Monthly Archives: March 2010

Healthcare bill and optometry (Harkin Amendment)

No matter where you stand on the political spectrum, it can be universally agreed that the Harkin Amendment to the recently signed Healthcare law is a positive for optometry. Whether or not the entire bill is positive for optometry is debatable and I don’t know enough to make any comments on it.

Harkin:

“A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law.”

Time will tell the impact on optometry.

Vision therapy presentation at SCCO – though mostly tips on great optometric practice management

Just attended a quick presentation by a elite level vision therapist in the bay area who sees 40-50 VT patients a week. And I wanted to jot down some of the take home messages quickly. In general, most things are common sense but sometimes you don’t think of the common sense stuff.

Most of his points were generalities:

Why do patients leave a practice to go somewhere else? It’s never the doctor’s fault. Optometry school is a great equalizer where by and large every student that graduates is an exceptionally smart, talented, and skilled doctor. They leave because of the person they come into contact with first, the staff member who answers the phone, they feel is incompetent or doesn’t care.

Take home message: either answer phones yourself or have the next BEST trained staff member answer the phones. Don’t delegate to the newby. You want the patient to get the most accurate information possible so they know the staff and office are competent.

You think debt in optometry school is a big deal? Not really, the biggest mistakes are the ones you make AFTER you graduate. Spending an extra 50k partying during optometry school is peanuts versus signing a wrong lease, opening cold in a town that can’t support you, hiring a bad staff member or associate doctor, or paying too much to buy out a practice.

THM: Don’t sweat it in school. But don’t rush into hasty decision after schools. All optometrists will be successful as long as they just avoid the trainwrecks.

Don’t inundate your patients with massloads of information. Don’t have a slew of pamphlets and give them information overload. Assess them quickly, and tailor your patient education to their condition.

The presenter sees patients like an orthodontists does, spending 5-6 minutes of individualized time per patient. Spending a lot of time is not necessary. If you watch TV with your spouse for 4 hours, is that quality time? Or is having a 30 minute conversation in a car ride more time well spent in the relationship than the 4 hours spent watching TV?

THM:  Specialize in knowing your patient and address their needs specifically, do not inundate them with information.

I believe his practice is setup right next to another multi-doctor practice that does general practice optometry. The situation is ideal because he can get referrals from them for VT and they don’t mind because they know he isn’t going to steal any of their patients.

VT is mostly private pay because no insurance covers for his patient base. The pay is thus limitless because no 3rd party sets the fee, you do.

He also talked about the most important thing to success is how you manage your failures. One successful patient might tell 1 or 2 others if you are lucky. But one failure will tell a dozen or more for sure.

THM: Your reputation is priceless. Manage the failed patient cases by quickly refunding their money. Everyone on staff must realize this as well, and the policy should be in writing and displayed proudly for all the patients to see. A patient can’t be mad at you if the therapy didn’t work if you refunded them the entire amount quickly and honestly. A key is to do it quickly and not grudgingly. (example, if your spouse asks you if you like their new haircut, don’t pause and then say you love it. You must say you love it unequivocally and without hesitation).

Take home message for optometric private practice in Southern California

From a presentation two nights ago.

Cheap stuff may be found at dotmed.com

For recall, patients don’t like emails or letters but postcards. Have them write the postcard if you want.

Hire a consultant if you are a inexperienced. The advice given will pay for itself.

Send postcards for Thanksgiving and Valentines day thanking a patient and showing them you care.

Why SCCO optometrists don’t want to do Private Practice

Why don’t future optometrists want to pursue private practice?

Because they realize they’re going to be broke the first few years out of optometry school if they start in private practice. That it’s a big risk, that working 9-5 and then going home sounds sweet after a grueling optometry school curriculum. And then they’re at Costco, or Walmart, or even a big HMO like Kaiser.

Why does this happen?

For the same reason I drove to Subway for lunch today. I’ve got sandwich supplies at home, but I still didn’t make my own sandwich because the thought of cutting up the tomato, getting the lettuce and turkey and mayonnaise to assemble my own sandwich was too great of a barrier to overcome. So instead I spent MORE time and energy driving around to spend more money on a sandwich that isn’t much better than what I could have made with the supplies at home.

I did it because of barriers.

Those that will have the most success in life recognize barriers quickly and ruthlessly tear them down.  Some barriers are obvious like needing a key to open a door, or opening a backpack to get a book. While others are invisible like the fact that not having a pen at my desk is an obstacle when someone calls and I need to jot something down real fast on a scratch piece of paper. Some barriers are helpful like when I want to stop surfing the internet mindlessly instead of studying, I drive to school and study there in the library or lounge.

But the number 1 obstructive barrier for anyone out there is simple. It’s not the local economy, over saturation of optometrists, OMDs, education,  or lack of money. Just look into a mirror.

It’s YOU.

Just as soon as you dream a dream, you start thinking of all the things that could go wrong.

“I can’t make it in Southern California because it’s so saturated.” When you should be saying “what are the things I need to do to overcome this barrier?”

“I can’t afford to go to optometry school.” instead of “how can I afford to go to optometry school?” (wait a minute, I think I read that somewhere in a Kiyosaki book…)

It’s why when I asked my friend about getting into private practice, she doesn’t ask me about where to find one, how to market and sustain it, or how feasible it is in certain locations. She asks “how the heck am I supposed to get a loan to buy one when I have no credit?”

Some people are afraid because they aren’t aggressive enough for private practice, that they have a hard time commanding people. But who says you need to have these traits? In the words of Dr. Paugh in lecture today, “it’s fine to be an introvert!”

How do you know you need to be aggressive to make a sale? Because you see salespeople on TV do it, or at a car dealership?

It’s more important to follow one rule. Really, just one rule.

Do what is best for the patient. If what is best for the patient happens to be more expensive, so be it, but always advocate for this and you will never go wrong when you advocate for what is best for them. If wearing polarized sunglasses while driving in the morning makes it easier to see, I’m recommending it. If wearing AR coating lets more light reach pass the lenses, I’m recommending it.

In the end, if you want to get from A to Z, don’t keep creating all these mental barriers that stop you from doing something even before you’ve started. If you want something, set a goal and go for it. I know I will, so good luck to the both of us.