• Therapeutic Cataract & Refractive
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  • Lid and Lash
  • Dry Eye
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  • OCT
  • Patient Care
  • Diabetic Eye Disease
  • Technology

Top 5 practice resolutions for 2019


Big change is hard work, and it doesn’t happen overnight. If goals feel as unreachable as the top of Mt. Everest, consider setting several smaller goals instead. Small changes do add up and can lead to greater changes.

Here are five small yet inspiring ideas to start your new year off on the right foot, setting your practice up for meaningful progress in 2019.

Related: What New Year's resolutions ODs make for 2019

1. Dive into medical optometry
“The demand for medical eyecare services is growing at a pace nearly three times the growth of comprehensive eye exams,”1 says Steve Ferrucci, OD, FAAO, in Sepulveda, CA.

Unfortunately, more than 70 percent of the average optometrist’s income still comes from goods and services related to glasses and contact lenses.2

Consider ways to move toward a more medical-based model this year by expanding your role when treating patients with diabetes, age-related macular degeneration (AMD), cataract, glaucoma, and more.

“The need for these services shows no signs of slowing due to the aging of today’s baby boomer population,” says Dr. Ferrucci. “Beyond our role as a diagnosticians, we can recommend treatments that make a meaningful difference.”

Related: How I am embracing the medical model in optometry 

Optometric care is needed. The ranks of ophthalmologists will remain relatively static over the next decade, while ODs will increase in number.1 Currently, 58,000 eye care professionals are licensed to perform comprehensive eye exams and only 18,000 of these are ophthalmologists.2

2. Add something new to your list of services
There are many ways to set your practice apart by offering services that are meaningful in your community.

If your practice sees many millennials, consider how to expand your ocular surface exam protocol for those patients who opt for LASIK or other refractive procedures.

If your population is largely age 60 and over, it’s time to get serious about early detection of age-related diseases like AMD. Discuss risk factors with these patients, consider testing for subclinical disease using functional diagnostic tests, and educate patients on lifestyle changes that can help preserve vision.

If you see a lot of kids, myopia control may offer value and provide a lasting impact.

Whatever you choose, make sure your community knows about it, says Pamela Lowe, OD, FAAO, in Chicago, IL.

“Place brochures and posters in your waiting area and add information about the disease and the technology you use to diagnose it to your website,” she says.

Related: Why doctors are rethinking AMD standards

If new services require additional technology or material investments, look at the numbers. How many patients will you need to see per day to cover the cost of new technology or treatment? Do your charts reveal that you can pull it off? If so, what’s stopping you?

3. Improve the patient experience
We are fortunate to be able to recognize disease in its earliest stages, but there is more to being a good doctor than science.

Good communication skills are vital, and every touchpoint matters. A patient’s perception of your practice begins at the first phone call to your practice or visit to your website.

One consulting group trains doctors and staff on a process called CLEAR.3 Here’s an abbreviated explanation of how it works:
• Connect with patients throughout the encounter
• Listen actively to patients and caregivers
• Explain diagnoses, directions, and instructions
• Ask key questions at key times
• Reconnect with patients before ending each part of the visit

Whether you follow this model or one of your own, try to observe your practice through your patients’ eyes. Do you like what you see, or is there room for improvement?

4. Focus on why
When you’re running a business, managing staff, and trying to fit 30 hours into a 24-hour day, it’s easy to lose sight of why you became an optometrist in the first place.

However, taking a personal inventory and redirecting attention to why you chose this field can invigorate you and clarify your path.

If saving patients from vision loss is your passion, find more ways to do that by incorporating new technology in your practice or by volunteering in underserved communities.

Christine Sindt, OD, FAAO, in Iowa City, IA, saw a need in her clinic to restore vision to patients who had run out of options. She developed a prosthetic scleral cover shell that improves vision by creating a smooth, refractive surface for the eye. EyePrintPRO is similar to a scleral lens, but it is designed using proprietary software to match the irregularities of each individual eye.

Teresa Sack, one of Dr. Sindt’s first EyePrintPRO patients, would be legally blind without these lenses. She has had 10 ocular surgeries for conditions related to myesthemia gravis, a condition she has struggled with for 27 years, which had left her with double vision, chronic pain, and an inability to hold her head straight.

Related: Why AMD supplementation should not be casual 

“When I met Dr. Sindt, I didn’t expect that a contact lens could change my life,” says Teresa. “But even compared to all the surgeries, EyePrintPRO has made the biggest difference.”

Teresa now has 20/20 visual acuity, can hold her head in a straighter position, and has far less pain and discomfort.

“Hundreds of thousands of people suffer from debilitating corneal disease like Teresa does,” says Dr. Sindt. “These patients represent why we chose optometry, so let’s live that truth by learning about and directing patients to vision-saving or vision-restoring technologies.”

5. Follow a Center of Excellence model
The term “Center of Excellence” gained popularity in optometry around the same time that dry eye tools and treatments were becoming more readily available. Prescription drugs, like Restasis (cyclosporine, Allergan) and Xiidra (lifitegrast, Xiidra) combined with point-of-care testing including osmolarity (TearLab Osmolarity System) and MMP-9 (InflammaDry, Quidel), along with in-office treatments such as LipiFlow (Johnson & Johnson Vision) and intense pulsed light (IPL) changed the dry eye landscape.

A few decades ago, ODs paid far less attention to dry eye-primarily because there was not much you could do to address it in a meaningful way. But today, Dry Eye Centers of Excellence are appearing across the entire nation, often with patients waiting weeks or even months for increasingly specialized exams.

Private practice ODs in smaller neighborhood practices have likewise benefitted from the relatively low-cost point of entry, with many doctors now devoting an entire clinic day exclusively to dry eye examinations and treatments.

But dry eye isn’t the only niche that you can grow using a Center of Excellence model. Another specialty that’s only just begun to rise in popularity is the AMD Center of Excellence.

Related: Dry eye protocol for any practice

“AMD is one of optometry’s biggest opportunities to impact patients’ lives as well as build stronger, more profitable practices,” says Dr. Lowe.

“Unfortunately, as many as 78 percent of patients are first diagnosed with AMD having already suffered irreversible vision loss, and nearly half of them are first diagnosed with an acuity of 20/200 or worse,”4,5 she says.

Dr. Lowe is committed to helping her patients fall on the other side of these grim statistics by performing dark adaptation (AdaptDx, MacuLogix) testing on at-risk patients.

“Dark adaptation testing is a reliable functional test that takes the guesswork out and lets you move forward with a plan to slow or prevent progression,” says Dr. Lowe. “This functional test allows you to detect early AMD up to three years before it becomes clinically evident.”6



1. Defining the Future of Optometry. Presented at the American Optometric Association Optometry’s Meeting, June 23, 2018.
2. AOA Excel Jobson Medical Information. The State of the Optometric Profession: 2013. The State of the Optometric Profession. 2013. Available at: https://www.aoa.org/Documents/news/state_of_optometry.pdf. Accessed 12/20/18.
3. SullivanLuallin Group. Six Steps to Create a Service Culture. Available at: http://www.sullivanluallingroup.com/healthcare-customer-service-training/. Accessed 12/20/18.
4. Olsen TW, Feng X, Kasper TJ, Rath PP, Steuer ER. Fluorescein angiographic lesion type frequency in neovascular age-related macular degeneration. Ophthalmology. 2004;111(2):250-255.
5. Cervantes-Castañeda RA, Banin E, Hemo I, Shpigel M, Averbukh E, Chowers I. Lack of benefit of early awareness to age-related macular degeneration. Eye (Lond). 2008 Jun;22(6):777-81.
6. Owsley C, McGwin G, Clark M, Jackson GR, Callahan MA, Kline LB, Witherspoon CD, Curcio CA. Delayed rod-mediated dark adaptation is a functional biomarker for incident early age-related macular degeneration. Ophthalmology. 2016 Feb;123(2):344-51.

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