By Eric M. White, OD
Increasing revenue-per-exam begins in the exam chair. Educate patients about needed products and services—and pre-set them to spend in the optical.
My revenue-per-exam is higher than the optometric average, which usually is about $300. In fact, my revenue-per-complete exam is twice that amount averaging $600+. Was it just dumb luck or serendipity that got me to this point? On the contrary, it was a proactive attitude about increasing my understanding of business and effective implementation of practice improvements that did the trick. Here are the key changes I implemented after attending seminars such as those offered by the Management & Business Academy, The Disney Institute and Transitions Academy.
The last jump in my revenue-per-exam occurred after I started using the techniques learned from Patient Driven Dispensing from Transitions. I have never hired a practice consultant but did it myself through listening and learning what my patients want. That means prescribing eyewear based on lifestyle in the exam room. Rather than just relying on a combination of auto-refraction and my examination to determine the ideal prescription and eyewear needs for patients, I take the doctor-patient interaction to the next level by asking about the patient’s work and hobbies.
For example, I might say: “It looks like your prescription has remained stable from last year, Mrs. Jones. But we have other eyewear that might improve your vision and eye health. I see on our patient history form that you marked your profession as accountant and I remember from our past conversations that you also enjoy a hobby of wildlife photography. Based on those needs, I recommend progressive eyewear with Transitions to deflect glare on your computer screen at the office and a pair of polarized prescription sunglasses. It’s amazing how much the right sunwear enhances enjoyment of the outdoors.”
Thoroughly Explain–Don’t Sell in Exam Room
Lifestyle dispensing based on patient needs, in addition to what I prescribe based on my examination, works because I explain why the products are necessary. Just as I explain the benefits to a patient of polarized prescription sunwear or A/R, I might also explain why a daily contact lens is superior to a two-week or one-month contact lens. I also might explain–rather than just prescribe–why custom eyewear is worthwhile or show the patient pictures taken with an OCT and Optos to explain why a medical eyecare treatment plan for a condition such as glaucoma or macular degeneration is necessary.
Prescribing based on unique patient need is just the first step. The second step has to be this kind of patient education based on explanation of your exam findings and your understanding of the benefits of the products you sell.
Gain Staff Buy-In for Products Sold
It’s not enough for me to prescribe based on lifestyle and for the opticians to reinforce my prescription in the optical shop. I also need them to get behind the products we are selling. That means ensuring they are well educated about each product line we sell. This education can be done via visits from frame and contact lens representatives who can point out the key selling points about their products. For example, a lens rep might point out the scratch resistance of a certain lens and how to sell the enhancement of A/R to the lens. Or a frame rep might point out the fashion versatility of a certain line of products.
I also believe the doctor has to take a leading role in understanding the products the optical dispensary sells and in making sure in staff meetings that staff members understand and are enthusiastic about new inventory. For instance, if we begin to sell a new contact lens, I will ensure staff members know how to discuss the lens with patients, and if a new frame line is added, I might ask the optician who recommended or added the new line to give a presentation to other staff members.
Price Products According to Metrics and Market Trends
We get a survey from the local lab and compare where we are in our pricing compared to other optometric practices in the area. We want to be high-end but not the highest. On average, we raise our fees every two years. In addition, we keep track of how much our patients are spending per visit with practice management software that tracks and then breaks down how much each patient spends. For instance, I can see how much patients on average are spending on eyewear and then within eyewear I can see an easy breakdown of how much they are spending on sunwear. I can do the same for contact lenses noting how many more patients can potentially be moved into higher-performing one-day replacement contacts. Optos software from Ron Bussinger makes this kind of analysis easy.
Each year I take these product sale breakdowns and decide how we can do better to improve our care for patients and boost our revenue-per-exam. For example, I might note that while sales of second pairs of eyeglasses has increased, we could still do much better in sales of sunwear, and specifically, sales of prescription sunwear. Recognizing the potential for improvement in sales in a particular area alerts me to ways I can improve the patient education I provide. I might realize that I’m not spending enough time discussing the benefits of polarized sunwear.
Ensure Patients Understand What They Get for Value
We may increase our prices slightly every two years, but that doesn’t mean we’re insensitive to the cost concerns of patients. We educate patients about financing options like CareCredit and sometimes offer bundled packages of eyewear with a reduced frame price when a certain kind of lens is purchased or a reduced price on sunwear with the purchase of an annual supply of contact lenses or when it is purchased as a second-pair. We always want to make sure our patients leave with everything they need to achieve the best vision and eye health possible.
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