What do you do after your questions are answered?

I often hear Docs aren’t asking enough questions. But I have to question if more questions are really the answer.

Great questions open the door for personalized solutions. No question, without a doubt. But where I see a disconnect, is if after a line of questioning the doctor learns the patient really is doing “fine” they simply refill the current Rx and they make the mistake of not allowing the patient to experience innovative technology that potentially takes them from “fine” to fanfriggintastic!

The “if it ain’t broke, then don’t fix mentality” is broken.

It’s a big reason why people don’t value a contact lens exam and why they think contacts are commodities. We cannot passively sit back and let our patients be ho-hum about their contact lens experience. That passivity often broods resentment as the patients see you just as a barrier between them and a new supply.

Instead, I advocate for docs to provide patients with lens technology that will enhance their experience and help to best maintain their ocular health, even if you refill their Rx. This means that I’m often fitting patients who are doing fine with their current contacts into a different brand that I feel would improve their contact lens experience or improve their odds of not having a contact lens-related issue.

Giving options

My formula is pretty simple, I ask open-ended questions that give me insights into how they are really doing with their contacts. I look for a “foot in the door” statement that allows me to set up another solution. If their current contact is something that I will re-authorize, then I let them know. Words sound something like, “I will take a look at your current contacts and if everything looks good with it, I will get a refill on your prescription for them. In addition, I definitely want you to check out at least one other option that I think you will like even better. Most likely two more as I have in mind an amazing contact that is a game changer for a lot of patients.” I give them the teaser and as we are doing the fitting, I give them the reasons why they are going to love it.

I will say something like “Ok, so what you are wearing is Option 1. However, next, we are going to try Option 2 which I think you are going to like even better. It should be more comfortable, give you better vision especially at night, and its super breathable so it will help keep your eyes in great shape.” That’s it, short and sweet but I do it with passion and enthusiasm. (side note: my office has a flat fee for a contact lens exam, regardless if its a renewal or a refit. This means I don’t have to be concerned with additional cost to the patient. I don’t have a lower fee for a simple renewal. Ask me more about this in the comments)

I then get it on their eye, check it and if it’s a good fit, let them know they will be taking it for a test drive. Option 2 mimics the wear schedule of their current contact, which means monthly 99% of the time even if it’s a “2-week” lens. I feel like this is an easy move for them to make as I can’t remember a patient who said no.

Then…and I get that this last step goes above and beyond what most are doing, I get Option 3 on their eye. Option 3 is daily disposable. “Next you are going to try something that I think you’re really going to love. It was a game changer for me. I feel its the safest, easiest, most comfortable and most convenient way to wear contacts. It’s in your eye than in the trash, aka a daily disposable. You put it on in the morning, love it all day and as your watching Netflix in bed you can just take it out and throw it on the floor. Just make sure your hands are clean.” Wait for the smile, smirk or chuckle then proactively address the 800-pound gorilla and the elephant in the room. Cost and waste. Both of which are easily diffused. (more to come on this topic in a future write up)

The follow-up

After that I let them know we will be scheduling them for a follow-up in a month. I tell them to do a week of the daily disposables, and then 3 weeks with the monthly. (I write “save” on one pair of the daily disposables to ensure they have a pair to wear into the follow-up.) I let them know to pick the one they want the Rx for and wear that into the follow-up so I can find out about their experience with it and make sure that after it’s been on their eye that it’s still the best one for them. I tell them if neither of the new ones are better than the old ones to email me directly so we can figure it out.

We have been about 75% daily disposable as of late much in part to this method.

I harbor the viewpoint that getting innovative technology on eyes is beneficial to the patient, the practice, and the profession. For the patient, its an opportunity to provide a better contact lens experience, often times in ways they didn’t think about or felt like they didn’t really care about! It becomes routine to hear something along the lines of, “I’m so happy you had me try these out. I thought I was doing fine, but these really are better! I love them.” For the practice, you become somebody they look forward to seeing versus an obstacle. For the profession, you help patients understand contacts are not commodities and that optometric care is essential if they want to have the best contact lens experience.

Bottom line. Tell patients what to do. The caveat is to do it in a way that allows them to feel good about it and ultimately thankful for it.