In-Office Lab
Building an In-Office Lab of Your Own
What you need to know about taking the step.
BY SHELDON KREDA, O.D., F.A.A.O., Lauderhill, Fla.
DIGITAL IMAGERY BY ANTHONY CERICOLA

When I built my first office, I made provisions for a finishing lab. Here, I'll share my experiences in building the lab to give you an idea of what you'll need to consider before you decide to build a lab of your own.

Why you should do it

Wondering why you'd need a lab? Here are some reasons.

Improved service. You could deliver eyewear faster. You could make a simple stock prescription in 5 minutes flat. Is this important to your patients? Sometimes. Emergencies do arise where patients need replacement eyewear immediately. But even under ordinary conditions, everyone wants glasses quickly.

Having an in-house lab can prevent patients from walking out the door and going to another practitioner. Patients who elect to replace lenses using their current frame can be inconvenienced if you have to send their only pair of glasses away to an outside lab. In my practice, our in-house lab comes to the rescue even when we have to custom grind non-stock lenses. When the lenses arrive, the patient returns to have them edged while he waits.

Also, think about the inevitable errors labs make. Mistakes and incorrect orders from commercial labs can double or triple an already slow turn-around time. Having your own lab avoids this pitfall.

Reduced lab costs. You may save money. The per-job lab cost is lower when done in-house (see chart below), but is this enough to balance the investment in space, staff and equipment? That depends on your patient volume, physical plant and staff. We'll explore this in detail later in the costs section.

Marketing. One-hour service is increasingly popular. The excitement a patient feels when he gets his glasses right away is a great practice builder. Fast service generates referrals; delays translate into lost patients. If you market yourself as a 1-hour source for glasses, that can give you an edge over your competition. I noted this service in my Yellow Pages ad, but you can include it in any form of internal or external marketing.

Typical lab layouts

Before you leap, look at . . .

If you do decide to build your own lab, you'll need to consider these aspects:

	Gerber Coburn's Kappa SP Lens Finishing System

Surfacing or finishing? For most optometrists, a finishing lab will be sufficient, and that's what I'll concentrate on. But don't rule out the possibility of actually placing the power on the lens surface. A finishing lab refers to the process of edging and inserting an uncut lens blank into a frame. A surfacing lab allows you to make the uncut blank. With a surface generator and surface polishing machines, you can grind the prescription onto a semi-finished lens blank. Semi-finished blanks are stocked by lens type and base curve, but don't have a lens power.

While surfacing labs have traditionally been thought of as prohibitively expensive for an optometric office, new technology is changing that. Molding systems are available that make lenses from a liquid monomer, and modified surfacing systems designed for small labs can be quite affordable. Besides offering more control over the product and lower raw material costs, surfacing lets you provide fast service on multifocal lenses, which can't be stocked as uncuts.

Cost. You can equip a basic lab for less than $5,000, staff it with existing employees and use the space you already have. The investment can be minimal.

Santinelli's LE-9000SX Multitasking, All-in-One Edger with auto safety bevel, auto groover and crystal cut edge polish.

How can you determine whether building a lab is a good investment for you? Calculate the cost of the construction and the amount by which salaries or staff size would increase. Then calculate a monthly payment for the entire project (as if it was a loan or lease payment), add in your material costs and compare this to your average bill from the outside lab. If they're comparable and having your own lab will increase business, it's a sound investment. But if costs are comparable and having a lab complicates your practice, don't bother. Leave it to the commercial labs.

It's also wise to consider the merits of having the job done by an outside lab versus doing it on your own. A rule of thumb we follow is: If the cost of materials is high and the job is complicated, let the outside lab do it. Just a few spoiled lenses can erase any savings earned by keeping jobs in house. Surfacing and molding, for example, require greater skill, time and investment. Unless you have a high-volume practice, your return may not be worth it.

Price can vary greatly between new, top-of-the-line equipment vs. used, entry-level equipment. Conventions are a great place to comparison shop for equipment to keep costs down.

A final consideration is investment potential of the money. What return could you make on it if you invest it instead of using it to build a lab? Would it outweigh the benefits of the lab?

	AIT's Practica 3-D edging system is affordable for low-volume independent retailers.

Equipment. First, you'll need an edger. This costliest instrument grinds the lens to the necessary shape and size and comes as manual or patternless.

• Manual edgers require a plastic frame pattern, or template of the lens, which you'd either get from the frame manufacturer or trace with a pattern maker.
• Patternless edgers combine the manual edger and the pattern maker to trace frames. Their digitized, 3-D processing allows more accurate sizing and edge profiling. They're costly, but may pay you back in reduced time, training and spoilage.
• Lens marking and blocking require great technical knowledge. You'll want lens blocks (holders applied to lenses to keep them in the edger and permit easy removal and replacement to check sizing).
• lens blocker applies the blocks. It helps you place the optical center or bifocal properly.

Some computerized instruments automatically calculate and decenter lenses when you enter patient data. The more features, the higher the cost, but the lower the chance for error. You'll also need a lensometer, hand edger, groover and tint unit.

Space. You can build a lab with as little as 10 feet of counter space. Locate it adjacent to the optical displays, not stuck in the rear of your office. The lab should be the hub of your optical center. Include an inside window so the opticians can see out to keep an eye on shoppers and goods, while patients can look in at the behind-the-scenes action.

National Optronics' 6E Patternless Edger includes several new features.	The Ultima5000 SG lens edger.

Staff. Who will do the lab work? If you already employ an optician to fit and dispense eyewear, you've got it made. He can perform lab work during the down time.

If you're so busy that there is no down time, adding a lab and additional staff is a no-brainer. If you have an employee who's optically challenged, train or eliminate him. Don't be held hostage by lack of skilled help.

The Briot Accura performs all finishing steps in one machine.

Training. The company that sells you your equipment will often provide on-site instruction. Lab work isn't difficult, and you as the O.D. should learn how to do it. Because of staff turnover, you may have to teach new hires. Or you might be short-handed because of an emergency and need to fill in for an absent employee. Furthermore, the more you know about lab work, the more you will be able to control material costs, such as substituting custom grinds where stock lenses will do, or keeping tabs on supplies.

An alternative to training current employees is to replace them with skilled opticians. This idea may have hidden benefits that outweigh any additional costs. For instance, an experienced optician may offer suggestions to patients that increase sales.

Stock. Lab supplies and lenses add to your cash outlay and storage needs. I stock single vision CR-39 lenses in powers ranging from ±4.00 sphere to -2.00 cylinder in quarter-diopter steps. A larger lens inventory costs far more than it brings in.

You'll also need to stock tints and coatings (ultraviolet, scratch-resistant). They yield among the highest return on investment available. With little cash outlay or technical skill, anyone in your office can apply them.

Insurance requirements. Some third-party payers dictate that an outside lab make the glasses you prescribe. If that portion of your practice grows, use of your own lab may diminish until it isn't a sound investment.

Give it a thought

So do the calculations, consider the angles and decide whether your own lab is best for you. You may decide to take the leap -- and be glad you did.

Dr. Kreda practices in a primary care setting in Lauderhill, Fla. He's a frequent lecturer and author. You can contact him at eyerx@peoplepc.com.