Build it and they will come. Oh my, they're already here!

The often-used phrase in the first half of the title of this article is taken from the movie "Field of Dreams," in which Kevin Costner, hearing voices and interpreting them as a command, builds a baseball diamond in the middle of a rural Iowa cornfield. People not familiar with the circumstances considered that to be foolish.

Analogously, ophthalmology is being asked to do something similar these days.

The American Academy of Ophthalmology (AAO) recently published three white papers under the title "The Boomers Are Coming! The Boomers Are Coming!" To torture the movie references a little further, that is a take-off on the movie titled "The Russians Are Coming! The Russians Are Coming!" in which the citizens of a small New England town become convinced they are being invaded.

Two years ago, the first baby boomer turned 60 years old. That was a significant demographic event because, as the study points out, 80 million baby boomers will become Medicare-eligible in 2011. The eyes of some people in that significant demographic group are beginning to become "sick." That means they are already beginning to present at ophthalmology practices; therefore the second half of the title above.

The AAO white papers also point out that the number of ophthalmologists is not expected to rise. In marketing terms, ophthalmology is being asked to handle a substantial increase in demand with a static amount of supply.

From a dispensary standpoint, those facts have numerous implications:

1. A greater need for efficiency. Practices will need to see more patients in 1 hour than they currently do. That means changing the way ophthalmologists currently see patients, specifically, more delegation.

2. Increased use of optometrists. Hiring ODs to see patients who require only routine vision examinations and those requiring postoperative follow ups would take the baby boomer class of patients off an ophthalmologist's schedule. Because ophthalmologists conduct 40% of the routine vision examinations currently performed in the United States, such a paradigm shift would significantly increase capacity.

3. Increase dispensary size. The input of a dispensary is the output of the medical practice that supports it. As patient demand and practice throughput rise, so will the demand for dispensary services.

4. One-stop shoppers. One psychographic characteristic of baby boomers is that they were raised as "one-stop shoppers." Their purchasing patterns are highly influenced by convenience, and they consider their time to be valuable enough to trade dollars for it. That is attested to by the capture rates of patients who purchase their eyeglasses at private optometry offices and commercial chains, the outlets where these customers currently purchase eyeglasses (85% for the former and nearly 100% for the latter).

5. Conspicuous consumers. Baby boomers have very different buying habits from their parents who were raised during the Depression. Boomers are known for spending money on high-tech consumer products and fashion merchandise, which includes eyeglass lenses and frames, respectively. As a result, I expect the sell-through of those items to rise as a percentage of customers seen.

6. Need for better-trained opticians. Opticians will be asked to work with customers who are more savvy. That will require ODs to know more about the features, benefits, and advantages of the products they offer and to be able to help customers select frames that will enhance their appearance. Such additional job responsibilities will be possible only if the opticians are well trained in sales and fashion dispensing techniques.

7. Bigger will be better. No one expects reimbursements to increase. Efficiency can come from the economies of scale that larger practices and larger dispensaries can provide.

author info

Arthur De Gennaro is president of Arthur De Gennaro & Associates LLC, an ophthalmic practice management firm that specializes in optical dispensary issues. De Gennaro is the author of the book The Dispensing Ophthalmologist, slated for release by the American Academy of Ophthalmology this summer. He can be reached at 803/359-7887, arthur@adegennaro.com
, or through the company's Web site, http://www.adegennaro.com/.

References

The boomers are coming! The boomers are coming! Preparing your practice for the onslaught: A series of white papers by the Task Force on Efficient Practice Models. American Academy of Ophthalmology Web site. Available at: http://www.aao.org/practice_mgmt/boomer.cfm/. Accessed April 28, 2008.

Caring for the eyes of America: A profile of the optometric profession. 8th ed. St. Louis, MO: American Optometric Association.