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2000 Hours, How Will You Use Them?

By Thomas and Amee Lecoq

One of the basic realities of being in practice is that your time as doctor is your single most valuable asset. If you work 40 hours per week for 50 weeks a year, you have just 2,000 of doctor time. But let’s get real, in a VT practice, training therapists and staff, case review, the whole intake process and writing reports, will eat up about 500 hours.

Take a week off at the holidays, some CE courses and you’ll wind up with maybe 1,300 doctor hours. If you are accepting insurance, lop off another big chunk for paperwork. (And you’re discounting your services, and your nonproducing payroll will be higher.)

If you’re a recent grad, or just starting practice, have a new family and setting up the life you deferred to complete your doctorate, it’s obvious you need to find ways to get a lot done and produce a lot of income per hour. Chair time, all the costs of operating the practice, divided by the number of doctor hours available is your hourly “nut.” Count that in hundreds of dollars per hour before you get to take a dime home.

OK, that’s the problem. What’s the solution?

One method would be to become very efficient, move lots of bodies through exams and delegate as many duties as you can. But to me, that’s the low road. Instead, we train doctors and staff to operate with extreme effectiveness. The difference is that by developing your practice by instituting the Lecoq Practice Development method, you get great results.

Conversion rate means what percentage of your VT evaluations result in patients in the therapy room. Most efficient practices we’ve evaluated had conversion rates of about 50 percent. Not bad until you realize that the declines represent ten thousand dollars or more per case. It actually costs you the difference between your fee and chair time cost, which can be $200 or more per evaluation.

But with a system in place to have staff EFFECTIVELY do the bulk of patient interactions, our clients often report conversion rates of 90 to 95 percent. At the fee levels we recommend, it only takes 100 to 125 VT patients per year to produce a $1,000,000 gross. That’s no more than 140 evaluations total. Not only that, but when you communicate effectively and everyone in the practice uses our approach, most clients say the parents who decline often enroll later after handling other issues. And they do it without having to accept insurance.

It means having a great, well paid Vision Therapy Administrator, who ushers the parent/patient through the enrollment process, so they arrive in your chair knowing that the problem they’re dealing with is probably vision, and without a hint of selling or manipulation, that you have the solution.

We do the training, provide documentation, materials, forms, and provide phone support for a year. And we do it in units, starting with our basic business course, “Mastering the Business of Vision Therapy.” In one weekend, you and key staff, or your spouse, get a detailed overview of the method.

We invite you to spend half an hour speaking with Amee Lecoq in a complimentary phone conversation. We’ve been at this for 40 years. We provide extensive documentation to support you long after we’re gone and also do “touch up” training for new staff. Courses are delivered in your practice, with your staff.

What you do with the hours you get back is up to you. But next time you wonder how you’ll get everything done in time to have dinner with family, do something about it and set up a conversation with Amee Lecoq. Read more at

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