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Forget “Butts in the Chair”

An often-ignored strategy can add to your practice’s bottom line.

GARY GERBER, O. D.

I’m going to do it. I’m going to actually scream if I hear another complaint about “getting butts in the chair.” It’s sounds logical that if your practice is struggling that “butts in the chair” (BIC), especially new ones, would offer the sought-after relief. But the BIC solution to a practice’s woes is misguided, not based in business reality and, for many practices, harmful to bottom lines.

The BIC flaw

The bottom line to the BIC comment is that butts by themselves don’t spend money. If you’re having trouble paying bills, want to redo your optical, want to hire more staff or buy more equipment and simply don’t have the money, a preponderance of BIC won’t help you. What will help you is a bulk of money. And the flaw in the BIC thinking is that more butts equals more money. THAT is not always the case, and with many low paying insurance plans it is rarely the case.

With all the talk about healthcare reform allowing us access to patients, it needs to be asked: if you succeed and gain access, will those patients be profitable? Sure, those patients need care. But the crux of this article isn’t about providing care. It’s about staying profitable and growing your practice. And access alone doesn’t guarantee profitability. For nearly every established practice, the answer to creating a preponderance of money is right in front of them (literally), yet the “getting new BIC” proposition is blocking their view.

There are only three ways to increase top line revenue: See more patients (falls under the above access comments), raise fees (difficult to do if you accept a lot of insurance) or get the patients you already have to come back sooner. This last strategy is the least farmed practice-building technique. Yet, focusing solely on this one aspect quickly adds profits to a practice’s bottom line.

Bring them back sooner

Current market data shows that, on average, non-pathology patients return for care roughly every 2.1 years. Let’s say that two years ago you performed 2,000 exams. If everyone of them comes back this year, you’ll see 2,000 exams plus whatever new patients you might add to your schedule. But, think about how your income would have changed last year if those 2,000 patients came back one year sooner. With no other changes in your practice, you would have doubled your income. Of course, achieving this is unrealistic. But, it highlights the effect of simply shortening the “buying cycle” for your current base of patients. Just shortening 2.1 years to 18 months would have an enormous effect on profitability. And it could effectuate this increase without a single new patient or an increase in fees.

Get established BICs

Yes, in the strictest sense of the definition, each of those patients who returns early is indeed another BIC — but they aren’t a new BIC. THAT is a key difference to focus on when your practice gets slow and revenues are anemic. Instead of going on a quest for new patients, get the established butts to come back sooner. And, keep in mind you are likely to spend much less money to attempt to shorten the return cycle of an established patient than you are trying to acquire a new one. Additionally, if your practice runs efficiently and your pricing is where it should be, returning patients have a higher proclivity to spend more money than a new patient who visits you solely because of “access” due to their insurance coverage. OM

DR. GERBER IS THE PRESIDENT OF THE POWER PRACTICE, A COMPANY SPECIALIZING IN MAKING OPTOMETRISTS MORE PROFITABLE. LEARN MORE AT WWW.POWERPRACTICE.COM, OR CALL DR. GERBER AT (888) 356-4447.