contact lens economics
Upgrading Long-Time Wearers Into Healthier
BY GARY GERBER, OD
A recent patient of mine said, "I want ViewVueSee lenses. I've worn ViewVueSee for 31 years. The last time I tried to switch to one of those so-called 'new' lenses, it felt uncomfortable and I couldn't read with my left eye. Doctor, you have to understand -- I can wear only ViewVueSee lenses! And by the way, make sure you fit my right lens steeper than my left and cut the power by 0.25D or I'll get headaches. Oh, and one last thing -- I can use only salt tablets and distilled water with my heating unit, so don't even try to tell me to stop cooking my lenses. Those toxic chemical solutions don't work for me."
Too Smart for Their Own Good
Whether it's because of the Internet or their long experience as contact lens wearers, we've all had patients who are well-informed about their particular lenses, care systems and vision. A management challenge often occurs when patients such as the one above, who purport to know more about contact lenses than all of you reading this (combined), wear archaic technology lenses that aren't the best for them.
For example, while (thankfully) few patients still wear PMMA lenses, most of us cringe when they're in our chairs and they tell us they have no complaints with their lenses. Invariably, after taking a careful history and completing a detailed corneal examination, topography and refraction, we find some problems.
Breaking the Mold
I really hate the phrase, "If it ain't broken, don't fix it." Where I grew up in Northern, NJ, we had a different saying: "If it ain't broken, then break it!" But even though I grew up hearing that phrase, I never really understood its power until I encountered patients such as the one above.
My clinical epiphany occurred when I realized that more often than not, "it" really was broken, but my patients just didn't know it! That changed my tactics from blindly fulfilling their lens requests to delivering news that many of these all-knowing patients don't want to hear.
Here again, I fall back on my New Jersey upbringing and use a tough love case presentation approach. I start with a simple fact: "I'm the doctor, you're the patient. I'm not saying that to be pompous, but because my education and experience have given me more knowledge than my patients about contact lenses and corneas." Specifically, I flat-out told my recent patient:
- ViewVueSee lenses are ancient technology lenses. While they aren't necessarily bad or dangerous (although certainly in some cases they might be), we have lenses that are better
- The so-called "new" lenses you tried before aren't the only fish in the sea. And the doctor may have fit them incorrectly. Don't banish all new contact lenses based on one less-than-optimal experience
- I thank you for the tip about which eye needs the steeper lens and lesser power. However, my goal isn't necessarily to fit the lenses to your particular specifications -- it's to give you a healthy, comfortable fit with good vision. I can do that. Trust me -- I'm a doctor
- Salt tablets and distilled water are good for many things. Cleaning your contact lenses isn't one of them. I'll find a care system that works for you. I'm the doctor. I can do that
Remember Who You Are
Patients come to us for recommendations and to solve their contact lens problems. You can't deliver recommendations if you don't first find the problems. Do so, then tell your patients. They'll love you for it. Trust me -- I'm a doctor.
Dr. Gerber is the president of the Power Practice a company offering consulting, seminars and software solutions for optometrists.
You can reach him at (800) 867-9303 or DrGerber@PowerPractice.com.
Contact Lens Spectrum, Issue: April 2004