Where Is the Money in Ocular Surface Disease? In Your Exam Chair!

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By Scot Morris, OD, FAAO

Here are the real business facts about ocular surface disease:

• Millions of people suffer from one form of OSD or another.

• Many of these people are in your chair every day.

• If you don’t treat them, someone else will.

As the marketplace becomes more competitive, we need to set ourselves apart. We need to find ways to bring in new patients for little cost and increase revenue per patient without involving costly external marketing efforts.

A niche OSD practice is it. I am not talking, “Let’s see one more patient a day.” I mean focusing on the most prevalent disease in your chair every day after presbyopia. What stands in our way? Most often, four simple excuses, which we can address one at a time.

I Don’t See OSD

Then look! If 20 percentof patients suffer from dry eyes and over 40 percent suffer from ocular allergies I am guessing that at least a few the patients you saw this morning had some form of OSD. They may not have said, “Doc—I have dry eyes so could you put me on Restasis.” Of course, they didn’t know they had an astigmatism or and needed a toric contact lens either but you treated that condition with a smile on your face and maybe even prescribed a pair of glasses with anti-glare as well to assist with the night glare that they didn’t mention. Three quarters of a unit of cyl probably causes them a lot less issues than their red, tired, irritated eyes. They just didn’t tell you because your staff asked them to read the lowest line—not tell them how their eyes felt. Ask the right questions and you will have “newly found” OSD patients all over your office.

I Am Too Busy
Really! If you are doing 30 to 50 patients a day that line may have some merit. If you are the traditional OD seeing 12 to 20 patients a day let me break it down for you. Let’s take an average 16 patients a day seen over an 8 hour day. That is two exams per hour. Is it really taking you 30 minutes to see a patient? If the answer is NO then you already know you have 5 minutes here or there every hour to fit in another exam. If your answer is YES, then you are inefficient and more importantly you are wasting a precious commodity—your patient’s time. Hire more staff, train them, delegate, get efficient. An extra tech may cost $120 a day but help generate $180 to 200. The reality is that most OSD exams take about 10 minutes of your time and can easily be added between those two vision exams.

I Can’t Get on a Medical Panel
Have you really tried or did you quit trying after one attempt? But more importantly do you really need to participate? When a patient walks in and tells your staff they didn’t have vision insurance do you turn them away with “I’m sorry but we don’t accept cash!” Then why would you turn away a patient who is cash pay (i.e. you don’t participate on their medical plan)? That is a patient decision—not yours!! If you educate the patient, describe how their life will be different with their OSD under control then something surprising happens. Patients pay cash to get relief because the other five doctors they went to didn’t treat their OSD. Even more amazing is what happens next: They refer friends.

You don’t want to solve people’s problems or make money doing it.If your excuse was this one then STOP READING THIS ARTICLE.

Let’s look at what a OSD niche practice can really do to your bottom line from both the direct and indirect financial perspective because once again—this is a business journal.

Direct impact.If you are seeing 16 patients a day, as mentioned above, then based on a conservative model you should be generating $145,000 per year from OSD. The table to the right reviews the assumptions to come up with this number based on a proprietary profitability calculator that I developed many years back. A more aggressive model could generate over $280K per year in revenue to the practice. And remember that most of that is pure profit since your staff is already working. We are not working more hours—just being efficient and solving patient problems with a smile.

Indirect Impact:Here is where the real money comes in.These patients are the very best marketers for your practice. Solve their problems, and they will shout from the highest building how you helped them and what a great doctor you are. They will tell their friends, their neighbors, their entire social circle. In my practice, we have tracked the referrals from our OSD patients. Each one refers an average of 4.6 new patients to our practice per year. Let me say that again 4.6 patients per year. It doesn’t cost me a dime to get them and based on the average revenue per patient numbers released by the MBA program these “referred patients” generate $1,380 per year. Of course then we draw in these “referred” patient’s family and friends. By the way, where do you think those new patients came from? Your “lost to follow-up” patients. If you want to grow your vision practice—treat the OSD. The OSD will in turn build your vision care practice.

Improve your bottom line!Provide a better standard of care for your patients! Start managing the easiest patient that you have: The one in your chair!! Of course, the net result is that you have to figure out what to do with the extra income. I’ll let you solve that one for yourself.

Scot Morris, OD, FAAO, practices at Eye Consultants of Colorado in Conifer, Colorado. He is a nationally recognized authority on dry eye. He is the director of an ophthalmic consulting service,Morris Education & Consulting Associates, as well as Ocular Technology Solutions. Contact:Scot@mecace.com.