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I think about office design a lot, for my own practice and that of my clients. How we use our precious,
limited office space can have a huge effect on productivity and revenue. I see office design as ever-evolving
over time as the needs of the practice change. Finding a different purpose for a room can change clinical
procedures, which can increase revenue by thousands of dollars per month.
One room that has historically been included in nearly every optometric office is the contact lens training
room. Also known as CL dispensing; insertion and removal; application and removal; patient education; hygiene;
instruction; or whatever you may call it, the need for the room has changed. In many offices, there are far
more important uses for this perfectly sized room. Just one additional room, put to optimum use, can provide
major benefits to a practice.
Times have changed
Consider these factors that may make you rethink the CL dispensing room.
Where to dispense contacts?
- The room is still incorporated in many office designs because it has always been there. But 35 years ago,
all contacts were made of hard materials. Training a patient to insert, remove and care for hard lenses was
much more complicated back then, and it could take a long time. Many patients had initial discomfort, red and
watery eyes, and apprehension to deal with. That scene was best held in a private room.
- I recall the days of the ego-boosting contact lens room that was set up to seat several patients at once in
classroom-like style, so training could occur in groups. Multiple chairs, mirrors and tissue holders were
built-in with the idea that this practice fit so many contact lenses, and the process was so complex, that
group classes were scheduled. It was a cool concept once, but it's outdated today and it makes my point that
this whole function has changed.
- By far, most patients we fit with contact lenses today have already worn them before. These patients need
a minimal review of insertion and removal at most.
- Many dedicated CL dispensing rooms are rarely used anymore. A new contact lens training session usually
takes less than 15 minutes.
- Today's lenses are easy to insert and remove even for new wearers. There is little or no initial discomfort
and very little inflammatory response. Female patients may begin to apply eye makeup at pre-teen ages, and
that experience eases apprehension.
- Contacts today are not the big ordeal they once were to the general public. Some ODs might want to keep
contact lenses medical and complex, but the public doesn't see it that way. I think we should educate patients
that there are medical risks with contact lenses, but we should also keep up with the times. I think we are
ahead if we present contact lens handling as something that's easy and quick to learn.
If there is enough office space, which there rarely is, I can see a dedicated room for contact lens training.
It would have solutions displayed and stored and it might also have sunglasses displayed. Some offices store
trial contact lenses and revenue packs of lenses in the dispensing room as well, for doctors and staff to access.
Other offices keep the contact lens inventory in a lab-like setting that is not easily seen by patients. Contact
lens inventories can be impressive to patients, so they could even be displayed in a large open area or hallway -
but keep the look uniform and professional. With all the various rack systems and box designs that are available,
it can easily look hodge-podge.
If office space is at a premium, however, I would consider dispensing contact lenses in the optical area. A
semi-private space could be set up with a table and stools for the patient and the technician, and it could
have a contact lens theme around it. Yet this space could be used for eyeglass dispensing, adjusting or frame
selection, when not being used for contact lenses. Some might think privacy is needed when a person is placing
a CL on his eye, but I don't think anyone thinks much of it or even notices. It's an eye doctor's office.
Contact lens care and handling can also be instructed or reviewed in any exam room, with a hospital table pushed
up to the exam chair. All you need is a mirror, solution and tissues. This offers a lot of flexibility for a
task that does not take long and does not happen all that often.
What else could you do with a CL room?
If you are thinking of converting an underutilized CL room to something else, I would think about pre-testing or
special testing. An extra room is a great way to increase the delegation of procedures to your staff, which
increases exam throughput. Here are some instruments you could place in this room.
Changes in your office send strong signals to your patients and staff that you are on the cutting edge of the
profession. It's great for your image to make something happen!
- A GDx or other nerve fiber analysis system.
- A digital retinal camera networked to the exam rooms.
- Corneal topography to be performed as part of the contact lens evaluation fee on all CL wearers every year
(networked to the exam rooms).
- A work-up room with a powered, arc-shaped tabletop with auto-refractor, non-contact tonometer and field
screening unit. Place a lensometer on a rear table or counter so the tech can read the habitual Rx while the
patient does the field screening.
- A computerized subjective refraction system to function as an additional exam room.
Best wishes for continued success,
Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week
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Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com.
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