By Ken Krivacic, OD, MBA
August 2, 2017
I’ve had conversations lately with several colleagues on the future of contact lenses in an optometric practice. Particularly worrisome is the trend of declining contact lens sales through our independent practices, and the increase in sales through big-box and online retailers.
My research has shown a 2 percent increase per year in patients buying their lenses online over the past nine years. That is in line with nationwide trends for sales of contact lenses.
Statistica.com estimated that 16.7 percent of contact lenses were sold online in 2012. Alcon Vision has the current percentage of contact lenses sold online at around 24 percent.
One piece of good news is that contact lens dispensing is growing. The segment saw a 3.85 percent compound annual growth rate from 2011-2016, according to VisionWatch and Jobson projections.
Here are three suggestions for keeping your contact lens practice healthy, viable and profitable.
Promote New Products
Using new products helps build and maintain your contact lens practice. Patients want to know there are new contact lenses that will make their lives easier. In our practice, we have been promoting new contact lenses since I started in practice over 30 years ago.
You can produce excitement in your patients to buy from you by offering contacts that enhance vision capabilities, such as new torics or mutifocals, and by encouraging modality upgrades, such as moving patients into daily disposables, and moving patients into lenses that are healthier for their eyes, such as lenses with a higher oxygen transfer, or lenses that are more wettable.
Can you imagine wearing the same contact lens that was available 10 years ago? How about 20 or 30 years ago? That would be absurd. Yet how often do patients who come in for an eye exam and contact lens evaluation, and say they are doing fine, are told “let’s not make a change – you’re doing fine”? Isn’t part of the reason they come to you for your expertise? My recommendation is let them know about new products and promote them. The prime example is the daily-disposable modality. That modality is healthy and convenient for the patient. Let the patient at least try them. In our practice, we have grown to 76 percent daily-disposable usage for our soft contact lens patients.
What’s in it for the practice? First, it shows that you are on the leading edge of new products available. How many times have you heard from a new patient to your office that their previous doctor never recommended anything new? A progressive office is one that will continue to grow.
Second, new products generally command a higher retail price, and therefore, a higher net to the practice.
Third, by staying up-to-date on new products, and promoting them, patients have a greater reason to return to you on an annual basis, enabling you to keep your appointment book full. How many years does it take for the patient to look for alternate sources of purchasing their contact lenses if you never upgrade them to something new?
Use Technology to Promote the Value of the CL Evaluation
Do you want contact lens patients to return to your practice annually for their contact lens evaluation before purchasing more lenses? I would think all of us would. Sure, we want them to purchase their contact lenses from us, but we also know that bad things can happen to patients when they are non-compliant. Corneal edema, corneal ulcers and neovascularization are just a few of the unwanted side effects from wearing contact lenses. Part of our job as optometrists is to educate our patients on how to keep the eye healthy while wearing contact lenses.
Retailers who sell contact lenses are primarily concerned with profiting from the sale of contact lenses. The retailer, and to some extent, most contact lens wearers, do not view contact lenses as a medical device. Our job as optometrists is to educate our patients not only on the benefits of contact lenses, but also to make them aware of the consequences of the improper wear of contact lenses.
You can talk to your patients about the bad side effects from improper lens wear, but I believe a picture is worth a thousand words. That’s where technology can help you. You can better educate your patients, and thereby, tie them closer to your practice, by using and showing new technology through the evaluation process. This can be done with the use of corneal topography, specular microscopy and anterior segment cameras.
My favorite instrument for this is our specular microscope. About four years ago, I started doing a specular test on all our contact lens patients, and pulling the results up in the exam room on a monitor that showed the cells, along with a cell count. I explain to patients that if they are wearing a healthy lens, and wearing it properly, (i.e., not over-wearing), then the cells will look uniform and the count will be within the range for their age group. Most new patients have never had this test before, and most are surprised that contact lenses could hurt the cornea.
Prices for specular microscopes vary, but ours cost around $30,000. That means your monthly cost is to finance the equipment over 36 months is approximately $900 per month. For purposes of this exercise, let’s assume you see 100 contact lens patients per month. To break even on the cost of the equipment you need to increase your contact lens evaluation fee by $8.65 ($900/104). You could reduce the cost even more by financing over five years. At five years, your monthly cost is approximately $540, which reduces your break-even.
The bigger gain to the practice is a better educated patient, which has led to a more compliant patient. That is a win-win for both sides. Patients now come in wanting to know what their cell count is, and saying they are more aware of not over-wearing their lenses.
Use Technology to Help After the Sale
How often does a patient just want to buy what their insurance covers? If they get a minimal supply, what is your practice doing to ensure they wear the lenses as prescribed, and not stretch out the wearing cycle?
That is a problem in our practice also, and we have addressed it by putting a recall in our EHR system to alert the contact lens technicians when it would be time for each patient to purchase more lenses. This works to some extent, but it can be labor intensive with time spent trying to contact the patient and complete the supply of lenses.
To fix this problem, we recently partnered with a company called My Eye Store that makes the purchasing of contact lenses through our practice online an easier process for the patient. The company seamlessly integrates with our web site, and allows patients to order their contacts through us online. Once the patient has registered through the site they can order anytime. We can specify the products to sell and the price.
Editor’s Note: My Eye Store is just one of a variety of companies that can make it easier for ODs to sell contact lenses online through their own practice. Another company to choose from, for example, is CLX.
I realize that pricing online through other sites can be a challenge to compete with because they are constantly changing, and some of the advertised prices sound too good to be true. We can’t compete on price, but we now have a way to compete on convenience. We will also provide the ability to purchase eye drops, beauty products, like eye makeup remover and eyelash extensions, and contact lens solutions online.
Through an agreement with one of our contact lens vendors, Alcon, there is no set-up fee, and we will pay a monthly maintenance fee of $100. We keep 100 percent of the sales of our products. We will test out My Eye Store over the next few months. I don’t expect it to replace what we do currently–selling in office–but it could be a way to help recover some of the 24 percent of contact lens sales that most offices lose to outside vendors, as is reported by Alcon.
Let’s assume three of those 23 patients a month, who shop elsewhere, decide to do so, but through your web site. How much is that worth to the practice? Assuming the average net on a years’ supply of contact lenses is $85, then those three patients would return $255 to the practice per month. Is that monthly fee worth it?
A healthy contact lens practice, and a healthy contact lens patient, can be rewarding for any optometrist. As optometrists and practice owners, we must constantly strive to do what’s best for our patients, which in turn, usually is what’s best for our practices.
Our greatest asset is ourselves, and our ability to adapt to changes in this challenging optometric business climate.