By William B. Potter, OD
To increase compliance, present contact lens patients with a value proposition: Daily replacement lenses cost more but provide more in comfort, eye health and visual performance.
William B. Potter, OD
Millennium Eye Care
Freehold and Marlboro, NJ
17-doctor practice
Pennsylvania College of Optometry
Class of 1983
Dr. Potter’s Specialties
Contact lens care, anterior segment disease (including non-contact lens patients and refractive surgery co-management).
Additional Practice Specialties
Cataract, glaucoma, cornea, retina, pediatrics and low vision.
Optical Dispensary Approach
“We put huge effort into our optical dispensary, with frequent remodeling, state-of-the-art computer inventory systems, and high-end eyewear.”
Annual Comprehensive Examinations
4,000
Yearly Patient Visits
6,500
Getting patients to adhere to approved contact lens wearing schedules has always been a challenge. It is sometimes hard to remember to throw contact lenses out after two weeks or a month. But I have found in my practice that patients seem to more easily remember to change their contact lenses on a daily basis. Between multiple locations, I have roughly 10,000 contact lens patients, with 1,000-1,500 of these patients in daily replacement lenses.
In addition to the health and comfort benefits to patients, daily replacement is more profitable to a practice. Assuming perfect compliance and 365 days per year of wear, the lens profitability is roughly double with a daily disposable ($100 vs. $200 profit).Perfect compliance, of course, doesn’t exist, but you can see that even if a smaller percentage, such as 70 percent, are compliant, daily replacement is still the more profitable modality for practices. Here are the benefits we have noticed by prescribing daily replacement contact lenses, and how we move our patients into this modality.
Present a Value Proposition to Patients
I offer a value proposition in presenting the costs and the benefits of the daily replacement modality. I present a simple calculation, assuming good compliance and name-brand contact lens solutions. Reusable lenses may be $200-$225 per year, plus $100-$125 per year in solutions, plus more in re-wetting drops. Our favorite daily replacement lens costs the patient about $400 per year. So, for an additional cost of $50 to $100 per year, the patient attains the benefits of comfort, safety, convenience and peace of mind. It’s not a hard sell in most cases. There is great value in the slightly greater cost.
In addition, I recommend stocking a year’s supply of your most prescribed daily replacement contact lenses to avoid shipping charges and encourage sales in the office. Offer discounted spectacle wear and sunglasses along with the purchase of daily replacement.
Daily Replacement High Compliance Tracked
I would claim 90 percent-plus compliance for daily replacement wearers. I base that estimate on self-reporting by patients combined with my examination of daily replacement contact lens patients’ eyes. The compliance has a huge secondary benefit, as daily replacement patients tend to be better at returning for an annual exam. This, in turn, tends to produce more eyeglasses sales, and encourages scheduling of family members. This leads to geometric growth of patient volume.
Daily Replacement for All New Wearers
For new wearers, if the Rx is available for the patient’s needs, I almost always advise a daily replacement lens. About 75 percent of my new spherical fits are daily replacement. Health, safety and convenience are superior for this modality. And parents don’t have to worry as much about a child’s compliance in daily replacement. A daily routine is easier to track than a biweekly or monthly wearing schedule!
Reduce Dropouts
Daily replacement wearers are less likely to drop out, as their comfort is better. Veteran lens wearers more often remain long-term contact lens wearers with daily replacement, as they often get frustrated with the storage and comfort challenges of wearing reusable lenses.
Encourage Patients to Try Daily Replacement: Enhanced Comfort, Performance
I go right to the heart of it and tell patients they will be less comfortable with lenses that must be reused. For what the patient saves with two-week and one-month modalities, it also may cost them in performance. A savings of $100 or $200 per year just isn’t worth the hassles of any potential complication or reduced performance. Sometimes it proves itself–most of our complications with daily replacement are due to non-compliance rather than the modality itself. Here is what I might say: “With these health and performance advantages in mind, I am prescribing daily replacement contact lenses for you….” That way I let patients know that in addition to daily replacement being better for their eye health, these lenses also will help them see better and will be more comfortable–an improvement they can see and feel.
Explain that “Daily” Replacement Really Means Daily
Just because you prescribe a daily replacement lens doesn’t mean patients will reap the benefits because at least some will neglect to change their lenses every day. Often patients who have not been compliant with the daily wear schedule complain of discomfort. That is always the easiest sell for the importance of adhering to the daily wear schedule. These non-compliant patients are usually hurting, so it’s not tough to convince them that a change in their routine is needed. Though we are a high-volume practice, I spend considerable time talking to the patient about complications. We are hands-on in our patient management. Our practice has every technological instrument you can imagine, but I have found that frank discussion about compliance rather than simply showing the patient pictures of their ocular surface gets us where we need to go.
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Eliminate Two-Week CL Prescriptions: Boost Compliance, Decrease Dropouts
William B. Potter, OD, is chief of optometry and contact lens service at Millennium Eye Care, in Freehold and Marlboro, NJ; and founder of Optometry on West 44th, in New York, NY. To contact him: eyedoc2180@aol.com.
