Welcome to question of the day #239

Eyetools question of the day #239 

I’ve set up a new practice and only see a few patients per week. How can I build may patient base and improve the finances of the business in these early days?

The early days and weeks of a new practice are difficult. When I opened my new practice there were several other practices in the area and all had been established for many years.

We had some patients who were happy to try some where new but we had many empty slots in our appointments book. We needed to be able to pay the bills and ourselves. One of the things we did was contact all the local nursing homes and care homes (places where older people live with medical and social support) and advertised a home visit service. We made it clear that if people were unable to come to the practice they we were happy to go to them. It meant we had more appointments in the book and a reasonable income stream.

Carrying out eye examinations in people’s homes means two things:

Allowing enough time for an eye examination and dispensing of a frame.

Having portable equipment.

Having a portable selection of spectacle frames.

Allowing time to take the completed spectacles back to the patient.

We allowed an hour per patient for examination time. All of our home visit patients were within a 15-minute drive.

My equipment consisted of a retinoscope, direct ophthalmoscope, trial frame, full set of trial lenses, ±0.25 and ±0.50 Jackson cross cyls (some people need the larger power in order to be able to see a difference), ±0.50 and ±1.00 spherical confirmation lenses (again people sometimes need to be shown greater power lenses to be able to see a difference) and a visual acuity chart that could be used at 3 m. I already had this equipment so there was no extra cost in setting up our home visit service.

There is some very modern equipment designed for home visits; hand-held slit lamps, hand-held fundus cameras, tablet based visual acuity charts and hand-held indirect ophthalmoscopes. This is all great but also expensive and probably beyond the reach of a practitioner who is starting a new practice.

It is possible to conduct a very good eye examination in a person’s home using the traditional equipment I have outlined above.

I used to work with an assistant who helped with the dispensing but it is perfectly possible for the optometrist to carry out the frame selection and lens measurements.

Of course, we did a very good job and some of the people who worked at the nursing and care homes booked appointments for eye examinations in our practice as did family relatives of the person we had examined.

This helped us grow our patient base, filled some of the empty slots in our appointment book and develop a prosperous business.