Practice Management

Pandemic Progress: Big Lessons So Far & Where We Continue to Make Gains

By Eric Rettig, OD

Oct. 28, 2020

When our office initially closed for a then-undetermined amount of time, it was one of the most difficult and contentious decisions we ever had to make as a group. What were we going to do about staff, unpaid bills, health insurance and other practice concerns? Here are the takeaways from our experience so far and where we are now, including our major milestones in progress.

After six and half weeks of that uncertainty, we were able to reopen our doors on a limited basis. As outlined in a previous article, we took extensive steps to keep our staff and patients safe while still providing the best eyecare we possibly could. Through the closure and reopening, our goals from a financial aspect changed drastically. We hoped we had enough to pay our bills and our staff. The Paycheck Protection Program was a huge help with that. It covered payroll, utility bills, health insurance, rent and several other major expenses. This allowed us to see patients and get money back into our bank accounts. This also was a huge help with cash flow/cash reserves. Being able to get those jump-started has been a massive factor in our financial security after we reopened.

Two Key Lessons
People Want to Be Seen By their Eye Doctor
One of the biggest things we learned when we reopened is that people wanted to be seen. Badly. Not only for emergent issues (which we were still seeing while closed), but just to get new glasses, order contact lenses, have their yearly diabetic exam, follow-up on their glaucoma, or any other non-emergent medical eye issue. People want a sense of control and normalcy in these completely uncertain times.

To be able to go outside of their home, while still practicing mask wearing and social distancing, have a conversation with someone and do something for themselves was something most people missed more than we anticipated. These behaviors are one factor we think drove sales in our optical and in contact lens sales. We did not change how we presented products to patients (second pairs, lens upgrades and other potential purchases). People just seemed more willing to make those purchases.

How You Manage Scheduling Makes a Huge Difference
Another huge factor we realized helped increase our sales was how we scheduled patients. Many practices have schedules for the clinic hours, but also have a schedule for their optical–for dispensing, repairs, frame selection, or anything that an optician may be needed for. This is something we never embraced at Mountain View Eye.

We had always had an “open door” policy as far as optical goes. People could come in anytime to pick up their glasses, pick out new frames or to have other eyecare needs addressed. This could make our optical extremely busy at times, which would add extra stress and cause our opticians to feel rushed. Once we reopened, we implemented a schedule for our optical department purely to keep the number of people in the office down at any given time. What we happily found was that when the optical department doesn’t feel as rushed or busy, they have more time to present things to the patient that would increase sales.

This includes upgrades to frames and lenses (more expensive frame, thinner material, anti-reflective, etc.) as well as second pairs of glasses or prescription sunwear. Our first month after reopening we saw a marked increase frame capture rate (up 20 percent from last year), lens capture rate (also up 20 percent), and our revenue per eyewear pair (increase of 6 percent from last year). This is all done while seeing an overall decrease in our number of refractions (down 25 percent) because we missed over six weeks of normal clinic hours.

Where We Are Now
Back to Full Steam
We’ve gone back to full capacity from a patient number standpoint. Initially we were about 60-70 percent patient volume, but now we are back to full volume. Patients are coming to our office for anything and everything eye related (comprehensive exams, emergencies, medical eyecare and follow-up care, among other needs).

We have a large office with eight exam lanes in which we are able to maintain patient flow so that there is little-to-no congestion in any area of the office. Patients are asked to come by themselves, unless they need a caregiver with them. Also, all optical needs (repairs, frame selection, dispensing) are scheduled ahead of time to cut down on walk-ins.

After we were extremely busy in June/July/August we found that we were greatly exceeding our expectations. July grew by nearly 50 percent compared to the same month in 2019. We decided this year to add digital photopters (Topcon (CV 5000) to six of the remaining eight exam rooms that still had manual phoropters. This allowed us to be further from the patient during refraction and has streamlined their time in the exam room. This, in turn, keeps the patients total time in the office to a minimum.

More Eye Emergency Patients
We have been seeing an influx of eye emergencies. We’ve been getting many referrals from local urgent care centers and primary care providers for ocular emergencies. We think part of this uptick is because there are some offices in the area that even now aren’t operating at full capacity and many patients are still avoiding the emergency room as much as possible.

Areas of Sales Growth
We definitely have seen an increase in sales of blue light protection eyewear. One of our doctors was even interviewed on the local news on that very topic. The standard AR that we recommend to patients includes approximately 30 percent blue light filtering, and the usage of that has gone up by 10-15 percent.

We’ve also seen a huge increase in selling anti-fog wipes and sprays. We tried several when we initially reopened and settled on one that we felt worked best and was the best value for patients. We went from selling next to none pre-pandemic, to selling 10-20 units per week since we’ve reopened.

Contact lens sales have also increased. We’ve always been adamant about making annual supply sales, but more and more people are open to trying contacts, especially presbyopes. Many are working from home or on a computer full-time, so they’ve inquired about multifocal lenses. Our multifocal contact lens fits have increased by about 15 percent.

Rainy Day Fund

Editors’ Note: Practice management consultants recommend that 2-3 months of money should be put aside for future emergencies

A Continuing Crisis & Ongoing Effort
I do not want to call this our “post-COVID” time because we are still very much in the midst of this pandemic. And our practice is continuing to take every step to keep our staff and patients as safe as possible while in the office. But I can say, besides learning to be prepared financially for disaster, we have learned a lot about our ability to adapt to unusual situations, and even use them to our advantage to continue to grow our business and allow it to thrive.

Eric Rettig, OD, is a partner with Mountain View Eye, a Vision Source practice in Altoona, Penn. To contact him: ericmrettig@gmail.com

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