave technology in 2014. There was a $1,000 on-boarding fee when I first signed on to use the technology, with an ongoing $600 per month fee. The ROI is substantial. I am spending $7,200 a year to capture $72,000 a year in appointments.

The texts from patients are delivered to my staff members’ work computers, so that they don’t have to use their own phones, or a phone provided by our office, to respond. The patient texts stay on their computer screens until they are responded to. If the internet goes down in an emergency, like a severe weather event, the texts are forwarded to a phone number we have designated as an emergency backup.

Appointments in our office are kept twice as often now that we text patients reminders than they were before we started doing this.

In addition to using the technology to improve our recall, we use it to facilitate communication between patients and our practice. People are accustomed today to communicating heavily by text. Many no longer regularly check their e-mail. A patient communication technology that does not enable communication by text is not meeting patients where they are. More than 90 percent of people read a text message within the first three minutes of receiving it, according to Mobilesquared, a mobile research firm.

Patients may not answer the phone with a staff member calling to confirm an appointment, and they may not read an e-mail from your office until it is too late, but they almost certainly will see and read a text from you–and remember to show up for the appointment they already made.

Live Online Appointment Scheduling
Another way we meet patients where they are, and in so doing, increase profitability, is by giving them the ability to schedule appointments on our website in real time. They are able to see our calendar, including all open slots, and select a slot on their own. In the past, we had a place on our website to click on to “request an appointment.” The patient would then have to wait for someone to e-mail or call them back. Now, they can schedule an appointment, with a confirmation of the appointment they made, immediately texted and e-mailed to them.

I use a technology that is a part of my Crystal Practice Management electronic health record to enable live appointment scheduling. The ability for patients to schedule their own appointments is a huge staff time saver, as I have calculated that scheduling an appointment with patients can take 8-10 minutes of time per patient. Let’s say the average OD sees 300 patients per month. If each of those phone calls could potentially take up to 10 minutes of your staff’s time, your staff is spending 50 hours per month, or the equivalent of seven full days per month, on the phone scheduling appointments.

There is an extra fee of $100 per month to use this functionality in our EHR. That money is easily recouped, and then some. If you’re paying your employee $20 per hour, you are spending $1,000 per month in staff time just to schedule appointments over the phone. Therefore, after paying the $100 monthly fee, I am netting $900 monthly in freed-up staff time. That time can be used for other, more profitable tasks like working with patients in the optical and selling eyewear.

Some doctors are hesitant to allow patients to schedule their own appointments because there are certain types of patients–new patients, for instance–whom they don’t want as their first appointment of the day, first appointment after lunch or last couple appointments of the day. I get around that by NOT making those specific slots available on the calendar patients see online when selecting a slot. I keep those slots open for follow-up appointments, walk-ins or emergencies.

“Click here to request an appointment” is the past; live online scheduling is the now and the future.

Live Chat on Your Website
When you visit most retailers’ websites, you can click to “chat” with a representative. You then are put into a live instant messaging exchange with a live person or artificial intelligence-powered chatbot.

To meet patients’ expectations for this kind of instant and easy question-and-answer exchange, we invested in Simplifeye, a technology that provides a live person, rather than a bot, 24 hour per day, who can “chat” via instant messaging on a practice website with patients. It costs us $349 monthly.

Technology Resource

Jennifer Tabiza, OD, and I have launched Techifeye, a network of 13 technology companies that are cross-promoting the services of each participant. The organization has as its goal helping ODs find ways to profitably and effectively invest in new technology.–Brianna Rhue, OD

Patients most often want to contact your office during their lunch break–just when many offices are closed. This technology gives you a way to allow for immediate response to the patient who wants to contact you during that time, or any other, when your office is not in operation. Common questions fielded via live chat include  “how do I make an appointment?” “What is your phone number?” “How do I pay my bill online?” “Where can I find reviews of your practice?” and “How do I reorder contacts?”

If you consider the appointments and product purchases you might miss because no one on staff was available in the moment to respond to such questions, a technology like this could easily pay for itself in thousands of dollars generated just in new appointments and eyewear and contact lens sales.

Online Contact Lens Ordering
Capturing contact lens purchases, and in the process, keeping contact lens patients in your practice, has more to do with convenience than price. Patients want to be able to visit their doctor’s website, like they would visit an online contact lens retailer, and reorder contacts with one or two clicks. That’s what Dr. Contact Lens, the contact lens ordering system I helped to develop, and now sell to other practices, does. The technology gives the the doctor a way to fulfill the obligation of the new FTC Contact Lens Rule by making the patient’s prescription available online. The program is HIPAA compliant and protects PHI as the patient has to login with a username, password and date of birth through a text message that is sent with access to the patient portal. The patient has the option to “click here” to download their prescription. The doctor is able to direct patients to a page accessed on their site for both their prescription and to order more contacts. This makes it more likely the patient will purchase from the same doctor who gave them the prescription, rather than taking a printed-out prescription at the office and then searching online for a contact lens retailer.

Keeping contact lens patients in the practice is essential to both patient care and profitability, as contact lens patients come more frequently for appointments because they need a yearly exam to renew their prescription. When in your chair annually, you have the opportunity to provide all other products and services they may need. You might, for instance, diagnose the patient during their annual exam with dry eye and be able to prescribe a treatment plan that will be fulfilled in your office.

Doctors pay a $1,000 on-boarding fee for the technology and then $249 monthly.

Between the additional revenues captured from keeping sales of contact lenses in your office, and the many products and services you can provide to the patient every year based on the exam they need to renew their contacts, a technology that keeps contact lens patients in your practice could be worth an additional $200,000, or more, in revenues annually.

Technology is here to stay. We can either embrace it and thrive or wait for all of the “bugs” to be worked out and be left behind. Change is hard, but is the only constant in the universe. Come up with a technology implementation strategy for 2022 and Techifeye your office. Your staff will thank you (eventually), your patients will become raving fans and your practice will continue to take care of you now and into the future.

Brianna Rhue, OD, FAAO, is the co-owner of West Broward Eyecare Associates in Tamarac, Fla. To contact her: 



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