Marketing your therapeutic privileges benefits the practice as well as the patient

Issue: November 1999

Marketing a therapeutic practice to the public and to the professional community can take many forms. When informing consumers about the scope of your prescribing privileges, the approach can be as elaborate as signage and take-home marketing materials or as simple as a mere mention during an exam. No matter what method you apply towards patients, colleagues or pharmacists, it is important to raise awareness all around about the specific privileges you possess — for the patient’s benefit as well as your practice’s.

“I don’t think the general public really knows what the optometric profession can or is licensed to do,” said Robert D. Houdek, OD, director of optometric services for CIBA Vision. “I think the majority of the population perceives an optometrist as someone who just makes glasses and fits contact lenses.”

One-on-one patient marketing

The simplest way to ease into marketing your practice and to let a patient know what therapeutics you can prescribe is by taking a few minutes out during chair time, said Dr. Houdek. “I think that every optometrist who is in practice could begin a marketing campaign that could be as simple as taking 10 to 30 seconds with every patient who’s in the chair,” he said. “At the completion of an exam, the practitioner should ask: ‘Did you know that we can now take care of red eyes (or glaucoma or whatever his or her license allows him or her to do)?’ Just taking the time to do a one-on-one, ‘by-the-way’ type of marketing campaign with each patient seen in the office is very low cost. That’s where I would start.”

Sometimes, the subject may be broached even more naturally during the course of the exam. Randolph Brooks, OD, in private practice in Ledgewood, N.J., said that talking about a patient’s medical history can generate conversation about what conditions the optometrist is qualified to treat should the patient suffer a particular problem again. “A patient may check off that he has had conjunctivitis,” Dr. Brooks said. “Of course, he’s not affected by it now, and, in terms of medical conditions, it’s not really important, but it is important in terms of marketing your practice. Ask him where he went for treatment last time. Then, let him know that the most appropriate place to treat that eye infection is right there in your office. That way, he’ll think of you next time.”

Dr. Houdek agreed, saying that when a practitioner asks why a patient did not seek treatment at the optometrist’s office, the patient is often surprised to learn of the option. “That should be a red flag that you’re not doing a really great job of educating your patients,” he said. “You can get out into the community, do seminars for local groups or at schools. These things are labor-intensive, but they work. There’s no better way to advertise than to do it face-to-face.”

Nonverbal forms of marketing can often be just as effective when the patient comes into the office, said Paula R. Newsome, OD, in group practice in Charlotte, N.C. “We have pharmaceuticals in a visible location in the office so when patients come in, they see them,” she said. “We place them on top of our refracting table.”

The power of the written word

Prescribing literature and signage in plain view in the reception area are nonverbal advertisements that speak volumes as well. Take-home materials that are easy for the patient to carry and keep on hand at home ensure that the patient will remember the message after leaving the office. “Some doctors have a card that they hand out to patients that specifically states the types of things they can treat,” Dr. Houdek said. “The card might also provide a beeper number or a 24-hour number patients can use. Simple things like a Rolodex card or refrigerator magnet that list what you do can be effective.”

Dr. Newsome said that when in private practice, she referred to her prescribing privileges on her business card to make the public aware. “Right under my name, it said: ‘Examination and treatment of the eye and visual system,’ ” she said. “I think that’s really important, because then people know that’s what you do – that you are a primary care provider and not just a refractionist.”

Making the public aware of current legislation on a sign or in other office literature may prove useful, said Dr. Houdek. “You could place a sign in your office that says, ‘Did you know …?’ ” he said. “You can put something together, even if it is a small office brochure.”

Dr. Brooks, however, is more reluctant to advertise therapeutic pharmaceutical agent (TPA) legislation to the general public, particularly if a state has recently passed the legislation. “When you first become certified to treat therapeutically, you don’t want to advertise that you’re now treating eye disease,” he said. “Nobody wants to go to someone who’s brand-new at what they’re doing or recently certified. We do let them know in terms of reappointment letters and literature coming out of the office that we treat eye disease, but we tend not to advertise it as a newly found ability. We find that can be counterproductive; people want to go to someone who’s been doing it for a while.”

Because several years have passed since many states received their TPA privileges, however, that may change things, Dr. Brooks conceded. “That’s something that experience resolves,” he said. “We’re now 7 years out in TPA law in New Jersey, and if you were certified back then, you’re not a novice anymore. Then again, every doctor is new at one point. If an ophthalmologist just opens up an office, then he or she is brand-new, too.”

Get to know your GP

Acquainting yourself with the general practitioners in the area is always a good idea, said Dr. Houdek. Calling a physician and inviting him or her to lunch, particularly if you are new to the area, is a good way to get started in networking. “For instance, if you’re trying to build a dry eye practice, there are probably a lot of GPs who don’t even know that optometrists do punctal occlusion or can manage patients like that,” he said. “It’s really just about networking and educating them about what you do.”

Sending report letters regarding the treatment protocol for a specific patient is another useful tool, said Dr. Brooks. “Perhaps they did not realize that optometrists can prescribe,” he said. “It’s important, in those cases, not to send letters that have all types of visual findings in them. They don’t care what all of the specifics were. They’re interested in what was wrong with the patient, what you’re doing to treat it and how it relates to their care.”

Marketing letters often get discarded, said Dr. Brooks, so he does not advise using that type of marketing ploy with doctors.

Both Dr. Brooks and Dr. Houdek support the idea of meeting physicians face-to-face at events — often, the more social, the better. “I don’t think we’re very good at networking, as a profession. Those are some of the growing pains of just recently gaining our legislation,” Dr. Houdek said.

Dr. Brooks agreed that meeting in social situations, or even in professional situations where informal conversation can take place, is a preferred mode of establishing contacts. “Meeting other doctors in church and civic groups as well as seeing them in the hospital — if you have hospital privileges — becomes more important in a therapeutic practice,” he said. “When they see you in the hospital hallways and in staff meetings, they realize you’re on equal footing with them.”

Getting your prescriptions filled

Because pharmacists are the link between the optometrist and the patient’s therapeutic treatment, good relationships with them are important to keep the process flowing smoothly. Many times, Dr. Houdek said, pharmacists may not think about optometrists as the individuals behind the prescriptions. “I don’t think many pharmacists think about optometry from a therapeutic standpoint,” he said, “so that’s a huge opportunity, and you’ve got to get to know them. Introduce yourself on the phone or in person, telling them who you are and that you’re going to be sending patients to them to get their prescriptions filled. Leave a card, and if they have any questions, they can call. These are things that aren’t hard to do, but they take time and concentrated effort.”

Another getting-to-know-you tactic that helps establish a good working relationship from the beginning is to hold an “open house” in your office, said Dr. Newsome, inviting general practitioners and pharmacists in the area. “When I first moved to the area, I wrote the pharmacists within my immediate area, because I thought that patients would be leaving my office and going there,” she said. “I invited them in for a tour of the office. Any time we have an open house I invite both pharmacists and primary care physicians.”

Many pharmacists do take note of the prescriptions they are filling, said Dr. Brooks, and realize that they come from an optometrist’s office. “When pharmacists see that you prescribe a lot, they’re likely to refer their customers to you when they come in with inflammatory, allergic or acute infectious conditions and when the patient just needs overall care and they suspect that a medical condition may be involved,” he said.

Dr. Brooks said that getting to know the local pharmacist is also important because of potential confusion regarding DEA numbers. “In about half the states, optometrists don’t have DEA numbers,” he said. “That’s something pharmacists have to be made aware of. There are definitely ways to identify practitioners without using DEA numbers.”

Referring fellow optometrists

Another important aspect of marketing your practice is to make referrals intraprofessionally, said Dr. Houdek. Do not overlook other ODs whose first instinct may be to refer to an ophthalmologist if they do not treat a particular condition themselves.

“Intraprofessional referrals to colleagues providing specialty services are a viable option for optometrists just entering the therapeutic arena,” he said. “There is really no reason to refer a patient to another specialist if it’s a procedure that’s licensed to be treated by an optometrist. For example, some optometrists are licensed to manage glaucoma, but they may not feel comfortable doing so. If they’re not, rather than referring them to an ophthalmologist, there may be an optometric colleague in their area who can help.”

Marketing your therapeutic practice to colleagues can prove to be a challenge, said Dr. Brooks. “There’s a traditional referral pattern to ophthalmology that some optometrists who don’t prescribe aren’t willing to break,” he said. “Perhaps they don’t want to admit that they don’t prescribe. I think the main issue is the fear that a therapeutically certified optometrist may, in turn, try to steal a patient or an entire family away.”

So when an optometrist does get a referral from a non-TPA-certified colleague, Dr. Brooks stressed, the prescribing doctor should ensure that the patient returns to his or her original optometrist to show good faith. “If you’re seeing the patient for an acute condition for which he or she was referred, you’re acting in the role of a specialist, and you have to act the same way you would want an ophthalmologist to act when you’re sending the patient for cataract surgery. Would you want them to try to make the patient their own?”

Dr. Newsome feels that as the profession becomes more specialized and therapeutic certification becomes more essential, the situation may change. “I think as we move more into specialization and board certification, the field will shake out and it won’t be as cumbersome to get optometrists to refer to one another,” she said.

Patient, practitioner benefits

When it comes to treating a patient for an ocular condition, Dr. Houdek said that patients are in better hands when they see their optometrist for primary eye care as opposed to running to the emergency room. “If I have a patient who’s scratched his or her eye, I can almost guarantee that patient will get better care by coming in to see me rather than going to the emergency room on the weekend,” he said. “It is not that those people aren’t talented and knowledgeable, but they probably don’t have as much specialized equipment or nearly as much training to look at the eye.

“Also, we’re really making a mistake if we don’t practice at the level of our education and the level of the law,” Dr. Houdek continued. “We have to practice that way, or nobody’s ever going to know that we do it. We’re doing our patients and ourselves a disservice if we’re able to treat something and we don’t take care of it, because then we’re not saving the patients’ time or money. We’re just adding to the cost.”

Expense, convenience and continuity of care are all benefits to the patient, added Dr. Brooks. “If there are duplication of visits, it’s more expensive, there is time off from work, there may be a long distance to travel to see an ophthalmologist in some areas of the country and, in some cases, the alternative is to see less-qualified practitioners,” he said.

Aside from the potential for practice growth and financial rewards, expanding your scope of practice is satisfying on its own, Dr. Houdek said. “Just for me, the diversification — the challenge to continually grow and to develop the knowledge to manage more and different types of situations — is a reward in itself,” he said. “I just think the more you can expand your scope of practice, the more challenges you face. If you’re not growing, you’re dying. There definitely are financial rewards that go with it, but the bigger reward is seeing somebody who may have a problem, recognizing it and managing it, potentially even preserving someone’s sight. You can’t put a price on that.”

For Your Information:

Robert D. Houdek, OD, is the director of optometric services for CIBA Vision Corp. He may be contacted at CIBA Vision Corp., 11460 Johns Creek Pkwy., Duluth, GA 30097-1556; (800) 533-1676, ext. 3168; fax: (770) 418-4202. Dr. Houdek has no direct financial interest in the products mentioned in this article, nor is he a paid consultant for any companies mentioned.

Randolph Brooks, OD, is in private practice in Ledgewood, N.J. He may be contacted at 410 Route 10, Suite 202, West Ten Plaza, Ledgewood, NJ 07852; (973) 584-1600; fax: (973) 584-4992; e-mail: Brooks2020@aol.com. Dr. Brooks has no direct financial interest in the products mentioned in this article, nor is he a paid consultant for any companies mentioned.

Paula R. Newsome, OD, is in group practice and may be contacted at AcuSight Eye Associates, 107 West Morehead St., Charlotte, NC 28202; (704) 375-3935; fax: (704) 333-7238; e-mail: Icaredoc73@aol.com. Dr. Newsome has no direct financial interest in the products mentioned in this article, nor is she a paid consultant for any companies mentioned.