Independent Eye Care

Optimizing outcomes for your patient and practice with Direct Care

Direct Care is a mode of practice that alows your staff and patients to experience what healthcare is supposed to be about. This strengthens the relationship between doctor, practice, and patient in a way that establishes trust.
Published 5.10.2023

In my last year of optometry school, I was more than a little taken aback by the depth and breadth of possibilities for my chosen career. There seemed to be so many different paths to take when deciding how I most wanted to practice my craft.

Do I go for a residency, work in a hospital setting, go into private practice as an associate or take the leap and open my own practice? Should I work in a corporate setting as an employee or sublease the exam side of an established practice? What about an ophthalmology setting, at a VA hospital, a research based setting, or academics?

Being an eye care practitioner is a fantastic career path for many reasons: the many different options new grads have to find their success is one of the best, the continued evolution of the eye care industry and optometric practice is another. Recently, I’ve started seeing an increased interest in a mode of practice that is both cutting edge and traditional: Direct Care.

Direct Care Explained

Direct Care first resurfaced in Primary Care as a mode of practice that allows the doctor more quality time and counsel available to spend with patients which results in highly personalized, comprehensive care. Think of Direct Care as a model designed such that medical staff and patients experience what healthcare is supposed to be about and to strengthen the relationships between doctor, practice, and patient in a way that establishes trust.

Optimizing Outcomes Webinar

If your goal as an eye care professional is to develop long lasting and impactful partnerships with your patients, Direct Care is a significant step in that direction. Studies show that with increased education and communication from the doctor, comes increased patient understanding, trust, and engagement.

This includes increased adherence to recommendations and better self-care skills which, in turn, positively affect health and well-being. Direct care is a pathway through which communication can lead to better overall health.

Some benefits of Direct Care

  • Increased patient access to care
  • Improved patient knowledge, engagement, and empowerment
  • Shared understanding which leads to
  • higher quality medical decisions
  • improved therapeutic cooperation
  • increased social support
  • Stronger emotional management

To build toward Direct Care gradually or dive in all at once?

I decided to convert my new practice, at the time, completely to Direct Care because I felt it was a simple and effective way to provide the best patient care and the best office experience for everyone. Direct care is simple and easy to understand for myself, for my team, and for my patients.

I appreciate that I’m able to get the testing that I want, and it’s all included under a simple, easy to understand price. The healthcare system has become so confusing, patients are afraid to let doctors get the testing they need without knowing what they’ll be paying later. Nobody wants to be saddled with a surprise bill for hundreds of dollars, especially when they expect it to be covered by insurance.

When you’re able to get patients to understand the reason for receiving their eye care from a direct care practice, it builds their trust in you as a provider and therefore increases their compliance as well. To put it another way: they choose your because they want you to take care of them. A third party, unsurprisingly, muddles the medical conversations you want to have with your patients with opaque and confusing financial implications.

Direct Care simplifies the experience for everyone.

  • On the phone

Here’s the full price of what you’ll pay for your exam, no surprise bills later and you might get money back

  • In the exam room

Get the testing that you want without feeling like you’re trying to sell the patient on photos. See the patient back for medical follow up without having to charge extra, it’s all included in the base price of the office visit. They feel good about not having to pay and actually come back for their follow up.

  • In the optical dispensary

Here are our recommendations on your visual and lifestyle needs in one simple price. You choose your lab, you choose your products, you set your prices, and you get to be profitable.

Working with vision insurances and defining independence

If practice owners could wave a magic wand and make their dream practice a reality, they would probably create an office that works with a growing and loyal patient base that loves coming to see them and pays for their goods and services at the time of sale and receives high quality eye care products in a timely manner. Now think about your practice and what working with insurance companies is really like. Are you free to provide the care you’d like?

Whether we’re discussing managed vision care companies or major medical insurances, most of you reading this know that they will exert influence over our care. It’s certainly a challenge to uncover what other options there are for OD’s in private practice. Some vision insurance companies make it seem like you have no choice but to be in-network, but I challenge you to take a true poll of your patients to see how they found out about you.

Also consider that most insurance companies are trying to direct patients to the offices they own, not your private practice. Even when insurance patients walk through your door, are you guiding them to the frames and lenses that are covered? The testing that they won’t have to pay extra for? Does that really sound like independence?

Common industry wisdom says that you need insurance companies to market for you, but that comes with a steep marketing bill in the form of revenue concessions, lab concessions, extra admin work, additional staffing required to handle the increased patient load and other hidden costs besides.

The cost of being in-network can be even more egregious when you realize that you can see as many as 35% fewer patients and generate the same amount of revenue while also having the time and energy to develop deeper relationships with them.

Solving this issue of helping private practices reclaim their independence and separating from managed care will make their practices and careers more sustainable. For practice owners that wish to maintain long term ownership of their practices and also find an independent OD to sell to when the time comes, a healthy and loyal patient base is an asset that pays for itself many times over. Can you say the same about vision insurances?

A happier team and happier patients

It’s been an evolving process of how to showcase our friendliness and customer service, but I think it starts with a strong team that is obviously happy to be at work and to work together seamlessly. Direct care means a smaller, more personalized office, so it’s important to have a team that works together well and truly wants to help patients.

With Direct Care, it’s easier to have genuinely friendly patient interactions. We feel like a family at my office, and that comes through to our patients. Because my practice is smaller in scale, we can afford the time personalized care requires. My team is kind, happy, and always willing to go the extra mile to help patients.

Patients trust your office and the individual team members they work with so they feels like you’re really helping them (because you are!). Patients come to see you because they like you and appreciate you, and you’re happy to see them too. When you can spend more time with people, relationships are stronger than if they’re transactional and/or constrained by time. Spending more time with people builds loyalty and satisfaction.

Nothing we’re discussing here should come as a great surprise: devoting more time to patients and serving them more effectively will make your practice better. A Direct Care practice should improve your day-to-day happiness by slowing the pace of patient visits, creating a more relaxed environment in which you and your team care for your patients.

Changing the system - One patient at a time

For me, the most amazing thing about being a Direct Care provider is that it gives us the chance to change the system. We are looked on to be leaders in our communities, educating our patients on how they can improve their lives. If we are able to improve the lives of all the patients we have access to and improve their knowledge base about their own health, how much reach can we have to change the world?

We have the medical knowledge to improve our patient’s wellness, their mental health, and their lives; should we really be spending untold hours and resources filing paperwork to receive less than our time is worth in reimbursement?

The Direct Care Difference lies in providing the space for eye care professionals to improve patient lives and build a successful business without the burnout that can come with being overworked. Patients deserve to have eye doctors who love what they do and can help improve their lives and vision. It’s up to us to help them.

Kara Foster
Kara Foster, Optometrist/Founder
Dr. Kara Foster was born and raised in western Pennsylvania. After graduating from the New England College of Optometry, she relocated to North Carolina in 2009. She currently lives outside Raleigh, North Carolina with her husband and their three girls. She opened her private practice in 2015, and in 2017, left the insurance network completely and founded the direct care movement in eye care. She's excited for this to be an opportunity for OD's to be truly independent.

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