Type in contact lenses on your favorite search engine, and within seconds, your screen is invaded by a barrage of discount mail-order contact lens companies. On Google, this search brings up more than 12 hits on the first page alone. Scroll to the bottom of the first page, and youve got 10 more pages to go. A sampling of these hits: JustLenses.com, 1-800-CONTACTS.com, Lenses ByMail.com, ACLens.com, Lens.com ... The list goes on and on, inviting more of your patients to forfeit your personal service and concern for their eye health to save a buck.

Does that leave you feeling frustrated? Dejected? Depressed? Well, in the words of Chers character in the film Moonstruck, Snap out of it! How? By following the seven tips provided by your colleagues in this final installment of Take Back Your Contact Lens Practice.
1. Provide excellent professional care.
Some patients tend to view contact lenses as commodity items rather than medical devices, so you need to concentrate on the non-commodity aspects of your practice to retain your contact lens patients. You have to provide the highest possible level of servicemeaning annual exams, progress exams and fitting special hard-to-fit cases, says Jerry Hayes, O.D., owner of Hayes Consulting in Ponte Vedra Beach, Fla.

Optometrist Glenda Secor, of Huntington Beach, Calif., agrees. I have found that choosing to make professional care, not contact lenses, a priority in my practice has translated into contact lens sales, she says. I really take the time to educate the patient about corneal health, and explain why I feel a particular lens is best for a patient. Doing this shows the patient that I can offer her the kind of personal care and eye-health expertise that a mail-order contact lens company cannot.

Provide a high level of service by educating the patient in the exam room, and your patients are more likely to buy their contact lenses directly from you.

To validate her professional care, Dr. Secor charges her contact lens patients with a professional exam evaluation fee (fitting fee)something she feels that not all practitioners do, but should. I feel that if you do not value your professional time, the patient will not value it, and frankly that will cause her to go elsewhere for her lenses.

New York optometrist Susan Resnick adds that charging a professional fee is also important because if the patient ultimately decides to fill the prescription elsewhere, you will not feel the loss financially. Your fitting fees, not the sale of contact lenses, should really be the bulk of your income, because there are some patients who are going to go elsewhere, regardless of the service you

2. Set up an e-commerce section on your practices Web site.
One reason mail-order contact lens companies may be hurting your practice is because you do not have your own e-commerce section on your Web site, says optometrist Gary Gerber of the Power Practice, a practice management consulting firm in Franklin Lakes, N.J.

Dr. Resnick decided to add an e-commerce link to her practices Web site (www.eyewise.com) about a year ago. A lot of patients told me that they were interested in, for instance, 1-800-CONTACTS, because of its convenience, but they never mentioned price, Dr. Resnick says. This was a red flag that convenience was as important as competitive pricing, so we decided to get an e-commerce link.

She had the lens-order page tailor-made to feel as homey as a phone call and to require as little work as possible for the patientsomething Dr. Resnick says has added to the allure of the link. The link has been very successful, and our contact lens recall cards now include a little note that alerts our patients to it, she says.

If youre thinking about putting an e-commerce link on your own practices site, Dr. Resnick suggests you look on optometry web sites, and read the currently available optometry and ophthalmology journals for advertisements and articles on e-commerce companies.

Optometrist Morris Sheffer, of Charlotte, N.C., has had an e-commerce link on his practices Web site for a year. His advice: Talk to your colleagues and your sales representatives about what e-commerce companies are out there. You can also find e-commerce companies by visiting your favorite search engine and typing in sell online.

Before you decide to add an e-commerce link, however, keep this in mind: By directing your patients to your link, you are also inviting them to check out other contact lens vendors, says optometrist Neil B. Gailmard, of Munster, Ind. Also, your staff will have to enter patient names, lens data and expiration dates for every case in advance if you use a third-party service, even if only a small percentage of your patients use the service.

3. Offer competitive pricing, but dont price yourself out of the market.
Many patients do not choose alternative contact lens sources based solely on price. I have found that patients tend to choose a contact lens vendor based on convenience and other factors, Dr. Secor says. So, you want to offer competitive pricing, but you dont necessarily want or need to meet the prices of the mail-order companies. I feel that matching their prices devalues my professional services.

To get as close as she can afford to the mail-order company prices, Dr. Secor looks them up on the Internet and calls their customer service lines. Once you find out what the true bottom-line is for replacement lenses from these mail-order companies, you can forge a plan to be competitive, yet still profitable to some extent, she says.

One way you can show patients that you offer competitive pricing: Use a worksheet that shows the mail-order contact lens fees vs. your fees. Having this sheet dispels the belief perpetuated by these companies that eye care practitioner pricing is exorbitant, Dr. Secor says.

Dr. Hayes adds that it is also important to offer competitive prices because if you price materials higher than the visible competition, you send a solid signal to your patients that your other fees may be out of line.

4. Offer incentives to provide an annual supply of contact lenses.
Ensure that your patients do not enter the mail-order market by offering them incentives to purchase an annual supply of their lenses with you. We try to get as many patients as we can to purchase their annual supply of lenses up front by reducing the per-box cost, Dr. Secor says. If the patient orders one box, the fee is customary. If the patient orders four or eight boxes, depending on the modality he is in, the per-box price is less. Some contact lens manufacturers help her patients purchase a years supply of lenses by providing new patients with $20 to $60 rebates, she adds.

But, you argue, dont sales of annual lens supplies promote noncompliance with exams? Not necessarily. Your patients will come back to see you if you can convey the importance of doing so, Dr. Gerber says. That goes back to how you and your staff interact with your patients when they are in your exam room.

While some practitioners opt for a six-month supply instead of an annual supply, Dr. Gerber disagrees with this decision. I feel that it is perceived by the patient as holding the lenses hostage because in order to get their lenses, they have to return to your office, he says. This will make your contact lens patients less likely to return to your office.
5. Keep a small inventory of your most frequently prescribed brands.
This is key to countering (and even beating) the convenience touted by mail-order contact lens companies. Why do patients go to Walgreens when they can order personal products at drugstore.com? Because they want or need the product now, and they like doing business in person, Dr. Gailmard says. They dont want to hassle with logging on to their PC, entering a credit card, waiting for delivery and wondering if they will be home to accept the package when it arrives.

Thus, nothing is more convenient to a contact lens patient than having a friendly employee hand her her contact lenseseither at the end of the regular exam, or on a drop-in, reorder basis, Dr. Gailmard says. If your office is the actual source of lenses, rather than the mailman, most of your patients will become comfortable doing business that way, he says. And, the cost of keeping eight multipacks of lenses in 0.25D steps, from -0.50D to -6.00D, in your favorite brand is surprisingly inexpensive. It amounts to 184 boxes of lenses, which total a little over $2,000 if you figure an average wholesale costa very small one-time investment toward retaining contact lens sales.

If you have a new patient, or you run out of a specific lens while another patient who uses the same lens is being examined, use doctor-directed delivery to dissuade the patient who was in the exam room from going elsewhere. Doctor-directed delivery enables you to have the lenses shipped directly to the patient from the manufacturer, Dr. Resnick explains. Many of the contact lens companies offer this alternative, and its great because the patient doesnt have the inconvenience of having to come back to the office and pick them up.

6. Offer a liberal exchange policy.
A liberal exchange policy reveals an aspect of customer service that cannot be found with mail-order companies. With our daily wearers, for instance, many of them tell me that by the end of the year, they always have 10 more right lenses, than left, so Ill give them 10 left lenses, Dr. Resnick says. I dont take back tons of open boxes, but I take back enough, and thats the cost of doing business.

7. Stay ahead of the curve on technology.
There are always new contact lenses on the horizon, so stay up-to-date on the latest innovations by reading the journals or attending CE courses. This way, you have the opportunity to be the first to offer these new products to your patients, Dr. Resnick says.

Also, realize that there are some great contact lenses that are not available through mail order, Dr. Resnick adds. So, if you feel that any of these lenses would benefit your patients, consider incorporating them into your practice as well.

For example, Ocular Sciences, a CooperVision company, only distributes its lenses through retailers that provide substantial eye care services.1 And, CooperVisions Proclear Compatibles lenses are only available to such establishments as independent eye care practices, select optical chains and select wholesale clubs and mass merchandisers.1

We need to be proactive and not reactive to mail-order and alternative delivery sources, and we need to accept that there are a proportionate number of people who are going to go to alternate sources just because its the thing to do, Dr. Secor says. But, you can prove to certain patients that you are not more expensive than the mail-order contact lens companies and that you can provide services they cant get from the mail-order companies.

1 .Federal Trade Commission for the Consumer. Commission and Staff Reports. The Strength of Competition in the Sale of Rx Contact Lenses: An FTC Study.www.ftc.gov/ reports/index.htm (23 May 2005)

We Want to Hear From You
Have a suggestion for winning the battle against mail order contact lens companies? E-mail ahellem@jobson.com with Letter to the Editor as the subject line. Or, send it by snail mail to:

Letters to the Editor
Review of Optometry
11 Campus Blvd., Suite 100
Newtown Square, PA 19073

Vol. No: 142:6Issue: 6/15/2005