Doctor Patient Relations

Lessons I Learned that Increased My Profitability By $85,000+ Annually

By Vittorio Mena OD, MS

June 2, 2021

Owning a practice offers the opportunity to learn many lessons. Some of those lessons can make a huge difference to your ability to serve patients and generate greater profitability. Here are three key lessons that are resulting in thousands of dollars in additional revenues annually.

Never Assume What a Patient Will or Will Not Purchase: Always Present Best Options First
Our job as eyecare professionals is to provide the best care for every patient. If there is something new and improved, we need to educate our patients on those newer technologies. That could be on dry eye products, contact lenses, nutritional supplements, myopia management, specialty contact lenses, vision therapy or another treatment. Like all humans, we tend to size a person up within the first few seconds of meeting them. The assumptions could be based on how well spoken they are, how they dress, how they communicate, their appearance or even their insurance. We assume patients can or cannot afford a product or service, but who are we to predetermine that for them?

For example, a person on Medicaid may still be willing to purchase a product they perceive as valuable. Patients want to know about the latest technology, whether that is a new television, smartphone–or eyecare product. Our job is to provide the patient with the information they need to make the decision that will be most beneficial to them. If the patient decides to do something else, at least you did your job as a clinician by presenting them with the best.

I once had a patient come into the office complaining of dryness in her eyes and discomfort in monthly contact lenses. I switched her to a daily disposable contact lens, but the lens I selected was still uncomfortable. I assumed since she was in a monthly lens that switching to a daily lens would be an unwelcome expense, so I selected a daily lens that was more “affordable.” The patient came back for a follow-up visit still complaining of the same issues of dryness and discomfort. I then decided to have her try Dailies Total 1. When she put the lenses in she was amazed. “I feel like nothing is on my eye,” she said. “I’m glad you enjoy those!” I replied. She then asked me the essential question: “Why didn’t you give this to me the first time?”

I realized that you should always present the patient with the ultimate best option first, and if price then becomes an issue, you can switch them to a less expensive lens. If they notice the difference in comfort after switching to the less expensive option, they will usually choose to switch back to the more comfortable lens, even if it is more expensive.

I now prescribe daily disposable lenses as the first option for most contact lens wearers. The front staff recommends daily contact lenses to our patients when they walk in, as will our technician, then the doctor, then finally at checkout with the optician, the patient will hear yet again about the benefits of daily disposables. After hearing that same message 3-4 times, and after trying daily disposables for themselves, most will decide to make a purchase.

The patient wins because they are more comfortable and hygienic in their lenses and the practice wins due to the greater profitability of selling daily disposable contact lenses. When you sell an annual supply of a daily disposable lens (depending on the type) over a two-week or monthly lens, the practice makes on average an extra $50-$150 per patient. An extra $150 per patient means that every 10 patients generate an additional $1,500–and I average at least 40 patients per month switching from a monthly or two-week lens to a daily disposable. $1500 x 4 = $6,000/month and $6000 x 12 = $72,000/year.

The practice also wins because the patient in a best-in-class daily disposable will probably be more comfortable than a patient in a second- or third-tier lens. And happy patients are more likely to tell friends, co-workers and family members about your practice.

Another example of offering patients the best first is center distance daily multifocal contact lenses for myopia control. These lenses are significantly more expensive for the patient because of the service it comes with. However, we still need to present the parent with the best option and explain that this is the best option because it lowers the child’s future risk of developing sight-threatening conditions. The same principal applies for any other specialty service you have in your office. Don’t be shy about presenting patients with everything you have to help them. They will appreciate you more in the end because you are doing everything you can to take care of them.

Always Ask Your Patients Open-Ended & Detailed-Oriented Questions
We need to ask our patients open-ended questions as opposed to questions that only give a yes or no response. Asking, “Do you like your contact lenses, are you having any trouble with your contact lenses or are your eyes dry with your contact lenses on?” elicits a yes or no answer. Instead, ask: “How can we enhance your contact lens experience? What can we do to make it more enjoyable for you to wear contact lenses?”

Patients sometimes assume that because they tried one lens in the past, and it caused dryness or negatively impacted their functioning, that all contact lenses will offer the same experience. I explain to the patient that today’s contact lenses are as different from a contact lens developed years ago as a new smartphone is to a phone that came out 10 years ago. The patient then often understands that they probably will not have the same experience in a newer lens that they had in a lens that was developed years ago.

 There are always going to be patients who tell you everything that is wrong with them as soon as they sit down in your exam chair. However, for many other patients, you have to pry out information to get to bottom of their discomfort. Only when you drill down to the root cause of the patient’s dissatisfaction can you find a solution.

In addition to asking open-ended questions about contact lens comfort and satisfaction, I always ask patients about their hobbies. I ask if they play any sports or have hobbies like fishing or playing poker. I also ask how many hours they spend on a computer or digital device daily. Getting patients to talk openly about their daily routines gives me a chance to prescribe the perfect pair of sunwear, computer glasses or another product.

It also pays to ask about the patient’s daily diet. That can open a conversation about the potential impact of nutrition on eye health, and why nutraceuticals might be a good idea.

Once you understand every aspect of your patient, the patient will feel at ease and be more likely to trust your recommendations. This is good for both the patient and practice. On average, I sell about three bottles of nutraceuticals a day and the office is open six days a week. That means I go through one case of vitamins in about a week and a half. $45 net a day x 6 days a week = $270 per week. On average, that is an additional $14,000 per year to the practice selling just three bottles a day.

Give Back & Get Involved with Your Community
If you can give back in any way it brings joy to both you and those you are able to help. Giving to others can boost dopamine in the brain, enhancing feelings of happiness. Charity work also can add purpose to life, confidence in oneself and bolster self-esteem. Giving to people in need in your community also shows your current and prospective patients that you care about others. The more the community sees you are interested in helping, the more people will recommend you to friends and family. That ripple effect can set you apart from other practices because word-of-mouth is the best advertising there is.

I have gone on mission trips to provide eyecare to under-served people overseas, and also am a clinical director for the Special Olympics Lions Club International Opening Eyes program for the state of New Jersey, where I volunteer 1-2 times a year. Many Special Olympic athletes become my patients because of this.

I typically get three new patients from each Special Olympics event I volunteer at, and sometimes those new patients refer others. That adds up to between $300-$1,500 annually per new patient. That means a minimum of $900 more per year and as much as $4,500 more per year. And that’s not even counting the patients who decide to recommend me to others because they want support a doctor who does charitable work.

I have photos in my exam room showing the Special Olympics events I have volunteered at. Patients see the photos and often ask me questions about it. Some even ask how they can get involved themselves. You get to give back, hone your doctoring skills and network with other doctors or students who will look up to you for advice, and then the circle continues!

Vittorio Mena OD, MS, is the sports vision director with Optical Academy. To contact him:menavitt@gmail.com

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