Getting to the Hidden Gold in your Practice




By Thomas Lecoq


I confess, I am addicted to the Gold Rush series on Discovery TV. Some of my favorites are the episodes about Freddy Dodge and Juan Ibarra. The two go to marginally productive gold wash plants, trouble shoot, and make improvements. The same pay dirt then produces 4 to 10 times the gold for the same effort.


It’s a great analogy for many VT practices, but especially in VT/primary care offices.


One fix for gold miners is to lengthen the sluice runs so the gold has a better chance of getting caught in the riffles. Fix it and the same effort catches the gold that used to run off into the tailings. We find something very like this in many primary care practices, and if they accept insurance, it’s even worse.


The analogy is to lengthen your intake process for VT, and to improve your “riffles” -the process that captures all a patient’s issues. The testing, exam, case presentation and sign-up consultation; the follow up steps to enroll VT patients.


On the primary care side, change your pretest to catch not-so-obvious binocular problems, and then perfect your exam conversation to identify children of your primary care patient with issues requiring VT.


Start with adding a couple of screening steps to your pretest. Add about 3-10 history questions asked by your tech, over the course of the testing. Primary care patients often hate filling in a complete history, so as the tech goes through the pretest, he/she asks questions about near-point, visual stress and fatigue, uses a double vision demonstrator, and several questions about signs of behavioral vision issues. All is recorded so doctor sees it. Get our Double Vision Demonstrator here:

Lecoq Double Vision Demo
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When I first started doing consulting, I sat in on dozens of PC exams. By asking a few questions, I found that half the patients had their issues ignored or not even probed. For lens only cases, this often meant adding one or two multiple prescriptions, and increased sales. Remember, the second and third pair are more profitable. Cost of sales is absorbed in the initial pair.


Each additional pair must address an issue that cannot be resolved by one pair alone. Specialty lenses of all kinds are best for many occupations. (Ever tried to fix a leak under a sink while wearing a progressive?)


By being “efficient” many ODs have cut their exam times, which means a quick and dirty case presentation. Not nearly enough time to make multiple recommendations. Among the first of our innovations was a different way of doing case presentation that increases patient acceptance of multiples while also ferreting out children who could use VT.


The next step is to lengthen the “sluice” by having the patient attend an evening workshop (90 minutes) held regularly in the office. Our “Mastering the Art of VT Communication” course trains how to do it. We have found that it takes from 90 to 180 minutes of exposure to the message for someone to make a choice about doing VT. It’s a step-by-step-by-step process. Rush it and all the gold winds up in the tailings.


Think about it, where did your case presentation come from? Have you adjusted it to the circumstance, to see more patients in less time? We’ve spent four decades perfecting the case presentation we teach. Tried and proven in dozens of practices. Our history form has been published twice by the AOA. Get this editable form here:

Lecoq Adult History Form
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How well does all this work? In one of the practices we consulted years ago, with its own lab, their multiples went up more than 100 pair a month. Moreover, the practice became the biggest draw in the business center, so to retain it, the rent went was reduced by 25%. The doctor has added associates over the years, but if they don’t adopt the method, he cuts them loose.


To complete the analogy with Gold Rush, if you improve the process, you’ll find yourself with far more “gold.” Translate that to VT patients and more profitable primary care, and you get an idea what Lecoq Practice Development can do for you. Contact us to learn more.


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