The scope of optometry has expanded through the years and today enjoys a scope of optometry only dreamed of in the beginning. However as the scope has expanded there has been a dangerous and continuous erosion of market share of an area long associated with the tradition of Optometry. The Spectacle Prescription. This seminar takes a serious look at this erosion of this base and how this erosion can be stopped with a strategy that reinforces everything that Optometry has sworn to be to its patients.
The AOA Optometric Oath says it all.
For the purpose of this seminar this oath will be our guide. It will serve as our mission statement.
This is no small problem- nor is it a recent happening. This steady erosion of the traditional base of optometry has been eroding for the last several years. Two-thirds of the public who received vision care received it from independent optometrist where they were exposed to the level of care that can be provided- yet only 45% on average chose to obtain their spectacle Rx from the prescribing doctor. Why?
Here we see the almost reverse mirror image with the retail chains. Who created this image and perception they were better? Or you were somehow lacking? Could it be we have met the enemy – and it is us? Make no mistake- this is a serious economic problem in serious economic times.
All of you want your patients to do three things- pay their bills, come back and refer others. Biggest Challenge ? Getting them to come back Your two daily concerns- volume of patients and revenue per patient. And the number one priority for you and your staff? To create and manage the perception of value in the eyes of the patient so that you are the preferred provider of choice. This includes the preferred provider of their spectacle correction.
The problem is eroding market share combined with aggressive competition and managed care issues. The results are declining capture rates and shrinking net profits. More and more we hear optometrists complain they are working harder than ever just to stay even. A strategy for success must address these issues.
There are opportunities. We added 30 years to the average life expectancy in the 20 th century. From an average life expectancy of only 47 in 1900 to 77.5 in the year 2000. But a survey done by USA Today in April of 2007 revealed just how important vision and healthy sight had become. When asked what was their greatest health fear as most negatively impacting their quality of life – two answers tied for the number one response. Being paralyzed and loss of vision. Amazing! What caused this dramatic change in attitude? Increased life expectancy has given us for the first time- six living generations including the largest generation – the baby boomer. They number 78 million and range in age from the youngest at 45 to the oldest who are turning 62. Key is the fact that some 13-15 million are primary care givers for elderly parents or in-laws. They see what a difference in the quality of life- that vision makes. Sometimes it is the sole defining difference between independent living and assisted living. They want to live longer- BETTER.
If optometry is stop this erosion, it must rebuild the foundation. We have the best materials, we must learn to use them and the tools we have to enact your oath and fully and honestly advise your patients of ALL that will restore, maintain and enhance their vision and general health. The spectacle correction and all that can be built into it are an important part of providing healthy sight.
The only thing that really matters is what kind of experience the patient has when they interact with you and your staff. Remember the number one reason they will not return, is they perceive you are indifferent to their needs. Positioning yourself as their partner in taking care of their sight is the best way to build patient loyalty. Referrals that come as ‘word-of-mouth’ referrals from loyal patients is the very mortar used to build the foundation.
It is important that you and your staff stay abreast of the latest technology. You always want your patients to hear about the latest technology from you. Value is based on three criteria: price, quality and service. To compete on price is usually the most dangerous strategy for an independent ECP. Creating unique services and packages will not only give one an competitive advantage but also increase your capture rate, revenue per patient and restore a healthy bottom line while providing your patients with healthy sight.
For purposes of illustration, let’s view your practice as a bucket that you want to keep adequately filled. Filling the bucket is a function of marketing- both internal and external. It is management’s responsibility to make sure there are no leaks.
Here are four key areas in your practice that you must make “ leak proof.” We will look at each of these areas and then explain how Spectacle Rx Fulfillment is an important strategy in each of these areas.
You cannot manage what you do not measure. Measurement is the beginning point of positive change.
Benchmarks are an excellent management tool that allow you to compare your practice to the average.
First steps are to seal the leaks in expenses that not in the normal range. Then look for ways to increase the flow.
There are usually classes on coding at every convention. Make sure you and your staff are not under-coding. Compare your fees with those in your area. Shipping costs are often overlooked in the order of single frames being shipped either to your office or to the laboratory. Today’s shipping costs can run from $3- up to $6 for an individual frame. Adding $5 to all of your frame would probably be a safeguard against high shipping costs. Measure your inventory turnover. A goal to shoot for is 3 to 4 times turnover. If you dispense 40 frames per week ( total of 2,000 per year) a four times turnover would mean you have an average inventory of 500 frames. Pre- appointing is a way to keep the bucket filled. There are also excellent proven methods for increasing capture rate ( share one) and we will be discussing a specific method for increasing RPP ( revenue per patient.)
There is nothing more impressive than a staff that knows what they are doing. Continuous improvement comes from ongoing training. There are many excellent sources for training- many of free services offered your vendors and don’t be afraid to invest in proven consultants. Everyone, including, Tiger Woods needs a coach. The cycle of service allows you to study each point of contact and make sure you and your staff are telling the best story at each point.
If we believe this USA Today Report ( and I do) we must question why our patients’ behavior does not reflect this belief. After all- they only come every 2.2 -2.5 years and spend less on vision care than they do coffee. The problem is behavior is learned..and you and your staff are the teachers. Your patients are looking for a trusted source of expertise…that preferred provider of choice. Have regular staff meetings, look at each point of contact and establish what is the best possible outcome at each point and how do we obtain it. Remember the only thing that matters is what kind of experience the patient has. Patient management is one of the most important elements of practice management.
Micro-marketing continues to be the story in marketing today. As the number of channels and choices of programming on television has exploded in addition to the internet- mass marketing is steadily being replaced or supplemented with micro- marketing. One-on-one marketing that takes place inside your practice from the time the patient walks through the doors until they leave.
Does it make sense to you after you have taken the patient medical history, asked the questions, completed the eye health exam and the visual acuity portion – that you will miss that “aha” moment when the patient gets the finished product of you and your staff’s hard work? This is the longest lasting reminder of their visit and when they think of that moment when they could see clearly- will it have taken place in your office or at the mall?
This is the process designed to help you and your staff fully and honestly advise your patients of all that will restore, maintain and enhance their vision and general health.
Vision occurs when light is processed by one’s eyes and interpreted by the brain. Therefore the proper control of light plays a vital role in seeing properly. The eye does three main things with light- it changes the speed, the direction and the amount.
Interesting that in the exam room- we do not simulate the real world of the 21 st century. In fact the Snellen chart is the basically the same chart that Dr. Herman Snellen developed in the 19 th century. The ability to see a three inch black letter against a white screen at 20 feet. In addition in the exam room we control the illumination and have patients make choices looking through lenses that are AR coated, where as in the real world illumination tends to control us. Correcting and protecting vision and providing healthy sight means taking into consideration the problems one incurs with varying light conditions.
Let’s refresh our memories of these types of glare and the solutions available.
Light is measured in lumens. Light measured between 1000 and 1400 lumens is considered optimal lighting. Glare can also be described simply as more light than the eye can comfortably handle or process.
These are the four types of glare your patients deal with on an every basis- they can range from annoying to dangerous. To enhance contrast, improve vision quality and comfort and reduce fatigue, you must deal with these culprits of healthy sight.
A simple problem with a simple solution- yet over 70% of patients do not have this solution.
Outside of the exam room where illumination was controlled- illumination controls us. The eye makes adjustments for glare, but sometimes requires help. New technology can help relieve this problem- yet only 17% have this solution.
According to a Bausch & Lomb study, outdoor light can be up to 25 times greater than normal indoor lighting. Adapting to the light can be a problem that causes fatigue, eye strain and headaches. It is estimated that in an average day your eyes will expend the same amount of energy that you leg muscles would if you walked 50 miles. This type of glare can also impact dark adaptation or night vision if left untreated. The cost for solving this problem of glare is minimal- yet the lack of people being educated about this solution is a glaring problem itself.
This glare often contributes to unsafe driving conditions and results in numerous accidents per year. Your patients who drive a lot during the day as part of their work or have east-west commutes will certainly benefit from this prescription solution. It is as much a part of safety as safety belts and air bags. Yet less than 10% have this technology for their prescription spectacles.
Whereas a clear pair of AR coated lenses will successfully lessen the effect of distracting glare, they will not help the problem encountered in bright light with Discomforting and Disabling Glare. However, an AR coated photochromic will help restore, maintain and enhance vision in distracting, discomforting and disabling glare. The most versatile primary pair you can recommend for your patients. For blinding glare polarized lenses are the best solution. So two pair or at least an AR Coated Photochromic with a Polarized clip are recommended.
These two pair or one pair with a clip enable your patient to deal with all four types of glare and include UV protection, AR coating and SRC. This technology allows more light in when it is needed, less light when there is too much and deals with all four types of glare. Enhanced contrast, glare protection, comfort, convenience and reduced eye fatigue are the results. Healthy sight and TLC go together.
Our TLC brochure and work sheet were designed to reinforce this packaging concept and help you and your staff present this solution, answer the frequently most asked questions and deal with pricing issues.
When considering what photochromic lenses to offer to your patients. This is a check list of “ must haves” . Your patients deserve the best materials available. New photochromic technology has indoor clarity comparable to regular clear lenses and meet standards for night driving. However, outdoors in discomforting and disabling glare, they darken to provide comfort, protection, enhance contrast and reduce fatigue.
Letting in more light is important to your aging baby boomer. Remember the average uncoated lenses only allow from 88-92% of the light to pass through the lens.By eliminating this distracting glare, you improve contrast, night vision, reaction time and reduce eye fatigue. Combined with photochromic technology this lens mimics the performance of the eye by allowing in more light when needed and less when there is too much.
Blinding glare or reflected glare can be an annoying problem or in the case of driving, a deadly problem. Polarized technology consisting of polarized film imbedded into the lens blocks the horizontally polarized light. Less than 10% have this technology in their prescription. An alternative for those concerned with the cost are clip-on polarized lenses to wear over the primary Rx. These “ training wheels” can allow the patient to experience the effects of polarized lenses and will serve to prepare the way for obtaining the polarized prescription lenses in the future. Together they block all four types of glare, reflections and harmful UV. They provide your patients with the tools to help them control illumination in all types of lighting.
One must never offer a solution until the patient understands their need for the solution. A Patient Medical History Questionnaire is available @Transitionstom.com . This questionnaire was developed at one of the leading teaching clinics in the country and can help you systematically uncover patients’ needs thru such basic questions as ‘ do you have trouble reading signs when driving at night?’ Are bothered by glare or bright sunlight, etc. What hobbies, recreation or outdoor activity do you enjoy? Lifestyle dispensing will never be a reality without lifestyle prescribing.
In the real world, price is always an issue. Staff must have some tools to deal with pricing concerns. These are some proven methods. First show the savings in the package vs. ala carte pricing. Always show what portion the patient’s insurance pays. Separate the difference by focusing on the difference they are paying over their previous pair of glasses. Example: patient is being offered a package that is $450 compared to $300 for their last pair. Focus on the $150 and what they are getting for that $150 and what need or problem it is solving. Costs averaged over time…average length of time between new pairs of glasses is 2.5 years. This is almost 1000 days so that means you can move the decimal over three places. A $450 pair of glasses “cost” 45 cents per day averaged over time. Relative value is a technique where you compare what people spend their money on and relate the value. Example: Eating out once in a nice restaurant for a couple could easily be $75-100 whereas, the benefit you are offering is only $150 and they will enjoy the added value for the next two and a half years. ( other examples are amounts spent on coffee, or cable television.) Then Top Down Dispensing is simply taking the package apart to finally balance the benefits to meet the patient’s budget.
These factoids not only help tell the best story, they also explain the source of some of the problems.
AOA tells us Computer Vision Syndrome is a major complaint and cause of eye fatigue. When you consider how hard the eyes work during the day- surely anything that makes the work easier for them is important.
The new photochromic technology is designed to be offered to current clear lens wearers as a new technology that gives them the benefits of clear lenses indoors and at night- but the ability to deal with glare and overall brightness outdoors with its photochromic chemistry that darkens in sunlight. Our research shows high patients satisfaction.
By providing comfort, convenience, protection and correction in one primary pair of lenses, you can expect a high percentage of returning patients. Healthy sight now and in the future addresses their number one health concern as most negatively impacting their quality of life.
Spectacle Prescription Fulfillment
in Medical Optometry
The mysterious erosion of the foundation of Traditional Optometry
AOA Optometric Oath:
“ I will advise my patients fully and honestly of all
which may serve to restore, maintain or enhance
their vision and general health.”
Our Guiding Mission
Providing healthy sight
Offering the best solutions
Executing your oath
The Cause For Concern
Independent ECPs provide almost 66% of all
Provide only 44.5% of frames*
Provide only 46.3% of lenses*
* Jobson 2007 Research
Retail chains provide 40% of exams.
Provide almost 60% of frames*
Provide almost 60% of lenses*
* Jobson 2007 Research
Three things you want your patients to do
Two daily concerns
The number one priority of your practice
Eroding market share
Declining capture rates
Managed care issues
Shrinking net profits
An aging population
The rise of concern over vision care
USA Today : American Foundation For The Blind
Stop The Erosion!
Rebuilding the foundation
Use the best materials
Use the right tools
“Build it and they will come”
Foundation Must Be Built On…
Professionalism- not sales gimmicks
Built on patient loyalty and referrals
The mortar of ‘word-of-mouth’
Materials Used Must
Restore, maintain and enhance healthy sight
Give your practice a competitive advantage
Increase your capture rate
Restore your shrinking net
The Bucket Concept
Keeping the bucket filled
Checking for leaks
The functions of marketing and management
Has Your Bucket Got a Hole in it?
Four Key Areas Where Leaks Occur:
Patient management leaks
Measuring and managing by benchmarks
“ If your outgo exceeds your income; then your
upkeep becomes your downfall.”
Measuring and Managing
Cost of good sold 33%
Staff compensation 17%
Dealing With The Leaks
Increase the flow
“ If you always do what you have always done- you
will always get what you have always gotten.”
Increasing The Flow
Check fees and coding
Increase prices of frames
Increase capture rate
Organization Management Includes
Cycle of service
Telling the best story
“One point of negative contact wipes out
three positive points of contact.”
USA Today Report: Number One Health Fear
Looking for a trusted source of expertise
Your oath to fully and honestly advise..
Manage the patient experience from start to finish
Put it all together in a seamless process
Internal and external marketing
Telling The Best Story
Correction plus protection
“ Come and see -your best and look your best with our unique
approach to providing each patient with Healthy Sight now and in
The Importance of
The Spectacle Rx Fulfillment
Love at “First Sight”
The “aha” moment that produces the “ I Can See
Clearly Now” response
The Spectacle Rx- the longest lasting reminder of
their last visit
The prescription they never fail to take daily
Healthy Sight Counseling
A three step proven method:
Regular maintenance and preventive care
Vision wear based on intelligent correction using
the latest technology
The Science of Vision
The science of vision is described as…
the study of how light enters the eye and is
transformed into our perception of the world
The Exam Room Experience
Snellen acuity chart
Phoropter with AR coated lenses
Glare, Reflections and UV
The enemies of good vision and healthy sight:
What is glare?
What are the four types?
What can you advise that will restore, maintain
and enhance your patients’ vision and general
“Glare is misdirected light. It is produced by a luminance
in the visual field greater than the luminance to which the
eyes are adapted, leading to impaired visual
performance and ocular discomfort. It is generally
measured by assessing the effects of glare on contrast
sensitivity, making the two intimately related.”
Susan Stenson, MD
Four Types of Glare
Occurs at day or night- indoors or out
Occurs between 1400-3000 lumens of light
Cause: reflections off the surface of uncoated
Uncomfortable and annoying causing eye fatigue
Occurs when going from indoors lighting to
outdoor lighting between 3,000 and 10,000
Causes one to squint, shade eyes with hand
Causes discomfort, blocks vision can inhibit night
vision and cause eye fatigue
Occurs when going from indoor lighting to outdoor
lighting greater than 10,000 lumens
Can interfere or block vision severely
Problematic in elderly
Causes diminished contrast, eye fatigue and
effects night vision
Results from incident light reflecting from shiny
Seriously compromises vision
Can create unsafe conditions- driving
Causes blocked vision, eye fatigue and effects
Prescription Solutions For Glare
Distracting Glare- AR coated clear lens or AR
Discomforting Glare- AR coated photochromics
Disabling Glare- AR coated photochromics or
Blinding Glare – AR coated polarized lenses
True Light Control
TLC is a packaging concept that addresses all four
types of glare:
TLC consists of two pairs of eyewear
Primary pair – AR coated photochromics
Secondary pair- AR coated polarized
Option: AR coated photochromics with polarized
The TLC Package
Everything you need to know about:
Anti-Reflective coated lenses
How to uncover the needs
How to deal with pricing issues
Photochromic Lenses Must Haves
Speed of performance
100% UVA & UVB blockage
Eliminate glare and reflections
Easy to clean
Block reflected glare
Restore vision in dangerous situations
Protect from harmful UV
Preserve night vision /dark adaptation
A method to systematically uncover needs
A patient medical history questionnaire
“ Questions are the answer.”
Dealing With Price
Separate the difference
Costs averaged over time
Top down dispensing
“Always balance the benefits with the patient’s budget.”
Telling the Best Story
Aging reduces the amount light reaching the
Example: Average 60 year-old receives
approximately 1/3 of the light of a 20 year-old
Uncoated lenses block from 8-14% of the light
Telling the Best Story
AOA reports 70-75% suffer from CVS
The human eye blinks 11,000 times per day
During an average day, the eyes will expend the
same amount of energy that your leg muscles
would if you walked 50 miles!
Offer your patients the ability to upgrade to the new
“ clear lens technology”
Provides patient satisfaction
Promotes healthy sight
Creates a unique competitive advantage
Enhances your professional image
Comfort, Convenience, Protection
Stops the erosion of spectacle Rx fulfillment
Creates a healthier practice
Builds for the future
“If it’s good for the patient , it’s good for the practice.”
Spectacle Prescription Fulfillment
in Medical Optometry