Finances

Are You an Optometric Jack of All Trades, Master of None?

By Brian Chou, OD, FAAO

In my travels, I came across a restaurant with prominent signage that it served Japanese, Italian and Mexican food. I can’t remember where I saw it, but I’d say there is a high likelihood that by now this restaurant has gone out of business. My initial reaction to their menu was that there was no way the restaurant could excel at preparing each different ethnic dish well. The restaurant owners were casting a wide net, trying to appeal to the largest number of diners. Yet the unintended consequence was that they were also communicating desperation and that they were really a jack of all trades, master of none.

I wonder if some of us in optometry are unwittingly headed in the same mistaken direction with our practices. Perhaps it would help to take a step back and look at the situation from afar. Material revenues are declining due to online and warehouse distribution of contact lenses, and increasingly, eyeglasses. This is compounded by the increasing supply of new optometric graduates, constraining service-based profitability. Where does this leave us, when the demand for core services is not increasing proportionately? One strategy is to seek the “riches in the niches” by developing specialty areas of practice, such as vision therapy, low vision, ocular disease, corneal refractive therapy, refractive surgery management, nutritional therapy, irregular cornea contact lens prescribing, eyelash enhancement and so on. I know of optometrists who have branched into audiology, and even promote to their patients their multi-level-marketing side businesses (think Amway).

While I believe it is a good idea to seek a predominant niche, I also hold a strong conviction that it is a mistake to incorporate multiple areas of so-called “specialization,” analogous to the Japanese-Italian-Mexican restaurant. Foremost, to the consumer, it looks ridiculous. Second, it spreads the resources of the practice thin whereas it is arguably better to commit completely by expending tremendous resources into a limited direction. Finally, multiple niches create operational complexities that reduce efficiency and increase the likelihood of error.

To the last point on efficiency, take for example, the Japanese-Italian-Mexican restaurant. I distinctly remember that their menu was extensive, perhaps over 100 items. In comparison, In-and-Out Burger, a popular fast-good burger joint in California, has just four main items on their menu: Double-double, cheeseburger, hamburger, and French fries. The operational procedures for supporting the In-and-Out menu are straight forward making it easy to develop efficiency and consistency. By comparison, a restaurant with over 100 items on the menu has much greater complexity and opportunities for a defect to arise in the delivered meal. Basically, with so many items on the menu, there is a plethora of moving parts which could break.

The analogy comes full circle when you realize that a practice that offers a multitude of services may distract patients to the degree that they wonder if they’re even good at providing a routine eye examination and delivering eyeglasses.

Have you tried to develop a key specialty or niche, in addition to the other services you provide?

Brian Chou, OD, FAAO, is a partner with EyeLux Optometry in San Diego, Calif. To contact him: chou@refractivesource.com.

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