Our cover story in this issue of Ocular Surgery News discusses the sobering “megatrends” that will shrink the health care dollar and change our future workplace. Most concerning is that health care costs now consume 20% of the U.S. gross domestic product and are growing. I’ve written before about how doctors will increasingly be commoditized like pilots. But I also believe we should see opportunity in these changes rather than only threats.
How should you prepare your practice today for these changes? To a large extent, it depends upon the size, location and time horizon of your personal desire to practice. If your practice is located in a busy suburban or urban area and has five or fewer doctors, and if you expect to work for 10 or more years, it’s time to plan ahead now. Here are some gradual steps to consider:
1. Examine data on your practice. Hire a consultant to help you and your staff assemble regular reports that answer questions like these: Are you paying too much for staff time? Is every doctor producing profit or just office activity? What is your actual cost (all in) to treat a cataract surgery patient, someone with glaucoma or whatever common conditions you treat? How can you improve each of these?
2. Get friendly with your colleagues. Chances are other nearby ophthalmologists with solo or small group practices are having the same worries as you. Consider working together, which might just start with sharing a call schedule, but it could lead to merging your entire practices. Chances are in the future you will be working together in some manner. Before you are forced into a “shotgun wedding” with other ophthalmologists, you might as well go on a few dates first. It’s always better to be proactive.
3. Let technology work for you. Our practice has had great success using technology like Brevium and MDbackline. The first reactivates patients and saves your staff time. The second automates communication with patients, drives premium lens adoption, increases positive online reviews, and helps you satisfy MACRA and MIPS incentives. Could automated patient engagement solutions like these increase your success? Can you afford not to find out?
4. Maximize cash revenue sources. Are you offering your patients premium IOLs? If so, when was the last time you adjusted your pricing? In most markets, prices have increased in recent years. What about optical? When was the last time you price shopped optical labs or ran a patient promotion to encourage sales of multiple pairs of glasses? Increasing profitability from existing lines of business is both easier and more productive than adding new lines of business. Both will prepare you for a rocky future.
5. Hire a physician. This is harder for solo or smaller practices. A one-doctor practice has to double its volume to fully utilize a new physician, whereas a 10-doctor practice only has to increase demand by 10% to justify a new colleague. But if you can find a part-time associate, especially with a subspecialty that complements yours, he or she will get busy faster than you think, and future growth only becomes easier. Hiring an associate also makes it even easier for you to take more time off, like most of us desire.
To be sure, there are some concerning changes ahead in health care, but if we can’t take care of a population using less than (20%) of its GDP, we aren’t even trying. Moving out of our comfort zone to prepare ourselves and our practices will take some effort and expense itself, but it will put us in control as future belt-tightening becomes inevitable.
Disclosure: Hovanesian reports he has a financial interest in MDbackline.