marketing

1. TM
Marketing an Optometric Practice
ABSTRACT
Background:
Most optometric practices devote too little attention and
resources to marketing the practice to both current and
prospective patients. The result can be sub-optimal financial
performance.
Recommendation:
Optometric practices should develop a simple annual
marketing plan and budget before the start of each business
year with quantitative goals and strategies and programs to
achieve goals.
Conclusion:
Effective marketing planning and execution has potential
to increase annual revenue from existing patients and
attract new patients to the practice.
MONOGRAPH
Permission to reprint this article can be obtained by contacting Practice Advancement Associates: rmummert@jobson.com.
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2. Background
Along with financial and staff management, directing practice marketing is one of the
principal duties of an optometric CEO. Management & Business Academy™
(MBA)
surveys among independent ODs consistently reveal that a majority of ODs devote
too little time and resources to practice marketing. The median annual marketing
expenditure of independent ODs is just 1.2 percent of gross revenue. Less than one-
third of practices spend 2 percent or more of revenue for marketing. The median
marketing spending per complete exam performed by independent ODs is just $4.11.
In 70 percent of OD practices, the majority of marketing funds are spent for internal
marketing activities directed toward the existing patient base. One-third of practices
spend less than 20 percent of the marketing budget for external marketing programs,
including media advertising, websites, exterior signage, direct mail and open houses.
Marketing activities are often critical to the financial performance of practices in their
formative and early growth stages. The patient base of new practices is often too small
to keep a doctor busy full-time, with the unfortunate result that fixed costs consume
a high share of practice revenue. Such practices need to attract new patients rapidly.
2
0.1% 0.4% 0.6% 0.9% 1.1% 1.2% 1.3% 1.8% 2.3% 2.7% 4.0%
percentile ranking
AVERAGE = 1.5%
5th 15th 25th 35th 45th 50th 55th 65th 75th 85th 95th
Low Median High
Marketing Spending % of Gross Revenue Performance Deciles
0% 6% 15% 22% 34% 40% 45% 58% 65% 80% 95%
percentile ranking
5th 15th 25th 35th 45th 50th 55th 65th 75th 85th 95th
Low Median High
External Marketing % of Total Marketing Spending
$0.25 $1.18 $2.05 $2.62 $3.54 $4.11 $4.76 $5.94 $7.82 $10.91 $21.92
percentile ranking
AVERAGE = $5.65
5th 15th 25th 35th 45th 50th 55th 65th 75th 85th 95th
Low Median High
Annual Marketing Spending per Complete
Exam Performance Deciles

3. 3
Practices in their early growth years often need to rapidly increase revenue to enable
investment in new instrumentation, to expand facilities or to add staff. They look to
both attract new patients and generate more revenue from the existing patient base.
When new or early growth stage practices spend less than 2 percent of revenue on
marketing, they often short-circuit their growth.
Many highly successful, established OD practices spend little on external marketing,
relying on patient referrals to attract new patients to offset the inevitable attrition of
existing patients. Such practices generate referrals by delivering a consistently high
level of patient service, usually the result of carefully planned orchestration of the
patient experience. Building patient loyalty and referrals is their chief marketing
priority. Such practices are also often effective communicators of the benefits of
high-value products and effective merchandisers of products. With these marketing
skills, they achieve much higher revenue per patient than other practices.
Some ODs equate marketing with advertising. That’s too narrow a definition,
because marketing encompasses all forms of patient communication that impact
perceptions of the practice and produce a brand identity, including:
• Practice positioning, name and logo
• The totality of the service process
• Product mix presentation and product merchandising
• Visual imagery of the facilities, decor, doctor and staff appearance, practice
website, marketing communications vehicles
• Pricing and fees
• Promotional offers
• Advertising messages
• Social media presence
This monograph provides guidelines for developing and delivering marketing
messages to attract new patients and to influence the decisions and behavior of
existing patients as they visit the practice and between visits. Marketing activities are
discussed in four categories:
• Marketing during patient visits
• Patient recall
• Between-visit marketing communications
• New patient marketing
No space is devoted in the monograph to a discussion of external advertising or
to media planning, because it is assumed that few practices will engage in such
programs. The monograph concludes with a template for creation of an annual
marketing plan.
Marketing During Patient Visits
A patient visit provides the best opportunity for ODs to create a powerful brand
identity and achieve the marketing objectives of a practice. Emails, mailings and
the practice web site do much less to influence patient perceptions of a practice
than do office visits. Personal interaction at the office creates an indelible, emotional
impression of the practice that verbal or visual communications in other media
are not likely to alter much. A patient visit experience conveys the essence of an
optometric practice brand. Visits should be carefully orchestrated to convey the
messages and impressions that will result in achieving marketing objectives and in
building loyalty and referrals.
Practice owners usually do not think of patient visits as marketing events that
create their brand image. But this key insight can be the launching pad for dramatic
improvements in patient communications.

4. 4
The MBA offers many tools to assist practice owners to structure office visits to
powerfully communicate the practice value proposition. Two particularly useful
tools include the MBA monograph tilted “Patient Experience Engineering” and
the MBA Service Excellence Workshop “Service Mapping,” both available on
www.mba-ce.com.
A patient visit is the premier opportunity to showcase what makes a practice unique
and special, as well as to educate patients about services offered and patient care
goals. It’s important that key messages be explicitly crafted and delivered. The
messages can’t be left to chance, or left for patients to decipher from hundreds of
spontaneous, non-verbal impressions they gather during a visit.
Every practice needs to decide which key messages it wants to convey to each patient.
It’s likely that the following key messages should be on every practice’s list.
• KEY MESSAGE:
“Here’s why you should continue to come here for eyecare.”
In most cities, there are plenty of eyecare providers, in both independent practice
and commercial settings. Nearly all of them provide competent eye exams and sell
eyeglasses and contacts. A powerful brand identity and patient loyalty don’t develop
by delivering just the basics that every ECP provides. It occurs only when the service
is memorable and exceeds expectations.
It’s up to every practice owner to define exactly what will differentiate the practice
from others in the community. With input from staff, think of the five to 10 things that
can separate you from the pack and keep patients coming back. Write them down.
Almost always, these are the things that your raving fans say about you when they refer
the practice to their friends and family. The MBA monograph “Mission Statements
and Practice Positioning” can help you frame what differentiates your practice.
After you decide on the major reasons patients should continue to rely on you for
eyecare, with staff input, determine how and when you will communicate these
reasons to your patients during their visits. Never assume that patients will intuit the
reasons they should return without being told explicitly. A major element of your
practice marketing program is the standard patient education script that explains
what makes your practice special.
• KEY MESSAGE:
“We provide therapeutic medical treatment for infections, dry eye,
allergy and other ocular conditions.”
Many practices assume that patients know the practice offers medical eyecare
services. But many patients do not know this and will never relate their symptoms of
ocular conditions because they assume the doctor is only interested in eye exams and
selling eyeglasses and contacts. Making it highly visible that a practice offers medical
eyecare will cause candidates for medical eye care treatment to step forward, and it
will enhance perceptions of the OD(s) as medical professionals.
• KEY MESSAGE:
“A yearly eye exam is an important preventative measure to protect
sight.”
Dentists have successfully created the expectation that semiannual visits are normal
and part of a good oral health prevention plan. Few ODs have been successful at
instilling the value of yearly exams, but they can be successful with explicit marketing
messaging. From the first words of the receptionist to the closing goodbye, the
importance of yearly comprehensive exams should be emphasized to patients.

5. 5
Each time the word “exam” is used it should be prefixed by the word “yearly.” The
appendix contains suggested scripts for doctor and staff to communicate the value
of yearly eye exams throughout an office visit.
• KEY MESSAGE:
“Your insurance allowance covers basics only.”
Half of the U.S. vision correction population has vision insurance. Few patients with
insurance understand or remember the complexities of their coverage, and many
expect that their insurance will cover the total cost of their eye exam and eyewear or
contact lenses. But, in fact, many plans cover only a very minimal and basic package.
This leads to misunderstanding and disappointment.
It should be made clear from the first contact with each patient that his or her
allowance should be considered a major discount on products and services, but may
not be sufficient to obtain products that offer the performance patients want. The
explanation should make clear which fees and charges will be covered by a patient’s
plan and which will not, before service begins.
Product recommendations should never begin with the words: “Let me show you
what your plan covers.” This can inadvertently result in self-imposed constraints on
presentation of eyewear or contact lens alternatives to limit or eliminate a patient’s
out-of-pocket expense. Insurance coverage should never dictate the sales process.
Product Mix Management
Every retail store owner knows that the array of products presented to customers--
or product mix--has a huge impact on sales and profits. The product mix a business
offers determines the average transaction size. Beyond dollars and cents, the product
mix creates an image of a retailer and a stereotype of the customers who are likely to
be satisfied by the business.
MBA surveys indicate the following benchmarks for median revenue production per
patient among independent ODs:
• $306 gross revenue per complete eye exam
• $227 gross revenue per eyewear Rx dispensed
• $150 annual contact lens sales per contact lens exam
“Your coverage pays for an exam and a very basic pair of eyeglasses, but
can be used to greatly reduce the cost of eyeglasses offering much better
performance, that most of our patients prefer to wear.”
“Your coverage pays for an exam and a six-month supply of contact
lenses. This will greatly reduce the annual cost of your lenses. For extra
convenience and savings we recommend an annual supply of lenses, at a
modest additional cost.”
“Your insurance will greatly reduce the cost of your primary pair of
eyeglasses and make it much easier to afford a pair of computer glasses
(or polarized sunwear, etc.) that will make your daily work a lot more
comfortable.”

6. 6
The same surveys show that the top performing 20 percent of practices on each
metric beat the median productivity benchmark by 50 percent or more. They well
exceed industry norms primarily through more effective product presentation, not
higher prices and fees.
Product dispensing ratios vary widely across OD practices. Disparities in usage of
individual product types, such as daily replacement contact lenses or anti-reflective
lenses, always trace mainly to ECP preferences and habits and not to patient choice
or demographics.
Unlike other retail environments, what a doctor chooses to recommend and prescribe
creates a sales mix, not what patients request or prefer.
Every practice should pay conscious attention to the product mix it routinely
presents to patients and to the details of patient education about products and the
sales process. Every practice marketing plan should set objectives for revenue per
patient and identify the strategies and tactics to improve productivity. The MBA has
developed many publications to educate ODs on effective techniques for product
mix management, including “Best Practices of Contact Lens Management,” “Best
Practices of Spectacle Lens Management” and the MBA monograph “Increasing
Gross Revenue per Patient” – all available on www.mba-ce.com.
Price Promotion
Unlike many patients of chain optical retailers, new patients of independent ODs are
seldom attracted by price incentives. New patients choose indepenent ODs because
they anticipate a higher level of personalized service and expect to pay more for the
goods and services they purchase there. As a result, optometric consultants advise
independent practice ODs not to market a practice with aggressive promotional
campaigns or ongoing discounts on goods and services. To the extent that new
patients are attracted by discounts, they tend to be less loyal because they are prone
to respond to incentives subsequently offered by competitors.
Despite the dictum to avoid price promotion, consultants recommend the following
exceptions to build revenue:
• Spectacle Lens Bundling
An effective technique to increase the average eyewear sale is to bundle lens
features into a limited number of packages, and to offer each package at a lower
price than if the features were purchased as add-ons.
• Multiple Eyewear Purchase Discounts
Multiple pair sales can be dramatically increased by offering discounts of up to
50 percent on purchase of second pairs, within a week of an eye exam.
• Contact Lens Annual Supply Discounts
Sales of annual supplies of soft contact lenses can be increased by offering
discounts of about 10 percent on the per box price of soft lens, presented in
combination with manufacturer rebates.
• Special Event Discounts
As a call-to-action to stimulate purchase during special events, event-day
discounts are effective.

7. 7
Practice Brochure
A practice brochure is essential to position a practice in the minds of new and
existing patients, identifying the service themes and value proposition that define
the practice. Keep a stack of brochures in the reception area and include them in
information kits.
Brochures should be also sent in a welcoming kit to new patients, used in mailings
to prospective patients and distributed at any public lectures given by the doctor.
Guidelines for effective brochures include the following:
• Brochures should be professionally designed. A brochure will make the critical
first impression of the practice for many prospective patients, so appearance is
important. A well-produced brochure will convey that the practice is a well-run,
highly professional business that takes pride in its reputation.
• Language and photos should convey that the practice is a caring, friendly place
that is medically up-to-date. Pictures of smiling, welcoming doctor(s) and staff
are the best devices to convey the human dimension.
• Provide a comprehensive listing of services offered.
• Provide a brief biography of the doctor and comments on any specialties or
patient care philosophy.
• If advanced instrumentation is an important asset of the practice, feature it.
• Emphasize the ability of the practice to improve the quality of patients’ daily
lives through better vision, not merely disease prevention or vision maintenance
themes.
• A tri-fold 8-1/2” x 11” design is economical to print and sufficient for most practices.
Signage and Displays
Guidelines for using manufacturer supplied point-of-sale (POS) materials are
listed below.
• Avoid display clutter.
Limit the amount of large signage and displays to a few brands—five or less in a
2,000-square-foot office. Overload may inadvertently create the impression that
the practice is primarily interested in selling products over professional care.
• Feature products offering high performance and premium profit margins.
These are often the products that appeal to segments of the market that may
never be discussed unless a patient inquires.
• Only use signage that is tasteful, professional and has high production value.
Even though you did not produce the signage, tasteless materials creates a
negative impression that reflects on your practice.
• Regularly refresh displays as new materials become available.
Faded or dated posters signal that the store is not being properly minded and
that the practice is out-of-date.
Patient Recall
Among all marketing processes, a practice’s recall system has a larger impact on
financial performance than any other and yet many ODs devote little management
attention to it. A 2011 MBA survey revealed that the median independent OD practice
spends just 3 minutes of staff time on recall activities per exam performed. Assuming
an hourly staff salary of $15, just 78¢ is spent on recall per exam in typical practices.

8. 8
Surveys among independent ODs show that nearly all recommend yearly exams
to contact lens patients, 80 percent recommend yearly exams to presbyopes who
wear eyeglasses-only and 69 percent recommend yearly exams to non-presbyopic
eyeglass-only wearers.
Most practices do not track the average interval between patient eye exams and
therefore can only guess at the average elapsed time before patients return. ODs
recognize that not all patients comply with their recommendations, and they guess
that contact lens wearers return for exams every 14 months and eyeglass-only
wearers every 18 months. But actual patient compliance with OD recommendations
on when to return does not reveal such a rosy picture. Patient surveys reveal that the
average interval between exams for contact lens patients is actually about 18 months
and is 28 months for eyeglass-only wearers.
Confirming these statistics, MBA surveys show that during a year, in typical
established independent OD practices, about 40 of every 100 active patients have an
eye exam. That’s equivalent to an average interval of two-and-one-half years.
Because many ODs have not done a good job conveying the value of annual exams
as a preventative measure, patients, left on their own, tend to wait until they notice
a vision change or problem, have a mishap with their eyewear or need more contact
lenses before they call for an appointment. It’s clear that when ODs take charge of
the recall process, proactively setting the date of patients’ next exams and confirming
appointments, they reduce the interval between exams.
Reducing the interval can have a major positive impact on practice revenue not only
by increasing professional fee income but by increasing product sales as well. The
table below shows that reducing the average interval between exams from the typical
2.5 years to an optimal two years increases the number of exams and gross revenue
by 25 percent. Clearly, effort to improve recall success will be time well spent.
Average Interval
Between Exams
Years Months
Median practice
Optimal
Annual
Complete
Exams
2,000
2,080
2,175
2,275
2,380
2,500
2.5
2.4
2.3
2.2
2.1
2.0
30.0
28.8
27.6
26.4
25.2
24.0
Annual
Gross
Revenue
$600,000
$624,000
$652,500
$682,500
$714,000
$750,000
Impact of Reducing Interval Between Eye Exams*
*Assumes 5,000 active patients, $300 revenue per exam

9. 9
Every OD practice needs a consistently executed recall system to reduce the interval
between patient eye exams. Pre-appointment for the next exam at the conclusion
of each eye exam is a best practice used by four-in-10 independent ODs. MBA
surveys show that a median 75 percent of pre-appointed patients have an eye exam
within three months of their pre-appointment. That compares to a median of just
40 percent who have an exam after receiving a recall mailing. See the MBA “Patient
Recall Survey: 2011” report on www.mba-ce.com for a more detailed discussion of
effectiveness of recall techniques.
An MBA monograph titled “Effective Patient Recall” outlines a detailed marketing
process to improve recall success, available on www.mba-ce.com.
Between-Visit Marketing Communications
Just 46 percent of independent ODs say they regularly communicate with patients
between office visits. That means in typical situations two or more years pass in
silence with no contact with individual patients. That silence opens opportunities for
competitors to communicate their value propositions to your patients.
Electronic communication is a very cost-effective method of communicating with
patients between their office visits. As of 2010, eight of 10 adults used the Internet and
nearly half used a social network. Use is nearly universal among people under 65 years
of age. For a majority of adults, email has become a daily means of communication
with friends, family, businesses and institutions. Electronic communication has
rapidly replaced the postal service for much personal communication and is also
capturing market share from traditional telephone services. All businesses must
adapt to the changed communications environment.
Some of the many uses of email to communicate with patients between office visits
include:
• Birthday greetings
• Compliance reminders
• Recall notices and eye exam reminders
• Opinion surveys
• Announcements of new services, significant new products, special events
• Staffing change announcements
• Articles about eye health topics
• Product promotions
• Thank-you for referral
There has been an upsurge of OD email communications with patients. Currently
63 percent of independent ODs say they use email regularly to communicate with
patients, but most still do not maximize their use. Affordable outside services are
available to manage email communication. Receptionists should be taught to gather
email of address from all patients and ask each patient to confirm their current
address. MBA faculty member Dr. Neil Gailmard tells his front desk staff that
getting an email address is just as important as getting a patient’s telephone number.
When a practice’s email address list is linked to its practice software system, it
becomes possible to customize electronic communications to selected individuals
or targeted segments within the patient base, increasing the likelihood that emails
will be read.
As of early 2012, some 68 percent of independent ODs say they host a social media
business page. If well managed, these pages can become an effective way to maintain
contact with patients between visits as well as to generate new patients. For a
discussion of how to get started building a social media presence, see Dr. Gailmard’s
Management Tips of the Week numbers 465 and 527 on www.optometric.com.

10. 10
Practice Newsletters
Just 30 percent of independent OD practices publish a newsletter--despite the fact
that Email has made transmission of newsletters virtually cost free.
Optometric veteran Dr. Irving Bennett devotes a chapter of his book Optometric
Practice Management to newsletters. He views this vehicle as an ideal way to keep
in touch with patients during the long interval between office visits which averages
more than two years. He prefers a format that gives the appearance of being a
personal letter from the optometrist, but professionally formatted newsletters can
also be effective.
Appropriate content for newsletters includes:
• Layman’s explanations of ocular disease, prevention tips, new medical research
findings
• New staff member profiles
• Awards or recognition received by doctor or staff
• Doctor publications or speaking engagements
• New instrumentation and testing procedures
• New services
• New product information (While product information is appropriate, the
newsletter should not contain a preponderance of product promotions to avoid
the appearance of commercialism.)
• Special events and promotions
• Reinforcement of the practice positioning
Other guidelines for newsletter production include:
• Hire a freelance writer to develop copy if you are uncomfortable with writing.
Discomfort with writing is one of the major reasons ODs do not undertake
newsletters. You can easily guide a freelancer to craft your message.
• Keep articles brief and conversational, no longer than three to five paragraphs.
• Pictures of the staff, instruments, facilities, products and illustrations of ocular
conditions add interest.
• Publish two to four times annually. Less frequent publication will reduce the
newsworthiness of the content.
• Request support from key vendors in return for mention of their new products
in the newsletter.
Special Events
Conducting trunk shows and open houses are widely used and highly effective
means of gaining a strong short-term revenue boost for a small investment of time
and money. They also inject a sense of fun and news into a practice and are a way to
maintain contact with patients between routine eye exam visits. Most optometrists
partner with frames vendors or contact lens companies to fund the events.
Guidelines for planning and executing special events include:
• Announce the event two months in advance. Target the specific audience most
likely to be interested. If supported by frames vendors, send a mailing to patients
who have bought the vendors’ brands in the past or those with high interest
in new frames styles. For contact lens events, target patients matching the
demographics suggested by the manufacturer sales representative. Post the event
details on the practice web site. Send a reminder notice one month before the
event. Ask for RSVPs.
• Offer catered food and beverages. This makes the event festive, will draw
attendance and is a way to thank patients for their past support.
• Do not conduct eye exams during the event. Instead, the doctor and staff should
mingle with guests.
• Put the expertise of frames sales reps to work to present styles to event guests.
• Offer discounts to encourage sales during the event.

11. 11
New Patient Marketing
Practice Web Sites
Nearly 80 percent of American adults have Internet access. The Internet has become
a frequently used source of information about products and services that is gradually
replacing traditional vehicles such as the Yellow Pages and service directories. Few
retail businesses today can afford not to have an Internet presence.
MBA surveys reveal that 80-85 percent of established practices have a web site.
But surveys and visits to dozens of optometric sites also reveal that relatively few
practices have harnessed the full power of their web site. Just 29 percent of practices
update their site monthly or more frequently. A 2011 MBA survey indicated that
the median expenditure to host and manage OD practices websites is just $360.
Spending on websites accounted for an average of 12 percent of total marketing
spending by optometric practices during 2010. The median expenditure to maintain
a practice website was $360. Some 17 percent of practices reported spending nothing
to maintain their website during the previous year. Another 26% of practices spend
more than $1,000 annually to host and maintain their site.
The 2011 MBA Web Site Survey showed that ODs estimate that just 4 percent of the
new patients they served during the past year were initially attracted by their web site.
But some practices attract 20 percent or more of patients with their sites. The survey
revealed a positive correlation between the amount of money spent to maintain
the site and the number of new patients attracted and between the frequency of
site updates and the number of new patients generated. For more details see the
“Practice Web Site Management Survey: 2011” on www.mba-ce.com.
Think of a web site as an unpaid staff member on duty 24 hours a day to answer
questions and present the practice in the best possible light. A practice web site has
two important functions:
• Attract prospective patients and communicate a differentiating practice story
that will cause people to make appointments.
• Communicateefficientlywithexistingpatientsincludingappointmentscheduling,
medical history updates, promotion and product news, contact lens reorders.
Visits to more than 100 optometric web sites reveal much opportunity to improve
the effectiveness of typical practice web sites. After reading this section, go to your
own site and assess what you see against the guidelines provided in this section.
The most significant defect found in a majority of optometric sites is that a site fails
to tell a memorable story about the practice that differentiates it from every other
eye care provider in a community. A typical optometric site conveys about as much
human personality and distinctiveness as a typical Yellow Pages display ad.
$0 $0 $100 $200 $300 $360 $500 $500 $900 $1,200 $3,400
percentile ranking
Source:August 2011 MBA Web Site Survey
5th 15th 25th 35th 45th 50th 55th 65th 75th 85th 95th
Low Median High
Annual Practice Web Site Spending

12. 12
If no distinctive words or images are present on the home page, the impression left is
that this is a cookie-cutter, plain-vanilla optometric practice, offering about the same
services that are available anywhere. Such sites fail to answer the question: “Why
should I trust my vision to this practice?” A web site is an excellent vehicle to create a
distinctive positioning of a practice, giving prospective patients a compelling reason
to make an appointment and a memorable story that current patients can tell others.
Some sites make it obvious that the practice devotes little attention to
e-communications. Telltale signs of this are news items (new doctors, new staff,
special events) on the home page that are outdated. Another indicator is that the
most recent practice newsletter is two years old or more. Other sites have expired
promotional offers prominently featured. Existing patients will notice if there are
photos showing staff who have left the practice. Inattention to the timeliness of the
information on the site conveys to both current and prospective patients that the
practice is not paying much attention to detail.
A few optometric web sites appear more interested in selling products than providing
professional care, with home pages dominated by images of new frames styles, new
contact lenses or new spectacle lenses. This leaves the impression that professional
care is a subordinate element in the service provided.
EyeCarePro.net, a leading developer of optometric web sites, estimates that
optometric sites typically receive about 202 visits each month for every optometrist
working in the practice. It’s safe to assume that each visitor is looking for information
that would otherwise need to be provided on the telephone which consumes valuable
staff time. Using the practice web site to communicate information efficiently can
provide important cost savings.
An analysis of the traffic at 100 optometric web sites conducted by EyeCarePro.
net revealed that 75 percent of site visitors were first time visitors, never having
visited before. This does not mean that all new visitors are not current patients,
but it suggests that a high proportion of optometric site visitors are not patients
of the practice. Prospective patients are looking for someone to entrust with their
eyesight, and a practice web site must quickly answer the question: “Why should I
trust my vision to this practice?” The answer must be delivered in a flash, because
the competition is just one click away. Perhaps surprisingly, relatively few practices
attempt to answer this question on their home page, and some do not answer it
anywhere on the site.
What do patients want from independent practice eye care providers? For most
people, it boils down to three things: 1) professional competence; 2) personalized
attention and caring; 3) life improvement through better acuity and quality of
vision. They choose providers who appear to satisfy these needs. The home page of
your site should telegraph how the practice will satisfy the three primary desires of
prospective patients.
Two other reasons people select eyecare providers are to have a convenient location
near their residence or workplace and to have their vision care insurance accepted.
Home pages should convey the convenience of a practice’s location and should lead
visitors effortlessly to a listing of accepted insurance plans. Contact information and
office hours should be found easily on the home page.
Here are the other topics most frequently searched for:
• Insurance coverage
• Questions about ocular conditions
• Medical history update
• Appointment scheduling
• Contact lens reorder

13. 13
The home page navigation bar should lead patients with a minimum of searching or
clicks to this information.
Community Outreach
Many optometrists believe that active involvement in their local communities is one
of the most effective strategies to establish a practice during its formative years.
This means being active in church, civic, service and philanthropic organizations.
It may also include offering services to local schools, nursing homes, senior centers
or manufacturers or conducting seminars at community or club gatherings. Dr.
Gailmard’s Management Tip of the Week #464, available on www.optometric.com,
provides a good discussion of community involvement opportunities.
Patient Referrals
Many optometric practices do little external marketing and rely on referrals from
existing patients to generate new patients. Referrals occur only when patients are
extremely satisfied with the care they receive and feel comfortable recommending
the practice to others.
A good indicator of the quality of patient service of an optometric practice is the
percentage of new patients generated by patient referrals. Independent ODs estimate
that a median of 30 percent of their new patients come from patient referrals.
Consistently delivering exceptional patient experiences is essential to achieving a
high number of patient referrals. This aspect of marketing the practice is discussed
under “Marketing During Patient Visits” above. In addition, referrals can be
encouraged in the following ways:
1. At the conclusion of each eye exam, ask patients for referrals.
Tell each patient that the practice welcomes referrals. In busy practices, existing
patients may assume that the practice is too busy to accept new patients. Say: “We
hope you were pleased with the professional care you received today, which many
of our patients tell us is a great value. If you were happy and know people who
might benefit from our care, could you give them one of our business cards?”
Provide several business cards to receptive patients.
2. Ask each married patient to refer their spouse and each parent to refer their
children.
As an eye exam concludes, ask married patients if they would like to schedule
an exam for their spouse or children. Tell them it’s easy to reschedule if the
appointment time does not work. Give the patient a reminder card(s) of the
scheduled appointment(s). When entire families are already patients of the
practice, before performing an exam for one member of the family, check the
records of the other family members to determine if the others are due for an exam.
Mention this to the patient having an exam and ask to schedule appointments.
Tell them it’s easy to reschedule if the appointment time does not work. Give the
patient a reminder card(s) of the scheduled appointment(s).
8% 10% 20% 20% 25% 30% 33% 45% 50% 65% 80%
percentile ranking
5th 15th 25th 35th 45th 50th 55th 65th 75th 85th 95th
Low Median High
% of New Patients from Patient Referrals

14. 14
3. Ask caregivers to refer aging parents.
Add a question to the medical history form asking if the patient is responsible
for supervising the medical care of an aging parent. Suggest that the caregiver
recommend the practice to the parent.
4. Offer incentives for patient referrals.
Send $10 gift cards to patients who refer a friend or relative. Mention this reward
to departing patients. Another idea is to conduct an annual referral contest,
awarding a weekend at a deluxe hotel to patients who make the most referrals
during the year.
5. Send a personal thank-you for each patient referral.
Send a personal handwritten note to each patient who makes a referral,
thanking them for their trust. This will deepen the relationship and encourage
additional referrals.
6. Encourage Facebook fans to write about their experience.
Publicity
With a minimum of effort, it is possible for practices in smaller communities to
obtain free press coverage of practice news. Local newspaper coverage can attract
new patients as well as enhance the reputation of the practice among existing
patients. As part of the annual marketing planning process, make a short list of the
topics that could be developed into press releases. A rule of thumb is that editors
will discard material that is promotional or self-serving, but will use information that
readers will find of interest or that educates the public. Appropriate topics for news
releases include:
• New research findings about common ocular conditions such as dry eye,
glaucoma or diabetic retinopathy
• Significant new product introductions by manufacturers
• Special events
• Awards and recognition received by the doctor or staff
• Support for local charities and civic organizations
Developing an Annual Marketing Plan
Every practice needs a simple marketing plan, but just 23 percent of established
OD practices develop one. Creating a plan does not need to take a lot of time. The
purpose is not to create a long document that will sit on a shelf. The chief reason to
develop a plan is that it forces you to prioritize your marketing objectives, targets
and messages. The focus will create a consistency often lacking when marketing
decisions are made in reaction to short-term crises or suggestions from vendors or
colleagues. An annual plan will help assure a continuity of effort and that adequate
resources are committed.
The best time to draft the annual marketing plan is after the annual financial goals
for the practice have been set and the principal growth strategies identified. This will
assure that the marketing objectives mesh with the overall business plan. The MBA
has developed a Management Improvement Implementation Track on Marketing
which outlines the analytical steps that should be taken to develop an annual business
plan, available on www.mba-ce.com.

15. 15
A practice marketing plan can be summarized on just a few pages: Key elements
include the following.
• Objectives — A quantitative statement of the results desired. Ideally, select
objectives on an analysis of business metrics and a comparison to performance
norms found in this manual and other sources. Aim to improve weaknesses in
practice performance. Objectives should be limited to five or fewer. They could
include the number of new patients to be attracted, revenue forecast from a
promotional program, an increase in the average revenue per patient, a reduction
in the interval between exams, an increase in recall success rate.
• Strategies — The broadly defined approaches that will be used to accomplish
the objectives.
• Tactical Plan — The specifics of implementation of the plan (communications
vehicles, frequency, timing, promotional offer terms, etc.).
• Budget — Monthly spending schedule.
An example illustrating the relationships between objectives, strategies and tactics
appears below.
Attract new patients Increase patient referrals -Offer referral incentives
-Improve service perception
Sponsor media advertising -Run newspaper ads
-Conduct mass mailings
Acquire a second practice -Purchase ABC Eye Care
Increase revenue Upgrade product sales mix -Encourage AR lens purchases
per patient visit -Increase daily disposable lens
Rxes
-Increase penetration of
multifocal soft contact lenses
by upgrading monovision
patients
Increase multiple pair sales -Discount second pairs 50
percent
Increase retail pricing -Increase photochromic lens
mark-up to 2.8 x COG
Improve capture rate -Upgrade frames displays
-Increase soft contact lens
annual supply sales ratio by
proactive presentation
Expand services -Offer glaucoma treatment
-Offer low vision services
Increase frequency Improve patient recall -Pre-appoint patients
of patient visits methodology
Promote new product arrivals -Conduct new product
mailings, e-mailings
-Conduct trunk show
Objectives Strategies Tactics
Sample Annual Marketing Plan
Item Monthly Expenditure
Sample Annual Marketing Budget

16. 16
Scripts to Reinforce Importance of Yearly Exams
• Appointment scheduling: “I want to confirm the date and time of your
scheduled yearly eye exam.”
• Reception: “Welcome back. It’s great to see you. I see you’re here for
your yearly eye exam. That’s a great way to enjoy the peace of mind of
always knowing everything is fine with your vision.”
• Escort to Testing Room: “Please follow me and we’ll get started with
your one-year tests.”
• Start of yearly testing: “We’ll be doing a series of tests to be sure
that everything is fine with your eyes. It’s important that we do these
every 12 months, because problems can begin to develop over those
months, and you may not even notice any symptoms.”
• During the yearly testing: “This instrument is a retinal camera. By
recording a digital image of your retina, we can compare next year’s
picture to the one I’ll take right now. That will allow us to detect any
subtle changes that are occurring.”
• Conclusion of yearly testing: “The doctor will explain what the yearly
tests show. We’ll perform these procedures again 12 months from now,
to be sure that no problems will go undetected that could threaten
your sight.”
• Start of eye exam: “Good to see you again. The year went by so fast.
I want to compliment you on your good judgment to look after your
eye health every year. I recommend that to almost everyone. I have
some patients with serious problems like glaucoma or diabetes who
come back more often. But so far you’ve been fortunate to only need
to come back once a year.”
• Handoff to optician: “Thanks for coming in. I look forward to seeing
you again one year from now.”
• Contact lens fitting: “We encourage our patients to visit us every year
to monitor their eye health. While you’re here it’s also an opportunity
for you to see some of the new eyewear options that are continuously
being introduced.”
• Check-out/Departure: “We look forward to seeing you in 12 months
for your next comprehensive eye health exam. You will be getting a
reminder from us about six weeks before your reserved appointment
time. Don’t worry about the exact day or time now. We’ll have plenty
of time to change that, if necessary. Thanks for trusting us to look after
your vision.”
Appendix

17. 17
Internal and External Marketing “Best Practices”
1. Hire a local advertising agency to create a distinctive graphic identity and logo for
the practice. Use those graphics on all marketing materials.
2. Develop a positioning statement encapsulating the key patient benefits of the
practice. Communicate the positioning in all marketing materials.
3. Develop relationships with leading product vendors and use the co-op money
they make available to invest in marketing communications programs.
4. Measure the performance of all marketing initiatives. When ads are run, include a
device on the ad to enable identification of those who respond. Measure incremental
revenue from special events. Track success of promotional offers. Ask every new
patient how he or she learned about the practice and record responses in a log for
later analysis.
5. Continuously inject news into marketing programs—new instrumentation, new
technology, new products and new promotions. News attracts, news signals growth,
and news conveys your intent to keep current.
6. Except for incentives to buy second pairs of eyeglasses, avoid continuous use of
discounts. Cash incentives degrade the perception of value and lower profit margins.
7. At the start of the office visit, ask every patient wearing eyeglasses if he or she
intends to purchase a new pair of glasses today. This makes it less likely that people
who learn they have no prescription change will avoid purchasing eyewear.
8. Develop a script to answer telephone inquiries from prospective patients who are
shopping for a new eye doctor. Include statements about the practice positioning
and the doctor’s strengths. Ask to book an appointment and make every attempt to
accommodate the new patient’s desires for date and time.
9. Ask female household heads during their office visits if they would like to schedule
appointments for other family members. Suggest tentative appointments be made for
the spouse and children, even when the schedules of the other family members are
not known. Explain that it is easy to reschedule an appointment if there is a conflict.
10. Avoid expensive Yellow Pages display ads. A consensus of optometrists
interviewed by Bob Levoy, author of 201 Secrets of a High Performance Optometric
Practice, is that Yellow Pages have limited value attracting new patients. They are
referenced most by existing patients, so a simple listing is sufficient.
11. Provide departing patients a kit of information including written exam summary,
compliance or product usage instruction, warranty, receipt itemizing fees and
purchases and practice brochure. Enclose in a branded folder.
12. Build a referral network of other medical professionals in your community
including primary care physicians, retinal specialists, cataract and refractive surgeons,
pediatricians and school nurses. Offer reciprocal benefits to these professionals.
13. Offer to speak about eyecare to groups of seniors, athletic teams or civic
organizations.
14. Use practice management software to create a patient database that categorizes
patients by age, sex, ocular condition, product usage and personal interests. This
will enable you to target communications effectively and efficiently.
15. Put the practice web site address on business cards, stationery, invoices and other
marketing materials as well as on optometry directories and on-line doctor finders.
16. Gather e-mail addresses of patients. Ask them to verify their e-mail address
during each visit or when they call to make an appointment. Then use email to
communicate practice news to patients.

18. 18
Marketing Idea File
1. Referral contest. Offer a weekend at a deluxe hotel to the patient who refers
the most new patients to the practice during the year. Announce the contest in the
practice newsletter, on the practice web site and in a flyer given to patients as they
depart the office.
2. Caregiver referrals. Add a question on the patient history form asking if the
patient is responsible for supervising the medical care for an aging parent. For
patients with caregiver responsibility, offer to provide your services to their parent.
Consider offering to have a staff member pick up the parent for his or her first visit.
3. Vision benefit expiration. In October and November, send letters or e-mails to
patients with vision benefits, reminding them there is still time to use their benefits
before they expire at year-end.
4. Frames aficionados. In every practice there are patients who enjoy having many
different frames for different events in their life or to match different outfits. A list
should be maintained of these patients. As new frames styles are brought into the
practice, send mailings or e-mails to this list. Frames vendors will likely provide
funds to defray expenses.
5. Plano sunglass gift certificate. In May, send a $20 gift certificate toward purchase
of a pair of plano sunglasses retailing for $60 or more to a targeted list of patients.
6. Local retailer co-promotion. Partner with a local retailer that targets the same
demographic as your most loyal and highest spending patients (beauty salons, luxury
car dealers, weight control clinics, high-end jewelers, travel agents, high-end clothier,
spas). Send a $50 gift certificate toward purchase of a complete pair of eyeglasses to
the partner’s customers who are not current patients of the practice.
7. Prize drawing. Place a fishbowl in a favorite local restaurant near the practice.
Offer a free weekend getaway at a luxury hotel in a prize drawing to anyone who
puts a business card or entry slip into the fishbowl. Gather the names and addresses
of the entrants and send a $50 gift certificate to each who is not a current patient.
8. Church donation. Approach the business manager or head of development of
your church or synagogue. Offer to mail a $25 gift certificate to congregants who are
not current patients and to donate $25 to the place of worship for each certificate
redeemed.
9. Partner retailer promotion. Offer a local retailer to mail a gift certificate for its
business to your patient base, at the expense of the partner. The certificate should be
forwarded with a letter from you thanking your patients for their trust.
10. Advertorials. Place paid monthly articles in your local newspaper discussing eye
health topics and featuring you, members of your staff and new instrumentation
and products. These articles are paid placements but have the appearance of being
written by the newspaper, avoiding a promotional appearance. This is a cost-effective
way to attract new patients and to elevate the reputation of a practice among current
patients.
11. Anti-reflective (AR) demo glasses. Request a spectacle lens sales representative
to provide a pair of glasses in which one lens has AR treatment and the other does
not. At the conclusion of each exam, put on this pair of glasses and demonstrate to
the patient the difference in the reflections. Also mention that AR lenses allow more
light to pass through to improve vision and make it easier to see while driving at
night. Close by saying, “I recommend AR lenses for all glasses.”
12. School outreach. Provide “eyecare emergency kits” to local school nurses
including contact lens cases, lens disinfectants, artificial tears, saline, eyeglass repair
kit, etc. Deliver the kits in person and include referral cards. Offer to be available in
emergencies, to renew supplies and to speak.
13. Community lectures. Speak about eyecare to local service clubs, civic groups,
senior centers and nursing homes. The AOA provides lecture materials.
14. Pharmacist outreach. Introduce yourself to pharmacists in your community, and
offer to treat patients who appear at the pharmacy suffering from red eye or other
ocular complaints. Provide referral cards to pharmacists.
15. Safety glasses. Contact the human resources departments of local manufacturers
and offer to provide safety glasses to employees.

19. 19
16. Free vision screenings. Offer to conduct free vision screenings for employees
to the human resources department of local manufacturers. Provide contact
information to all people screened. Offer to be the no-charge consultant of the
company for vision problems.
17. New-resident mailing. People who recently moved into your area may be looking
for a new eye doctor and are likely a productive target for external advertising.
Companies such as Welcome Wagon provide a vehicle to reach these people. Lists
can also be constructed from other sources. Send a personal letter and an office
brochure to new residents in a hand-addressed envelope.