Article Date: 1/1/2008

Prescription for Success With Contact Lenses
contact lenses

Prescription for Success With Contact Lenses

Here's a plan to make your contact-lens practice healthy for you and your patients.

JON FORCHÉ, O.D., F.A.A.O, & NADINE FORCHÉ, O.D., M.S., F.A.A.O. Athens, Ga.

Many optometrists find the competition in the contact-lens field overwhelming. Creating a plan for success can make your contact-lens practice enjoyable again. This requires planning and time, but once in place, you'll realize the clinical and financial benefits of contact lenses. Here are the four steps we use in our practice to create success with contact lenses.

Step 1: Start with your costs

Do you know how much you pay for a box of "x" brand contact lenses vs. the practice down the street? Most of us know that big-box and online retailers get their boxes for less due to their volume — and some even sell them for less than our wholesale cost. Don't worry about what others pay; maximize your profit by using these three ideas:

Put your money in a "bank." You can purchase a set amount of given contact lenses at a discounted price from a distributor, and the distributor will manage the inventory offsite in a "bank."

We've used banks in the past for our most commonly prescribed specialty contact lenses, such as torics or multifocals. The reason we bank specialty lenses is because it's unrealistic to have in-office inventory of these products due to the large number of parameters available. Most distributors will offer net terms of 60 days, giving you time to "sell" a significant amount of product before your bill arrives. This makes the initial cash payment upfront less of an issue.

Keep a basic inventory of your favorite sphere "go-to" lens. You will often get better pricing when buying boxes in "bulk," and patients are impressed when they can leave your office with their contact lenses in hand. We typically have -0.50D through -6.00D spherical lenses available in our inventory and enough boxes to enable us to dispense a year supply in each power.

We recommend you replenish missing stock at the end of every day or week (depending on the volume of your contact-lens practice) to maintain your inventory. (See "An Introduction to Speciality Contact Lenses," in the August 2007 issue for the benefits of inventory for your practice.)

Use manufacturer and distributor tools. Your sales reps have a wealth of information about your specific prescribing habits and the contact-lens market. Remember that they have a vested interest in seeing you succeed with their lenses. So, use them to tailor your banks and inventory to what you prescribe. This will help you set prices based on the range of selling prices for their product and will help you market rebates directly to your patients. Bar scanners are another tool some manufacturers and distributors are starting to offer so you can keep track of trials and inventory boxes. Vendor Web sites offer practices the ability to order and reorder missing trial powers and inventory boxes, keeping your stock continually up-to-date.

Step 2: Set your retail prices

What is the normal markup for contact lenses? It depends. Many doctors used to mark-up twice the wholesale cost, but for popular spherical lenses that's no longer the case. So, use your reps to help determine your retail pricing for widely available lenses. It's also helpful to have your staff research the local competition and Internet sellers. The markup for specialty lenses — such as keratoconic lenses, high-toric soft lenses and GP lenses — can be higher, as companies often custom make them.

Most of us aren't going to beat large Internet companies on price, and we think most practices shouldn't try. Instead, offer benefits of convenience or quality that patients can't get from online purchases:

Keep an inventory of your "go-to" lenses, so patients have one-stop shopping.

For non-inventory lenses, ship directly to patients free of charge, saving them another trip to your office and additional administrative work for your staff.

Offer complete satisfaction. We put stickers on every box that has our practice name and phone number, a place to circle right or left eye and a statement that we accept unopened, unmarked and unexpired boxes for return at any time. Of course, we make exceptions to that statement to keep patients happy, allowing some to return opened boxes when powers change (some manufacturers even let you return opened boxes for credit). Our goal is to offer patients something they can't get from a faceless Internet company: personal contact and consideration for their specific needs and problems. On occasion, we dispense our diagnostic lenses to help patients whose lenses are on back-order, as well.

Offer in-office rebates for a year supply of contact lenses. In addition to any manufacturer rebates, the savings patients get from obtaining their lenses from you can add up. Show them their savings using an easy-to-read handout that lists the cost per box when they purchase in "bulk." Our society is used to getting deals for buying in bulk, and patients easily understand the concept. It also saves your staff time, as there's only one transaction for that patient for an entire year.

Step 3: Set your professional fitting fees

We've all heard that patients pay doctors because we have specialized training to help them with a healthcare need or concern. We all took many hours of contact-lens classes in optometry school and continue our education in seminars every year. Set your professional fees to reflect this higher education and the difficulty of the fit. We have several different levels of contact-lens fitting in our office. For instance, patients with more difficult needs or who require more time-consuming fits are at a high level (see "Table 1: Levels of Contact Lens Fitting Fees").

Step 4: Educate your patients

What? You don't have a separate fee for a contact-lens evaluation? The first step in educating your patients about contact-lens services: Separate your contact-lens fees from your comprehensive eye-examination fees. Contact-lens wearers require more diagnostic testing, time and skill from you and your staff. To help patients understand this difference, we use a laminated handout, "What is a Contact Lens Evaluation," throughout our office. We keep copies in every exam and waiting room and in our business office for when patients have questions when checking out. We find this handout a valuable educational tool for both current contact-lens wearers who are new to our practice or established patients who have already undergone an initial contact-lens fitting in our office.

For established contact-lens wearers, remember to ask about their current wearing habits. The contact-lens history should include but not be limited to: contact-lens wear schedule, cleaning/disinfecting solutions (care regimen), comfort and vision. This information not only helps you, it shows the patient the complexity of contact lenses. In our office, we use the American Optometric Association guidelines for healthy contact-lens wear to remind established patients how to properly care for their lenses. Long-time contact-lens wearers may fall into bad habits, so these guidelines remind them that contact lenses are medical devices that require a prescription, proper care and yearly examinations.

For new contact-lens wearers, we use several tools to educate our patients about contact lenses:

Patient education software. Several excellent patient-education software programs are available to educate your patients while they wait for you in the exam room.

Personalized brochures. We created a personalized brochure containing contact-lens materials, modalities and services to educate patients on our practice's offerings These professionally produced brochures are available in all exam rooms and waiting areas for easy-patient access.

Talk. Use the time at the biomicroscope to talk about what you're looking at and your findings, so the patient hears your clinical decision making and understands your recommendations. For example: "Now I am looking at your cornea, where the contact lens will rest. Your cornea looks very healthy and with a few contact-lens diagnostic tests, we'll find the best contact lens to give you clear, comfortable, healthy vision." Also, have your technical staff use scripts to explain diagnostic procedures, such as keratometry, autorefraction and topography.

Enthusiasm and confidence in your clinical ability and the contact-lens performance. Enthusiasm is contagious. It motivates wear and confidence in your contact-lens selections. Use simple phrases: "It's a great time to be a contact-lens wearer…" or "New contact-lens technology that was never available before can now help your visual problem (insert dry eyes, astigmatism, presbyopia here)." We discuss newer materials that provide better vision, comfort and more options than older materials. We also discuss how state-of-the-art contact-lens designs and our diagnostic equipment make it easy to fit almost any patient.

Personalized presentation of fitting fees. We find it effective to use our "Contact Lens Evaluation" handout (described earlier) when we present fees. After quoting the fitting fee, mention that the fee includes "X" number of office visits, diagnostic (not trial) contact lenses and solutions. Also mention that once the contact-lens prescription is finalized, the only additional cost is for the supply of contact lenses, which you can ship directly to the patient or even hand to him at his final fitting visit, if you stock that brand.

The contact lens agreement. After we complete the fitting, we have each patient sign a contact-lens agreement for their particular contact lens. This agreement shows the price per box as well as the discounts associated with a purchase of a year's supply. We show the patient the discounted price per box with all rebates included.

The agreement also includes the recommended time for his next examination and a list of symptoms that he should not ignore, such as burning, to keep his eyes healthy.

Promote the value of your services

Today's contact-lens environment is more challenging than ever. Many patients view contact lenses as a commodity that they can purchase anywhere from a doctor's office to the local gas station. As optometrists, it's our duty to show each patient the value of high-quality contact-lens service. We've found that researching contact-lens material costs, setting appropriate material and service fees and educating patients about all aspects of contact lenses can make a contact-lens practice more pleasant and profitable. OM

Drs. Jon and Nadine Forché are in group practice at Five Points Eye Care in Athens, Ga. They both completed residencies through the Department of Veterans Affairs. Drs. Forché also provide optometric consulting services and lecture in Georgia through Forché Consulting Group.

Optometric Management, Issue: January 2008