“I’D LIKE TO do more myopia management. I discuss it with the parents of all age-appropriate children, but few want to spend the money.” This is a common complaint I hear when consulting with eyecare professionals nationwide.
The reality is that parents are willing to pay almost anything if they believe it is in their child’s best interest. If you are having these conversations but your capture rate is low, the problem is likely your presentation, not the actual cost. There’s a subtle art and psychology to “selling” myopia management to parents. I call this using language for success. Here are a few tips to help you increase capture rates.
REMEMBER WHO YOU’RE TALKING TO.
The target is adults aged 33 to 43, who are the parents of these myopic children and teens. In my experience, this age group obtained their two-week disposable lenses for $13.95 a box at a big box store before having laser-assisted in situ keratomileusis (LASIK). They often fail to see or understand the value of contact lenses in general. They’ve never worn GP lenses, but their parents did…and told them how lucky they are to never have to wear them. They may be filled with all sorts of preconceived ideas regarding contact lenses in general.
STOP SELLING REALLY EXPENSIVE CONTACT LENSES.
Move the emphasis of your patient education to myopia management rather than which contact lenses you prescribe. The value is in the therapy you provide. Contact lenses are just one of the many tools you have available. Always focus on the medical condition—myopia—first!
BEFORE THE PATIENT LEAVES THE OFFICE, SCHEDULE A MYOPIA MANAGEMENT CONSULTATION FOR ONE TO TWO WEEKS AFTER THE EXAM.
To increase the likelihood of parents returning for a consultation, it’s important to schedule the next appointment before they leave the office. Introduce the concept of myopia management to parents at the end of your comprehensive eye examination. Clearly explain to them that their child’s prescription progression is a cause for concern and could lead to ocular health complications, and possibly even vision loss, in the future.
Emphasize that starting myopia management therapy now will yield the best possible outcome. Provide a straightforward, one-page overview of daytime and nighttime contact lenses, detailing how they focus light on the back of the eye and discourage eye growth. Keep the conversation centered on the complications of excessive myopia and the diseases that could arise from it.
Explain that you want to bring their child back for special testing and consultation. It’s good to let them know that there are fees for this service that are not covered by insurance, so coming into the consultation they’ll know what out-of-pocket expenses will be associated with this program.
If the question of fees comes up, explain that once you have additional information from the testing, you’ll explain which modality best meets their child’s needs. You’ll be able to explain the fees associated with their program once you have those results. You may also mention whether you offer payment plans and if their treatment is eligible for payment through health savings accounts and/or flexible spending accounts.
“WHY ONE TO TWO WEEKS LATER? I CAN DO THIS AT THE END OF THE EXAMINATION.”
Yes, you can conduct a consultation at the end of an examination, and many eyecare professionals find some success in doing this, but how much higher could your capture rate be? You’ve identified an issue that parents didn’t know their child had and identified a solution they may be unfamiliar with.
Asking someone to spend large sums of money after you’ve just thrown copious amounts of information at them can be overwhelming. Most people will want more time to think about their options or talk it over with their partner. By introducing the concepts, providing suitable information, and giving parents a few weeks to consider, they will come to the consultation with a more open mind and be ready to hear what you have to say.
DO NOT OFFER A MENU OF CORRECTIVE OPTIONS.
You’re the professional; make a recommendation. Keep your presentation simple, and do not overcomplicate the message. This is what you recommend, and this is why you think it’s best. Discuss the process, discuss informed consent, and allow time for parents to ask questions. Use easy-to-understand language and avoid industry jargon. The patient’s parents likely do not know what “biometry’ or “axial length” means.
DON’T FORGET THE CHILD IN THE ROOM.
Remember that depending on the age and maturity level of the child, the idea of something going in their eyes can be scary. If you tell them that the lenses are rigid, make their eyes water, and cause them to blink often, it will only increase anxiety. You want the child to be excited. Focus on the positives and be overenthusiastic: “I’m extremely happy that you are going forward with a treatment plan. It will be great, and you won’t need daytime correction. How cool is that!”
When discussing what the first lens-wearing experience is going to be like, explain that the child will experience some lens awareness for the first few days of wear, but as soon as they close their eyes, the sensation will go away; they will feel almost nothing, and that’s how sleeping will be.
I recommend using proparacaine for the first lens application experience, which allows you to apply the lens and check visual acuity and lens movement without difficulty. Once you see the patient blinking slightly more, it’s a good time to indicate that you see that they “feel” the lens. Confirm that while he or she is blinking more often, the lens doesn’t hurt.
Now is an excellent time to reinforce that if they close their eyes and look down, it feels better and that is exactly what it will be like when they apply the lenses at home. There’s nothing to be afraid of; reinforce that they can do this!
TRACK YOUR CAPTURE RATES.
Tracking capture rates will measure your success and alert you to how many children are slipping through. Consider reevaluating your process if your capture rate is less than 70%. Be sure to also have a process to recall those who don’t choose to move forward after the initial conversation. To instill a sense of urgency and prevent significant myopic progression, a three- to six-month recall is recommended.
WORDS MATTER; CHOOSE WISELY.
A few word choice swaps can make a big difference. You can overcome many preconceived ideas by not introducing them into the conversation in the first place. When I say “hard lens,” what is the first thing that comes to mind? It could be uncomfortable, difficult, old technology…lenses your grandma wore. When you say “hard lens,” parents’ minds are filled with thoughts, and none of them are positive.
Start the conversation with words like “retainer” or “nighttime lens” instead. Now that you have the parent’s attention, you can explain that it will help slow eye growth, protect their child’s vision in the future by reducing risk factors for eye disease, and eliminate the need for daytime correction.
A few word choices can make a huge difference in how parents perceive the information you deliver. If you’ve done this correctly, your glasses-wearing adults should be asking you if it’s something they can do too. Because, yes, orthokeratology really is that cool! CLS