Read more from the Q&A issue

• Methodology: Keep the questions coming
• How can optometrists efficiently schedule ocular disease patients in light of the COVID-19 pandemic?
• How can optometrists create a successful dry eye disease spa?
• How can an optometrist include the patient’s opinion when it comes to glaucoma treatment?
• How can O.D.s differentiate the neovascular form of AMD from similar diseases?
• How can an optometrist obtain diabetic patient referrals from a primary care physician?
• What should optometrists know about effective management of myopia?
• What is the value optometrists can provide and communicate for the fee charged?
• How can optometrists set up an appropriate fee schedule for specialty contact lenses?
• How can O.D.s get more engaged in luxury frame sales?
• How can optometrists get more new patients?
• How do O.D.s create a system for quick and efficient coding?

A: “Mrs. Rabinovich, the biopsy shows you have acute myeloid leukemia,” explained a doctor she sought for a second opinion. My mom’s cancer had been misdiagnosed by her primary care physician. She fought long enough to meet my son in 2015, but lost her battle with the condition one month after he was born. As a daughter, I fought the grief to celebrate my mom’s life. As a health care provider, I decided to fight for more effective care for my patients, while asking “if doctors, in general, had more than the average seven minutes to spend with a patient, could we do better?” Soon thereafter, I came across an article about California doctors who provided a yearly service, in addition to accepting health insurance patients. I decided to apply this concept to my practice, but not accept third-party plans. As a result, Theia Concierge Care (theiavisioncare.com/concierge-care/ ) was born in 2017. Specifically, Theia Vision Care offers a single payment membership for the entire year, in addition to an à la carte option, along with product benefits to every patient. Since we opened in 2017, we have offered both Theia Concierge Care as well as à la carte, in an open-access model.

“You must welcome change as the rule, but not as your ruler.” ~Dennis Waitley

So, how have I been able to create a thriving concierge practice? I have found that building this business is like building a house: creating a solid foundation takes time, but allows the house to stand strong for many years. Here’s how I’ve built a solid foundation for my concierge practice:

SEEK LOCAL RESOURCES FOR FUNDING

“Whatever you want to do, if you want to be great at it, you have to love it and make sacrifices for it.” ~Maya Angelou

I have used Hartland Business Development office for access to resources, such as low-interest loans, along with the Hartland Chamber of Commerce for a facade grant and a sign grant. Since there may be fewer patients initially in a practice of this type, any opportunity to conserve working capital and improve cash flows in the opening stages provides a longer runway to build the practice. This can free up cash for overhead, marketing and salaries and allows for more flexibility and patience to stay the course rather than turn to vision plans to fill up the books. Using local groups and resources to seek such funding has been instrumental in keeping our doors open as we grow deliberately.

DEVELOP STRATEGIC EYEWEAR PARTNERSHIPS

“People will stare, make it worth their while.” ~Harry Winston

We work with independent eyewear designers and an independent lab. We do not compete on volume or price. We compete on quality and service, and appreciate vendor partners who have our back with honest pricing!

CONTINUE TO LEARN AND EVOLVE

“I’ve learned that I still have a lot to learn.” ~Maya Angelou

My staff and I continue to learn through an array of classes, such as SPARC and Scale Up Milwaukee (scaleupmilwaukee.org ). SPARC is designed to promote growth by working directly with ambitious business owners, CEOs and the stakeholders that support them, thereby accelerating the environment that makes growth a core, self-sustaining part of the fabric of the region.

Another impactful course I am taking is the Leadership Academy, via the Wisconsin LGBTQ Chamber of Commerce at wislgbtchamber.com/businessleadershipacademy/ . This interactive, 10-month experience develops and strengthens the skills of existing and emerging leaders.

We also surround ourselves with leaders who we admire in other industries, including those in IT, hospitality, lawn care and construction. We meet monthly, via a local business roundtable group, to share experiences and pick their brains about marketing, human resources, finance, supply chain, company culture and more. I have learned in the last three years of running a start-up that I was woefully unprepared for business after graduate school. As a proud Illinois College of Optometry (ICO) alumnus, I felt confident that the depth and breadth of my clinical experience provided a robust start for my career as a doctor of optometry. Additionally, extensive business knowledge and experience is necessary for anyone looking to be an associate, run a practice, purchase a practice or start one, whether concierge or not. From understanding contract negotiation and vendor relationships to marketing and HR, the more you can learn sooner, the better. I find it vital to actively and continuously seek such learning.

“The best time to plant a tree was 100 years ago, the second-best time, is now.” ~Chinese proverb

Transitioning to a Concierge Practice

The following are some tips from the article “Concierge Eye Care: Opportunity or Impossibility?” written by Scot Morris, O.D. It can be accessed at bit.ly/3iYhmxm .

Perform a comprehensive demographic review. Is a concierge practice model attainable?

 

Survey current patients. Are current patients interested? 

 

  Address all legal and ethical issues. It may be beneficial to consider the services of an attorney familiar with retainer-style practices.

 

Create a menu of premium services and fees. 

 

Review current managed care contracts. 

 

Create a marketing plan. Produce the necessary related materials. 

 

Develop a clear and detailed consumer contract. Does it explain the services and product terms?

 

Create a timetable for service introduction. 

MARKET SERVICES

“Give them quality. That’s the best kind of advertising.” ~Milton Hershey

The practice website theiavisioncare.com/concierge-care , for example, provides a detailed description of the concierge services provided, such as a full hour per appointment and expanded access, such as my personal phone number. We always charge for our time, such as in the case of repairs, adjustments, PD measurements, etc.

Additionally, we find a way to always say “yes” to our community when we get asked to donate. We sponsor, offer free eye exams or a gift card and have even donated a year of concierge care services to local charities, schools, sporting events, children's events, parades and more. Showing up in the community consistently is key to our mission to do good.

Further, when a patient calls to make an appointment, my staff has been trained to frame under the concierge umbrella what the practice can offer based on the patient’s specific needs. For example, if the patient desires contact lens wear, my staff discusses that services, such as a contact lens evaluation, are included; patients are given extended access to contact lens rebates and more. Finally, we refer to and use other local businesses. I have a stack of business cards at the ready for my local gym, chiropractor, nutrition coach, physical therapist, dentist and travel agent. You get the idea. I use them all personally and refer to them. They do the same for my practice.

CURATE PATIENT SOLUTIONS

“Speak to your audience in their language about what’s in their heart.” ~Jonathan Lister.

I reinforce the value of the concierge subscription during the exam by illustrating how it can be used as part of whatever recommendation I make to the patient. For example, if the patient requires a spectacle prescription, I explain how our concierge practice model includes a free warranty with every optical purchase and that they can earn $20 on each referral eyewear purchase to spend on future eyewear purchases, among other perks. While the patient is waiting to dilate, my optician goes over the pricing, in part, re-emphasizing to the patient that payment is due in full at the time of service or when the product order is placed.

Data mining is another concept we have started to incorporate, especially for concierge patients. For example, when I attend CE and learn something new, I come back to the office and implement it with patients who come in. Taking it one step further, my team searches our system for patients who may benefit from this new information or a new product, even if those patients are not due for an exam. We then proactively reach out to invite that patient to come in to learn more about this new offer. The benefit is two-fold: Patients feel that we truly care and are getting high-quality service, which in turn results in additional business.

ASK FOR PATIENT REVIEWS

“The purpose of a business is to create a customer who creates customers.” ~Shiv Singh, senior vice president of global and marketing transformation at Visa

Specifically, I ask for a review from my chair and my team follows up with emails. I ask if there is anything we can improve on to be able to resolve any concerns. When the patient is pleased with the experience and products, the positive reviews work to attract prospective patients. Sharing customer reviews, testimonials and photos, always with signed permission, on our social media, is also an effective strategy.

ON MY TERMS

“You teach people how to treat you, by what you allow, what you stop and what you reinforce.” ~Tony Gaskin

As a clinician, I wanted to set enough time aside for me to get to know my patients, their lifestyles and health goals. With a preventative and holistic approach, I wanted to make sure the entire person was being heard and treated. A concierge practice has enabled me to do this. The initial growth in a concierge cold start practice may be slower than elsewhere, but once it achieves traction, the optometrist can attract enough patients who understand and appreciate the value of high-level, personal care.

“Success is liking yourself, liking what you do, and liking how you do it.” ~Maya Angelou OM

DR. KOECK is the CEO and Founder of Theia Vision Care in Hartland, Wisc. She attended graduate school at the Illinois College of Optometry where she graduated cum laude in May of 2014. Prior, she attended UW-Madison where she earned a Bachelor’s of Business Degree with a triple major in Finance, Marketing and Economics.