Paul S. Koch, M.D.

Ophthalmology on Demand

�This is medicine, not pay-per-view-on-demand!� the doctor scolded me. This conscientious student of the healing arts was conflicted � frustrated by the realization that a modern physician straddles two worlds: illness medicine and consumer medicine. The doctor was trained in illness medicine and skillfully managed very complicated cases of diabetes and glaucoma. The problem was reconciling that world with the land of consumer medicine, where patients can declare a desire for refractive or cosmetic surgery.
�Oh dear, young Cricket,� I replied. �It appears I have not been a good teacher. You are completely wrong if you think medicine is not pay-per-view-on-demand. Pay-per-view-on-demand is exactly what we are.�
When patients select a service, let�s say an eye exam, they pick up their remotes and open their programming guides. There are hundreds of channels. Those are the medical practices. Each channel has a day�s worth of programming. Those are the services each practice offers.
Patients begin by either selecting a channel (your practice) or picking a program (an eye exam, evening office hours, a happy doctor, whatever). When they find the programming they want on a channel they want, they make the on-demand selection (call for an appointment).
If they think you did a good job, patients may stay on your channel. If they don�t like your program, they might switch channels. Patients get to pick which channel they watch. You only get to set up your channel and pick the content you want to offer on it. If you offer the programming that a patient wants and will pay for, you will be successful.
Your medical practice has no �rights� to any patient. Patients can, at any time, change channels, or even turn the TV off. If that happens, your medical practice will have no patients coming in and no revenues.
Program With the Consumer in Mind
So you not only have to provide a service that patients want, but you also have to provide it in such a way that they (on-) demand your channel and not someone else�s. If you do not have the programming that patients want, they will look for a channel that does.
You cannot control their decisions. You can only set up your channel and determine the programming. With enough planning, and a bit of luck, you will offer selections that patients want, whether it be for illness medicine, consumer medicine or a little of each.