Contact Lens Economics

Contact Lens Fees: Would You Like the Dinner of A La Carte?

contact lens economics

Contact Lens Fees: Would You Like the Dinner or A La Carte?

September 2001

For most of us, contact lenses are not the only source of revenue in our practices. Most of us also provide primary eyecare services and eyeglasses. Our contact lens service fees are usually seen as being "added" on to our other services. Indeed, one of the greatest practice management challenges many of us face is how to charge (and collect!) the professional fees generated from the many facets of our "contact lens exam."

Two Ways to Charge

Let's take a look at corneal topography as an example. There are fundamentally two ways, and only two ways, to charge for this procedure. One way is to include it with the rest of your contact lens (or primary care) examination or to charge separately for it. In the first case, you could consider raising your total global fee to cover the added expense of providing the test and also to generate some incremental profit. The second way would involve coming up with a fee that is reasonable for topography and charging only those patients who actually have the test performed. The first way is the dinner, the second is a la carte.

Which Is Better: Dinner or A La Carte? One or Two?

Just as our patients rarely can decide during the refinement of their subjective examinations, "Which is better - one or two?" figuring out how to charge for extra tests like topography is equally challenging for many of us. So which is better? The dinner or a la carte? One or two? Honestly, I don't know.

It's OK to Be Wrong

I often counsel my clients that one of the best things about being a small businessperson is you get to be wrong. Unlike working for a large publicly-held corporate global conglomerate where being wrong might cost you your job, small businesses can make most mistakes and continue to drive the business forward. One such small "mistake" is determining how to set your contact lens fees: a la carte or global. The worst case is that you pick the "wrong" fee method. Then patients complain, or you don't maximize your potential revenue stream. If that happens, there's a very simple solution ­ choose the other method and move on.

Many of us are reticent to change things in our practices, like adding new procedures, lenses or technologies, for fear of not knowing how to integrate or charge for them. A simple visualization exercise might help to overcome this phobia. Let's say you buy a topographer and after much angst, decide to charge globally. In your visualization exercise, you have many patients complaining about the fee, staff becoming disillusioned and a suffering bottom line. All you would need to do is to change to an a la carte fee system. The same holds true if you started with a la carte.

Don't allow figuring out how to charge for something be an obstacle to using or purchasing it. Don't let fear of how to integrate a new procedure scare you away from using it. Rather, embrace the challenge and feel the power of being a small businessperson. Feel the power of being able to make changes without a committee, without having to answer to stockholders and start growing your practice. Pick the dinner. Pick a la carte. It doesn't matter long as you choose one.

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