In my most recent optometric incarnation Wednesday is my private practice day. I have the privilege to work one day a week at a local private practice. It is eye opening.
It is different than the other 3-4 days a week where I am at commercial practices.
Better?
Different.
This is not my first experience with private practice.
For that we would have to travel all the way back to the fall of 2001. One of my fourth year "externships" was with a private practice somewhere east of the
This optometrist has owned his practice for decades. He owns his own building and while I was there he opened a satellite location. He scoffs at so called low-ball vision plans and made it a point to tell the students to seriously consider how much it costs to see a patient (overhead, etc.) and what the vision plans were offering. In many online internet circles his optometric face would be cheered and applauded.
He is in private practice.
He charges for everything.
Everything.
And his fees are astronomical.
I was speaking with the mother of one of his patients during the daughter’s VT session one day. She referred to the owning OD as a "used car salesman".
He is incredibly intelligent. Very skilled. Up to date.
But everything he does has to be a sales job.
You need a GDX, visual field, and poly AR glasses.
Your child needs 52 weeks of vision therapy.
They may very well have needed these things but his approach was abrasive. He turned people off. Many were happy to leave and not return. Staff turnover was high because he didn't pay as much as others.
I learned a lot of optometry while I was there.
I was challenged more than I've ever been challenged. I chased autistic kids around the room trying to do retinoscopy.
I sat on the floor doing eye exams because that was the only place it would work.
I learned a lot about practice management as well.
I learned what NOT to do.
Just because one is in private practice doesn't mean they are worth holding in high regard. One's character is what needs to be looked at.
One's ethic.
One's professionalism.
My second experience with private practice came following graduation. Where we were living it was difficult to find an optometry career so I had to take a number of jobs.
One of these jobs was at a private practice while the owning OD took 3 months of maternity leave.
She worked right up to the day before she gave birth and I was there the next Monday. It, too, was a learning experience.
This private practice was located in a mall. (It no longer is but at that time it was.)
This private practice was built on insurance.
VSP to be exact.
If there were no VSP there would be no practice.
I would see upwards of 16 patients some days. 15 of them would be VSP.
Nothing wrong with seeing insurance patients but I learned that it’s probably not wise to have the bulk of your income coming from one place. I also realized that this private practice was very commercially driven. That is the exams were refractive exams and the goal was to sell spectacles.
Nothing wrong with that but I failed to see how this practice stood out from the crowd of other optometric practices. The only difference I could see between this practice and the commercial practice down the hall was that the OD kept the profits from the sale of the spectacles.
I worked at a few other private practices during the two years immediately following graduation. Some were older practices with old equipment but a loyal patient base; others were newer practices with newer equipment and a non-loyal patient base. Most of the practices I visited were surviving by doing basic optometry – refractions and red eyes. Not many had visual field machines, OCTs, etc. They were refractionists and treaters of red-eyes. And they were succeeding in what I would consider a saturated market. They found their niche and they were filling it.
Upon our return from the
Today I’ve seen one patient.
I’ll be leaving in an hour.
One patient.
This practice has been open for 20 plus years although the current owner has only been here for 5 or 6 years.
Why did I only see one patient?
Because I’m not yet credentialed on any of the practices insurance panels.
They cannot find anyone willing to pay cash to see me.
This is another private practice that survives by taking a million insurance plans.
There is nothing wrong with this. It’s a style of practice.
And the owner works with it.
It’s not the style of practice Swell and I see ourselves working in.
Our dream practice will, of course, take insurance but we won’t be on every plan known to man. We will try to capture some private pay patients but we’ll work smart rather than hard.
Swell’s current job is happy that only 10% of their gross is insurance based. If we were that practice we would drop every insurance immediately. Although insurance only makes up 10% of their gross it takes up a very large portion of their time. Time that could be better spent with their private pay patients. Time that could be better spent doing other things.
The practice’s view is that “Thank goodness we take insurance or else we’d have 10% less money.”
So I have some experience in private practice. Not a lot but enough to have seen things I like and to have seen things I don’t like.
We’ll take from our experiences and hope to build something we can be proud of. Somewhere where our patients are treated well. Somewhere where our patients receive quality care.
We will be a doctor’s office.
We will be an optical.
We will be a low vision center.
We will be a vision therapy center.
We will do what we can, refer what we can’t.
And we realize, realistically we won’t be all of the above all at once. We’ll start with the doctor’s office and the optical and hope to become successful enough to add other areas to our practice. Not because we’re looking for revenue generators but because we enjoy them and we want our patients to receive the best care possible.
Tomorrow is our phone meeting with the consultants. They will outline their services and I’ll report back with what our next step will be.
No comments:
Post a Comment