Is Now the Time to Add a Specialty?

There are a lot of financial pressures and constraints being placed on ODs these days. Some examples are rising costs (labor, cost of goods, etc.) and insurance reimbursements that have either declined or remained flat. Specialty care, much of which is private pay, offers an alternative path to generating revenue. Specialty opportunities in optometry continue expanding, including dry eye, myopia management, vision therapy, nutrition, and even aesthetics.

There is also a high burnout rate with traditional practice, often forcing doctors to see a high volume of patients and deal with a lot of administrative burdens. If adding a specialty is aligned with the doctor’s passion and interests, it can vastly improve career satisfaction and lower burnout. Specialty care adds a profit center to your practice, while simultaneously restoring the joy of practicing eye care.

Finding the Right Time to Add a Specialty
While there are exceptions, and some practices are launched as specialty practices, in most cases, the specialty side has grown from an established patient base of a traditional eye care practice. In an established practice, there is a larger pool of people who are candidates for specialty care. Without the pool of candidates, the specialty side depends on a lot of marketing and word-of-mouth to grow. Some practices even start creating a list of candidates prior to launching the specialty and then implement an outreach campaign once the specialty is launched.

For smaller practices, incorporating a specialty could become a distraction from growing the core business. While some practices focus solely on a specialty, most still derive the majority of their revenue from traditional eye care, including professional services and the sale of glasses and contact lenses. Smaller practices are also challenged with limited people and resources, and divesting efforts away from the core business could be counterproductive. While I’m generally bullish on specialty care, small or early-stage practices must consider priorities and focus when growing a business.

A practice in its early stages without an established patient base could experience more challenges adding in a new specialty. A practice going through a lot of changes or adversity may not want to divest time, money, or resources into a specialty until the practice is more stable and can devote adequate time to the specialty. Similarly, incorporating specialty care into a cold start practice will take a lot more effort and marketing than an established practice.

What’s Your Passion?
If you’re considering adding a specialty to your practice, I think the two most important aspects to consider are whether you have an interest in a particular specialty and whether there’s a market for it in your community. From what I’ve seen, most ODs who succeed with growing a specialty are passionate about that specialty. It’s the fuel that keeps them going. Their eyes light up when they are talking to patients about the specialty and the success they’ve had with treating patients. 

Also consider if there is a market in your community. For example, a dry eye specialty can thrive anywhere, but perhaps you’ll see even more growth and success in a part of the country that is very dry. On the contrary, would it make sense to start a vision therapy practice in a heavily geriatric community? Think about where your practice is located and the majority of the patients who are coming into your office every day. What missing need can you fill in your area by adopting a specialty?

Something else to consider: maybe an outside OD can fill that need for you. If you want to add a specialty but personally don’t have a lot of interest in any particular area, you can hire another OD who does have interest in that area. Your practice will still reap the benefits of an added service, and you won’t be bogged down in new equipment, training, etc. that comes with adding a specialty. 

Think About Your Bottom Line
If you’re considering adding a specialty to your practice, but you’re not sure where to start, another factor to weigh in could be the profitability of different specialties. Right now, dry eye and myopia management are two of the most profitable specialties to incorporate into your existing practice. 

Dry eye is easily the low hanging fruit. Now, most ODs already treat dry eye, but not all ODs treat dry eye at the same level. A true dry eye specialty requires an investment in technology, high level of clinical expertise, and effective marketing and word-of-mouth to promote the practice’s dry eye brand. This can be a very profitable specialty. Similarly, myopia management is a growing niche, but many ODs still struggle with getting the patient/parent’s buy-in.

Looking to the future of the eye care industry, I think myopia management will continue to grow, along with other specialties. I think this will be largely driven by a shift in the model of practice toward more specialty care, which will drive more awareness in communities across the country. Also, the more people receiving specialty care, the more word-of-mouth it will receive. We could make a comparison to the early days of refractive surgery. There was a time when LASIK was new, but as more people got corrective surgery, awareness of it grew, which led to more people seeking this option.

We should also be thinking about the financial/logistical aspects of specialty care. This will depend entirely on the specialty. Dry eye, for example, may require more financial investment than a myopia management specialty. A vision therapy or sports vision practice may require more time (classes, certifications, etc.) than a dry eye specialty. I would advise creating a business plan prior to launching a specialty that estimates resources such as finances, scheduling, training, and staffing. Another key item is space. Does your practice have adequate space for the specialty along with additional patients and staff? Some specialties take up a larger footprint than others.

Do Your Research
If you’re considering adding specialty care to your practice, talk to other ODs who have been successful with it. I find that many successful people love to talk about their success and are very willing to help others. Don’t be shy about asking for help. The only caveat is to contact people outside your competitive area. The specialty practice up the road may not want to share its secret sauce with you, but the practice an hour drive from you may be more willing. Ask if you can visit the practice and just quietly observe. Perhaps spend the morning in the practice, offer to take the doctor or staff to lunch where you can pick their brain, and then be on your way. How valuable could that be? How much time could that save you? How many fewer mistakes could that lead to?