Contact Lens Practice --
A Not-for-Profit Organization

BY JOSEPH T. BARR, O.D., M.S., EDITOR
MAY 1996

In the old days (when there were only PMMA lenses) it was common for us to mark up lenses 10 to 20 times what they cost. This amounted to approximately a $200 to $300 fee for prescribing and professional follow-up care. Keep in mind, however, that these lenses lasted nearly forever and needed little care.

Today, we have more lenses than we need (and we're thankful for that), but many of us are whining and gnashing our teeth about the low professional fee/mark up/profit on contact lenses per patient.

Many argue that this is largely due to the limitations imposed by vision care plans and managed care organizations. Still others blame the contact lens industry and its professionals. But perhaps rather than look for someone to blame, we should focus our attention on the cure. Our patients.

Certainly, we're all feeling the pinch of lower examination fee reimbursements, and requests by vision care plans to reduce material charges and fees. But remember the old cliche: "You get what you pay for." In any economy, in a free or overly regulated market, patients/consumers usually get what they pay for. Unfortunately, they can easily be misled into thinking that contact lenses are frivolous, that cheap deals are good enough, and that what's covered by their insurance plan is all they need.

We can change that mindset through proper communication. In the best interest of our patients, we must give them all the infomation they need to help justify our fees. For example . . .

"Ms. Smith, -- can I call you Susan? -- we've completed your comprehensive eye exam and tested for every disease we can. Because we've ruled you out as a candidate for refractive surgery, I recommend the Supercon contact lens that provides these benefits . . .

"I also find that your extensive reading demands and computer use require some vision training. My staff will outline a program for you. I recommend the following treatment plan for your moderate eyelid irritation, which we call blepharitis, and for your dry eyes. We'll want to make sure that this is resolved before we start you on orthoptics and contact lenses, so let's meet again in two weeks.

"Now what questions can I answer for you? Yes, all managed care/insurance/vision care plans do not cover all of your needs. That's so they can keep costs low. But obviously your eyes are very important to your livelihood and we want the best for you. We'd be pleased to work out a payment plan that satisfies your budget."

I can only hope that continued debate with third-party carriers about quality (and not just low reimbursement) and our efforts to properly communicate the value of contact lenses will pay off -- not for us but for our patients. They need access to the best, most complete care, not the cheapest, fastest care. And it's our duty to make sure they understand the difference.

Why continue to provide contact lenses for lower profits? Whether you're motivated by profit or not, patients will still want and need contact lenses. It's part of comprehensive primary optometric and ophthalmologic care and, in many cases, people can't see, work or play optimally without them. CLS