Presenting the PRP Option In 2 Minutes or Less

BY WALTER D. WEST, O.D.
APR. 1997

A reader has asked, "What is the most efficient way to present the planned replacement option to patients?"

Yes, it can be an exercise in frustration when we try to present the myriad variations on the planned replacement theme succinctly to inquisitive patients who want to feel they are active participants in their health care decisions.

One of the most important aspects of your discussion of planned replacement is your attitude toward the modality. Patients appreciate hearing about all their options, but they also want to know what you would recommend specifically for them. Patients like to feel they're making the right decision, and they gain confidence in that decision knowing that it's the same as the majority of patients.

THE PRP RAP

Typically, with a new spherical lens patient, I explain the types of lenses and wear schedules in a brief, point-by-point manner. My presentation usually goes something like:

"There are two basic types of contact lenses -- rigid gas permeable and soft lenses, and for each type of lens there are two ways of wearing them -- extended wear, which means you can sleep with the lenses on your eyes, or daily wear.

"If we put you in soft lenses on a daily wear schedule, you'll have two options. There are disposable lenses that you wear for only one day and then throw away, and there are lenses that you discard every two weeks. We also have conventional lenses that you can keep for up to one year, but you must maintain them with daily cleaning and weekly enzyme cleaning."

At this point, I'll give the patient the opportunity to ask questions. I know I've done my job and communicated well if the patient asks, "Doctor, what do you think is best?"

I believe in the benefits to ocular health provided by replacing lenses frequently, so I usually respond:

"For patients like you, I have greater success with disposable contact lenses. I find that patients are more comfortable when they replace their lenses more frequently with a clean, scratch-free lens. Plus, they enjoy having the added security of spare lenses in case they lose or damage a lens."

SOUNDS GOOD, DOC, BUT HOW MUCH DOES IT COST?

Some patients base their decisions on price alone. It's the only relative value scale they know. When someone asks, "Which lens is more expensive?" I tell them:

"This is what you'll spend on a premium conventional lens. Now, here's what you'll pay for your initial supply of disposable lenses. In six months, you'll need to buy another supply. Yes, you'll spend a little more money on the disposable lenses, but you won't need the amount of solutions or the enzyme tablets you'll need for conventional lenses."

Also in my practice, we replace all lost or damaged planned replacement lenses free for the first year. (We don't offer the same service for conventional lenses.) This is similar to our warranty on spectacle frames, which we will repair or replace for a year. This type of service adds value and improves the quality of our relationship with patients.

BEST, BETTER, GOOD -- BUT NEVER BAD

Although there seems to be a lot of discussion today about contact lens profit centers, I believe in contact lens care centers. In my practice, our primary concern is what's best for the patient. If I present the various contact lens options and wear schedules in a 'best, better, good' manner, I feel I've educated patients sufficiently. If a patient is especially price-conscious or chooses conventional lenses for some other reason -- perhaps because a family member is wearing them successfully -- I can still feel good about focusing on patient needs rather than my profit margin. If all the opportunities I've presented are appropriate, but merely one is better than the others, there really is no bad choice. CLS

Dr. West lectures nationally and internationally and has served as a clinical investigator for contact lenses. He is in private practice in Brentwood, Tenn.