Four tips for developing a proactive practice


Special to Ophthalmology schedules®

Growth-conscious cataract and refractive surgeons understand that investment and creative thinking are the seeds of progress.

Each firm faces its own treasury, operational and competitive challenges, and there is no one-size-fits-all approach to building a bigger and better firm for the future.

However, some general principles can be applied to many types of practice.

Consider applying some or all of the concepts below to your practice as you seek to thrive in 2021 and beyond.

Fully equip your practice
Some practices try to take a step-by-step approach to increasing membership.

While hiring at a slow, steady pace may seem like the least disruptive option, the truth is, it stifles your firm’s growth potential and puts you at risk of being left behind by your competition.

Many practices are at or below the pre-pandemic age endowment levels, but patients are scheduling appointments with cataract and refraction surgeons at the highest rate in years.

Without trained technicians, office workers and other support staff, a practice cannot increase its volume of patients.

Some of the staff you hire may already have experience, as they will be from other practices that have downsized or shut down during the pandemic. Others will require training.

Regardless of their skills and professional backgrounds, the staff you hire and train now will increase your clinical and surgical capacity in the future.

This means a better experience for your patients and more revenue for your practice.

Develop new sources of income
Offering new products and services is a reliable way to maximize the potential of a well-managed practice. Start-up costs for new offerings vary.

After estimating your return on investment, you can calculate how long it will take for your investment to make a profit.

Non-surgical investments may be appropriate for some practices. Adding allergy testing, for example, helps generate new revenue in the practice while giving your patients the chance to learn about proactive eye allergy treatment at certain times of the year or in certain situations. .

Adding aesthetics to a practice may appeal to patients who have previously considered premium offerings. Including an optical dispensary in your clinic provides patients and their families with convenient options for glasses or contact lenses.

Alternatively, new surgical offerings may allow your practice to reach more patients or enhance the premium aspects of your more personalized surgeries.

If you want to expand your patient base, consider adding minimally invasive glaucoma surgery (MIGS) to your practice repertoire.

Since almost all MIGS procedures occur alongside cataract surgery, anterior segment surgeons are well positioned to incorporate this new technology into their practice.

If you want to enhance your practice’s personalized offerings and build your reputation as a leading surgeon, it might be a good idea to add drug delivery technology like Dexamethasone 9% Intraocular Suspension (Dexycu, EyePoint Pharmaceuticals ). (Figure 1).

Administering Dexycu at the end of surgery eliminates concerns about patient adherence to the steroid drop regimen and, in my experience, provides calm eyes on postoperative day 1 and week 1.

All of this helps to optimize the patient experience, which in turn leads to happy patients and possible future referrals.

Any surgeon who adds new technology to reduce or eliminate postoperative drops should be aware of the latest information regarding these technologies.

Repayment should also be a priority. Fortunately, in the case of alternatives to drops for the postoperative treatment of cataracts, the market options have favorable reimbursements.

It should be noted that adding a new surgical option, such as Dexycu for cataract surgery or iStent inject W (Glaukos) for MIGS, often does not require a major investment on the part of the practice and could be a inexpensive way to open up new sources of short- and long-term income.

The investment in learning how to place a new premium IOL, for example, is based on time rather than money.

If you’re willing to spend more time expanding your surgical offerings by learning to use the latest technology, your practice will likely pay off quickly.

Abandon telemedicine
During the COVID-19 pandemic, many practices turned to telemedicine as a way to interact with patients.

While it may work for other specialties, it is not particularly conducive to ophthalmic practice.

No diagnostic test can be performed via telemedicine, and the common problems associated with telemedicine due to technological limitations and patients’ ignorance of telecommunications often end up creating barriers to success rather than eliminating them.

It’s time to point out to your patients that telemedicine, while a pandemic necessity, is not well suited to their needs. Bring your patients back to the office.

Re-evaluate the space
Some practices see the capacity for growth limited by architectural realities. After all, you can only install a limited number of diagnostic platforms in one room.

Still, it might be time to re-evaluate your office layout strategy as you commit to growing within the confines of your existing space.

Can a room once used as a catch-all for various equipment be transformed into a space for technicians to enter patient imaging data?

Could a more intentional patient journey through your practice lead to more efficient patient visits, and therefore more appointments per day?

Questions like these require creative answers, and you might be surprised at how small adjustments can have disproportionate consequences.


Which growth strategy is right for you?

The above suggestions are not an exhaustive list of ways to strengthen and expand your practice.

Nonetheless, you might find them useful in assessing your future. Each surgeon is the expert in the development potential of his practice.

As you plan the growth strategies that are right for you for the years to come, look at your practice from an objective perspective and decide which paths to take deliver the cost-benefit ratio that’s right for you.

Steven Silverstein, MD
E: ssilverstein@silversteineyecenters.com
Silverstein is a founding partner of the Silverstein Eye Centers, in Kansas City, Missouri. He is also an Assistant Professor of Ophthalmology at the University of Missouri, Kansas City School of Medicine and a Clinical Professor of Ophthalmology at the Kansas City University of Medicine and Bioscience. He reports the following relevant financial information: Speaker and consultant for EyePoint.


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