Maintaining Profitability In These Competitive Times

BY DAVE A. ZIEGLER, O.D., F.A.A.O.
JULY 1997

Implementing these patient management techniques will help you maintain a profitable practice and put the enjoyment back into prescribing contact lenses.

The scenario is all too familiar. You've just completed an exam of a patient for whom you prescribed disposable contact lenses a year ago, and you point out that there's been a slight prescription change. Just as you're ready to dispense the next six-month supply of lenses, you hear the dreaded request: "May I have my contact lens prescription?" While trying to compose an answer, you hear the fax machine ring in the outer office. It's another request for a patient's contact lens prescription from a mail-order firm. Situations like these can make contact lens practice frustrating and worse, unprofitable.

YOUR EXPERTISE WILL GENERATE PROFITS

Historically, contact lens practitioners have relied on the sale of the lenses to generate profits, but in doing so, they've all but given away their services.

Today, patients can buy contact lenses from any number of alternative sources at prices that are far lower than those charged by some eyecare professionals. Ironically, this situation has had a positive effect on our profession. It has forced us to position our expertise as the most valuable commodity we can offer patients -- something we should have been doing long before now.

EXPLAIN YOUR FEE STRUCTURE

Patients will accept your fees if you present them properly. In our office, we provide a concisely worded explanation of our services and what we charge for them (Table 1).

We use this fact sheet for information purposes only; it is not a binding agreement. On the other hand, many practices develop formal contracts between practitioners and patients. I recommend that you avoid these Contact Lens Service Agreements, sometimes called VIP Programs. Patients tend to perceive formal service agreements as unnecessary add-ons developed to pad the practitioner's pocketbook.

COST COMPARISONS ARE ESSENTIAL

So, what should you do when contact lens patients want copies of their prescriptions so they can purchase their lenses elsewhere? Relax and try to appreciate that these patients are merely being cautious consumers. They will appreciate your taking the time to help them compare costs.

Explain that your practice offers contact lenses at prices comparable to those of mail-order firms and other outlets. We use a chart (Table 2) that lists the prices we charge for different types of contact lenses alongside those charged by a well-known mail-order firm and a local pharmacy. Once patients see this comparison, most are reassured that our prices are competitive.

However, if a patient continues to insist on ordering lenses from another source, we don't argue. We give the patient a copy of the contact lens prescription with a six- to twelve-month expiration, and then charge him or her for our professional services. In this instance, we won't profit from the sales of the lenses, but we will be reimbursed for our time and expertise. Most important, we won't lose the patient.

TAKE THE TIME TO DISCUSS CONTACT LENS OPTIONS

When discussing contact lenses with patients, it's best to give them options and let them participate in the decision-making. We find that patients who are involved in their own care tend to be more compliant.

Because most people have difficulty sorting through a lot of options, we limit the discussion to the three contact lens options that we believe best meet the needs of most patients -- daily disposable wear, daily wear two-week replacement and conventional daily wear soft contact lenses.

To help patients understand the differences among these modalities, we have developed a brochure that provides the details of:

• the features and benefits of each modality;

• the fees associated with each modality;

• the importance of routine contact lens care and the associated costs; and

• the issue of alternate sources for contact lenses and lens care supplies.

Seeing this information in print helps patients to make informed choices. If they're still undecided about which contact lens modality they would like, we give them a copy of the brochure to take home and read at their leisure.

A CAREFULLY PLANNED DISCUSSION CAN MAKE THE DIFFERENCE

Certain contact lens options require more discussion than others. The time is well-spent if you convince patients to try an option that's better for them and more profitable for your practice. For example, daily disposable contact lens wear, which is clearly the healthiest option we can offer any patient as well as the most profitable for our practice (Table 3), requires a thoughtful presentation.

It's fascinating to me that many patients who previously had no interest in contact lenses want to try daily disposable contact lenses. We've developed a short script that includes key points to emphasize and important questions to ask. (See "Doctor-to-Patient Presentation of Daily Disposable Contact Lens Wear" on page 34.)

Many practitioners hesitate to mention daily disposable lenses because of cost, but I've found that patients will pay more for a product if they understand that it offers distinct advantages over other options. We discuss the benefits of daily disposable lenses with all candidates for this regimen and leave it up to the patients to decide if they can afford it.

The cost of daily disposable wear is best presented as a per-use cost. I tell first-time contact lens wearers that their lenses will cost $1.67 per wearing -- about as much as a newspaper and a cup of coffee. When talking with patients who are wearing two-week replacement lenses, I explain that daily disposable wear will cost about 70 cents per use more than they're paying for their current contact lenses -- about the price of a soft drink at lunch. When you compare the cost to that of items patients readily purchase every day, they can more easily justify the expense.

TOOLS FOR SUCCESS

The key to maintaining a successful contact lens practice in today's competitive market is effective practice and patient management.

• Structure your practice so that you derive about 50 percent of your profits from professional fees. This approach enables you to prescribe and dispense contact lenses at competitive prices with a minimum markup.

• Develop a contact lens fee document that explains concisely what patients are getting in terms of professional services and why these services are important.

• Use a comparative chart to illustrate how affordable your lens prices are in comparison to alternate sources.

• Develop marketing tools that explain the options you offer, and then take the time to discuss these options in detail.

• Expand your range of offerings to include the latest advances in materials, such as daily disposable lenses, ultraviolet protective lenses and other products that patients expect to obtain from a skilled, knowledgeable eyecare professional. CLS

Dr. Ziegler is a private practitioner who specializes in contact lens prescribing in West Allis, Wisc. He is on the Vistakon Advisory Panel.

Contact lenses are medical devices that require ongoing care. This program of continuous care will enable us to monitor your eye health and the quality of your vision while you enjoy the vision and comfort that a well-fit contact lens provides. Our professional fee to manage your contact lens care is $56 per year. The services we will provide include: