PATIENT RETENTION
Retaining Soft Contact Lens Patients
Try these tips to keep your soft contact lens patients coming back for continued care.
By Eric Porisch

Over the past few years, some notable economic trends have occurred in eye care. Expenses have been climbing. The minimum wage has increased, as have the compensatory wages to retain properly trained staff. Health insurance for eyecare staff has gone up at proportions far exceeding the cost of living, which itself is rising at three to three-and-a-half percent each year. Newly graduated practitioners also face the reality of paying back school debt at a much larger percentage of their future income than their predecessors paid.

Revenue, however, struggles to keep pace with these increased costs of managing a traditional eyecare practice. We can attribute this to the slowdown of the economy, diminishing returns on investments, declines in insurance reimbursements and a general saturation of the primary eyecare market in both optometry and ophthalmology.

Another source of this struggle lies within the contact lens sector. I'll provide suggestions for maintaining income just by prescribing soft contact lenses.

It All Starts with Service

Retaining your soft contact lens patients is a dynamic process that requires more than just clinical skills. Patients have the right to stop seeking your professional opinion at any time. We provide patients with a service, so they have come to expect that we will serve them when they visit us.

Service begins with your receptionist's and staff's ability to make a patient feel as though he's the most important person to visit your office that week. It's the staff's job to promote a friendly environment, keep the office clean, keep personal conversations to a minimum and, above all, to smile and make patients feel as though they've chosen the right doctor for their family's visual needs.

The staff should focus on keeping patient flow moving smoothly. They can help accomplish this by verifying insurance coverage before the day of the exam. I'm sure you've experienced how frustrating it can be to stand in line at the grocery store. Likewise, standing in line at the eyecare office with blurred, dilated eyes can spoil a patient's mood and experience no matter how his actual exam went.

Once the patient enters the exam room, your job is to continue this high level of service. Smile and create a friendly environment, praise patients on their concern for their ocular health and then perform a thorough examination so they leave feeling as though their money is well spent. Don't talk down to younger patients -- they prefer it if you address them as people possessing adult responsibility. Conversely, older patients would rather you treat them as you treat their younger counterparts who are full of energy, life and vigor.

For contact lens patients, tell them about the many steps and the complexity associated with customizing a proper contact lens fit for their eyes. Education helps patients understand your procedures and results in better acceptance of returning for follow-up care. Furthermore, explaining your fees results in a better understanding of the charges associated with the fit. If you provide this explanation to patients rather than leaving it to the receptionist, then you'll ease the burden placed on the typically over-worked front desk staff.

Figure 1. The number of soft contact lens patients retained and lost (by age group).

Educate Patients About Eye Health

Many patients in today's fast-paced society feel that as long as their contact lenses provide satisfactory vision, they don't need to return to their eyecare professional. These patients often use expired prescriptions to order contact lenses from Internet-based retailers. This could cause patients to receive lenses with the wrong prescription or base curve, which could result in lens-related complications.

To prevent this, you need to emphasize the importance of regular eye exams, proper lens wear schedules and lens care systems. You can provide patients with manufacturer brochures explaining why it's in the their best interest to return for care as recommended. Tell patients that contact lens exams encompass more than just a refraction. You could even show representative pictures of damaged eyes and lids that resulted from excess lens wear or improper cleaning techniques to reinforce the importace of returning for continued contact lens care.

Sometimes using different terminology can make a difference. I know of an eyecare practice that has better patient recall when they ask contact lens patients to return for a six-month "corneal exam" as opposed to a six-month "contact lens checkup."

You can also prevent patients from using expired prescriptions to order lenses online by limiting the expiration date to one year. This prevents credible Internet-based retailers from endlessly refilling lenses without proper eye health assessment.

Encourage patients to purchase yearly lens supplies. A one-year lens supply can serve as a recall notice to remind patients to return for their annual exam. When you allow patients to choose their own lens supply amount, they usually select one box for each eye. This could result in the "two box shuffle." Industry sources report that patients who initially order two boxes of two-week disposable lenses will not purchase the recommended six more, but rather only three more for the entire year. This likely results because patients have fewer lenses on hand, so they overwear the ones they have.

Furthermore, if you can convince patients to order a year's supply at the exam, you'll save your staff from handling many small, two-box orders. Such small orders indirectly decrease the net profit and take your staff away from giving care to the patients in your office.

	Figure 2. The percentage of soft contact lens wearers retained and lost (by age group).

Provide the Convenience that Patients Want

I've heard that consumers prefer to purchase along the path of least resistance. Use this thinking to your advantage. Express your ability to cater to the patient's needs while you conduct your exam. Many new patients aren't aware of the conveniences you can provide. If you have their lenses in stock at the day of the exam or at a one-week follow up, then the patient realizes that it's much quicker for them to get their lenses through you than buying them online.

Offering patients this convenience means that you become their instant buying source. Patients often won't be enticed to price shop when you place their new lenses right in front of them. Then you can tell patients that you offer a full year's supply, that you accept unopened boxes for a change in prescription and that you can immediately replace torn lenses.

To further retain your patients' loyalty, match the conveniences of outside sources. Maintain consumer-friendly hours, ordering abilities by e-mail, voicemail, fax or a practice Web site and lens delivery by mail, which is especially beneficial for college students who are away from home. Don't overlook the conveniences of having a prompt staff or examining the entire family at one visit, which can also display your ability to be the path of least resistance.

Offer Competitive Pricing

Some patients look for the lowest price rather than for the most convenience. These are the patients who are most likely to shop at warehouse superstores, buying items in great bulk to save money over the long term. We too can package our contact lenses in this manner and make them appealing to the price-conscious consumer. As stated previously, start by offering a full year's supply. Some manufacturers offer a rebate when you purchase their lenses in large amounts. You can offer rebates to patients along a tier system of contact lens pricing to promote buying in bulk and avoid the "two-box shuffle."

Try using different phrases to express the savings for the patient. You could simply state how much money the rebate will save him or that the rebate will be similar to receiving a certain amount of lenses for free. You could also mention the new cost per box with rebate and compare it to online prices. Producing a list of current Internet prices for the patient's comparison will show him how you can provide the same product without the anxiety of credit card disclosures over the Internet, possible damage in shipping and receiving the proper lenses. All of these techniques help to show a true cost comparison.

Furthermore, you can provide discounts on spectacles, contact lens solutions or sunglasses with the purchase of a one-year supply.

Here's how you can stay afloat while offering such competitive pricing on contact lenses:

• With the manufacturer's rebates, the patient is taking money out of the pocket of the manufacturer while your practice retains the customary charges for the initial purchase. All three parties win in the transaction, and patients perceive you as the charitable doctor.
• It's time for an overhaul in the payment amount we receive for services. Traditionally, contact lens practices have accrued revenue through products, but this avenue is quickly narrowing as more retailers enter the market. Conversely, contact lens exam fees have remained fairly stagnant. Patients often understand and appreciate when you charge an additional fee for contact lens examination and consultation -- with an explanation of the complexity of fitting and importance of maintaining good corneal health.

Some practitioners have tried other ways to discourage patients from geting their lenses from other sources. They may prescribe custom-ordered lenses or private-label lenses or they may switch patients into GP lenses to keep them loyal because of the relative inability to find these lenses online. However, unless these lenses are physiologically superior or are found to be medically necessary, this tactic of changing patients into an alternative, and sometimes more expensive, lens for the sole purpose of preventing them from obtaining lenses from other sources is arguably unethical.

Know Your Clientele

Perform an analysis on the demographics of your contact lens patient base. Find out who you're fitting and who you many be neglecting. In a study of 558 soft contact lens wearers, only 12 percent (65) were over the age of 54, even though this age group represents 21 percent of the total population.

Find out which age groups are most and least likely to remain loyal to your practice. The same study indicated that the patients most likely to not return as their supply of contact lenses diminished were in the 26 to 35 age group (Figures 1 and 2). Many reasons could contribute to this loss, including computer savvy, insurance change, prices too high, death, overwearing of lenses, moving to new area or college or ocular changes such as emerging presbyopia, eye disease or refractive surgery. Others could have simply discontinued contact lens wear altogether.

Patients most likely to return for care were in the age groups 11 to 20 and 41 to 55. This may be because most patients in the younger group aren't purchasing their own lenses, and those in the older group have become more independently wealthy. Remember that the children in the 11 to 20 age group will become paying adults in the future, so maintaining good relationships with them could multiply your investment with time.

Another study found that the distribution of soft lens wearers according to age group is as follows:

• Age 17 and under: 10 percent
• Age 18 to 25: 23 percent
• Age 26 to 39: 45 percent
• Age 40 and above: 22 percent

The high percentages in the two older age groups equates to an increased potential to fit or continue patients in bifocal contact lenses as these groups age.

The study further found that females represent 64 percent of the total soft lens wearing population. When speaking with marketing professionals at a well-known online distributor of contact lenses, they revealed that they emphasize convenience to women aged 18 to 40. This group, not so coincidentally, makes up the largest group of soft lens purchasers.

Conclusion

I believe that we should get paid what we're worth. We're highly educated professionals with immense responsibility for the eye health and visual function of the patients who seek our care.

You can't do much about the economy, poor market or insurance reimbursement troubles, but if you follow some of these suggestions, then you'll likely discover that retaining your clientele can bring you increased revenue associated with soft lenses.

To receive references via fax, call (800) 239-4684 and request document #100. (Have a fax number ready.)