contact lens economics
First Things FirstMention
Contact Lenses to Your Patients
BY GARY GERBER, OD
Your long-time contact lens patient shows up on time for his 1:00 p.m. appointment wearing the same disposable contact lenses he has worn for years. You hand him a history sheet to make sure
everything is up to date. You or your technician then escort the patient into a room to do a few preliminary tests with contact lenses on. The lenses are removed and more testing follows. If you find no change in his contact lens Rx or fitting parameters, an identical pair of lenses is dispensed. You check the fit and vision with the new lenses and dismiss the patient.
Plus or minus a few steps, this order of testing is standard fare for most of us. It appears to be quite logical and indeed is almost like a family recipe that has been handed down through the ages. Step one, step two . . .
But is it effective? Are there things we could do to make the process more efficient without compromising clinical care? Are we doing these tasks out of clinical necessity or out of habit?
Rethinking Old Habits
In this scenario, the patient is leaving with the exact same lenses he came in with, which have already been checked. Therefore, we are doing at least one step twice. And, what about eyeglasses? They apparently have been dropped by the wayside as we have forced the patient into our mold of how things ought to be done. He has been crammed into the "Returning Contact Lens Patient" mold. There is no room for deviation in our firmly-established process.
What about the sequence of how an eyeglass patient is examined? We customarily do not even mention contact lenses until after our clinical findings have been recorded. After all, how do we know if the patient is a contact lens candidate until we have thoroughly examined him?
I contend that nowadays, with the multitude of lens alternatives available, it would be safe to say that virtually any motivated patient requiring vision correction can wear contact lenses. Indeed, the ability of a patient to wear lenses, particularly specialty lenses, may be more a function of motivation (doctor's and patient's) than what parameters are available. This being the case, we would fit many more patients with contact lenses if we mentioned them first instead of last.
Give patients the chance to think about contact lenses during their entire time in your office instead of waiting until the last possible moment when they are already focused on leaving the office. You have often read that a way to build your contact lens practice is to ask patients, "Have you ever thought about contact lenses?" Yes, it's a good question to ask, and asking it sooner is better than asking it later.
Even better, simply say (don't ask) to patients early on in your encounter, "There's a good chance you can wear contact lenses." (There's a good chance you're right). Say that simple sentence and stop talking. Let the patient respond next. That will give you a good sense of motivation. Besides planting the contact lens seed for your patient, you have just done it for yourself. Now, as you go through your examination process, you too are also thinking of how your findings relate to fitting the patient with contact lenses as opposed to waiting until you are done.
Dr. Gerber is the president of the Power Practice a company offering consulting, seminars and software solutions for optometrists. He can be reached at 800-867-9303 or
Contact Lens Spectrum, Issue: November 2001