How to Start an Eye Care Practice from Scratch
Part 3 of 3

The Build-Out, Choosing an EHR, and Product Research

An interview with Courtney Dryer, OD
Autarchic Spec Shop, Charlotte, NC

Dr. Courtney Dryer shares her step-by-step approach to a successful cold start.

Dr. Courtney Dryer began her own practice in Charlotte, NC after deciding that working for someone else was not her dream. With her Autarchic Spec Shop, she chose to become more of a boutique, high-end business serving patients that would appreciate the quality of care and products that she offers.

Located in an upscale area of town, Dryer and her team enjoy treating patients like friends and family. After six years, and more than 2,000 patients, Dryer offered up some thoughts to anyone contemplating striking out on their own.

For many doctors, the idea of having to think through all the steps of a build-out is just too daunting. Tell us how you managed yours.
Build-out refers to your construction, your lay-out, your architectural plan. I actually loved the construction part of it. It was fun because I got to see my vision come to life. It was pretty neat! But I did learn a few lessons along the way.

The first thing I recommend is to consult with several construction companies for quotes on your build-out. I talked to three or four and there was a huge difference in cost. Talking to several companies will give you an idea of an average and will help you decide who you want to work with. Visit your space on a weekly basis during construction and do a walk-through. This helps prevent any mistakes from occurring. Changes can be very expensive so it’s just better to catch things early.

When picking flooring options, consider areas of high traffic and noise when deciding on material. Your construction company should be able to help you with these options.

Cool colors are usually preferred for medical offices because warm colors make spaces feel more enclosed. That’s not what you want! You want patients to feel welcomed. On the other hand, white walls feel sterile and uninviting. That’s why we did the gray stripe at Autarchic – we kept it light but gave it some style.

Consider décor that will not get dated quickly or that you can make changes to inexpensively. Your office should be redecorated or remodeled every seven years, and that can be a huge undertaking if you’re not able to do it easily.

It’s also very important to consider traffic flow between rooms and pre-testing when laying out your space. Mistakes here can be a big hindrance if one of your techs is getting in the way of your other tech.

Most new offices need at least 1,800-2,000 square feet of space and I don’t recommend you go any smaller. Buy the most that you can afford but not too much where you end up paying for and wasting square footage.

Make sure your optical design is consistent with who you want to be. I always recommend you think about a retail experience that you enjoy. For example, I really love Anthropologie, so that was kind of the inspiration for my office and keeping that aesthetic in mind helped me create a destination optical which sets me apart from my competition.

What advice do you have for doctors when choosing their EHR?
I was very lucky because I was able to work with almost all the EHR providers out there prior to starting my own practice, and knew that RevolutionEHR was the easiest to use. I also knew it would grow with me.

In my experience, there are some very important considerations when choosing an EHR:

  • Is the company innovating and changing to meet the demands of healthcare? I’ve been out of school since 2011 and I’ve seen health care change in big ways.
  • Does the EHR allow for customization? Personally, I love the way RevolutionEHR allows me to lay everything out the way I want to.
  • Will it save you time, money, and reduce your risk of errors?
  • What about integration with other equipment and business solutions? We use Solution Reach which sends appointment reminders to patients. RevolutionEHR also integrates with most equipment.
  • Is the software intuitive to learn? Staff turnover is very high within optometry. It’s important to me that every staff member I’ve had come on board has learned to use Rev within a week.
  • How simple is the optical ordering process? For example, RevolutionEHR’s vision web integration makes it very easy to send glasses from the system to the lab.
  • Is it easy to manage/input inventory? RevolutionEHR allows you to import certain frames from Frame Data, but it’s also easy to manually input data if you have something unique.
  • Are you able to run reports and track KPIs (Key Performance indicators)? There are a lot of new programs that RevolutionEHR has put in place that allow you to track your KPIs easily. I worked for a doctor once and managed his AR and saw that no-one knew where the money was. I really love how easy it is to track the accounts receivable that are out there. You can see all the claims that have been accepted, denied and why.
  • Is the software cloud-based or tied to a server? This is a huge consideration, especially if you plan on working patient files while offsite.
  • What about the security systems in place to protect your patients’ privacy?

We know that choosing eyewear inventory can also be a daunting process. What is the best way to start?
When I talk about product research, I’m referring to both spectacles and lenses. There’s a lot out there so product research is important.

I suggest you meet with lab reps to find out which relationship works best for you. Schedule a meeting with all the major frame manufacturers. Ask them if they can work with you on pricing.
Develop a working knowledge of lens options, treatments, and technology for yourself. We may rely on an optician to do most of that, but most of the time now there’s a big emphasis on doctor-driven dispensing. It’s been shown that patients will buy more when it’s the doctor recommending. It’s very important to be able to explain to the patient why you’re recommending the treatment or the lens options.

With vendors, clarify extras like shipping and handling. Sometimes there’s additional edging charges on certain types of frames. What are their re-do policies? The base price can be different than your end price and that affects your cash flow.

It’s beneficial to look into popular buying groups to get an idea of fair pricing and rebates. This gives you a good starting point and you’ll know what you should charge and what you should pay.

Consider labs that are insurance plan approved for consolidation and simplification. It’s easier for your staff if you simplify the process and consolidate most of your jobs into one or two labs. It just makes their lives easier.

Develop a working knowledge of frame materials, hinge construction, and manufacturing processes. Again, this will set you apart from other practices and will allow you to communicate to the patient why they may pay more for this frame than that frame, which is important in their decision-making process.

As far as frames go, ask about the company’s trade-out policies, shipping costs and buy-in policies – do you need to carry a certain number of frames? You want to clarify this up front so there are no surprises later.

Some frame lines offer 30/60/90-day billing which can help you with cash flow in the beginning. Ask, because not all of them will do it.

Most importantly, you want to choose companies that are easy to do business with! Make sure they’re willing to work with you, that they want you to carry their line and they want to be in your practice.

Some practices choose to participate in consignment frames. I don’t have much experience with this, but basically you don’t pay until the item is sold. One company that does this is New York Eye, and when you’re considering the number of frames to carry, remember that less is more. Buy the minimum, because you don’t want to buy a lot of frames and have them sitting on your shelves. In the beginning you’re not going to have a lot of patients. Think metals, plastics, a conservative line, a funky line, frames that are covered by insurance, and then have a luxury brand for the patients who are looking for that.

If you missed Part 1 or 2 of our series, check them out here:
Why Start Your Own Practice, Choosing Your Location with Care, and Finding the Funds
Your To-Do List, Branding, and Marketing

Want to hear more helpful tips for starting a new practice? Watch the 9 Essential Ingredients for Successfully Starting a New Practice.

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