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The Trouble with Withholding
When patients seek the best care, should you prejudge their willingness to pay?

Should a practice withhold a recommendation for a product or service based on the assumption that the patient is either unable or unwilling to pay? We can expand this question to all of healthcare. We might even do well to compare a situation in an optometric practice with that of another medical practice.

Glasses and white teeth

As eyeglasses represent the largest single category of product that optometrists dispense, let's compare them to teeth whitening, a popular dental procedure. (Feel free to substitute eyeglasses with another product or service offered by your practice.)

Professional teeth whitening can cost between $300 and $800, which falls in line with premium eyeglasses that include lightweight, anti-reflective progressive lenses.

Both premium glasses and whitening elicit the "wow" factor and referrals from patients. Family and friends who buy premium glasses can't wait to tell me about the experience ("Look, these turn into sunglasses when I go outside!"). If you know of someone who recently bought glasses and had their teeth whitened, be prepared to add 30 minutes to your next conversation and rest assured that they'll do most of the talking.

There are differences. Dental care plans do not cover whitening. However, most vision plans offer a set dollar amount for premium eye wear.

Also, teeth whitening offers no direct health benefit. Patients may even experience pain a day or two after the procedure. In addition to correcting refractive error, premium eyeglasses provide obvious benefits for healthy vision as they reduce glare, protect eyes from UV radiation and eliminate the need for readers.

Understanding value

From a clinical perspective, premium eyeglasses offer more benefits than whiter teeth. But many dental practices don't market white teeth — they market a lifestyle. According to a study by the Academy of Cosmetic Surgery, an attractive smile is a social asset and an unattractive one may hinder career success. Regardless of income, patients will invest hundreds of dollars because of the value they see in whiter teeth.

Optometric practices don't always capitalize on the power and value of their products and services — even when there's a clear benefit. For example, rather than presenting healthier vision or safer driving at night, a practice might present "eyeglasses with add ons." You have to ask: Are these practices looking out for their patients, or are they making recommendations that have no teeth?