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How the Managed Care Monster Crushes
VT: Exploring the Causes and Cure You get busy with primary care, the staff gets buried in claims and it seems there is never enough time to effectively present your VT case to candidate parents. Therapy dwindles, therapists quit, parents just say no to therapy. How does a doctor with a managed care caseload, and a deep interest in VT wind up in this situation? Is it possible to shake off the third party yoke and make vision therapy the centerpiece of a practice? We’ve helped dozens of doctors in this situation reverse course. Here’s what we’ve learned. The conventional wisdom in optometry is that to be successful, you need to sign up for a couple of third party plans to get access to potential patients. The problem begins with the difference between the patient experience of a high volume practice and a behavioral or developmental optometrist’s care. The behavioral OD provides an exacting visual analysis, does more testing and writes a more accurate and subtle Rx that really helps. Compare that to a typical 7 and 4 and out the door eye exam, a one-solution-fits-all Rx that doesn’t work as promised or makes vision worse--"just wear it for awhile until you get used to it." TOO BUSY FOR VT Which is better, one or two? Plan members quickly fill in available appointment slots but pay discount fees. The conventional wisdom says, structure your practice for efficiency, see more patients in less time. Hand off pretests, cut down on Hx time, break into the next patient’s case presentation time to get back to the dilated previous patient. Cut out "unnecessary" tests. When a potential VT patient arrives, doctor has little time for testing or to make a convincing case presentation. We find it takes from 90 minutes to three hours of communication for a parent to know VT is the best choice. But in an efficiency-driven model, there’s never that much time so most parents either raise objections, decline outright, or put off the decision by saying they want to find out about insurance or learn more about VT on the internet. The bottom line is that a patient flow and communication structure that makes a third party based practice viable usually manages to suppress VT. That means thousands of children will never get the vision therapy they need in order to have a great future. SOLUTIONS: That’s the problem, now what’s the solution? Making VT thrive alongside a primary care practice requires reorganizing for effectiveness, not efficiency. For us, managed care plans are a marketing expense, a way to access not only patients, but their families, the people they know, the groups to which they belong, the educators and other professionals to whom they are connected. An efficient operation wastes this wealth of contacts because it does not incorporate time to make and follow up on those connections. A VT friendly practice organized for effectiveness has systems in place to make certain that compelling communications occur during every single interaction with patients, parents, educators and professionals in a position to refer. The first phone call is a pivotal conversation. In our system, the Patient Care Coordinator asks open questions about what is happening with the patient’s vision. The process allows quick detection of a potential VT patient. PT. PREPARATION: Once detected, the PCC conducts an interview designed to have the parent become certain that the problem is probably visual and that this is the office with a solution. There should be no hard sell, but a reach into the powerful emotions that often go along with dealing with such a child. Finally, the parent is prepared for a step by step intake process, alerted to the potential costs involved. The outcome is that the parent and child arrive seeking therapy, fully prepared to handle costs and time demands of therapy. If the caller's issues seem overwhelming or the caller is doubtful, the parent or patient is directed to an alternative intake process, starting with an effective workshop so they have a deeper experience of vision as a source of their child’s problem. If outside issues are a stopper, the doctor doesn’t invest precious chair time until the concern is resolved.. In our system we have staff keep in unobtrusive touch with the parent until they are finally ready to act. An effective practice’s system allows and charges sufficiently for doctor time to test for, demonstrate and get to the heart of the matter with every potential therapy patient or parent. It takes considerable time to develop the kinds of interactions that work best, and more to train all staff to learn to conduct them to maximum effect. The payoff for all that effort (or for getting consultative help) is that every assistant tells the same story so patients are fully prepared for each step and there are no unpleasant surprises to cause parents to balk. PARENT ORIENTATION: An effective system includes a plan for ongoing coaching and inspiration. This assures that every staff member knows in their heart that performing their role with joy means that more child and adult patients will have a better life. An effective system doesn’t rely on some hard sell artist who knows how to manipulate the emotions of parents to close a sale. Such people don’t last long around vision therapy practices because parents seldom trust them. In an effective practice, patient contacts with staff are compassionate, full of caring and empathy for what it's like to contend with a child with serious visual issues. An effective system continually probes for and captures all the connections between patients and the community and conducts a steady program of internal and external to take the VT message out to the community. This includes ongoing contacts with referral sources, past and prospective patients and parents and to organizations and media you want to have present the vision therapy story. GOING IT ALONE We know a few doctors will read this and put it into action on their own. Good for them. But many more doctors will remain stuck unless they get some support. You don’t have to do this alone. Long days, disappointing earnings, little or no VT activity, paperwork hassles, ho-hum staff and ho-hum days in the office. The future looks just like the past unless something changes. There is no way an article can give you exact details and methods for shifting VT into the forefront of a practice. Training doctor and staff in our method takes several days of onsite work, plus extensive phone and email support. But we hope that the information in this article will help committed doctors take steps to make VT a strong factor in their primary care practice.. Lecoq Practice Development is a great source of help making changes that get vision therapy rolling. We have the system, training and coaching, software, materials for communication, marketing and PR. We teach you and your staff how to deliver the VT message in a way that has parents arrive seeking VT and guide you through implementation. Look through our web site. You’ll find many helpful and informative details and even a few free items on the Download page. Be sure to read about our new program, the More Patients Breakthrough Course, which provides a big head start for expanding VT. If you have had enough of ho-hum optometry and want vision therapy to grow and thrive, take time to download and fill in our questionnaire about your practice. Fax it to Thomas or Amee Lecoq and we’ll call to discuss what might be possible for you. We don’t preach or practice hard sell, so expect your complimentary preliminary phone consultation to be helpful and informative. |
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