Feedback & Communication

One of the things I enjoy most about optometric practice is getting positive feedback from patients. It provides immense satisfaction and confirms that you are on the right track and providing solutions that in many cases can be life changing for the patient. It also provides motivation because as we all know the demands of modern practice can be quite daunting at times: Tricky patients, consumerism, commercialism, Internet spectacles and contact lenses, Dr. Google, admin, compliance, compulsory CPD, audits and medico-legal threats can all hover at the back of our mind.

Another thing I really appreciate is the kind feedback I get from readers of my column. Again it tells me that the topics I cover are relevant and interesting and provide benefit to readers. I was recently blown away by a few such feedback items. As you may have read in the October edition of mivision, I attended and covered the Novartis Future Directions in Ophthalmology meeting in Brisbane. I was surprised how many ophthalmologists came up to me and told me how much they enjoy this column. Although it does not always reference their subspecialties they told me they do find the general issues interesting and also how contact lenses are evolving and providing excellent outcomes. So thanks to all and please keep that feedback coming as it helps me target items of interest.

A communication I recently received via LinkedIn referenced my September column Independence… Always.

Tricky patients, consumerism, commercialism, Internet spectacles and contact lenses, Dr. Google, admin, compliance, compulsory CPD, audits and medico-legal threats can all hover at the back of our mind

It read as follows; “Hi Dr Saks, Thanks for your article in mivision Sept 2016! It’s great to follow your journey through Optometry Practice! It sounds like you found the Merino-wool jacket of Independent Practice considerably better than the heavy duffle coat of corporate practice. I hope you’re enjoying the freedom of Independence. If you were starting a brand new independent practice, how would you go about branding it? I’m guessing that you would use a double name like Mortimer Hirst. When you find your brand, what social media networks would you use? Thanks again for your insightful article, and for supporting Independents!”

It’s a great question so let me address some of the issues raised and add a few other thoughts I’ve been mulling over.

Practice Set Up

Firstly, although I believe that starting up cold can be quite daunting in these challenging times, it certainly is possible. I’ve see it done with success but at the same time some will battle and may not survive the first few years when cash flow can kill you. Similarly, I’d stay out of the malls as their seven day/late night trading and escalating rentals will add massive overhead and you will most likely have at least one chain to compete with.

I know of many who operate their practice out of a house, with benefits of being your own landlord while having a good property investment. Of course opening up on the local high street is probably the most common option. I’d do my market research and demographics but would probably open up in an area where I’ve been practising in the past so that at least some of my patients would follow me.

To my mind, the best bet is to purchase an established practice and go from there.

There are a number of older practitioners that are at or near retirement. In many cases they’ve let the practice run down a bit with a lack of marketing, old equipment, antiquated systems, poor integration and a generally cluttered environment. Many have to walk away and simply close the door and a lifetime of effort is worthless. What these practices do have going for them is a solid database of loyal patients, an established location and so on. A potential purchaser can thus get a pretty good deal and use what equipment they have while upgrading the fit-out, de-cluttering, integrating a practice management system and adding the necessary high tech equipment. Of course, not all of us can afford all the toys, so you have to decide on your focus and subspecialty interests.

We as a profession are fast reaching the point where a combined OCT/fundus camera and super-widefield imaging are becoming the standard of care. An automated perimeter is also a necessity. If you plan to specialise in contact lenses a topographer is also needed, however if you plan to only fit disposable lenses then you could get by with an old-style keratometer (at a fraction of the cost) or rely on K readings from an autorefractor. I would go for a four-in-one instrument that also provides pachometry and IOPs. An LCD test chart, a quality manual phoroptor and a decent slit-lamp complete the equipment list as we all have our own handheld instruments, fundus lenses and so on.

I also believe that we are approaching a point in eye care where if we are not offering some form of myopia control for progressive myopes, then we could almost be guilty of malpractice. In that case a topographer and system for measuring axial length become necessary.

What’s in a Name?

As to naming a practice, in my case I would use my surname in the practice and likely combine it with the name of any partners – so it could be Saks + Dubrosky or whatever, so long as it reads well and sounds good. If you already have an established name, then I would definitely go with that. That said, if you’re purchasing an existing practice with a good name and local reputation I would wait some years, until the practice is running smoothly, before I changed the name.

I personally don’t like plays on optometric words or logos that include eyes and ray diagrams as I find it a bit cliché, but it does work for some. For a boutique practice we opened some years ago our marketing guy gave us a list of names to work through. We didn’t go for a double-barrelled name but settled on ‘Vigil Eyewear’.

Social media is, in my view, now an essential part of attracting patients, as is a website using the tricks of the trade and search engine optimisation to make sure you get high rankings. That said, I know of examples where start-ups have simply used Facebook and rating sites to good effect to grow their practice. You need to keep your practice Facebook page well separated from your personal page: Potential or existing patients don’t care about your fluffy cat and that image of you sprawled in a gutter after a big night out is not going to have a positive effect.

To my mind Twitter is a waste of time but some do manage to leverage it to good effect. A LinkedIn presence is more professional and it does work but is not massive in attracting new patients. Of course, you have to be careful about using patient testimonials and doing stuff on social media that may be in contravention of your professional bodies` ethical rules or fall foul of the registration authorities. Also, don’t offer patient advice via social media; that thing you suggested was a low risk floater could become a detachment in a week and you’d be in deep water. Simply tell the patients that they need to see you, a specialist or hospital clinic ASAP to rule out any risk factors.

I could go on and on but space constraints mean I have to leave it at that for now. We will however continue to explore such issues and elaborate on some of the aforementioned concepts and the way to the best possible patient pathway and outcomes.

Alan P Saks MCOptom(UK) Dip.Optom(ZA) FCLS(NZ) FAAO(USA) is a third generation optometrist based in Auckland, New Zealand and columnist for mivision. He is actively involved in the profession, having served multiple terms as president of Contact Lens Societies and arranged numerous conferences. He has also served on education committees, as examiner in contact lenses and clinical optometry examinations, lectured contact lenses to ophthalmology registrars and written several columns about eye health and the practice of optometry.