‘But I don’t want to be a salesperson’

May 15, 2013

On the art of recommending eyeglasses to patients during the examination


Because the success of an ophthalmologist’s dispensary is at stake one would think that nearly all ophthalmologists would embrace the idea of making recommendations. Oddly enough, this often does not prove to be true.


Dispensing Solutions By Arthur De Gennaro

I learned a long time ago that the success of an ophthalmology dispensary has a lot to do with how supportive is the doctor.

To be sure, some ophthalmologists recommend appropriate pairs of eyeglasses to patients and some do not. It should not be surprising then that those ophthalmologists who make recommendations have higher capture rates, more successful dispensaries, and more satisfied patients than those who do not.

Because the success of an ophthalmologist’s dispensary is at stake one would think that nearly all ophthalmologists would embrace the idea of making recommendations. Oddly enough, this often does not prove to be true. Let’s look at some reasons why.

‘It’s not rocket surgery’

Some years ago, I worked for 1 year with the attending physicians and residents of the ophthalmology department of a major teaching hospital in the Midwest. What I learned is that ophthalmology residents are taught very little about eyeglass lens and frame materials or dispensing. It was not surprising then that the attending physicians did not know a lot either.

On one level this is understandable. Residency programs must turn out physicians who can pass medical board examinations and perform surgery. On another level, this is regrettable because 30% of the revenue of a comprehensive ophthalmology practice should be derived from its dispensary. How an ophthalmologist can achieve this type of performance without any training continues to be a mystery.

Many ophthalmologists who recognize their lack of preparation find ways to learn the skills needed to be successful. As a friend of mine jokingly likes to say, “It’s not rocket surgery”-meaning that the precepts and information are not difficult to learn. A consultant is one obvious resource. There are obviously other resources as well.

Hiring a consultant, however, is not the answer per se. It is not the answer if the ophthalmologist continues to feel uncomfortable making recommendations. There are two reasons for this. The most common reason is the physician’s fear of being interpreted by the patients as trying to sell them something. This is an extremely interesting perception, because the doctor is characterizing the process of recommending new eyeglasses to a patient as selling. That same physician, however, will rarely, if ever, consider recommending cataract surgery to a patient as selling.

Recommending cataract surgery

As a way of making the point, let’s look at what the average ophthalmologists might say to a patient when recommending cataract surgery. For the record, the script below is roughly based on a recent interview of an ophthalmologist friend.

“Arthur, you mentioned that your vision has deteriorated to the point where you are beginning to have difficulty doing the things you want and like to do. That is because your cataracts have developed to a point where you should consider having them removed. So, you have a number of options. You can choose to wait a while longer or you could choose to have surgery. If you choose to have surgery, after removing the cataract I will implant a lens. There are a number of different lens implants. Some correct only for distance. Some correct astigmatism as well. Advanced lenses are the latest technology and correct for both distance and near, meaning you will be less dependent on eyeglasses. Each implant option has advantages and disadvantages, as well as related costs. You are a candidate for any of these implant options. I’m going to introduce you to (name), who is my surgery coordinator. (He/she) will explain each option in detail and answer all of your questions. Whichever lens you feel will work best for you and your lifestyle is the one I recommend you choose.”

Recommending eyeglasses

I cannot think of an ophthalmologist who would feel uncomfortable saying this or something similar to a patient. The funny thing is that recommending eyeglasses to patients is no more “hard sell” than recommending cataract surgery. Not convinced? Let’s look at a script an ophthalmologist could use to recommend eyeglasses.

“Arthur, you mentioned that you are having difficulty seeing small print and other close objects. This is because your eyes have less ability to focus up close than they used to, a common condition known as presbyopia. You have a number of options. You can choose to wait a while longer or you can get eyeglasses. If you choose to get eyeglasses, there are a number of different lenses that will help you. There are bifocals with lines and progressive lenses. If you choose progressive lenses, there are various types. Each is best for certain visual tasks. The most advanced progressive lenses are made using high-definition digital technology. Each lens type has advantages and disadvantages, as well as related costs. I’m going to introduce you to (name), my optician. (He/she) will demonstrate the different lenses for you and answer all of your questions. You are a candidate for any of these options. I suggest you choose the one that benefits you and your lifestyle the best.”

The average optician I meet would be delighted if his or her ophthalmologist would say just this much to each patient. They would be delighted because it will allow him or her to offer the patient a range of lens options and price points. The patient, who is now fully informed, then has the ability to consider which of the options and prices fit their lifestyle needs and budget best.

The more you know

The second most common reason why ophthalmologists do not make recommendations is because they do not feel they know enough about the products they are asked to recommend. This is an easy fix. The ophthalmologist only needs to have the optician make a list of the products dispensary patients purchase most often.

The optician would then teach the ophthalmologist by delivering a series or “lunch-and-learn” sessions. Each session should cover one product. The goal is to teach the major features, advantages, and benefits of that product. Armed with this information and a will to succeed, a dispensary’s capture rate can only rise, perhaps significantly.

Arthur De Gennaro is president of Arthur De Gennaro & Associates LLC, an ophthalmic practice management firm that specializes in optical dispensary issues. De Gennaro is the author of the book The Dispensing Ophthalmologist. He can be reached at 803/359-7887, arthur@adegennaro.com, or through the company’s Web site, www.adegennaro.com. He maintains a blog at www.adgablog.wordpress.com.