This month’s Practice Profile focuses on Jeff Binstock, OD, who joined Redmond Eye Clinic in August of 2016. By January 1, 2018, Dr. Binstock and his his wife, Dr. Kim Skyles, who had been associates at the practice, officially became practice owners, taking over when the previous owner was looking to sell.
The practice is located in Redmond, Washington, about 20 minutes east of downtown Seattle on the east side of Lake Washington. Redmond Eye Clinic operates with two doctors and 10 staff members: Dr. Binstock, Dr. Skyles, Office Manager, Nicole; Biller, Erin; Technicians, Brooke and Wren; Front Desk, Teo and Jen; Virtual Front Desk: Zahraa; Opticians, Angella and Zephyr; Contact Lens Tech/Floater, Julia.
Read the full interview with Dr. Binstock to learn more about the importance of being independent, how he educates patients, and how he was able to drop all vision care plans and maintain practice success:
IS: What does being independent mean to you?
Dr. Binstock: Optometry is a wonderful profession that allows its doctors to practice in a large range of modalities. Unfortunately, the refractive side of optometry attempts to put its practitioners and owners into a box, limited by low reimbursement vision plans and competition from big-box retailers for optical products. In order to remain profitable, these practices are then forced to have to either see more patients or bring in lower quality products to compete. This “race to the bottom” does not benefit anyone except for the higher-ups of these corporations. Exam quality suffers, patients’ expectations are difficult to meet, and stress increases.
Being independent allows a practice to escape the “box,” focusing on providing patients with the highest quality care, with the best products and services this wonderful profession can provide. When many of us graduated from optometry school, we all had a vision of how we wanted to practice, and sadly, many of us were quickly met with the harsh reality of what private practice actually entails. However, being independent gets you one step closer to achieving that vision. And once you start, you realize you never need go back.
IS: Please tell me what inspired you to be vision care plan/insurance free.
Dr. Binstock: I am a big fan of numbers. The numbers tell the story of how efficient, organized, and profitable your practice is. Starting in 2019, we started quarterly tracking everything. These “key performance indicators” showed that, although we were growing quickly, we were being overwhelmed by vision plans. An easy assessment of a practice’s “revenue per exam” can show the difference in net revenue between a cash-pay patient and a vision discount plan. We were working harder not smarter. Quickly, we started to adjust our schedule, limiting VSP patients to certain exam slots, and filling the other slots with services that aligned with our vision for our practice: myopia management, medical exams, dry eye, pediatrics, cash-pay patients, and non-vision plan comprehensive exams. Over time, we focused on building our schedules and practice with these types of exams, lowering our overall percentage of vision plan patients. This year, we decided to finally become officially out-of-network.
IS: What was the journey/timeline like to get there?
Dr. Binstock: The only vision plan that we ever took was VSP, so we did have a good base to start from, but there were a lot of VSP patients. In 2019, when we started really focusing on the numbers, VSP was about 60% of our comprehensive eye exams. As of 2023, it has been lowered to about 30%, which allowed us to finally drop them.
IS: How do you educate patients about this decision?
Dr. Binstock: Everything starts with effective patient communication. We find that honesty has been the best policy with regards to communicating our decision. We spent many of our weekly staff meetings over the course of months training our staff on verbiage, preparing them for likely scenarios where they would have to answer patient questions. We also drafted a letter, written by the clinic, that explained this decision in more detail. Overall, we have had a positive response to it. Our loyal patients do care and do appreciate our clinic, so it was just about them understanding the reasons why, and then explaining what we can do for them while being out of network.
IS: How do you market to patients without being on an insurance plan list?
Dr. Binstock: As I mentioned, we don’t really market our comprehensive eye exams. Instead, we focus on marketing our medical and specialty services. If you can get a patient into your practice for those services, then converting them to a glasses or contact lens exam is fairly easy.
IS: How has this experience changed optometry for you?
Dr. Binstock: Our focus on specialty services and medical eye care has made optometry more enjoyable for everyone at the clinic. We officially dropped VSP on 1/1/24, and our staff has been excited about not having to deal with it anymore.
IS: How has it changed your staffing needs? Practice size (sq ft)? Equipment needs? Frame/lens mix?
Dr. Binstock: We don’t foresee any large changes at this point. We do plan to rework our optical a bit to bring in some frame lines that fall within a package that we can offer to out-of-pocket patients.
IS: Has there been any pushback?
Dr. Binstock: There is always going to be pushback. All we can do is explain the ‘why’ behind our decision and let patients know that we still would love to see them. We try our best to focus on what we can do for the patient instead of what we can’t do for them.
IS: What is your best advice to doctors who feel they can’t do what you have done?
Dr. Binstock: The first thing you have to do is understand the numbers. Think of your practice metrics as blood values during your routine physical. Some values might be too low (revenue) and you need to raise them. Some might be too high (costs) and you need to lower them. Some might be perfectly where you want them to be (do more of these things). Once you understand what the numbers mean, then you can understand how the day-to-day of your practice influences those numbers. Most will be surprised at what they see. This can often give a practice owner the confidence to be able to drop a vision plan when you realize that even though you are seeing quite a few patients, this plan makes up a small percentage of your revenue.
IS: What is your next goal for your practice?
Dr. Binstock: We desperately need to move! We have officially outgrown our little practice, and I have been continuing to look for locations to move. Our current location doesn’t look that great, as the building is older, and we are on the second story in the corner of the office building. My hope for the near future is to buildout a 3,000-3,500 square foot location with better visibility and a better clinic flow than what we currently have.