Article Date: 4/1/2010

staff training


By educating your staff, you can shift the contact lens portion of your practice into high gear.

LOU MANCINELLI, Contributing Editor


If you're looking to breathe life into the contact lens portion of your practice, consider starting where many of the top practices have found success. And that is with their staffs.

This success often begins when the patient first contacts the office. In Highland, Calif., private practitioner Pamela Miller, O.D., J.D., trains her staff “to know why the patient is coming in.” The best answers are those that are as specific as possible, she says. For example: “Do they have red eye? Is it because they can't see? It's helpful to ask ‘Is this for an exam? For contacts lenses? For glasses?’ ”

When a patient calls to make an appointment at Midwest City Vision Source, Midwest City, Okla., the staff is trained to ask whether the patient is interested in contact lenses, says Corey Christensen, O.D. This simple step “generally gets the ball rolling,” he says.

Other practices wholeheartedly agree. “We train our staff to recognize that sometimes, just planting the seed makes all the difference,” says Jay Petersma, O.D., Johntson Eye Care, Johnston, Iowa, and president of the Iowa Optometric Association.

Train from the start

The optometrists interviewed for this article all agree that it's never too early to provide staff with an education in contact lenses. Sheldon H. Kreda, O.D., Kreda Eyecare and Laser Center, Fort Lauderdale, Fla., starts training his staff to present lenses “from day one,” and staff “can't touch a phone until they are trained.”

The learning process may also include an attitude adjustment — that is, “the staff is trained to have a positive attitude about contact lenses,” says Dr. Kreda.

Identifying candidates

Beyond the front office, staff education during pre-testing is critical. Technicians should learn to first identify prospective contact lens patients based on those patients' medical histories and pre-test results.

The staff must also learn to identify the factors other than eye health that contribute to successful contact lens wear, including occupation, recreation, lifestyle choices and motivation.

For example, at Midwest City Vision Source, “we are big advocates for children in contact lenses for sports,” says Dr. John C. Smay, who practices along with Dr. Christensen.

Dr. Miller teaches staff that patient motivation is an essential element in identifying a prospective contact lens wearer, regardless of age.

“A young patient has to want to wear contact lenses, it's not just about the parents wanting their child to wear them,” she says. “It doesn't matter if the patient is eight or 15-years old.”

In recent years, age has become less of a factor in the decision to recommend contact lens wear, as studies show children can adhere to contact lens regimens. Dr. Kreda tells all his staff members about a report he saw more than 30 years ago on television about six-year-old diabetics who were able to inject themselves with insulin shots.

“Every parent thinks their kid is not responsible enough [to wear contact lenses],” says Dr. Kreda. “I share this experience about the report with the staff. We train our staff to give parents a hand-out about kids and contact lenses.”

You can also train your staff to suggest lenses for social functions, says Dr. Petersma.

“We teach our staff to suggest to patients who are in their 40s now, that they might want to put in one contact lens when they go out to dinner so they can see the menu, or at the theatre, so that they can read the program and see the show,” he says. In these situations, the staff is helping patients when they need just a little help seeing while providing them with an introduction to contact lens wear.

Another effective technique is to train staff members to offer disposable lenses to patients after their exams to help them see while they check out new frames. “A lot of times, the patient likes how clear their vision becomes in the contact lens,” Dr. Petersma says.

For issues, such as keratoconus, several doctors train their staff with handouts to suggest contact lenses as a treatment to slow and adapt to the thinning of the cornea.

“The same is true of training staff to fit patients with presbyopia, and hard-to-fit patients,” says Dr. Christensen.

Those interviewed also emphasize a larger benefit of this strategy: By delegating contact lens tasks, practices may free up, you, the doctor, for other responsibilities.

When the answer is “no”

If a patient is not interested in contact lens wear, train your staff to understand why. Top practices understand that the patient may feel more comfortable voicing objections to the staff.

“If a patient says ‘no,” says Dr. Kreda, “we train the staff to ask them ‘why not?’ Depending on the response, we either let it be or continue to ask questions until we hit a sort of dead end.”

By asking “why not” the staff may uncover an opportunity to dispel misconceptions about contact lenses. For example, patients may assume they aren't good contact lens candidates for any number of reasons including astigmatism, dry eye, allergy or previous unsuccessful wear.

“Some patients might have tried contact lenses years ago, but found them uncomfortable,” says Dr. Kreda. “So we train our staff to say, ‘You know, there have been tremendous advances in contact lenses, similar to advances in computer technology.’ A lot of patients are not aware of this.”

And what happens if the patient still declines contact lenses? “We teach our staff that some patients are just not interested, and that's fine,” Dr. Kreda says. “We need to remember that we are treating patients, not selling contact lenses.”

Understand too, that today's “no” might be next year's “yes.”

“Patients often change their minds,” says Dr. Miller. “If the patient says ‘no,’ or they aren't ready for contact lenses, make a note to ask them again at their next visit,” says Dr. Miller.

The O.D. handoff

After check-in and pre-testing is completed, the staff must communicate the patient's contact lens information to the doctor. Many practices train staff to use a standard exam sheet, checklist or routing sheet, which indicates the patient's reason for visiting the office and interest, or lack thereof, in contact lenses.

“In our office, the technician is trained to indicate whether a patient is interested in contact lenses by marking it on the front of the routing sheet so our doctors can see this as they enter the exam room,” says Dr. Christensen. “They also document the patient's interest in contact lenses on the exam record in the computer.”

Tips for training

In busy practices, it can become challenging to find the time to train staff properly. However, the O.D.s interviewed all agree that it's time well spent. Midwest City Vision Source takes advantage of a number of opportunities to train staff including initial one-on-one training with new employees, says Dr. Smay. Also, the practice holds monthly clinical department meetings as well as “lunch and learns,” sponsored by contact lens companies, “where the entire staff is educated on the newest materials and designs available,” Dr. Smay says.

Dr. Kreda trains staff himself or assigns a specific staff member for the task. “It's important they don't get everything secondhand,” he says.

To ensure their skills are sharp, Dr. Kreda observes staff. He may also test them, use scripts, go over hand-outs and review techniques for explaining different types of contact lenses to patients.

Dr. Kreda provides his staff with laminated sheets of basic lens information, separated “not by brands, but by categories,” such as silicone hydrogel.

At Johnston Eye Care, Dr. Petersma provides one-on-one training, but he also relies on the staff to take the initiative and absorb training through their experiences in the office.

The bottom line

In the end, all interviewed agree that the staff's effectiveness in supporting contact lenses is a reflection of the practice's CEO.

“The key to success is education and communication,” says Dr. Miller. “You want your staff to be a team. You want them to have the same attitude as you. So it starts with you. And empathy is key.” OM

Mr. Mancinelli is a freelance writer based in the Philadelphia area.

Optometric Management, Issue: April 2010