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Ramp Up:  Getting Serious About VT Growth

By Amee and Thomas Lecoq

Many clients come to us when seeing 15-18 patient visits per week.  Some of them have been stuck at that average for some time, see-sawing up and down, not really making enough to call therapy profitable and unsure about what to do next.

Many of these doctors know a lot about delivering therapy, having done a lot of it themselves.  And, often, they’ve been in this situation for years.  What to do?

This series will outline the steps required to build a serious VT practice, but none of it means anything until a doctor says “I’m not sure how, but I’m going to build up Vision Therapy no matter what.  It helps when this is a public declaration, made to people who will hold the doctor to their word, even when the inevitable hurdles appear.  A supportive spouse and friends help too.

How to build a great VT practice is no mystery, there is a certain pattern of actions, communication and behaviors that are common to every thriving practice.  Once the commitment is made, we suggest you think of the building process in terms of units of 30 patient hours of therapy per week.  This is the number of hours a full time (or 2 part time) therapist(s) can handle in a 40 hour work week.  Much more than that and you will have turnover.

The next step is to fill certain staff positions, begin training therapists, make changes in primary care to generate VT patients, and hire a Vision Therapy Administrator (VTA) who will do the work required to keep the growth and patient flow growing.

This will require some capital, perhaps a loan or tapping reserves. In most practices we work with, it also means raising fees to a more realistic level.  For example, a course of 36 sessions for a relatively uncomplicated learning related case should generate between $8,000 and $10,000.  Before long, you will find that many parents with such children have already spent that and more on unsuccessful interventions. 

In our Essentials for Vision Therapy Success course, you’ll learn how to present this in a way that works.  You will charge a moderate amount for the initial evaluation, a larger amount for the more advanced perceptual battery of tests, and then cash or credit, for the balance.  When we present this in our Essentials course, it becomes clear that charging less does not increase patient enrollment. 

That’s where a well trained VTA comes in.  Their most important role is to escort the parent or adult patient through the entire enrollment process, in particular, the initial phone call.  It takes us several days to fully train a VTA to handle this “Triage” call.  The objective of both the call and the doctor’s initial evaluation is to have the parent come to see for themselves that vision is the problem and, by implication, that you have the cure.

The Triage call begins with a question about "what’s going on with the child’s vision?"  The response determines whether the patient goes onto the primary care track, or your VT track.  The conversation that follows gently probes what the parent and child are experiencing.  By listening and asking probing, then predictive questions, the parent realizes that the VTA knows exactly what’s happening, and that the doctor knows how to fix it.  This is what Dr. W. C. Maples called “empathetic communication.”

The two tracks are distinct, each has specific steps, yet allow for mixing appointments for VT evaluations with a busy PC schedule.  The Essentials course goes into considerable detail on this and provides a visual map of the steps, plus the Triage Interview Form, makes it easier for the VTA to conduct each call and perform the follow up.  Notice that the doctor is not directly involved, relieving her/him from trying to “sell” VT in a hurried call between PC patients.

Hiring therapists:  Trained therapists are rare, you will probably have to train them, or attend a course together.  Some ODs think they need to hire someone with a degree, but we suggest you find an empty nest mom, someone who would love to work with children, but doesn’t believe such a job is possible.  One of our favorite doctor clients says he looks for nice -  “You can train everything else, but you can’t train nice,” he said.

Hire two part timers and train them together, as you put them through therapy.  Most people learn more about how to deliver therapy by doing it themselves.  Don’t expect them to solo for a couple of months, and then only on the activities in which they have demonstrated competence.

We support the Ideal Vision Institute, which is an intensive, 2 part, 6 day course on testing, prescribing an delivering therapy for uncomplicated cases.  It presents a grid of activities and activity sheets meant to help train additional therapists.  If you have a grid of activities that range from basic to advanced, pick about 5-6 basic and teach those, then the next 6-7 and so on.  Test at the end of each set and give a certificate for each level attained.  It’s a little like the Wizard of OZ’s diploma to the scarecrow and really boosts confidence.   Remember, most therapists quit because they feel inadequately trained.

The VTA needs to be comfortable speaking with people about important matters, without resorting to salesmanship or emotional manipulation.  This means being able to listen and empathize, while still sticking to the intention that the child needs help.  The VTA also learns how to do basic public relations, setting up community outreach (Our More Patients Breakthrough Course includes key actions).  The VTA will also handle much of the final sign up consultation and doctor’s report in our system.  This means doctors will have more time for training and educating staff, and after a year or two, more free time for family and other activities.

I recently ran across someone I would hire in a minute as a VTA.  She is the daytime manager of four Carl’s Junior restaurants (Hardee’s back East), handles people and situations gracefully and juggles a thousand details all day long.  She has 3 children of her own so she knows kids.  When I spoke with her, the possibility of working with children all day made her light up.  This was not something she ever considered possible, and I think she would excel with some training.  

We’ve noticed that humble and quiet people seem to do well as VTA.  Boastful, over-confident people who have sales and marketing backgrounds often fail because they can’t resist delivering a sales pitch.  Selling and children don’t mix.

Budgeting for growth:  It will cost you between $20,000 and $30,000 over the course of the first year to pay salaries, course tuitions, and equipment to reach the first 30 patient/week level.  About 30 percent of  that will come from patient fees, so it comes back down to your commitment to get VT going, no kidding, no matter what. 

The next chapter in the series will cover moving up to the 60-90 patient/week level and beyond.  The final chapter will be about setting the practice up for retirement so VT lives on in the community.

If you're thinking about starting or expanding VT.  Or if you're a client who wants to refresh your understanding of the system, including what you missed or forgot, then this is the course for you.

If you're not certain about enrolling in this course, contact Amee Lecoq.  Ask more questions, discuss your practice plans and situation.  Don't miss this course.  Amee Lecoq, idealvt1@verizon.net, 760-686-4648, call to set a time to talk.
 

What you can expect from the Essentials Course

 

The Essentials course is delivered in 6 structured segments of various length.  There is ample of time for questions and discussion.  This is a business course, not clinical. 

             

Section 1:   The market for VT;  startup expenses and income expectations for VT; facility requirements; insurance issues; pricing strategies; profit margins; going all private-pay. 
KEY DEMO:  Up Down Reader.

Section 2:  Communicating the VT Message;  explanation vs experience; power of observable signs; the communication protocol that works; inviting to take action;  preview of the practice flow map. 
KEY DEMO:  Double Vision Demos.

Section 3; The Structure mapped out; details of each step; staff actions; what to say at each step; the sign up process; patient/parent orientation; setting up a VT space. 
KEY DEMO:  Near Point of Discomfort.

Section 4:  Triage the critical first contact; the system map of the step-by-step-by-step Lecoq system; VT with primary care/VT only (care tracks).  
KEY DEMO:  Why saccades count.

Section 5:   Marketing Vision Therapy; workshops & community outreach; what to say; how to set up talks and events; electronic outreach; teacher outreach; build referral sources. 
KEY DEMO: Pursuits and Mixed Letters.

Section 6:  The staff run practice; the key employees & what they do; details of the critical role of Vision Therapy Administrator in enrollment, marketing and patient interactions; Plus our hiring guide and roles guide.

Section 7:  Marketing and Demo documents and guides.

Section 8:  A variety documents to support training and implementation.

 

 

Demonstrations and "Free Offers"

Copyright Notice:  All but the 30 question list are covered by copyright and may not be redistributed or included in any publication without express permission of Thomas D. Lecoq.  Feel free to use any of these materials in your own practice or to share with others a link to this page where they may download the material.  All other rights are reserved by Thomas D. Lecoq

(Contact Us)  OR: download our pdf Doctor Information Form, fill it out to tell us about your practice and situation, then fax it to 760-240-4794. Amee Lecoq will contact you to set up your free phone consultation.

 

 

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Lecoq Practice Development
14420 Iroquois Rd. Apple Valley, CA 92307

CONTACT US BY PHONE:     760-686-4648
To Reach Thomas Lecoq: visionisfuture@yahoo.com
To Reach Amee Lecoq: idealvt1@verizon.net 
For Therapist Training, Lyna Dyson:  visionhlp@juno.com
FAX  760-240-4794