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Fee for Service and Specialization
This pairing is the key to financial success. Read on to find out why.

Q I'm an optometrist and I have three locations. As long as I've been in practice, my concentration has been on the optical side of the business. Only 4% of my gross is from contact lens professional fees and products. What's the best way for me to increase the contact lens revenue to at least 20% of my gross?

Dr. J. L. Willoughby, via e-mail

A: Many doctors and other business owners have a fixation on the gross income (monies collected). It would be best to add contact lens services in a manner that will increase your net income (monies the owner earns before taxes). The high-net areas of contact lenses are professional fees (if the O.D. charges what he's worth) and specialty lenses such as those for keratoconic treatment and CRT.

Give and take

The key to making a profit with contact lenses is fee for service. All practitioners need to concentrate on educating patients that the fees reflect higher service fees for their time, skill, knowledge and risk. Material fees must compete with the telephone-order companies. The way to beat the retailer and phone-order companies is to "wow" your patients with services that beat -- not compete with -- the competition. Offer contact lens packages with an increasing scale of professional fees. As the fee for service increases, offer the patient valued benefits such as:

• Replacement lenses at no charge if new lens is torn upon opening the blister pack (phone-order companies can't compete).
• Follow-up evaluations on any contact lens-related visit from three to 12 months, depending on the package.
• Larger savings on plano sunwear and prescription eyewear with larger professional fee packages.
• Three-month contact lens solutions at fees lower than retailers.
• Annual polishing at no charge to patients who have certain packages for oxygen permeable lenses.
• Mail lenses on a scheduled basis for a fraction of the cost of phone-order companies.

The key is to train staff to explain these unknown values to each contact lens patient. Demonstrate the savings on an annual basis. What you get in return is:

• Limited patient erosion (patients taking contact lens prescriptions elsewhere).
• Patients purchasing both services and products from your office.
• Patient loyalty.
• "Wowing" the patient with service and value.
• Higher net income because fee for service is the major part of the transaction. (No lab bills on the fee for service side.)

Corneal reshaping therapy is a great specialty that offers tremendous service to all patient populations. The material costs are low, leaving the majority of the care fee for service. High-net income and a tremendous "wow" response from patients and their families.

With 90 million presbyopes in the United States, a huge market for bifocal contact lens options exists. Remember: The new presbyopes are much more cosmetic-minded than their parents. Numerous options are available, such as:

• Monovision
• GP bifocals
• Soft contact lens bifocals.

Your fees need to reflect profits on the professional service side while supplying the lenses with a minimal mark up.

Getting the right mix

Dr. Bailey retained my services and I instructed him on handling clinical, management, fee structure and collections in his practice. After the onsite visit, I supported his office for two years. During that period, I assisted Dr. Bailey with many CRT fittings. Three years after I taught him this exciting specialty, Dr. Bailey grossed more than $100,000 from the service. His net profit was 60% of the total. The key to financial success is fee for service and specialization.

Dr. Kattouf is president and founder of two management and consulting companies.  For information, call (800) 745-EYES or e-mail him at advancedeycare@hotmail.com. The information in this column is based on actual consulting files.