A successful eye care practice means educating clients

Dr. Trevor Elmquist, a blonde-haired, blue-eyed ophthalmologist, has the formal, commanding presence of a military leader. In fact, after medical school, he served as the "family doctor" for a squadron of Air Force pilots and was chief resident at the Walter Reed Army Medical Center in 1988.

EVAN WILLIAMS / FLORIDA WEEKLY Dr. Trevor Elmquist A friend from the military encouraged him to move to Fort Myers two years later. Since 1992, Dr. Elmquist has run a successful private practice here, Elmquist Eye Group. He opened an office in Cape Coral in 2007.

Although he takes pride in using the latest eye surgery techniques and technology, Dr. Elmquist has also been recognized for his business acumen. His continuing education, an MBA from Florida Gulf Coast University, reflects that; so does his designation last year as a Certified Ophthalmologist Executive, a title for eye doctors who also exhibit good business practices.

It is quality he views as inseparable from being a great eye doctor.

"Good medicine is good business," he said. "(And) the service aspect of things is the only way you can make yourself unique."

Educating his clients is the primary way he sets himself apart. He cites poor doctorto patient communication as a common complaint among his clients, especially when it comes to life-changing operations.

"Patients are frustrated," he said. "You can't go back and undo (a surgery). The effort we put into a very critical decision sets us apart."

One of Dr. Elmquist's specialties is cataract implant surgery. He educates his patients about it by closing his office twice a week for two hours for a private seminar with them.

If they are educated about it, then "they've taken the responsibility of making the final choice," he said. "These options are there for them, but it's elective. I think these days, with the complexity and choices patients have, they should really go through an educational process."

The surgery implants a corrective lens behind the retina to correct cataracts, the most common cause of blindness. He also uses a ReSTOR Lens for some cataract surgeries, which was approved by the FDA in 2005. It's an implant that replaces the human lens and in many cases allows people to never have to wear glasses or bifocals. The procedure takes 10 to 15 minutes.

"It's an opportunity to change the refractive power of the eye," he said. "Many times you can offer people more freedom from glasses."

He also helps patients with hundreds of eye-related diseases, malfunctions and injuries, including cancer, the effects of diabetes, dry eyes, retinal detachments and glaucoma.

"Every individual is unique and I see something different every day I come to work," he said.

Many of those patients are regulars, so his business hasn't been as affected by the recession as some. But plans for a third location were put on hold until better times. Also, a popular refractive surgery called LASIK is "way down because of the recession," he said.

And because Medicare payments make up 70 to 80 percent of his revenue, that program puts a fixed price on many of his procedures, so he has very little control over how much to charge for them. That sometimes causes him to lose money, because Medicare doesn't reimburse doctors for the full price of medical care.

Meanwhile, the cost of keeping up with new technology has been steep. For instance, he replaced all his paper records with electronic medical records, one of only a handful of ophthalmology practices in Lee County to do that.

"In order to spend money on electronic medical records, you have to do innovative things," he said.

To offset a dip in revenue and higher costs, he branched out into optical sales, including glasses and contact lenses. He also partnered with the University Eye Surgery Center across the street from his Fort Myers office (Its owned by a Miamibased company called AmSurg, which creates specialized surgery centers). Elmquist Eye Group also provides eye care to all the residents at Shell Point, a large retirement center in South Fort Myers.

"Without these alternative things, the reimbursement is not sufficient," he said.

Dr. Elmquist, 56, grew up in Tampa and attended the University of South Florida where he met his wife, Carol. They have two children, Eric and Summer. He attended the Kansas City College of Osteopathic Medicine before serving as a physician in the Air Force and completing a residency at Walter Reed.

Dr. Elmquist said he will continue to strive to educate his patients. As if to prove the point, he pulled a book off his shelf for an impromptu lesson. On the cover was a picture of the English ophthalmologist who developed cataract surgery, Harold Ridley, standing with a group of World War II fighter pilots.

Because of an accident in which canopy plastic from one of the airplanes had ended up in a pilot's eye, Mr. Ridley discovered that it was a form of plastic the eye would tolerate, and later that it could be used to correct vision. The first cataract surgery was performed in 1949 at St. Thomas' Hospital in London.

"It's such a very valuable surgery for humanity," Dr. Elmquist said.