Post-LASIK Education: Let Patients Know They Still Need You

Providing ongoing care for post-LASIK patients keeps them in your practice and ensures that they receive the services and products they need.

LASIK has become a common procedure improving the lives of many of those who undergo it, but many of those same patients don’t realize that they still need to visit their eye doctor annually. In addition to co-managing pre- and post-operative care for LASIK patients, ODs need to educate these patients about why they still need to visit for a comprehensive exam each year. Education also is needed about which products, such as sunwear, are still beneficial, and why a successful LASIK procedure doesn’t mean a patient won’t need to address presbyopia.

Vision and Eye Health Could Change

Although patients can now see well, they need to be examined on an annual basis. For those getting close to presbyopia, they may need reading glasses in the near future and need to continue monitoring their eye health for such issues as glaucoma, cataracts and macular degeneration. Other LASIK patients are very non-compliant and literally disappear after their surgeries, either showing up rarely or never again.

Monitor and Treat LASIK-Related Dry Eye

Many LASIK patients are people who have had dryness issues that affected their ability to wear contact lenses and require treatment methods for anyone who has dryness including lubricants, Omega 3 supplements and punctal plugs when necessary.

Educate On Added Need for Sunwear and Driving Eyewear

LASIK patients are more prone to glare problems after surgery, especially at night. Many patients have LASIK with a monovision modality, so their eyes are unbalanced for distance vision and these patients can often benefit from night driving eyeglasses, as well, that balance both eyes to distance.

Monitor Eye Health Long-Term

Continue to monitor post-LASIK patients for the same medical eyecare problems that can affect anyone such as glaucoma and cataracts. Also monitor the cornea for any signs of a condition called ectasia, which is an abnormal thinning and bulging of the cornea. Since the surgery leaves the cornea thinner, this can happen, although it is uncommon.

Anticipate the Rare Poor LASIK Outcome

In most of these cases, the problems were not medical, but a result of a patient with unrealistic expectations. Some patients who had the oldest refractive surgery, radial keratotomy (RK) have had massive shifts in their refraction over the years, ending up extremely hyperopic. In addition, their best corrected visual acuity is often not correctable easily to 20/20 vision.

Generate Post-LASIK Patient Referral

Ask for referrals of the patient’s friends, family and co-workers who may be interested in LASIK surgery. Often, the patient’s happiness and enthusiasm is highest right after the surgery, so this is a good time to ask for referrals. The referred patients will not necessarily be excellent candidates for surgery, but will then continue coming to our office for their eyeglasses and contact lens needs.

How Satisfied Are Patients With Exams at Independent OD vs. Chains?

Independent ODs are leaving a more favorable impression with patients than corporate-owned optometry chains, according to Jobson Optical Research’s 2012 Adult Consumer Eye Exam Experience. Fewer consumers who had an exam at a chain in the last six months strongly agreed with the statement that overall they were satisfied with the eye exam experience compared to those who had an exam at an independent in the last six months (45.3% and 58.1% respectfully). Indeed, just under half of those consumers who had an eye exam at a chain in the last six months (46%) said the exam was thorough, compared to 58.9% of those consumers who had an eye exam at an independent in the last six months.

Among consumers who had their eye exam at a chain in the last six months, 53.4% said they were extremely likely to return to the same place for their next eye exam. By comparison, 70.7% of those who had their eye exam at an independent in the last six months said they were extremely likely to return to the same place for their next exam.

Of the respondents who had their exam at an independent in the last six months, 63.5% reported that they are currently covered by a type of managed vision care or vision insurance plan. This is greater than the 53.9% who have a vision plan and chose to have their eye exam at a chain in the last six months.

Do Your Patients Know About their Sports Eye Injury Risk?

Every 13 minutes, an emergency room in the United States treats someone for a sports-related eye injury. According to the National Eye Institute, eye injuries are the leading cause of blindness in children in America, and most injuries occurring in school-aged children are sports-related. The results of an eye injury can range from temporary to permanent vision loss.

The NEI notes that baseball is the sport responsible for the greatest number of eye injuries in children aged 14 and younger. While basketball is the sport that records the highest number of eye injuries for those ages 15-24.

Polycarbonate lenses must be used with protectors that meet or exceed the requirements of the American Society for Testing and Materials (ASTM). Each sport has a specific ASTM code. Polycarbonate eyewear is 10 times more impact resistant than other plastics.

Eye injuries can include painful corneal abrasions, blunt trauma and penetrating injuries, inflamed iris, fracture of the eye socket, swollen or detached retinas, traumatic cataract and blood spilling into the eye’s anterior chamber. All athletes who have poor vision or blindness in one eye should take particular care to protect their remaining vision.

Wide Discrepancies Between Vision Care Attitudes and Practices, Says VISTAKON Study

While Americans rank sight as the most important of the five senses, a new survey shows that nearly half did not get an eye exam in the past year and approximately 30 percent do not believe that taking care of their eyes is as important as other health issues. The 2012 Americans’ Attitudes and Perceptions About Vision Care Survey, conducted online by Harris Interactive on behalf of VISTAKON Division Johnson & Johnson Vision Care, Inc., tracked attitude and behavior changes among 1,000 US adults compared to 2006 benchmark data and revealed surprising discrepancies between attitudes about vision care and actual practices.

Results show a consistently high value placed on maintaining proper vision, although the number of respondents who indicated they do not regularly visit an eyecare professional increased 36 percent compared to 2006 (19 percent vs. 14 percent in 2006).  Alarmingly, approximately one in five (21 percent) US adults mistakenly agrees that they do not need an eye exam unless they are having trouble seeing.

“Despite knowledge and perceived importance, Americans are not making eye health a medical priority,” says Cristina Schnider, OD, senior director, Professional Communications, VISTAKON  “Seeing an eyecare professional regularly for a comprehensive eye exam will not only assess vision and the potential need for updated prescriptions, but it may also help identify and lead to a diagnosis of other health concerns such as hypertension and diabetes.”

Among the respondents who have a regular eyecare professional, the study shows an upward trend in satisfaction rates. Significantly more US adults are extremely/very satisfied with their regular eyecare professional, an 18 percent increase vs. 2006 (80 percent vs. 68 percent in 2006). When asked about the reason for their last eye exam, significantly more respondents noted that they had established a set eye exam schedule (32 percent vs. 29 percent in 2006) or received a reminder from the eye doctor’s office (20 percent vs. 17 percent in 2006–an increase of 10 and 18 percent, respectively).

Nearly 80 percent of respondents indicated they sought a referral when selecting their current eyecare professional, with a family member, friend or co-worker serving as the single greatest referral source (40 percent), followed by a health care provider (21 percent). Women were significantly more likely than men to seek referrals for a new eyecare professional (48 percent vs. 37 percent, respectively).

Sources for obtaining information on vision care products are also evolving. Eyecare providers’ offices remain the number-one resource–and the most trusted/reliable–but a growing number of US adults say they seek out a family member or friend for information.The Internet has gained traction as well; an increase of 33 percent of respondents cited this as an information resource for vision care (20 percent vs. 15 percent in 2006).

“These findings are consistent with data from a recent Harris Poll that showed three quarters (74 percent) of all adults have gone online at some point to look for health information,” says Humphrey Taylor, chairman, The Harris Poll, Harris Interactive. “As the influence of the Internet as a valued source of health care and medical information continues to grow, eyecare professionals need to work hard to ensure that they are providing the public with relevant, user-friendly and reliable information.”

Other findings from the Americans’ Attitudes and Perceptions About Vision Care survey included the following:

•    Many attitudes regarding contact lenses did not change significantly since 2006, with one exception
o    Compared to 2006, significantly more contact lens wearers agree that it is important to take lenses out daily to give their eyes a rest (93 percent, 2012 vs. 86 percent, 2006).
o    About one-in-five contact lens wearers (17 percent) say they wear daily-replacement contact lenses.

•    Cost is less of a barrier to vision care
o    Approximately three in ten adults (29 percent) agree that they avoid going to their eye doctor because of cost, a 12 percent decrease vs. 2006.
o    Two in three adults have some type of eyecare insurance coverage.

•    Vision correction surgery remains minimal
o    Six percent of US adults reported having vision correction surgery, compared to seven percent in 2006.
o    The likelihood to have vision correction surgery is significantly less, declining from 10 percent extremely/very likely in 2006 to six percent in 2012.

Make Eye Drops a Practice Builder

Natural homeopathic eye drops can be part of your treatment plan for a variety of ocular conditions. A key to success: Offer drops for sale, and make it easy for patients to comply.

Conditions such as dry eye, irritation from contact lens wear, cataracts and the occurrence of floaters afflicts a large and diverse cross section of optometric patients. Among the treatment plans you can offer for these conditions are homeopathic eye drops from Natural Ophthalmics. If you start selling the eye drops, you will find that they are a patient loyalty builder, with patients happy to find relief for ongoing conditions, and a revenue-generator, to boot.

Introduce the Eye Drops As a Standard Treatment Option

Natural Ophthalmics offers a wide range of products that are effective with floaters, cataracts, dry eye and contact lens wear. You can have your patients use the oral eye spray (Total Ocular Spray) and the company’s cataract eye drops for eight months and then have them back for a follow-up visit. At this point the least improvement in acuity is half a line better with the best improvement three full lines. You can recommend this protocol to patients who do not want to have surgery or have eye conditions that would cause a higher risk of vision loss post-surgery.

Natural Ophthalmic products come as drops, pellets and an oral spray. For people with dry eye syndrome you can prescribe tear stimulant drops, for cataracts you can prescribe Total Ocular Spray and cataract drops or cataract pellets. For corneal staining, you can prescribe Ortho-K Thick for night time and Ortho K Thin for daytime with or without contact lens wear.

The biggest advantage of these products is that there are virtually no side effects and all of the eye drops can be used with or without contact lenses on. There are no steroids in them, and they are only sold through professionals.

Start with a Conservative Investment

You can start with a $350 dollar inventory, but you could start with just one Natural Ophthalmics product at a time and gradually add eye drops and eye pellets for other conditions as your patients became more confident with the products. Doing it this way, your original investment could be as low as $60 with a net of $60.

Natural Ophthalmics has a recommended price for their products. None of their products retail for more than $24.75. With the correct presentation of the products, you should break even with the $350 investment in three weeks.  

Tie Eye Drops to Practice Branding

The holistic branding may be great for your practice. You may let your patients know that you provide holistic care, not just eyecare, with point-of-sale products and show a DVD provided by Natural Ophthalmics in your reception room.

Educate Patients

First, you should ask the patient if their symptoms are worth using the products. If they say no, then you can suggest procedures they can do at home and over-the-counter products. If they say yes, then you can explain how the products work.   

When patients purchase products for eye or general health conditions, you should tell them to call if they feel the product didn’t help with their symptoms and you should consider giving them full credit towards future services.

Do Patients Like to Make Small Talk With You?

Patients prefer some friendly conversation at the start of their exam, according to Jobson Optical Research’s The Waiting Game report. Just under three quarters of respondents (74.5%) said that they think it’s nice when a doctor starts to make small talk about general topics such as their job, kids or the weather. Women (77.2%) prefer it just slightly over men (72.8%) and older respondents preferred it over younger (18 to 34: 70.7%, 55+: 78%). Apparently a little small talk can go a long way.

Be sure to make notes in the patient records about things that are important to patients such as children, pets, jobs and anniversaries. On the patient’s next visit to the office, with targeted small talk you can ask about how the new dog is making the transition now that the kids are away at college. Don’t rely on your memory, use your patient records to help keep you accurate.

Train your staff to add to the patient notes section as well. When they hear a nugget of news that is important to the patient, add it to the record to help keep the doctor informed. Don’t forget to include news such as the death of the spouse or child. Make it a habit for doctors and staff to have access to a computer when reading the paper so that quick notes can be made in the patient records.

Everything you do should be designed to make sure the patient completes your prescribed treatment plan. Showing that you care by sharing details of life that you know about the patient that are important to the patient goes a long way to achieving this goal.

Hire More, Earn More?

The average salary of OD owner/partners in practices with one to three people is $87,188, according to Jobson Optical Research’s and Local Eye Site’s ECP Compensation Study. The average salary of OD owner/partners increases to $182,592 in practices with four or more people. The average OD owner/partner’s salary at practices with one location is $137,546, while the average salary of OD owner/partner’s at practices with more than one location is $207, 771.

A common problem in a smaller practice is the doctor who is doing two jobs-the jobs of both a data gatherer and a data analyzer. If the doctor is doing the entire examination without assistance from staff, then the doctor is seeing fewer patients per day than is possible. Delegating some of the examination to staff frees up the doctor to see more patients per day. This raises the gross revenue of the practice and, with careful management, also raises the doctor’s income.

A common misconception why doctors do not delegate is the belief that patients think they are getting a better examination if the doctor does all the testing. This is simply not true. Think about your last visit with your general physician. Who did the majority of the testing? Odds are it was not the doctor. The doctor came in at the end, looked over the results, maybe did a test or two, then, made the case presentation.  

If we are going to exist in the medical world, then we need to make our practices look more like the medical world. That means the doctor needs to become more of a data analyzer and less of a data gatherer. Start today by assigning a few tests to staff to do for you such as visual acuity. As you get comfortable, then you can assign more tests to staff to do for you. When you feel proficiency levels are reached, then you can readjust your schedule to see more patients per day without working any more hours per day.  

Efficiency is the key word for making the practice work well in the managed care environment in which we live today.