By Rachael Click OD
Oct. 26 2016
Revenue-per-comprehensive exam, one of the key barometers of practice profitability, is a strength for my practice.
But it wasn’t always. Initiating doctor-driven dispensing, coupled with strong staff training and effective optical hand-offs, has enable many more of our patients to leave with the total eyewear package I prescribe.
Our current revenue-per-comprehensive exam is $395. It has always been in the $390-$420 range above average as per Management & Business Academy (MBA) and Vision Council statistics. Our success depends on many factors including working together efficiently as a team strong communication skills and continuous staff education.
According to MBA data the median gross revenue per exam in independent practices is $306.
The top 10 percent of practices achieve a median gross per exam of $500 the bottom 10 percent just $159. The 5 percent of practices that generate the very highest revenue per patient produce $529 per complete exam. Click HERE to read more about this metric.
When our revenue-per-comprehensive exam needs improvement
We typically move the needle by increasing Transitions sales and annual supplies of contact lenses. We typically see an increased revenue per exam of about $80 on average for selling Transitions and when we average over 40 percent in annual contact lens supply sales our revenue-per-comprehensive exam also starts to rise.
Set Goal & Track
Make sure you are tracking your stats. Have a goal for your revenue-per-comprehensive exam and monitor it weekly monthly quarterly and yearly. Seeing the number is powerful and that alone can change the metric for the better. Over time we found the following approaches worked best in our practice:
Prescribe from the Chair
Doctors have to prescribe from the chair. The times in my practice–and probably yours–that we don’t do a good enough job at this is demonstrated through an occasional decrease in our revenue-per-comprehensive exam. An example of good doctor-driven dispensing is prescribing the correct optical product for the medical need of the patient.
For instance say a patient who has early onset cataracts is wearing Transitions DriveWear at night because the polarization of the lens helps reduce glare. We might also prescribe Transitions Vantage so that the lens is clear at night but still gets the additional glare reduction. Now the patient has two pairs of driving glasses for different light conditions.
Don’t Prejudge Patients’ Buying Power
Patients come to us because they want a doctor to meet their needs and solve their problems. It is my duty to prescribe the best products and explain the medical benefits to them. I don’t struggle with price concerns because I view it as my ethical duty to my patients to tell them all the options that would solve their problem.
I present a framework of prescribed options in contact lenses and eyewear and then enable patients to choose within that framework. When patients are made part of the decision making process they feel good and empowered about their purchasing decision and therefore the price.
For example I almost always only prescribe daily-disposable contact lenses. Within the framework of daily-disposable contact lenses, however, I engage the patient in choosing which one they like best.
In eyewear I always prescribe anti-glare lenses to reduce eye fatigue from fluorescent lights and computers. I also have trained my opticians to assume that Transitions lenses will be on every pair of glasses and have them engage with the patient about what Transitions color or feature of adaptability is important to them.
Create a Confident & Knowledgeable Staff
The doctor has to be doing a good job at doctor-driven dispensing but opticians also need the knowledge and confidence to fill the doctor’s recommendation as a prescription. Optical has to put aside personal bias regarding price and understand that the doctor’s prescriptions fulfill the patient’s medical and visual needs. Sometimes I see struggles with this in new staff members as their product knowledge and presentation is developing.
When I do an effective baton pass opticians are able to concentrate on the next step helping patients with frame selections measurements color choices of Transitions and insurance calculations. Ideally there is no “sales” component in the optical. However opticians need to be educated and prepared to answer patient questions and skepticism about the doctor’s prescriptions. They should be able to explain why the doctor prescribed what she prescribed and how each lens characteristic will benefit the patient. They have to be prepared in other words to seal the deal.