in-office lab

In-Office Lab Profitability

These three steps can enable you to achieve in-office optical lab success.

Harry N. Halscheid, O.D., West Chester, Pa.

“THE ONLY SOURCE OF KNOWLEDGE IS EXPERIENCE,” Albert Einstein once said. Through the past 20 years, the practice to which I belong has operated an in-office optical lab. As a result, we have tremendous experience in this area. From this experience, we've learned that a highly profitable lab is contingent on three main factors.

Here, I discuss these factors.

1 Skilled staff

Having a separate, skilled optical staff overseen by a proficient optical manager has enabled us to offset high lab bills, handle a large percentage of jobs, maintain a high level of quality control and provide an increased level of patient convenience, satisfaction, loyalty and patient referrals.

Currently between our two offices, we employ four opticians. We've been fortunate in that three of our opticians have several decades of experience among them. Therefore, we've been able to rely on them to train additional optical staff, including our most recent hire who spent the past year becoming trained and moving toward optical certification. Clearly, every practice differs in needed optical staff. Patient demand, managed care plans accepted and the presence of an in-office lab are all factors that influence this decision.

Hiring a highly qualified, experienced optician is ideal, but often not possible. In general, we've found that job candidates who have outgoing personalities and who display great attention to detail make the best hires. The reasons: These individuals tend to be very easy to work with, and their attention to detail on their resumes translates to attention to detail when performing jobs. When you find the “right” person, don't be afraid to invest time and resources in them. Your optical represents a key area of income, so your optical staff must be prepared to meet patients' needs.

Most recently, our optical staff has successfully taken on complex, though very profitable jobs, such as drill mounting. This has been a boon to our practice revenue, as optical industry data have revealed an increase in consumer desire for premium products (e.g. digitally produced, rimless frames, etc.). Obviously, when dealing regularly with premium products, frequent errors resulting in damaged product can be very costly. The rate of product damage due to operator error is extremely low (roughly 2% to 3%) in our practice, however, by virtue of our opticians' skill set. Further, we've found that the cost for the equipment required to handle these tasks has easily been offset by both the savings on our lab bill and, again, our optician's skill set.

Currently, approximately 85% of our drill mount work is completed in-house. Utilizing two edgers, our opticians are able to provide very efficient delivery on the majority of optical orders. In other words, generally every job is turned around between two-to-three days.

Given all the aforementioned benefits, it's been easy to justify their higher salaries.

2 Knowing industry trends

Industry data, which we routinely monitor through related trade magazines, trade shows and, most recently, various industry websites, have revealed the aforementioned premium products are a hot commodity. (Incidentally, such research has also shown that AR coating remains the best-selling lens treatment on the market.) In order to meet our patients' needs and remain profitable, our optical staff has begun handling a higher percentage of complex jobs, such as drill mounts, in-house. Further, to ensure we're providing in-demand jobs to our patient demographic, we review cost-of-goods as a percentage of total sales every quarter to ensure we are purchasing wisely and selling effectively. Within this analysis, we look at the lens products and treatments that are selling best. This insight assists our staff in addressing future patients' needs.

We've also used optical industry data to determine our uncut lens inventory. In fact, our opticians research lab costs at least twice a year and present their findings to us. Their research has shown that overnight shipping from stock lens warehouses is a prevalent and cost-effective service. As a result, we don't maintain what could become a costly lens inventory. Instead, we stock a modest range of clear polycarbonate lenses—particularly in minus powers—to cover emergency needs for quick turnaround. (Maintaining a limited supply of lenses between −1.00 and −5.00 is generally sufficient for emergency needs.) We've spent some time in recent years trying to find a wholesale lab that offers the quality, efficiency and pricing that meets our needs. Having selected a lab, we attempt to order as high a percentage of lenses through them as possible, allowing us to reap the benefits of volume pricing and decreased shipping costs.

Additionally, because our opticians have found that the cost of single-vision uncut, untreated lenses is relatively minimal (a fair estimate would range from less than $10 for plastic to roughly $30 for hi-index with a 1.67 index of refraction), we determined that purchasing in bulk doesn't provide much of a discount, and that any modest advantage is offset by the cash-flow advantages of purchasing as needed. Thus, overnight shipping from stock lens warehouses has become our primary source for uncut lenses. (For more information on inventory management in general, see “Inventory Management is as Easy as ABC,” article.)

3 The “right” equipment

Based on our experience, here's what you should look at to ensure the lab equipment you buy isn't disappointing. (See “The Latest Lab Equipment,” below.)

► Capability. Be sure the equipment meets your needs, in terms of enabling you to provide the in-house jobs you've decided you want to offer. Keep in mind that knowing what you want in advance will help you resist the lure of functions you don't need. For instance, if you want to provide drill mounting, make sure the edgers you're considering offer this function. (See “Lens Waste Disposal,” below.) Depending on the volume and complexity of jobs handled in-office, an automatic lens tracer/blocker may be an attractive option. Automatic tracers today offer features, such as automatic drill point recognition for rimless jobs, auto decentration and 3D tracing. Also, manual blocking can be a very effective option, offering precise results in the hands of a skilled optician.

When we added a branch office, we decided we wanted to provide remote tracing. This way, when patients who visited our branch office chose to update their lenses, but not their frames, a tracing of the frame shape could be transmitted to our lab, located in our primary office, and the patient would simply have to return to either office location for insertion of their new edged lenses. The investment has been well worth it. The optical job is expedited within the lab, patients appreciate the convenience and not having to be without their glasses, and theoretically we are able to utilize one in-office lab for two offices worth of optical work.

► Size. Measure the specific space you've allotted for your equipment, and refer to these dimensions when assessing devices that interest you. Don't ballpark it. These measurements play a major role in your device choice, and you don't want a situation in which the device is delivered, and there's not enough room for it. For reference, devoting 150-to-200 square feet for two edgers, a blocker and a tracer is sufficient.

► Operability. Although in-office lab equipment has become more sophisticated, more accurate and easier to use than in the past, some systems can be quite complicated to learn and correctly operate, even for the most seasoned staff. As a result, have staff test-drive those devices in which you're interested before you buy. And remember: The easier it is for staff to operate a device, the greater percentage of jobs they'll be able to handle, enabling you to get the most value from the device(s).

► Company reputation. Choosing a reputable company from which to purchase may be the most important factor in the shopping process, as you want a company on which you can rely. To start, make sure the company offers support. This should include coming to your office for device set-up, providing staff training and availability, in terms of trouble-shooting. A warranty of three-to-five years, so long as parts availability is okay after that, should be sufficient, considering the quality of in-office lab devices currently on the market.

Our practice networks with other eyecare practices, most of which operate in-office labs, so we've asked these fellow practitioners for their input on both the devices themselves and the companies who make them. If you don't have networking resources available, ask the company for references, and consider posting on one or more of the optometry- and/or opticianry-themed websites for input.

► Potential profitability. Several in-office lab equipment companies offer online cost analysis. Or, you can call the company itself, and ask someone to help you with cost analysis. As edgers, in particular, can be noisy, you may want to consider soundproofing the walls that house your in-office lab. If you've determined this is necessary, be sure to incorporate this cost into your in-office lab cost analysis as well.

► Equipment cost. With many quality lease options available and considering the long life cycle of in-office lab equipment, cost should not be the primary factor in your purchasing decision. A reasonable estimate for a new, entry-level edger capable of handling the majority of basic optical jobs, such as a single vision job of varying material types, would be $25,000 to $30,000. (Obtaining a five-year lease with a purchase price of $29,000 and a 10% purchase option would equate to monthly payments of roughly $590.) Devices that enable more complex jobs, such as drill mounting, may exceed $40,000. In terms of blockers, a manual blocker capable of handling most jobs may cost less than $400. An automated lens blocker costs between $10,000 and $15,000.

Even the most polished, state-of-the-art in-office labs don't garner the jobs of every spectacle-wearing patient. Yet, through our experience, we've found that having highly skilled staff, a pulse on the latest industry trends and knowledge of in-office lab equipment prior to purchase has not only enabled us to get the most from our lab, in terms of profits, but has also attracted and retained a majority of our spectacle-wearing patients. OM

THE LATEST LAB EQUIPMENT
	AIT Industries' WECO Edge 580 Patternless Edger processes high base curve wrap frames and includes integrated drilling. Also, the device produces Chemistrie Magnetic Sunlenses and polarized 3D magnetic lenses and integrates with many Indo tracer/blockers. Other features: a grinding wheel for beveling all materials; automatic polishing of CR-39, hi-index, Trivex and polycarbonate lenses; an automatic internal/external safety bevel and automatic program-guided, manual and flat bevel programs; minibevel technology; a camera-assisted blocking system with auto recognition and a superhydrophobic lens roughing process. Visit www. aitindustries.com.
Briot USA/Visionix, Inc.'s VL 1000 Automatic Lensmeter provides the fast and easy measurement of progressive, prism, PD, UV and contact lenses, the companies say. For instance, in the PAL Mode, progressive lenses are automatically detected with a graph to improve accuracy and speed in the measurement of near and far vision, the companies say. Also, the UV Mode provides a graphical presentation of the percentage of UV transmission. The Contact Lens Mode measures soft and hard contact lenses using a specialized mechanical jig and display. The device also includes a built-in printer. Visit www.briot-usa.com and www.visionix.com.
	Coburn Technologies (formerly Gerber Coburn) introduces the Excelon 7000 XD edger, which is part of the company's new Excelon in-office finishing series. The device will edge all lens materials, including glass, plastic, hi-index, polycarbonate and Trivex, as well as edge polish bevels and flats. Also, it provides hole editing functions with a “drag and drop” function. The device includes dual side feelers, which scan the lens simultaneously for fast lens reading, the company says. An optional 3D drill offers up to 30° of mobility to support high-curve lenses and drill mount frames. Visit www.coburntechnologies.com.
Essilor Instrument USA's Mr. Blue in-office edging system offers fully automated centration; accommodates lens shapes as low as 17mm B size and features a hybrid platform for wet and dry processing, including milling and drilling. The milling tool, in particular, makes the device ideal for fashionable high-wraps up to base 9, specialty shapes and premium AR-coated lenses, the company says. Visit www.essilor.com/-instruments,191-.
	Optical Dynamics' nanoCLEAR AR 5.1 anti-reflective coating machine, which runs on the company's newest version of nanoCLEAR chemistry, works exclusively with the company's Q-2100R Digital Lens System. The Q-2100R develops the patient's lens from a liquid plastic, utilizing an in-mold process. Before creating the lens, you place the nanoCLEAR AR stack on the molds. This results in an AR lens with a hydrophobic top coat in roughly an hour, the company says. Visit www.opticaldynamics.com.
QSpex Technologies, Inc.'s QSpex Premium Lens System enables you to cast single-vision or progressive lenses with any combination of premium lens treatments in roughly 30 minutes, the company says. The System can produce clear lenses, seven-layer, vacuum-coated oleophobic and hydrophobic AR lenses, polarized lenses and polarized lenses with backside AR. (The device will be able to cast photochromic lenses and AR/photochromic lenses beginning in January.) Visit www.qspex.com.
	Santinelli International's Ice 900 CAD lens blocker features an Integrated Shape Imager (ISI), which photographs demo lenses, including those for rimless drill mounts, and identifies hole position. The ISI function is supported by a “Wizard Tutorial,” which is displayed on the device's screen. Other features: an Advanced Shape editor function, which edits shapes in a customizable fashion; a motorized lens blocking process, which takes two seconds; an LCD screen, which tilts 27° to 60° from vertical, and a data management feature, which allows for storing, searching and recalling traced data. Visit www.santinelli.com.
Super Systems Optical Technologies' ADDvantage HD high definition progressive lens is digitally enhanced to create maximum visual comfort by eliminating distortion in distance vision while providing a smooth progression through the intermediate into a generous reading area, the company says. The lens, which can be produced on the company's Fast Grind 2200 System, is available in a regular corridor design with fitting heights of 18mm and above. It also comes in a Short design with fitting heights of 14mm and above. Materials: plastic and photochromic. Lenses are also available with an optional AR coating. Visit www.superoptical.com.
	◄Tomey USA's TL-3000C auto lens-meter measures bifocal, hi-index, prism, progressive, standard and trifocal ophthalmic lenses as well as both hard and soft contact lenses. Once you set the device's nosepiece for measuring contact lenses, it automatically switches to the contact lens measurement mode. Further, the device measures interpupillary distance with automatic right/left detection and can measure a lens' UV transmittance while also measuring the lens' power. Visit www.tomeyusa.com.

Dr. Halscheid is a partner in two primary care optometric practices, where he provides comprehensive care, ocular disease management and low vision services. E-mail him at HHalscheid@crhvision.com, or send comments to optometricmanagement@gmail.com.