CLINICAL

  PEDIATRICS

THE BUSINESS OF PEDIATRIC EYE CARE

HOW I CREATED A SUCCESSFUL PEDIATRIC PRACTICE

FIFTEEN YEARS after opening my part-time practice, I decided to leave academia and establish a premier pediatric optometry office. The reason: One of my mentors, Dr. Harold Solan, convinced me that if I wanted to have a thriving private practice, I could no longer divide my attention between University administrative duties and the demands of a successful private practice.

Here, I discuss the steps I took to accomplish this.

1 I SPOKE WITH CONSULTANTS

I met with business coaches and optometric practice consultants to determine a specific plan of action to make the practice a success. Although practitioners in other pediatric fields, such as dentistry, see child patients exclusively, very few optometric offices limit their practice to pediatrics. In my experience, this is due to the relative lack of exposure to this population in optometric clinical education.

More commonly, your business plan will address how much of your office you want to dedicate to being pediatric friendly. This includes furniture, decorations and space in the reception area, as well as within examination and treatment spaces.

You’ll then decide whether you want to take the lead in learning more about pediatric optometry (The AOA, COVD, OEPF and AAO have considerable material on their websites), or bring in another practitioner with experience in the field. Hiring a recent graduate who has multiple externships or a residency in pediatric eye care can be a cost-effective approach. I have had the pleasure of seeing many of my former externs and residents help expand the pediatric base in existing practices or ultimately start their own practices.

2 I PURCHASED PRACTICE SPACE

I decided to purchase my space, arranging to co-own the building with a well-respected pediatric medical practice. The reason: I felt this was a good way to jump-start the practice.

I occupy 4,000 square feet, which includes a storage area on the lower level. At the outset, we offered full-scope optometric services, with Family Eyecare Associates, P.C., as our principal business, and The Vision & Learning Center as the placeholder name for the vision therapy and rehabilitative component of the practice. I entertained the idea of having two parallel pediatric practices with separate Tax ID numbers, one that would be a participating provider in third-party care and the other that would not. (See “Advantages/Disadvantages of Two Parallel Pediatric Practices,” below.)

If you decide to have two business entities with separate tax ID numbers, there may be state board and insurance company issues to initially address. For example, state boards vary in their stipulations about what constitutes the practice of optometry. Some insurance carriers require a licensee to be a participating provider in all locations the doctor is licensed to practice. The ability to “opt out” of participation may not be as flexible as you anticipate, and it requires a very close reading of the contract to participate on the primary eye care or optical side of your business.

I decided to remain as one business entity and evolved in the direction of being a non-participating provider in third-party care plans because I wanted my principal obligation to be to the patient and not to a third party and its dictates. This decision also gave me the latitude to be a strong advocate for reimbursement on the patient’s behalf.

The transition from being a primary care practice with a special interest in children, to becoming a specialized pediatric and rehabilitation practice occurred gradually through an 18-year period. The most rapid phase of this transformation occurred five years ago after we withdrew from the only remaining plan we participated in that also had an optical component. This coincided with the implementation of our private practice residency program.

3 I SOUGHT ADDITIONAL PEDIATRIC PATIENTS

I hosted community screenings and networked with pediatric practices in allied healthcare fields. Networking was accomplished mostly through in-services and seminars. I made a point of taking staff to visit other practices and facilities, and, in turn, hosted them in our practice.

In addition, you can cultivate infant patients through the AOA’s InfantSEE program. This requires minimal capital investment. Lastly, consider setting a budget for sponsoring local children’s events or teams to further identify your practice’s name with young children. We sponsored local baseball teams and a softball fundraiser.

4 I BALANCED MY SCHEDULE

I learned pretty quickly to maintain a balance between infants and preschoolers, who are better seen earlier in the day, with after-school appointments. If you’re in an area with a strong home school population, I highly recommend you schedule them earlier in the day because their schedules are relatively more flexible.

LOOKING BACK

I have no regrets about my decision to leave academia and focus my full energies on building a premier pediatric and rehabilitation practice. Although I miss the camaraderie of faculty, my interaction with colleagues through CE lectures, publications and organizational ventures has enabled me to enjoy the best of both worlds. OM

LEONARD J. PRESS O.D., F.A.A.O., F.C.O.V.D. is the optometric director of the Vision & Learning Center in Fair Lawn, N.J. He specializes in pediatric vision. Dr. Press completed his residency program in pediatric optometry at the Eye Institute of the Pennsylvania College of Optometry, and he served as chief of the pediatric unit of the Eye Institute. In addition, he’s a Diplomate of the AAO and has written three textbooks encompassing pediatric optometry and is a Diplomate in the Pediatric Optometry/Binocular Vision and Perception section of the AAO. Email him at visionlecture@gmail.com, or visit tinyurl.com/OMcomment to comment on this article.