Optometric Management Tip # 455   -   Wednesday, November 03, 2010
Maximizing Profitability in Your Contact Lens Practice

How would you like to increase the profitability in your contact lens practice without raising your fees?  There are many market forces that affect your contact lens revenues, such as vision plans, mega-discount retailers and online vendors, but there is still one major factor that you control and it offers a practical way to increase your bottom line.  It's the efficiency of the fitting process itself.

Our contact lens paradigm
Part of the problem that I see with profitability of contact lenses is that ECPs are not changing with the times.  We can blame all kinds of external factors but the marketplace and technology are changing very fast while doctors tend to fit contacts the same way we were taught in school.  And even recent optometry graduates were likely taught those same techniques because the schools may not be changing fast enough either.

The economy and market conditions of our time require that we become more streamlined.  We must find a way to deliver high quality professional services with less doctor time.  Fortunately, today's contact lenses and lens care products are so advanced that we can achieve very high success rates and excellent ocular health while delegating much more of the work to paraprofessionals. 

This delegation is happening in every health care field from pharmacy to medicine to dentistry, but I don't see much change in the way we fit contact lenses.  If we reduce the chair time and doctor time involved in contact lens care and management, our profitability increases.  So let's think out of the box that we stepped into in optometry school or over many years of practice and invent a new approach.  Read on for ways to involve technicians in each phase of contact lens practice.

Contact lens trial experiences
I use the term experiences because I want to promote the idea of easy free trials of contacts in the office.  These are not really fittings, but just a simple try-on after an eye exam.  Encourage patients to let you put contacts on their eyes just so they can experience what they are like while they browse for frames or sit in the reception area and have a cup of coffee.  Of course, this entire matter should be handled by your staff.  Just tell the technician what lenses to put on and let them take it from there.  The technician can answer questions about fees, wearing schedules, lens design, etc. while you move on to another patient.  Many of these trial experiences will become fittings.

Diagnostic fittings
Ideally, this will happen on the same day as the comprehensive eye exam, even if a contact lens fitting was not planned in advance.  You can make it so easy and so fast that a separate appointment is not needed.  The old approach was to make the contact lens fitting work more impressive by making it separate, but I think patients are even more impressed when you make it fast, easy and convenient.  When same day fittings are the norm, you save future appointment slots that can be used for other patients and generate more revenue.  Your revenue per visit goes up because you did more at the initial exam.  Your contact lens revenue per unit of doctor time just doubled.

Think about how simple the fitting can be if you turn it over to your technician after an eye exam.  The technician inserts the trial lenses you specified and then takes acuity, does a spherical over-refraction, assesses comfort, evaluates the lens fit with a slit lamp and discusses lens options.  If there is a problem, she may even change a trial lens.  When a proposed final pair is in place, you drop back in and check the fit and talk to the patient.  The entire fitting process should not take more than five minutes of doctor time.  This is even true for torics and bifocal contacts.  Contact lens correction of presbyopia often requires a great deal of subjective trial and error work and lens changes.  Delegate it and it becomes more profitable.

Dispensing visit
In keeping with our out-of-the-box thinking, patient training for insertion, removal and lens care is no big deal.  Why not just complete it today and dispense the trial lenses?  It can be done in an exam room, or in an eyeglass dispensing area or in a dedicated contact lens room, but the technician just does it in about 10 minutes.  The vast majority of contact lens fittings are on people who have worn them before and the rest get the concept quickly.  Streamline your process and the patient education.  Give the patient take-home materials.  Drop the video; we're doing things differently now.  If you have the rare patient who has trouble with insertion, reappoint him for more work.

Progress exams
Really, why can't your technician do the entire progress visit by herself and just ask the doctor to see the patient if there are problems?  Zero doctor time in most cases.

Need for more staff
It is true that the model I described here will require more staff.  But productivity skyrockets with this system, so the payroll costs will be very affordable.  The use of scribing technicians brings an availability of staff that is critical to this increased patient flow.  See more patients in less time and your profitability will increase.

Best wishes for continued success,

Neil B. Gailmard, OD, MBA, FAAO
Chief Optometric Editor, Optometric Management