Power Hour Optometry: Episode Summary

Title: The 4 Pillars of a Highly Profitable Practice: How to Build a Scalable, Patient-Centered Business
Host: Eugene Schottzman
Guest: Dr. David Cockrell
Release Date: February 26, 2025

In this insightful episode of Power Hour Optometry, host Eugene Schottzman engages in a comprehensive discussion with Dr. David Cockrell, a seasoned optometrist who has successfully operated his practice since 1981. Dr. Cockrell shares his extensive experience, outlining the four pillars that underpin a highly profitable and scalable optometry practice. Additionally, he delves into the hidden gems that complement these pillars, offering actionable strategies for optometrists aiming to enhance their practice's efficiency and patient-centeredness.

1. Physical Space: Designing for Efficiency

Dr. Cockrell emphasizes the critical role of physical space in ensuring a successful practice. He recounts the early days of his practice, beginning in a small, landlocked location, which taught him valuable lessons about the importance of scalable space design.

Dr. Cockrell [02:33]: "If you don't have enough room to grow in that particular place, then you're either going to be fixed in what you can do with that particular size, or you're going to be constantly moving."

To avoid frequent relocations, Dr. Cockrell strategically purchased a city block, allowing for phased expansions without altering the building's aesthetic integrity. This foresight resulted in a seamless 12,000 square-foot facility that appears as a single structure despite multiple additions.

Key Strategies:

• Pod Layout: Designing examination rooms and ancillary areas in a pod format minimizes movement and maximizes efficiency.
• Time Studies: Conducting quarterly time studies helps identify and eliminate workflow constraints, ensuring patients are consistently attended to without unnecessary delays.

Dr. Cockrell [09:50]: "Each time we've done this, we built essentially a pod format. So you work within an individual pod that you're in and you're not wandering all over a large building."

2. Staffing: Maximizing Team Efficiency

Efficient staffing is the second pillar, where Dr. Cockrell highlights the importance of having the right number of staff to support multiple ODs effectively.

Dr. Cockrell [18:08]: "Number two is staffing. You know, you have to decide. I'm going to use a lot of staffing."

His practice employs a robust team structure, including scribes and specialized technicians, allowing doctors to focus solely on patient care without administrative distractions. This model not only enhances patient experience but also significantly increases the practice's capacity.

Key Strategies:

• Scribes: Utilizing in-person or virtual scribes to handle documentation, enabling ODs to maintain a high patient throughput.
• Staff KPIs: Monitoring key performance indicators, such as collected revenue per staff member, ensures optimal staffing levels and identifies areas for improvement.

Dr. Cockrell [30:01]: "We have to make sure we're generating a minimum of collected revenue. If I'm below that number, I probably got staff that are standing around or I'm not being very effective with what I'm doing."

3. Demographics: Tailoring Services to Community Needs

Understanding and adapting to patient demographics is the third pillar. Dr. Cockrell discusses the importance of analyzing patient age groups and tailoring services to meet the community's specific needs.

Dr. Cockrell [31:08]: "If you want to develop a specialty practice defined by XYZ, you're probably not going to develop a big pediatric practice if you're surrounded by geriatrics."

His practice engages in proactive outreach to schools, hospitals, and senior centers, ensuring a diverse and steady influx of new patients. This approach not only sustains the practice but also fosters strong community relationships.

Key Strategies:

• Outreach Programs: Conducting in-service education sessions in schools and hospitals to establish the practice as a trusted local provider.
• Demographic Analysis: Regularly reviewing patient demographics to identify gaps and opportunities for service expansion.

Dr. Cockrell [34:13]: "We do presentations to the local hospital, to the diabetes groups. Every year that we've done it for so long now, the hospital schedules us to come in and do it."

4. Internal Drive of the Doctor: Sustained Motivation and Growth

The fourth pillar centers on the internal drive of the practitioner. Dr. Cockrell underscores the necessity for continuous motivation and a commitment to growth to sustain and expand a successful practice.

Dr. Cockrell [38:40]: "The drive of the doc. How busy do you want to be?"

He emphasizes setting both short-term and long-term goals, encouraging a mindset that seeks to overcome constraints rather than accept them. This proactive attitude is crucial for maintaining high standards of patient care and practice innovation.

Key Strategies:

• Goal Setting: Defining clear short-term and long-term objectives to guide practice growth.
• Continuous Learning: Staying updated with the latest clinical advancements and incorporating new technologies and services.

Dr. Cockrell [42:58]: "Optometry should fill that role. We can certainly refractive care is always going to be necessary. We're always going to do that in our office. But I want to fill those other roles if I can, which makes me believe the future is very bright."

Hidden Gems: Enhancing the Four Pillars

Beyond the four main pillars, Dr. Cockrell introduces several hidden gems that amplify the effectiveness of a practice:

1. Time Studies: Regularly performing time studies to monitor patient flow and identify bottlenecks ensures ongoing operational efficiency.

2. Staff Culture and Engagement: Encouraging staff to present research and share knowledge during meetings fosters a culture of continuous improvement and engagement.

   Dr. Cockrell [46:36]: "One of the last ones was on the genetics of eye color... another was on a new type of spectacle lens."

3. Advocacy Work: Active involvement in advocacy groups, such as the Health Care Alliance for Patient Safety, helps address legislative and regulatory constraints, expanding the scope of optometric care.

   Dr. Cockrell [59:17]: "We're advocating above and beyond just eye care. There's multiple different things that, you know, it's the first time in my career that we've had the industry involved in helping us do that."

4. Aesthetic Services: Diversifying services by incorporating aesthetics, such as Botox and IPL treatments, provides additional revenue streams independent of third-party payers.

   Dr. Cockrell [50:36]: "But all of our discount vision plans we accept are VSP and Eye Med. Aesthetics is a cash-based business."

Patient Flow and Experience

A seamless patient flow is essential for maintaining high satisfaction and maximizing revenue. Dr. Cockrell shares his practice’s approach to minimizing patient wait times and ensuring consistent attendance throughout the appointment process.

Dr. Cockrell [12:11]: "We record it when they walk in, they just put their initials and they record it when they're done with that and the charts ready for a technician."

By maintaining near-zero wait times and ensuring that patients are continuously attended to by staff members, his practice achieves a high capture rate—effectively converting patient visits into sales within the optical department.

Dr. Cockrell [25:28]: "Once we get a patient to our optical, we measured everything in our office... between 95 and 100% of the patients that go to the optical are purchasing an optical good."

Advocacy and Patient Safety

Dr. Cockrell’s advocacy efforts are pivotal in shaping the future of optometry. As chairman of the Health Care Alliance for Patient Safety, he collaborates with major industry players and patient advocacy groups to address and remove barriers to care.

Dr. Cockrell [60:42]: "We're working with Federal Hill on a couple of different pieces of legislation that will make it easier for a patient to actually be able to access care through a payer."

His work ensures that optometrists can expand their scope of practice, enhancing patient safety and access to essential eye care services.

Aesthetic Services: Expanding Revenue Streams

Recognizing the limitations imposed by fixed third-party fees, Dr. Cockrell diversified his practice by integrating aesthetic services. This move not only supplements revenue but also positions his practice as a comprehensive eye care provider offering the latest technological advancements.

Dr. Cockrell [49:17]: "I wanted to be able to say, our office does everything that could be done in eye care."

By establishing an aesthetic suite and training technicians to facilitate these services, his practice attracts a broader patient base and meets diverse patient needs without overburdening the ODs.

Dr. Cockrell [52:36]: "We actually ask them, are you interested in any aesthetic procedures... our technicians are going to ask them."

Future of Optometry: Bright Prospects Amid Challenges

Looking ahead, Dr. Cockrell is optimistic about the future of optometry. He highlights the increasing demand for eye care due to an aging population and the projected shortage of ophthalmologists, positioning optometrists as essential providers of both primary and specialized eye care services.

Dr. Cockrell [54:34]: "Optometry should fill that role. We can certainly refractive care is always going to be necessary. We're always going to do that in our office. But I want to fill those other roles if I can, which makes me believe the future is very bright."

Conclusion

Dr. David Cockrell's comprehensive approach, grounded in the four pillars of physical space, staffing, demographics, and internal drive, offers a robust framework for building a highly profitable and scalable optometry practice. His emphasis on efficiency, continuous improvement, community engagement, and advocacy not only enhances patient experience but also ensures long-term sustainability and growth. For optometrists seeking to elevate their practice, Dr. Cockrell’s insights provide valuable guidance on navigating the complexities of modern eye care.

Notable Quotes:

• Dr. Cockrell [02:33]: "If you don't have enough room to grow in that particular place, then you're either going to be fixed in what you can do with that particular size, or you're going to be constantly moving."

• Dr. Cockrell [09:50]: "Each time we've done this, we built essentially a pod format. So you work within an individual pod that you're in and you're not wandering all over a large building."

• Dr. Cockrell [30:01]: "If I'm below that number, I probably got staff that are standing around or I'm not being very effective with what I'm doing."

• Dr. Cockrell [38:40]: "The drive of the doc. How busy do you want to be?"

• Dr. Cockrell [59:17]: "We're advocating above and beyond just eye care. There's multiple different things that, you know, it's the first time in my career that we've had the industry involved in helping us do that."

Contact Information:

For more insights and resources on building a successful optometry practice, visit www.PowerPractice.com.