Contact Lenses For a Convenience-Driven World
For many patients, the convenience of single-use daily disposable and continuous wear lenses is well worth the added cost.
By Gary Gerber, OD
When was the last time you used a pay phone? If you're like most practitioners reading this, you can't remember when. You're also probably one of the millions of Americans who routinely use a cell phone. Consider the cost difference between the two. The cell phone industry reports that the average cell phone customer's monthly bill is about $61.00. A pay phone call costs about $0.25. That's quite a significant difference in cost. Yet, if you are one of the millions of us who have come to rely on the convenience of your cell phone, you have already come to grips with that significant price difference and you have done so specifically because it is convenient.
So it goes for your patients using single-use disposable lenses. It is this single fact patients, or to be more broad, consumers want and are willing to pay for things that are convenient. Practitioners must keep this in mind when building their single-use disposable contact lens practices. Eye health, good vision, fewer solution reactions sure, those are all important considerations. But ask most current single-use wearers what they like most about their lenses and they'll tell you, "I don't have to do anything. Wear 'em once and throw 'em away."
Before continuing, we need to define this newest modality: single-use. It refers to lenses that are worn once and thrown away. You'll notice that how long they are worn is not included in this definition. That would mean that the two current major categories of single-use lenses include daily disposable and 30-day continuous wear lenses. Either modality is worn once and thrown away. Why would patients do this? Why throw their lenses away after only one use? As we've learned with cell phones and other consumer products, the driving force for patients who choose this modality is convenience.
A World of Convenience
There's no doubt that we live in a technology-filled and convenience- driven world. Not recognizing this and offering patients older, less convenient technology creates a disconnect for your patients and positions your practice as one that is somewhat out of touch with the rest of the world. Consider a complete typical patient encounter not just in your office, but before a patient's eye exam.
Your patient uses EZ Pass when driving to his office. Once there, he immediately logs on to the Internet to check his e-mail. After listening to his voice mail, he starts to work. He has a 1:00 p.m. appointment at your office, so he has lunch at a drive-through fast food restaurant that also uses EZ Pass-type technology. Of course, in order to speak to his order taker, he zips down his power window. Gobbling down his lunch while talking on his cell phone with his headset, he drives to your office. After his exam, you discuss two-week daily wear disposable lenses.
Your patient replies, "What? I have to clean my lenses? Why can't I have lenses like my friend? She wears them once and throws them away! I want those. Do NOT complicate my life!"
Your patient is expressing his techno-disconnect. Two-week disposables that require maintenance do not gel with the rest of his easy, streamlined, convenience gadget-filled life. Single-use lenses, however, are a perfect fit. Indeed, if there were a pill or other such miracle, safe, fast cure for ametropias, patients would opt for that. Consider the market drivers for refractive surgery, and you'll start to understand why patients want single-use disposable lenses. They don't need them. They don't need contact lenses at all. They need to see better and they want to do it the easiest way possible.
The Under-prescribed Modality
When we look at this category, particularly single-use daily wear lenses, we see that only about 3 percent of new fits are being prescribed these lenses. Talk about a disconnect! Patients want it, but practitioners don't fit it. Let's examine why.
"It's too expensive for my patients." "Patients will think I'm selling them something and just trying to have them spend more money." "Patients pay a lot more for lenses and I don't make any more money. So why bother?"
I have lectured and written extensively on this topic and have heard all of these comments from many practitioners. The theme is generally the same regardless of the region I speak in, and it's always focused on money.
Having clients all over the country in diverse demographic and economic areas, I can comfortably say that value knows no boundaries. Value is something that has to be defined by the patient not the practitioner. If patients see a value in single-use lenses, they will pay for them. My experience is that most do. In fact, when presented to patients in a positive way at a reasonable fee, 70 percent will choose the modality.
Not your patients? Your patients can't afford it? Aren't these the same ones whose cell phone rings during their eye examination? Aren't these the same ones with power windows in their cars? Aren't these the same ones who are already cognizant of the benefits of technology-driven conveniences and who have already committed to pay for them? A resounding "yes" is the answer. These same patients who you think might object to the cost of single-use disposable lenses might be the same ones who go on to have more expensive and riskier refractive surgery. Why? Because it's what they want, and it's convenient. It's not any more complicated than that.
When it comes to presenting a more expensive (perceived by the practitioner) modality to your patients, many practitioners feel uncomfortable and fumble around looking for the exact words. They become very adroit at "un-selling" these better and much improved modalities to patients. If you're one of these practitioners, I have a few tough love words for you: Get over it. If patients want something, they will pay for it. If they want it and you don't give it to them, they'll get it from someone else.
How should you present these new single-use lenses? Simple. First, come to the realization that clinically, they are what's best for your patients. The clinical benefits of daily disposable lenses are obvious cleaner lenses, no solutions, fewer allergy symptoms, no deposits. For 30-day continuous wear, the benefits are equally obvious. For those patients who desire to sleep in lenses, why not have them sleep with the highest Dk/t lenses available? Silicone hydrogels have an unmatched safety record when it comes to overnight wear, be it one night or 30.
Next, keep your presentation short, to the point and be positive. Tell patients, (don't ask) "I'm going to fit you with some new technology lenses that you'll wear once and throw away. Would you like to change them every day or wear them continuously and change them once a month?" This presentation immediately sets a tone that is positive and keeps you in charge. It exudes confidence that the lenses will work and that you believe they are best for that patient. It is also concise.
The words are not as important as the message, which should be high tech, confident and positive. Presented this way, more patients will accept your recommendations and immediately say, "Yes," provided of course their cell phone doesn't ring while you're talking.
Compliance is the last point that needs to be addressed when discussing this modality. We have all had "two-week" wearers tell us, "I change my lenses every two weeks just like you told me." When questioned as to how long they've been wearing their current pair of lenses they'll then tell you, "Well, this particular pair has been on for five weeks because it was my last pair, and I wanted you to see them."
This non-compliant behavior is what accounts for the two-week industry average of 44 percent. Meanwhile, compliance with single-use lenses is reported to be over 90 percent. There appears to be an apparent paradox that many practitioners can't sort out. These practitioners believe that since patients have paid more for their single-use contact lenses than their two-week lenses, that they are more likely to "stretch out" the wearing schedule and be less compliant.
Practitioners who believe this compliance fallacy fail to realize that it is because patients have paid more that they are more compliant. How many people who currently own a cell phone would use a pay phone? If you now have power windows in your car, would you ever go back to manual ones? If you have a cable modem or DSL connection for your computer, would you consider paying less to use a slower dial-up connection? Once patients experience the convenience and other benefits of these new single-use lenses, there is no going back, regardless of pricing issues. Also, many studies have shown that comfort diminishes significantly when daily disposables are worn for more than one day.
Remember the four Cs (convenience, comfort, cost, compliance) when fitting your next patient. Getting started is easy. Practitioners tend to fit patients out of habit. This is because much of what we do is repetitive. After you finish examining your next 2.00D myope, keep the four Cs in mind. They are what your patients want. Break the two-week auto-pilot fitting habit by not reaching for those older technology lenses. Instead, reach for lenses that will position you to be perfectly in synch with the rest of your patient's life. Reach for lenses that are profitable for you and healthy for your patients. Given all the patient and practice benefits of single-use disposables, I am hard pressed to understand why (parameters allowing) any practitioner would reach for any other lenses.
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 DrGerber@PowerPractice.com.