Pointers for a Solo Practice

Originally posted in "eyetubeOD" by Maurice W. Geldert, OD

Geldert_Maurice_BWSolo practice can be challenging, particularly in a rural area, as mine is. Granted, we all have our own preferences, but the following pointers have proven valuable to my practice. I hope at least one of them can be of value to yours.

1. Crunch your schedule.

Even if your practice is fairly new, make the days you see patients as full as possible. Time spent outside of your exam room can be filled in a number of ways: social networking, working in another office, training staff, reviewing accounts, taking advantage of online continuing education opportunities, etc.

2. Use LensFerry S.

My practice loves this new program. Although owned by CooperVision, the LensFerry S subscription service works with many brands of soft contact lenses. Patients pay a monthly fee to have contact lenses shipped directly to their homes, and my practice is paid directly from LensFerry. Our sales of daily disposable contact lenses have risen as a result of using LensFerry S. With this subscription service, daily disposables become a reasonable monthly charge rather than a large expense, and, therefore, they are a more attractive option to patients. Additionally, we tell patients who choose to use LensFerry S that their vision insurance can then be better used to purchase a new pair of glasses at our optical shop.

3. Stay open late once a week.

Our office is open on Tuesday until 8:00 pm, allowing us to schedule a final appointment at 6:30 pm. Appointment slots from 4:00 pm to 6:30 pm are in high demand. Working patients will love your practice if you can accommodate their schedules. Put yourself in the patient’s shoes: Would you rather have an after-work appointment or take off from your job—assuming you’re even able to do so? Otherwise, you’ll spend a Saturday getting your eyes checked.

4. If you have an OCT or retinal camera, use it.

My office performs free retinal scans for every patient undergoing cataract surgery. In the event that postoperative macular edema issues are identified, I then have preoperative and postoperative scans I can use to compare anatomy. If you have a retinal camera you can use without paying per use, consider taking fundus photographs of young patients who play contact sports. I let parents know I am verifying that no potentially sight-threatening issues are present. I have found a number of retinal injuries tied to sports-related trauma by doing this, and almost all incidents were previously unknown to the patient or parent. Rather than viewing such extra work as giving away free services, consider how these wonderful tools can expand your reputation as a doctor who goes the extra mile for patients.

5. Turn occasional patients into routine patients.

Inform patients with vision plans who visit the office every 2 or 3 years for eye exams that they are wasting benefits they pay for. There are a number of web-based programs that a practice can use to monitor when patients are eligible to return for their eye exams. This can save staff time and could also increase the rate at which patients return. Costs associated with such services have fallen during the past few years.

Always be willing to try something new, to be wrong, and to teach (and learn from) your staff. Evolution in business is key. If I ran my practice today the same way I ran it when I started 41 years ago, I would rather mow lawns than practice optometry—and I hate mowing lawns!


Solo practices may benefit from taking measures to accommodate patients’ busy lives and offer top-rate services.


We see many patients with age-related macular degeneration, diabetic eye disease, and glaucoma. These patients are brought in on a separate date before their comprehensive encounter for required visual fields and optical coherence tomography (OCT) imaging; these are performed when staff is not working on regular exams. This takes pressure off of the staff if patients are slow in testing, which may be due to age, health, or both. Likewise, patients are not exhausted by going through ancillary testing, a full exam, and possibly (hopefully!) a trip to your optical shop all in one day. You will also have time to analyze tests more thoroughly before the encounter.

Maurice W. Geldert, OD, Diplomate, AOB • optometrist, Roswell Vision Source, Roswell, N.M. • financial disclosure: none disclosed •

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