Practice Management

Office Improvements that Generated $70,000+, Increased Per-Patient Revenue 30-40% & Saved Time

Dr. Davison’s Premier Eye Spa, an addition to her office that generates more than $70,000 annually.

By Janelle Davison, OD

July 21, 2021

Your patients and practice sometimes need more than the status quo, even if that status quo has been working well enough. Here are a few improvements my practice implemented over the last year that have created happier patients and a more efficient and profitable practice.

Addition of Eye Spa
I want patients to leave my practice both seeing and feeling better. “Eye care is self-care,” is one of our mottoes. In addition, I wanted to create the brand of an upscale optical boutique with the capability of providing advanced medical eyecare. The creation of our Premier Eye Spa helped us achieve all of those things. The spa, where we do advanced dry eye treatment using ThermaEye Plus intense pulse light (IPL), MiBo Thermoflo heat treatments and eyelid cleaning, and where we have an esthetician come in twice a week to do facials, brow waxing and lash extensions, is a patient-pleaser and profit-builder.

To create a true spa atmosphere, we invested in a reclining chair that can be lowered all the way down so a patient can lie flat when needed. We also added a towel warmer rack, and bring snacks and water in for the patient.

I do all the medically oriented treatments for dry eye, while an esthetician, who has an independent contract with us, but is not on our regular payroll, comes in when I am not in the office to do to facials, brow waxing and lash extension procedures. I have a profit-sharing arrangement with the esthetician so that she gets 60 percent of the profits from her work in my office and I get 40 percent. She also gets to keep 100 percent of her tips.

The spa has been a hit with our patients, which can be seen in the significant profitability it generates:

Space required: 10.5 x 8=~84 square feet

Overall cost of creating and maintaining spa:
Total investment $60,000 investment in August 2020 (I want to keep the pricing confidential)
1. Facial Steamer
2. Reclining treatment chair & stool
3. Facial care products
4. ThermaEye Plus IPL
5. MiboThermo Flo
6. Lid Pro
7. Towel warmer
8. Cabinets/shelving
9. Lash extension products
10. Retail products (Skin Script RX, Oculaire, Eyes are the story, and Zoria)

Profit: On pace to make $73,000 in sales by December 2021
$60,000 for IPL+miBo
$10,000 2020-2021 annually facials/lashes
$3,000 product retail sales

The optical in Dr. Davison’s office, which features houseware furnishings to showcase frames rather than furnishings specific to the optical industry. Per-patient revenues have gone up since making this change.

Non-Optical-Specific Furnishings
It is typical for OD offices to use rods and shelving designed specially to showcase frames. The problem with that is you are left with gaps in the display or board to fill every time a product is sold. You also are left with an office that looks like many other eyecare offices.

My solution was to use cases and tables from IKEA and to display frames. Once you decide that you will use furnishings not specifically designed for the optical, your options for outfitting your optical greatly widen. I was able to outfit my optical for less than $20,000, using the money that I would have spent on furnishings on high-end inventory instead.

We never have to rush now to reorder frames to fill a vacant spot on a frame board or display. This has resulted in inventory cost-savings and savings of staff time.

Along with the greater flexibility and cost-savings of using furnishings for the home for your optical, patients are put in a shopping rather than medical mindset when they get to your optical. Instead of thinking solely in terms of what the doctor prescribed, the homey yet elegant ambiance encourages my patients to take their time browsing and leads them to think about all the eyewear they want for their day-to-day life, rather than on just what they need.

The effectiveness of this approach for creating an optical can be seen in our sales numbers and other practice metrics:

Staff time savings and cost savings: We reorder inventory 2x per month now vs. 2-3x per week before we switched to non-optical-specific furnishings.

Per-Patient Revenue: Aesthetically the office is more appealing for an enjoyable shopping experience coupled with our cloud-based lens packaging & frame picking solution (Paradeyem). Our revenue per patient is up on average monthly 30-40 percent from previous year (May 2021 was $433 compared to $326 May 2020).

Capture Rate: Our overall capture rate is 87 percent for glasses and contacts exams. Glasses alone is 73 percent (above national average).

The elimination of a front desk has improved patient flow and practice efficiency, saving staff significant time. The practice uses wireless payment processing technology Square rather than a traditional POS system.

Removal of Front Desk & Use of Virtual Check-In
The front desk can be a tinderbox for disputes between staff and patients and can be a place that aggravates patients as they wait to be helped. For those reasons, along with space savings, I eliminated it a year ago. We use virtual check-in powered by Solutionreach technology to send patients a link to click on when they confirm their appointment. That link takes them to the same forms, including those with HIPAA information and consent for additional wellness testing, which they would have had to fill out at the front desk. We were already using Solutionreach for practice-patient communications, so adding the additional functionality of virtual check-in was just an estimated extra $79 per month.

When patients confirm their appointment, and again on the day of their appointment, they receive a text asking them to text us when they arrive. Everyone in our office, including myself, gets that text, and we can all see when the arriving patient’s text has been responded to. I can make sure that each patient has been responded to within a few minutes of sending their text, either to be let into the office or texted back that they will be welcomed inside shortly.

Our general manager created a virtual routing form on Google Drive that enables whichever one of us is checking the patient in to access a routing form pre-filled-out with the patient’s co-pay and other insurance information. We then just must confirm that all forms have been filled out and take the patient’s co-pay. We started using Square, a wireless payment processing system, that gives us the ability to process payments wherever we are in the office, rather than having to go back to a central location, like a front desk, to process the payment.

Knowing that not all patients would fill out the forms ahead of time online, no matter how many times we prompted them before their appointment, we purchased two refurbished iPad Minis for $170 each, including the case. We use those iPad minis to help the patient fill out the needed forms and check them in for their appointments. Often, when those patients see how much faster other patients, who have already filled out the forms online, are checked in, they tell us they will do it that way too in the future.

Our office is more efficient, and patients are happier because they are moved in and out faster and more smoothly.

The benefits in money and time savings from removing our front desk, and creating a virtual check-in process, have been substantial:

Point-of-sale (POS) fees: $3,000 savings per year using Square instead of a traditional POS system.

Paper, ink cartridges and shredding services: $520 savings per year saved in paper, $1,440 saved annually in computer printer ink cartridges and $350 saved annually by no longer having to use paper-shredding services.
Total cost savings of our virtual check-in: $5,310

Savings in Time:
Average check-in time prior to virtual check-in: 25 minutes to fill out and complete paperwork and confirm exam type with patient and collect fees upfront (exam co-pay, contact lens fitting co-pay and/or iWellness screening).

Average check-in time virtually: 5 minutes (in-office staff now is usually only confirming exam type with patient and collecting fees upfront (exam co-pay, contact fitting co-pay and/or iWellness screening).

Staff time saving 15 minutes per patient check-in x 8 hours day (480 minutes)
Total minutes gained by staff: 7,200 minutes per day

Janelle Davison, OD, is the owner of Brilliant Eyes Vision Center in Smyrna, Ga. To contact her:


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