The Benefits of Combining MD and OD Practices

Several years ago, four independent and successful eye care practices in Bloomington-Normal, Illinois, faced some major challenges. A number of the doctors in these practices were thinking about retirement, some practices had more patients than their current location could accommodate and no ability to grow, and the bottom line of others was being negatively affected by a shift to online eyewear purchasing. At the same time, private equity firms were purchasing practices across the country.

After various discussions and agreements, first between just two of the four practices that now make up VisionPoint Eye Center and eventually expanding to include all four (three OD practices and one MD practice), the practices’ owners enlisted the help of two consultants. One represented the OD practices—McLean County Eye Center (David Landess, OD; Jeffrey Huettemann, OD; and Jason Dunn, OD), Central Illinois Eye Care (Eric Norell, OD; Michele R. Willenbring, OD; and Tom Mahaffey, OD), and Eye Care Associates (Wilson Movic, OD, and John Couillard, OD). The other consultant represented the MD practice—Eye Surgical Associates (Daniel Brownstone, MD; Catharine Crockett, MD; and Scott Pinter, MD). After a series of further discussions with the assistance of the consultants, the four practices merged to become VisionPoint Eye Center.

VisionPoint opened in August 2019, just more than 1 year after breaking ground to build a 28,000-square foot, $10 million facility. The center has 40 exam rooms, a LASIK surgery suite, a conference room, two additional patient lounges within the clinic space, and a break/meeting room with seating for more than 100 people. This article describes the benefits of the merger.

A WELL-THOUGHT-OUT SPACE

We were able to design a space that was both functional and welcoming. The building is unlike any eye care practice we know of in the Midwest. Several patients have commented that they feel like they are checking into a 5-star hotel on arrival. The welcome area is spacious and has upholstered chairs and coffee tables, high ceilings, multiple large-screen TVs, and plenty of natural light (Figure 1). The adjoining eyewear boutique was designed with unique features to attract patients to visit (Figure 2).

VisionPoint was open for only 8 months when the COVID-19 pandemic shut down all but essential and emergency services. The practice kept a small crew working to see patients for urgent care. When routine procedures resumed, we were able to maintain distance between patients in the sizeable welcome area and throughout the building in the many exam rooms and lounges. Within a few months, the practice was operating at pre–COVID-19 capacity without jeopardizing the safety of patients or staff. Had the practices not merged, most would have spent 18 months significantly below capacity because of their small offices.

MD AND OD OWNERSHIP

After the merger, all patients were assigned an OD as their primary eye doctor. This allowed the MDs to add at least half a day of surgery per week or every other week to their schedules. The strategy allows all of VisionPoint’s doctors to do more of what they do best and to feel confident that their patients are receiving optimal care.

Combining optometrists and ophthalmologists in a single practice is not a new concept, but VisionPoint’s ownership arrangement is unique: Four optometrists and three ophthalmologists share equal ownership. The OD owners benefit from services such as LASIK, cataract surgery, and other surgeries that were not previously a part of their service mix. The MDs benefit from robust eyewear and contact lens sales and a consistent in-house OD referral stream (Figure 3).

IMPORTANT CONSIDERATIONS FOR DOCTORS AND STAFF

Recruitment and retainment. Being able to afford an attractive benefits package had been a challenge for some of the smaller practices. VisionPoint offers its 110 employees a competitive benefits package, including multiple health insurance plan options, retirement accounts, short- and long-term disability, life insurance, and longevity and production bonuses. Recently, recruiting staff and physicians has been challenging in central Illinois, but the new facility created explicitly for efficient patient flow and outstanding aesthetics attracts candidates.

Efficient care. One challenge that routinely made for long workdays before the merger was accommodating urgent care visits. It is tricky to maintain a full schedule and allow walk-in patients. One of VisionPoint’s eight optometrists is designated the urgent care doctor each day. The responsibility rotates, and this person’s schedule is kept light to accommodate the average number of urgent patients on any given day. If an urgent care patient needs to be seen by an ophthalmologist, the transition is simpler and less time-consuming than before the merger because the ophthalmologists are in the same building and use the same electronic medical records system.

Work-life balance. On-call responsibilities have also improved for all doctors. Each optometrist is on call for about 7 to 8 weeks per year. The MDs rotate on-call duty every 3 weeks, but the OD on call generally sees patients first and brings the MD in only as needed.

A NEW OUTLOOK

Large patient population. VisionPoint sees an average of 225 to 250 patients a day, which was an adjustment for both the providers and the staff. The prevalence of certain eye diseases in our large, consolidated patient population also became apparent. In response, we created a comprehensive dry eye clinic and introduced CXL for patients with keratoconus. Additionally, we are growing our scleral and specialty lens business into an area of specialization in the practice.

Group purchasing. Before the merger, each practice saved on purchases by being part of group purchasing arrangements. VisionPoint is a large customer, and this has unique benefits.

When we created a comprehensive dry eye clinic, we were able to purchase and fully utilize a broader range of equipment for diagnosis and treatment, which can provide additional savings. We have also been able to partner with our local school districts to offer free eye exams and eyewear to children who would not otherwise have access to these services. A lens and frame vendor provided the glasses for free because of the number of products we buy annually. It would have been difficult for any of the smaller practices to offer this charitable service before the merger.

CONCLUSION

VisionPoint was founded as a response to the challenges facing its component practices.

Each of these shared similar values, including excellent medical care, a focus on patients, and synergistic teamwork. Creating VisionPoint inspired a can-do spirit in the staff and developed employees’ problem-solving skills. Most gratifying is hearing patients say how much they love their experiences with us.