It can be uncomfortable and frustrating to “defend” to patients the professional fees associated with the contact lens (CL) exam. After all, aren’t they seeing us because of our recognition and understanding of the complexity of evaluating and managing their anatomical, refractive, and physiological needs? Yet, this push-back continues and, in fact, was a subject of top concern in the contact lens realm, based on this year’s “Optometric Management Reader’s Survey.”

There’s no question that ODs deserve to be fairly compensated for the CL exam. So, how can they increase the likelihood of patients valuing vs. questioning its need?

Here, I share four steps that result in bolstered patient and professional satisfaction.

Provide clear and transparent communication

My practice accomplishes this by both determining and itemizing the associated services they anticipate will be required for a particular encounter. The patient is then given as accurate an estimate of cost as possible.

If an unanticipated procedure or service is then deemed necessary, the patient is informed of its importance, value, and cost before we proceed.

Definitively separate the exam

Whenever appropriate, the CL patient is asked to wear their CLs to their visit, and they are told that the CL exam will be conducted first. This provides a definitive separation of the CL exam from the primary care exam for the patient.

To further instill this separation, my staff and I use descriptive and value-associated language, such as “diagnostic evaluation,” “lens design,” and “progress checks” regarding the CL exam. This refined verbiage has a more positive impact on patients’ perception of my expertise, as well as their compliance vs. commodity-associated descriptors, such as “routine exam,” “lens brand,” or “follow up.”

Make the CL exam stand out

Let’s face it: If you conduct a thorough clinical evaluation but the patient isn’t aware of what you’re doing, they won’t see the value in it. To show patients the value in my practice, each procedure is highlighted with a few words regarding what is being done and why, from pretesting to the exam room. Also, my staff and I relate what is being done and why it is essential to the assessment of their CL fit, performance, and their ocular health.

For example, in our practice, our technician performs an autorefraction as a preliminary test. She briefly explains to patients that this gives the doctor initial information regarding CL-prescription accuracy.

Following suit, during the clinical exam, I describe what I am checking for and what I see with the slit lamp, both with the CL on and off.

In further differentiating the CL evaluation from “standard” exam procedures, I utilize and explain the importance of all CL-related diagnostic procedures, such as topography, vital dye staining, meibomian gland evaluation, and lid eversion.

Summarize CL exam findings

To further show the value of the CL exam, I clearly summarize my exam findings, reasons for recommending a new technology, as well as discuss future developments relative to their needs.

Also, I communicate that exam findings that reveal “there is no currently indicated prescription or design change” are equally valuable and important, as they reveal the patient is doing well in what they’re currently wearing.

Finally, I always leave the patient with a reason to return, such as “I look forward to seeing you in one month to reevaluate your new contact lenses.”

Satisfied patients

I find that the most compliant and enthusiastic referrers are those not surprised. By following these simple steps, ODs can get patient buy-in to the CL exam. OM

DR. RESNICK is president and managing partner at Drs. Farkas, Kassalow, Resnick, and Associates, a contact lens and anterior segment specialty practice in New York. She is a diplomate in the Cornea, Contact Lens, and Refractive Technology section of the AAO, a diplomate of the ABO, and a fellow of the Scleral Lens Education Society.