contact lens economics
A Simple Question Leads to Important Answers
BY GARY GERBER, OD
So much of what we do as optometrists is repetitious. If we have a 50-year-old patient wearing +175 reading glasses having near point problems, we reflexively "prescribe" about +0.50 more. Similarly, if we have a patient who says, "I'm thinking about wearing contact lenses," we instinctively check his subjective prescription or current eyeglass prescription. Finding, for example, a spherical prescription of 2.00 OU, we mechanically say to the patient, "Okay, you can wear contact lenses."
Because much of how we interact with patients happens in an almost robotic way, it's good to examine those steps that happen nearly automatically. The above example is a great place to start.
Why Ask Why?
The next time a patient intimates a desire to wear contact lenses, avoid a knee-jerk response. Instead of involuntarily going through your contact lens fitting logic tree, ask the patient a simple question: "Why?" The answer, and how carefully you listen and truly understand it, can help you build your contact lens practice.
Here's an example of asking "why" and interpreting the responses:
"Doc, this might sound silly, but I want contact lenses because I hate wearing glasses," says your myopic presbyopic patient. Wanting to know more, you again ask, "Why?"
Your patient replies emphatically, "Because they get in the way when I'm on my sailboat!"
Of course, this is a different response then, "Because I hate the way I look in them!"
Your sailing patient might be content with part-time wear while on his boat. Beyond just being content, he might prefer part-time wear. Knowing this helps you frame your thoughts about the lens type you'll prescribe, and helps you pin down the best modality more expeditiously. This sends a strong signal to the patient that you genuinely understand and are concerned about his vision desires and lifestyle.
In the case of the sailor, you can rapidly hone in on the advantages of single-vision, single-use distance contact lenses with a pair of Polaroid distance plano progressive eyeglasses for use on top, for any needed near tasks. By giving a strong lifestyle-focused recommendation, you avoid the common, "Well, you can wear contact lenses in one of three ways" discussion that so often comes up with presbyopic patients.
In the second case, bifocal lenses or monovision make more sense. Someone who says, "I hate the way I look in glasses" will hate reading glasses just as much as distance glasses.
The Follow-Up Why
When your two patients return for follow-up, by simply being perceptive enough to have originally asked, "Why" before they were first fit, you can change the tenor of these visits accordingly.
For the sailor, you can begin, "So how did you enjoy wearing contact lenses on your boat?"
For your second patient, "How did your friends think you looked without glasses?"
Shake Up Your Routine
As I've written before, in both cases you've dodged the common case history faux paus of starting with the classic negative question, "Are you having any problems?" Not only have you avoided starting the follow-up visit on the wrong foot, but you've forced yourself to eliminate robotic banter and truly customized your line of questions for the patient.
Changing a few words and raising consciousness in your existing "routine" can add significantly to your practice's bottom line. Think about "why."
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
Contact Lens Spectrum, Issue: October 2004