PRACTICE PROFITABILITY
Boosting Your Contact Lens Practice Profitability
Changing your "habits" gives you an edge on the competition — and retains your contact lens patients.
By Dave A. Ziegler, OD

Are contact lenses still a profitable enterprise for today's eyecare practice? Across the country I hear from practitioners disappointed in what their contact lens practices have become.

These eyecare practitioners see the profit from the sale of materials disappearing because of numerous alternative contact lens sources. Each day brings more faxes from 1-800 Contacts to their desks. As far as many eyecare practitioners are concerned, contact lenses have become a commodity driven by the lowest price.

These practitioners respond by switching to the latest "hard-to-get" brand, with promises from the manufacturer that patients won't be able to find this lens online. Or they explore private-label brands to discourage the contact lens price shopper. But it seems that all lenses eventually end up online, and practitioners learn that this isn't something they can run and hide from.

This sounds like a pretty bleak scenario, doesn't it? Is it time to quit fitting contact lenses and look for other profit centers for our practices?

I believe that times have never been better to develop your contact lens practice, to remain profitable, and keep the best interest of your patients in mind. You just have to change, that's all!

What worked in the past won't work in today's marketplace, and certainly won't take you into the future. I'm going to borrow some thoughts from Stephen R. Covey's great book, The 7 Habits of Highly Effective People, to show you how to increase your contact lens profitability in this changing environment.

HABIT #1 Be Proactive

The best way to restore the profitability of your contact lens practice is to establish profitability in your contact lens services. This essentially shifts some of your profit from the mark-up on materials to the professional services and expertise that you provide to your patient. These are contact lens professional fees you charge to the patient in addition to your routine comprehensive examination fees.

You perform a different collection of tests for a contact lens wearer. These tests may include a different patient history; contact lens corrected visual acuities; a biomicroscopic evaluation of the cornea, palpebral conjunctiva and tear films; and corneal topography. In addition, there's your decision-making process to determine the new contact lens prescription, with a possible over-refraction and another slit lamp examination.

Sometimes this process is very easy, as in the case of an asymptomatic spherical disposable soft lens wearer. Other times it's not. The ease of the case shouldn't determine whether you charge a professional fee. If you have hypertension and visit your internist to find that your blood pressure is well-controlled and no change in medication is needed, you don't expect that evaluation to be free! So even if you find no change in the contact lens prescription, your time and expertise justifies the contact lens professional fee.

Create a variety of fees for different contact lens patients so that more complicated cases such as bifocal or toric contact lens wearers have higher fees. Then be proactive by giving the patient a question and answer sheet when he checks in with the receptionist that explains your policy on professional fees. This document sets the stage for the visit by addressing the five most common questions a patient would have about your fees.

Here are some sample questions and answers we include in our handout.

• What are contact lens professional fees for? As a contact lens wearer, additional tests are done for you that are necessary to make sure your eyes are healthy, that your lenses fit properly and to ensure that you're seeing as well as possible. Contact lens professional fees are for the extra testing and time that the staff and doctor take each year to properly evaluate your contact lenses.

• What types of additional tests are needed? Corneal topography is one example of a test done for contact lens wearers. With this computerized data we can detect any undesirable changes of the cornea that may occur from wearing contact lenses. A second test uses the microscope to examine the fit of the contact lens and the health of the cornea. Thirdly, we perform prescription measurements, which are different from those for glasses.

• Isn't this part of my annual exam? We perform these contact lens-related tests in addition to the eye examination. These are procedures that we need to perform for contact lens wearers, and less frequently for patients who have corneal problems who don't wear contact lenses.

• Doesn't my insurance cover contact lens professional fees? It depends on your plan's coverage. Most insurance plans cover a comprehensive eye exam that determines your glasses prescription and evaluates your eye health. Contact lens services are separate procedures that often aren't covered by insurance.

• How much does it cost? Depending on the type of lenses you wear, the costs range from $____ to $____ annually.

Patients don't want to hear about fees at the end of the examination when they're checking out. When you proactively inform them at the start of the visit, they will accept them. If the patient refuses to accept your fees, which rarely happens, inform him that you'll be able to provide him with a spectacle lens prescription at the conclusion of the examination.

HABIT # 2 Begin with the End in Mind

While patients want choices with their health care, the sheer number of contact lens options can be overwhelming. You have to simplify the decision-making process for your patients. Consumers make their best decisions when three choices are available. More choices make more confusion.

For spherical soft disposables, we offer daily disposables, two-week disposables and monthly continuous wear. At the outset of the exam you should have an idea of the best lens option for that patient, and by doing so, you're beginning with the end in mind. Our contact lens brochures provide the features and benefits of each modality to assist the patient with his decision. My personal preference is a daily disposable lens, so that's what I often recommend.

HABIT # 3 Put First Things First

The "first thing" is that your patient came to see you to get a comprehensive eye health exam and your recommendation on the best contact lens for his needs. So make sure to thoroughly evaluate the anterior segment and use the best and newest lenses that our industry has to offer. Invest in new equipment so you're offering the best care available. That's putting first things first.

HABIT # 4 Think Win-Win

Patients think that the box of lenses that you sell is the same as the box they can buy anywhere. And they're right! So how do you keep the patient in your practice? You can do it by being competitive with mail order suppliers and keeping your prices in line with their prices. Because you've shifted more of your profit to the professional fees, you can afford to reduce your product mark-up and retain the patient's lens purchase.

Consumers aren't necessarily looking for the lowest price, just a fair and honest price. They probably would rather buy lenses from you, as long as you're competitive. So make it a win-win situation. Present patients with a simple price comparison chart that shows your fair pricing. In addition, use this document to explain the other advantages of buying from you such as free samples to replace ripped or lost lenses, or an exchange of unopened boxes if the prescription changes. You receive a moderate margin on materials as well as your professional fees, and they get a fair price. It's a win-win.

HABIT # 5 Seek First to Understand, Then to be Understood

When a patient orders his lenses from an alternative source, many doctors don't really understand how the patient could do this to them. The doctor and staff may become defensive, resistant or even resentful of the patient who seeks lenses elsewhere.

You have to listen with the intent to understand. Get inside the patient's perspective. It's the consumer's job to question price. It's your job to establish value. You must demonstrate value in the contact lens services you provide and be price-competitive or you'll lose the patient.

HABIT # 6 Synergize

Develop strong relationships with your contact lens representatives. They provide valuable information on new products, provide trial lenses and train your staff. These highly trained yet under-utilized professionals are your business partners. When you work with them your practice benefits.

HABIT # 7 Sharpen the Saw

Renew your skills through continuing education and investing in new technology. Expand into specialty products such as post-refractive surgery reverse geometry lenses, bifocal contact lenses, new torics and corneal reshaping. There are so many great new contact lens products. We can fit more patients who desire contact lenses than ever before. Isn't it a great time to be a contact lens practitioner?

Dr. Ziegler's patient handouts and price comparison charts.