Optometric Management Tip # 520   -   Wednesday, February 15, 2012
How is Your Daily Disposable Percentage?

I think most optometrists agree that daily disposable lenses are the best contact lens modality. We can make a strong case that the clean fresh lenses offer the best corneal health and hygiene, the best visual acuity, the best comfort, and the most convenience. These lenses are excellent for overcoming common issues like allergies and dry eyes. The daily modality is highly regarded by eye care professionals, yet only about 15% of contacts prescribed in the United States in 2011 were for one-day use. This number is dramatically better than the 5% we held at for years, but we are still far short of the 40% to 60% usage of daily disposables in Europe and Asia, respectively.

The difference in our prescribing pattern rests mostly with our own perception and bias about the daily disposable modality. I know many optometrists in the U.S. who routinely fit 60% of their patients with daily disposable lenses. These ODs don't practice in extremely wealthy communities or have unusual practices; they have a high usage of daily lenses because they recommend them with confidence. Let's look deeper at how most ODs view daily disposable lenses.

Should cost be your first reaction?
When I talk with colleagues about their prescribing preferences for daily lenses, cost almost always comes up as a factor right away. I actually think that optometrists think about the cost much more than patients! I think patients eventually become concerned about the cost because the OD plants the seed early on. ODs often bring up the cost first in the discussion and can easily send up a red flag that the patient locks onto.

Our view of daily disposables is much like the bias we complain about when our staff prejudges the patient's budget when it comes to selecting eyeglasses. We tell the optician to start with the best frames and recommend premium products first, but we don't practice what we preach! I think we should forget about trying to guess the patient's budget and just recommend the best lens for ocular health, comfort and convenience. Price is not the most important factor for many people.

What if you recommended daily disposables to every contact lens patient you see for the next 60 days? I mean current wearers and new fits alike. But you would have to really believe in the product and not talk about price until the patient asks about it. Read on for how to present the daily modality with success.

Enthusiasm and confidence sells. Rather than take the ultra-professional approach with patients where you work hard to not reveal any preference and just present the options for the patient to choose fromů why not just come right out and tell patients what you think is best? I actually think that is a duty we owe to our patients. Who knows better about contact lenses than you? If you are actually excited about a product, most patients will read that as a very positive sign from someone they trust and they will embrace it.

Of course, price is a concern for some patients, but I would let them be the ones to determine that. You will be shocked at how many people do not let cost stop them. When a patient does bring up the price of daily lenses, be sure to mention that the cost of lens care products is greatly reduced to the point of almost offsetting the increase in the cost of lenses.

Put them on more people
The best way to increase your number of daily disposables is to put more free trial lenses on patients. Tell each patient, even those who are just in for a routine annual exam with no complaints, that you would like him to try on a free pair of daily disposable lenses, wear them for a few minutes in the office, and tell you what he thinks. Here is an example of what to say: "Mary, your current contact lenses look fine, but if you have a few minutes, I'd like you to try on a free trial pair of a new contact lens design that most patients tell me is the most comfortable lens they ever wore. Even people with dry eyes and allergies can usually wear these contacts all day and night with no problem. I'd really like to know what you think of them; would you like to try a pair on? By the way, these are daily disposable lenses so you just throw them out at the end of the day and you never have to clean them."

If asked, the trial process is no additional charge. I would tell your assistant what brand and power to use and the doctor moves on to another patient. The technician takes care of everything else. If the patient loves the new lenses, and many will, the technician can discuss the fees involved, take visual acuity and do an over-refraction (with autorefractor or phoroptor based on your state law and personal preference). The doctor can circle back to this patient and check the fit with the slit lamp if needed. If the patient does not want to proceed with the new lenses, the technician just discards them and re-orders the patient's previous brand.

If you don't have enough staff to try this technique, you may need more staff to foster practice growth. If you don't see any benefit in changing patients to new and better contact lens modalities, your fees may not be high enough.

Best wishes for continued success,

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