Optometry as a field uniquely supports the demands that so many practitioners face – balancing family, personal and professional growth, as well as investing in a highly satisfying career. Owning a practice, however, comes with many of the challenges faced by any business owner in any industry.
Starting a new practice cold as a solo practitioner in 2013, I was juggling a number of priorities myself. Succeeding in the business and supporting my outside obligations required me to bring a laser focus to the business, optimizing every part of my schedule to make it all work. Over the past 10 years, I’ve found my best success and even been able to grow my practice by continuing that careful attention to maximizing the patient encounters and realizing the potential of each patient.
Small Scheduling by Choice
Starting cold, I knew it would take some time before I could count on my new business to reliably support itself and also pay my bills, so I started with a small schedule, allowing me time to create additional revenue outside the practice. Since then, I have discovered that that “smaller” schedule has been the best way to support the rest of my life, allowing me to participate with my family, work on my own professional development, give back to my profession, expand my advising services, and have time to work on the business itself.
Growing the Practice Without Burnout
Even knowing that I was happiest working 3-4 patient care days a week, I still found myself working longer hours, spending less time with each patient, and experiencing significant burnout toward the end of 2019. It was important to me to be able to come to work every day loving what I do. Running the business, plus handling all the additional “life activities” was just too much. I wanted to get back to that smaller schedule, but I also wanted to see my practice grow and expand. I needed to figure out how to think differently about my practice and my role in it.
Identifying the Basics
First and foremost, I needed to find out what was happening in my practice. I started by reviewing our metrics, specifically the Revenue per Comprehensive Exam, and found that we were doing pretty well – sitting just above the national average at a little over $400 revenue per comprehensive exam. I wanted to move the business into active growth, so there were really only two options: see more patients or make each patient encounter more profitable. Since I wasn’t willing to expand my schedule to accommodate more patients, I began looking for ways to actively improve that core KPI.
Staying True to Myself
I had a few non-negotiables that I wanted to maintain. I wanted to see patients 3-4 days per week, and at a rate of 2-3 patients per hour. That is a pace that allows me to spend enough time to properly educate patients, and adequately solve their problems, which also helps me connect with the parts of optometry that I find most satisfying.
Another important thing for me in terms of my job satisfaction is focusing on doing the things I really love to do. For instance, I am a big fan of Vision Therapy, but I don’t have a real passion for it. If I have patients who need that service, I am happy to refer them to an optometric colleague for that portion of their care, or, when I look for an associate, I may be actively looking for a practitioner who is interested in VT. I spend my time handling things like specialty contact lenses, myopia management, or dry eye therapy, which are services that I really enjoy providing.
I started with a goal of increasing our Revenue per Comprehensive Exam. I shared that goal with my staff, and set a measurable, achievable (but also challenging) target for each quarter and also for the year. To help them get engaged, I created an incentive program, with quarterly, performance-based bonuses and a profit-sharing element. We all began to strategize together about how to reach that objective.
I also find that this particular KPI is significantly impacted by how well I explain the benefits of my product recommendations. It’s one of the big payoffs for spending a little more time with my patients. They are more likely to buy into the options I prescribe if they understand why I am prescribing them. Taking that extra few minutes in the exam room for good patient education can really help the bottom line – and the patient.
Focusing on Private Pay Services
One key to our success in building our Revenue per Exam has been to focus on the goods and services that are outside the scope of insurance. By reducing dependence on insurance, we’ve been able to get away – somewhat – from the mindset of “I just want what’s covered,” and help our patients get great outcomes without worrying as much about the finer points of managed vision care.
The outcome of these initiatives has been outstanding growth in my business. In just two years, our Revenue per Exam has grown by more than $120, moving our performance from “above average” to the top 10-15% of practices nationwide. In 2022, my practice saw a 23% growth in overall revenue, which has translated to expansion. I was able to hire my first associate and we’ve acquired a new building that we’ll be moving into during 2023.
There’s more than one way to succeed in optometry and in business. Some practitioners find great satisfaction in serving large numbers of patients at a fast pace, and they do that very successfully. However, there’s also room for practicing on a smaller scale without sacrificing profitability. It is possible to figure out what makes you happy, then design your practice to meet those needs.
If you’re paying attention to your metrics and making thoughtful decisions about your cost and revenue drivers, there is no reason you can not only succeed, but also grow, even while leaving yourself enough space to excel in other areas of life at the same time.