DDx — EYE CARE GROUPS
Eye Care: the five ways this presents
Each presentation below lists what could be causing it, ranked, with the finding that tells the causes apart and what resolution actually looks like. 25 causes, 25 tests, each cited to a primary source for this specialty rather than borrowed from another one.
Nothing on these pages describes a client or an engagement.
PRESENTATIONS
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Patient acquisition cost is climbing
Spend is up and exams are not. The operator can feel that each exam now costs more to produce than it did two years ago, and suspects the ad platforms. Underneath it, the exam itself is quietly worth less: more of them arrive on a plan, the fee is discounted, …
5 CAUSES · 5 TESTS
WORK IT THROUGH → -
New patient volume is short of plan
The chairs are reasonably full and the phones ring, but the optical is quiet. Frame boards look untouched at the end of the week, revenue per exam has not moved in two years, and patients keep leaving with a prescription in hand and nothing in a bag. The opera…
5 CAUSES · 5 TESTS
WORK IT THROUGH → -
Growth has plateaued
Exam count has been flat or drifting down for three or four quarters. Some days the schedule is tight and some days there are open chairs by 2pm, and the operator has started to assume the market is saturated or that the chain that opened two miles away took i…
5 CAUSES · 5 TESTS
WORK IT THROUGH → -
Performance varies by location
Two or four offices under one name, the same practice-management system, the same buying group, broadly the same frame selection. One location produces four hundred dollars an exam and another produces two hundred and fifty, and the operator cannot say why. Th…
5 CAUSES · 5 TESTS
WORK IT THROUGH → -
Preparing for sale
The owner is in the last stretch — a transition somewhere in the next two to four years, maybe to a group, maybe to an associate. The P&L looks healthy and the practice has a good name in town. What is missing is any way to show a buyer that next year's revenu…
5 CAUSES · 5 TESTS
WORK IT THROUGH →
WHICH ONE
How to tell which one you have
These five overlap, and two or three usually apply at once. The order to read them in is set by which number actually moved. If cost per new patient moved, start there. If demand held and bookings did not, start with the volume page. If nothing moved at all, start with the plateau page — and if the group total looks acceptable while one site keeps coming up in conversation, read the variance page first, because a pooled number is structurally incapable of showing you what you are looking for.
Every cause on every page above carries a measurement you can run in your own systems, with the finding that confirms it and the finding that rules it out. Run two or three before you brief anybody. If the tests tell you this is not a marketing problem, that is the correct answer and it cost you nothing.
RESOLUTION
What resolves each, and what resolved looks like
Each presentation resolves to a different part of the work, and the pages say which: reporting and attribution where the finding is a measurement error, conversion and desk work where the loss is between the inquiry and the admission, acquisition where the demand genuinely is not there, and pre-sale work where the question is whether growth can be re-run by somebody else.
Each also carries what resolved looks like as a number — the measure, the published median, the top decile where an honest one exists, and a target range — with the source in the row. Where no credible distribution is published, the page says so instead of borrowing one from an adjacent specialty. That absence is itself a finding: it means your own trailing history is the only benchmark worth measuring against.
WHERE YOU STAND
Reference ranges for eye care groups
See also where you stand and what decides the outcome before any of this is treated.
A differential narrows the list. It does not close it — that is what the examination is for.
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