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<\/span><\/p>\nThe loss of a single contact lens patient has a cost, both to your patient and to your practice. For the patient who drops out of contact lens wear, they are doing so for reasons that can often be addressed by you, their doctor and contact lens specialist. For the practice, the loss of revenues from that patient is considerable, and, for the first time, a study has placed a value upon that.<\/p>\n
A patient who drops out of contact lens wear can cost a practice\u00a0up to\u00a0$24,000 over the patient’s lifetime. Much of that revenue loss is attributable to the fact that contact lens patients visit your practice more frequently than do eyeglasses-only patients and pay enhanced fees for the additional services you provide.<\/p>\n
Don’t Underestimate Dropout Rate The conventional wisdom is\u00a0that the\u00a0dropout rate is five\u00a0to 10 percent of wearers, but it is, in fact, much higher, according to an\u00a0ongoing worldwide study conducted by Practice Resource Management (PRM). An interim report on the study, which appeared in Review of Optometry in January 2010,<\/span> puts the dropout rate at 16 percent\u00a0in the U.S., and even higher in other parts of the world. \u201cWe don\u2019t know enough about how, why or which patients discontinue contact lens wear,\u201d said John Rumpakis, OD, MBA, founder of PRM, \u201cbut we do know this has a considerable economic impact on a practice.\u201d<\/p>\n Contact Lens Patients Spend…<\/strong><\/p>\n Contact lens eye exam Separate charge for CL services\u00a0 $70<\/span><\/strong><\/p>\n Spending on eyeglasses $245<\/p>\n Follow-up care Contact Lens Patients Dropout Because…<\/strong> Comfort\/fit: 50% (U.S. Data, based on 138 practices, 2009)<\/p>\n Be Part of the Study.<\/strong><\/p>\n The PRM study is ongoing. John Rumpakis, OD, MBA, founder of PRM, invites ECPs to contribute to the growing database about contact lens dropouts: http:\/\/GCLAC.PracticeResourceMgmt.com<\/p><\/div>\n Address Discomfort: Ask Patients Questions \u201cA lot of patients have issues they never mention to the doctor; they just put up with it.” says Kevin Roe, OD, director of professional relations at CIBA VISION. “If the doctor doesn\u2019t ask in a way that elicits a candid response, the doctor will never know. Eventually, the patient quietly stops wearing the lenses,\u201d\u00a0says Roe.\u00a0That\u2019s why Dr. Roe recommends that ECPs ask leading questions [see Talk the Talk, below], rather than a simple, \u201cSo how are you doing with your lenses?\u201d<\/p>\n \u201cMost patients will just say, \u2018Fine.\u2019 They don\u2019t know that the doctor could refit with a different lens material or design, that there is new technology that can help,\u201d Dr. Roe observes.<\/p>\n Use Many Tools to Address Discomfort Dr. Roe said ECPs should proactively refit low astigmats with toric lenses so they do not ultimately drop out for eyeglasses that provide sharper vision.<\/p>\n As contact lens wearers reach their late 30s, Dr. Bennett \u201cplants the seed\u201d by mentioning presbyopia and the multifocal lenses that are available. When they become emerging presbyopes, he refits with multifocal lenses before they drop out of contact lens wear. Dr. Bennett also recommends that presbyopes who previously dropped out of contact lenses try the newer multifocal lenses.<\/p>\n Talk the Talk<\/strong><\/p>\n How long can you wear your lenses? \u201cIs there a time or place where your contact lenses bother you?\u201d<\/p>\n \u201cDo you see better with your contact lenses or your eyeglasses?\u201d<\/p>\n Once the patient gives an answer that indicates a comfort or vision issue, Dr. Roe will respond: \u201cThere are new materials\/designs that can help you. I recommend that we try another lens on you today.\u201d<\/p>\n Are you happy in them? \u201cWhat would it take for you to love them?\u201d<\/p>\n Dr. Bennett responds by describing his plan to diagnose or address the issues.<\/p>\n When contact lens wearers are in their late 30s, initiate a new conversation. Recapture dropouts. \u201cHave you ever worn contact lenses?<\/p>\n \u201cWhen was this?<\/p>\n \u201cWhy did you stop wearing them?\u201d<\/p><\/div>\n<\/div>\n Present Benefits of Silicone Hydrogel Lenses Also in this contact lens series:<\/p>\n Part 1:\u00a0Recommend Daily and Monthly Lens Replacement, Improve Compliance and Profits<\/a><\/p>\n Part 2:\u00a0Prescribe an Annual Supply of Contact Lenses<\/a><\/p>\n Part 3: Specialty Contact Lenses: Growth Lies in Niches<\/a><\/p>\n Judith Lee is a health-care writer and founder of\u00a0Communication Works Now<\/a>, an online communications firm. Contact her at judith@judithlee.net<\/a><\/p>\n <\/strong><\/p>\n<\/div>\n
\n<\/strong>Dropouts are difficult to diagnose because great numbers of contact lens dropouts do so silently; they simply start leaving their contact lenses in a drawer. It is only when they are asked, by their doctor or staff in the course of an annual visit, “How are you enjoying your contact lenses?” that they reveal problems. Common answer: “Well, um, I don’t really wear them much…I mean, not at all.”<\/p>\n
\n$101<\/span><\/strong><\/p>\n
\n$157<\/p>\n
\nEyeglasses vision better: 16%
\nExpense: 12%<\/p>\n
\n<\/strong>The PRM study points to discomfort as the leading reason for dropping out of contact lens wear: Fully 50 percent of the dropouts in the study cite this, followed by 16 percent who say their vision is better with eyeglasses. The next logical conclusion: Effectively dealing with these issues can reduce the number of dropouts and minimize losses to your practice. Again, the challenge is patients are reluctant to speak up about lens discomfort.<\/p>\n
\n<\/strong>Steven Bennett, OD, FAAO, a contact lens specialist in Ann Arbor, MI, says clinicians now have excellent tools to resolve lens discomfort. If Dr. Bennett suspects a solutions issue, he will recommend a hydrogen peroxide care system, or refit the patient into daily disposable lenses. For dry eye patients, he will do a complete workup, then recommend whatever he believes will help: a different lens, prescription meds or over the counter artificial tears. \u201cA lot of patients think irritation is just a part of wearing contact lenses,\u201d he says. \u201cOnce the patient is educated about the problems, they often will not drop out because they understand it now,\u201d Dr. Bennett said. Patients with low amounts of astigmatism (52 percent\u00a0of the astigmatic population) are also likely to \u201cgrin and bear it.\u201d According to CIBA VISION data, something like 30 percent of current soft lens wearers have cylinder in their spectacle Rx, yet only 16 percent\u00a0are wearing toric lenses.<\/p>\n
\n<\/strong>\u201cCan you wear your contact lenses as long in the day as you need to?\u201d<\/p>\n
\n<\/strong>\u201cDo you love your contact lenses?\u201d<\/p>\n
\n<\/strong>\u201cYour eyes are fine now, but in the next few years you will be needing correction for near vision. There are some lenses that will really help you when you do.\u201d<\/p>\n
\n<\/strong>Dr. Roe suggests you ask these questions of every eyeglasses-only patient:<\/p>\n
\n<\/strong>Not only are newer lenses more stable, delivering better vision, they are available in silicone hydrogel (SiHy) materials, which is healthier for the eye and more comfortable for many wearers,\u00a0notes Dwight Akerman, OD, FAAO, director of professional programs for CIBA VISION. \u201cFor aging patients, silicone hydrogel materials are a major step forward. As people age, dry eye symptoms may begin or worsen. They need a lens that doesn’t exacerbate dry eye, and new silicone hydrogel designs fill that need,\u201d Dr. Akerman says.
\nSome\u00a061 percent\u00a0of single-vision contact lens wearers are now in SiHy lenses, but only 30 percent\u00a0of multifocal wearers are in SiHy, according to CIBA VISION data. Drs. Akerman, Roe and Bennett all say that proactively moving patients into monthly replacement lenses will improve compliance, which helps contact lens wearers succeed.
\n\u201cConsider that 72 percent\u00a0of patients who wear monthly replacement lenses are compliant with the manufacturer’s recommended replacement schedule, compared with just 48 percent\u00a0of two-week replacement wearers,\u201d Dr. Akerman explains. \u201cWhen you convert these patients, ECPs are supporting a better wearing experience.\u201d<\/p>\n