Jump-Start Your Practice Today
And Grow Well Beyond Y2K

by Randolph Brooks, O.D., F.A.A.O.

First of two parts.
By this time, the millennium hoopla will have died down, empty champagne bottles will have been tossed and (we hope) our fears about the Y2K bug will have been unfounded. You'll also realize that managed care hasn't gone the way of the millennium bug.

That means we still need to find new ways to grow our practices. The new millennium seems an ideal time to look carefully at your practice. In this first of two columns, we'll look at 10 ways you can jump-start your practice for Y2K and beyond. Next month's column will offer 10 more.

1. Re-evaluate your mode of practice. Are you a solo practitioner, or do you employ associates? While you may enjoy solo practice, you may also find that group practice is more efficient. It may also offset reduced managed-care fees, since having more doctors allows you to offer more hours to patients.

2. Consider opening a satellite office. You'll be able to attract more patients who find your location convenient to their homes or offices. MCOs may find you more desirable, too, especially if you open in an area in which they need more doctors on their panels. Having these additional patients also offers you added protection should a managed-care or vision plan you don't accept suddenly sign up a large portion of your patient base.

3. Get involved. Community involvement is personally rewarding and can be a powerful tool for growing your practice. The time you spend on committees, in service or religious organizations, or doing vision screenings may expose you to prospective patients.

Also, if you haven't done so, join the AOA and your state and local optometric associations. Consider serving on a committee, too. As your colleagues get to know you better, they'll be more likely to refer patients who move to your area.

4. Evaluate your recall system. No patient should leave without scheduling his or her next visit, whether it's in two days or two years. Some practices have found that pre-appointment doesn't work for them, but I urge you to try this system before you decide it doesn't work.

Another idea: Combine postcards or letters with follow-up phone calls. Have an experienced employee do this. Also, determine the best times to call patients; 5-8 p.m. weekdays usually fits that bill. You won't reach everyone, but you should reach enough to keep your schedule full.

5. Comanage surgical patients as soon as appropriate. Although many of us comanage cataract and other surgery patients, we often don't do so until at least 30 days post-op. New cataract surgery techniques have greatly reduced the incidence of post-operative problems. We should feel comfortable comanaging the patient as soon as medically indicated.

Refractive surgery is another important opportunity. You can provide accurate information and be involved in the pre- and post-op care. Try to be with the patient the day of the surgery and, if allowed, perform some of the evaluations at the surgical center. Patients have greater confidence in your choice of a refractive surgeon when you're there to help your patient through the surgery.

6. Add specialty services. These can set your practice apart. Learn to fit keratoconus patients with RGPs, do low vision exams, treat pediatric patients or comanage difficult ocular disease cases.

7. Update your computer system. If you haven't already done so, think about upgrading your hardware and converting your software from a DOS-based to a Windows-based system. Many optometric software developers are converting to Windows-based programs. And, Windows may let you perform more practice management and marketing functions.

8. Grow your contact lens practice. Start by keeping more Rxes in your practice. You must comply with your state's laws about releasing contact lens prescriptions. Still, when patients ask for their Rxes, show them a chart you've prepared that compares your fees with those of alternative sources. Include information about membership fees, shipping costs, and any other fees and return policies so patients understand the true cost of using these sources. Consider shipping lenses directly to patients to offer the same convenience as mail order.

Also let patients know you offer specialty contact lenses. New bifocal and disposable toric designs allow you to serve the growing ranks of presbyopes and astigmats. You differentiate yourself as a specialist, so these patients are more likely to refer friends and family.

9. Increase staff training. You've read enough by now about the importance of delegating more testing and patient education to your employees. Paraoptometrics can be important to patient care, and increased training can help employees feel good about their jobs.

Pay for your employees to join paraoptometric sections, and bring them to CE conferences when possible. Use audio- or videocassettes and manuals from optometric organizations and consulting groups. Hold weekly staff meetings.

Involve your employees in the business aspects of your practice. Set goals and offer incentives for good performance.

10. Improve your billing and coding. Correct coding is your responsibility. Know whether your patient has a vision or medical plan, and which diagnoses that plan covers. Keep a list of CPT-4 and ICD-9 codes in your exam rooms, and use routing slips to give employees accurate information for claims.

Also attend coding courses with employees. Obtain updated coding manuals. Learn how to use CPT modifiers and which ICD-9 codes require one or two digits after the decimal point. Remember, MCOs may have different rules than your local Medicare carrier.

Now that we've finished celebrating the new millennium, it's time to look closely at our practices. Implement those ideas that work for you. As you jump-start your practice to grow beyond Y2K, you'll feel like you had good reason to engage in all the hoopla in the first place.

Send questions to Dr. Brooks at reviewofoptometry@jobson.com, or c/o Review of Optometry, 11 Campus Blvd., Suite 100, Newtown Square, PA 19073.