At Virginia Eye Consultants, we have 17 doctors, 220 employees, and five locations, and we have been growing rapidly. Playing a significant role in our growth has been our establishment of a Dry Eye Center of Excellence. The center’s success has been driven by the multiple spokes of its business plan, which range from a burgeoning market need and top-line revenue projections to staff engagement and mostly internal marketing.

What: Tap into a Burgeoning Market to Foster Practice Growth

There are likely as many as 19 million people in the United States who suffer from moderate to severe dry eye.¹ An estimated 10 million of them use artificial tears, spending approximately $3.2 million on that alone.² This market is a major target for not only over-the-counter product companies, but also prescription medication and device companies. Sales of dry eye medications and devices at the manufacturer level are expected to generate $4.5 billion by 2020.³

Today, we have at our disposal more therapeutic options than ever for addressing dry eye, and many of the latest options go beyond palliative care to effectively treat the root causes of the condition. We have, for example, nutraceuticals and thermal pulsation. We also have several new diagnostic tests that enable more precision and the tailoring of treatment plans for each individual patient. Osmolarity (TearLab) and MMP-9 testing (InflammaDry, Quidel) are just two of the tests we use multiple times daily in our practice. We rely on these tests to help guide our treatment plans in many situations and for many patient categories, including:

• new dry eye patients
• all surgical patients
• punctal plug decision analysis
• lipid or aqueous prioritization
• treatment follow-up assessment
• neurotrophic assessment
• post-LASIK hyperesthesia syndrome
• contact lens decision analysis.

In addition, we prescribe a variety of FDA-approved medications, as well as some compounded medications, such as preservative-free dexamethasone. Some tests and treatments are covered by insurance and others are not. However, they all contribute in some way to reaching our overriding goal, which is to provide dry eye patients with the relief they seek, thus improving their overall ocular health and quality of life, improving our surgical outcomes, fueling practice growth through positive word-of-mouth referrals, and increasing revenue. (See “Projected Annual Dry Eye Revenue.”)

Through extremely accessible in-house financing partners, such as CareCredit, our practice enables far more patients to access not only retail dry eye procedures, but premium IOLs, corneal refractive surgery, and oculoplastic surgery and injections as well. Financing consultations and approvals have become an integral part of the cash-pay counseling process, so all of our highly skilled patient advocates have mastered the nearly instantaneous credit approval process.

We have a retail component to the Dry Eye Center of Excellence, too. We sell our recommended nutritionals as well as other adjunct therapies, such as lid wipes, lid compresses, and humidifying masks, through MyEyeStore.com. The site is connected to our practice website, and it takes all of the shipping out of our hands. We tell patients about the site at the end of their visit.

Who: Engaged Providers and Personnel

Crucial to the success of a Dry Eye Center of Excellence is making use of physician extenders so the physicians can be efficient, and ensuring that all personnel are engaged in what the practice is trying to do. That said, the 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 to patients these products and services — some of which, as I mentioned, are retail-oriented. 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 surgery candidates to a non-surgical provider in the practice, who assesses and treats the ocular surface before sending them back for surgery. This is a very effective way for the surgeons to work with our optometrists, physician assistants, and nonsurgical ophthalmologists. All personnel are involved in our efforts to help dry eye patients:

• ODs, PAs, RNPs
• nonsurgical ophthalmologists
• technicians
• scribes
• movers (escort patients from point to point during their visit)
• counselors (educate patients about any dry eye products and services the physician recommends, then complete the scheduling process)
• checkout staff.

Everyone is trained to talk with 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 them almost no time at all, and when patients arrive at checkout, staff members immediately know what to counsel them about.

Why: Far-reaching Benefits

With our Dry Eye Center of Excellence up and running for several years now, we can say with confidence that many of the long-held beliefs about dry eye care — it gets in the way, it slows things down, profit margins are low, it distracts from a core surgical practice — are simply not true. In fact, the benefits are multiple and far-reaching. Patients benefit from better, faster diagnosis and targeted, effective treatment. Insurers benefit because effectively targeted therapy saves money. Doctors benefit from the satisfaction of elevating the practice through stellar patient care. And the practice benefits from income diversification and significant additional top-line revenue. ■

References

1. Market Scope. New Drugs and Procedures Will Drive Dry Eye Market, Along with Better Access. Dec. 31, 2016. Available at: https://market-scope.com/pressrelease/new-drugs-and-procedures-will-drive-dry-eye-market-along-with-better-access/ . Last accessed Jan. 26, 2018.
2. Gayton JL. Etiology, prevalence, and treatment of dry eye disease. Clin Ophthalmol. 2009;3: 405-412.
3. Cannady K. Dry eye products market expected to generate $4.5 billion by 2020. 2017. Available at: https://market-scope.com/pressrelease/dry-eye-products-market-expected-to-generate-4-5-billion-by-2020/ . Last accessed Jan. 3, 2018.