By Matthew Ward, OD
May 26, 2021
Presbyopic patients are eager to hear solutions that will help them recapture a sense of youthful vision. Many are also motivated to stay in their contact lenses. Others have never worn glasses and have no desire to start wearing them now. For most of these patients, multifocal contact lenses could be a way to happily manage presbyopia.
Here is how my practice delivers a high level of care to presbyopic patients while maximizing profitability.
A Subset of Patients Well Worth Growing
My practice is just in its third year, so we are still building all of our patient bases, including presbyopes. I recognize that this is a subset of contact lens wearers that is well worth growing.
Let’s say you offer a new multifocal contact lens to two patients per week and charge $150 for a contact lens evaluation. Profitability on each multifocal lens can be anywhere from $30-$50 a box, depending on how each practice prices.
So, if a practice is able to get a multifocal lens on two new patients per week, and that patient ends up ordering even a six-month supply of monthly lenses, that would be the $150 fitting fee per person, plus $80 profit on the six-month supply per person = $460 /week gross that the practice owner might have missed out on if they just didn’t offer the lens.
The $80 profit for six months comes from the fact that an annual supply (12 months, thus 4 boxes) is about $140 profit (depending on COG and what you set price). So, at only six months (2 boxes), it’s about half of that, and could be about $80 profit.
$460 is simply two new patients in contacts ($150 each for the fitting fee, $150 x 2 = 300). Plus, assume each of those patients orders a six-month supply. We just said that a six-month supply is $80 profit to the practice each. So, that means: $80 x 2 = 160. 300 + 160 = $460.
Now assume you could do that with one patient a day, and you are working 263 business days per year = $230/person x 263 days = $60,490. That number would be even bigger for a daily multifocal lens. A big deal.
Huge Growth Potential to Serve Toric Multifocal Patients
Most major contact lens companies have their own multifocal. CooperVision and Bausch + Lomb both also offer a monthly toric multifocal. I believe it is in this category of toric multifocals where there is the most growth potential.
Recent research from DeNovo Research Solutions suggests that up to 92 percent of presbyopic astigmats would be willing to purchase a multifocal toric lens if recommended by their eyecare provider. This same study indicated that 91 percent of patients have a more favorable impression of their ECP after being offered and trying the lens. We are in the business of improving the lifestyles of our patients. I have personally seen great growth in the practice, as well as an increase in patient excitement, when I am able to offer these products to patients.
Offer Multifocal CLs & Let Patients Experience It
Simply offering multifocal contact lenses has been my best marketing venture. I continue to encourage patients, even those who never thought of wearing contacts, into successful multifocal fits and lens purchases.
Let’s say we have a toric presbyopic patient, and I know that I can get their parameters in a contact lens. I’ll ask that patient if they ever considered contact lens wear. If they indicate they have zero interest (and you can judge this pretty quickly in the conversation), I move on without talking much more about it. However, if there is any indication of interest, I offer to have my staff put a contact lens on the patient’s eye so they can experience what their vision could be like.
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Patients don’t know what they don’t know. We can’t expect them to know if they want contact lenses if they have nothing to base that decision on. I explain that there will be no charge to have my staff put the lenses on, just so they can see what the vision would be like.
My staff member places the lens I am recommending on the patient’s eyes, and takes the patient back to the welcome area to walk around, look outside, read something. In 10 minutes, that same staff member comes back. They ask the patient what they think. If the patient isn’t impressed, doesn’t like it, or is not interested, the staff member takes the lens off, and no fee is charged to the patient. In my experience, this happens maybe one-in-10 times. The other nine-in-10 patients say something like, “Hey, I think we’re on to something here.”
After the patient expresses satisfaction and interest in the lens they have experienced, my staff member sits down with the patient and shares what the costs will be to move forward. We go over what the contact lens exam fee is, what follow-up fees are, and any other costs to the patient. If the patient at this point says, “thanks, but no thanks,” the contact lens is taken off by the staff member, and no evaluation is done by the doctor. Most patients who like the lens they experienced agree to the fees, sign the form indicating that we proceed, and then I see them again for a follow-up evaluation.
Manage Patient Expectations
I remind the patient they will always have clearer, more consistent vision in their glasses. I always say we can do a lot with polycarbonate or trivex, and anti-reflective lenses, blue blockers and other lens treatments, that we can’t do in contact lenses yet. I remind the patient that if they see 100 percent in their glasses, the goal is to hit about 80 percent in multifocal contacts. What I have found is that the three most difficult things for patients in multifocal contacts are:
1. Dimly lit restaurants
2. Medicine bottle print
3. Small book print.
Everything else should be pretty clear, from shopping to cleaning to cooking to enjoying weekends with family. I also remind the patient that it might not be perfect right away. I remind them we may need to tweak the Rx a little, and that is normal. I also explain simultaneous vision to the patient, as concentric ring contacts are different from a progressive lens.
With Practice, the Exam Room Conversation Doesn’t Take Much Time
It may sound like it takes a lot of time, but once you get your presentation down, it usually takes less than five minutes. Understand the patient may have questions, and that is OK. Whenever I feel like it’s taking longer than I would like, I remember that we are offering something new to this patient. Contact lens patients statistically come in more often for exams than eyeglasses-only patients, we profit from the fitting fees and these patients love their new lenses. It’s always great to have a new patient come in and say their friend/spouse/sibling was fit in multifocal contact lenses in our office, and now they want to try it themselves!
Matthew Ward, OD, is the owner of Valley Eye Clinic in West Des Moines, Iowa. To contact him: firstname.lastname@example.org