Donna A. Suter

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,” a blog series featuring contributions from members of the ophthalmic community. These blogs are an opportunity for ophthalmic bloggers to engage with readers with about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by 

, president of Suter Consulting Group. The views expressed in these blogs are those of their respective contributors and do not represent the views of Ophthalmology Times or UBM Medica.

On paper, your administrator and I want you to invest in and open an in-house optical. It just makes sense. You are already in the business of helping people see well, and the growing population needs eyewear.

It’s a great cross-sell to grateful patients who love your clinic and your surgical abilities.

But you should pay attention to 1960-the World Series, in particular, when the Yankees were coming off their tenth pennant in 12 years. They outscored the Pirates 55 to 27, they outhit them, average-wise, .338 to .256, they hit ten home runs against four, they got two complete-game shutouts from Whitey Ford-and still they lost.

I love sports metaphors, and I got this 1960 baseball story from a type-two, pre-cataract-surgery diabetic with a glasses prescription guaranteed to drive your optical manager crazy.
	What does baseball have to do with anything? It is proof that it is always possible to snatch defeat from the jaws of victory.

Losing is what you would be doing if you built out an old procedure room with frame bars, signed up for a bunch of vision plans to keep your optometrists busy, or hired a lone, hardly trained employee and anointed him or her with the unearned moniker of “optician."

More important than losing money, you would be losing your patient’s trust and good will. Google ratings are powerful, and every granny-and-pop shop in town knows how to write bad things about someone on a social media outlet.

Recruit like you want to be in the World Series. Opticians are not technicians who know how to refract. They are a wonderful blend of makeover stylists and mathematicians. He or she understands the importance of deadlines and time management and how to close a sale. The career path for opticians differs across communities and states but one thing is for sure-not understanding and paying market rates for top talent will hurt your optical’s performance in the long run.
		 

Run the optical like a small-business owner. Know how much money is in the bank, how far you are from set goals, and have a working knowledge about the steps between today and success. It takes a trained optician about 4 months to get up to speed. If you aren’t seeing the results you want by then, either start over or double down on training.
		 

Set your prices to make a profit. Spreadsheets are your friends. Do some basic projections and set your fees (retail on frames and spectacle lenses) so that you are making a net profit. Use MRRP (manufacturers recommended retail price) as a starting point. But remember, you are the one who is either taking a loss, or making money.
		 

Expect set-backs. Baseball has something in common with vision-plan participants. Getting a lifetime average of more than .300 gets a player in the hall of fame. Upselling 33% of the time is good. Being rejected is tough. Cheer your opticians on even when they strike out. They have to be willing to stay in the game even when they can’t seem to “buy” a decent sale.
		 

Don’t reward order-takers. “What are you interested in?” and “Let me tell you how your vision plan insurance works.” These are not the way to have a million-dollar optical. High-performing opticals are twice as likely to provide ongoing training as low-performing ones. Just like winning the World Series, closing a high-dollar sale day after day is a team sport. 
		 

Find out what the patient’s most visually challenging situation is and solve that problem with premium technology. There's a clear relationship between the number of questions asked and your optical’s chances of making a profitable sale. In other words, if you want your investment in a dispensary to go well, make sure everyone-from front desk to optical-is periodically posing lifestyle questions to the patients.
		 

Use your practice software. The optical software you use should be able to turn retail prices into vision plan reimbursement just like your clinic software. Accepting retail sale numbers and depositing just vision plan reimbursement (minus charge-back fees) means you may set up a commission sales plan for your optician that keeps them happy.


	
	The same retired sports writer who told me about the 1960 World Series is in a college football betting pool. Each participant puts in $32 at the beginning of the season and the national championship is the last game participants wager on. I looked at his statistical average for the 2018 college season.

Funny thing, the odds of him picking a winner are higher than anyone else in the pool. This is worth remembering because he has never won the pot.

Don’t presume your patients will choose to use your optical. Train well and choose your merchandise carefully. Being the odds-on favorite doesn’t guarantee a win.

Be excited about looking at the odds and following your team as they begin the long process of qualifying for playing in the World Series. Spring training is just around the corner and who doesn’t love a good ball game?

Everyone loves clear, sharper vision in life’s most challenging circumstances and I do think you should enjoy the profit of a well-run optical.

If it were not hard, everyone would be doing it. Let’s play ball!

Articles

It’s your optical’s time to play ball 

, president of Suter Consulting Group. The views expressed in these blogs are those of their respective contributors and do not represent the views of 

Would your patients walk 500 miles for an eye health appointment? If you can’t hear the music embedded in this blog, start your internal audio of the Proclaimers’ hit “

Think about how an army of devoted, sold-out fans compares to your patients.

Why isn’t devotion a thing in eyecare and premium eyewear purchases? It is with other lifestyle enhancement items. 

Doesn’t every Apple store have a line of devoted fans outside when a new product is introduced

? Why doesn’t that happen when you introduce new spectacle lens technology?

One barrier may be the way you and your staff talk about your services. For example, “Optical is just a convenience. We do mainly medical in my practice.”

I’m not saying it’s not important. You are saving vision and that’s your jam. Please continue to expand your skills. What I am saying is that do not do so at the expense of total patient care.

 loss of sight as the "worst possible" health problem someone could experience. This fear was cited by a majority of Americans (47.4%).

The author, Sarah Rense, wrote the following profound sentence: “Blindness, for those keeping track, is often preventable with regular healthcare.”

When someone asks, “What do you do?” Answer with, “We prevent 

 and help our friends and neighbors see clearly in life’s most challenging circumstances.”

You will be on your way to building a fan base of dedicated patients and the practice of your dreams. It means knowing and acting on the awareness that you are going to calm fears. Assurances that create patients willing to walk 500 miles to fall down at your door.

Fear of losing sight has a strong emotional element. Rational assurances of eye health do not make blurred vision go away. The consumer links poor acuity with vision loss. Providing quality eyewear is a total person fix.

This is one reason we don’t see (at least for now) “medical eyecare” chains and do see optical chains. There are healthier eyes in most of these practices than medical ones.

The optical side of our industry, managed properly, is hugely profitable in part because it assuages fears of blindness. The hard, demographic facts remain that there are fewer sick eyes than eyes that can be made to see better with glasses.

First, accept that the optical side of your practice instills patient confidence in your medical skills. Don’t run 500 miles. Embrace the total patient and his or her fears!

Go and learn about marketing and merchandising of premium products. (You don’t sell premium products? You do? Ask your patients if they think that’s the case.) What is it about a modern, premium product store that makes it so appealing? What is it about your least favorite store that make it not so appealing?

Your job is to communicate: Take charge of selection.

The number one flaw of the optical: self-help and allowing the consumer to order “just what my insurance covers.”

Computer stores do not encourage browsers. They know a fan that will walk 500 miles for next generation tech wants something custom built.
	Learn the story behind every frame and spectacle lens package you sell. Begin the story of visual comfort and clarity when you greet that patient. (This is called “lifestyle questions.”) Caring communicators first listen to patients.

They actively listen as he or she describes their most visually challenging situations. In the optical, the optician confirms the doctor’s recommendation and then takes charge of the sales and education process.

Having patients browse or wander around your optical is setting them up for confusion and your practice for reduced sales. Put yourself in a situation where you’re confronted with choosing one item out of 700 possibilities. Wouldn’t you want some guidance?

Better and more consistent staff training

You take CE to stay up to date, shouldn't your staff? One argument that often comes up is, “We're so busy, we can't close and give up appointment slots.” If you're also saying, “We're so busy but we're not maximally profitable,” there's a good chance that taking time to catch your breath once a week and focusing on office procedures with your staff is a great idea. Clearly, you can't afford not to close for about an hour each week.

If your practice is slow, the same thought still applies: You need to devote time to keeping your staff top notch, no matter what your patient volume. Successful eyewear recommendations match the patient’s visual and lifestyle needs. Every person who comes into your office should be asked to fill out a questionnaire that focuses on both health and lifestyle issues. Your pre-tester can then ask how much time the patient spends doing each potentially visually challenging activity.

Don’t know how to train employees to emotionally connect and listen? The following is my go-to list:

invite an industry trainer (like me) to your practice;

have employees scour the internet for premium eyewear information;

have them find and watch vendor-made YouTube infomercials;

have a “gathering lifestyle information” contest with the grand prize-perhaps a night’s lodging at the 

, or a boutique luxury hotel/inn near you;

enlist the help of the product manufacturers’ sales force.

In fact, have your staff ask sales reps the same questions asked by patients, and have them role-play the answers. Videotape these training sessions, and document them in a transcript. Then, compose a test from the transcript. Use this test as a training tool for new employees as well as a refresher course for your veteran staff members.

To help elevate your staff’s level of understanding of the nature of the sales process, take them on field trips to non-medical venues that sell premium products. For example, a shopping trip to a local high-end retail department store. Silence nay-sayers by providing them with a sheet to fill out.

This fill-in-the-blank should include the following answers to the HOW question:

the merchandise was shown to them and put back;

The sales check-out process was and whether any follow-up instigated another sale or lead toward building a better customer relationship.

When your staff returns, have them discuss their “findings” at a staff meeting, and brainstorm ways to make your patient’s buying experience more positive.

 or a stay at The Ritz-Carlton, premium eyewear fills a strong emotional need and rewards the patient for choosing it. How do you earn devotion? Raving fans willing to walk 500 miles?

“Blindness, for those keeping track, is often preventable with regular healthcare.”

Premium eyewear leads to patient compliance with treatment plans. By following the tips mentioned above, you and your staff will see the power of clear vison. Only then will you get your patients to see premium eyewear as more than devices that hold lenses paid for by vision plans that allow them to see “just OK.”

I challenge you to make sure all your medical patients have a great pair of up-to-date glasses that you are proud to have them wear. That way, you’ll be happy to say, “I do a lot of optical” with the same zeal that you profess your medical victories.

Medication compliance and regular exams are important to maintaining healthy vision. Turn your patients into a loyal ‘fan base’ with these consumer-friendly tips.

Crowds for hire: Finding the voice of patient needs

In your practice, it’s important to follow three rules when it comes to frame board management: Optimize inventory turnover, stick with ‘bestseller' classics, and be open to current frame trends.

Have you found yourself looking at your wardrobe and asking what pieces bring you joy? A new friend once offered me advice on how to dress. “If you would dress as I see you, you would be beautiful.”

I thought that an odd statement and never pressed for details. How would I know what clothes others would like to see me buy? Wouldn’t dressing to please others be a little emotionally unhealthy?

Reflecting back, 12 years later, I realize this individual was offering the same nugget of wisdom that Marie Kondo now shares-an invitation to find what sparks joy in my closet.

Do you see the application in your optical? Is it time to trim down the total number of frames in inventory to a more manageable number? Frame inventory is defined as the total number of eyeglass frames on display and in storage.

I recommend you decide on how many frames to keep on hand by looking at your historic turnover rate. Frame inventory turnover is defined as the number of pairs of compete spectacle Rxs (frames and lenses, excluding reuse of existing frames) dispensed in 12 months, divided by the total number of frames in inventory.

If you are just getting into the optical game, your turnover might be just once a year. If that’s you, really take a hard look at those frames. If the total number you own is over 500, consider cutting the number down to 500 until your turn rate improves.

If you are grossing $500,000 in optical sales, your annual turnover should be two to three times a year. I have clients who turn inventory six times in a year.  Four or five turns per year are optimal for most optical departments. Three turns per year is the minimum with which I suggest you will be happy.

Practice ratio lower than successful peers

One reason for poor performance may be that your frames aren’t sparking joy in consumers. Wanting your patients to see the beauty completely applies to successful frame board management. Marie Kondo-ing your frameboards to spark joy isn’t as odd as it sounds.

(NOTE: If you are the optician reading this blog, I did not just say it is OK to binge-watch her Netflix show when it’s slow in the optical. If you are the owner/manager, what I am asking you to do is to set an emotional climate that is supportive of change. Ground those positive emotions in reality. Your reality is the gap between where you are and where you want to be. That gap will not go away by itself.)

The challenge opticians face is that probably 20% of frame inventory sells very well. It’s the other 80% of that number that tend to cause heartburn.

Please, please don’t throw all your frames on the floor and wait for joy. Keep the basics and those required by the vision plan programs. Don’t replace or trade out inventory just because you are bored with what you have to carry.

There are two ways to evaluate frames. Selling a device needed to put spectacle lenses into and selling something that the patient feels excited about wearing.

‘Basics’ are frames which people come in and buy. “Bless their hearts” as we say here in the South. They haven’t heard of Marie or understand they should only wear what sparks joy. They just want what their plan provides or a repeat of what they have been wearing since they were 20.

Basics are also frames that are sure sellers. Some eyewear aficionados might refer to these frames as your bread and butter lines. These are styles that always sell. Styles like aviators or heavy geeky plastic frames. Bread and butter also refer to frames that fit a certain size face. Narrow-width women’s frames that fit a petite granny’s narrow face as well as frames that add structure to a full round face should always be on your frame board.

Within your budget, purchase 20% of the number for possibility thinking. Frames you think would add beauty to your patients’ faces. Frames that are different and not what the patient can find on a virtual frame-buying site.

To make room on your boards, and to have enough money to invest in fresh merchandise, may mean “breaking up” with an existing vendor and forming a new liaison. Before doing this, ask your frame representatives if he or she sells a product line that you don’t carry. Telling them what you don’t want more of might lead to a productive conversation about viable options.

Evaluate your current frames to determine which vendors have the product you need to achieve your goals.  When deciding between two sources, pick the one that will help train your staff. One of your most valuable assets is your people. Invest in optical training. They must know how to talk about the frames that you want your customers to buy.

When you get your new frames home, follow sound merchandising guidelines. Group frames by material, followed by eye shape, then by designer and vendor. Eye level is buy level. (This is the universal granddaddy of retail display.) This truism applies to frames as well as high-end merchandise in Manhattan boutiques.

And just like a boutique, put two or three really interesting frames on each group of dispensing tables.

How good are you at putting yourself in the other person’s shoes? Selecting frames that look good on someone that doesn’t look like you or anyone in your office requires thinking outside of the box. Freshening the frameboard means buying frames that are so appealing to the consumer that he or she wants to max out their emergency credit card just so they can wear them.

Powerful and productive change is accomplished when you think outside the box. A great frame buyer knows how to objectively observe their own frame-buying habits and then evaluates their own performance.
	Pick frames only based on styles that appeal to the consumer

Typically, a seasoned frame inventory manager buys frames that fall into categories. Categories might be gender, age and venue (men, women, children, unisex, Rx sun and sport) or retail price points. Examples of price point categories are budget, core, designer, and luxury.

As you evaluate your frames, ask and answer questions such as these:

Is it new and now? Would it appeal to a fashion-forward individual?

Is it sturdy enough for people who think they are rough on frames?

Is it so trendy that a diva looking for a unique look would have to have it?

Is the brand name a draw for my specific demographic patient base?

Cultivating empathy for your target market’s buying patterns means higher profitability and lower material expenses in the optical department-frames that sell won’t be around to return or to mark down.

Once you decide on a certain brand of frames, commit. Purchase a good representation of your new exciting frames and give them prime board space.

Frame buying is a skill that can be learned. To be financially successful, you must know what an acceptable inventory expenditure is when compared to revenue as well as what frame styles are hot right now.

In order to get an idea of what styles your patients are buying, sell off the boards and only reorder best-selling frames. (It’s a good idea to keep best sellers as understock. Understock is defined as merchandise not displayed on the boards but kept onsite, often in a locked storage room.)

I can see your practice sparkling from here

A good brand does for your practice everything Marie says your favorite outfit does for your personal swagger. Successful brands evoke an emotion in your patients. Positive relational connections enhance brain function. What this means to you is patients will buy it.

It also means you have succeeded in delivering your message clearly. You have confirmed your credibility and the patient will become a loyal patient.

Your frames project your practice image and links your identity with the brands you choose to sell. Just like you choose your clothes with care, manage your frames and display cases in the same manner. They all impact the way patients perceive you and your professionalism.

Enjoy the journey. Like efforts to reshape a wardrobe, it might take a little longer than you would have thought; but eventually you will create a beautiful signature look.

Suter is president of Suter Consulting Groyp.

Follow Marie Kondo’s lead and spring clean your practice to make way for fresh frames.

‘Spark joy’ in your ophthalmic practice with these frame board tips

In her latest blog, practice management specialist Donna A. Suter shares how you can allay financial fears and gain back profit using the three “R’s”: Relief, Recovery, and Reform.

President Franklin Delano Roosevelt offered Americans the New Deal in March 1933, which was a series of economic programs aimed at combating the financial slump of the Great Depression. The stimulus package passed because Roosevelt was focused on the "3 R’s": Relief, Recovery, and Reform.
	
	Back then, consumers were very uncertain of the economy and many expressed their fears when asked about the future. Flash forward 86 years, and not much has changed-many are still worried about their financial situations today.

However, you can make a ‘New Deal’ with yourself and use Roosevelt’s “3 R’s” as a template to alleviate financial woes and gain back profit for 2019.


		Everyone wants relief from managed care, and the first step in achieving this goal is identifying a profitable patient. This patient, statically speaking, comes with a good vision plan.
		
		Wouldn’t it be a relief if the staff time necessary to keep up with all the demands placed on doctors and employees could be paired with acceptable profit? Ask your management team if it’s possible to collect and analyze 24 months of raw data to determine your profitable patient.
		
		If your practice management software generates real-time performance data and profit-and-loss data, use it to track total receivables back to your most profitable revenue sources

Data, with proper analysis, can guide you into a future where tough decisions are clear. Demographic data is also available that tells you what that profitable patient looks like.
		
		Here is an 

 of how census data and practice can be compared and used:
		
		Most of the U.S.’ professional- and managerial-level workers are women. Women bring in half or more household income. Women also make the majority of health-related decisions for, not only themselves, but for everyone in her household. How are you catering to this demographic? Try treating this demographic with respect, and give her the option to upgrade to customized, VIP care.


		After he was sworn in, Roosevelt ordered all banks to close. He then asked Congress to pass legislation guaranteeing that citizens would not lose their money if there was another financial crisis.
		
		What bold move are you willing to make to recover? Can you convince patients that you are concerned about their vision, and not just your profit margin?
		
		Employees may look at a payor group on their digital device and discretely sigh or a shoot a subtle behind-the-back-eye-roll to a coworker. Both nonverbal gestures are noticed by intuitive patients.
		
		This patient might interpret this type of body language as animosity. The result is that he or she will purchase “just what my vision plan covers” or leave and purchase eyewear online. He or she is also the surgical candidate who says they are going to seek a second opinion. Small cues matter, and even the smallest-positive or negative-patient interaction counts.

What are you willing to change to attract the profitable patient? Can you be quicker? Educate about options without being pushy? Not be a vision plan hater?
	Decide among your practice’s doctors and management team who to invite to a five-person think tank. This group will then identify the practice’s internal strengths and weaknesses from the perspective of your most profitable patient demographic.
	
	In order to do this, this team should be given access to historic financial graphs as well as asked to give input into a twelve-month budget. The budget will be used to implement the recommendations that your team ultimately suggests.
	
	Which graphs? What financials? Surgical and patient visit graphs are a must. Graphs (A/R, gross charges, and net) showing extrapolations of increasing the practice’s market share of this population group will help you decide how much money you can afford to budget for internal and external marketing.


		The dictionary defines the verb tense of reform as to make better or to improve by removing faults or abuses. Reform cannot happen in a murky environment.
		
		What’s the current “state of the practice”? Could you and all the key players agree on a brief positional statement? Do you all agree on strategic initiatives that might guide process improvement? What would you like to see improved in the next 12 months?
		
		You now have your New Deal going. In this environment of reformation, take bold action that demonstrates to your most profitable patient that you want to become his or her practice of choice.

Change doesn’t happen overnight. Roosevelt’s New Deal was passed by Congress over a period of three years. His biography tells of personal growth, leadership changes and compromise. It was a tough time.
	
	Do not kid yourself. Perseverance will be needed to maintain profitability. Taking actions that are guided by the tough decisions that your data tells you should have been made months ago will not be easy. Egos will be bruised, and heroes will emerge from areas that you though contained only villains.
	
	If you are successful, the practice will undergo a metamorphosis. What will emerge is a realistic plan for the future. Think of how amazing you are. In 2019 you are able to preserve the vision of individuals who might have gone blind in the year 1933!


	E: suter4pr@donnasuterconsulting.com
	P: 423-545-4562
	

Ms. Suter is a business coach/trainer specializing in the eye care field. She frequently presents instructional courses at trade shows and conferences. Her topics range from trends in ophthalmic product technology to team building and marketing communications. She is best known for her emphasis on enhancing the patient’s perception of quality with an optical dispensary.

Take control of your practice's finances using these three easy tips

Author | Donna A. Suter

Articles

Crowds for hire: Finding the voice of patient needs

‘Spark joy’ in your ophthalmic practice with these frame board tips

Cut yourself a ‘New Deal’ to gain back profits

It’s your optical’s time to play ball