Cutting Her Losses and Gaining New Benefits

When initial refraction system didn’t work, OD went all in with a change

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When Emily Bussey, OD, bought an existing practice in Bartlesville, Oklahoma, eight years ago, she expected it to grow quickly.

And it did. “From the time I bought the practice, I had 30 percent to 40 percent growth every year,” she says, which is why, in 2015, she built a new building with a more efficient layout and more space.

That helped her take advantage of the demand, but that new building wasn’t big enough. “Last year, we had 1 percent growth,” she says. The slowdown wasn’t caused by a lack of demand; the problem was a lack of space and an indication of a high-performing practice. “I had maxed out my efficiencies,” Dr. Bussey says.

Now she’s preparing for another expansion, this one less complicated than the last. In 2017, she bought the building behind hers and moved some of the back-office functions there, such as the ODs’ offices and the staff break room. Those two rooms will now be converted into exam lanes.

The new space will increase the practice capacity by 50 percent. “We now have four exam lanes, and that’s not enough,” she says. The backlog was so large “that patients couldn’t get in for six months,” she says. “We’re booked out insanely. If my land were big enough, I could double the size of the practice and be fine. It’s a weird problem to have.” She and her associate, Jenny Johns, OD, will be able to increase their time in the office, too, expanding from a total of five doctor days each week to eight doctor days.

A key part of her success in managing this demand is the technology investments she’s made. She purchased an automated phoropter system when the practice opened, not only for the efficiency but because she has arthritis in both shoulders. “I needed it to do my job,” she says.


But the investment didn’t work out that well, she says. “I couldn’t integrate it into the rest of the office systems, such as electronic health records. We spent days on the phone with the company” trying to fix the issues, without success. “I chose it because it cost less,” she says.

She had since seen Marco equipment excel in the field, so she replaced the two units she had and added two more Marco TRS systems, knowing she was expanding the exam lane space. Eventually, she expects to have a Marco TRS system in all six lanes. She also has the OPD-Scan III, which provides aberrometry and topography among other diagnostic measures. “Not only is it working with my electronic health records, but Marco’s customer service is great,” she says. “The equipment is easy to use. I love it.”

With the previous system she needed a scribe, but with Marco, “if I don’t have a scribe, I’m not going to fall behind because it integrates so well. The refraction is quicker, and the data entry is quicker.”

Her favorite features help her illustrate the need for eyeglasses to parents for their children and the ability to allow patients to compare their prescriptions quickly. With just a toggle switch on a tabletop unit, “it is so easy to show patients the difference between their unaided vision, last year’s prescription and what the new exam showed. I use that every single time. It absolutely helps the capture rate.”

So seeing that year-over-year growth had slowed so dramatically was, in a way, a confirmation that expanding the physical space was the right plan. “The practice is so beautifully efficient, and we couldn’t have done that without the Marco automated phoropters. I fully believe that.”