Practice Profile: EyeCare for You

In this Practice Profile, Dr. Kara Ramsey Foster shares how dropping vision care plans allows her to spend more with her patients.

Dr. Kara Ramsey Foster cold started her practice, EyeCare for You, in Apex, North Carolina nearly a decade ago. With 1,400 square feet of office space and four staff members, Dr. Foster has created a family atmosphere in her practice without accepting insurance plans. Learn more about her experience dropping vision care plans and how she’s able to practice in a way that best serves her and her patients.

Independent Strong: Can you please tell me a bit about yourself and your practice, including how you got started in eye care?

Kara Ramsey Foster, OD: I was born and raised in western Pennsylvania and graduated from the New England College of Optometry in 2009. I relocated to North Carolina in 2009 and opened my own practice in 2015, called EyeCare for You. I have my own daughter and two bonus daughters, and I’m fortunate that my mode of practice allows me to have a lot of family time and better work life balance than I’ve had in other settings. I love to travel and go on adventures with my family.

I love eye care because it feels like we have the opportunity to serve our patients and help solve their problems. I knew I wanted to be in health care, but when I realized that in eye care we can truly help patients improve their quality of life, I knew this career was for me. I also love the opportunity to have an independent practice and be able to do mission trips with eye care as well. The look on patients’ faces when they put on their first pair of glasses is indescribable.

My practice has a small town feel, and we know most of our patients by name. I truly love seeing patients and helping them solve problems of their day-to-day activities. I actually changed my practice to be no insurance, or direct care, in order to have more time with my patients. I also started a consulting company called Direct Care Difference to help optometrists learn how to start practices based on accepting no insurance.

Independent Strong: What does being independent mean to you?

Dr. Foster: Independent eye care to me is being able to take care of patients in the way you feel is best, without having to rush them through their exam or limit care based on insurance company restrictions. I think patients really appreciate the personalized care they receive at private practices, and I chose to take it one step further by eliminating insurance companies.

Independent Strong: What inspired you to be free of vision care plans/insurance? 

Dr. Foster: Patient care and work life balance. I opened my office to spend more time with my patients and have more freedom with my family, but the more I worked with insurance companies, the more I realized if I stayed within the confines of insurance, I wouldn’t be able to maintain the level of service that inspired me to open my practice.

Independent Strong: What was the journey like to get there? 

Dr. Foster: It wasn’t easy at first, mostly because I couldn’t find any other optometrists who were practicing this way. There wasn’t a template to follow. At the time, there was a lot of negativity around dropping insurance plans, and I was told by frame reps and ODs that I’d be out of business in a month. Eight years later, I’m excited to be able to share my story with others.

In the beginning, we had to develop a process to make sure all of our bases were covered. We worked to come up with the proper language to explain to patients why we don’t take insurance, while still keeping the conversation positive. We had to notify our patients with enough time to let them use their insurance before we were out of network, and we also had to let the insurance companies know we were ending service. We spent several months preparing and rehearsing our scripts and updating our website with frequently asked questions and pricing to be completely transparent with patients.

Dr. Foster has created an office with a family atmosphere in Apex, North Carolina.

Independent Strong: How do you educate patients about your decision to not take insurance?

Dr. Foster: As we dropped each vision plan, we sent our patients a letter explaining the decision, how it benefits them, and what to expect. We also have all our information on our website about direct care, and we spend extra time explaining the process when new patients call to book an appointment.

Independent Strong: How has this changed optometry for you?

Dr. Foster: It made optometry a long-term, sustainable profession for me. Practicing without insurance is a career that I’d love for my children to follow, compared to corporate optometry. Even in private practice, the insurance model feels like you are not the one in control of your practice and patient decisions.

Independent Strong: How has it changed your staffing needs? Practice size (square feet)? Equipment needs? Frame/lens mix?  

Dr. Foster: It has allowed me to keep a smaller, close-knit team. I have an amazing staff who understands the importance of taking great care of patients and customer service. I truly think it’s easier to find a good team that works well together when you can keep your team smaller. Not taking insurance allowed me to eliminate positions related to insurance verification and billing.

My office is 1,400 square feet with two exam lanes, a tech room, a contact lens room, and two offices. Once in a while, I consider moving to a bigger space, but I also love the small, family feel of my office.

In addition to our exam lanes, where we have Marco electronic phoropters, we also have an OCT, fundus camera, small visual field machine, and our newest addition, an IPL. To have better annual monitoring and add value to our exams, we do a screening OCT and fundus photos on all of our patients.

It’s important to me to keep our frame lines as independent as possible. We work with Europa, Gucci, LaFont, Eco, Kate Spade, and several more. We have been very successful with Shamir lenses and hope they continue to keep the quality of their lenses high.

By dropping vision care plans, Dr. Foster has been able to spend more time with each of her patients.

Independent Strong: Has there been any pushback?

Dr. Foster: Initially, we had patients who went elsewhere because they wanted to use their insurance. However, we’ve been very impressed with the amount of those patients who have come back once they realize the price isn’t that much different for them out of pocket, and they appreciate our customer service.

Independent Strong: How do you market to patients without being on an insurance list? 

Dr. Foster: Word of mouth, especially on social media, and Google reviews are our biggest sources of new patients. Before dropping insurance plans, we didn’t get many patients who came to us only because we were in network.

Independent Strong: What is your best advice to doctors who feel they can’t do what you have done?

Dr. Foster: Your patients love you and are willing to listen and to understand why you won’t be taking their insurance plan. If you charge $119 for an eye exam, you can see one no-insurance patient for the same revenue as seeing three patients using their insurance. Time is our most important currency. Use your time for the patients who appreciate you.

Independent Strong: What is your next goal for your practice?

Dr. Foster: We’re currently working on expanding our dry eye practice to serve our computer and techie patient base.

Independent Strong: Is there anything else you’d like to share?

Dr. Foster: I believe that not taking insurance will make your life happier, because when you see fewer patients and can make the same amount or more money, you have more energy to give to yourself and loved ones.


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