Enhance the Medical Side of Your Practice With Dry Eye Care

Follow the “Four Ps” to success

■ By Scot Morris, OD, FAAO

As eye doctors, our job is to solve vision and ocular health problems. So, if we’re not diagnosing and treating dry eye, we’re not doing our jobs to our fullest potential. Dry eye care is not only the key to healthier, happier patients, but also, through the provision of medical services, a financial driver for the practice. Approximately 20% of the people who walk through our practice doors have some form of ocular surface disease,^1-3 so if we’re not making those medical diagnoses and billing for that medical care every day, we’ve got work to do.

The idea of shaping a practice to conform to a medical model can be intimidating. But, in reality, increasing the medical services portion of a practice by focusing on dry eye care is readily achievable. You don’t even need to attract more patients; you simply need to take better care of the patients you already have. So, how can you enhance the medical side of your practice? I’ve done it in mine, and coached many others through it, by using what I call the “Four Ps”: Plan, Procedure, Product, and Promotion.

PLAN

Set Goals, Track Progress

The first key to expanding the medical services portion of a practice through dry eye care is to know where you stand. Even if you see only one medical patient each day, that’s the basis for your next step, which is goal setting (Figure 1). You can start small, aiming to double your current daily number from one to two or four to eight, and by asking every patient just one additional question (e.g., “Are your eyes always that red?”).

Figure 1. If the percentage of your practice that is medical (medical revenue/total revenue) is less than 15%, it’s very likely you aren’t identifying your dry eye patients.

No matter what your first goals are, track your progress weekly or monthly. If you’re committed to making changes, even your first small steps fuel a self-fulfilling cycle that propels you toward improvement. The difference from a financial perspective will eventually be tens — if not hundreds — of thousands of dollars added to the bottom line of your practice.

PROCEDURE

Implementation of the Plan

To reach the goals you have set, you must establish procedures or processes that you and your staff will follow each day. And although your staff has to accomplish these goals, the effort begins with you.

Think first about your clinical protocols. It helps to write them down. For example, how would you manage meibomian gland disease? What tests would you order? What treatments would you recommend? Next, think about all the different steps that take place from the time a patient enters the office to the time he leaves. What occurs between the patient and the front desk, the technician and the doctor, the doctor and the patient, and everything in between? Each of those points in the work flow is an opportunity to identify the dry eye patients in your practice and educate them so they’ll know that you can take care of their red, uncomfortable, dry eyes and fluctuating vision.

For example, you might have the front desk person ask patients whether their vision ever fluctuates and if blinking makes it better. Each patient could also be given a dry eye questionnaire. Then, have the technician collect the questionnaire and ask a follow-up question, such as “Do you ‘feel’ your eyes?” If the answer is yes, the technician can let the patient know that doesn’t need to be the case: “We can work on that.”

These types of changes in the work flow prompt patients to think about their symptoms, which they may not necessarily associate with problems. Being asked about and educated on their symptoms leads them to realize they need a solution, and makes them aware that you treat medical eye problems.

Once you find the points in the workflow where medically oriented interactions take place, you can work on fine-tuning them. Scripts work wonders for helping everyone in the practice talk with patients about dry eye and treatments in a consistent manner. You can write your own script or use staff and patient education materials created by the companies that have a vested interest in dry eye. Either way, practice using the scripts. You can role play, but there are other ways. I sometimes surreptitiously leave my phone at the front desk and hit record. My staff does the same to me; then we listen and determine whether we’re all saying what we’re supposed to say.

In addition to defining staff roles so they know what to do and providing the tools and training they need, it’s crucial that they understand WHY you want the practice to be more medically oriented, so they will be motivated to help achieve that goal.

Incentives, which can come in many forms, are powerful tools.

As the doctor in a medically oriented dry eye practice, you, too, must re-examine and fine-tune your interactions at key points in the workflow. With patients, you should verbalize everything you’re seeing during the exam, confirm the test findings and diagnosis, provide further education on the findings, prescribe treatment, explain treatment expectations, and — most importantly — tell patients to schedule a follow-up visit. Patients should never leave your office without a return appointment, whether it’s next week or 3 years down the road.

PRODUCT

Help Patients Obtain What They Need

In a medically oriented dry eye practice, you can’t be afraid of charging for services and products. Dry eye bothers people and affects their quality of life. You can help by recommending what’s best for them. If that means selling them a product, service, diagnostic test, or treatment, then it is your ethical responsibility to provide these products or services.

Recognize, too, that you can treat patients whether or not you accept their managed medical plan. If you’re not on their plan’s panel, but they consider you a trusted provider who can solve their problems, many patients will pay out of pocket for your services.

PROMOTION

Simple is Effective

A question that always arises when I discuss building a medical/dry eye practice is how to promote it. Promotion and marketing don’t have to be expensive or complicated. As previously noted, you and your staff promote dry eye care at various points in the daily workflow. In addition, you can raise awareness through your on-hold phone message, your website and social media presence, stickers on your envelopes, a booth at a community event, and so on — all of which are relatively simple and inexpensive ways to achieve to your goal.

A Focused Approach

Taking a focused approach to treating dry eye will be the single biggest business-builder most of you will have in your practice. If you’re willing to work ON your business rather than IN your business, you can make your patients’ lives better and in the process, achieve significant practice growth. •

REFERENCES

Dr. Morris is medical director of Eye Consultants of Colorado and an operating partner in Morris Education & Consulting Associates. He is the president of Ocular Technology Solutions, Inc. and is also chief optometric editor of Optometric Management.