Article Date: 3/1/2009

The In-Office LAB Advantage
optical lab

The In-Office LAB Advantage

How can an in-office lab impact your practice and patient satisfaction?

TODD M. CLARK, O.D., Westerville, Ohio

Is a substantial amount of your practice comprised of spectacle-wearing patients who aren't required to get their eyewear from third-party insurance company labs? Are you interested in how ophthalmic equipment works and the decision-making involved in their function? Do you enjoy being in control of your practice's reputation? Does your practice have at least four feet of counter space, or can you create this space? If you answered yes to these questions, I have one last question for you: If your practice doesn't have an in-office lab, why not? You're the perfect candidate! Here are the two reasons you should consider it.

1. It saves and makes you money

Examine your most recent lab bill. Imagine the bill decreasing by 20% or more. Now, multiply that number by 12, 24 and 36. This is substantial additional revenue for your practice.

I've discovered that most in-office edging systems cost roughly $30,000. A five-year lease would cost you about $630 permonth. (Keep in mind, however, that you're likely to get an even better leasing agreement because interest rates are down due to the current state of the economy.) Selling one single-vision pair of spectacles a day pays for your in-office edging system. The rest becomes profit. (See, "Rough Profit Analysis Based on a 50-Week Year," below.) Traditional bifocals and progressive lenses offer the same profit profile as this sidebar illustrates. Meanwhile, polycarbonate and Trivex lenses offer a similar profit profile, while hi-index and freeform lenses offer an even greater profit profile (patients are pre-conditioned to pay for technology-driven lenses).

Think back again to your lab bill. Now, pay particular attention to the additional fees for edge polishing, grooving, drill mounts, ultra-violet protection and scratch-resistant coating. Add-on costs are probably one of the main profit centers for your current lab that could be yours — if you employ your own in-office lab. (See "Profit Analysis for Add-ons: Based on One Job Per Day," below.)

A tinting unit can provide additional income as well. I've found that outside labs charge between $15 to $18 to perform this service (i.e. dipping the lens in a UV chemical for 15 minutes). The bottle of the UV chemical costs between $15 to $18 and lasts four to five months. I've had several patients purchase new eyewear and express concern regarding what to do with their old eyewear. Having the tinting unit enables me to give these patients the option of turning their old spectacles into sunwear. While this isn't a true multiple pair sale, it has increased my per-patient revenue. (See "Profit Analysis for a Tinting Unit: Based on One Job Per Day," below.) In addition, patients tell me they greatly appreciate the service. This has not only created patient loyalty to my practice but some referrals as well.

You can maximize profits with your in-office lab by shopping for the best lens prices and using it for every indication possible. When purchasing uncut lens blanks, don't limit yourself to using one lens lab or a wholesale lab, as you may be paying more than you need. Because some lens labs only distribute single vision or progressive lenses in mass quantities, they can offer exceptional pricing. In addition, direct distribution offers savings as well. To determine which lens labs and direct distributors offer the best deals, ask your colleagues who currently operate in-office labs; ask the manufacturer of your in-office lab equipment; and browse the advertising sections of the various optometry-related journals. To get the most for your money, you must always think of your profit margin. This requires a constant "shop-around" mentality.

Some practitioners use their edging systems for single vision jobs only. Because progressive lenses are more expensive than single vision lenses, practitioners send them to an outside lab to prevent a possible financial loss, should the practitioner or in-office lab technician make a mistake with the lens. Although edging errors will occur, the right equipment selection and unrushed staff training minimizes these mistakes and maximizes profit.

The addition of any new technology often reinvigorates an employee's interest in his or her job, as it provides the opportunity to learn something new, have an increased role in the success of the practice and the potential for an increase in compensation — especially with the operation of optical equipment. The amount of staff training required depends on your staff members' skill levels in operating your current ophthalmic equipment and their comfort level with the in-office lab equipment. The specific amount of training a lab equipment company offers can also play a role in your decision-making regarding which equipment to purchase. I've found that most lab equipment companies offer an initial day of training with follow-up training a few months later to implement more advanced features. (See "The Keys to Selecting In-Office Lab Equipment," below.) Remember: Your equipment purchase is only as good as your ability to use it. If you operate a very busy practice with a lean staff, you may need to hire additional staff to assist in the operation of your in-office lab. But, I encourage you to assess the possibility of cross-training your current staff members first.

The Keys to Selecting In-Office Lab Equipment
1. Assess your specific needs. Prior to shopping around for your in-office lab equipment(s), make sure you know what your specific needs are for both today and the future. Some questions to ask yourself: Will it improve patient care? Will it fit in the space I have? Does the lab savings provide additional income after the expense of a loan payment, staff costs and allocation of space? Do I need a remote tracer? Do I need a drill for drill-mount frames? Do the device's features meet my expectations in terms of the eyewear I want to deliver? Can I add features down the road?
2. Request an in-office demonstration. Several companies produce in-office lab equipment — many of which offer similar features. As a result, request an in-office demo from the companies whose devices you like. You want both you and your staff not only to be comfortable with the equipment but also with the company representative who's going to help you with the installation and training.
3. Examine the warranty and services contract. Is the warranty for parts only? Does the service call come at a high hourly rate including travel? Is the training included as part of the service contract, or is there an hourly rate for training? These are all questions you should have answers to prior to purchase.

If hiring more staff seems likely and you want to know whether the in-office lab equipment will offset this cost or you want to make sure it costs less than using an outside lab, contact the lab equipment company or companies to conduct a cost analysis. The following lab equipment company web sites allow a cost analysis: www.aitindustries.com/pages/consulting/profitanaly sisform.html, www.briot-usa.com/profit/profit.php, www.santinelli.com/fin_profitanal.aspx, and www.topcon.com/medical.html. (See "The Latest Lab Equipment," at the end.)

2. It creates patient loyalty

Imagine this: A cataract patient presents needing a prescription change in one lens and wants to use his current frame for the new lens. You explain to him that you have to send his frames to your outside lab, which means the patient won't have his spectacles for a few days. The patient may have an old back-up pair he can use in the interim, but he'll likely leave your practice with his prescription. Why? He, like other patients, knows that optical chains, such as LensCrafters and Pearle Vision, can sometimes provide same-day delivery and often within an hour of the prescription drop-off. In addition because several of the optical chains have an optometrist onsite, there's a chance the patient may not return to you. Everyone puts enormous value on convenience.

If you had an edger with a tracing unit and memory system, you could trace the patient's frame, store it and edge the lenses when he arrives. Then, you could notify the patient that his new lenses are ready. He just needs to stop by so you can insert them.

Or, if the edger doesn't have a memory feature, you could order the lenses and when they arrive, notify the patient and schedule an edging appointment.

In both cases, the patient doesn't have to be without his frame, making him more likely to purchase his eyewear from you.

For argument's sake, however, let's say that the patient agrees to wait for your outside lab to create his eyewear because you provided him with impeccable service, and he assumes your outside lab will do the same. When you send your patients' spectacle prescription to an outside lab, you relinquish quality control, which places both you and your practice at risk of losing your reputation for impeccable service.

So, if you have to call the patient and explain that he'll have to wait a few more days for his frames due to lab error, his past impression of you and your practice will be tainted. Although the lab made the mistake, and not your practice, the fact is you chose to send the patient's spectacle prescription there. So, in the patient's eye's (pun intended), you're at fault. If this occurs, the patient may seek his future eyewear elsewhere (i.e. an optical chain or another private O.D. who has an in-office lab).

Every patient won't fill his prescription with you. But, an in-office lab greatly improves the chances of the patient not only purchasing his eyewear from you but also retaining you as his eyecare practitioner.

Practice growth in other eyecare areas, such as contact lens wear, may be minimal due to the current state of the economy. The addition of an in-office lab is an excellent way to increase profits. So, if a substantial amount of your practice is comprised of spectacle-wearing patients who aren't required to get their eyewear from third-party insurance company labs; you're interested in how ophthalmic equipment works and the decision-making involved in their function; your practice has at least four-feet of counter space or you can create it; and you enjoy being in control of your practice's reputation; there's no time like the present to consider incorporating this money-saving and making, patient-pleaser. OM

THE LATEST LAB EQUIPMENT
AIT Industries' AIM Network, which is an abbreviation for AIT In-Office Mini-Lab, divides the duties of tracing, blocking and edging to provide you with the efficient production of finished eyewear, the company says. In addition, the AIM Network offers you a remote tracing solution for multiple location dispensaries to work with one central finishing lab with encrypted secure communication via the Internet. Other AIM Network features: computer-integrated blocking through VCA communication standard for enhanced productivity; wrap frame edging technology; and hi-luster polish capability. Visit www.aitindustries.com.
Briot USA's Accura Silver Plus finishing system has built-in tracing, blocking and edging. The system's multi-axis tracer measures frame height, length and curve, while analyzing frame thickness to ensure an accurate frame fit. Also, it features specific edging cycles for hydrophobic and fragile lenses; automatic safety beveling (pre-set and manual bevel options) hyper-polish and a full-size screen to provide error-free verification of the uncut lens to the frame shape, the company says. Visit www.briot-usa.com.
Gerber Coburn's Kappa D Edging System consists of the Kappa CTD edger and standard Kappa Tracer. It enables you to perform tracing (memory storage is available), shape modification, edging, polishing, grooving/chamfering and drilling coordination. Further, the system includes a two-way video system allowing for manual centering and automatic blocking. Shape modification is available for A and B size with homothetic transformation as well as ½ B size in one point. Visit www.gerbercoburn.com.
National Optronics' Dimension Tracer enables you to perform difficult tracings, including all frame styles, patterns and lenses, such as high wraps, via its touch screen, the company says. It allows you to modify traced shapes in all dimensions to create custom lens designs; automatically detects frame movement during tracing; and alerts you to differences in shape geometries between the eyes. Further, it captures 3-D data on frames and lenses for optimized lens size and bevel placement. Visit www.nationaloptronics.com.
Optical Dynamics' nanoCLEAR AR anti-reflective (AR) coating machine works exclusively with Optical Dynamics' Q-2100R Digital Lens System. The Q-2100R develops the patient's lens from a liquid plastic employing an in-mold process. Before creating the lens, you lay the nanoCLEAR AR stack on the molds. This creates a lens comprised of an AR coat in roughly an hour, the company says. Visit www.opticaldynamics.com.
Santinelli International's ME-1000 Design+ Edger now has the same software as the LEX-1000 edger, enabling it to effectively bevel high base-curved lenses, as it processes the front and back bevel independently. This process creates a consistent and custom profiled bevel around the circumference of the lens, resulting in an accurate fit, the company says. Visit www.santinelli.com.
Super Systems Optical Technologies' Fast Grind 2200 System surfacing device is now available with AR capability. It features a three-pad process that produces fine and polish prescription multifocal and single-vision lenses (ranging from +6.00D to -9.00D in up to a 3.00D cylinder) using tap water alone, in less than 12 minutes, the company says. The device doesn't use resins, slurries or chemicals. Visit www.superoptical.com.
Topcon Medical Systems' Ultima 5100 series offers three different finishing systems: an entry-level model, the SG (safety beveling and grooving) model and the XP (express) model with cosmetic beveling. All three include a 10.4-inch color LCD screen and enable you to edge and polish all lens materials (with individual settings/cycles for Trivex and super-thin high-index lenses). The SG and XP models provide safety bevel polish. In addition, the XP provides roll and polish to reduce the thickness of high-power myopic lenses. Visit www.topconmedical.com.
Visionix's VL3000 Lensmeter/Mapper employs wavefront technology to objectively measure any frame and lens type with the push of a button. It features real-time power mapping of various lens types, such as single vision, automatically measures the addition and far vision of any progressive lens and presents a schematic representation of frame fitting and papillary distance measurement. Other features: a diagram representation of the progressive addition channel, automatic progressive addition measurement and right and left fitting heights. Visit www.visionix.com.

Dr. Clark owns Image Optical — a two location solo practice in the Columbus metro area. E-mail him at toddmclarkod@aol.com.


Optometric Management, Issue: March 2009