Website Design 2017: 7 Things You Need To Know

Website design standards? What the heck are those? Who determines them and how do they impact my practice website?

I don’t expect Optometrists to be expert web developers or coders, but there are some basic aspects of a website you need to consider when looking at your online presence. We are all consumers at heart and we all appreciate a good user experience when we travel around the web – our own practice websites should be no different.

Here are the top 7 website design aspects you need to consider for 2017.

1. Mobile:

We’ve been saying it for years now but a mobile friendly design that works across all devices is still this years number one factor. Over 65% of traffic to Optometry websites comes from mobile devices and as of March 2015, Google began actively punishing non-responsive websites moving them lower in search rankings, and positively ranking websites that are mobile friendly. To test your website use Google’s mobile testing tool.

2. SEO (Search Engine Optimization):

This helps search engines know what your website is all about, which helps your all important search ranking. Things like keywords in content, images with titles and descriptions and your proper locality information (name, address and phone number) – all are important factors to keep in mind.

3. Content Management System:

CMS’s like WordPress, Drupal etc. are powerful content publishing tools that allow you to quickly update and add content to your website without being beholden to your web designer. At the very least you should be able to add practice news or write a blog post on relevant content on your own. Google looks to see how often a website is updated and this is the easiest way to do that. If you cannot easily add content to your own website I suggest you have a serious conversation with your website designer / host.

4. Secure:

Who has access to your website? Who is responsible for the security of your website? Is it being updated frequently? Is it being backed up? Websites are being hacked and taking down all the time, you should talk to your web host to see what safeguards are in place in case disaster strikes.

5. Fast:

In 2015 it was mobile responsiveness, in 2016 it was speed and in 2017 – well get to that in a second! Speed matters, Google rewards faster sites with higher search results. According to Kissmetrics, nearly half of web users expect a site to load in 2 seconds or less, and they tend to abandon a site that isn’t loaded within 3 seconds. GTmetrix has a great tool that will analyze your site. It provides you with a ton of data but one number you should pay attention to is how long the homepage takes to load, see screen shot below.

eye care website speed

6. https://

Before your eyes glaze over, 2017 is the year that Google wants the web to become more secure. Https:// provides the little green secure lock icon in the top left corner of your browser bar (in Google Chrome), see screenshot below. Google will once again reward those that make their site secure and punish those that don’t. Talk to your web host to see if they can convert your site to this new standard. A few years ago you had to pay an annual fee for this service but there are now free / opensource options available such as Let’s Encrypt

7. A Clear Call To Action:

People visit your site for some pretty basic reasons such as your hours, phone number and location. Make sure these elements are easily found on each and every page of your site. Try and position a click to call or request appointment button in a prominent place. The site below has a “sticky” button that does not move as the user scrolls, making it easy to request a consultation. Click here to see it in action.

CTA button for eye care websites

In summary, user expectations and behavior are constantly changing. As small business owners with a web presence it is our job to keep pace with that. It doesn’t mean that you need a new website each and every year, far from it. All of the above items can be added to your existing site quite easily. I encourage you to reach out to your web designer to discuss these items and look at those which can easily be added. Back in the day, the outside of your practice was super important in attracting new patients, but your website is your new storefront and it needs the same care and attention that the outside of your practice does.

Dr. Jeff Goodhew, OD is co-editor in chief for Canadian Eye Care Business Review, he is also part owner of Abbey Eye Care in Oakville, ON. He has special interest in web design and digital marketing.

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Scribes: Give Patients Your Full Attention & Improve Work Flow

Practice, Specialty Practice, The Patient Journey

DECIDE ON NUMBER OF SCRIBES & DUTIES

We currently have four scribes, each employed full time. We are constantly training staff to become scribes. All scribes begin in our office as pre-testers, and learn most of all by also working at the front desk. We found quickly that each job in our office (outside of optician) feeds on the others, and can become monotonous if that is the only thing you do. For that reason, we like to rotate our support staff between the roles of front desk receptionist, pre-tester and scribe. Those who excel at scribing, however, end up concentrating mostly on that task.

DETERMINE PAY SCALE

Our scribes are paid based on their ability to grasp each job role in our office. We begin with scribes hired to pre-test, and as their skill set increases, their pay increases. The highest pay for a scribe is when they can perform in all areas, including: checking in and out patients, pre-testing and scribing for the doctor. We also have them involved in other technician skills such as retinal photos, visual fields, genetic testing and other imaging.

Miamisburg Vision Care
Miamisburg, Ohio

Locations: 1

Doctors: 3

Support Staff: 16

Annual Exams: 6,000

Annual Revenues: $2.2 million

HIRE EMPLOYEES WITH POTENTIAL TO LEARN SCRIBING

We have long believed in hiring based on personality, and then training the skillset needed for each job role in the office, included that of scribe. It is impossible to train someone to become more friendly or to have abetter work ethic. It is much easier to train someone how to check visual acuities or record a medication list into an EHR.

IDENTIFY EMPLOYEES WHO WOULD MAKE GOOD SCRIBES

Scribes need few skills starting off, and the knowledge comes as they get more experienced. The primary characteristic of a good scribe is multitasking ability. This is why we prime employees for the job by having them work at the front desk before they train to become a scribe. If they are able to answer the phone and schedule a patient while checking another patient in, as well as dispense a contact lens order to someone else, they can handle the duties of chair-side scribe.

Another skill that is needed is the ability to be flexible and change pace. Often during the course of the day, the “typical exam” becomes anything but typical. The course of each encounter with patients varies, and the scribes need to understand what test is being done, and incorporate the data as the exam unfolds. The last skill, and most critical, is being very detail-oriented. Notes for patient encounters function in many ways, but primarily they are medical-legal documents and need to record the information as it happened. The notes also will be used to shape future encounters with patients, and to guide the care we give them. Capturing the small details ensures we have great continuity with our patient encounters, and that we address all the issues for each visit; not just at that one visit, but as a continuum.

IMPROVE EXAM EFFICIENCY

We initially looked at EHRs as a burden to efficiency since we were not used to working entirely online, so before we even added an EHR to our office, we added scribes. We trained a few staff members on the anatomy of the eye and common findings, and how to input that data into the EHR. The typical exam is about 15-20 minutes, and this has never really changed since adding scribes. Without scribes, the doctor is either making lots of exam notes after a patient leaves, or there is time added during the visit to note all the details needed for the EHR to be complete.

The scribe puts in over 95 percent of the information needed in patient’s EHR chart. On occasion, I may clarify something in the record or add to the information they put in. However, most of the time, the information inputted by the scribe is accurate and complete. The only things I need to do within a chart include: authorizing a glasses or contact lens Rx (and I like this as a double-check on accuracy), signing the records and writing letters–all of which I do on the fly with a touchscreen laptop that I carry from room to room. The scribe works on a desktop workstation in each room to input all the information, and I finalize most patient encounters before leaving the room with a few key strokes and button clicks.

IMPROVE DOCTOR-PATIENT INTERACTIONS

The key moment in my decision to add scribes to the exam room occurred when my daughter was seen in the Cleveland Clinic by a neurologist in 2009. This was my first experience with EHRs, and the entire time we were with the doctor he was facing his computer screen typing notes. He seemed very efficient, but rarely looked at us or our daughter. This, of course, was through no fault of his own, but the reality of charting on a computer. I considered a laptop and facing the patient, or taking notes and adding later, but the reality was that the volume of information that needs to be captured by the EHR is too big to not have a scribe’s help.

I am able to face the patient, perform needed tests, and frankly, examine the patient–not my computer screen. The interaction with patients even improved with scribes, as I so rarely even look away from them during the examination. My scribe gives me information from previous visits, so I don’t need to turn away to look at the chart. I don’t look at a screen more than a few seconds during the course of an exam–all my attention is on my patient.

ENSURE ALL SCRIBES WORK WITH ALL DOCTORS

Good rapport develops when the same doctor and scribe work together, but we have been bitten by only having one scribe work with one doctor when a scribe left the practice or was out sick or on vacation. We try to have the same scribe with the same doctor all day, but switch them to different doctors during the week to ensure all scribes have a good understanding of the workflow for each doctor, as well as differing terminology. We consider this cross-training. If a scribe can only work with one doctor, they do not add enough flexibility to our practice.

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 Ahmos Henry

Insights

Ahmos Henry is the President of Hoya Vision Care Canada.

Ahmos moved from the pharmaceutical industry to eye care over 13 years ago.

He shares with us what got him interested in eye care and what changes

he sees coming in the near future.

Ahmos Henry

President Hoya Vision Care Canada

EMBA Saint Mary’s University, 2008

B.V.Sc., Veterinary Medicine, Cairo University, 1987

How did you get into the eye care business?

My career in the eye care industry started by sheer coincidence! After many years in the pharmaceutical field, I happened by chance to meet a friend at an eyewear trade show (MIDO Eyewear Expo) that his company was participating in. I was completely fascinated by the unique combination of science and fashion. Innovation and fun radiated throughout the entire show and I immediately knew that I wanted to work in the vision care field. When the opportunity came, I pursued it passionately until I got in. It has been over 15 years and I have never regretted my decision, nor do I want to join any other industry! I love what I do, enjoy working with my team, and embrace the many relationships formed with Eye Care Professionals (ECPs) over the years.

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

I see differentiation to be more important for independent ECPs as they fight for a more ethical and professional patient eye care experience. I praise the Optometrists and Opticians’ associations in Ontario as they stand for providing patients with proper education and dispensing. An example of this is when they took legal action against online vision care product providers and were rewarded by settling their grievance.

What is something you plan on implementing in your business this year?

Hoya has already launched some exciting “first to market”, innovative products and services this year and are currently planning to launch more over the next few months. Some of these include, a national offer for independent ECPs who are looking to differentiate themselves in the market. These products include the Sensity Dark and Sensity Shine photochromic lenses, as well as the revolutionary redesign of Hoya’s most popular LifeStyle progressive lenses.

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

We have done numerous things to set Hoya Canada apart. We pay special attention to our team and through the implementation of our “Core Leadership Values” we focus on “integrity,” “innovation”, “treating each other with dignity and respect”, and being “passionate about winning”. Reading about them is one thing but if you come to visit our facilities you will see a difference in how we communicate. It is refreshing to see a manufacturing facility run with these values as the cornerstone of operations.

What was the last gift you gave someone?

Ironically, I came across an excellent Spanish red wine by the name of Hoya. I just gave it to a friend of mine and she was happily surprised!

Tell me something few people know about you?

Very few people know that I received my Executive MBA at St. Mary’s University in Halifax with a focus on the optical industry. I was totally fascinated with all its aspects from manufacturing, sales and marketing, and even human resources! The pinnacle of this experience was my graduation thesis which was a comprehensive business plan for a full-service optical laboratory in Canada.

Describe your perfect day.

Believe it or not, every day I go to work is a perfect day! I am alive, well, happy and healthy. Furthermore, I go to work knowing that Hoya helps thousands of people see better and live better. Because of what we do, thousands of people EVERYDAY avoid an accident, excel at school, enjoy their lives and loved ones, do better at work, and the list goes on!

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Optometry Giving Sight Works to Prevent Blindness Due to Refractive Error.

Products | Services | Industry News

Optometry Giving Sight is the only global fundraising initiative that specifically targets the prevention of blindness and impaired vision due to refractive error. Our aim is to help the more than 600 million people who are blind or vision impaired simply because they do not have access to an eye exam and a pair of glasses. Optometry Giving Sight funds the solution by supporting programs that deliver vision care, train local eye care professionals and develop infrastructure.

We fund sustainable development projects which support the goals of VISION 2020: The Right to Sight. So far, more than US$10 million in funding from donors and sponsors had been disbursed to 97 projects in 39 countries throughout Africa, Asia and Latin America.

Established in 2003, Optometry Giving Sight is a joint initiative of the World Council of Optometry, the Brien Holden Vision Institute and the International Agency for the Prevention of Blindness. Optometry Giving Sight is currently raising funds in Canada, Australia, USA, Ireland, the United Kingdom, Italy, Norway and Singapore.

Optometrists are eliminating refractive error blindness and vision impairment – simply the need for an eye exam.

Raising funds…

By inviting regular monthly or annual donations;
By inviting optometrists and their practices to participate in one of our appeals, such as the World Sight Day Challenge or other fund raising activities;
By inviting optometrists to “Tick Yes to OGS” on their annual association dues renewal invoice;
Through optometry industry corporate sponsorships and donations by their employees;
Through patients making donations;
Through general donations at givingsight.org.

Funding programs…

We distribute funds to partners who implement projects that ensure sustainable, lasting results in three ways:

Train – local eye care professionals and;
Establish – vision centres for sustainability to;
Deliver – eye care and low cost glasses.

OPTOMETRY GIVING SIGHT

For More Information about OGS in Canada please contact Corrine Waldon as follows: B110 – 4 Parkdale Cresent NW, Calgary, Alberta T2N 3T8, Canada Tel: 1-800-585-8265 ext 4 Tel: +1 403-670-2619 Fax: +1-888-425-7296

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Key Financial Metrics to Track–and Improve–for Profitability

Finance|Wealth, Practice Metrics & Benchmarks, Resources

One of my favorite expressions is “measure twice and cut once!” These words of wisdom have been a mainstay of the construction industry for years. If you double-check your measurements, it is less likely that errors will occur and the business will be more profitable.
This business philosophy can also apply to an optometry practice. It is important to measure the financial key metrics of a practice in order to maximize the NET income and ensure an efficiently run business.
Here are the Hayes Center for Practice Excellence’s 7 Key Financial Metrics and how my practice has benefited from measuring and monitoring these financial benchmarks.
How do you measure the 7 Key Metrics?
The use of a computer financial software program has made the reporting of financial metrics much easier. We use QuickBooks by Intuit for all of our bill paying and deposits. At the end of each reporting period, my business manager generates a profit and loss statement with “percentages of gross income” selected in the reporting criteria section. Some initial work is required to set up the categories in QuickBooks based on deposits and payments to vendors and suppliers during the reporting period.

IDENTIFY KEY METRICS

ET SPENDING GOALS

Cost of Goods Sold COGS (26 percent-32 percent) – The Cost of Goods sold category is always the highest single expense in a traditional optometry practice. The following items should always be included in your Cost of Goods:
• Lab bills, blanks, uncut lens blanks
• Frames and cases
• Fair allocation for lab floor space
• Lab equipment, edger, surfacing equipment, dye unit
• Pro rata share of optician’s salary (excluding labor as a COGS is a common mistake)
Staff Expenses (18 percent-24 percent) – The second largest expense for traditional practices is what it costs to employ and support your staff. Staff expenses does not include the salaries paid to employed ODs; that goes under Doctors’ Net Income. Staff expenses also does not include wages for lab employees who cut, edge or surface lenses. Those wages go under the Cost of Goods category. Staff Expenses includes the following:
• Salaries
• Payroll taxes
• Uniforms
• Insurance
• Continuing education and other training
Occupancy Costs (5 percent-8 percent) – If you own your building, treat yourself as the landlord and your practice as the tenant who rents from you. Be sure the practice pays you fair market rent even if the building is paid off. Otherwise, you will be personally subsidizing the overhead of your practice in our profitability model.
While rent and interest are tax deductible, principal payments are not. The total you are spending to occupy your office is what counts, not how much you write off. The following are all considered occupancy costs:
• Rent
• Property taxes
• Utilities
• Maintenance
• Janitorial
• Insurance (property)
Examination Equipment (3 percent-5 percent) – Your examination equipment includes not only the equipment, but also the expenses associated with the equipment such as:
• Leases
• Interest on Loans
• Depreciation
• Service Contracts
• Maintenance
Marketing and Promotion (1 percent-2 percent) – Marketing expenses are highly discretionary. Interestingly, low-netting practices tend to spend more on marketing than high-netting practices. However, this does not mean that low-budget advertising is the way to go. The effectiveness of low-budget advertising is questionable. Things you should include in marketing and promotion are:
• TV, radio, and newspaper advertising
• Direct mail advertising
• Yellow Pages listings (However, this cost is often lumped in with the phone bill.)
• Web site
• Recall Services
• Web Review Site fees (Yelp, etc.)
General Office Overhead (6 percent-9 percent) – This category will include all other expenses you have for running your practice. It should include things such as the following:
• Front office equipment
• Phone
• Postage
• Legal fees
• Accounting fees
• Dues
• Subscriptions
• Insurance
• Office Supplies
Doctor’s Compensation (30 percent+) – The last item on the Hayes Seven Key Expenses is doctor’s compensation. Hopefully, this will be your largest percent of gross. This compensation would include:
• Salaries for the owner and any employed ODs
• Heath Insurance and Other Benefits
• Corporate Profits
• Pension and Profit Sharing
• Personal automobiles
• Cell Phone

SET PERFORMANCE GOALS

What made you change the way you look at your practice finances?
One of my job responsibilities at Southern College of Optometry is Director of the Hayes Center for Practice Excellence. I teach current and future optometrists the business side of practice. This provided me with the opportunity to enter into a Master of Business Administration program at a local university. My practice was struggling with its profitability and I was also looking for answers. The completion of the MBA degree taught me how to better manage the business side of my own practice. I can now share this knowledge and my experiences with students and fellow practitioners.
What are some of the variables that can affect the key metric percentages?
The first variable to look at is your fee structure. If fees currently charged for professional services, as well as materials, are too low, then the resultant key metric percentages will be significantly affected. This may signal the need to raise fees to compensate for increasing costs and expenses. Our practice had gotten complacent over a 3-4 year period and did not raise fees. This resulted in a steady decline in our NET income. We initiated a review of our current fee schedule and raised our professional service fees over a two-year period. Ophthalmic material fees were also adjusted where needed.
The other variable to examine is expenses. As mentioned in the breakdown of the Hayes 7 Key expenses, Costs of Goods sold and staff expenses are the two biggest expense categories. I personally feel that a staff that is efficient and productive should be well compensated, so I don’t have a problem with staff expenses being on the high side of the 18-24 percent range. Our staff expenses are 24 percent and they are very dedicated and hard working! Assuming the practitioner is doing a good job managing their operating expenses such as occupancy costs and equipment expenses, COGS is the category that deserves the most attention and can have the greatest impact on your bottom line.
What about Managed Care?
There is no doubt the increase in the number of managed care vision plans has affected the profitability of many optometry practices. Lower reimbursements can translate into lower collected gross receipts and lower NET income for the doctor. There are ways to battle this giant! Increased use of staff delegation and improvement in patient flow through the office can result in improved efficiency, and thus, more patients can be seen during the work day. But other changes may be needed to maximize the practice NET income. Better optical material purchasing decisions along with policies controlling other office expenses need to be in place. We scrutinize all purchases in the office and compare prices before a decision is made. We also use a manageable amount of good debt when purchasing major equipment and make lease hold improvements. By measuring the key financial expenses regularly and running your practice like a business, managed care can be beneficial to many optometry practices.

How did measuring your practice improve the bottom line?
After setting up our QuickBooks accounts and measuring the expense categories, we found our COGs percentages were significantly out of line with the Hayes Key Metric suggested goals. We made a change in our office manager and frame buyer and empowered a new trusted employee to correct the COGS problem. By doing this, our office reduced the COGS percentage in a short period of time. Our new office manager/buyer was given a budget and began the task of reorganizing the frame inventory and examining the ophthalmic lens and contact lens expenses. She eliminated some of the frame companies that had poor customer policies and this allowed us to increase our bargaining buying power. Our new office manager also attended education courses on frame board management and merchandising. Negotiations with ophthalmic lens suppliers also helped with margins. Contact lens purchases were more closely monitored and product returns expedited in a timely manner. In other words, the entire practice mentality changed and resulted in a significant increase in the net income.
How was your new office manger compensated?
Part of the new office managers/buyers salary compensation package was a merit-based bonus based on the improvement in the NET income. As a result she received a sizeable bonus, but more importantly, the doctor’s NET income was significantly improved.
Improve YOUR Practice’ s Profitability
I would make a couple of suggestions to my colleagues. Enroll in a business course at a local college or university. This additional course may provide a fresh new way to look at the financial health of your practice.
Another helpful change I made in my practice was joining an optometry peer group. It allows for the sharing of practice ideas and additional practice management education. I would strongly recommend a practitioner join one of these groups.
But the most important suggestion I can make is measure and measure again! Take the time to set up a financial software program and begin to measure the Hayes 7 Key Financial Metrics. You may discover an expense category that needs addressing or maybe that fees need to be increased. You won’t know this unless you take the time to measure the metrics and evaluate them!
If you measure these key metrics, you may be surprised to find out how successful or problematic your practice may be. Even if your efforts increase the practice NET income by 1 percent, the profitability of an average $600,000 practice will increase by $6,000….and no one would be upset about that!

Related Review of Optometry Articles

Advice for New and Experienced ODs: Understand Essential Business Concepts
Getting There: Planning a Successful Optometric Career
Practice By the Numbers: Track Your Key Expenses

GERALD A. EISENSTATT, OD, MBA,

GERALD A. EISENSTATT, is director, Hayes Center for Practice Excellence, at the Southern College of Optometry. Dr. Eisenstattalso is the owner of his own independent practice, Memphis Family Vision in Memphis, Tenn. To contact him: geisenst@sco.edu

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Metrics to Manage By: How to Calculate Chair Cost per Exam

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

This final article of our three-part series on important benchmarks ODs need to monitor, looks at chair cost and expense ratios. All six benchmarks discussed in this series were pulled from a VisionWeb discussion of eight metrics optometric consultants Gary Gerber, OD, and Steve Sunder, of VisionWeb, deemed as important metrics to be tracked on a regular basis.

When we break down these benchmarks, we look at data drawn from the Management & Business Academy (MBA),a research program sponsored by Essilor. Over seven years, MBA gathered performance data from more than 1,800 optometric practices across the US. It has published the most comprehensive compilation of benchmarks currently available. You can visit mba-ce.com to access the MBA metrics research.

DOWNLOAD COMPLIMENTARY E-BOOK:
8 Benchmarks ODs Need to Monitor in Their Practice

In total, the benchmarks covered in this series have included:
• Gross Revenue per Patient
• Gross Revenue per Staff Hour
• Optical Capture Rate
• Inventory Turnover Ratio
• Chair Cost
• Expense Ratios
If you want to monitor these benchmarks, plus two bonus benchmarks, in your own practice, you can download VisionWeb’s e-book HERE.

Chair cost is an important metric for independent ODs, providing one basis to establish professional fees and make judgments about which managed care plans to accept. There are a couple different ways to look at chair cost. You can determine chair cost from the total number of annual visits, or total number of annual exams.
Formula 1: Fixed Costs / Complete Annual Exams = Chair Cost per Exam
MBA Example: $260,876* / 2,156 = $121 per Exam
Formula 2: Fixed Costs / Complete Annual Patient Visits = Chair Cost per Visit
MBA Example: $260,876 / 2,598 = $100 per Patient Visit

The first thing you need to do in order to determine your chair cost is to calculate your fixed costs. You can calculate your fixed costs by subtracting your operating expenses, your doctor payroll, and your net, from your gross income. From there, you will divide your fixed costs by the number of complete annual exams, or annual patient visits, to get your chair cost.
MBA norms calculate a chair cost of $100 per patient visit. The most important thing here is making sure that your chair cost is lower than your insurance reimbursement.
*Fixed costs were determined by this formula: Gross revenue minus OD compensation minus Net minus COG.
MBA norms calculate a chair cost of $100 per patient visit. The most important thing here is making sure that your chair cost is lower than your insurance reimbursement.

METRIC #2: EXPENSE RATIOS

Monitoring expense ratios helps ECPs develop annual budgets and evaluate opportunities to raise net income by reducing expenses. The MBA has published expense ratios for the major expense categories that all independent ODs face.
The Formula: (Expense / Revenue) x 100 percent = Expense Rate to Revenue
MBA Example: (Cost-of-Goods): ($191,323 / $659,736) x $100 = 29% of Revenue

Typical expense ratios vary by practice size. In general, larger practices have somewhat lower ratios for cost-of-goods, occupancy, and general overhead expenses, but somewhat higher staffing ratios. The result is that larger practices, on average, enjoy net income ratios 10-15 percent above the median for all practices.

THOMAS F. STEINER

Thomas F. Steiner, Director of Market Research for ROB, has spent more than 25 years helping eyecare practices succeed, including pioneering the introduction of color contact lenses into optometry. To contact him: tnlsteiner@comcast.net

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Metrics to Manage By: Revenue per Patient & Revenue per Staff Hour

Finance|Wealth, Practice Metrics & Benchmarks, Resources

One of the most important management tasks in any eyecare practice is routinely tracking practice performance. Keeping a close eye on key metrics can reveal the successes, failures and opportunities. As CEO of your practice, you need to be on top of the financial health of your practice, and take corrective action to improve the areas of your business that may be falling behind compared to others. This is where key metric monitoring comes in.
VisionWeb produced an e-book, authored by Gary Gerber, OD, of the Power Practice;and Steve Sunder of VisionWeb, that includes eight key metrics deemed the most helpful in measuring the performance of independent optical practices. Their eBook, 8 Benchmarks ODs Need to Monitor in Their Practice, comes with a downloadable excel sheet that does all of the math for you! The eBook can be downloaded HERE.

DOWNLOAD COMPLIMENTARY E-BOOK:

8 Benchmarks ODs Need to Monitor in Their Practice

METRIC 1: REVENUE PER PATIENT

Revenue per patient is calculated in a few different ways, depending on if you want to determine revenue per comprehensive exam patient, or revenue per all patients (including medical eyecare treatment patients). Let’s take a look at both formulas below:
The Formula: Gross Annual Revenue / # of Annual Exams Performed = Revenue/Patient
*MBA Example: $659,736 / 2,156** = $306
OR
The Formula: Gross Annual Revenue / # Total Patient Visits = Revenue/Patient
MBA Example: $659,736 / 2,598*** = $254

The national performance of ODs on this metric is very slowly increasing, through inflation and the gradual increase in dispensing of new technology products. On top of that, there is considerable variation in gross revenue per exam across practices. The most productive 10 percentof practices see revenue per exam nearly two thirds higher than the median (see table below).

*MBA example numbers are based off MBA norms. MBA has not directly measured gross revenue per medical eyecare visit, but available data suggests that the average revenue per medical eyecare visit is roughly comparable to that from an eye exam visit.
**Assumes 1.1 complete exams per hour for ODs working 1,960 hours annually (49 weeks at 40 hours per week).
***Assumes 2,156 complete exams and 442 medical eye care visits (17 percent of total visits).

Shown above in the chart are MBA (US data) norms: The median is $306, but the goal to aim for is the higher amount achieved by the75th percentile of all OD practices in the database. The highest percentile achieves an even higher revenue figure.

Improving Your Gross Revenue per Exam

If your practice is falling below the median, there are opportunities to increase revenue per exam with little or no cash outlay through office practice changes. Many variables can impact gross revenue per exam, but ODs should focus on the following to help increase revenue per exam:
• Average eyewear sale/dispensing ratios for premium lenses and frames
• Eyewear capture rate
• Professional fees
• Eyewear retail pricing
• Multiple eyewear purchase ratio

METRIC 2: REVENUE PER STAFF HOUR

Monitoring revenue per staff hour will help you evaluate the efficiency of patient management by your staff, and can signal if your office is over- or under-staffed. The median staff hours and revenue in this calculation can vary depending on the time period you want to measure. Here we look at annual hours and revenue, but you could also measure this on a monthly basis.
The Formula: Gross Revenue / Annual Median Staff Hours = Median Revenue/Staff Hour
MBA Example: $659,736 / 7,949**** = $83

****Equivalent to four full-time staff members.

Revenue per staff hour is weakly correlated with practice size, and the norm for this benchmark hasn’t changed in over seven years of measurement! Sixty percent of practices have a revenue per staff hour ratio between $70 – $100. If you’re getting a revenue per staff hour over $100 you should review your workflow and determine if staff additions would improve patient service. On the other hand, if your practice is suffering from a low performance on this benchmark, it could be from:

• Over-staffing
• Low revenue per complete exam
• Active patient base too small to support staff
• Staff hours to OD hours ratio of five or more – indicative of an inefficient patient service process

Related ROB Articles

Top Metric to Track: Eyewear Rxes per 100 Complete Exams

Top Metric to Track: Complete Exams per OD Hour

Top Metric to Track: Gross Revenue per Complete Exam

THOMAS F. STEINER

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Metrics to Manage By: How to Compute Optical Sales Capture Rate

Finance|Wealth, Practice Metrics & Benchmarks, Resources

There are two important metrics that ODs should be monitoring in thedispensary: Optical Capture Rate and Inventory Turnover Rate. We’ve pulled these metrics from a recently published discussion, by VisionWeb, of eight metrics that optometric consultants Gary Gerber, OD, and Steve Sunder, of the VisionWeb team, consider the most useful diagnostic tools for independent ODs. Their e-book, 8 Benchmarks ODs Need to Monitor in Their Practice, comes with a downloadable Excel sheet that does all of the math for you! The e-book can be downloaded HERE.
In order to present the data for these metrics, we have drawn numbers from the Management & Business Academy (MBA) – a research program sponsored by Essilor. Over seven years, MBA gathered performance data from more than 1,800 US optometric practices. It has published the most comprehensive compilation of benchmarks currently available. You can visit mba-ce.com to access the MBA metrics research.
While the first article in this series discussed two key revenue metrics every practice should be keeping track of, this article will present two key metrics ODs should be monitoring in their dispensary.

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8 Benchmarks ODs Need to Monitor in Their Practice

OPTICAL CAPTURE RATE

Showrooming has become a big problem for many eyecare practices. Patients are coming in and trying on frames in your dispensary, only to go home and make their frame purchase online. Evaluating this metric can help you determine if your practice is falling victim to showrooming.
You can look at this formula two different ways. Adding the results of these two formulas should give you 100 percent of your patients given a prescription. Let’s take a look:
Formula 1: Number of Patients who Filled their Prescription in your office / Number of Patients given a Prescription = Optical Capture Rate.
MBA Example: 44 Filled Prescriptions / 68 Prescriptions Given = 65% Capture Rate

OR
Formula 2: Number of People who didn’t Fill their Prescription / Number of Patients given a Prescription = Walkout Rate
MBA Example: 24 Unfilled Prescriptions / 68 Prescriptions Given = 35% Walkout Rate

Industry data, based on consumer surveys, indicates that independent ECPs perform 68 percent of all exams given, but sell only 44 percent of frame units. That’s how we got to the numbers used in the MBA example above. Close to one in three patients of typical independent ODs take their eyeglass prescription to be filled somewhere else, and this walkout rate represents a large loss of revenue for ECPs.
The MBA surveys also indicated that many ODs grossly underestimate the true walkout ratio of frame purchases by their patients. And relatively few ODs are taking the time to track their capture rate. While it’s uncertain for sure that all patients who don’t purchase frames from you are purchasing from another vendor, you can gain a reasonable estimate by tracking the number of frames dispensed and the number of Rxes given.
Survey data shows that patients take their eyewear Rx elsewhere, usually to a chain provider, for perceived reasons including:
• Lower price
• Better selection
• Better assistance from greater expertise of chain opticians
• More attractive merchandising of frames
• Greater focus of chain retailer on selling eyewear
If you’re unhappy with your practice’s capture rate, these are the areas you should be focusing on in your dispensary.

METRIC #2: INVENTORY TURNOVER RATE

Measuring inventory turnover rate in your dispensary is a simple metric to monitor, as most practices have easy access to the variables: number of frame sales in units and number of frames in inventory over the same period.
The Formula: Annual Frame Unit Sales / Number of Frames in Inventory Annually = Inventory Turnover Rate
*MBA Example: 1,603 / 890 = 1.8 Inventory Turnover Rate

Inventory turnover is highly correlated with practice size, so a single benchmark for all practices can be hard to determine. The median practice, measured by MBA, has an annual inventory turnover rate of 1.8, while practices grossing over $3 million had an annual turnover of three or more.

Larger practices have a higher turnover because a majority operate single locations and are able to offer patients more choices without increasing the number in inventory proportional to their volume differential, over smaller practices.
Keep in mind, a high frame turnover is not always a desirable goal. Frame turnover can be kept high if you have limited options available, which might be the case for higher-end dispensaries. But, having lower inventory can lower your eyewear capture rate. Typical ECPs carry 5-10 percent fewer frame options than they should to optimize patient selection.

Action Points to Fine-Tune Frames Inventory

Assuming your practice offers sufficient selection, a higher turnover can be achieved by:
• Regularly monitoring turnover of each frame and frame brand, and eliminating the number of frames with no unit sales in 12 months and slow-moving brands.

• Eliminating duplicative product lines.

• Limiting the amount of frames in storage and not on display to less than 5 percent of total inventory.

Related Review of OptometryArticles

Key Benchmarks to Track for Practice Profitability

Key Revenue Metrics for Independent ODs: Revenue Per Patient & Revenue Per Staff Hour

Top Metric to Track: Eyewear Rxes per 100 Complete Exams

THOMAS F. STEINER

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The Challenge of Selling Multiple Pairs

Advertising & Promotion, Marketing, Pricing, Products | Services | Industry News, Resources

Despite the fact that most of your clients own numerous pairs of gloves and shoes, several hats or caps and many other accessories that serve to improve their comfort and enhance their appearance, getting them to buy a second pair of glasses is often a real challenge. And yet, glasses serve a dual function as a medical/well-being necessity and a fashion accessory. Both functions provide excellent starting points for selling multiple pairs of glasses.

Why do some wearers own more than one pair of prescription glasses? A survey of about 10,000 Americans conducted by Vision Council[1] has some answers. For 39.3% of respondents, it is important to have an extra pair of glasses as a back-up. 36.9% of people gave convenience as the reason: a different pair of glasses in different locations (home and office). The third reason given was functionality; 34.2% of multiple pair eyewear owners have different pairs for different activities. This reason was popular among men over the age of 45. Finally, a handful of people stated fashion as their reason (to complement their wardrobe). A more recent survey conducted by VuePoint IDS also found that the “fashion accessory” aspect was one of the least popular arguments used by Canadian eye care professionals to encourage the sale of multiple pairs.

VuePoint research indicates, that Function trumps Fashion, when it comes to advocating a second pair sale.

Over the last few years, pollsters have not seen any major swings in the intentions of wearers. It is therefore up to eye care professionals and the industry as a whole to educate the client to associate visual comfort with wearing a different pair of glasses for different activities.

The Power of Advice

Of course, clients have access to information everywhere, namely on the Web. Are they well informed? Not necessarily, but they are willing to listen to advice. One of the main influences on consumers when choosing their glasses is the recommendation of their eye care professional. It is well known that advice provided in the examination room is golden. That’s the first key to success, according to a recent poll by VisionWatch,[2] followed by appearance and affordability.

Considering that only 20% of patients[3] own a second pair of glasses, the potential is enormous. Manufacturers are doubling their efforts to help you give the best advice, to increase sales and to encourage people to purchase multiple pairs of glasses.

In our December survey, 60% of our readers stated that they need more training to perfect the technique of selling multiple pairs. On top of reducing the cost of lenses, that’s what ZEISS proposes with its marketing material and training to encourage the sale of multiple pairs. At the same time, ZEISS has launched a DriveSafe ad campaign targeting consumers. The lenses are designed to provide the best vision while driving in all conditions. Compelling safety arguments are likely to positively influence clients and convince them to purchase a second pair of glasses.

Oakley has also launched its prescription sun lenses with Prizm technology to enhance vision for people who enjoy outdoor recreation activities. These lenses facilitate outdoor activities such as golf, baseball, hiking and cycling. Essilor recently introduced a line of lenses for connected people. The Eyezen lens won the Silmo d’or 2015 award and is designed for most patients who are worried about the effects of blue light from digital devices.

Room for Education

“Did you know that 25% of consumers are willing to invest in a second pair of glasses when they are told it’s the best visual solution? Informing the client about available products is educating them, advising them, and guiding them to make an immediate or future purchase. Various concrete actions can be implemented to create opportunities to recommend a second pair,” says Arnaud Reichenbach of Essilor’s client service department.

Reichenbach believes that you can spend a great deal of time and money developing new strategies to attract clients, but often the potential is already in your office. With the right tools, you can take advantage of that potential. Initiating the discussion in the examination room, keeping the message consistent, knowing your offer well, and identifying the advantages and benefits for consumers are all marketing elements that will help you sway them. Ask questions that give you an idea of your clients’ individual needs. The questionnaire will provide valuable information to help you make the sale. Using open-ended questions to identify needs and closed-ended questions to confirm them creates an opportunity to reinforce the validity of purchasing multiple pairs.

“Everyone can benefit from owning multiple pairs, each tailored to a specific visual need: Crizal® No-Glare lenses, Xperio® sun lenses, Essilor® Junior lenses, Transitions® lenses, Essilor® Eyezen^TM lenses, Varilux® Digitime^TM specialized lenses, protective eyewear for sports, lenses that filter blue light such as Crizal® Prevencia^TM, not to mention current promotional programs such as Perfect Pair or Multi-Pair Plus^TM. Of course, you need to automatically tell consumers about these products,” concludes Arnaud Reichenbach.

Encourage Trying Different Lenses

Consumers may think that, due to the fact that they darken when exposed to sunlight, photochromic lenses are a substitute for sunglasses, reducing the possibility of selling multiple pairs of glasses. “This is not the case,” says Isabelle Tremblay-Dawson, marketing director at Transitions Optical. “According to our research, 33% of Canadians, independent of whether or not they wear Transitions lenses, buy a second pair of glasses. This shows that proposing Transitions lenses does not hinder the sale of a second pair of glasses and reinforces the main advantage of photochromic lenses as a first pair, which is to generate higher profits on the first pair of glasses, while leaving the door open to the sale of a second pair.”

But the Transitions study also shows that 38% of Canadians do not wear or stopped wearing (32%) Transitions lenses because they prefer sunglasses. This means that they were not informed of the differences between Transitions lenses and sunglasses.

There are numerous opportunities to promote the sale of a second pair of glasses during a patient’s visit. While discussing the patient’s visual needs, the optometrist can mention the advantages of Transitions lenses and talk about the additional benefits of polarized sunglasses for when the patient spends time in bright sun or in conditions where the sunlight is bouncing off surfaces such as water or snow.

“At the end of the consultation in the examination room, the optician should join the conversation. The optometrist can summarize the discussion with the patient about multiple pairs, thus opening the door for the optician to continue providing the patient with information about available products,” says Isabelle Tremblay-Dawson.

Incentives and Promotions

Stephanie Gingras, marketing and promotions specialist, points out that “when an eye care professional orders two Rx for the same patient with the same prescription, the ECP receives a 60% discount on the standard price listed for the second pair of lesser value. For independent offices, we offer a program that allows the ECP to easily offer a second pair.”

In addition, since April 2015, Hoya has developed an iPad app––HVC Viewer––which allows patients to experience the lenses before they wear them. In a few seconds, the patient can see the benefits of lenses and comes away with a highly motivating and personalized experience. This is a wonderful way to stay ahead of the game!

Lens design is another advantage when it comes to promoting multiple pairs. In particular, lenses designed with iD FreeForm Design Technology are progressive lenses supported by the Integrated Double Surface Design that provide a wider field of vision. Another example is the Array free-form progressive lens, which features variable length corridors for better adaptability and acuity, even when the wearer is in motion.

The Reading Corner

Most of the time, people in their forties start having a hard time reading restaurant menus or their smart phones.

Presbyopia affects 1.7 billion people worldwide today, and that number is expected to soar to 2.1 billion by 2020. A U.S. study showed that nearly half of young presbyopic patients avoid wearing reading glasses for fear of appearing old.[4]

These clients are therefore likely to be open to purchasing multiple pairs of glasses for reasons associated with appearance. Reading glasses aren’t what they used to be and manufacturers know how to design styles that are original and attractive. This is the case with Read Loop, a unique French company with a collection of about 60 extremely stylish and very colourful frames… Attractive to young (and not so young) presbyopic patients! ThinOptics recently introduced a line of ultra-lightweight, thin frames that can easily fit in your suit or jacket pocket, and its universal case can even be attached to the back of a smartphone.

Finally, a new study has confirmed that of the 77% of Canadians that require a prescription to see, 10% of them use reading glasses that they change every year or so. Over 3.4 million pairs were sold in the last year![5] This market, along with single vision sunglasses and protective eyewear, are key markets for starting a conversation about multiple pairs.

Some Keys for Multiple Pair Success:

Understand the needs of each patient
Start the conversation about multiple pairs of glasses in the examination room
Sell the second pair before the first
Discuss eyewear designed for outdoor activities before indoor glasses
Talk about safety and visual advantages
Transfer information to the optician to ensure consistency in your message
Improve training in selling multiple frames for your sales team
Use available marketing tools to prominently display promotions
Identify frames that are part of a promotion to reduce the time it takes to select a second frame
Offer payment options, if any
Update the client’s file for the next visit. This will help you remember the last discussion you had, validate any changes in the client’s visual needs and adjust your recommendations accordingly.

Source: Inspired by our VuePointIDS survey, by Arnaud Reichenbach of Essilor and by the Review of Optometric Business (several articles by Mark Wright, O.D., FCOVD, and Carole Burns, O.D., FCOVD).

[1] http://www.theopticalvisionsite.com/marketing-trends/the-vision-council-report-fashion-v-s-function-in-eyewear/

[2] http://www.visionmonday.com/business/dba/article/doctorretailer-recommendations-among-top-reasons-consumers-cite-for-lens-choice/

[3] https://www.2020mag.com/CMSDocuments/2010/1/2ndPair_Guide_LR.pdf

[4] http://www.reviewob.com/new-study-nearly-half-of-americans-want-to-avoid-reading-glasses.aspx

[5] Study published by VuePoint IDS together with VisionWatch and VisionWatch Canada. https://infoclip.ca/en/insights-into-canadian-and-us-vision-consumers/

ISABELLE BOIN-SERVEAU

Isabelle is a longtime observer and chronicler of the optical industry and the Editor-in-Chief of OPTIK Magazine and Tmag Optical Trends, VuePoint Publications.

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Hurry Up and Fit Them While They’re Young

Products | Services | Industry News, Resources

With an aging population, the opportunity to fit both current contact lens wearers and emmetropic patients with multifocal contact lenses is enormous. The benefits of doing so range from delighting patients through to increasing your revenue from higher value contact lenses and add-on sales of reading glasses. So take a moment to consider your practice: do you talk about multifocal contact lenses with every emerging presbyope or do they take a back seat until you have tried and exhausted other options such as monovision?

There are, of course, a number of positives for fitting monovision: it is quick, easy and costs no more than ‘normal’ contact lenses. However, monovision does not do so well in the long run for many patients. As the required near addition increases over time, it becomes more difficult to use the same prescription for both reading and intermediate distances. In my experience, more than half of monovision wearers have difficulty once the near add is over 2.00D. It is then that an alternative solution, such as multifocal contact lenses needs to be explored. The difficulty of this approach is that the patient already requires mid to high adds, and these are harder to adapt to.

My preference is to be proactive and fit multifocals early. In much the same way we might recommend low add varifocal spectacles to ease adaptation, fitting low add multifocal contact lenses makes initial adaptation easier for patients. It also maintains their binocular vision and provides a contact lens solution that can adapt with them over time.

Starting the Conversation Early
While no multifocal contact lens can promise to deliver perfectly clear vision 100 per cent of the time, steps can be taken to promote successful outcomes. In my experience, the most crucial step is to get communication right. Conversations about presbyopia should happen early, before its onset. I routinely talk to pre-presbyopes about what will happen to their vision in the future. It means they are not surprised when reading becomes more difficult and that they are aware of their options.

Communication is also key when it comes to setting expectations. Defining success with multifocal contact lenses helps patients frame their experience more realistically. Explain that multifocal contact lenses will work for a majority of the time and that supplementary reading glasses may occasionally be necessary for fine detail. Setting realistic expectations enables more patients to feel their contact lenses are working as well as could be expected. Scoring the relative convenience of both their spectacles and contact lenses works well too. An 8 out of 10 may not be perfect, but it’s certainly ‘good enough’ for many patients, particularly if they also score their reading glasses or varifocals at the same level. Also bear in mind that multifocal contact lenses are not the best option in every case: patients with unrealistically high expectations or specific detailed visual demands may do better with other forms of vision correction.

I follow three tips when fitting multifocal contact lenses. (1) I always use the manufacturer’s fitting guide, which will have been produced after extensive research. If the guide quotes a particular rate of fit success, it will have been achieved by following specific steps, so no matter how tempting it is to stray, I cannot recommend strongly enough that sticking to the guide should lead to the greatest fitting success. (2) I assess vision with ‘real world’ targets. I try to understand my patient’s visual environment and use that to assess how well they can see. Use real life reading material, ask patients to view their smart phone, tablet or laptop and check their vision across the street. Optimise their vision for everyday tasks. (3) Know when to stop making adjustments. As a young practitioner trying to achieve perfect vision, I would tweak multifocal prescriptions a lot, a practice that is not realistic and leads to disappointment. Use the fitting guide to make one or maybe two adjustments. Have the confidence to face your patient and say ‘this is as good as we can get it’. It is amazing how often they will accept that statement and happily choose to continue with those contact lenses. It avoids the endless pursuit of perfection and puts a sensible limit on chair time.

Increasing Choice for the Practitioner and Patient
Good choice exists for frequently replaced soft multifocals with options available in daily disposable and monthly modalities. Adding to this selection, it is worth being aware of some more recently released designs too. Available in three adds, Johnson & Johnson’s 1-DAY ACUVUE® MOIST® Multifocal is a new hydrogel daily disposable. It combines the performance of etafilcon A with an optimised aspheric centre-near design that accounts for pupil size variance due to both refractive error and age across the power range. Bausch + Lomb’s Biotrue® ONEday for Presbyopia is another new hydrogel. It delivers a centre-near, three-zone progressive design with two add powers. Less recent, but an important alternative in this category is the Clariti® 1-Day Multifocal from CooperVision, currently the only multifocal daily disposable available in a silicone hydrogel material. With many patients choosing part-time contact lens wear, increased choice in the daily disposable portfolio is welcome. Perhaps the most recent addition in the frequent replacement sector is the PureVision®2 for Presbyopia from Bausch + Lomb. Offering an updated design with a wider intermediate area and predictable, efficient fitting, it is a welcome addition to the silicone hydrogel category, alongside other options such as Alcon’s AIR OPTIX® AQUA Multifocal which offers three add powers.

In summary, fitting presbyopes with multifocal contact lenses is best done early and with good clear communication to ensure your patient’s expectations are realistic. Have confidence to be proactive with this group of patients and you will experience the professional and business rewards that follow.

This article was published originally in OPTIK Magazine, February 2016.

KAREN WALSH, MCOPTOM

Karen Walsh, BSc(Hons) PGDip MCOptom FIACLE Medical Research Fellow Phone: (519) 888-4567 ext.37548 Email: karen.walsh@uwaterloo.ca Karen graduated in Optometry from Cardiff University, Wales in 1997. She subsequently worked in the UK across all forms of clinical practice, along with supervising undergraduate contact lens clinics at Aston University, Birmingham. Following seven years of working with Brian Tompkins in his independent practice that specialized in contact lenses she joined Johnson & Johnson Vision Care as a Professional Affairs Manager for the UK & Ireland in 2007. Karen has authored clinical articles and educational training programmes on both contact lenses and UV radiation; she has lectured internationally, and has taught at the VISION CARE INSTITUTE™ of Johnson & Johnson Vision Care in both Prague and the UK. She holds a post graduate diploma in Clinical Optometry from City University, London and is a Fellow of the International Association of Contact Lens Educators. She joined the CCLR in 2015 and currently holds the post of Medical Research Fellow.

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METRIC #2: INVENTORY TURNOVER RATE

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