Over the last 10 years, I have had the honor of speaking with thousands of eyecare providers across the globe. I like seeing practices that are innovating, and I love hearing the passion of those practitioners. Without exception, they are all super successful both in patient care and in business.

I’m not sure why, but after giving a presentation about innovation or better care, I generally have at least one practitioner come up and share with me how their patients cannot “afford” the technology or treatment. Let me be the first to say that I respect financial situations. When the word “afford” comes up, I always bring up “value.”

As healthcare practitioners, we are not in the business of selling. Rather, we should be in the business of educating our patients into the best treatment. There are times when a treatment will bring about a marginally better outcome, but at a great price; these are generally not pursued by the practitioner or patient.

However, most of the time in eye care, the benefits of better treatments (for example, thermal pulsation for meibomian gland dysfunction, daily disposable lenses, vision therapy, etc.) carry along with them a much better value compared to their alternatives.

I have taken on an approach of eye health first, patients’ vision second, and their pocketbook last. I personally do not want to be the one who looks back and says that we only offered the least expensive option because it was all that patients could afford.

I have bumped into many practitioners who say, “But it is what the patient wanted.” As Henry Ford and Steve Jobs are famous for saying, people do not know what they want until we tell them. When two treatments are available, but one carries a significant health value at only a marginal price difference, the choice seems obvious.

It’s All About the Options

It is incumbent on me to ensure that my patients are aware of the choices that they have when it comes to treatment selections. It is then my obligation to help move them in the way that is most beneficial to both their short- and long-term comfort and health.

In the case of contact lenses, we know that the majority of our patients will drop out of lens wear by the time that they reach their 40s (Nichols, 2015). Focusing on their pocketbook and current success is what led to this in many cases. It is time to take the insanity out of our fitting and to approach comfort in a new way.

Because discomfort and dryness are the top two reasons for dropout (Riley, 2006), I want to do all I can to stop these problems before they start. Initially, we focus on the ocular surface. By ensuring proper lacrimal and meibomian function before symptoms occur, I maximize my outcome. Then, I ensure that compliance and solution sensitivities are minimized by the selection of a silicone hydrogel daily disposable lens.

When patients think that they are happy, it is time to question what their ocular surface is telling us. Maybe their current happiness is overrated and we can exceed it with a long-term solution. As healthcare providers, do what is best for your patients. CLS

For references, please visit and click on document #260.