As a practice, if you don’t know where your weaknesses lie, then it is impossible to take the right measures to gain strength in those areas. This is where GPN Technologies and their EDGEPro analysis software comes in. By highlighting critical metrics and tracking staff performance, EDGEPro enables optometrists to find the best opportunities for increasing revenue and improving workflow and efficiency. This, in turn, empowers practices to take actionable steps in their training and operations.
According to Katie Lauver, ABOC, FNAO, VP of Business Relations, “I was an EDGE client before I joined GPN, so I used it in the practice, and we implemented training based on the metrics.” She explained, “I think is so important that when your doctors are actually looking at what I like to call the “report card” inside of EDGEPro that they line up their associates side-by-side and see who is performing really well, who does have a good capture rate, who doesn't have a good capture rate? Look at what's the average revenue per exam. All of that. Then, they can take that information and coach them on having a better conversation with patients to increase revenues.”
However, before you can properly utilize the metrics, you have to understand them and their capabilities.
What do metrics mean?
One issue within the industry is a lack of consistency in metrics terminology. As Chief Operating Officer at GPN Technologies, Evan Kestenbaum, MBA, has witnessed the OD confusion, particularly when distinguishing between revenue per hour, revenue per exam, and revenue reportings based on collections, new business, and net. He said, “When you read something or have conversations with your colleagues, you really have to pay specific attention to what exactly they mean? Because when their number is $600 per exam and yours is $300, you may not actually be that far off, depending on which metric you're talking about.”
Within the EDGEPro software there is a dictionary defining these terms to put everyone on the same page and facilitate clearer communication. Kestenbaum also offered this advice: “Whatever metric you decide to use, just choose one and use it consistently all the time over the course of a couple of years.”
Kestenbaum placed specific importance on the metrics of per exam and per hour. “Generally, OD production per hour means how much revenue a doctor generates per each hour they’re available for appointments. So, if a doctor/owner is scheduled to see patients from 10-6, but then stays in the office until 8 doing paperwork, only the hours they’re available to see patients counts.”
Revenue per hour also factors in variables such as how much medical eyecare follow-up and insurance billing are being done as opposed to refractions and contacting glasses exams, which both often lead to the sale of a product. In EDGEPro, production per hour is calculated under new business/hours entered in the timekeeping section.
Benefits of having an associate optometrist
Another perplexing issue to many doctors/owners is whether or not to add an associate optometrist. Often, it is a matter of weighing out and assessing the financial feasibility. Both Kestenbaum and Lauver pointed out the benefits of having a dual- or multi-doctor practice and how EDGEPro can help alleviate some of the concern.
According to Kestenbaum, “For many single ODS, the hard part about going on vacation is not how much the vacation costs, it's that now my business essentially shuts down and we don't generate new revenue. Once you hire associates, set up systems to scale, and grow their collections per exam to as close to yours as you can, you now have the freedom to reduce your day seeing patients or to go on those family vacations. It's a liberating experience.”
Lauver echoed this sentiment: “The freedom that you gain by hiring an associate OD balances out the initial effect of taking in a little less revenue. Consider reinvesting some of that time into getting your new associate accustomed to the way you'd like to see things carried out, and you'll see that revenue—and that free time—come right back.”
Once an additional doctor is added, metrics should immediately be set in place to ensure a scalable practice.
Kestenbaum said, “Tracking your associate ODs performance is critical. You can easily do this in EDGEPro by utilizing our doctor dashboard in our business overview. Once you see what their capture rate is and how they’re performing with frame, lens, and complete pair sales, you can then coach them on the proper way to set the stage in the exam room, in turn increasing revenue.”
How to track and interpret associate optometrist performance
In his experience, Kestenbaum has found that the associate optometrist's revenue per hour is almost always lower than the owner because they don't have “the same skin in the game as the owner.”
He pointed out, “Mentally and emotionally, sometimes it's really hard for an owner/doctor to see that the associates are generating so much less than they are. But what I think is important to realize is that you, as the owner, don't have to do all the exams anymore. If you're focusing on the business and creating a practice that's scalable and doesn't just rely on you, that's the key to success to grow and have some freedom from the practice.”
By using metrics, the owner/OD can formulate a plan to remedy the situation by first focusing on the two aforementioned factors: revenue per exam and revenue per hour.
GPN works with over 10,000 locations, and part of their service is to anonymize and aggregate information. In doing so, they found, from July 2020 to July 2021, the average revenue per exam was $397 and the 50th percentile was almost $380 per exam.
“So if you understand the 50th percentile is $380 per exam, the 75th percentile goes up to $450 per exam, and the 90th percentile goes to $533 per exam. The first thing to say is, ‘Where do I want to be?’ And set a one, three, and five-year goal.”
The next step is to determine how many exams you have available in your day, taking into consideration that not all of your exams are with refractions; some will inevitably be medical or contact lens follow-ups. Kestenbaum stated, “So when you figure out approximately how many exams you do per hour, you could then calculate an approximation of what your revenue per hour should be. For those who use EDGEPro, that connects to the practice management system; all you have to do is enter in how many doctor hours you have available and it figures all that out for you. You don't have to do any calculations on your own.”
Figured into the broader collections per hour are the sales that each exam generated.
Implementing change to increase optometry practice revenue
Once you have looked at the data, it is time to use your findings. According to Lauver,
“EdgePro allows you to really dive into those metrics and go into that granular level to see how your staff and doctors are performing, so that you can have a better conversation, like how they should be talking to the patients to get them to buy. Taking a look at the missed opportunities for growth is an area that's important.”
Some of the biggest missed opportunities derive from prescribing from the chair. Lauver elaborated, “If you have a patient's sitting in the chair and their prescription didn't change, is your associate doctor just letting them walk out the door and saying, ‘Okay, we'll see you next year?’ Or, are they actually going the step further to have the conversation to say, ‘Well, you really should get a backup pair of glasses with an extended warranty.’”
By analyzing the metrics, an owner/doctor can deduce whether an associate OD needs to be more effective at talking to patients about the importance of a second pair of glasses or anti-reflective lenses and then transferring the authority to the optician to complete the sale.
According to Kestenbaum, “The key is making those calculations and tracking those metrics, and then implementing behavioral changes based on them in the practice.”
In an owner/doctor practice, the ultimate goal should be deciding the optimal per hour revenue for your particular practice and setting up a system where there are not large gaps between the owner/doctor and the associate optometrists. “If you have a multi-doctor practice, the best way to start is looking at each doctor individually. And the goal is to see how far apart they [the doctors] are from each other. If you're seeing the same client base, in the same office, there's no reason you shouldn't have about the same revenue per hour,” Kestenbaum said.
Kestenbaum suggested to “level up,” practices should use all the available metrics as well as the resources offered within the eyecare community. He stated, “We're believers at GPN that there are a lot of great consultants in the industry and programs available, whether it's from vendor partners or alliances with buying groups. It’s not necessarily that you can't figure it out on your own or you wouldn't figure it out on your own at some point, but all of these great organizations want to help you grow your patient base and grow revenue, because when the doctor's office grows, the vendor partners and alliances all grow as well.”
Lauver added, “You’re building your company culture. All of it goes into how you want your patients to feel when they're in the office.”