Success Steps: How to Reduce Contact Lens Dropouts

Practice, Products | Services | Industry News, Resources, The Patient Journey

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Contact lenses can be a lifestyle-enhancer for patients and a profitability-builder for practices. You can maximize patient satisfaction, and the potential to grow your profitability, if you find ways to help patients to succeed in contact lens wear and not drop out.

Studies show that contact lens patients return more frequently for office visits and contribute more revenue over time than do eyeglasses-only patients.

In addition to working part-time at We Are Eyes in Boca Raton, Fla., I teach at Nova Southeastern University College of Optometry. In most typical primary care practices, approximately 30-40 percent of patients will be contact lens wearers. At NSU, I work primarily in the contact lens clinic, so 90 percent of my patients are contact lens wearers. Recent studies reveal that the typical contact lens drop-out rate in the U.S. is approximately 10 percent, but it can range up to 60 percent.

How Much Are CL Dropouts Costing You?
It is challenging for the typical optometric office to determine the financial impact of contact lens drop out. Many doctors rarely calculate it. But if you do the math, there is significant money at stake when a patient drops out of contact lenses.

For example, contact lens examination fees for standard hydrogel, or silicone hydrogel, lenses typically range between $60-$100, and average revenue for an annual supply of contact lenses range from $100-$500 per year. That adds up to a revenue loss of $160-$600 per year per patient.

So, if you take into account the entire lifetime of a typical contact lens wearer, every time a patient drops out of contact lenses, a practice could be losing upwards of $20,000 -$30,000. If five patients drop out, this could add up to $100,000 for the practice. In addition to that, if a patient is dropping out of their contact lenses because they are unsatisfied with the doctor, or the lenses that the doctor prescribed, a practice could potentially loose their optical business and referrals from friends and family also.

Curb Discomfort: Ask the Right Questions
The most common reason for contact lens drop-outs is discomfort, mostly related to dryness. Patients also drop out because of blurred vision, the cost of the examination and supplies, the inconvenience, or fears of complication from wearing contacts. And many patients won’t tell the doctor exactly why they are dropping out.

Therefore, the first step in preventing dropouts is asking the right questions of every contact lens wear. The only way you can prevent contact lens drop-out is by identifying the problem to begin with.

Never ask: “How are you doing with your contacts?”

Never ask: “Are you doing OK with your contacts?”

Always ask: “How do your contacts feel at the end of the day compared to the beginning of the day?”

Always ask: “How can I make your contacts even better?”

Stay Ahead of Discomfort and Complications
Once you have asked the right questions, the next step in preventing drop-outs is by making improvements before complaints occur, or get worse. Even if a patient denies discomfort, I always try to prescribe something new to each patient. Contact lens technology is constantly evolving and improving. There is a strong likelihood that there is a better contact lens available today, compared to the last time the patient was examined. If a patient is already wearing the newest lens, then I re-educate them about the most appropriate artificial tears to use. I prescribe a specific re-wetting drop and a specific dosing, even if the product is available over the counter.

Prescribing daily disposable lenses is another way to reduce contact lens drop-outs. Many long-time contact lens patients are unaware that single-use lenses are the standard, not the exception, now. There are many daily disposables to choose from for spherical, toric and multifocal patients. Single-use lenses are ideal for the part time wearer, but for the full-time wearer, as they can provide superior comfort and convenience.

When offering daily disposables, focus on the benefits, rather than the technical features. Educate patients on the health benefits, minimized risk of infection and complications, and superior end-of-day comfort.

Most manufacturers will provide diagnostic lens sets at no charge. So, there is no initial cost to an OD to educating, and enabling patients to experience, new lenses! I can’t think of any other situation in optometric business where there is no initial financial investment needed. But ODs have to be willing to use the newest lenses and prescribe them to their patients with confidence. And ODs have to know that contact lens technology is constantly evolving. In a year, there may be yet another lens that they have to learn about and be willing to try.

Address Dry Eye
The majority of patients, who drop out of soft contact lenses because of lens discomfort, have dry eye. So, managing underlying dry eye is critical. Eyecare providers should recommend a specific brand-name artificial tear and a specific dosing, along with other vitamin supplements, as part of the treatment regiment.

There should also be a discussion regarding environmental factors that can lead to dry eye, such as ceiling fans and air conditioning vents blowing directly toward the eyes. And even if a patient does not need prescription-strength medications for dry eye, they should be monitored closely.

But continued monitoring is even more important if a contact lens wearer needs to be on a topical medication for dry eye such as Xiidra or Restasis. A re-evaluation and re education every 3-6 months can significantly prevent contact lens dropouts.

When it comes to dry eye from more chronic, severe ocular surface disease, scleral contact lenses can revolutionize a practice. I have many patients with severe Sjogren’s disease that cannot tolerate standard contact lenses. Patients with true keratitis sicca often see better with scleral lenses. Scleral contact lenses correct for a patient’s refractive error, but can act as a shield from the elements to protect the cornea from dehydration.

In addition, the sterile saline used to fill the scleral lens before it is inserted acts as therapeutic tear reservoir. This can heal a patient with significant corneal superficial punctate keratitis or filamentary keratitis.

Prescribe Multifocal Contact Lenses
Many presbyopic patients believe that if they have to wear glasses over their contacts to read and work on the computer, then they might as well just wear glasses full time. This is the reason many presbyopic patients drop out of contact lens wear. For that reason, multifocal technology can also help to reduce dropout rate.

Patients should be educated that multifocal contact lenses have improved dramatically recently. They provide a better range of vision compared to monovision, and now even single-use multifocal lenses are available. For part-time wearers, daily disposable multifocal lenses can provide comfort, better ocular health and vision, as well as convenience.

THUY-LAN NGUYEN, OD

Thuy-Lan Nguyen, OD, teaches at Nova Southeastern University College of Optometry and works part time as an associate at We Are Eyes in Boca Raton, Fla. To contact her: TLNGUYEN@nova.edu

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Optometry Giving Sight’s Our Children’s Vision Program

Human Resources

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Here’s a sobering thought. Seven hundred years after glasses were invented, there are still children in the world suffering from severe vision loss—simply because they have no access to a pair of glasses. And once children develop even a common eye condition such as myopia (shortsightedness), life for them will no longer be the same.

 

That’s why Dr. SooJin Nam from Eyecare Kids is so passionate about children’s vision. Good vision allows children to experience all the joys of childhood—identify colours, count objects, see shapes, play outdoors, recognize loved ones’ faces.

 

“As a behavioural optometrist, I am fortunate to be in a position that allows me to help children with real vision problems,” say Dr. Nam. “Every optometrist knows the importance of good vision and the impact it has on children. It is our desire that all kids have access to eye care and glasses in order for them to achieve their best.

 

Dr. Nam has proudly introduced Optometry Giving Sight’s Our Children’s Vision program into her practices because it’s easy to implement and it’s a great way to have fun with her patients.

 

“When our little patients come to us and we see how their quality of life improves tremendously because of what we do, we desire it for every child with a vision problem,” she said. “Our children are our future, so I see nothing more important than giving them the best chance in life.”

 

Dr. Nam implements the program by making a donation for every pair of glasses sold in her practice. Optometry Giving Sight provides marketing items including posters, counter cards and social media materials to promote their generosity to their patients.

 

After every glasses purchase, the patient receives a small card emphasizing that because they purchased glasses there, the practice will make a donation to help a child in need to receive an eye exam and a pair of glasses.

 

Optometry Giving Sight also provides tear-off sheets to give to each patient to remind them of the importance of an eye exam for the children in their lives. The sheet has an area for the practice to stamp their contact details to invite patients to call to set up an appointment for their own children.

 

The benefit for practice participation in the program is two-fold: a large amount of positive publicity as patients see the practice making a difference in the lives of children around the world, and every patient is reminded of just how important good vision for children is and to make eye exam appointments for their own children.

“Optometry Giving Sight’s ‘Our Children’s Vision’ campaign support materials are available to any optometric practice in Canada. If you wish to use OGS materials as part of your social marketing program to support your practice, please contact Corinne Waldon at canada@givingsight.org or
1-800-585-8265 ext 4.” 

 

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Roadmap to Success: Picking Your Experts

Finance|Wealth, Practice, Products | Services | Industry News, Resources

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Introduction

Not too long ago, we introduced you to Jane and Steven Buchan, a pair of licensed optometrists who are looking to take the next step in their careers by purchasing an independent eye care practice. It’s a daunting leap forward for them, but they’ve chosen this route for several reasons:

  • They will be working with an existing client base, instead of developing one from scratch.
  • They don’t need to build the office from the ground up, choosing instead to renovate and maintain the existing facility.
  • They will have the opportunity to take over, learn from and build on the financial history and business plan of the previous business owner.
  • They will be able to get the business up and running faster than if they were starting net new.
  • They now have better chances for securing a good loan or additional lender support, as the existing business already has its own financial statements and a cash flow history that can be used to demonstrate profitability.

They’re both incredibly excited and anxious to begin putting their name on a business that they can own and grow together. Despite the comprehensive optometry training and experience they’ve acquired in recent years, they still somehow find themselves completely overwhelmed by the mountain of paperwork and obligations looming over them as they prepare to purchase. Who do they turn to for help?

The good news is that there are professionals you can count on whose expertise ties directly into complex business transactions such as these. The acquisition of any business is a big game and life changer for any healthcare professional, so it’s always good to take time and seek out specialized advice. Whether you are a seller or a buyer, arming yourself with the knowledge and counsel of licensed, reliable professionals is a benefit that cannot be understated.

Certified Public Accountant

Arguably the most important step in preparing to sell or buy a business is to make sure that its financial records are clean, up to date and duly completed. For sellers, it is also a good idea to make sure that all outstanding payments (to vendors or from customers) are settled before putting the business up for sale, as any unpaid balances increase the liability of a business and the risk associated with purchasing it.

This is where a certified accountant comes in handy. An accountant is your guide into doing due diligence and delving into the nitty gritty of the company’s financial paperwork. This will include anything from cash flow statements, evidence of working capital, accounts payable and receivable, previous and current vendor contracts, employee files, tax records, employment agreements, lawsuits, debts, leases, and all other details related to the company’s history. Accountants for both the seller and the buyer will need to examine these records. For either party, accountants will help you devise and negotiate a financing strategy that best aligns with your interests over the course of the transaction, taking into account important considerations such as capital gains deductions, tax deferral opportunities, purchase and sale of assets, purchase and sale of shares, valuations and potential sources of funds. Long after the business sale has been terminated, you will continue to rely on the help of your accountant to help you improve your business plan, maximize profitability and maintain the financial documentation required of you by the government and your shareholders.

Lawyer or Specialized Business Sale Attorney

Because businesses vary in size, specialty and complexity, it is important to find a law firm or a lawyer whose abilities cater to your specific professional needs. One of your first steps should be to reach out to your network to see if anyone has recommendations for firms or professionals with industry-specific experience, preferably a lawyer who has handled a similar transaction for another eye care professional in the past. Once you find a lawyer who appears to be a good fit, do not hesitate to check and ask for references.

An experienced, trustworthy lawyer can be one of your most valuable assets in detangling the intricacies that surround a business sale. As a seller, a business sale lawyer can assist you with drafting the necessary paperwork to prep the sale, which includes non-disclosure agreements, letters of intent, regulatory approvals, and agreements of purchase. As a buyer, your lawyer can help you evaluate the health of the business in question, examine the tax and liability implications of the acquisition, outline agreements related to shares and equity, and vet the contracts and clauses that are involved in the purchase.

In most cases, a lawyer can provide an objective second opinion on many aspects of the business sale that would have otherwise gone unnoticed and without consideration. This is the type of decision that will change your life and impact your family for several years to come. Your lawyer will be there with you every step of the way to help you face the more difficult questions that you will have to consider:

  • “What are the responsibilities of your business partner and/or your significant other if you were suddenly deemed unfit to continue working?”
  • “What will happen if the business defaults before the entire loan amount is paid?”
  • “In case of a drastic change of circumstances, is there flexibility for renegotiating repayment terms and what assets can be used to help repay the balance?

Like accountants, lawyers can also assist buyers with due diligence, which for them includes thorough research on the business’ history and finances, with a projection of its sustainability and future profitability. Most importantly, they represent your best interests when collaborating and communicating with all the parties involved in the transaction.

Since legal services are largely a buyer’s market, you have more leverage than you think when negotiating your attorney fees. At the same time, you must be cognizant of the specialization and the quality of the service provided and be ready to pay an appropriately high fee for their time and experience. Revising an existing contract or drafting one from scratch, can cost a business owner thousands of dollars for that single document. To make sure you are both on the same page, it is important to communicate your needs and your intentions for the business to your attorney early on. For the rest of the transaction and beyond, they will have a great influence on the success of your acquisition, and how well the business itself succeeds post-transition.

Business Market Brokerage

This type of brokerage is very different from other types of brokerages that you may already be familiar with. A reliable full-service business sale brokerage can provide a premium service to sellers by overseeing and coordinating the business’ entire transition from one owner to the next. A brokerage can act as the liaison between your lawyer, your accountant, the valuator and all other professionals that represent you or your buyer. The broker will also help prepare your business for sale by establishing a list of potential buyers and ensuring that a selected buyer is a good fit for the purchase. According to Jacqueline Fleischmann, Director of Business & Legal Affairs for ROI Corporation Brokerage, experience counts: “You want to identify a broker with proven expertise and a track record in your industry. Look for a brokerage that understands how an optometry practice is operated and managed. A good brokerage will be able to provide insight about current trends in the industry and how they translate to your region/location.” Brokers are typically paid a commission based on the final sale price. Jacqueline also says, “If a broker demands a fee up-front, this is a red flag.”

Brokers also help relieve business owners of much of the stress and time-consuming follow-up related to overseeing the business sale. Most buyers and sellers tend to have limited experience with these types of sales, and selling a practice that one has spent years to develop can be extremely stressful for business owners. Jon J. Walton, the General Manager of MBC Brokerage, says, “One of the most critical aspects of a broker’s job is to keep emotions of the seller and the buyer down. It is scary for all parties, and it is easy for them to get stressed out and unintentionally sabotage the sale because they allow their emotions to get the best of them.” By hiring a broker to oversee the transaction on the business owner’s behalf, the owner can continue to run the business as usual, or devote time to commitments other than what is already required for the business acquisition.

Appraiser

A professional appraisal is required to evaluate the business and establish a fair market value for it. This is done by examining its financial history and analyzing its ability to maintain its sustainability and profitability in the future, by examining it in the current economy, the economy’s projected future state, trends in the industry, the business’ current assets and liabilities and other factors relevant to the business. Although the seller almost always has an professional appraisal done as part of the preparatory work for establishing the sale, a buyer can choose to have their own appraisal done as well. This appraisal will also be required when applying for financing and most major financial establishments have strict requirements that appraisers must meet for the appraisal to be considered.

Certain brokerages like MBC Brokerage and ROI Corporation Brokerage also provide professionally-recognized appraisal services in addition to their regular role as business transaction brokers. Walton sums up the teamwork aspect of the sale very nicely: “Appraisers, brokers, lawyers and accountants all have different jobs, but we all work together to ensure everything is done properly for the seller or buyer… It’s not just about selling a business, but transferring and preserving a legacy”.

Conclusion

When you purchase a practice, you are not only investing money in the business, you will also be dedicating hard work and sacrifices in the years to come so you can allow it to grow and mold it to your vision of what it should be. As terrifying and exciting as that journey may seem, there’s no need to go at it on your own. With a trusted team of experts on your side, you’ll have the resources and the confidence to make good decisions, while dedicating your own time and energy towards your family, yourself and towards nurturing the business that fuels your dreams.

LYANNE AUGUILAR

Lyanne Aguilar is a Toronto-based writer who specializes in finance and healthcare-related content, both in English and French

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Install a Referral System–and Track Your Growth

Marketing, Practice, Practice Metrics & Benchmarks, The Patient Journey

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Referrals are a key driver of practice growth. At our practice, our five ODs and support staff of 18 conduct about 7,500 comprehensive exams annually.
When new patients come in, we ask how they came to us, and an average of 50 percent are friends of patients, and 65 percent are family of patients. Surprisingly, about 25 percent come from search engines, and the remaining from insurance lists, and passersby. Before the advent of search engines and social media, our second-largest source of referrals were insurance provider lists.
Tracking referrals from patients to friends and family, and delivering service that impresses patients enough for them to spread the word about us, continues to bring new patients into the practice.
We started our practice cold 28 years ago. We started with the referral of our very first patient by a friend of a friend. Since then, we have always placed a high value on referrals. I believe it is the best way to bring in patients who are most likely to be loyal over time. We make a concerted effort to treat each patient like our only patient and try to make everyone feel like family.

The patient intake form Dr. Smith makes available for patients on her practice web site. Dr. Smith says it’s important to ask new patients how they found your practice, and to encourage those who had a positive experience to let their friends and family know about your services.
USE EVERY OPPORTUNITY TO ASK FOR REFERRALS
Many patients make comments like, “I should bring my husband/wife in” or “I should bring my kids in.” This reassures us that we did a good job of marketing our practice during their visit because they want their family and friends to have the same experience.

When a new or existing patient calls for an appointment, our front office staff asks if there is anyone else in the family we could help make an appointment for. If a patient expresses appreciation for a job well done, then our staff says, “Thank you! It has been our pleasure, and if you or any of your family or friends need our services, we would be happy to help them as well.”

To increase the likelihood of people wanting to tell their friends and family about a business, that business should excel and stand apart from the norm. People vary in what things and experiences may impress them most. However, If you look at the most successful businesses, especially service-oriented businesses such as restaurants, hotels, and healthcare practices, it is undoubtedly the service that drives the most referrals.

Our practice mission statement is “Focused on your needs. Committed to excellence.” Our goal is to have our patients tell others that they had excellent, thorough care and that we provided great service.

We e-mail thank you notes and surveys to every patient after their exam. We currently have a 95 percent satisfaction rate with a “yes” when asked if they would refer others.

TRACK CONSISTENTLY
For the past 23 years, we have tracked where our patients come from. We have a Welcome Sheet, which we ask every new patient to fill out. If the answer to the question of how the patient found us is left blank, the front office staff is responsible for asking the patient directly. On the rare occasion that the response to that question is still blank by the time the patient reaches the exam room, I ask the patient directly myself. It is really a pleasure to hear that most of them are referred by friends, work colleagues and family members.

OFFER EXCEPTIONAL SERVICE & SAY THANK YOU
In California, where our practice is based, it is illegal for any healthcare professional to offer incentives for referrals. However, we make sure our patients are thanked and appreciated verbally for their referrals.

By focusing our efforts on providing exceptional care and service to our patients, we hope to earn their loyalty and the referrals of their friends and family. You can’t put a price on service and building relationships with patients. It is like putting a price on friendships. I believe that as old fashioned as this may seem, building a practice based on loyalty and referrals is far less expensive and time consuming than the cost of any type of ad marketing or media advertising. Our practice has not had much response from paid advertisements. It may be that the public does not respond to objective ads anymore with the advent of more subjective, personal internet ratings.

We used to have a large ad in the yellow pages, which was astronomically expensive. It was a big book of large ads for businesses, which made it difficult for consumers to decide where to go for services. Now, with internet reviews that are free for consumers to use, we virtually have free advertising by the reviews placed by our patients.

Approximately 25 percent of our new patients find us directly through internet search engines and reviews.That is a lot more than the number of patients who came in after seeing our yellow page ad, which was only about 5 percent.

TRAIN STAFF TO OFFER A MEMORABLE EXPERIENCE
The majority of patient referrals are from happy, satisfied patients who report having had the most thorough exam, or best service, ever. We also receive many referrals from long-time patients. Other popular referral sources are patients who have not received successful contact lens fits elsewhere. Many refer their friends, colleagues and family members simply because our staff has shown them great customer service, and were able to develop a strong rapport with them.

I cannot over emphasize the value of a well trained staff in order for patients to want to refer others. The staff actually spends more total time with our patients than the doctors, so it is imperative that our staff is on board with our goals and objectives for growing the practice. Patients will stay with a practice or leave a practice very easily because of their interactions with the staff.

TAKE OPPORTUNITY TO PASS ALONG PRACTICE BUSINESS CARD
When a patient compliments our office, a front office staff member might give them a business card and say, “Thank you so much! We appreciate your compliment! Please take a business card in case you know someone who may need our services.” Most of the time patients take business cards, or ask us for our business cards, without any prompting, and this is really the best compliment they can give us!

BEVERLY JUE-SMITH, OD, MBA

Beverly Jue-Smith, OD, MBA, is the owner of San Ramon Family Optometry, Inc., in San Ramon, Calif. Dr. Jue-Smith also is owner of Optometric Consultants, a private practice consulting firm. To contact her: srfoptometry_drb@yahoo.com

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Create a Healthy Eyes Plan for Healthy Contact Lens Practice Growth

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by Beth Lennox, O.D. Cambridge Eye Care, Cambridge, Ontario.

I often hear, unfortunately, from many colleagues that their contact lens practice is in decline.

In our practice, contact lens revenue has shown good growth in the past five years and accounts for an increasing share of our total revenue. Our growth comes from more than simply upgrading patients from frequent replacement to higher priced daily disposable modality. We are generating new fits and increasing the total sales provided by the tremendous potential of the contact lens patient – not only in contact lenses, but in solutions and other products and services we provide.

The contact lenses conversation starts from the very first contact with our office. When booking an appointment, the first thing that our staff does is ask, “Are you a contact lens wearer?” It’s obviously important to know if they are wearing contacts, but it also opens the opportunity for the patient to indicate their interest in contacts lenses.

During the case history, even if there has been no indication of previous contact lens wear, I’ll ask the patient if they’re a contact lens wearer. It’s important to not to make any assumptions, even if I’ve seen the patient before and know they have not ordered contacts from our practice.

Maybe they’ve ordered lenses online or tried something that a friend or a sibling provided. It gives me the opportunity to say, “Okay, what happened in that situation, why didn’t you continue? Let’s refit you into better technology.”

The Full Potential of a Healthy Eyes Plan.  

If patient stays with you for lifetime, i.e.  about 20 years or so, they are worth about $20,000 in revenue because they tend to spend more every year. They are not only buying an annual supply of contact lenses, but also purchasing other products such as rewetting drops, solutions as well as prescription glasses and plano sunwear.

We’ve created a Healthy Eyes Plan, which bundles contact lenses of every modality into a package of benefits that offers patient convenience and “no-surprise” price transparency.  Patients can opt for a 6-month supply or, for a modest discount of around 5%, a full annual supply.

The HEALTHY EYES PLAN is the driving force for add-on sales to the contact lens patient.

Our Healthy Eyes Plan includes a bundle of contact lens services as well as special offers for other vision care products. It encourages loyalty and compliance using a simplified one-price approach. The Healthy Eyes Plan includes:

  • “20-20 Special Savings Plan” which includes $20 dollars off frames and $20 off ophthalmic lenses
  • $25 or $50 off designer non-prescription sunglasses
  • All contact lens office visits and progress checks
  • Complimentary replacements for torn or damaged lenses

Our professional fitting fees are separate from the Healthy Eyes Plan, but are also presented as a one-price bundle that also communicates the value of our services; including lens and solution selection, training, all sample lenses, and a solution starter kit.

The bundling approach encourages patients to purchase as much as possible with our practice to help with all their vision needs. We highlight UV protection with contact lenses on the Healthy Eyes Plan brochure to reinforce the health message and help patients understand the need for full protection from harmful UV rays. The UV message is also a tie-in with the discount benefit for designer sunglasses. Our goal is to discuss the importance of UV protection with every patient, and present UV protection as an option.

UV Blocking option is offered to every patient.

When a parent is given the choice of UV protection or no UV protection for their child, they will most often choose the protection, as they want them to have the best.

The Healthy Eyes Plan also includes 24/7 contact lens reordering from our website, which is also a great counter to shopping online. The one-stop convenience, and the benefit of bundling solutions for their full eyewear needs, is something that simply cannot be replicated online. The easier we make it for our patients, the greater success we’ll have.

Our approach works extremely well with family members and is often spread by word of mouth and through social media. Recently one daughter came in with the idea of getting contacts. We ended up fitting the sister and mom, all with annual supplies of 1-day modality lenses. Of course, we actively promote contact lenses through our social media sites. When we bring in a new product, like Acuvue Oasys 1-Day, we’ll put that onto our social media feed so that patients know. We find that patients are happy to share their contact lens success even without us encouraging them to do so.

Recently a teenager on the school volleyball team was hesitant and afraid to wear contact lenses. I said, “Let’s have some fun and put a trial lens on your eye to see how they will perform for you.” Now he is a successful 1-day modality contact lens wearer since I was able to remove his fear barrier.

My advice to colleagues who may not be having the same level of success with contact lenses as we have: keep fitting the latest technology, take charge, be the expert and show enthusiasm! Consider a bundled Healthy Eyes Plan like ours to tap into the full potential of the contact lens patient and their social network. It will score points for the patient and your practice.

Dr. Beth Lennox is a Professional Affairs Consultant with J&J Vision Care

BETH LENNOX, OD

Cambridge Eye Care, Cambridge Ontario

Dr. Beth Lennox is a co-owner of Cambridge Eye Care, in Cambridge Ontario, a successful high-growth single-location practice, with 4 doctors and 13 staff.  The office has three lanes running full-time. Cambridge Eye Care is moving to an expanded space in August 2017.

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Insight with Dr. Scott Mundle

Insights

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Scott is a partner in a large, multi-doctor practice in Winnipeg, MB.

He believes in giving back to his profession, having served as president of MAO, CAO, and is currently

president-elect of the World Council of Optometry. 

When not giving back to his profession Scott enjoys running marathons.

 

Dr. Scott Mundle

Doctor of Optometry

Henderson Vision Centre

University of Waterloo 1983

Winnipeg, MB

 

What is something you have done in your practice to set you apart?

For many years we have been part of pre-launch trials with most contact lens companies. As a result, our patients have benefitted from the most current contact lenses available and they have come to expect that if there is anything new, it will be offered to them. As well, they know that if we are at the forefront of contact lens innovations, we are likely at the forefront of most other innovations, whether that be diagnostic services, spectacle lenses, frames, etc. Our patients have come to realize that no other practice has any offering that is superior to ours, so they have no reason to seek care elsewhere.

What advice would you give a new grad today?

Remember why you became an optometrist. Have a passion for our profession. It is not just a job. You will have a tremendous impact on the well-being of your patients that go beyond the care you give. You will give peace of mind to your patients by the care you give them. If every decision you make in your practice is with the patient’s best interest in mind you will never stray from giving the best care and you will never have to explain or justify why you provide the care you do. And finally, give back to the community and the profession. It is the right thing to do and you and your practice will be rewarded in the end.

Which ECP speakers/leaders do you admire?

We all need mentors to become better ourselves. As someone who has been active in the politics of our profession, I have had the pleasure of meeting, observing and learning from most of the optometric leaders from the past fifty-plus years. These would include (in no particular order) Roy Brown, Scott Brisbin, Roland and Margaret Hansen-des Grosseilliers, Jim Kerr and Kovin Naidoo to name a few. Each of them has or continues to have an effect on how I practice optometry and serve both our profession and the public.

What’s your favorite past time/hobby?

Running. I have run 27 marathons. I love the discipline of the training and the challenges of the races. You learn a lot about yourself when you are put in challenging circumstances and the end of a marathon is about as tough mentally and physically as it can get. The other reason I run is to be with the group I run with – The Windchill Warriors (we do live and train year-round in Winnipeg after all!). Oh, and they are all funny!

Describe your perfect day.

Because I like to run and our family members are all physically active, my favorite day is when we all run the relay portion of the Manitoba Marathon. It happens to be run on Fathers’ Day which is a double bonus. We all run a leg of it, have brunch at our house, turn on the TV to watch US Open Golf and I often fall asleep in front of the TV – with my bowl of popcorn!

What was your last indulgence?

Everybody who knows me, knows I love popcorn. I will make or buy popcorn at any opportunity – hockey games, movies, TV shows at home, it’s why I shop at RONA. And the only kind I make is Orville Redenbacher the old fashioned way, with oil in a pot. Everything else is a cheap imitation.

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Associate OD Compensation: Set a Competitive Salary with a Revenue Percentage System

Human Resources, Managing Others, Talent Acquisition

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Under-paying an associate OD can result in poor patient care, and a practice that doesn’t meet growth goals. Pay your associates a fair salary that spurs them to contribute to the growth of your practice.

According to Jobson Optical Research’s 2016 ECP Compensation Study, the average compensation for an owner/partner is $124,134 for a practice with revenue less than $500,000, and $166,827 for a practice with revenue of more than $1,500,000. This compares to employed optometrists who earn an average of $99,663 at the low-level practice revenue, and $117,757 at the high-level practice revenue locations.

Calculate What You Can Afford to Offer
If a practice net is 34 percent, and the associate OD is getting paid 22 percent of production, then the business owner profit margin is 12 percent. Who is making 12 percent in the market or real estate today? It is a great investment.

Understandably, many doctors who push back on paying associates more tend to have practices whose profit margin drops below 10 percent once all doctors, including owners, are paid. By our optometry standards, this would be a practice net under 30 percent. In a true business model, the owner ODs would be paid and then profit margin would be calculated. When the profit margin is below 10 percent, then a practice cannot afford to pay associates well.

When you can afford to pay more, but don’t, it’s a short-sighted victory. Let’s say you pay your associates 15 percent of production (gross collections before office expenses are factored in), and maintain impressive profit margins, but then, each year you need to find and integrate new OD staff into your practice. Recruiting, training and integrating new staff into your practice costs money and time, so you might have been better off just paying the associate a fairer amount, based on what you can afford.

Attract & Retain Talent
If you pay an associate OD well, an owner can depend on them to give more than the minimum required, and if they don’t perform, then there are many other associate ODs looking for a position that rewards them for the responsibility of being an optometrist. The OD is no longer a refractionist, but an active medical professional in the American healthcare system. That carries with it a large responsibility, and it should result in compensation that reflects that responsibility. I don’t think that it is right to pay associate ODs 12-18 percent of production, as many practices, and large corporations, do. With so many associates under-paid, owners willing to pay 20-24 percent of production have their pick of many great doctors to employ.

For any profession, you pay well to get the most out of top performers. An owner may start an associate OD at 20 percent of production, and then increase that as the OD shows their commitment and dedication to the patients and the practice.

Paying an associate OD well also increases your chances of keeping them in the practice. We all are less likely to look around if we are compensated above what is considered fair. When you feel like an employer has been overly fair, you tend to gravitate toward being fair and loyal to that employer in return.

Communicate the Right Message to Potential Partners
Some practices pay associates less in return for an agreement that they will be considered for a partnership in the practice. But if you would like to add the associate as a partner, why would you want to communicate that “we will pay you lower than another associate because you are going to be a partner”? That logic makes no sense. That is like paying a future franchise player in the NFL half the salary because they are potentially good enough to be a franchise player. Rather, pay them more to communicate you want them, and that you are investing in them becoming a partner.

Finding an associate who can, and wants, to buy-in, is not like finding a new sweater. It’s a major process, so if someone looks like they are your future partner, communicate you want them by treating them well. Otherwise, you create a hostile culture. When they get to be partner, you will always be haggling with them because they will still be bitter that you treated them so badly when they were an associate.

When you create a contract with an associate for eventual partnership, you are giving them a letter of intent, or promise, to consider them as partner if you and the associate are professionally compatible. Even with a contract promise, they are not partners until shares are actually sold to them, so that agreement could always be retracted after years of unfair associate compensation, or any other reason.

Factor in Experience Level of Associate
Pay more for an experienced associate OD, especially if they will be bringing a patient base with them. I would initially pay more, in essence, to buy a patient base. This may, or may not, be adjusted down the road as the associate OD’s schedule grows because of an already-established and growing practice that the associate OD benefits from.

Give Associates Compensation Options
We offer two options for new associates. They can either have a percentage of full production that is between 20-24 percent of production, or they can have a salary, and once their salary “pays for itself” at 20-24 percent, then they earn a lower percentage above the base. This has worked out well, and has been a model in our practice, along with other practices that I have had the privilege to coach.

Most associate ODs coming in want a guarantee, so they know that they will be making money, and not living on commission alone. Performance-based incentives are best started one year after the associate OD has settled in, and hopefully, the practice has been able to supply a schedule that is beneficial for both the associate OD’s second year and the practice owner’s investment.

Tip for Associates: Have Options of Your Own to Propose
If you are interviewing to become an associate OD, always have more than one option in mind when negotiating, otherwise, you leave yourself with no negotiating power. In negotiating, an associate looking for a position should be able to give value-added reasons for why they should be compensated at higher levels then 12-18 percent. An associate should have a game plan to communicate how they are going to pay for themselves, and grow the practice, so the owner sees an ROI on the associate. As an associate, be prepared to walk away from a deal, and if you can’t walk away from the deal, then propose a good reason for higher compensation, and negotiate for an incentive-based program. Then deliver by growing your practice.

Consider Non-Monetary Benefits & Perks, Too
Today’s associates want to be paid fairly, but they also want flexibility and autonomy. Many big companies, like Best Buy and Google, are getting the best talent because they work with mantras that let employees know, “we don’t care when, or where, you work. We just care that you get your work done.”

It’s a win for both owners and associates to offer flexible hours that make it easy for a parent to grow their family, while pursuing their career. To allow for flexibility, you may be better off hiring two associates for three days a week each than hiring one for five days a week.

Work together with your associates to find a win-win in salary and schedule for both them, and the practice. It’s worth it because a practice with positive feelings between associates and owners is peaceful, upbeat and productive, rather than full of underlying tension and employment battles.

Finding mutually beneficial arrangements with associates requires a commitment to communication, and a willingness to be a servant leader. In my own practice, it’s a continual work in progress, as I continue to be humbled working with the talented people I have hired.

 

CHAD FLEMING, OD, FAAO,

Chad Fleming, OD, FAAO, is a partner with Wichita Optometry, P. A. in Wichita, Kan. To contact: optometryceo@gmail.com

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Future of Independent Optometry – Webinar

Differentiation | Business Strategy, Practice, Webinar

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An optometry though-leader panel shared their views on the future of independent optometry in Canada in a live webinar on Monday May 29, 2017.   Hosted by Canadian Eye Care Business Review Co-Edits Drs. Jeff and Tina Goodhew, six panelists from vastly different types of practices and business areas, addressed 6 critical issues on the minds of Canadian optometrists.

Panelists included Dr. Daryan Angle, Executive VP, Iris Group, Mr. Ken Barbet CEO of Eye Recommend, Mr. Pierre Bertrand, President, Essilor Canada, Dr. Sheldon Salaba, OD practice owner, Hamilton ON, Dr. Altaz Shajani, OD practice owner, North Vancouver BC and Dr. Al Ulsifer, CEO & President, FYiDoctors.

The webinar, attended by nearly 200 attendees, was the largest ever live web event specifically for the Canadian eye care industry.  Attendees participated in live polls to provide on the fly input to the hosts and panelists as they addressed the issues, and audience questions were fielded by panelists following the discussion.

Critical issues examined included:

  • The impact of supplier side consolidation and its potential effect on independents.
  • The reasons why ODs are selling practices to larger retail groups.
  • How optometry can avoid being swept up in the general sea-change in retail.
  • Importance of the “customer experience” in practice success.
  • The risks to solo practitioners in today’s environment.
  • The commercial opportunity for optometric medical services vis-à-vis retail dispensing

With panelists representing corporate optometry, buying groups and solo entrepreneurial ODs, a rich variety of opinion was expressed.

You can stream or download an audio recording of the live webinar below.

Download Now

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The Future of Independent Optometry – A Thought Leader Discussion

Differentiation | Business Strategy, Practice, Resources, Webinar

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Canadian Eye Care Business Review is proud to announce that registration is now open for their first webinar; “The Future of Independent Optometry”.  The webinar will be available live on Monday May 29th from 8 PM to 9PM EDT.

This format will provide optometrists across the country an opportunity to hear from a group of Canadian thought leaders on topics critical to the future of independent optometry.

Drs. Jeff and Tina Goodhew,
Co-Editors of Canadian Eye Care Business Review will host the webinar with the following panelists:

Dr. Daryan Angle
Executive Vice President Chairman of the Board, IRIS The Visual Group, Waterloo ON

Mr. Ken Barbet
Eye Recommend, Chief Executive Officer, Calgary AB,

Dr. Altaz Shajani
Practice Owner, North Vancouver BC

Dr. Sheldon Salaba
Practice Owner, Hamilton ON

Dr. Al Ulsifer
CEO and President, FYidoctors, Calgary AB

The questions that will be addressed include:

  • What is the impact of supplier side consolidation on independent eye care?
  • Why are independents selling out to larger groups? Fear or opportunity?
  • What are the risks and opportunities in moving from retail to medical?
  • How should independents create great customer experiences and loyalty?
  • How do solo practitioners manage the risk in today’s environment?

We are excited to have a discussion such as this on a very important topic, one that is top of mind for many in the industry.
There is no-cost to register. Please reserve your virtual place by registering online:

We look forward to your active engagement.

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Fill Your Exam Chair with 6 Social Media Posts that Work

Digital Marketing, Marketing, Resources

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Social media is the means by which many of your patients, especially Millennials, communicate with friends and family. Understanding the kind of social media posts that will capture their attention, and bring them into your office, is essential to building a profitable practice.

Depending on the demographics of your practice, one channel of social media, versus the others, may be preferable for you. In my practice, I utilize both Instagram and Facebook. Regardless of the platform, your social media posts should always keep four goals in mind:

1.    Reflect your practice’s vision/mission
2.    Brand your practice in your community
3.    Attract potential patients who identify with, and buy into, your brand
4.    Retain loyalty of your existing patients

At our practice, we dedicate one hour of time per week, and $0.00 to social media, which is our central marketing effort. It is paying off in an average of four recurrent patient visits a week, two new patient referral visits per week, and an increase in the average frame purchase price of $100, and in premium daily lens sales. Our primary focus is on high-end frame lines and in premium contact lens technology.

If you are looking for a simple way to evaluate return on investment for the time and money spent on social media marketing, one of the best resources I have found is this short guide, “The Delightfully Short Guide to Social Media ROI” by Kevan Lee. This blogger has a formula to calculate the exact monetary value of each of your likes, comments or interactions. It’s important to have a specific goal such as “gain new followers” or “increase online purchases of x.”  Secondarily, track this goal by tracking your social media analytics using an online resource like Buffer.  Thirdly, assign a value to that specific goal like “average sale” brought in by an Instagram follower.

Here are six kinds of posts that have worked for my one-OD practice in Charlotte, N.C., in generating interest in, and visits, to my practice.

Before and after shots of one of Dr. Dryer’s patients, who signed off permission, allowing the practice to use her photo for marketing purposes. Dr. Dryer says photos like this show potential patients the difference your practice can make in their lives.

Before/After Photos
Why does it work?: This kind of post is successful because it involves your patient in the eyewear selection process. Patients love getting their picture taken, and they get excited about their appearance in their new frames.

Additionally, this particular type of post also showcases the expertise of your staff in frame selection. When the new frame accentuates the patient’s best features, and updates their appearance, potential patients recognize the talents of your optical staff.

Your practice is no longer just an eyecare facility, but a destination. Your staff is sought out for their skills. This is key to separating your practice from online glasses sales.

What resources are needed?: I love the app Polamatic, which I paid about $2 for. It adds a border to your photos, so they look like old-fashioned Polaroids. These are particularly successful with my Millennial-based practice due to the resurgence of all things retro and vintage.

How do you measure its success?: I primarily use Instagram to connect with my patients. It’s difficult to measure the success of an Instagram post. Mostly, success is based on likes and/or comments. I typically post twice a week, and expect anywhere from 50-70 likes. We have around 530 followers. I also take note of people who follow me on Instagram after a post. If it’s a local company or person, I consider my post successful. I’ve made someone aware of my business and what we offer to the community.

Dr. Dryer’s selfie in her practice’s optical. Dr. Dryer says posts that show you and your staff in your office help patients get to know you, and feel comfortable with coming in for a visit.

Doctor and Staff Photos
Why does it work?: I find that the posts that receive the most overall involvement by current patients are those that involve the doctor or staff. If you’ve been successful in winning them over during their eye exam, they feel connected by social media. In my practice, when I include photos of myself, I try to showcase a new frame or capture my “fun” side, whether it be holiday or sports team wear.

What resources are needed?: Creativity! If you aren’t the creative type, engage your staff. What things are you passionate about outside of optometry? What do you want your patients to know about you that they might not learn during an eye exam? What would make your patients tell their friends about your practice?

How do you measure its success?: I’m not convinced these types of posts are best for bringing in new patients to your practice, but they are successful in engaging already-existing patients and retaining their loyalty. Patients like to connect with you, to share your interests, and to know you have a life outside of optometry.

Dr. Dryer says showing patients all of the products you sell, including contact lenses, gives them a better idea of how you can help them, and why they should book an appointment.

Product Promos
Why does it work?: At 4 Eyes Optometry, we pride ourselves on having the newest and latest from contact lenses to frame lines. I spend a lot of time educating patients on why I prescribe what I do, and why we carry the products we carry.

This type of post is effective in targeting both existing patients and new patients. I’ve dedicated posts to both eye conditions and products, and I get the most response with products.

Instagram is primarily known for its visual content and product sales. A showcase of our products is what customers expect from this type of social media.

What resources are needed?: A camera and a new product.

How do you measure it’s success?: This has been the easiest to measure. Since I’ve started introducing lens technology, I’ve had several existing patients come in and specifically ask for the contact lenses featured. I’ve also had patients come in and ask for a specific frame I’ve featured.

Dr. Dryer salutes St. Patrick’s Day, reminding patients in the process of her practice, and why they should schedule their next visit.

Holidays, Community or Special Events
Why does it work?:  For holiday posts, the goal is not to be too cute or redundant. Too many reindeer, or back-to-school apples, take away from what makes your practice unique. Do holidays, but make it reflect your practice. Your practice, or your products, should always be the main event. Less is more.

Anytime I participate in an optometry-related event, I think, “How can I share this with my patients?” Patients enjoy seeing their doctors involved in activities relating to their community or their profession.

What resources are needed?: No financial investment.

How do you measure it’s success?: Social media site likes and comments are an easy way to measure success.

One of Dr. Dryer’s patients shows off how happy she is with the new eyeglasses she got at Dr. Dryer’s practice. The practice got permission from her to use her photo for marketing purposes.

New Glasses Photos
Why does this work?: The key to this post’s success is to re-post it from the patient’s Instagram account. This gives your business maximum publicity. Those who follow your patient’s account will see it, along with your patients. If your patients are influencers in your community, you could see a even bigger response!

What resources are needed?: Your patients and customers involvement is key! Additional monetary resources may be needed if a partnership is to be formed between key influencers.

How do you measure its success?: The success of this post is dependent on the number of followers that your patients have. Many small businesses elicit the help of influencers, bloggers or community leaders to wear their products. Forming these types of partnerships can be mutually beneficial to small businesses.

Dr. Dryer says re-posting to her practice’s social media pages favorable posts like this can be a powerful marketing tool. Patients read first-hand about another patient’s positive experience, want to experience it, too.

Social Media Reviews Re-Posted
Why does it work?: This is extremely effective because it’s your patient’s words about your practice. Word-of-mouth is always your best marketing technique. If potential patients only visit your Instagram account, they will miss your fabulous Yelp reviews.

What resources are needed?: Reviews are easily pulled from your other social media pages. If you don’t have any, actively ask your patients for them, or you may consult with other paid sources like Weave.

How do you measure its success?: Online reviews are now my No. 2 source of referrals, just behind word of mouth. When I ask patients how they hear about us, they will say “you have good reviews.” Every practice should keep track of the ways patients hear about their practice to make good investments in marketing dollars. We track this by asking “How did you hear about us?” on patient intake interviews.

Action Plan: Additional Tips to Get the Most from Social Media

GET PATIENT SIGN OFF. Make sure you have your patients fill out a HIPAA marketing release form before using their images or private information in social media posts, or other marketing.

EXPERIMENT WITH HASH-TAGGING. “Trial” your hash-tagging on posts to find the most popular hashtags for bringing in new patients. You may look at popular bloggers in your area for ideas.

ASK PATIENTS TO POST. Encourage patients to post directly on their social media and “tag” you. This is a great way to generate more awareness, and will likely bring in more new patients (their followers).

ASK PATIENTS TO “LIKE” YOU. Actively promote your social media among your patients. Ask them to “like” or “follow” you.

COURTNEY DRYER, OD

is the owner of 4 Eyes Optometry in Charlotte, N.C. To contact her: cdryerod@gmail.com

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