The key to success in optometric practice today is balancing medical eye care and optical dispensing. Optometrists are in a unique position to provide both vital vision care services seamlessly, which, in turn, can result in extremely high levels of patient satisfaction and loyalty.

In this article, the second installment of our series, Back to the Basics, we will discuss how to make optical dispensing a huge stimulus for your practice growth.


A Fresh Look

During the past 30 years, as the scope of optometric practice has rapidly evolved and expanded, two factors have created an urgent need for better optical care.

The first factor is the shift away from optical dispensing services provided directly by optometrists. While one would never know it by observing practice patterns today, optometrists once actually performed some optical duties themselves. They assisted with frame selections, measured seg heights, adjusted eyewear and handled many other fundamental tasks. While I strongly believe in delegating these duties to trained employees, my observations as a consultant for many practices indicate that the widespread absence of the optometrist in the dispensary has led to a decline in the quality of optical care delivered.

The second factor is the unprecedented growth of retail optical storesespecially those owned by discount corporations. In an effort to provide eyewear at the lowest possible price, it is difficult to find enough highly-skilled opticians to handle the huge volume of eyeglasses sold in such venues. Optometrists in this mode of practice have little or nothing to do with the selection and fitting of eyewear.

A basic tenet of good business is to find a need and capitalize upon it; I see a need to provide higher quality optical products and services.

While optometrists have become complacent about eyeglasses and are increasingly more interested in providing medical eye care, patients often fail to make the same distinction. Consumers think eyeglasses are very important visual aids, but some individuals also have a very poor understanding of ophthalmic lenses. Quality eyewear is expensive and people want to find a professional advocate whom they trust when they make the purchase. Eyeglasses that do not fit or work properly can undo all the efforts the doctor put forth to achieve the best vision possible for the patient. Private-practice optometrists are perfectly positioned to fill the void. Here is how you fit in.

The O.D. as CEO

 Today, the primary role of the optometrist in optical dispensing must be considered from a business standpoint. For an optical dispensary to reach its full potential, the O.D. should be an active leader in all aspects of the operation. In reality, there is often very little management occurring in any area of optometric practice, especially the optical department. It is typically on autopilot.

The dispensary at Gailmard Eye Center in Munster, Ind.
The Management and Business Academy, an educational program sponsored by CIBA Vision and Essilor of America that studied over 850 highly successful optometric practices since 2005, found that more than 80% of the typical optometrists work week is spent performing eye exams. 

While that may be acceptable in smaller practices, larger practices need the owner to work on both the business and clinical aspects.
An optometrist should be integrally involved with the following management duties of the optical department in a private practice:

Lead the customer service culture of the optical department by setting the tone for how people are treated and how complaints are handled.

Develop and review sales policies and warranties.

Examine the frame inventory. Consider number of frames, range of styles and price points.

Work with optical staff members to create a strategy for frame buying, including what lines to carry.

Set and monitor optical prices.

Monitor vision plan participation and profitability.

Supervise and approve frame/ lens displays and merchandising.

Manage all staffing issues.

Develop and lead training programs for staff.

Review quality control


Develop a process for ordering, receiving and delivering eyewear.

Supervise in-office laboratory services and equipment.

Meet with lab, lens and frame representatives to remain current with lens technologies.

The O.D. as Patient Advisor

Optometrists can become focused so intensely on the medical aspects of an eye exam that optical needs are completely overlooked. In some cases, O.D.s are so self-conscious about not wanting to be perceived as product salespeople that they overcompensate and ignore optical products altogether. In truth, optometrists should play an important role in the selection of optical products.

As the premier expert on ophthalmic lenses, coupled with data from the eye exam, the doctor is in the best position to advise and educate the patient while still in the exam room.

This service is part of good eye careno matter where the patient decides to purchase eyeglasses. If the patient chooses to buy glasses from the practice, this consultation is the beginning of a sale.

The role of the O.D. in optical products begins with the case history. In addition to the medical aspects of a history, optometrists are trained to analyze how the patient uses his or her eyes at work and play in order to properly prescribe lenses. Ideally, this service not only extends beyond arriving at the best prescription power, but also should result in recommendations for lens design, including optional lens features. Multiple pairs of glasses are often a consideration. This prescribing service is best done in consultation with the patient. Through patient education, interview and discussion, the doctor can recommend the products that will best serve the patients needs.

It is important to distinguish between simply listing options for the patient to choose from and recommending what you think is best. Patients prefer the latter. Take a stand and tell the patient what you think will best serve his or her visual needs and prescription. Do not prejudge based on cost. Time and time again, we have been proven wrong when trying to decide from appearance how much a patient can afford. If the patient does not want to follow your best advice or cannot afford it, you can easily help him or her come up with plan B. However, patients usually want your expert opinion, and they will often follow it.


A System for Optical Sales

The optical department in my practice is simply an extension of my office, with a retail look and feel. While the goal in this department is to sell optical products and produce an excellent profit, that effort coexists nicely with our mission to develop and maintain a long-term relationship with the patient and his or her family. We build our whole practice by maximizing patient loyalty and cultivating patient referrals.

Eyewear dispensing booths at Gailmard Eye Center.
Success in optical sales can certainly be influenced by the optician. I believe in hiring people with a natural personality for selling and providing additional sales training; yet, I have also found that there are many factors that affect how well your practice generates sales. In the real world, we face a wide range of sales skill levels among our employees and associate doctors. Therefore, I find it is valuable to develop an office system that is bigger than any one personthe system can sell even if the individuals do not.

Building a powerful office system that attracts patients and drives sales upward requires a significant investment in time and money, but it produces the best return you can find. Once this type of practice is established, it attracts non-vision plan patients and out-of-network patients, and it stimulates vision plan patients to purchase products beyond their covered allowances. This is what I consider the infrastructure of an ideal optical dispensing system within an independent optometric practice:

Philosophy of service. The best strategy is to provide high-level

services and products. Be aware that service excellence is only sustainable if fees and prices are also at a high level. It is impossible in a business to be all things to all people. Although many O.D.s try to offer excellent service at reasonable prices, services typically end up dipping down to the average level. Without high-fee revenue, a practice cannot afford all of the things that will make it a great practice. This places most optometrists in the nondescript middle of the pack. There is really no competitive advantage to being in the middle.

The optical floor space.
I find that most optometric offices have insufficient floor space devoted to optical. I think this trend reflects the basic core belief that optometrists do not really like to deal with optical products. They want to be doctors, not salesmen. An impressive optical dispensary needs at least 1,000 square feet, and could easily be bigger. If that means that the whole optometric office must be larger to accommodate all the other clinical and administrative needs, so be it. Optical sales are too important to marginalize by floor design.

Optical displays. The dcor of the optical is extremely important to sales. Frame display units are primary, but lighting, furniture, wall surfaces, window treatments, carpeting, accessories and countertops all play important supporting roles. Optometrists may be so accustomed to the office furnishings that they do not notice when they become outdated.

Hire a professional frame display company and a local decorator to make your optical look like it is the best place to go for glasses. The investment may seem large, but the return is quite real.

Frame inventory. It is easy to simply continue to do what you have always done; however, fashion-related products must always be innovative and new. I recommend that you make time to be aware of trends in frame design and meet regularly with optical staff to discuss and review the lines you carry. Your current frame reps would be quite happy to have you continue to buy from them. But, unless they are providing new, cutting edge designs, do not be afraid to look elsewhere.

Attend Vision Expo and other major meetings. Read the optical magazines and research new lines on the Internet. Visit upscale optical boutiques in major cities and see what brands they carry. Push what you thought were the upper limits on high-end frame prices for your office; you may well find that the old limit was prohibitively low. Great optical dispensaries have large selections of frame styles. I think 1,000 frames on display is a good goal to shoot for. Do not forget to keep some understock so you can always fill the holes on the displays at the end of the day.

Sunglasses. Non-Rx sunwear is an exciting and fun aspect of dispensing, with offerings for the fashion-
conscious to the extreme sport-minded. Sunglasses sell well and add a nice profit center to your optical if you make a commitment and stick with it. And, carrying name-brand, non-Rx sunglasses helps you sell prescription sunglasses as well.

The role of scribing technicians. The use of clinical assistants as exam scribes offers many benefits in office efficiency. Also, they play a big role in the overall success of your optical dispensary. In my practice, the clinical technician stays in the exam room with the doctor and records all data in the chart.

At the end of the exam, she listens to the doctor-patient consultation and performs whatever is needed. The doctor does not have to walk the patient into optical, search for an available staff member, and repeat the eyewear recommendations that were just discussed. It is easy to cross-train clinical technicians to perform optical dispensing tasks, and it is a great business strategy to have one staff member work with the patient from start to finish.


Optical dispensing typically generates as much income for your practice as all the other services combined, and the optometrist does not have to perform the actual work. Dispensing is truly a jewel hidden in our own backyard, just waiting to be rediscovered.
Dr. Gailmard is President of Gailmard Consulting, a management firm that helps optometrists increase profitability, based in Nokomis, Fla. He is also in private practice at Gailmard Eye Center in Munster, Ind.

Vol. No: 145:04Issue: 4/15/2008