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A s e y e d o c t o r s , o u r job is to solve vision a n d o c u l a r h e a l t h problems. So, if we're n ot d i a g n o s i ng an d treating dry eye, we're not doing our jobs to our fullest potential. Dry eye care is not only the key to healthier, happier patients, but also, through the provision of medical ser vices, a financial driver for the practice. Approximately 20% of the people who walk through our practice doors have some form of ocular surface disease, 1-3 so if we're not making those medical diagnoses and billing for that medical care every day, we've got work to do. The idea of shaping a practice to conform to a medical model can be intimidating. But, in reality, increasing the medical ser vices portion of a practice by focusing on dry eye care is readily achievable. You don't even need to attract more patients; you simply need to take better care of the patients you already have. So, how can you enhance the medical side of your practice? I've done it in mine, and coached many others through it, by using what I call the "Four Ps": Plan, Procedure, Product, and Promotion. Set Goals, Track Progress Te frst key to expanding the medical services portion of a practice through dry eye care is to know where you stand. Even if you see only one medical patient each day, that's the basis for your next step, which is goal setting (Figure 1). You can start small, aiming to double your current daily number from one to two or four to eight, and by asking every patient just one additional question (e.g., "Are your eyes always that red?"). No matter what your frst goals are, track your progress weekly or monthly. If you're committed to making changes, even your frst small steps fuel a self- fulflling cycle that propels you toward improvement. The difference from a fnancial perspective will eventually be tens — if not hundreds — of thousands of dollars added to the bottom line of your practice. Implementation of the Plan To reach the goals you have set, you must establish procedures or processes that you and your staff will follow each day. And although your staf has to accomplish these goals, the effort begins with you. Think first about your clinical protocols. It helps to write them down. For example, how would you manage meibomian gland disease? What tests would you order? What treatments would you recommend? Next, think about all the different steps that take place from the time a patient enters the ofce to the time he leaves. What occurs between the patient and the front desk, the technician and the doctor, the doctor and the patient, and everything in between? Each of those points in the work flow is an opportunity to identify the dry eye patients in your practice and educate them so they'll know that you can take care of their red, uncomfortable, dry eyes and fuctuating vision. For e x ampl e, you m i g ht h ave the front desk person ask patients whether their vision ever fluctuates and if blinking makes it better. Each patient could also be given a dr y eye questionnaire. Then, have the technician collect the questionnaire and ask a follow-up question, such as "Do you 'feel' your eyes?" If the answer is yes, the technician can let the patient know that doesn't need to be the case: "We can work on that." Tese types of changes in the work flow prompt patients to think about their symptoms, which they may not necessarily associate with problems. Being asked about and educated on their symptoms leads them to realize t he y need a s olution, and makes them aware that you treat medical eye problems. Once you find the points in the workflow where medically oriented interactions take place, you can work on fine-tuning them. Scripts work wonders for helping everyone in the practice talk with patients about dry eye and treatments in a consistent manner. You can write your own script or use staff and patient education materials created by the companies that have a vested interest in dry eye. Either way, practice using the scripts. You can role play, but there are other ways. I sometimes surreptitiously leave my phone at the front desk and hit record. My staf does the same to me; then we listen and determine whether we're all saying what we're supposed to say. In addition to defning staf roles so they know what to do and providing the tools and training they need, it's crucial that they understand WHY you want the practice to be more medically oriented, so they will be motivated to help achieve that goal. Incentives, which can come in many Enhance the Medical Side of Your Practice With Dry Eye Care Follow the "Four Ps" to success ■ By Scot Morris, OD, FAAO PLAN PROCEDURE 4 | FEBRUARY 2016