How do you build value in your practice? It’s an open topic. There are probably as many answers as there are practitioners. The goal is to make patients feel that their visits have been more than worthwhile, and perhaps even better than what’s offered by the doc down the street.

Figure out what interests the patient. It’s a heck of a lot easier than developing interest in new areas, though that is an important skill, too.

One of my strong suits is to try to demonstrate knowledge in as many pertinent areas as I can. As uveitis and ocular inflammation are key interests, I will try to convey this knowledge to my patients who have correlating systemic diseases. Most are surprised that an eye doctor has studied the systemic diseases themselves, as well as their ocular implications. So, surprise them, I say!

More broadly, the expertise you develop in systemic medicine can be an additive for your practice and your patients. Knowing current therapies and warnings for systemic pathology will make you a strong part of the vaunted “healthcare team.” Know that there is no quick route to success. Rather, it is a lifelong study that involves lots of reading, talking to physicians in various specialties, and most importantly getting involved with patients directly. Understand the rationale for their physicians’ prescribing, and expand your knowledge base when you don’t. Consider again the value that you’ve built by taking a role in the patient’s systemic care, especially as it is not usually expected!

Is there a line to avoid in this approach? 

Of course. I’ll never suggest alternate therapies unless I think the patient is really going in the tank. For example, a patient seeing an old-time family doctor for rheumatoid arthritis is taking 10-20 mg of oral prednisone daily, for who knows how long. I’ll suggest a rheumatologic consultation to consider one of the biologic agents like Humira. What’s the opposite? Let’s say that someone is discouraged and not doing well on Humira, and needs help. Some of the chronic patients simply give up. I’ve helped not by suggesting alternative meds, but by simply insisting that the patient get back to a top-level rheumatologist to consider options. One of the strongest steps you can take is to get a discouraged patient back to the specialist’s office, or even to get a second opinion. Value, it is.

One of the beauties of optometric practice is that a doctor can develop specialty care while maintaining a solid primary care enterprise. 

This means delegating well. Get an expert to run your optical, or at least to consult regularly. It’s difficult to stay on top of frame pricing and market changes while practicing at the highest level. Pay until it hurts for tax, legal, and accounting help, in the same vein.

Building value is hard to force into an area that does not catch your passion. I’ve made many referrals for low vision and vision therapy, as I couldn’t begin to practice those specialties myself. It’s just not in me to do so. How do you know your passion? Aside from saying, “You’ll know it when you see it,” there is another marker that I’ve used. 

That is, ask yourself one question: “What article or video would I take in at the end of the day when everyone else might be watching a Game of Thrones rerun or the late news?”

I’ve often found one hard-copy journal article that seems to be staring back at me from the nightstand. Or, a fleeting thought leads me to Google a topic, with the word “Pubmed” tacked on. Within seconds, the world is at your feet!

From the passion comes the value. Display that “something extra,” as a knowledge base that will impress the patient and personalize the care that you give. Work hardest to have the patient return, and to have that patient feel strongly enough to refer friends and family for your kind care. 

Enough about my approach! Next month, we’ll talk about some other methods to attack the value proposition.