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Issue: March 2009 Set Goals to Build a Lucrative Ocular Allergy Practice
CONTINUING EDUCATION

Set Goals to Build a Lucrative Ocular Allergy Practice

Here's how to outline your objectives and track them over time to ensure success.

Creating a vibrant allergy practice requires planning. The key is to develop a set of goals that are specific, achievable and measurable, and to set a realistic time frame for achieving them. But don't just hope to reach your goals. Create a framework for tracking your progress and making adjustments over time.

One of the chief ingredients you need to have is the ability to execute your plan. So it's best to keep your plan simple. It should be efficient. And it should be effective.

This article will discuss the importance of setting goals to develop an allergy practice, tracking your progress and being persistent until you succeed.

Goal Setting

Ask yourself what you want to achieve with your ocular allergy practice. What steps do you need to take to get there? What can you do right now, and what can you achieve in months or years? How can you integrate these changes into your day-to-day routine? Think about the answers to these questions, and then develop a set of specific goals that will help you succeed.

As a broad goal, you want to ensure you satisfy patients by providing effective treatment and the results they want. Your marketing efforts to existing and potential patients should reflect all that you have to offer for ocular allergy care, and they should educate patients about the condition and the treatment options.

Be sure to include goals for your staff. Currently, if you don't provide much allergy treatment, you may need to change the mindset your staff has about the practice. You'll also have to educate your staff to support the changes you'll make so you can quickly implement a new approach to allergy care. The faster you can integrate these changes, the faster you'll make an impact on patient care and your bottom line.

What's more, you'll need to set goals that involve delegating certain tasks to your staff. You might want to consider creating a new position, such as an ocular allergy coordinator. This isn't something you can do by yourself. It has to be a collective endeavor. Your staff should have a collective interest in expanding your allergy practice, which means everyone should ensure the plan is executed effectively. Delegating tasks also offers your staff opportunities to develop their careers.

Sample Goals

To give you an idea about the kind of goals you'll need to set, here's a sample to help get you started:

Set allergy prescription rates. Realistically, in a vibrant allergy practice, you're going to write allergy prescriptions for close to 30% of your patient base on a regular basis. So your goal, for example, might be to write allergy prescriptions for 15% of patients in 6 months if you're just starting out.

Follow the standard of care for allergy. How often will you see ocular allergy patients? How will you handle annual visits, and when will you schedule additional visits? For example, your goal might be to see your allergy patients every 6 months or so — which is the standard of care for allergists.

Incorporate staff education. Your staff must be able to talk to patients about allergy. How do you want to educate them? Your goal could be to spend 15 minutes a week at your regular staff meetings discussing topics, such as the allergic cascade, the steps you take to diagnose an allergy patient, allergy coding and billing, treatment modalities and the most effective drugs you prescribe. To jump-start the changes, you might hold a longer session.

Plan for seasonal allergies. Depending on where your practice is located, patients can have seasonal allergies in the spring, fall or year round. With this in mind, adjust your goals and the way in which you track and evaluate your progress. For example, if allergies are most prevalent during the spring or summer in your area of the country, set projections that will give you an idea of how much your allergy business may increase during these times and prepare to meet the needs of your patient base. You don't want to expect a steady rate of allergy symptoms all year if the people in your area have serious allergies only in the spring and summer.

Take advantage of sales promotions. Free help is available to you. Communicate how much of an emphasis you want to place on allergies with your sales representatives so they can serve you better. Sales reps can give you free product samples, posters and pamphlets to educate your patients. You also can visit manufacturer Web sites and download rebate forms for prescriptions and OTC products.

Market to internal and external customers. When you shift to more comprehensive ocular allergy care, you'll realize that your most lucrative patients are the ones you already have. Develop marketing strategies, such as sending direct mail to patients, displaying posters and providing pamphlets in your waiting room. Train your staff to discuss allergy and educate patients in the exam chair. Also, develop strategies to attract new patients for ocular allergy care, such as offering a referral incentive program for existing patients.

These are just a few ideas. You'll develop others that will fit your own practice. Whatever goals you set, make sure you schedule time to create and execute your plan and devise a method to track your progress.

Tracking Your Work

Have you achieved your initial objectives? Are you halfway to your goal? What parts of your plan are going well, and which need improvement?

To answer these questions, you have to develop a way to measure the results of your efforts. For example, if you're marketing to current patients, you need to develop a method or formula to track the response rate. You have to track how often you're reappointing patients for allergy and how often you're prescribing allergy medications.

Set milestones from the start. Have a definable measure for each goal, and set times when you'll evaluate your progress. You won't be prescribing allergy medications for 30% of your patients after 3 months, but you could reach that goal in 18 months. Determine where you'd like that number to be at 6 and 12 months, and monitor snapshots of your percentages for any given month as well.

You'll need help to track these measures. You might choose a point person from your staff who can manage your database. You can monitor ICD-9 codes yourself, and you can get a weekly statistic on how many 99213 codes you used, tied with a diagnosis of chronic allergic conjunctivitis. Alternatively, you could assign this task to an insurance biller or your receptionist. The answer depends on the dynamics in your practice, but it helps to have assistance.

As you evaluate your data, you can adjust your plan for the future, target weak areas and emphasize what's working.

Sticking to It

Be persistent in all that you do. Setting goals and executing your plan aren't one-time events. They're an ongoing part of a process that involves building the identity of your practice and getting your staff and patients on board with you. The tasks get easier once your patients understand the scope of what you're doing, so be consistent in these efforts. Make sure you review your goals with yourself and your staff periodically, follow your timeline, measure and evaluate your progress and remain flexible about adjusting your plan. Remember, these efforts can have a very positive impact on your practice while delivering the best care to your patients. OM

What Patients Want
When it comes to eye care, 74% of patients visit an optometrist first, and continue to do so on a regular basis.1 Optometrists see 68% of the American population,2 yet general practitioners prescribe 69% of allergy medications. Patients who express dissatisfaction with their allergy care say their doctor doesn't spend enough time with them, only prescribes certain types of medications and doesn't understand their allergy needs.2
To get these patients to see an optometrist for their ocular allergies — and ensure they're satisfied with their care — you need to give patients what they want:
Good advice. When you consider the complaints of dissatisfied patients, it's no surprise that 80% appreciate getting advice from their practitioner, and 86% say they like when doctors give them treatment choices.2 This means we need to listen carefully, make informed recommendations based on their needs and your professional expertise, and discuss all alternatives to find the treatment that best fits each patient.
Fast relief. Asked what is the most important thing they want in an allergy medication, 83% of allergy sufferers pointed to speed of action.2 We can achieve this far better with a medication — such as olopatadine 0.2% (Pataday, Alcon Laboratories Inc.), which relieves symptoms within 3 minutes — than patients can achieve by self-medicating with OTC allergy medications.3
Treatment that lasts. Patients want you to fix their problem. If their symptoms keep returning, they won't be happy and they'll think you've failed. We can help promote long-term success by prescribing treatment that's convenient, which is more likely to promote compliance. Because my patients tend to use treatments less frequently than prescribed, I prescribe medications requiring q.d. dosing instead of b.i.d. dosing. If patients won't follow the schedule, I want them to have the greatest duration of action.
Less expensive treatment. Patients with ocular allergies already are spending money on OTC medications, but it's more economical for them to purchase a prescription drug. According to my calculations, the average person spends $108 per year for OTC remedies. This same patient could spend significantly less on pharmacy copays and use a much more effective prescription medication.3
If you can give patients what they want, you'll go a long way toward enhancing their allergy treatment and building your practice.

References
  1. Caring for the Eyes of America 2007: A Profile of the Optometric Profession. American Optometric Association, aoa.org/x9791.xml. Last accessed December 8, 2008.
  2. Allergy and Asthma Foundation of America, Annual Report, 2005.
  3. Practice Resource Management, Inc., 2008.

What Patients Need
People with ocular allergies need a doctor's expertise and effective medications, but often they're unaware of this fact. Instead, they're treating themselves with OTC medications, and many come to accept that they have to live with their ocular discomfort. These patients need:
A complete diagnosis. Allergy is a complex problem, and ocular symptoms warrant focused attention. About 94% of all ocular allergy symptoms are related to seasonal or perennial allergies, which cause itching, redness, watering and chemosis.1 The eyes are particularly vulnerable to allergens because the conjunctiva has 50 million mast cells that aren't protected by natural filters, such as those present in nasal passages. Allergens interact with the mast cells, which release histamine and secondary mediators, such as tryptase and chymase, which cause secondary effects.
Because you understand ocular allergy, you can give patients a full diagnosis and ensure you're treating the problem in all its complexity — something OTC remedies and even prescribed oral antihistamines can't promise.
To discontinue DIY allergy treatment. Your patients may have been self-treating their ocular allergy symptoms for a long time. Once you explain exactly what's happening to their eyes and how you can help, they'll start taking the problem more seriously and stop accepting ineffective treatments.
Prescription medication. State-of-the-art treatment options address allergic inflammation across the board, blocking primary, secondary and tertiary pathways. They're the best way to show patients the difference in efficacy and comfort between self-treatment and optometric care.
Used at low concentrations, topical antihistaminic drugs usually have the desired effect. At higher concentrations, most can cause mast cell degranulation, disrupting the membrane, releasing secondary mediators and causing a release of histamine. Some new medications don't have this effect at higher concentrations, so you can determine the appropriate drug and concentration for any patient.
Easy compliance. This is another area in which patients may not know they need help. Don't patients often promise they'll take their medications as instructed? However, 59% of patients surveyed admitted they don't follow dosing instructions for allergy medications.1 About 30% of them don't take medications as often as they should, and 6% take them more often. Consider these numbers along with the patient's lifestyle when you prescribe treatment. Less frequent dosing or other changes may help keep a patient on track and happy with the care they're receiving.

Reference
  1. Allergy and Asthma Foundation of America, Annual Report, 2005.

Strategies to Sell Yourself As the Allergy Expert
■ Educate your receptionist, assistants and technicians about your role in providing allergy care to patients.

■ Inform patients that you're the most qualified to treat ocular allergy, glaucoma, infections and other ocular emergencies.

■ Let patients know you care about them.

■ Develop a treatment plan that's easy for patients to follow.

■ Show patients images of ocular allergy symptoms to illustrate the allergic response.

■ Discuss the state-of-the-art medications available to treat ocular allergy.

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