By Charles Aldridge, OD
Prescribe a care regimen to contact lens patients–and have staff reinforce your initial conversation–to improve lens care compliance and comfort. Here are three critical conversations to have with your patients that will reduce costly contact lens dropouts–measurably.
Over the last year, my practice has made a conscious effort to not only prescribe contact lenses, but to prescribe detailed care instructions including a specific solution to use. The more guidance we provide our patients, the more comfortable they are in their contact lenses and the longer they stay in them, bringing long-term revenues to the practice.
According to “New Data on Contact Lens Dropouts: An International Perspective” by John Rumpakis, OD, MBA, a study published by the Review of Optometry in 2010, the loss of a single contact lens patient may cost your practice up to $24,000 over the patient’s lifetime. Since becoming more specific in the instructions given to patients and recommending one specific brand of contact lens solution, dropouts in contact lens wear in our practice has gone down by at least 50 percent. Here is the three-conversation approach my practice uses to facilitate comfortable, long-term contact lens wear.
Charles Aldridge, OD
Aldridge Eye Institute
Southern College Of Optometry, Class of 1980
Two Doctors ODs
Annual Comprehensive Examinations
16 percent of Gross Revenue
Doctor-Directed “Solutions Differ…Here is the Best for You.”
When a contact lens patient is in my exam chair, I have a conversation about the care necessary to keep them comfortable in their contact lenses. If they are new patients who are being introduced to contact lenses, I start at the beginning, explaining the care regimen necessary for the contact lenses I have prescribed, and if they are not daily-replacement contact lenses, which solution should be used. Here is how the conversation might sound:
Doctor: “Julie, I’m glad we finally got you in a pair of contacts–I think you’re really going to like them. But before I send you to our technicians, who will go over proper insertion and removal of the lenses, I wanted to talk to you about the importance of proper care. As I mentioned, these are one-month disposable contact lenses, so you can wear them for a full month, but it is important that you remove them every night to sleep, both to give your eyes a rest and to cleanse the lenses. For daily cleansing and storage, I am prescribing Alcon Opti-Free PureMoist.”
Patient: “Oh, my best friend wears contacts and we were talking about how I’m about to start wearing them, too, and she told me I could save a lot of money by using one of the generic solutions instead. She said they all work the same, so you might as well save money.”
Doctor: “Actually, that’s a popular and understandable misconception. It would be great if that were the case because, of course, we all want to save money, but, unfortunately, there are big differences in the quality of branded solutions like Opti-Free PureMoist and generic solutions. While it’s true that all solutions, even the generic ones, disinfect, not all improve wettability and enhance the comfort and performance of the contacts. Also, not all generic brands are compatible with the material your contact lenses are made of–silicone hydrogel. The solution I have prescribed was specifically designed with silicone hydrogel contact lenses in mind.”
Patient: “Oh, I didn’t realize it actually mattered. It kind of bothers me, though, that it’s more expensive than the stuff my friend uses.”
Doctor: “Believe me, you will literally see how comfortable the solution I have prescribed keeps your eyes.”
Contact Lens Technician-Reinforced: “As the Doctor Pointed Out….”
Just as I would hand-off an eyeglasses patient to the optical to pick out frames and ophthalmic lenses, I hand-off a contact lens patient to one of our contact lens technicians: “Julie, I would like to introduce you to Sheila, our contact lens technician who will go over everything we talked about regarding the care of your contact lenses, including the importance of using the solution I have prescribed, as well as the proper insertion and removal of your lenses.” At that point, our technicians have been trained to reinforce my care and solution prescription. Here is how the conversation between technician and contact lens patient might sound:
Technician: “Wow, I see here this is the first time you’ve ever worn contacts. You must be really excited! I remember how excited I was to finally have an alternative to wearing glasses all the time. As the doctor explained, there are a few things we have prescribed for you to do to make sure you love your contact lenses long-term. The first is that you follow your wearing cycle regimen very closely, and throw out your lenses once a month and put in a fresh pair. The second is that in the days between lens replacement you take your contacts out every night to rest your eyes and thoroughly clean the contacts. As the doctor pointed out, the best way to clean your lenses is to rinse them off the way I am about to show you and then store them overnight in the solution we have prescribed, Opti-Free PureMoist.”
Patient: “Is it really that much of a big deal? I mean what would happen if I wore the contacts for two months instead of one or if I happened to try out–just to see if I like it–a less expensive kind of solution?”
Technician: “I can understand why you’d like to simplify your regimen further and keep costs down–with everything getting more expensive these days, it’s understandable! But as the doctor explained, it’s important for the health and comfort of your eyes that you follow the care regimen we have prescribed. Not changing your lenses at least once a month can result in the build-up of dirt and bacteria on your lenses, increasing your chances of eye infections and making the contacts not work as well–you won’t see as sharply in them or they may begin to make your eyes feel dry.”
Patient: “Oh, so I guess you agree with the doctor that there is no way for me to cut costs on this one?”
Technician: “The doctor and I are definitely in total agreement there! But on the bright side, using the solution we prescribed makes it much more likely you will enjoy your contacts and that your eyes will remain healthy.”
Give CL Patients Take-Away: “Here is the Kit with the Solution You Were Prescribed”
We not only have the two vital conversations–with the doctor in the exam room and with the contact lens technician in the optical–but we also give the patient a contact lens care kit with a sample bottle of the solution we have prescribed, an empty case and printed-out instructions that explain yet again how often they should remove their lenses, how they should clean them and what solution they should use.
We know that especially first-time contact lens wearers may be overwhelmed at all the information we have given them, so we want to make sure they have information that they can refer to whenever they get confused. It’s equally important for patients who have been wearing contact lenses for years to have this information (as well as the conversations on prescribed care and solutions with the doctor and technician) because many of those patients have so far not been following the right regimen.
Here is the send-off our technician might give a contact lens patient after reviewing the care and solution prescription, while handing the patient the contact lens kit:
Technician: “Now, if you have any questions at all, Julie, don’t hesitate to call or e-mail. We want to make sure you stay as comfortable and healthy as possible in your contacts.”
Patient: “Thanks! I’ll do my best to do everything the way you showed me.”
Technician: “Great! I know how much information we gave you today. To help you remember, here is a contact lens care kit with the solution we have prescribed and a contact lens case. And, here is a print-out of all the instructions we went over on how you should insert and remove your lenses, how often you should change them, how you should rinse them off and store them–and, importantly, which solution to use for the nightly rinsing and storage.”
Patient: “Thanks again–I think I can handle this. I’ll let you know if any questions come up.”
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Charles Aldridge, OD, is the owner of Aldridge Eye Institute in Burnsville, N.C. To contact him: firstname.lastname@example.org.