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“ 7 Best Practices in<br />
Contact Lens <strong>Management</strong>”<br />
Laurie L. Sorrenson, O.D., F.A.A.O.<br />
Austin, Texas<br />
LakelineVision.com<br />
Sorrenson@att.net
% of Gross Income<br />
AVERAGE<br />
• Professional fees 35-40%<br />
• Spectacles 40-50%<br />
• Contact lenses 15-20%<br />
16%<br />
• Other sales 1-2%<br />
Source: MBA Key Metrics
30%<br />
Percent of active patients who wear contact lenses, even part time.
$64<br />
$110<br />
$135<br />
$158<br />
$174<br />
$201<br />
$221<br />
$255<br />
$298<br />
$478
SCL gross profit margin<br />
Low Average High<br />
Contact lens exam fees<br />
New Spherical Contact Lens Patient:<br />
Lowest Next 20% Median 20% Next 20% Highest<br />
$120 $153 $181 $221 $274<br />
Established Contact Lens Patient:<br />
Lowest Next 20% Median 20% Next 20% Highest<br />
$95 $112 $139 $167 $215<br />
Definition: This is the normal, undiscounted fee for a comprehensive eye exam and lens fitting for spherical new<br />
contact lens patients, or the normal, undiscounted fee for a comprehensive eye exam for existing contact<br />
lens patients not requiring refitting. Source: MBA, 2008
The profitability of contact lenses for<br />
European eye care practitioners 2<br />
ECPs<br />
<<br />
1.5x<br />
2. Ritson M. Which Patients are More Profitable? Contact Lens Spectrum March 2006:38-42.<br />
2007-05-0535
“In the time that it takes me to fit a<br />
patient for contact lenses I could<br />
have sold two pairs of spectacles…”<br />
2007-05-0535
ONLY<br />
3. McLean K. Best of Both Worlds. Eyecare <strong>Business</strong>, April 2006.<br />
4. Goldberg L. Contact Lens Prescribing Revisited. Ophthalmology <strong>Management</strong> April 2006.<br />
XM =<br />
2.5 Years<br />
2007-05-0535
5. Nowak J. <strong>Business</strong> school studies contact lens profitability. PCONSuperSite.com April 2006.<br />
6.Goldberg L. Contact Lens Prescribing Revisited. Ophthalmology <strong>Management</strong> April 2006.<br />
7.McLean K. Best of Both Worlds. Eyecare <strong>Business</strong>, April 2006.<br />
XM =<br />
15 Months<br />
Examination Fee<br />
2007-05-0535
60%
Conclusions<br />
8. Ritson M. Which Patients are More Profitable? Contact Lens Spectrum March 2006:38-42.<br />
2007-05-0535
Contact Lens<br />
Patient<br />
Spectaclesonly<br />
Patient<br />
(2.4 yr. purchase cycle<br />
@ $242 per sale)<br />
6 year value of contact lens and<br />
spectacles patients<br />
6-year<br />
CL Revenue<br />
($119/year)<br />
6-year<br />
# of Full<br />
Exams<br />
Median<br />
Exam Fee<br />
Revenue<br />
6-year<br />
Spectacle<br />
Revenue<br />
6-year<br />
Patient<br />
Revenue<br />
$714 4 $480 $484 $1,678<br />
$0 3 $270 $606 $876<br />
Contact lens patients generate 91%<br />
greater revenue over 6 years!<br />
Source: Practice Advancement Associates estimates based on CL industry audits, CIBA Vision wearer model, <strong>Jobson</strong> Publishing frames and lens estimates. 2007-05-0535
Discount on Back Up Glasses?<br />
–10%? 20%? 50%?<br />
–Free Frame?<br />
–Free Lenses?
SunGlasses<br />
Consider sunglass display in<br />
contact lens dispensing area
30%<br />
Percent of active patients who wear contact lenses, even part time.
Positive Correlation<br />
Percentage of contact lens patients<br />
and…<br />
... annual gross revenue<br />
per active patient
How can we increase % of<br />
Contact Lens Patients?<br />
STUDY<br />
32% MORE $<br />
21
Proactively present CLs<br />
to glasses patients<br />
(Dailies for frame styling)
Same Day = Exam + Fit + Dispense<br />
Staff = CL insertion<br />
Staff = Scribing<br />
Staff = CL Review<br />
Staff = CL orders
Follow-ups
Delegation
#3<br />
“fine”
How are you doing with your<br />
contact lenses?<br />
“Fine / OK”<br />
“OK” - all right;<br />
satisfactory or under control;<br />
adequate but unexceptional or<br />
unremarkable;<br />
tolerable 9<br />
9. http://dictionary.reference.com/browse/ok<br />
2007-05-0535
"How are your contact lenses?"<br />
“Oh, they’re adequate.<br />
Kind of unexceptional,<br />
you know, tolerable…”<br />
2007-05-0535
“My patients will tell me if they<br />
are not happy”<br />
WRONG!<br />
2007-05-0535
Total SCL<br />
Dropouts<br />
Went to Eye<br />
Doctor to Solve<br />
Problem Before<br />
Dropping out?<br />
Yes<br />
46%<br />
No<br />
54%<br />
Tried any different<br />
brands/types prior<br />
to dropping out?<br />
Yes<br />
9%<br />
No<br />
37%<br />
Less than 50% even saw an ECP<br />
Only 9% tried a different brand<br />
before dropping out<br />
CIBA Vision data on file, 2006<br />
2007-05-0535
“My patients will tell me if<br />
they are not happy”<br />
WRONG!<br />
% experiencing<br />
at appointment<br />
% telling<br />
the doctor<br />
Eyes dried out when wearing CL’s 81% 44%<br />
Contact lenses felt uncomfortable at EOD 73% 34%<br />
Eyes felt irritated when wearing CL’s 60% 26%<br />
Ability to see changed throughout the day 52% 18%<br />
Among patients switching to another brand of lens at last appointment<br />
CIBA Vision data on file, 2007.<br />
2007-05-0535
Are they telling us?<br />
Eyes got red 48% 16%<br />
Vision was blurry or hazy<br />
after sleeping in lenses 39% 7%<br />
Cleaning and disinfecting<br />
too much of a hassle 36% 3%<br />
Contact lenses required<br />
% experiencing at<br />
appointment<br />
% telling the<br />
doctor<br />
too much effort 35% 4%<br />
Among patients switching to another brand of lens at last appointment<br />
CIBA Vision data on file, 2007.
How are you doing with your<br />
contact lenses?<br />
“Fine / OK”<br />
Getting past<br />
"Fine"…<br />
9. http://dictionary.reference.com/browse/ok<br />
2007-05-0535
Case history – ask probing<br />
questions!<br />
"Comfortable ALL DAY?"<br />
"…change ONE thing…"<br />
2007-05-0535
Case history – ask probing<br />
questions!<br />
Sleep??<br />
Nap??<br />
2007-05-0535
Don’t want to sleep in<br />
their lenses<br />
54%<br />
Sleeping??<br />
25%<br />
21%<br />
Want to sleep overnight<br />
in their lenses on a<br />
regular basis<br />
25%<br />
21%<br />
Want to sleep<br />
overnight in their<br />
lenses occasionally<br />
Source: CIBA Vision, data on file, 2005.
Ave. = 21 nts/mo.<br />
41% > 7 nights<br />
–28% not approved<br />
for such use<br />
66% accidentally<br />
Sleeping in lenses<br />
fall asleep/nap<br />
(Source: CIBA Vision, data on file, 2005)
Case history question of the day<br />
Tired?<br />
Red @ End of<br />
Day??
Limbal hyperemia<br />
•“… significant decrease in limbal hyperemia within one month …” 3<br />
“Bulbar and limbal hyperemia decreased significantly …<br />
The reduction … occurred mainly between the baseline and 1 month visits. 4<br />
3. Dumbleton K. Daily wear performance of Silicone Hydrogel Lenses. www.siliconehydrogels.org June, 2005.<br />
4. Dumbleton et al. Redness, dryness and comfort following refitting long term low Dk hydrogel lens wearers with silicone hydrogel lenses. Optometry and Vision Science 81<br />
(12S):31. 2005-12-0640
Ordinary hydrogel lens N&D contact lens<br />
Limbal Redness<br />
Localized Oxygen Transmissibility<br />
at Lens Periphery<br />
Vascularization<br />
Bulbar Redness<br />
Limbal hyperemia is directly related …oxygen transmissibility in<br />
the peripheral… area of the lens. 6<br />
The minimum Dk/t necessary to avoid limbal hyperaemia in<br />
daily wear = 125. 5<br />
5 Papas, E. On the relationship between soft contact lens oxygen transmissibility and induced limbal hyperemia. Exp Eye Res<br />
1998;67(2):125-131.<br />
2005-1-0005
Dangerous Attitude??<br />
My patients<br />
are satisfied!<br />
2007-05-0535
#4<br />
Same Products
The two most powerful words in<br />
your vocabulary…<br />
"I recommend"<br />
2007-05-0535
2 - 3 Years<br />
2007-05-0535
Daily<br />
2-week<br />
Monthly<br />
Replacement Schedule<br />
5.7% replace “every couple of days”<br />
0.5% replace up to a week<br />
18% replace every 3 weeks<br />
23.1% replace every month<br />
3.8% replace every 4 to 6 months<br />
47.6% replace every 2 weeks<br />
28.3% replace every 2 to 3 months<br />
66.2% replace every month<br />
93.8% replace<br />
every day<br />
0% 20% 40% 60% 80% 100%<br />
Source: Bailey, GM. Shovlin, JP. Compliance and Contact Lenses.<br />
Review of Cornea and Contact Lenses March 2006:2–3.<br />
2007-05-0535
0.75 Cyl<br />
Spherical<br />
Equivalent<br />
Specs??
Keys to Success<br />
Enthusiasm<br />
2007-05-0535
#5<br />
Not charging
Review
Basic<br />
Complex<br />
Specialty
"What contact<br />
lens exam?"
Recommendation from<br />
Clarke Newman, O.D., F.A.A.O.<br />
• Pick five specialty lenses<br />
• Learn them "inside out"<br />
• "Don't worry about making<br />
money on your first few patients<br />
because it will make you a lot of<br />
money in the long run."
#6<br />
Annual supplies
Make it easy
Review<br />
Annual<br />
Supplies
Laurie Sorrenson, OD, FAAO<br />
Sorrenson@att.net<br />
www.LakelineVision.com<br />
Austin, TX