Alternate Practice Revenue? Part 2, Tips4EyeDocs Daily for 10 JAN 2012 No. 22


The fitness industry has an annual January ritual, known as the “January effect” (Bishop and Klein, 2010 at It’s built around the post-holiday guilt of over indulgence and lack of exercise. For most clubs and fitness equipment vendors, the January effect can create up to 25% of a year’s business.

Optometry has a similar “guilt” period. It’s usually before school or during the month of December when patients scramble to use up their health savings accounts or to choose to use the calendar year benefits. But like the fitness industry, how does optometry “even” out the year to create a more predictable revenue pattern for the year.

In the past, optometry has leveraged the cooperative advertising of contact lens, frame and lens manufacturers who have a very large promotional budget. But that cooperative advertising serves to promote the brand name product. What about the doctor? Does this kind of advertising help the doctor? I don’t’ think so.

So what can help the doctor have a mixed revenue pattern? I hinted that “out-of-pocket” expenditures such as health testing or nutriceuticals can help. A third leg of this alternative revenue stream is managing chronically ill eye patients.

If you’re not already certified, become certified to diagnose, treat and manage glaucoma, dry eye and allergic patients. These three entities are well within the current scope of practice in 49 of the 50 states. While ill patients may not create revenue from spectacles or contact lenses, their biannual or quarterly visits can almost equals a “well-eye” patient whose frequency varies from 1-2 years. On the other hand a chronically ill patient can be seen from 1-4 times a year. In some respects, the revenue from this kind of patient can be as important as one derived from product.

I know and I have heard that optometrists aren’t part of the medical insurance plan for this and that, but a significant proportion of those patients are now starting to purchase large deductible plans that make it almost impossible to qualify for regular benefits until well after $5,000 or even $10,000 of out-of-pocket expenses. These are the patients that optometrists should be attracting.

In summary, there are opportunities to complement the revenue from spectacles, contact lenses and refractive eye problem patients. You may have to do some extra work, but I think it is well worth the effort.


  1. The author makes a case for always writing an original blog. Of course, this doesn’t mean that you cannot link to it, but there should only be one blog post location. Don’t even think of duplicating a blog as a guest blog or duplicating a guest blog as your own. Spotted on Twitter via @Blogpreneur_ :Why You Must Never Duplicate A Blog Post…
  2. Should your optical staff use professional sales tips to create more sales? I think so. If you don’t use everything available to you, you just might see that prescription walk out the door? Spotted on Twitter via @naikorea: Sales Tips-The No. 1 Key to a Successful Close: Sales Tips-The No. 1 Key to a Successful…


OVERVIEW: I’m sure that a patient dilated with tropicamide and treated with an oral carbonic anhydrase inhibitor as a routine would have a low probability for acute angle closure glaucoma. However, I am not sure that such prophylaxis is needed. What do you think?

Lavanya R, Baskaran M, Kumar RS, Wong HT, Chew PT, Foster PJ, Friedman DS, Aung T.
Risk of Acute Angle Closure and Changes in Intraocular Pressure after Pupillary Dilation in Asian Subjects with Narrow Angles.Ophthalmology. 2011 Nov 23. [Epub ahead of print]

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About Richard Hom OD, MPA

Dr. Hom holds Doctor of Optometry and Masters in Public Administration degrees and practices family eye care and consults on public policy, health information technology and program evaluation.
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