Harness the Practice-building Power of Dry Eye Care

Backed by the right approach, today’s products and services can be revenue generators.

John Sheppard, MD, MMSc and Karen Spencer, CEO Virginia Eye Consultants

John Sheppard, MD, MMSc
Virginia Eye Consultants

Whenever we’re asked why we’ve chosen to position our practice as a Dry Eye Center of Excellence, chief among our answers is that it’s necessary: we are committed to continued clinical leadership in our community. In addition, as a result of our efforts, we can say with confidence that many of the perceptions ophthalmologists have about providing dry eye care — it gets in my way, it slows me down, profit margins are low, it distracts me from my core surgical practice — are simply not true. Having a Dry Eye Center of Excellence can be integral to growing a practice, as long as a plan of execution is developed and followed (Figure 1).

Our plan hinges on this point of view: Every patient who walks in the door has ocular surface disease unless proven otherwise, and we can help. It’s the same type of mindset that leads to success with the refractive and premium channel components of a practice. Everyone who visits our practice is a potential candidate for a premium IOL, a lid lift, Botox, LASIK, and so on — whatever solutions the practice offers. Other fundamentals in our approach include incorporating the latest diagnostic and treatment tools while continuously educating and involving all of our personnel.

The Tools

Today, we have at our disposal more treatment options than ever, such as nutraceuticals and LipiFlow (TearScience) thermal pulsation therapy, that go beyond palliative to effectively address the root causes of dry eye. We also have several new diagnostic tests that enable more diagnostic precision, allowing for better tailored treatments for each patient. Some of these tests and treatments are covered by insurance and others are not. However, they all contribute in some way to reaching our overriding goals: providing dry eye patients with the relief they seek, thus improving their overall ocular health and quality of life, improving our surgical outcomes and fueling our practice growth through positive word-of-mouth referrals and increased revenue. (See “Annual Dry Eye Revenue.”)

The People

Crucial tenets for the success of a Dry Eye Center of Excellence are making use of physician extenders so doctors stay efficient, and making sure all personnel are engaged in what the practice is trying to accomplish. That said, momentum must originate with the practice’s physician leadership. The revenue collected is directly proportionate to the physicians’ adoption of the diagnostics and treatments and their ability to recommend the products and services, some of which are retail-oriented, to patients. In addition to the physician champion(s), it’s necessary to have a lead administrative person responsible for getting all the moving parts of the enterprise aligned and keeping them moving.

Most of the surgeons in our practice immediately refer their ocular surface disease patients to a non-surgical provider in the practice, who “tunes them up” and sends them back for surgery. That’s a very effective way for them to work with our optometrists, physician assistants and non-surgical ophthalmologists. All personnel are involved in our focus on dry eye patients:

• ODs, PAs, RNPs

• non-surgical ophthalmologists

• multiple technicians

• two scribes per clinic provider

• movers (escort patients from point to point during their visit)

• counselors (educate patients about any dry eye products and services the physician recommends)

• check-out staff

Everyone is trained to talk to patients about the ways in which we can help them with their ocular surface disease — getting them excited about what the doctor may be recommending and enabling us to convey a consistent message. This goes hand in hand with involving everyone whenever we’re integrating new technologies or products into the practice so they know their specific role and how it correlates with what we’re trying to accomplish.

To further enhance efficiency, we use a checklist of our dry eye-related products and services that follows the patient through the practice. The doctors check off their recommendations. This takes no time at all, and when patients arrive at check out, the staff knows exactly what to counsel the patient about. In addition, we have a dry eye brochure that lists our products and services. Those are placed throughout our lanes for patients and also serve as a reminder for doctors and staff to address these issues with patients who identify dry eye among their chief complaints.

To ensure the entire staff is aware of the fruits of their labor, we have a morning huddle every day in which we can highlight a positive patient experience or how we were able to find a solution in a complex case. We provide some incentives for staff as well, monetary and otherwise, to motivate them to jump on board with whatever initiative we’re trying to implement in the practice.

The Rewards

With our Dry Eye Center of Excellence plan in full swing and all personnel on board, the last piece of the puzzle is to continually analyze our performance. We monitor services provided and revenue, sometimes as frequently as weekly. This keeps us aware of any drop-off in our pursuit of our goals so we can take steps to keep ourselves motivated and on point.

The result is beneficial all around. Patients win with diagnostic accuracy and targeted treatment. Insurers win with targeted therapy as well. Doctors enjoy the satisfaction of helping an entire group of patients in a new way. and practice growth. The practice wins with growth and income diversification. ■