The Business of Glaucoma

By Steven D. Vold, MD

At the core of every successful business is a relentless pursuit of creative ways in which to improve its product and operations. As health care costs rise and reimbursement decreases, the importance of developing innovative new strategies for successfully providing quality medical care grows. Successful practices look far beyond financial indicators. They carefully evaluate patients’ outcomes and satisfaction and critique every step of patients’ experiences.

I opened a new clinical practice and ambulatory surgery center less than 4 years ago, and I have learned several critical lessons that have changed my life forever. Here are four.

First, the quality of the people working in a practice will largely determine the level of its success. Poor hires quickly undermine a business. The value of a strong leader cannot be underestimated.

Second, a practice’s focus should be on its patients’ and employees’ experiences, not on profits. I believe that my practice benefits when patients and team members know that I genuinely care about them. Word of mouth attracts patients and exceptional employees.

Third, building a successful business culture is an intentional act. Detailed, well-considered processes are critical. Every person on the team should have a defined and valued role in the organization. Proper staff training is mandatory and must be provided in an organized and systematic fashion. Team members are then held accountable. High performers are rewarded. Poor performers are reassigned to positions that better fit their skill sets or are encouraged to find work elsewhere.

Fourth, glaucoma can include components of a cash-pay business. Listening carefully to my patients and focusing on improving outcomes revealed the willingness of many of them to pay out of pocket to improve their quality of life. Adherence has long been a tremendous challenge in glaucoma therapy. Many patients suffer greatly from the side effects of topical medication and the visual symptoms of dysfunctional lens syndromes. New drug delivery alternatives and microinvasive glaucoma surgery offer the promise of both improved IOP control and reduced dependence on patients’ medical adherence.

I have been amazed at how eager patients are to proceed with microinvasive glaucoma surgery, even when their insurance plan does not cover the procedure. With the cost of health care such a concern in the United States, it makes sense to allow patients to share the expense of procedures deemed elective by Medicare and insurance companies. This health care model quickly weeds out procedures that perform inadequately while allowing patients to embrace technologies that actually improve glaucoma-related outcomes.

Steven D. Vold, MD

Chief Medical Editor


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Glaucoma Today is mailed bimonthly (six times a year) to 11,519 glaucoma specialists, general ophthalmologists, and clinical optometrists who treat patients with glaucoma. Glaucoma Today delivers important information on recent research, surgical techniques, clinical strategies, and technology.