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Practice Building: Four Pearls for the Young Ophthalmologist
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After years of hard work, many sleepless nights on call and volumes of reading and multiple rounds of anxiety-provoking standardized tests, you’ve finally finished your ophthalmology training, lined up a great job and are ready to enter practice as a full-fledged Eye M.D. Congratulations! Though the clinical learning curve will still be steep for the next few years, you’ve now got a solid set of comprehensive — and possibly subspecialty — ophthalmology skills that will serve you well. Now, there’s just one more small detail: How do you find yourself some patients?


Whether you are joining an established practice or setting out on your own, success in your new professional life is directly tied to the number of patients you serve. Thus, expanding your patient panel is now a top career priority. But how do you grow your fledgling practice from a trickle of patients and a mostly empty waiting room into a bustling clinic and booked-out OR schedule?

If the thought of standing on a street corner wearing an “Eye Surgeon — Will Work for Food” sandwich board may have crossed your mind, there are probably better ways of getting patients in the door. In this article, I’ll pass on some great bits of advice given to me by my mentors on how to effectively market yourself and build a thriving practice.

Tip 1: It Takes Five Years to Build a Practice.
Building a practice is not an overnight project. In fact, a five-year horizon is a more accurate estimate of the point at which your practice will be fully established. With each passing year, more momentum is gained through patient-to-patient word of mouth, community doctor referrals and, of course, returning patients. But even within those first few years, there can be considerable ebb and flow in volume. As long as the average number of patients is on the rise, don’t sweat those days — even two or three years into practice — when your waiting room seems uncomfortably quiet. Just remember that even in the best of practice opportunities, building a practice takes time.

Tip 2: Remember the Four As.
As you start out on your ophthalmology career, it’s handy to keep in mind the “four A’s” of practice building: affability, accessibility, ability and advertising.

Topping the list in order of importance is affability. Being pleasant and at ease in talking to patients is consistently ranked as a top characteristic that patients desire in their doctor. In fact, your ability to interact affably will typically be what patients remember most about you and will be the basis for their future referral of friends and family members. Referring doctors, too, will quickly appreciate your affability as you help them care for their patients. Though affability is clearly important in dealing with patients and other doctors, it is also critical to extend that same level of warmth, respect and professionalism to your staff. In fact, if you win the staff over early on, they will become some of your biggest cheerleaders as they help shepherd patients through the clinic and interact with your referral sources.

Accessibility is also key to the growth of a fledgling practice. While being available to patients is typically easy in the wide-open schedule of a new doctor, easy access is often critical to new referral sources as well. Willingness to take a phone call at any time or see a patient in need of urgent care on Friday afternoon goes a long way in establishing and cementing a good relationship with other doctors. Soon, those doctors will be thinking of you when they need help with non-urgent patients, too.

While ability seems all-important during training, in regard to practice building, it ranks only third on the list of critical traits. Although a new doctor must have a strong clinical and surgical skill set, stellar diagnostic and surgical skills are not required. In fact, all the ability in the world will be of little value in building your practice if affability or accessibility is lacking. By doing your best for each patient and committing yourself to lifelong learning and skill building, your solid ability will quickly become known to patients and referral sources alike.

Lastly, new doctors must advertise that they are “open for business.” While billboards around town and television ads might do the trick, they’re probably neither necessary nor the most cost-effective way of getting the word out. Typical initial advertising approaches are a letter sent to one’s new professional colleagues and potential referral sources in the community and — possibly — a reception hosted by the practice to welcome the new doctor.

Less-formal but equally effective avenues of advertising are involvement in the local ophthalmic and medical societies and volunteering at hospitals and community committees. These efforts allow your new colleagues to get to know you on a personal level. Airtime opportunities, such as speaking at local medical-education or public-service events, are another great way to get your name out there and advertise your skills.

Tip 3: Learn to Love “a Flurry of Letters.”

Another great tool for building your fledgling practice is your dictaphone and the motto “a flurry of letters.” Dictations are a part of a doctor’s life, but rather than viewing them as an unwanted chore, think of each dictated letter as an opportunity for practice growth. When dictating consultations to referring doctors, use language that can be understood by a layperson and send a copy to the patient and primary care physician (if the latter is different from the referring physician).

Sending follow-up letters to new patients recounting their visit, your treatment recommendations and important points of discussion will make a favorable impression. Similarly, sending a follow-up letter to update the referring physician on the patient’s progress will help cement referral relationships. With this new perspective on the power of your dictaphone, the paper trail created by your flurry of letters will lead to ever-growing numbers of patients to your office.

Tip 4: A Phone Call Goes a Long Way.
While formal letters are a must, remember that the telephone is a great practice-building tool as well. A phone call is not only an efficient means to communicate clinical information and feedback to patients, but it is also important in building personal rapport with the referring doctor. While the conversation will, of course, include the business of the case at hand, you will also have the opportunity to share some information about yourself and your new practice. This personal touch, in combination with your letter following in the mail a few days later, will go a long way in engendering a loyal following of referring doctors.

There’s nothing quite like the excitement of hanging up your newly printed shingle and starting your practice. There’s a blank slate in front of you, waiting for you to create your bright future. Just remember that practice building isn’t accomplished by just a snap of the fingers. But, with a little time, plenty of effort and perhaps a few practice-building pearls, you will be able to nurture a deeply rooted, steadily growing ophthalmology practice.

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About the author: This article was repurposed from a July 2009 Practice Management Pearls article. It was originally written by Sherman W. Reeves, MD, MPH, a cornea/refractive surgeon at Minnesota Eye Consultants who has been in practice for three years. He is a member of the AAOE YO Subcommittee and was endorsed by the Academy as a 2004 AMA Foundation Leadership Award recipient.

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