Grow Your Practice with Proactive Prescribing

If you want more contact lens patients, then go out and get them.

Grow Your Practice with Proactive Prescribing
If you want more contact lens patients, then go out and get them.
By LaMar Zigler, OD, MS, FAAO

What is proactive prescribing? Proactive means moving forward or ahead of. It's a positive action. Proactive contact lens prescribing creates new opportunities for practice growth. I'll explain how you can be more proactive to grow your contact lens practice.

Don't Just Proactively Prescribe

You first need to be proactive in all areas of your practice. Being proactive is a positive action that anticipates or prevents negative consequences in practice. You can apply it in administration, insurance and billing, recalls, optical, disease diagnosis through special testing and contact lenses.

Being proactive will allow you to be in control and therefore experience less stress and burnout. It'll help you meet the competition head on and do well in adverse markets.

Analyzing External Forces To become proactive in contact lens practice, you need to analyze how external forces can affect your practice. First, define your competition. Where can consumers in your area obtain contact lenses? Your list should include mail-order and Internet providers, deep discounters and other eyecare practitioners.

List each provider's strengths and weaknesses. Convenient, less expensive, more professional, good location, large referral base and excellent reputation in contact lenses all describe strengths. Competitor strengths could also relate to your area's public opinion of ophthalmologists vs. optometrists vs. opticians.

No services, just materials, no return policy, poor reputation, hidden costs, hard to work with, poor Web site, too busy and inconvenient location all describe weaknesses.

Analyzing Internal Forces Next, analyze your practice to determine your strengths and weaknesses. Compare your strengths and weaknesses to those of your competition. Decide how you can enhance your strengths and minimize your weaknesses.

For example, do your office policies and procedures make it easy and convenient for patients to purchase lenses from you? Are you professional and do your patients perceive you as a contact lens specialist? Is your practice "the place to go" to obtain contact lens services? If you discover road blocks, then find ways to eliminate them.

Is your staff friendly, helpful and service-oriented? The impression your practice makes with patients starts with the initial telephone call. Does your receptionist ask, "Is your visit for an eye examination or contact lenses?" Does your staff send out office brochures in advance of appointments and do they make appointment reminder calls?

From a patient's perspective, look at your office from the outside, then enter through your front door. Is the office clean and up to date? Does it look professional? Is it a place you'd go for contact lenses and eye exams? Continue to follow through a patient's visit and make notes on what you perceive. Then make a list of appropriate changes and follow through on them.

Proactively encourage contact lens patients to purchase sunglasses.

Keep Up with the Latest Technology

Education is the key to becoming proactive in a contact lens practice, and it starts with you and your staff. You need to use your sales representatives, journals, the Internet and seminars to learn the latest contact lens information.

Next, you need an educated and motivated staff. Send them to contact lens and practice management seminars. Ask sales reps to hold staff meetings to discuss new contact lenses and answer staff questions. Use video and audio tapes or CDs and encourage staff members to use the Internet to obtain more information. Hold staff meetings to educate all staff on new contact lenses so everyone is aware of the latest technology in contact lenses.

Take Advantage of the Goldmine Within

The next step to proactively growing your contact lens practice is to reap the goldmine that already exists in your practice -- your patient records. Educate your patients through newsletters, mailings, brochures, videos and through your well-informed staff. Send brochures and flyers from contact lens companies with your monthly billing and recall letters, or send them out by themselves. Start a practice newsletter and send it out on a regular basis. Ours includes a front-page story about the newest technology in our practice. We also have a contact lens page, an optical page and a human interest page.

Don't be reactive and let your patients educate you, your receptionist or your staff about the latest developments in contact lenses. Be proactive and take responsibility for your patients' education. Educated patients tend to be more loyal and more compliant, which results in a healthier practice.

Another way to become proactive is to reactivate inactive patients. Send them a special letter. Tell them how long it's been and why you wish to see them. Show care and concern for their eye health, especially for lens wearers. Tell them about new lens designs that are now available and invite them to schedule an appointment to discuss new lens options.

Hold Open Houses

Our practice has been doing open houses for years. We've found that they're a great way to proactively prescribe contact lenses and other new eyecare technology. We announce open houses for LASIK seminars, new types of contact lenses and children's vision screenings in our practice newsletter.

Any new contact lens design becomes an "excuse" to hold another open house. When a manufacturer introduces a new design, we work with the manufacturer's local sales reps to design an open house fitting night. My contact lens technicians create a list of potential patients for the new design. We then choose a date and time (usually 3:30 p.m. to 6:30 p.m.), then we personally invite patients to make an appointment or they call in after receiving our newsletters or flyers. Our local sales reps help us with refreshments and mailing costs. They also bring extra diagnostic fitting lenses. Sometimes they offer a drawing or other promotional items for the open house.

We schedule patients close together to maximize our time. Our technicians schedule them for comprehensive exams before the fitting night if they're due. On the day of the open house, we pull all scheduled patients' records out and get diagnostic lenses ready. We can fit the patients rapid fire because we're fitting only one design and we're not doing other things or seeing other patients. The sales reps discuss the new lens design with patients while they're waiting for the doctor to fit them. Patients also interact with each other about the new lenses, which adds to the excitement. If successfully fit, then patients return for a one-week follow-up visit.

Open houses allow us to quickly become acquainted with new lens designs in one session. We have recently held fitting nights for bifocals, daily disposable lenses, 30-day continuous wear, colored lenses, torics and orthokeratology. Open houses are enjoyable for us and our patients, and they generate interest in our practice. Also, they let our patients know that we are at the forefront of the contact lens industry, and this generates word-of-mouth referrals.

Use Your Power as an Eyecare Professional

Patients come to us for professional advice and to receive treatment for their chief eye complaints. Always recommend the contact lens that's best suited to a patient's way of life or that would solve a current contact lens problem. Base your recommendations on the best treatment option and not on cost. Educate the patient about why the treatment is in his best interest. Let him tell you if cost is an issue before you proceed to a less costly option.

I always ask patients if they're interested in contact lenses or in a new lens design. In a similar fashion, I always ask lens wearers if they need to update their eyeglasses, especially if they have vision insurance to help with the cost. Persuading contact lens patients to obtain backup eyeglasses and sunglasses is an excellent way to improve your bottom line.

Prescribe for Population Trends

Consider population trends to help your contact lens practice grow. Look at pediatric patients, young adults and presbyopes and determine which lens designs are most suitable for each age group.

Pediatric Patients The pediatric group is large; some have called it the baby boom echo. Never assume that a patient is too young for contact lenses. Parents want what's best for their children, which is why daily disposable contact lenses are an excellent first choice. Parents appreciate the convenience and the health aspects. Also consider prescribing tinted lenses and two-week disposables for younger patients. Carefully explain the importance of compliance to both children and parents before fitting.

Overnight ortho-k can serve as a huge growth area for your pediatric practice. Explain the possibility of preventing or reversing myopia to both children and parents as well as how ortho-k works. Most myopic parents will jump at the chance to prevent myopic progression in their children.

I prescribe 30-day continuous wear lenses with caution to pediatric patients because teenagers often forget when to remove them. I tell patients and parents to discard the lenses on the first of every month to help them keep track of the replacement schedule.

Young Adults Young adults may be active in sports and social activities or starting careers. Many are perfect candidates for contact lenses. Recommend daily disposables for the part-time contact lens wearer who wants to wear lenses just for sports and social events. Overnight ortho-k also appeals to this group because they can be free of contact lenses during the day for all of their activities. Recommend 30-day continuous wear over LASIK for young adults; LASIK may be too expensive or they may fear the risks and possible long-term effects of the surgery.

Presbyopes This is the largest group of patients and it continues to grow. The baby boomers have arrived, and many don't want to give up wearing contact lenses. Emmetropes, low hyperopes and low myopes in this group may need correction for the first time, and many don't want eyeglasses, half eyes or bifocal spectacles. Don't assume someone is too old to have interest in contact lenses. Recommend multifocal lenses first rather than monovision. Many soft and GP multifocals have proven success records, so don't wait any longer to start prescribing them.

Monovision and distance lenses with reading glasses are still good options for some presbyopes. In such cases, 30-day continuous wear lenses are excellent for patients who've never worn eyeglasses or contact lenses because they're convenient. Daily disposable lenses work well for either part- or full-time wearers and they're easy to care for. Also, overnight ortho-k using monovision design works well.

Stock your dispensing area with lens brochures and care products to educate your patients.

Promote New Materials and Designs

Thirty-day continuous wear lenses incorporate advanced technology and new materials that represent the future of contact lenses. They're available in both GP and soft lens designs. Be sure to offer this option to your patients. Explain the benefits of high oxygen transmission, convenience and less eye redness. Also tell patients that these are good lenses for dry eyes. Hopefully we'll soon be able to offer toric and multifocal lens designs in these materials.

Overnight ortho-k is a great new service that you should offer to your patients. It has more appeal than daily wear ortho-k. It's also a good alternative to refractive surgery, eyeglasses and other types of contact lenses. Start your learning process with myopes who need ­2.00D or less of correction. You'll be impressed, as will the patients, with how they can read 20/20 after the first night. Higher myopes may take up to seven days to reach this effect, and they also require more troubleshooting.

Overnight ortho-k produces excited patients and great referrals. Also, you receive compensation for your time, services and expertise rather than for materials.

Proactive Prescribing Also Includes Fees

Stop trying to make a living off of contact lens materials. Charge appropriate fees for your professional services. Base your fees on the medical model of case history, complexity, time spent and treatment plans. Patients want value and they'll pay for it. Value doesn't mean "less expensive." Value is available in any price bracket, and it's based on perception. For example, at an expensive restaurant, you expect impeccable service, wonderful ambience and exquisite food. If the restaurant doesn't meet these expectations, then you'll feel cheated. If you go to an inexpensive restaurant and get more than what you expected, then that's value. So set fair fees for your services and make sure your office décor and staff exceed patient expectations. Proactive prescribing is more successful in this type of environment.

Simply Ask

Ask your patients about contact lenses at each exam. If you don't, patients may think that contact lenses aren't available for them. It takes little time to ask. If a patient responds positively, then be proactive by educating him about what you'd prescribe and why. Give him a brochure, ask him to watch a video and instruct your technicians to follow up with more detail. Evaluate and dispense the lenses the same day, if possible, while you have the patient's interest. If you reschedule him, then he may not return.

Try asking your next few patients about one type of lens option, such as daily disposables. Ask both nonwearers and current contact lens patients, after their exam, if they'd be interested in wearing daily disposable lenses. When they say "Do you think I can? I never thought about daily disposable lenses," you can reply, "Let's do an evaluation and find out." Keep track of your fittings and watch the numbers grow. Becoming proactive in prescribing contact lenses is easier than you think. Simply ask.

Dr. Zigler is in private group practice in Columbus, OH, where he specializes in difficult to fit contact lens cases. He's a prominent lecturer and speaks extensively across the country on various topics related to contact lenses and laser vision correction.