Hubble-Proof Your Contact Lens Practice

Marketing, Practice, Pricing, Resources

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Editor’s Note: Hubble Contacts started supplying Canadian residents late in 2017 and provides its services to Canadian addresses. The Canadian price point is $40 for a monthly subscription (versus $30 US for US residents).  TV and Internet ads do spill over from US media to Canadian viewers. InfoClip.ca previously reported on the funding Hubble received for a Canadian launch. Click here to read more.

By now, you’ve probably heard–or seen on TV or online–that Hubble has launched. Not the space telescope, but an online subscription service marketed as a low-cost source for daily disposable contact lenses.

Hubble clearly presents their value statement–and independent ODs who specialize in contact lens services are challenged to be clear in presenting ours, as well.

First off, with Hubble the contacts won’t be the ones we have prescribed for the patient; rather, they are a generic daily disposable created especially for Hubble. The lenses are made of a version of methafilcon with a Dk/t of 18.8, rather than today’s standard of Dk/t of 80 or even 100 for premium lenses. In other words, Hubble lenses allow four-five times less oxygen to reach the cornea that do branded lenses than we regularly prescribe.

Whatever the quality of the lenses, the lure of inexpensive daily disposables may be hard for patients to resist. The site touts: “With your first shipment you’ll get 15 pairs of Hubble lenses for free. Just cover the monthly $3 for shipping & handling.” After that first complimentary shipment, you can get 60 lenses per month for $30.

The site has a doctor locator to facilitate prescriptions especially for Hubble lenses by connecting the patient to doctors who have Hubble fitting sets, and are open to writing prescriptions specifically for Hubble’s product.

Instead of being alarmed about this new price-driven option for consumers, at our practice we have a practical and workable solution: Before we talk about price, we talk about value.

Increase Marketing of Daily Disposables
One thing I like about Hubble is they are promoting daily disposable contact lenses. Currently in the U.S., daily disposables are just under 30 percent of the contact lens market. One of Hubble’s goals is to grow that market. That growth would be good for Hubble, but also good for us as practitioners.

I have a large three-doctor practice that places a heavy emphasis on contact lenses. Last year my practice generated just over $3 million in total revenue. Approximately 17 percent of our total revenue is generated from the sale of contact lens materials, and another 8 percent from contact lens professional fees.

Our practice is close to 60 percent daily disposable lenses of all soft lens sold, and 76 percent daily disposables in the spherical category. We have gotten to those figures by educating patients on the advantages of the daily disposable modality. In my view, there are two advantages to daily disposables over other modalities: health and convenience.

My staff and I explain to patients that having a fresh lens every day is the healthiest way to wear a contact lens. That statement by itself is usually easy for a majority of patients to understand. Most patients who are in a frequent-replacement lens can relate to the feeling of putting a new fresh lens on. Now they can have that feeling every day.

For convenience, I merely ask patients if they like cleaning their contact lenses. Most, if not all, patients do not like having to clean their lenses every day. I explain to them that with daily disposables, cleaning is a thing of the past. Also, they will save the average of $100 per year that most people spend on contact lens solutions.

To sell any product you need to show the consumer why that product is better than other products. Contact lenses are no different.

Price Isn’t the Primary Motivator for CL Buyers
Price is not the number-one reason people purchase a product. Research reveals that price often is the fourth mostly important reason for purchasing, following functionality, utility and brand. Ten percent of consumers purchase based on price alone. For that reason I’m not overly concerned about Hubble. As independent practitioners, we should concentrate our efforts on the people who buy based on the other reasons listed above. Besides, how many patients come to us to purchase on price? My guess is most come to us for other reasons.

Even Hubble realizes that price isn’t the only reason to purchase from them. Like other companies, they are trying to build their brand. Greycroft Partners’ Ellie Wheeler, a Hubble investor says, “In a lot of categories, you didn’t care about a brand until you did. We’re making a bet that Hubble can create a brand that resonates with consumers. Delivery and convenience are only part of what they’re offering.”

Click here to read more about how Hubble and Warby Parker are impacting the industry.

Talk In Terms of Benefits
Rather than getting mired in a price conversation, point out the benefits of the contacts you prescribe. If the patient broaches the possibility of purchasing from Hubble instead, emphasize how the contacts you prescribe provide greater benefits to the patient’s eye health and vision than those available through Hubble.

In my practice, we don’t talk price as much as we talk value. For us, that value proposition is twofold: health and new technology.

For health, I mention to patients that the newer lenses to the market generally allow about four times more oxygen to reach the cornea than older-generation lenses. The cornea needs oxygen to function properly. Inadequate oxygen supply can lead to a higher incidence of corneal ulcers, an increase in redness and corneal swelling, which can result in poor or changing vision. I use that wording rather than neovascularization or edema to make it easier for patients to understand.

New technology is also mentioned to the patient and explained, as newer materials that are healthier, more comfortable and more wettable, which aids in reducing a dry eye feeling.

Hubble contact lenses are made from methafilcon A, which is a material that has been around for over 15 years, and has a Dk of 18. In comparison, newer daily disposables, such as Oasys 1-day (Dk 103) and Dailies Total One (Dk 140), are both over that 100 Dk threshold. They are also manufactured to help maintain moisture in the lens better than previous-generation contact lenses. Without getting into medical jargon, I explain that the contacts I have prescribed allow more oxygen to permeate the lens, and keeps the lens moister, resulting in greater comfort, and less chance of having to take the contacts out and switch into glasses for relief on a long day.

Most patients assume all lenses are alike, and Hubble is trying to capitalize on this perception. It is our job as optometrists to educate our patients as to the difference in lenses. Again, in our office we do this by highlighting the differences in lenses, such as oxygen transmission, wet ability, comfort, technology, etc.

Offer Resistant Patients Options
In our daily disposable lenses we have several tiers of products. On the high end we offer lenses like Dailies Total One and 1 Day Oasys. We explain to the patient why these cost more–higher oxygen, newer material, more comfortable, etc. I recommend those lenses first as I believe they are better products. From there we move down the lens category list to lesser-priced products if cost is an issue. My experience has shown that most patients will opt for the better product, and even if they do not, they will still purchase the lower-priced daily disposable lens, and stay in the daily disposable category.

If patients are skeptical, then I at least let them experience the better lenses by letting them “test drive” the contacts I have prescribed outside the office for a week. Nothing sells a daily lens better than letting patients experience the comfort and convenience of the newer lenses that are on the market.

Closely Track Your CL Sales & Adjust as Needed
Internet sales account for 15-20 percent of all contact lens sales, and Hubble itself has not yet had a significant effect on our practice.  Our sales of contact lenses remain strong, and it is integral part of our practice, accounting for close to 20 percent of our revenue. If we see sales drop, then we will have to rethink our pricing.

I do not think we would lower the price of our premium lenses, but we may offer a lower tier if too many sales are leaving the practice. We have to be careful in that area, as trying to be too many things to too many people can be a disaster for a business. Just look at companies like Sears and JCPenney that tried to be too many things, but they weren’t really great at any one thing. As an independent practice, I believe we need to have a game plan for what type of practice we are going to be. If you are high end, stick to high end; if you are low cost stick to low cost. That is what Hubble is doing, and they know their niche.

Even the founders of Hubble realize their limitations. When asked about the potential for Hubble, co-founder Jesse Horwitz replied: “Dollar Shave Club and Harry’s together have taken 20 percent of the cartridge market. If we were to take 10-15 percent of the U.S. market, that would be $600 million, but we are also expanding the market. If you can claim a few points of market share, you can have a very good-sized business.”

As independent optometrists, we should focus on the 80 percent of patients who want to buy from us, and not the 20 percent who want to shop elsewhere.

 

KEN KRIVACIC, OD

Ken Krivacic, OD, is the owner of Las Colinas Vision Center in Irving, Texas. To contact him: kkrivacic@aol.com.

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Why an Ontario Judge Ruled in Favour of the Optometrists and Opticians Against Clearly

Finance|Wealth, Practice, Products | Services | Industry News, Tax & Legal Matters

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The Ontario Colleges of Opticians and the Ontario College of Optometrists jointly filed an application in December 2016, as is their right under Ontario legislation, to request the Court to issue an order to Clearly to comply with Ontario’s Regulated Health Protection Act and the related Optician Act and Optometry Act. The case was heard in October 2017 and the court rendered its decision on January 11, 2018.

The Ontario Supreme court ruled in favour of the Colleges of Opticianry and Optometry, ordering Clearly to comply with Ontario regulations. For those not inclined to read the 31-page decision by Justice J. Lederer, here is a synopsis of the key points in rendering his decision in favour of the Colleges.

The Investigation

The Colleges used the investigative services of a legal firm to purchase eyeglasses online from Clearly.ca. While the site has clear notices regarding the requirement for an up-to-date prescription, the investigators were able to find links on the site that allowed them to proceed to order glasses without meeting the requirement of a valid prescription. The investigation details the use of the site and interactions with non-professional and professionally trained staff (Optician) based in the British Columbia head of office of Clearly. In each case, glasses from Clearly were delivered to their respective customers in Ontario.

Eyewear:  Consumer Retail Product or Health Care Delivery?

The Court distilled the case down to the definition of “dispensing” as a “controlled act” that is imbedded in the related health legislation and regulations of the province of Ontario.

Submissions by Clearly argued that the rise of e-commerce is satisfying consumers’ demand for more choice and competition, and implied, according the decision, that the Colleges are complicit in a wider effort of professional associations and colleges to protect competitive advantage in the market.

The Court however dismisses this argument as unhelpful and irrelevant. “It could be right. It could be wrong. It does not respond to the issues at hand,” wrote Justice Lederer in the decision.

The judge noted that basis for the decision lay in the underlying purpose of Ontario’s regulated health professionals legislative framework. Unlike British Columbia, where legislation was changed in 2010 to reflect a purpose of consumer choice and enhanced competition, such is not the case in Ontario, where the framework of professional monopolies exists to deliver health care while protecting the interests of Ontario residents. The decision reads, “There is no justification for imposing the purpose of health professional legislation from British Columbia on those who reside in Ontario.”

Why Were Optometrists in Quebec Unsuccessful in Blocking Internet Sales?

A similar action taken by the Ordre des optometrists du Quebec v. Coastal Contacts Inc.  ruled in favour of the company against the Ordre (College) in December 2014. What was different then and there?

Turns out, words do matter!  The Quebec case is distinguishable in the detailed definition of the practice of Optometry in Quebec’s code, which includes the words “sale and replacement of ophthalmic lenses.” The decision in the Quebec case is driven by the word “sale”. The law of British Columbia ruled the day since it was determined that the sales contract between the company and the resident was substantially entered into in BC, and that the product was only “delivered” to a resident in Quebec.

“Dispensing is qualitatively different than selling”, wrote the Justice. As such, notwithstanding the position held by the Company and their attempt to draw parallels with various classes of pharmaceutical agents, the Judge returns to the basic tenets of the Ontario Legislation; “…what professional (optometrists and optician) is responsible for providing the health care associated with obtaining eyeglasses and contact lenses (“prescribing”, ”preparing”, ”fitting”, “adjusting”, “adapting” over the internet from Coastal and Clearly?  I repeat, apparently this is not one.”

No Harm, No Foul

Clearly’s counsel additionally submitted that controlled acts should be narrowly interpreted and that evidence of “risk of harm” is a requirement of the Colleges; “Despite the recommendations of two seasoned regulatory law firms, the colleges have not introduced any evidence of the risk of harm.”

The Court however held that the risk of harm assessment is intrinsic to the controlled act (“Dispensing”) definition in the related legislation and that the Court has no role in the risk assessment of harm. To suggest otherwise, is, according to the decision, “…to negate the value of the regulation.”

 So, Now What?

Clearly is appealing the decision. While the appeal process is underway, Clearly plans to continue to service customers in Ontario.

Clearly representatives advised the following; “Clearly is committed to making vision care accessible worldwide and believes that the Internet is complementary to other distribution channels”, says Clearly Managing Director Arnaud Bussieres. “Clearly is well-known for accessibility, affordability, consumer satisfaction and quality of service throughout its eighteen years in business,” added Bussieres.

According the company, Clearly has a history of engaging in dialogue with optometrists and opticians across Canada to find areas of collaboration and ways to provide better products to consumers. “We don’t see this decision impacting our progress and ambitions of working directly with eyecare professionals to address opportunities for additional vision care access in the market,” commented Bussieres.

The Ontario Association of Optometrists (OAO), upon request, indicated they were “not in a position” to comment, given that the application was brought on jointly by the College of Optometrists and College of Opticians.

A statement from the Ontario Association of Opticians was not available at the time of publishing.

 

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Cross-Train Staff for Consistent, High-Level Patient Care

Human Resources, Training & Onboarding

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Failure to deliver the best care and services because one person is out sick is not acceptable. It is costly to your practice, and avoidable through cross-training. Our four-OD, 19-support staff practice, which delivers over 6,000 exams per year, has found cross-training to be an effective way of ensuring consistent care.

In addition to consistency of care, cross-training also has allowed us to provide staff with opportunities to grow in our practice. Sometimes we find a staff member has a great desire to learn something new, and occasionally, we may find a staff member has a strength that we didn’t realize until they performed another task in our office.

The staff of Miamisburg Vision Care delivers consistent care to patients, thanks to cross-training. Each is trained in a primary task and at least one secondary task. There is no disruption to patient service and flow when a staff member is out sick or on vacation

Along with the benefits to our patients, cross-training helps us keep our staff happy, as they feel more valuable, and experience joy when they find something new they can become an expert in.

IDENTIFY WHERE CROSS-TRAINING IS NEEDED

In deciding what tasks to cross train, we first reviewed the areas where we already had challenges throughout our day, but also looked at situations in which the variables can’t be controlled, such as when patients come in late causing a bottleneck in pre-testing.

In those situations, having an additional staff member who can step in and do pre-testing is beneficial. Or having another employee who can pinch hit in the optical when the opticians are backlogged can mean the difference between making and missing a sale.

As another example, it would be great to have everyone trained in all areas, but working with the billing, and reconciling an EOP, is not critical to patient care. So, be sure to prioritize in cross-training areas that most impact patient care, or those that patients perceive to be something that should not include significant waiting, like scheduling an exam or picking up contact lenses.

It is important to continually expose your staff to the secondary tasks you would like them to perform, so the skills stay fresh in their minds.

Our personnel manager is responsible for setting the schedule to ensure each staff member is placed in both their primary and secondary tasks throughout the upcoming week. We always have in place a back-up for key tasks in case an employee is absent. After the daily schedule for primary roles is determined for the upcoming week, we then decide who the back-up employee will be for each of the key roles in the office for each day. It’s like having an under-study at all times for each essential role in the office.

SET EMPLOYEE EXPECTATIONS

It can be challenging when an employee finds their primary task is not what they want to do, and they would rather perform their newly learned task. We prevent this from happening by having a clear conversation with the staff member to set expectations and the purpose for learning the new task.

For instance, we told an employee, who was a scribe and pre-tester, that we needed her to learn contact lenses since one of our contact lens technicians was going on maternity leave. We clearly indicated that she would be working as a scribe, and that was her primary role, but we also were having her learn contacts to ensure we could maintain consistency in patient care for contacts. The other thing we did was to provide scheduling to allow her to work in both roles once the contact lens technician came back from maternity. She was thrilled to be able to work in both roles, and this allowed our practice to maintain the excellent care without the patient suffering or waiting because we couldn’t handle their needs.

TRAIN IN PRIMARY & SECONDARY TASKS

The importance of cross-training is it ensures there is no change in the care you provide every patient, regardless of who is sick or on vacation.

Staff should always have, at a minimum, a primary task with a secondary task, and possibly other tasks they learn well enough to perform when necessary. What If only one person can take retinal photos, or run ancillary tests, such as a visual field? At the worst moment when a field is needed for patient care, you can be stuck making the patient wait while performing the task yourself. Or what if somebody decides they want to try contact lenses, and needs training, but your primary trainer is gone? It is much better to be able to help the patient right then versus having them come back. This works for all areas, like dispensing glasses or contacts, scheduling patients, or patient pre-testing.

CARVE OUT TIME FOR CROSS-TRAINING

The time needed for cross-training varies, but can be done in many ways. A big thing I do in my office is include training during our weekly meetings. This generally means we break up into groups and the person who has the best knowledge of a primary task will teach someone the task as their secondary responsibility.

We also make sure that whenever an employee is not needed for their primary task, they shadow the employee doing their secondary task. For example, an employee who normally performs contact lens training may follow the visual field tester if there are no fits being done at that time.

There also is continued training during the course of a typical day by the personnel manager in my office, on-the-job, as the need arises.

 

DR. DAVE ANDERSON, OD

Partner Miamisburg Vision Care, Miamisburg, Ohio

Dave Anderson, OD, is a partner withMiamisburg Vision Care in Miamisburg, Ohio. To contact: doca@burgvision.com

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Insight with Dr. Peter Rozanec

Insights

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Dr. Peter Rozanec owns a two doctor clinic in Port Credit Ontario.

Peter has been active within the profession of Optometry both at the

association level and the college level. Peter is the co-founder and current moderator

of the Canadian Optometry Group or COG for short. COG is a private online forum

consisting of close to 1000 OD’s across Canada.

 

Dr. Peter Rozanec

Port Credit Optometry Clinic, Port Credit, ON

Doctor of Optometry, University of Waterloo, 1990

 

Why did you choose your field?

I choose optometry because I had bad eyesight and I really liked visiting my optometrist the most – he (Dr Harvey Mayers in Toronto) was professional and with my being ‘a gadget guy’, he had all the latest cool ‘gadgets’ so optometry felt like a natural fit.

What advice would you give a new grad today?

Listen to thought leaders in your profession. Participate in your association and college – be a volunteer. You’ll meet great people and learn from them. Find a good practice analyst/coach that will objectively assess your practice and help it grow. Market your practice one patient at a time – subtly make every patient your ‘sales rep’ when they walk out your door. Have your patient’s back, and they will have yours. Lastly, and not less important – join the Canadian Optometry Group – which is a free email resource for Canadian optometrists that allows you to get real-time information on cases, news etc from your peers in Canada. Email me at peter.rozanec@gmail.com

What changes to eye care do you see coming down the pipe?

Practice consolidation. Solo practice will die a slow but not so painful death. At the very least, you may see very rare examples of ’boutique’ practices catering in very specialized care but for the most part, you will see more multiple practitioner practices with more services under one roof.

Where do you see your practice/eye care in 10 years?

On a personal side, I plan to be in practice a lot less in 5 years. I would, however, like to work in some limited capacity seeing patients so as ‘to keep my mental saw sharp’, volunteer again at the college and/or association, and allow for more time to travel which I really enjoy doing with my wife. Optometry will be alive and well in 10 years, 25 years, a 100 years. Every decade has brought optometry challenges and its naysayers, but the profession and its knowledge base continues to grow – which is the mark of a healthy profession.

What is your favorite TV show / Netflix series?

Seinfeld and Breaking Bad. Having said that, my favourite show as a kid and teen was Hogan’s Heroes, in university it was Cheers, and in my working years it was Seinfeld. Because all were well-written they have withstood the test of time. Breaking Bad is a phenomenal series that has set the bar so high it will be difficult for other shows to surpass it – it’s ‘The Godfather’ of drama series.

How have you changed since high school?

I see the world far more in shades of grey rather than black and white. And perhaps that – and this is somewhat tangential – I also see that maybe the only thing that might bring the world together is an alien invasion – that we would fight off, and allow us to realize that we have a lot more in common as humans, than those petty things that often set us apart.

Dr. Peter Rozanec circa 1964

 

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Tie Your Staff Incentive Program to Gross Revenue per Doctor Day

Finance|Wealth, Human Resources, Practice Metrics & Benchmarks, Resources

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Any well-oiled machine works smoothly because all the moving parts work in synchrony with one another. So too does a  successful Optometry practice.

We are often asked what the best way is to motivate staff. Although there is merit to rewarding staff individually based on very focused goals and targets, one of the best ways to motivate for team effort is a group incentive based on total gross revenue.  The basic premise is that if everyone performs well at their assigned tasks, the team will meet their goals.

For simplicity’s sake, a practice can set monthly targets based on a percentage increase over the same month last year. A more strategic approach is to set targets based on revenue per “Doctor Day”.

Calculating Doctor Day Revenue
You can calculate revenue per “Doctor Day” by dividing the number of patients you see in a month by the number of days there is a doctor available for an entire day (7 hours) in a month.

Two doctors seeing patients in one day equals “2 doctor days”. For example, Dr. Opto generated an average of $80,000 each month and was in-office for an average of 20 doctor days each month.  Dr. Opto’s revenue per “Doctor Day” is $4000.  We recommend building in a 10% increase and then using this as your target. So in this example, the target revenue per “Doctor Day” for Dr. Opto would be $4400 per “Doctor Day”.

To get started, set up an excel spreadsheet with gross revenues targets for each doctor day in the office. The next step is to ensure that every member on your team understands how their efforts contribute to the attainment of the “Doctor Day” Revenue Goal.

Setting goals based on Doctor Days makes the incentive program fair, since we know that we need a doctor in the office. If the doctor takes two weeks off in July, then the targets should reflect this: some months like February are shorter with less Doctor Days, and March is a longer month with usually more Doctor Days. The targets need to match.

Fairness in the incentive program will enhance staff buy-in.

Link Behaviours to the Targets

Setting goals will only be effective if staff can see a direct link between their behaviours and the results.

Here are some tangible actions that can be established for each department:

Front desk staff

  • Understand and follow scheduling rules
  • Practice scripts to ensure they are ready to answer the more difficult objections and questions
  • Ask to book in family members that haven’t been seen in a while

Pre-testers

  • Anticipate who will need what testing
  • Check insurance coverage

Gallery staff

  • Make note of if and when the patient last purchased
  • Ask to give current glasses, including sunglasses, a “tune up”
  • Check insurance coverage

Lab Staff

  • Make sure jobs are ordered and received promptly.
  • Ensure jobs are delivered to patients in pristine condition

Doctors

  • Make notes on each patient on what tests and products you are anticipating the patient will need
  • Practice a solid hand-off to staff
  • Make solid, multiple-solutions recommendations from the exam room

Getting staff to contribute to this list and make suggestions to the above will further enhance buy-in to the program.

In the beginning, the owner of the practice should keep track of the results and share them with the team each day. This is a chance to rally the team spirit and encourage enthusiasm for the day ahead.   This is a great opportunity to reflect quickly on things that went well and things that did not go so well in the previous day. Once this routine is well established, many offices are able to successfully pass this role to their office manager.

It is key for staff to make the association between proactively engaging with patients to offer solutions rather than passively serving patients and improving the revenue per Doctor Day.

Lastly, when it comes to motivation, it is important to keep the reward and the positive result as close together as possible. We recommend either rewarding at the end of the month or quarter, but we wouldn’t recommend waiting longer than a quarter.

Sharing a percentage of the gross revenue at the end of the month is a great way to celebrate success!

 

KELLY HRYCUSKO

is the co-founder and managing partner of Simple Innovative Management Ideas (SIMI) Inc. and expert Practice Management contributor for Optik magazine. She can be reached at info@simiinc.com.

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Improve Your Holiday Promotions

Advertising & Promotion, Digital Marketing, Marketing, Resources

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There are a number of ways to help boost sales in your optometric practice this Holiday Season.  They are all based on the concept of filling a need—a basic marketing and sales concept.

Every year, many insurance benefits go unused. Reminding patients to use their health benefits before they are reset helps the patient optimize the value of this asset. “Use it or Lose it” campaigns are especially effective when they are combined with ideas that would benefit the patient. These ideas can be anything from a second pair of back up glasses to daily contact lenses for special occasions.

With the change of season also comes a change in extra-curricular activities. Consider a central display and marketing pieces aimed at the skiers and snowboarders in your practice. Be sure to include the idea that it is possible to buy a gift certificate for this purchase. A grandparent, for instance, may not know which goggle will work best and will appreciate the gift card idea.

There are actually a number of products in the office that are well suited to gift giving. The trick is to present ideas! Set up a pretend mantel with stockings filled with lubricating drops, vitamins, eye wipes, omega 3 drops, and contact lens solution.

Optometric clinics can also take advantage of the classic retail sale of Boxing Day. Offering blow out prices is a great way to move stale inventory and boost your year-end cash flow. Also, bringing in new stock gives the clinic energy and focus for the new year.

The holidays are also a perfect time to support your brand by giving back to the community. Many consumers want to support retailers who give back. Choose a charity that is near and dear to the practice owner’s heart. We have seen everything from giving a 20% discount for bringing in an item for the Local Food Bank to getting $25 off sunglasses for bringing in an item for the local SPCA.

Whatever promotions you choose to do, put resources into making professional marketing pieces to support the promotions.  You would not expect to walk into a mall and find notices created by the staff up in the store shops windows. The same holds true for your offices.  Make sure marketing pieces are made for all platforms, including in-house digital promotion and for social media networks.

If you haven’t taken advantage of the Holiday Season this year, don’t fret.  Make a plan for the entire 2018 year. Include plans for all of the major retail days. The further ahead you plan, the more success you will have.

 

 

KELLY HRYCUSKO

is the co-founder and managing partner of Simple Innovative Management Ideas (SIMI) Inc. and expert Practice Management contributor for Optik magazine. She can be reached at info@simiinc.com.

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Defining the New Four P’s: Passion, Principles, Process, and Partners

Human Resources, Marketing, Practice, Resources, Training & Onboarding

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Josée Falardeau jumped in and bought an independent practice one week after her graduation in 1992, and has been going full-steam ever since. She still finds time and energy to walk, run and cycle in the summer, and snowshoe, curl and ski in the winter. While the traditional four Ps of marketing are Price, Promotion, Product and Place, Dr. Falardeau shares her redefined four P’s for success in her two-location practice.


I’ve been practicing optometry since 1992 in Malartic, a little town in Quebec, in a practice I acquired one week after graduating from University de Montréal School of Optometry. At the time, the clinic had only two staff members. The previous owner retired immediately; we never worked together to hand over the practice. Fifteen years later, I acquired a larger two-OD clinic in Val-d’Or, a gold-mining and industrial city of about 30,000 in Northwestern Quebec. For nearly three years, I ran two different clinics in two different towns doing the job of three ODs.

Today, our team consists of four optometrists, an office supervisor, two receptionists, several dispensary assistants and a laboratory technician: over 20 in total.  While initially, the patient base reflected the age of the retiring optometrists, the practice now has a very diversified patient base, consisting still of the original older patients and now many younger families. We often see three generations of patients – a true “family-based” optometric practice.

Underline Passion with Principles and Process  

In a small, isolated city like ours, it may be easier to be close to your patients. It also means that word of mouth can make or break your practice reputation quickly! Our success is based upon three core principles: respect, honesty, and loyalty. We are totally committed to provide the best services and products for our patients based on their needs, but always anchored by our values.

Passion and principles, however, need to be grounded in an effective process to discover the patient’s needs and convert these into revenue opportunities. To do this, we ask all our patients to fill out a questionnaire, which helps us to assess their lifestyle and their visual needs. This questionnaire is a very important tool for us to begin and sustain our relationship with patients.

Our survey has been constantly fine-tuned over the years and evolved into specific questionnaires based upon age of the patients:  children, adults and seniors.  Since the patient’s activities may change over time and we need to be aware of these changes, the survey is taken on each visit. The patient questionnaire travels in each step of the customer journey, including into the examination room. The answers allow us to easily identify patients’ needs and fulfill these needs with the best available solutions that our key suppliers make available.


Partners in Practice

The eye care professional’s duty is to keep patients well informed about eye care diseases and about the various solutions, provided by our partners, that can help them to see better or be more comfortable.

Solutions like Crizal Prevencia®, Transitions®, and the Varilux® X series fit perfectly with this approach. We now commonly see visual fatigue for most people using digital devices and prescribe advanced single-vision design Eyezen™ lenses for these cases. In addition, we use Essilor’s Visioffice® for all measurements for all patients, to provide personalized lenses and a unique eye technology experience.

These advanced technologies provide added value by enhancing their lifestyle and vision. Our approach, backed up by products in which we have full confidence and know patients will love, builds loyalty, trust, and client satisfaction.

Our industry is constantly evolving, which makes keeping up with innovation and the latest technologies a critical success factor. We organize one to two-hour training and review sessions for optometrists and assistants every four to six weeks. Our key suppliers including Essilor and Opto-Reseau (our network group) are partners in this approach.  Training allows the team to be aligned in our values and goals, encourages their involvement in achieving our objectives, and most importantly provide the best possible solutions for our patients.

Participation in the Community

Reaching beyond the walls of the practice is also very important to me. We participate in fundraising with the Leucan Association for Children with Cancer, for the past three years sponsoring a Saturday afternoon children’s show at a local comedy festival that the children perform in. We donate 50 pairs of sunglasses to children under 12 participating in the show. We also maintain communication with our patients through our monthly newsletter, website, Facebook page, and patient recall postcard mailings. We advertise promotions on local radio, where I am also the talk show eye health expert.

We always stay true to our core principles and encourage the team to participate in the sales process. We leverage the resources and excellent technologies of our partners to provide patients the best services and advanced technology products with a satisfaction guarantee. When you believe in what you’re doing, it’s easy to share that passion with others.

 

JOSÉE FALARDEAU, OD,

Is the owner of Clinique Opto-Réseau Val-d’Or and Clinique Opto-Réseau Malartic. She can be reached at valdor@opto-reseau.com. At Opto-Réseau, our mission is to offer exemplary eye care and to provide the products that best suit the needs and the personality of each of our patients.

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The Weakness Independent ODs Don’t Talk About

Differentiation | Business Strategy, Practice

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TAYE Think About Your Eyes is a USA national public awareness campaign, presented by The Vision Council and the American Optometric Association, designed to educate the public on the benefits of vision health and promote the importance of getting an annual comprehensive eye exam.  Click here for more information and a full list of the participating organizations.

A strategic weakness of independent optometry that rarely gets discussed is fragmentation; an industry condition in which the providers function as individuals instead of as a collective or aggregate. An extreme result is the condition of each practice as out for itself, rather than as part of an industry that needs to unite to preserve itself. By noting this weakness, we may be able to find ways to work together to overcome it.

The egg, beef and milk industries all experienced fragmentation, and successfully addressed it. These are industries that produce products to be sold, rather than licensed professionals who provide services, but we can still use their example to give us ideas of what we in eyecare could do. The independent growers and purveyors of the egg, beef and milk industries committed to national advertising to support their collective need, and eyecare can do it, too.

Consolidation in the pharmacy and real estate markets, which have experienced a roll-up process similar to what is beginning in eyecare, were capitalized upon because of their fragmentation.

TAYE Is a Good Start, But More Is Needed
Can you imagine how hard it would have been in 1985 to get ODs to contribute money to a national marketing campaign like Think About Your Eyes? TAYE is making significant inroads to educating the public of the services independent optometrists provide, but it’s still an uphill battle convincing ODs to pitch in contributions to a marketing campaign benefiting independent optometry as a whole, rather than just their individual practices.

Despite the relative success of TAYE, after 50 years of interaction with my colleagues and friends, I see the odds of a successful collective response as slim, meager and none. Added to the challenge of fragmentation is the mass retirement of Baby Boomer ODs, who are looking for their personal best exit, with understandably greater concern for their own finances than the state of independent optometry.

Personal Cost and Effort, Not Just Legislation, Is Required
As difficult as it will be, it is not too late to consider a collective strategy to preserve independent optometry. The counter-measure will require increased personal cost and effort, and must represent a much stronger counter-fragmentation strategy. The strategy needs to be a business strategy, in which independent ODs are shown that it is in their personal financial interest to come together. A legislative or legal strategy having no sound economic value is doomed to failure.

Consolidate While Maintaining Independence
The individual independent practitioner will do well to continue to look for the ability to gain the benefits of a consolidated aggregate buyer and seller of care while maintaining their independence.

Join Alliances, Buying Groups and Optometric Associations
There’s never been a more important time for participating in buying groups, management groups and professional associations that can, while avoiding anti-trust laws, improve the ability to buy and sell care like an aggregate. This is a sound strategy for maintaining independent ownership. Think regionally when joining together with your colleagues to form operating collectives for the most manageable and effective outcomes.

What ideas do you have for how independent practice owners can join together to preserve independent optometry?

 

JEROME A. LEGERTON, OD, MS, MBA, FAAO,

 is co-founder and chief clinical and regulatory officer with Innovega Inc. He is the co-founder of SynergEyes Inc and co-inventor of Paragon CRT. Dr. Legerton was the managing partner of a seven-doctor, four office, multi-specialty practice in San Diego. He holds 52 issued U.S. patents, and has 70 pending applications registered in more than 45 countries. Products flowing from these patents enabled eyecare practitioners to earn more than $1 billion in fees for services and lenses in the last 15 years. Contact : jlegerton@aol.com.

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How to Convince Undecided Clients

Differentiation | Business Strategy, Practice, The Patient Journey

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One of the more difficult situations to handle is a customer who can’t decide whether or not to buy.  Their indecision can cause a lot of frustration for staff, particularly if other patients are waiting for help.  There are a number of strategies that can help alleviate the stress of this bottleneck.

The first step is to make sure that your offerings are clearly laid out, including costs.  Create pricing tools that offer choices in different categories.  For example, clearly show your customers the cost difference between lens technology and material options.  Highlight what other features are available, including photochromic material and anti-reflection coating.  With the choices clearly laid out, it will be easier for the client to select what makes the most sense for them, in terms of benefits and price.

Make sure your staff understands the difference between a feature and a benefit.  While anti-reflection is a feature that is offered on most lenses, the benefit to the patient is being able to see better, particularly at night, which is a common patient complaint. In their own words, staff can explain that by way of letting more light through to the back of the eyes, anti-reflection coating can actually help patients see better!

Story telling helps illustrate the benefits most effectively.  If your staff has a personal experience or anecdotal experience from another patient that helps highlight the benefit of a product, encourage them to share it with patients.

Offering a satisfaction guarantee can also help move the needle.  Patients who are well informed will make a great choice for themselves. Being able to make a clear, informed decision also reduces the risk of buyer’s remorse.

Demonstration can be an incredibly powerful tool. Have a pair of polarized sunglasses and a pair of tinted lenses for demo purposes only. Invite patients to take both pairs outside and see the difference for themselves. Experiencing the benefit for themselves can help the patient arrive at a decision.

If a patient is having trouble narrowing down their frame selection, there are strategies that can assist them in the process of elimination. Use a decorative shopping tray in which to place all the finalists. Which is your least favourite between these two choices? Is it fair to take that one out of the decision pile? Once you have narrowed the selection to two or three, sit down with the client to discuss primary and secondary pairs of glasses.

Contact lenses are a commodity product. They can be shopped and purchased easily from many different sources.  Price is usually a deciding factor. Be sure to inform patients about rebates, as many are unaware of them and it can be the reason they decide to buy. For convenience, also offer to ship the contacts directly to the patient’s home.

Most ODs are selling drops and vitamins as a convenience for patients. It is important to stock this product in different price points and break it down to a cost per day for the patient. Stocking these products also reinforces the importance of the recommendation. Like contact lenses, many of these products are a commodity, so offering selection and choice helps the consumer to feel more confident in their purchase.

Practitioners who offer specialty services like Vision Therapy or Customized contact lenses, can face skepticism and price objections. Particularly if the service is new to them, the patient may lack confidence in the effectiveness of the intervention. Testimonials on the website and in writing can help build confidence and make the decision-making process easier for the patient.

With all of these strategies, the key idea is choice.  Take the time to review all of the choices and you will encounter fewer indecisive clients.

 

CHRISTINA FERRARI

is the co-founder and managing partner of Simple Innovative Management Ideas (SIMI) Inc. and expert Practice Management contributor for Optik magazine. She can be reached at info@simiinc.com

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Insight with Dr. Paul Gray

Insights

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Dr. Paul Gray is a partner in a large multi-doctor practice in Halifax, NS.

Paul has been active within the profession of Optometry, having

served as the President of the Nova Scotia Association of Optometrists and as

the chairman of the board of OSI (Canada’s largest group of Independent Optometrists).

Outside of eye care, Paul is extensively involved with the competitive motor sports community as

a driving instructor and a competitor.

Dr. Paul Gray

Insight Optometry, Halifax, NS

Doctor of Optometry, University of Waterloo, 1980

What business books would you recommend other ECP’s read?

Who Moved my Cheese, by Spencer Johnson and Kenneth Blanchard. This little gem is required reading for many of our docs/staff in our practice.  It’s a timeless business classic which uses a simple parable to reveal profound truths about dealing with change. At the risk of generalizing too much, it’s my sense that many ODs are less than forward thinking or proactive in their approach to change. Too often I witness reactionary strategies to trends that have clearly been established while growth or differentiating opportunities are lost. While I don’t consider myself an innovator, I would at least fall in the category of an early adapter and I believe that has served our practice well over the years.

What metrics in your practice do you use to gauge your success?

We have always used a variety of factors to help us in decision making and gauging the financial help of our practice.

As a member of OSI multi-services group, we utilize very capable Optosys 2 software for our EMR. The continued development of this software application has, in recent years included a KPI (Key Performance indicator) module which allows numerical and graphjcal analysis of the key indicators that Optometrists need with just keystrokes. It’s been a very helpful addition to our management. Some of the many things we track on a “per doctor basis” include:

  • all sales numbers
  • total patients, new patients/previous
  • production booked
  • No shows
  • Contact lens fits/new old
  • Conversion rate to in house dispensing
  • Multiple eyeglass sales, sun Rxs
  • External Rx’s sales from other eye docs
  • $$ generated per patient seen for full evaluation
  • all revenue generated for specific instruments (OCT, fields, topography, etc )

 

How do you hire new staff? What is the process and who does the hiring in your office?

New hires present from a variety of sources, and are generally internet-based as initial point of contact.  Our staff also act as ambassadors to source employee possibilities when they meet people in various environments who they think might be a good “fit” for our office. Potential employees are directed to our website to click on our application process. This is designed to screen out those who don’t necessarily aspire to our environment and are simply casting a broad net to secure employment that may/may not be a good match for them. We use a 3rd party group for this but it’s viewed as seamless through our web portal.  The current tool we are using is called “Talentsorter”,  (no financial disclosures) which assists in titrating our choices more specifically and helps determine a “fit score” for a given employment postion. Should a potential employee continue the application process (thus authenticating ambition/genuine interest) they are then contacted by a key staff member by phone.  We consider this initial touch point by phone as an important part of the interview process and current staff utilize a check sheet to judge phone manner, voice clarity, enthusiasm, use of the language, etc.  Based on the outcome of initial contact, 2 separate interviews are done at our office, the second one involving our office manager. Finally, the potential staff member is invited to spend a day with us to interact with their potential co-workers and understand the sort of environment they could become part of.

We tend to hire on attitude and “fit” versus specific skill sets for at least some of the positions in our clinic. Once a new staff member has competed their initial weeks, I will typically meet with them and do a more formal “doctor welcome” to get to know them on a bit more personal level, promote the concept of easy accessibility to management/docs, and share practice philosophy toward patient care. I invite them to take advantage of their opportunity to observe current “systems” through fresh eyes and to be comfortable suggesting better ways to do things should they have experiences that may assist our team.

Favorite past-time / hobbies?

I have had the privilege of being very active in the motorsport community earning National and International race licences with many podium finishes in over 400 competition events. These included a wide variety of open wheel, closed wheel, open cockpit race cars on dedicated road courses or street circuits. I have taught performance driving and race schools on a volunteer basis for almost 30 years.  Other passions include downhill skiing, martial arts, golf, sailing, and guitar.

Tell me something few people know about you?

I spent most of my childhood in the First Nations Cree community of Moosonee, Ontario.

What was the last gift you gave someone?

For me, when I’m able, it’s often the gift of time…working on a friend’s farm helping harvest a crop, repairing a barn, swinging a hammer.  Agreeing to welcome yet another Optometric intern to our practice. Listening… when needed.

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