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How to offer concierge-like care without the fee


I like to describe my practice as “concierge like.” We are all familiar with the concept of MD VIP practices. They require patients to pay a flat fee to be part of the practice’s patient base, and, in return, the patient has free access to his physician at any time.

I like to describe my practice as “concierge like.” We are all familiar with the concept of MD VIP practices. They require patients to pay a flat fee to be part of the practice’s patient base, and, in return, the patient has free access to his physician at any time.

I don’t require my patients to pay a flat fee to be part of my patient base. However, because I participate only with Medicare and Horizon Blue Cross Blue Shield, I am able to offer “concierge-like” care for all of my patients.

Like MD VIP doctors, I partner with my patients to create a tailored wellness plan for their general health and their ocular health.  Patients are seen on time unless I truly have had an emergency or the patient just prior to them has arrived late.

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When you open your own practice, you have to decide to whom you will market yourself. ODs cannot be all things to all people. If you participate with a lot of managed vision care plans, most of your patients will be initially selecting you because you are “on the list.” It will become increasingly more challenging to build rapport with your patients when you have less and less time to spend with them. I am proud of the fact that when I tell my patients, “I love what I do,” they say that it’s quite obvious.

Part of the family

My muse at Montgomery Eye Care is my paternal grandfather, Mat G. Boname, MD. He was the primary physician in my hometown for 65 years. He had an office in his home. Together with my grandmother, Altha C. Boname, RN, they provided primary medical care for five generations of people in my hometown and surrounding area. My grandfather made house calls and dispensed medication from his own office.

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I receive many compliments on the style of my office and how it makes my patients feel like they are being welcomed into my home when they arrive here. To pay homage to my family and family history, my office is decorated with family photos and college textbooks from the 1920s (belonging to my grandfather). New patients and previous patients enjoy looking at my family memorabilia. Often they are reminded of similar pictures they have of their own family.  My patients say that they feel very welcome in my office and I have created an atmosphere where they want to hang out and check out the latest styles in our optical dispensary or drop by to say hello and see if anything new has arrived.

Next: How my office works


How my office works

My interest in providing more customized optometric care began in 2011 with the development of a dry eye treatment specialty within my practice. I became a speaker for Inspire Pharmaceuticals and prescribed AzaSite for the treatment of meibomian gland dysfunction (MGD). Then in January 2013, I was invited to give a presentation to the faculty of Salus University on MacuHealth, further solidifying my interest in forging a preventive care practice.

I began to offer MacuHealth, Blink Lid-Clean Wipes (AMO), FreshKote (Focus Laboratories), and Reviatlens OcuTec (AMO) products for purchase in my office. In the summer of 2013, I began training with NutraMetrix and discussing with my patients nutrition, minimizing the risk of medical and ocular problems by eating better, getting better sleep, protecting their eyes from blue radiation, and more.

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In my practice, the emphasis is on the total health and wellness of each patient I see. A thorough social, medical, and ocular history is crucial to partnering with my patient in the creation of a comprehensive plan for her general and ophthalmic care.

My practice mantra is to provide exceptional patient care for every patient every time he is examined in my office. I like to spend 30 to 40 minutes with each patient to review his treatment plan. No one leaves my office without being pre-appointed for the next visit. I want my patients to be certain that it is my privilege to care for them and for their eyes, and that care is continuous. I make sure to provide them with ample opportunity to ask me questions, and I am available by email or text.

Just a few years ago, we completely renovated the office from floor to ceiling. We retained the collection of framed photos of my family and display cases with my grandparents’ and great-grandparents’ eyewear. Patients have donated a scleral contact lens from 1949 and a folding lorgnette and a pair of cat-eye glasses from the 1950s belonging to a patient’s mother. I ask the patient what type of music she likes, and we select soothing sounds for her. Each patient is offered a beverage while he awaits the dilation of his pupils, and that is when the optician will discuss his spectacle Rx and address his optical needs. Soon, I will be adding a diffuser of essential oils to my office to create an environment that is pleasing to the visual, auditory, and olfactory senses.

Next: Pros and cons of concierge-like practice


Pros and cons of concierge-like practice

There are advantages and disadvantages to practicing the way I do.

Advantages include low patient volume, which lends itself well to customizing care to each patient and providing details about all aspects of their ocular and general care, and leading by example with products. I wear BluTech Lenses (Eye Solutions Technologies) every day, and I educate my patients, especially younger ones, on the need to protect the health of their macula and minimize the risk of insomnia by limiting exposure to blue radiation from iPhones, iPads, laptops, and indoor lighting.

Low patient volume is also a disadvantage. I must maximize each patient encounter without coming across as too aggressive. This practice mode is also labor intensive because of the amount of time and effort I spend with each patient.

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Patient education and product sales

In order to facilitate and grow a concierge practice, I provide products for sale, both prescription ophthalmic products and non-Rx ophthalmic products, nutritional supplements, and more. The creation of my dry eye center within Montgomery Eye Care has made it necessary to stock the products my patients need. Doing so helps to ensure compliance with my therapeutic regimen. 

My ocular surface disease (OSD) and MGD patients require more frequent care, and they have proven to be a very reliable source of referrals. The same holds true for my patients who have filled Rxs with specialty lenses. A patient with OSD/MGD and ocular fatigue from all-day computer computer use found success with specialty spectacle lenses in her latest pair of glasses—she now wants to post a Google review of my practice and the product.

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Ben Fazio, licensed dispensing optician at Montgomery Eye Care, has started shooting YouTube videos on recommendations for the proper care and maintenance of Rx eyewear, specialty and polycarbonate lenses, Rx vs. OTC reading glasses, and more. He has developed a following and is excited about sharing his optical knowledge with current and prospective patients.

I educate patients on quality nutritional supplements and direct them to my website. It takes only a few minutes to identify patients who have a genuine interest in minimizing the need for Rx medications.

During the holidays, we hosted a holiday stress relief open house with festive food and drink, essential oils, and chair massages. I am planning an upcoming open house centered around NutraMetrix products and DNAfit genetic testing. I work closely with a nutritional consultant who will be joining me for the event. We will offer prizes and incentivize patients to attend and bring a friend.

Presently, there is a lot of buzz about online refractions and patients filling spectacle Rxs online. But, I have found that my patients crave a personalized healthcare experience and forming a relationship with an optometric physician and optician who are local and supportive of the community.

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