Practice Management

3 Ideas from Outside Optometry = $2,600 More Monthly

Dr. Richard, far right (in green) with her staff members. Dr. Richard says that she has gotten valuable ideas for improvement from outside of optometry.

By Melissa Richard, OD

Jan. 25, 2023

Great ideas can come from the optical industry conferences and association meetings you attend, but transformative ideas can also come from outside of the optical world. Here are a few ideas from outside of optometry that made a huge difference to how we care for and serve patients and grow our profitability.

Offer Good, Better, Best Pricing in All Aspects of the Practice
The Good, Better, Best approach to pricing has been widely adopted throughout industry. Here is an excerpt from a great article in Harvard Business Review by Rafi Mohammed that discusses the history of Good, Better, Best in the auto insurance industry. It tells the story of the 2005 Allstate launch of the Your Choice Auto program:1

“The program relied heavily on modifications to a feature in the company’s standard policy (which it continued selling) called accident forgiveness, in which drivers who went five years without accident claims would have no premium increase after their first accident. It introduced a Value plan, priced 5 percent below Standard, that didn’t include accident forgiveness. A new Gold plan, priced 5- 7 percent above Standard, offered immediate forgiveness (no five-year wait) along with a deductible rewards feature in which repair costs borne by the driver would decline by $100 for every year of accident-free driving. And at the highest end, a new Platinum plan (15 percent above Standard) also included forgiveness for multiple crashes and a safe-driving bonus under which credits were issued for each accident-free six months,” according to the article.

The Good, Better, Best approach is applied throughout my practice:

Screening Tests: We started out when we opened offering the Optomap for $40 as an alternative to dilation for our comprehensive exams. We got around a 75 percent acceptance rate. A couple years later, we started offering a “wellness package,” which included the Optomap, iWellness OCT and the Macular Pigment Optical Density (MPOD) for $60.

We created a form where patients would check off their risk factors for AMD, glaucoma, diabetes, and other eye diseases, and then check off if they wanted the Wellness Package, Optomap only or no extra testing.

Having the increased options increased our capture rate for the Optomap (or higher) to 90 percent, generating an additional $600 monthly. It seemed as if offering a “best” option made some people choose Optomap who hadn’t in the past.

Optical: I created three options for progressives we offer bundled with AR lens treatments. The optician will always first offer the “best” option. Since we use these combinations often, it is easy for her to price them out with each of the vision plans we accept. If there is any push-back on price, she can go down to the “better” option and to the “good” if needed.

Medical Eyecare: We offer multiple solutions for dry eye and meibomian gland disease (MGD). We now offer Low-Level Light Therapy (LLLT), TearCare and Intense Pulsed Light (IPL). I present this in the exam room as the Good, Better, Best options to the patient.

Using a Good, Better, Best approach enables us to increase self-pay/out-of-pocket payments from patients over and above what is covered by their insurance/vision plans. Patients value our expertise in offering them the best quality products and technology. It also feels good to offer your patients multiple levels of solutions that you know they aren’t getting elsewhere.

In addition, narrowing down choices to Good, Better, Best makes your life simpler, especially in the optical, and it makes it less overwhelming for the patient to make a decision.

Empower Your Employees
The Ritz-Carlton approach to staff management gave me this idea. I was invited to a meeting in January 2020 that featured John Cashion, Director of the Ritz-Carlton Leadership Center, as a keynote speaker. He spoke about the effectiveness of empowering your employees, your “ladies and gentlemen,” as he called them, instead of “employees.” Giving your employees the power to make decisions for the company will allow them to better relate to your customers and will allow your customers to better relate to them.

I have since delegated more tasks to my employees, giving them an area of the practice to make “their own.” I ordered business cards for everyone. I also started offering monthly personal incentives if we hit certain goals.

This approach of employee empowerment improved the relationship between our employees and patients, which helped boost both care and sales. It also helped me because my employees started solving problems without having to involve me at every step.

Patients were better served by a more attentive staff, and we made more money. Our patients were happier and more likely to spend more money because they felt they were being better served by us. Offering incentives to the staff also helped them sell whatever we were targeting for improvement (AR lens treatments, year supplies of contacts, more Optomaps/wellness screenings, etc).

Morning Huddle
Many restaurants have a daily huddle to review the specials of the day, assignments and other important information. Some have the wait staff try the specials, so they know how to describe the meals to customers.

Our whole practice team meets in the morning to review the charts for the day. We make sure we have the paperwork together for the new patients. We review the testing established patients have done in the past. We note if they wear contacts, what their insurance allowance is and what rebates are available. If they wear glasses, we note the add-ons they have gotten in the past.

Additionally, we only offer services we have tried ourselves. We try each type of progressive lens, Neurolens, Transitions Lenses, AR, multifocal contacts, daily disposable contacts, dry eye treatments and other products and services. We have an internal ambassador for each service or product we offer. We discuss at the morning huddle which of our internal ambassadors will be needed to provide guidance to each patient coming in that day.

Having a quick staff review each day makes the check-in process much faster. It makes screening more efficient if we know the patient needs to do Optomap or dilation, for example. If the patient will be ordering contacts, we can quickly tell them what they’ll owe. If they’re ordering glasses, we know what they like and can offer them upgrades. The established patient feels like we remember them and know their preferences. This makes them feel like “regulars” or part of the family.

Patients have proven more likely to spend money when we remember what they got last year. If you can present them the cost of the year supply of their contacts, they are more likely to purchase at the time of the appointment.

Thanks to the information at our staff’s fingertips about each patient via our morning huddle, our Neurolens sales increased by over $2,000 monthly. Like many other products and services, sales of this product are dependent on technicians running the necessary test and opticians to help sell the lenses. A morning huddle reminds staff of the importance of conducting needed testing and reviewing resulting product needs in the optical.

1. The Good-Better-Best Approach to Pricing, Rafi Mohammed, Harvard Business Review, September-October 2018

Melissa Richard, OD, MS, is the owner of Spectrum Vision in Chalfont, Penn. To contact her:

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