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Making the In-Office Lab Decision
Use these factors to determine whether or not it's right for you to invest.
Zack Tertel, assistant editor
Every purchase we make is typically accompanied by a decision of whether or not the benefits outweigh the costs. From deciding whether a sweet-tasting candy bar is worth the negative effects to your body to deciding whether the price of a new hybrid vehicle is worth the long-term savings at the pump.
On a professional level, the same applies to optometrists who consider operating an in-office lab.
Here, those optometrists who run successful in-office labs discuss the necessary factors for making the investment in an in-office lab worth it and the edge it can provide your practice, should these factors be in your favor.
Amount of spectacle-wearing patients
First, identify the number of patients in your practice who wear spectacles and don't have to go through third-party insurance company labs to acquire their eyewear. If only a small percentage of patients use such labs, then an in-office lab can be worth the investment. Therefore, be sure to research your patient records before making any equipment purchases.
If you have a practice in which the majority of your patients present with VSP as their third-party vision plan, then an in-office lab will not be a profitable investment, according to optometrist Whit Lord whose practice, Lord Eye Center in Statesboro, Ga., currently has six locations, each with a complete surfacing and finishing lab. However, the opportunity to use an in-office lab may present itself with other vision plans.
“VSP is actually one of a couple of plans where they insist on doing their own lab work, while some of the other vision plans let you do them in house,” he explains. “So you would have to analyze your practice and determine if it is worthwhile to you.”
In addition, conducting such research will enable you to determine what type of lab equipment, if any, you should purchase. It's important to research all the options and what each company offers in terms of levels of pricing, warranty, maintenance and customer service.
The Weco Edge 680 Patternless Edger, from AIT Industries processes high base curve wrap frames and includes integrated drilling. Also, the device produces Chemistrie Magnetic Sunlenses and polarized 3D magnetic lenses and integrates with existing AIT tracer/blockers. Other features include: a large tiltable LCD screen, a grinding wheel for beveling all materials; automatic polishing of CR-39, hi-index, Trivex and polycarbonate lenses; minibevel technology; a camera-assisted blocking system with auto recognition and a superhydrophobic lens roughing process. Visit www.aitindustries.com.
Dr. Lord says he feels that many of the companies producing lab equipment are very reputable with good warranty programs, but there are some that set themselves apart with premium customer service, which you can determine by discussing the options with your colleagues.
“My recommendation would be to call the optometrists who are running the lab equipment, and they could easily tell you some of the companies that are very strong in terms of service,” Dr. Lord says.
With regard to specific devices, entry-level edgers that handle basic optical jobs for single-vision lenses run in the general range of $14,000 to $25,000, says Dr. Lord. While the capabilities of edgers are limited, they do allow you to produce glasses quick, he explains. A complete surfacing lab, which can produce bifocal or progressive-type lenses, can cost between $115,000 and $140,000, Dr. Lord adds.
Another issue to examine when contemplating a surfacing lab is the fact that digital surfacing appears to be slowly becoming the norm.
|Briot USA/Visionix, Inc.|
The Emotion edger with drilling capabilities, from Briot USA/Visionix, Inc., includes a built-in tracer that records the frame's shape and curvature and measures the frame's thickness at the eye-wire to fit even if the frame is not present during the edging process. The Emotion also has the ability to trace patterns and demo lenses and can store 300 jobs and 200 patterns in its memory. The data input system of the Emotion incorporates a high-resolution touch screen and a 1:1 scale display of both eyes. Visit www.briot-usa.com and www.visionix.com.
The reasons: Starting inventory costs and on-going inventory costs for lenses goes way down with these devices. This is because the starting lens blank is typically a single vision semi-finished lens blank rather than a semi-finished blank with the progressive add molded into the front surface as with conventional surfacing, Dr. Lord says.
“Conventional surfacing requires an almost endless inventory of semi-finished blanks with duplicate inventories needed for the right and left eyes and in a wide range of base curves and a different blank with all the above for each progressive add power,” he explains.
The Excelon 7000 XD edger, from Coburn Technologies, is part of the company's Excelon in-office finishing series. The device edges glass, plastic, hi-index, polycarbonate and Trivex, as well as edge polish bevels and flats. It provides hole editing functions with a “drag and drop” function and includes dual side feelers, which scan the lens simultaneously for fast lens reading, the company says. An optional 3D drill offers up to 30° of mobility to support high-curve lenses and drill mount frames. Visit www.coburntechnologies.com.
Another benefit: Digital surfacing equipment has less moving parts and is likely to need less mechanical intervention than conventional surfacing equipment. That said, any repairs, if needed, are typically more complicated and require outside repair assistance, which can be costly.
While it is important to stay within your budget, you shouldn't let the price of the equipment hold you back. The reason: Savings will follow, according to optometrist David Golden of Golden Optometric Group in Whittier, Calif.
“If you want to edge premium lenses, which is really where you realize significant savings, then you must invest in a good piece of equipment,” Dr. Golden says.
Although advances in technology have enabled the automation of several in-office lab device features, each still requires a human operator. For this reason, you must determine who, specifically, is going to oversee your in-office lab and whether the cost of salary still makes the investment in an in-office lab worth it.
Something to keep in mind: The more advanced and intuitive the equipment, the less experience and manpower required: “When you buy newer technology, which is what I completely recommend, the level of sophistication [required by] a bench optician goes down… ,” Dr. Golden says. Also required, he says, is a technically savvy individual, as the equipment today is computerized.
|Essilor Instruments USA|
Mr. Orange, from Essilor Instruments USA, features the management of high curves up to base 9 and optical tracing that is twice as fast as mechanical tracing for rimless and groove jobs, the company says. All edging, grooving and drilling tools can incline up to 30°. The device also includes a touch-screen interface and visual alerts. Exclusive, patented Fit-4-Frame technology lets users determine the best lens level profile for each frame/lens combination depending on lens thickness at four strategic points. Visit www.essilorinstrumentsusa.com.
In terms of staff compensation, it is naturally influenced by both the level of an individual's experience and the practice's location. That said, Dr. Lord says a reasonable range (depending on location) is from $12 to $20 per hour.
“If the lab is turning out many jobs per day, and the lab person oversees several other lab folks, they would be at the upper end of the [pay] scale, and if they are under the direction of someone else, they naturally would make less,” Dr Lord explains. He adds that a premium should be placed on the ability of the staff person to maintain and repair the equipment as those situations are bound to arise.
Optical Dynamics' nano-CLEAR AR unit produces and delivers digital quality AR lenses, progressives and photochromics. The nano-CLEAR AR system is designed to work in conjunction with the company's Q-2100 Digital Lens System and allows the user to produce AR lenses in-office in less than 90 minutes, the company says. Optical Dynamics incorporates nano particles into the different layers of their in-mold AR stack. Through the curing process a chemical bond is formed between each layer of the AR stack, the hard coat and the lens substrate. Visit www.opticaldynamics.com.
The required space for a finishing lab is roughly 160 square feet for your computer, frame tracer, blocker, edger, hand tools and a tinting unit, in addition to the space for adding a drill for drill mounts, according to Dr. Lord. A surfacing lab would require an additional 160 square feet. While he maintains that one could squeeze [their equipment] into a tighter space, he says his labs are somewhat larger, and his lab staff appreciate the extra space. You could also benefit from viewing what your colleagues have in their offices.
“I would suggest visiting a lab to get a good idea of where the equipment should be positioned within the space so the optical jobs flow nicely,” Dr. Lord says.
Beyond space, the additional requirements to consider is the voltage the equipment requires, the needs for water lines, air lines and drainage into a sewage system. So you, the optometrist, should not expect to simply place the equipment in an empty office, plug it in and be up and running.
As previously mentioned, gathering advice from fellow optometrists on their experiences and visiting their labs will also help you to make the best decision. Optometrist Jim Haines, of Zionsville Eyecare in Zionsville, Ind., says he first considered constructing a small production lab about 15 years ago when he was moving into a new building.
He says one of the biggest determining factors for him to move forward with the lab was personal contact with colleagues who already operated such labs.
“I asked, ‘Do you use an edger in your office? What do you like about it? What do you not like about it?'” he explains.
Receiving such information and applying it to your own practice can enable you to consider issues you may otherwise not have.
|QSpex Technologies, Inc.|
QSpex Technologies, Inc.'s QSpex Premium Lens System enables you to cast single-vision or progressive lenses with any combination of premium lens treatments in roughly 30 minutes, the company says. The System can produce clear lenses, sevenlayer, vacuum-coated oleophobic and hydrophobic AR lenses, polarized lenses and polarized lenses with backside AR. The device casts photochromic lenses and AR/photochromic lenses. Visit www.qspex.com.
Gaining an edge
If you find an investment in an in-office lab is worth it, you should go for it, as once it's up and running you can expect additional benefits in the way of patient satisfaction — something that can create patient loyalty and referrals.
“Since even progressive blanks cost much less compared to what a wholesale lab charges, you can be very generous with remakes. Rather than getting upset with a patient who wants a small change, it becomes easy to be a nice guy and simply make the change for the patient,” Dr. Lord explains. “Instead of telling the patient to wear it and get used to it, you can say, 'this is a very small change and I'm not sure it will make a noticeable improvement for you. But we want to do everything in our power to make you happy, so we are going to throw these lenses away and make you some more.'”
Dr. Haines says his ability to complete eyewear fast has increased the percentage of his patients who purchase their eyewear from his office.
“Patients like the ability for same-day service on a single vision lens,” he says. “It has raised the image of our practice…” OM
The Me 900, from Santinelli International, is a more economical version of the company's Me 1200 Multifunction Edger, the company says. It features the identical 3-D Drilling, 3-D Grooving and Advanced Shape Editor functions as its predecessor. In addition, the Me 900 features a Radius Measurement Unit that measures the radius of the lens for proper cutout and orients the lens for faster processing speed. The Me 900 is available with the optional Click Mode software for processing the Chemistrie Magnetic Layered Lens System. Visit www.santinelli.com.
|Super Systems Optical Technologies|
The Fast Grind 2200 Modified Lens Surfacing System, from Super Systems Optical Technologies, has been refined for 2012. Updates to the system include enhanced tuning to produce digital HD progressives. Other developments include a new portable water system, which can recirculate water from a storage device via a pump and filtration system, allowing for every pair of lenses to be produced with the same quality. This is also useful for optical dispensaries that might not have an existing water line available. Visit www.superoptical.com.
The TL-3000C auto lensmeter, from Tomey USA, measures bifocal, hi-index, prism, progressive, standard and trifocal ophthalmic lenses as well as both hard and soft contact lenses. Once you set the device's nosepiece for measuring contact lenses, it automatically switches to the contact lens measurement mode. Further, the device measures interpupillary distance with automatic right/left detection and can measure a lens' UV transmittance while also measuring the lens' power. Visit www.tomeyusa.com.
Optometric Management, Volume: 47 , Issue: August 2012, page(s): 40 - 47