CHALKEYES… Give me back my patient!

‘Dave the drainlayer’ was driving his digger at the new development last week. I hadn’t seen him at the practice for more than five years.


He wasn’t wearing his glasses. I suppose that was good. I know Dave sleeps in his contact lenses.


I know Dave quite well. His script is +4.00 in both eyes and he’s presbyopic. His inept contact lens handling paved the way for him needing to wear them overnight. His freedom from glasses transformed his work and leisure so much, I remember fitting him with lenses as if it was yesterday. He was an early triumph in the days that fitting extended wear contact lenses was still a good idea. Sure, he’d had a couple of red eye visits over the years - one quite serious - but getting him sorted had been a personal victory for both of us.


I wonder which optometrist he goes to now? I know I shouldn’t care where, but I do. It really annoys me!


Who stole you, Dave? I thought we had something!


That said, I’ve been accused of stealing other optometrists’ patients. Patient theft; you actually hear this quite a lot, “My patient”. There is a practice in the area that gets quite worked up and irate about the stealing of their patients. Complaints have been made.


I wonder if these patients realise they’ve been ‘stolen’ when they phone to book an appointment? What kind of fool pays to become someone else’s property? Is it a kinky reverse slavery-thing perhaps; commercial bondage?


Thinking about it, I have ‘bought’ patients; nicely wrapped up as the ‘good-will’ part of a practice’s value. Formally calculated and negotiated to be presented as a fait accompli by accountants who really don’t know the first thing about the optical industry. Willing buyer, willing seller, I suppose… Of course, what we are really buying is a database and databases can be really valuable. Data is the new oil. Ask Google.


Optometrists are really good at measuring things. That’s the “…trist” part of our title, but we suck at databases. Accountants usually know more about business, but I’m not sure about databases. I’ve bought some really bad databases.


Dave, you unfaithful drainlayer you, if you are wondering, my book is full! I have to squeeze people in during my lunch-hours and write letters after hours and, I’m told, I’m very expensive, even though my exam fees haven’t really changed in the last four years.


Hardware has been added to improve the quality of the eyecare I provide. I think my patients get a good deal. My eye exams now only cost the same as a dog license or a bright green cordless drill from Bunnings.


Interestingly, I now almost never see a first-time patient that hasn’t seen some another optometrist first. Gone are the brand-new patients for me, I have become a second opinion person; a problem fixer, or not - as is often the case.


The real truth is that my fees are much too cheap. I’m selling fewer glasses every year and that full appointment book contains fewer and fewer selling opportunities. Dry Eye treatments, complex contact lenses, annual glaucoma screenings and red eyes; primary care doesn’t sell glasses.


It’s easy to forget that the relationship with our clients is a strictly commercial one. The person “who does the paying does the saying” is how the old one liner goes. The ‘saying part’ is about freedom of choice. Choosing the products, service and expertise required. But it’s us who does the ‘paying part’, covering overheads and maybe making some profit to pay the tax man. How long can the patient have a bob both ways? How long can I be a busy community optometrist and not sell glasses? The current business model is flawed.


Give yourself fright and do some easy sums. Divide your fixed overheads (wages, rent and insurances etc.) by the number of minutes your practice is open a year. How much money do you need to make to keep the lights on? Scary number? Hell, yes! And this is before you buy a frame to sell or a lens to put into it. If you feel like a little more painful distraction, divide this number by the number of staff (including you) working in the practice. This is the ‘dollar per minute’ fee that every single person in the practice needs to generate. Team goal setting? Maybe. But sadly, preaching this number tends to have a very demotivating effect; better to talk about the weather.


Don’t get me wrong, you’re welcome back any time, Dave. You look like you’re keeping well; waving with a smile in the afternoon sun, while working the new development. But Dave, don’t leave it too long because it will cost us more every year.


The views expressed by Chalkeyes are his or hers alone and not necessarily the views of NZ Optics. If you wish to comment on Chalkeyes’ views, please email a brief letter to the editor at for consideration. Letters can be edited for space, style, grammar and clarity.


Bottom Banner Advert