Article Date: 7/1/2005

Strategy Session
Whether you're just starting out or ready to take your contact lens practice to the next level, you'll need to know about four bedrocks of success.

Certain aspects of successful practices are universal. Good communication between patients, doctors and staff. Cutting-edge technology. A strong, growing list of patients and the positive relationships that keep them. Here, four voices of experience offer the strategies that help them achieve these goals.

Communicate well

The panelists attribute much of their success to good communication. "Patients' perceptions hinge on the doctor's communication," Dr. Kerksick says.

"They perceive us as competent and thorough if we offer a wealth of good information and answer all their questions."

But how to begin? "I try to listen more and speak less, taking my cues from the patients' words and body language," Dr. Kerksick says. "I'm always checking for clues like fidgeting, checking a wristwatch, or showing signs of feeling flustered or overwhelmed. These things affect my approach."

When it comes time to ask questions, says Dr. Kerksick, you can improve your interactions, not just by asking the right questions but by asking enough questions, especially when discussing contact lenses.

"Beyond just making sure a patient can see well and can apply and remove his lenses, I've stepped it up a notch," she says. "I also ask, 'Can you wear your lenses for 8 hours and are they comfortable? Are you motivated to wear them the next day?' Then we talk about those issues." This caring approach has improved patient loyalty and netted more referrals, says Dr. Kerksick.

Your office staff needs to become skilled at communicating with patients as well. "Staff training is incredibly important," Dr. Stiegemeier says. "We can't answer every question in one visit, so we need to constantly renew our staff training. Teach them about new products and even have them wear new lenses to get a feel for them. I also instruct staff how to get the necessary information from patients."

Dr. Stiegemeier relies on her staff's communication skills to help her market contact lenses. "From the minute patients walk in the door — from the receptionist to the technician to the optician and, finally, to me — they're hearing about contact lenses," she says. "On the sign-in sheet, we ask whether patients have ever worn contact lenses and if they're interested in learning about newer, more comfortable lenses. This helps us identify dropouts and potential new contact lens patients. A satisfied patient who has had trouble wearing contact lenses in the past is a great annuity for your practice."

When Dr. West teaches communication skills to his staff, he combines research and personal experience. "I cite Albert Mehrabian's rule: Of the information people absorb about a speaker, 55% is appearance, 38% is voice and only 7% is the real message," he explains. "I didn't know this rule when I started practicing. I thought people came to me because I was the best optometrist in the world. Over the years, I learned they returned because I could remember their names and talk about their kids, and I duplicated that type of personality in my staff."


"I thought people came to me because I was the best optometrist in the world. Over the years, I learned they returned because I could remember their names and talk about their kids, and I duplicated that type of personality in my staff."

— Walter D. West, O.D., F.A.A.O.

Project progressive values

Certainly, when we think of top practices, we think of cutting-edge treatments and research involvement. For these doctors, building a progressive practice is a two-fold process: Taking action and spreading the word. "To really succeed, you want to establish your practice as progressive in nature," Dr. Knight says. "If you do, patients will feel confident enough to recommend you to friends and family."

Publishing articles can help enhance a progressive image, says Dr. West. "If you and your staff can tell patients, 'Here's an article that doctor published,' that goes a long way in establishing credibility," he says. "Regardless of the publication or the topic, patients are very impressed."

One hallmark of a progressive practice is a doctor who uses the latest technology. "If we give patients the same tests and the same lenses year

after year, what's their perceived value in coming back annually?" Dr. Knight asks. "My patients know I work with state-of-the-art materials, so they return each year asking, 'What's new?'"

Be sure to use all your resources, adds Dr. Stiegemeier. "To be up-to-date with the latest products, you need to build good relationships with your reps," she says. "They can even help with staff training."

Certain instruments can add value to your practice, says Dr. Stiegemeier. "I love my anterior segment camera, and so do my patients," she says. "I can demonstrate what I'm doing or use a photograph to explain an unusual problem. It's a great tool for illustrating pathology. It really helps patients understand why they need treatment." Dr.Stiegemeier also likes to use pachometry to help extended-wear contact lens patients see the effects of sleeping in their lenses.

When doctors embrace the latest technologies and tell all their patients about them, the positive impact is exponential. "When we talk to patients about a new technology, regardless of whether it will work for them or not, they're likely to pass along the information," Dr. West says. "They might have a grandchild who wants LASIK or a son-in-law who has complaints about his contact lenses. When we talk about a new technology, the information goes far."

Not only will patients pass along information, Dr. Knight says, but they'll come back when a product becomes available. "I keep my comments open-ended," she says. "Maybe I know we'll have a new product soon that will help a dry eye patient wear contact lenses. Or I may just mention, 'The technology is always improving, so we could have something for you next year.' I try to build hope and anticipation for a patient's next visit."

Dr. Stiegemeier contacts appropriate patients as soon as a new technology is available. "I love it when patients see a new product on television and come into the practice to learn more, but I'd much rather be the source of that information," she says. She tells all her patients about new products in the practice newsletter. She targets specific patients in person.

"I'll tell patients with a certain need, 'A new lens that might work better for you is coming out in November. I'll call you when it arrives,'" she explains. "When it comes in, we call or send a note saying, 'The new lens we talked about at your last visit has arrived. Please call for an appointment,' and they come in for an extra examination."


Small Gestures — Big Rewards


When Dr. Knight hears or reads about a patient's accomplishment — maybe a sports or academic achievement — she dashes off a note of congratulations. "It's amazing," she says. "They're so excited to get a note, and they remember that."

Don't hold back

The panelists agree you need to charge appropriately for what you do. Dr. West adds another important caveat: Offer every patient the best level of care.

"I can't offer toric lenses to one candidate and not another," he says. "I'd miss some new toric patients. And imagine that those two patients are neighbors, and one of them comes back and says, 'Why didn't you tell me about those lenses?' I wouldn't want either of us to be in a conversation where I say, 'It didn't seem like you could afford it.'"

Dr. Kerksick admits as a new practitioner, she once struggled with recommending more costly products. "Then I bought a new house," she says. "After it was completed, I learned the contractor didn't offer me a $1,000 fireplace upgrade that I definitely would have purchased. It made me realize I can't assume people are content or they don't want to pay more for something better. Since that epiphany, I've transitioned a number of patients to specialty contact lenses."

A contact lens upgrade certainly exceeds patients' expectations, a goal Dr. Kerksick says is essential for growing a practice. "Specialty lenses are a very profitable area, but we need to fill all of our patients' needs, not just good vision and comfort," she says. "We need to build their confidence and offer thorough education — training them to apply and remove lenses, explaining what to do if the lenses are a little dry, for example. It takes just an extra 5 minutes, but it makes a huge impact on a patient's satisfaction."

Take the time — rewards will follow

The panelists agree building lasting relationships does take time, but they're critical for practice growth and patient retention. Are these goals attainable, even in today's competitive environment? Watch upcoming issues of Optometric Management to track the progress of two contact lens practices selected for an "upgrade" as they begin employing the strategies recommended by Dr. West and other key consultants over the next several months.

Sharing Success Through Referrals

"One barrier that keeps some practitioners from achieving success is a lack of good relationships with other doctors," Dr. Stiegemeier says. "It's so important to maintain a healthy referral relationship with ophthalmologists, surgeons and even family doctors."

These relationships hinge on mutual respect and good communication, says Dr. Stiegemeier. "I let the M.D. down the street know her patient came to me and why, and I also tell the patient he needs to return to the M.D. for scheduled visits," she says. "In return, that doctor will refer or even turn over contact lens patients. I've had many M.D.s say, 'This patient really doesn't need to see me unless there's a problem. Please go ahead and take care of him.' In either case, I always take the time to write a thank-you letter."

Dr. Kerksick looks at education as a vital part of initiating these referral relationships. "I tell doctors what we can do for their patients," she says. "This has paid off particularly well with children. That facet of my contact lens practice has grown quickly because I'm aggressive in fitting children with contact lenses. I've let doctors know this is available."

These relationships with colleagues are a success in themselves, says Dr. West. "From a doctor's perspective," he says, "one of the hallmarks of success is the professional respect of our peers."


Embrace the "D" Word

All the panelists agree: Well-trained staff can contribute to your success. They help set the tone for your patients, keep the practice running smoothly and play an integral role in contact lens marketing.

"If you want to take your practice to the next level, you simply can't do everything yourself," Dr. Stiegemeier says. "Delegation is one of my most important practice-builders. By training and empowering people to work as an extension of the doctor, you can feel confident that the work will be done to your satisfaction. My staff does the entire contact lens fitting from initial lens application to insertion and removal training and care instruction. This lets me use my time better."

Delegating appropriate tasks will make you more efficient and your staff happier, says Dr. West. "When we started training our staff to accept greater responsibility, they became happier," he says. "They appreciate the opportunity to grow within our organization. And the benefits are twofold — they get a better job with more money, and we get a better employee and make more money. Doctors often say it's difficult to hire or retain good people. I find that delegation is a good solution."


What About Those Drapes?

When it comes to the appearance of your contact lens practice, subtle changes and simple cleanliness go a long way, says Dr. Knight.

"After buying a 40-year-old practice, I received a lot of feedback from my patients," she says. "My challenge was to update the practice's technology while keeping the homey environment patients said was important. I started making changes gradually — nothing radical, just things like adding up-to-date magazines and fresh flowers — and patients had positive comments."

And remember, your patients don't just look at the drapes. They look at you. "How we and our staff present ourselves — how we look, whether we're in uniform, our hygiene — all of these things affect our credibility with patients," says Dr. Knight.

Dr. Stiegemeier agrees: "Cleanliness is really, really important. Patients have to feel they're in a very clean environment. It's important that you wash your hands in front of them and that everything looks neat and organized. A calm, gentle environment makes people relax and feel good about the care they're getting."


Optometric Management, Issue: July 2005