3 ways to build patient loyalty

Patients who are loyal will always return to your office for their regular exams instead of going elsewhere. Loyal patients will refer their friends and co-workers in need of eye care to your office. Loyal patients are key to a successful optometry practice.

Loyalty cannot be purchased, it must be earned by connecting with patients beyond the exam room interaction and going above and beyond their expectations.

Here are 3 ways to build loyalty in an optometry practice.

  1. Call patients – Calling patients on the phone is difficult for me. I would rather craft an email or send a short text, but neither of those methods are good for communicating personal and sensitive health information. Remember, you are talking about one of a person’s most cherished senses–vision. Even though making a telephone call seems antiquated and awkward, it is important. With a phone call, you can be sure the information is getting to your patient and not someone else, and you are on the line and available for questions or clarifications. Doctors who take a couple of minutes to call their patients with test results or important information will find their efforts will reap huge benefits in the practice, not only financially, but relationally. Relational connections lead to referrals and more loyal patients.
  2. Refund an unhappy patient – Yes, give it away. If you see a patient who has had her new pair of glasses for four months and she is disappointed with the new prescription, give her a refund. You will take it on the chin, but that’s better than leaving an unsatisfactory situation to fester. Repeat offenders are a different story, so learn to distinguish the two.
  3. Give services and products away – I will never forget the friend who was present in my life when I was at my lowest. Many of our patients come to our office at their lowest times. As a doctor, when you discern patients’ extenuating circumstances, you may decide forgo the charge for the exam or the treatment. This transforms to growth, loyalty, and security of a long lasting healthy practice. Many of the most profitable practices give and give big.

Being successful is not always about who ends up with the biggest practice or most money. The funny thing is, when you don’t focus on becoming a bigger practice or making more money, and instead focus on having the heart of a giver, the bigger practice and more money tends to follow. If you feel like you can never quite get over the proverbial hump, maybe it is time to start giving things away.


The #1 way to increase your production by $80,000 this year

Most business owners want to grow their businesses, and optometry practice owners are no exception. However, growing the bottom line in today’s economic climate is tough. Many optometrists are forced to sign with insurance companies that have negotiated rates that are 60 percent less than usual and customary fees, which means the reimbursement for that $100 exam will only be $40. Other optometrists feel pressured to offer discounts on glasses and contact lenses to keep up with online competitors. The optometrist who is also a savvy investor will look for ways to minimize marketing dollars spent while maximizing their return. However growing the business for medical facilities usually means attracting more patients, and today optometrists need to see twice as many patients than they did ten years ago to make the same amount.  But how do you get more patients through the door?

Wisely investing in online real estate is the number one way to increase your production this year. This does not mean haphazardly throwing money at just any company promising to take your optometry practice to the top of search engines while dominating your presence in social media.  This means researching the companies who have proven to be successful in the optometry market. A successful website should be run by a company that knows optometry and is currently putting optometry businesses at the top of the search engines.

In 2013, we made an investment in a little company by the name of iMatrix. They specialize in optometry websites and allow a practice to be as involved in the process as they want. They posted to Facebook, Twitter, and Google+ for our office and managed the website, changing content as frequently was we wanted. Check out our site Wichita Optometry. Through 2013 we watched as 6 new patients a week walked through our doors stating they found our office at the top of Google search.

I personally would not choose my eye care provider solely from a Google search, and you might not either.  However, hundreds of thousands of patients throughout the country are doing just that. Most importantly, most of them are paying cash.

It is difficult and often risky to invest in online real estate. But seeing that we can measure the number of new patients (in our case, over 250 last year) times the average new patient visit (about $300), we now have an investment that returns much more than the principal (an $80,000 increase in our case).  And most importantly we can track our return on investment.

How to protect yourself in an optometry employment lawsuit

Letting go of an employee may be one of the hardest confrontations that a CEO of an optometry office will face. Telling someone that he or she no longer has a job is difficult, and the smaller the office, the closer the acquaintance and the harder it is.

Along with this unpleasant task come other not-always-pleasant tasks, like going through the hiring process to replace the employee, and explaining to patients that a certain employee is no longer with the office.

Although terminating an employee is difficult, if a staff member is not meeting expectations it may be one of the best decisions you make all year. The key to letting a staff member go as painlessly as possible is following a well-thought-out set of procedures once an employee has been determined at risk for termination.

All optometry practices should have an employment manual that is updated every six to 12 months. Included in the manual should be guidelines for terminating employees. This can be your protection against being named in an employment lawsuit. By defining the boundaries of proper work conduct and documenting and enforcing breaches of the rules when they occur, terminating an employee becomes a process that follows the steps prescribed in the employment manual. Having everything outlined for new hires at the beginning of their employment shows them this is business, not personal.

Here is an example of a Dismissal Policy from the pages of an Optometry Employment Manual

The following may be cause for dismissal: inefficiency, inability to perform assigned duties, excessive absenteeism or tardiness, insubordination (undermining authority of the doctors), ongoing display of improper attitude toward work, poor personal hygiene, dishonesty, misleading use of sick leave, breach of confidentiality or unprofessional ethics, divulgence of individual salaries and refusal to perform assigned duties. This list is not considered to be all-inclusive.

Usually, an employee at high risk for dismissal will be notified and the opportunity to remedy the situation will be given; but the employer reserves the right for immediate dismissal without warning.

Employee Dismissal Guidelines

  1. Warning – An explanation of what is expected will be communicated to the employee. If an employee receives a warning from the doctors they will be excluded from the production incentive for the month the warning is given.
  2. Probation – This may accompany the initial warning or may serve as a final warning, this is the time period for which an employee has to make improvements or termination will occur.
  3. Termination of Employee – This may occur with or without the two previously mentioned steps depending on the severity of the cause for consideration of dismissal.

Firing an employee is never easy. However, having the proper documentation and guidelines as outlined in your employment manual will make the termination straightforward, less personal, and less likely to end up in court.

What all buyers and sellers of optometry practices need to know

All sellers want to get top dollar for their optometry practice, but many of them are not.  One reason they are not getting 65 percent of gross or higher is because they have not taken the time to remove all their personal expenses from the income statement.

Owners of optometry practices can take advantage of many tax benefits. For example, many owners take family vacations during the week of Optometry’s Meeting, which allows them to write off the trip as continuing education, but also enjoy time with family. If the owner is not planning on selling the business in the near future this plan works well.

However, optometrists  planning to sell their practices in the next three years should take their personal expenses off the books. This not only cleans up the books for a sale, but reduces expenses and thus appropriately increases the bottom line. Here are four categories to consider as personal expenses.

  1. Club memberships – Memberships to health clubs and golf courses, as well as clubs for hunting, fishing, poker, etc. need to be discontinued or paid for personally.
  2. Car expenses – The owner may be claiming a vehicle as a business expense. Unless that vehicle goes with the purchase of the practice, all monthly payments, insurance payments, gas, and car services need to be considered personal expenses and removed.
  3. Spouse on payroll – All family members that will not be replaced at an equal or lesser expense need to be removed from the payroll.
  4. Travel – Sometimes convincing cases can be made for keeping travel expenses in the books, like in the scenario above. Some moderate travel-related business expenses are not unreasonable. However, sellers who complete most of their continuing education in expensive locales like Hawaii or Europe with family and friends probably need to clean some of those expenses up, especially if the amount exceeds usual and customary expenses for a weekend CE.

A seller who takes the initiative to clean the books in preparation for a sale will not only increase the value of the practice by showing a better bottom line, a seller will also demonstrate integrity and good faith. Sellers who lead in good faith are the ones most likely to close a deal.

3 reasons your appointment template should not specify type of appointment

Let’s face it. We optometrists who have been practicing for a while like our comfort zones and tend to resist something new. However, electronic health records and the Affordable Care Act are changing how we do business, and we would be wise to pay attention to the ramifications.

In the past, optometrists depended upon the comprehensive eye exam to be the main source of revenue generation. Appointment schedule templates reflected this by allowing for a good number of these every day. Appointments for other care, like a red eye evaluation or a contact lens evaluation–while extremely important to patient care–have been minimally profitable from the eyes of the practice’s CEO. Consequently, these visits were limited in number, or scheduled around the more lucrative comprehensive exams.

Moving from this traditional refractive-based mindset to the new medical model mindset will require changes in the fundamentals of your business right down to your schedule template. Here are three reasons why you should no longer designate a specific type of appointment for a specific time:

  1. Online patient scheduling – Many of you have not planned for online scheduling, but as more professionals offer patients the convenience of booking their own appointments online, optometry will be expected to follow suit. If the online appointment slots allow for any type of patient encounter the process is simplified for the patients. When patients are successfully scheduling their own appointments your staff is free to focus on other jobs in the office.
  2. Supply/Demand – If your schedule has two comprehensive exams per hour plus a check time for contact lenses or acute care, then a bunch of patients needing comprehensive exams may have to wait for a couple of days or weeks while your check times remain open. The medical model approach to patient care will actually decrease the amount of time required for a comprehensive exam. Having three or four “any type” appointments in an hour allows a doctor to treat the needs of the patients as they come, without leaving unfilled slots in a schedule due to a limited appointment template.
  3. Decreasing reimbursements – Most are quite aware of the reimbursement chopping the 92000 ophthalmological coding tree has taken. Practices continuing to focus on the traditional comprehensive mindset will see the greatest hits to their profit margin. As reimbursements continue to decline, practices that are problem-focused will be better able to manage their patients. With the new mindset, revenue per patient could continue to remain steady or potentially increase based on the new approach to the appointment template.

Vision is the ability to see those things ahead of you that will require you to make an adjustment to your predetermined path. Having vision for the future of your practice requires you to assess the way you do things now and ask yourself if the current systems will continue to serve you well in the future.

When buying or selling, get a confidentiality agreement

Wine loosens lips. At dinner parties or family gatherings wine can cause people to relax and increase their enjoyment of the evening. That is, until your brother-in-law has a glass too many and tells everyone about his recent gambling adventure when he lost $1,000 at the craps table. The story might be amusing if you had not recently heard how their family was struggling to make ends meet. So your sister is embarrassed about her husband and your mother is quickly picking up the dishes and trying desperately to change the subject.

When you are in negotiations to buy or sell an optometry practice, the details of your deal may be one empty wine bottle away from becoming common knowledge at the next social gathering. You can assume the people with whom you are negotiating won’t talk, but what if they do? Insisting on a confidentiality agreement up front for all buy-sell negotiations communicates the importance of keeping lips sealed until the deal is done.

Here are seven key components of a confidentiality agreement.

  1. Confidentiality – It’s a given, but make sure you have it.
  2. Material exchange – When the buyer receives information about the seller, the documents exchanged are for informational purposes only.
  3. Limits on disclosure – The buyer and seller agree to take responsibility for any breach by respective advisors.
  4. Buyer can inform – This outlines who the buyer will inform such as employees, attorneys, accountants, consultants, and bankers.
  5. Destroying the evidence – Any documents distributed should have specific guidelines on how they will be destroyed or returned to the seller.
  6. Who talks to whom – This section designates the liaisons for communication between the buyer and seller.
  7. Length of confidentiality – Most agreements are between one or two years. Do not sign an agreement that does not have an end date.

I have worked with many buyers and sellers who ask if all of this is really necessary. I believe a signed confidentiality agreement is a must. Assuming the best in someone is a great principal to live by–until that individual cannot be trusted. If you are in the middle of a deal and learn you cannot trust the other party, you will regret not having a signed confidentiality agreement. A confidentiality agreement is ALWAYS good practice.

Top 10 reasons an OD should change EHR/practice management software

Slim man laughs at his fat self

Have you ever found yourself laughing at what you have become only to shake your head in disbelief?  You may feel this way as you look at the current software you utilize in your optometry office. Maybe you thought all software was pretty much created equal or maybe you make excuses when you overhear your colleagues praising their practice management software while you curse yours.  Just like all cataract surgeons are not created equal, all software for optometry offices are not created equal.  

Below are real-life examples of why one office is going to stop making excuses and do something about it. The office doctors have all attested to meaningful use stage 1 and are looking to qualify for stage 2 this year.  They did not want to change but knew they needed to.
  1. When you checkmark an MU box the result is a PQRS auto code which works some of the time, even when the exact boxes are checked.
  2. Customer service gives multiple answers for the same question (verified by numerous doctors and staff members).
  3. A programmer locks himself out of the SQL database on the server.  The irony is the SQL database is the one the programmer works on all the time.
  4. Blood pressure readings default from a past exam of Patient A into the new exam of Patient B, resulting in Patient A’s blood pressure readings in Patient B’s chart.  This happens on all patients when a blood pressure has been taken.
  5. Notes previously made just disappear days later. . . no reason.  Call customer service. . . yeah, that happens sometimes.
  6. Exams lost after closing them, although the message says it is saving. . .gone, gone, gone. Who needed that exam anyway?
  7. During the coding process, the first diagnosis code automatically defaults to all the procedures listed. When you attempt to change to a different diagnosis code to match the appropriate procedure, the default first code pops back in automatically when saving and exiting. This results in improper coding that is sent to Gateway unless our coder catches it and corrects it on the insurance claim.  Even if caught by coder, it still remains incorrect in the EHR.
  8. The software is so “bulky” it requires the office to upgrade computers much sooner than necessary.  Hardware will last much longer when software runs with little effort (if you use a Mac you understand).
  9. When exam pulls forward different boxes are checked resulting in incorrect information defaulting from previous record to new record, this requires doctor and staff to read through every documentation of new exam deleting many incorrect elements that were pulled forward.
  10. When closing a CL order in one patient and opening another patient CL order, the closed out patient’s CL information pulls to the newly opened patient and replaces the correct information, and it is never consistent, sometimes it is prescription only, sometimes all of the info, data substitution varies.
It is difficult enough for practices to comply with all the regulations of HIPAA and meaningful use. An optometry practice that has a software which works against them results in a greater number of staff hours and a very inefficient office. If you are struggling to make your practice profitable in our world of electronic healthcare, maybe it is time for you to seriously consider switching to another practice management/EHR system.

3 ways to build staff morale

The task of managing staff can make you want to sell your practice.

After spending a busy day in the exam room, you’re frustrated to learn a staff member has been spreading gossip throughout the office. Upon opening your email, you see one of your morning patients replied negatively on a post-exam survey.

When you find your ship sinking, reach for these three ways to build staff morale. Or better yet, don’t wait for trouble but proactively incorporate these suggestions to foster a positive work environment.

  1. Plan a staff activity – So you’re a tightwad–loosen up a little and spend some money above and beyond on your staff. The number one reason staff members leave their jobs is not money, but a lack of appreciation from their employers. Show your staff you care and take them out for a fun activity. It could be as simple as dinner and a movie.
  2. Take a staff trip – Two doctors and three staff from our office recently took a road trip to a city five hours away. The purpose was to observe another optometry office and their systems as we prepare to switch to a new software system. The added benefit was the chance for us doctors to interact with staff in an informal setting. Building staff morale with key players on your team is an investment that will reap many benefits.
  3. Attend regional staff training – As you’ve advanced in your optometry career, you’ve most likely visited numerous places throughout the country, both for business and for pleasure. Your staff probably has not had the same opportunities. Consider taking your staff to a regional continuing education meeting. Staff members will not only advance their knowledge in the field of optometry, but they will spend time with you and each other. Getting to know staff members outside of the office, and giving them a chance to interact with you and each other in a different setting can be beneficial and go a long ways in rebuilding broken morale.

When your staff is creating a negative environment at the office, patients suffer. Sometimes removing the staff from the negative environment and creating a positive experience can be the catalyst to rebuilding staff morale.

Are female optometrists changing the profession?

On the record and off the record colleagues often ask my opinion about the growing number of women in optometry. Interestingly, many of those asking are male baby boomers who have been accustomed to a male-dominated profession for most of their careers. Below you will find a question about female optometrists posed to me by a leading optometric journal.

More women. How has the increase in female optometrists changed the profession? What is the expectation for women in optometry in the coming decade (more, stay the same, etc)?

Here’s my answer:

© Ann Yarrow Photography

The number of women in optometry has been increasing over the last 10-15 years. Due to these changes I believe optometry has become more well-rounded in the delivery of care and the availability of optometrists to care for patients.  Many women are looking for a lifestyle that complements both their family and profession. This often leads to an increase in the demand for part-time employment. Women tend to seek opportunities that allow them to continue to manage the family while fulfilling their professional aspirations. Women are also looking to share responsibilities. It is not uncommon to see two women buy a practice together to share the workload and still allow for ample time to tend to family needs. Because the practice of optometry is generally conducted during regular office hours and doesn’t often involve nights and weekends, and because patient loads can be shared, it is an especially attractive option for parents raising young children. Taking this into consideration, I would expect the number of women in optometry would continue to grow over the next decade.

If you were asked the question, how might your answer had been different?

How to Convert Website and Phone Leads

Guest post by Rachel Cunningham

As a business owner, you spend valuable time and resources marketing your optometry practice both online and offline. However, those valuable investments can be wasted if you don’t plan ahead to maximize conversions. Maximizing conversions means turning phone calls and emails into new patient appointments.

Planning for Lead Conversions

The first place to start is by educating your staff. Hold monthly or weekly meetings to let your staff know about any website, social media, or direct mail specials you are running. Keep copies of the specials and redemption guidelines at the reception desk. Having a knowledgeable staff shows that your practice is professional and organized, which creates a great first impression.

Next, coach your staff for closings. Create formal or informal training to show your staff how to close phone call or email leads. For a formal training, create a script that they can follow while they are learning how to close a lead. Informal training can involve giving feedback after listening in to a phone call or allowing a receptionist to listen to a phone call that you handle. Your front office staff do not need to be sales people. In many cases, “closing” a lead simply entails asking for the appointment.


Caller: “Hello, I saw your website special about 20% off eye exams. Do you accept VSP insurance?”

Receptionist: “Yes, we do accept VSP. What time can I schedule you to come in for an eye exam?”


Be Accommodating & Available

Make it easy for your staff to get new patients in as soon as possible by being available. Set aside time on certain days for walk-ins, phone leads, and website leads. Advise your staff to give new patients priority (without negatively impacting loyal patients). Getting new patients in as soon as possible shows you are willing to go the extra mile for them and you appreciate their business.

Ensure that your staff responds to all new patient leads in a timely manner. Set expectations for responses, both voicemails and emails. For example, it is best to require that all emails and voicemails be handled same day or by end of day. Not responding in a timely manner could lose you potential business. Consumers often have a choice when it comes to optometrists and if it takes you two days to return a request for an appointment, they may have assumed you weren’t going to respond and scheduled with another optometrist.

Create a Great Experience

Create a great in-office experience for new patients to ensure they return. This includes everything from parking, to greeting, to completing forms, etc. When possible, allow new patients to complete paperwork from home or their office to reduce the amount of time they spend in your reception area. Advise staff to greet patients immediately or quickly after they arrive in the office. Ensure return visits by advising the front desk staff to schedule a patient’s next appointment when they are checking out.

General Phone & Email Etiquette

As an experienced doctor and business owner, professionalism is likely second nature to you. However, younger generations, like Millennials, are used to more relaxed and casual environments. You cannot expect that simply because an employee is qualified and skilled that they have the same perspective on professional etiquette that you maintain. In order to ensure you and your staff are like-minded regarding expectations and professionalism, create guidelines and spend time training your staff on phone and email etiquette. Be very clear in your expectations and emphasize that they are often the first point of contact a new patient has with your practice and let them know how you want the practice represented.

It is very common for businesses to spend money driving traffic to their website and generating new leads but overlook the conversion portion of the equation. As an optometrist and business owner, you want to spend your marketing budget efficiently. The best way to effectively control marketing spending is by focusing on ROI. Improve your ROI by providing training, communicating clearly, and checking in with your staff about new patient conversions. Continually ask your staff about the response to specials, ask questions about new patient experiences, and focus on retaining existing patients. Keeping communication open and clear regarding new patient generation will help your team to successfully increase lead conversions and increase new patient appointments.

Rachel Cunningham is a Marketing Content Writer at iMatrix, a provider of affordable web marketing solutions for small, practice based businesses. She earned a Master of Arts degree in English from CSU Long Beach and a Bachelor of Science from Boston College in General Management. Rachel is experienced in writing content optimized for search engines and users, creating engaging content for social media, and crafting articles about SEO and social media marketing for small businesses.