By Amy Hellem

It’s not a secret that it takes longer to fit a specialty lens than it does to hand out a commodity lens. However, this added investment of time should be neither excessive nor financially burdensome.

On the contrary, when approached smartly, custom lens fittings help establish a saner pace in the eye care practices that embrace them, offering true respite from the typical tailspin that other doctors feel as they rush from one exam room to the next.

Schedule Basics

No system is born perfect and what works in one practice may not work in another, but there are a few general guidelines that provide good scaffolding for most strong specialty lens practices.

Secret #1:  Don’t assume you are Superman or Wonder Woman.

As in all aspects of running a practice, you can’t do it all alone. Specialty lens fitting success is a team effort. The more knowledgeable and involved your staff is, the more successful you will be.  

Since optimal success generally requires a degree of hand-holding, a well-trained and knowledgeable staff can greatly improve clinical flow and leads to better scheduling practices.

Secret #2: Don’t be fooled into thinking, you can squeeze in that unscheduled custom contact lens fit today.

Another hard and fast rule in specialty lens fitting: Don’t be fooled into thinking that just because you have ten or fifteen extra minutes before the office closes for lunch, you can spare Mr. Jones the inconvenience of an extra visit.

Most all experts agree: when it comes to fitting custom lenses, the diagnostic fit should be scheduled separately from the initial exam. Referred keratoconus patients, in particular, have a lifetime’s worth of questions that they can’t wait to ask you. This time-consuming process should be built into the schedule—not attempted on the fly.

Secret #3:  Well-trained Technicians are a Key to a Smooth Specialty Practice

Well-trained ophthalmic technicians project professionalism and help maximize efficiency, so train at least one member of your staff to support you in meaningful ways throughout the process. This will take the burden off of your schedule. Ideally, this individual should be able to discuss the benefits of the lenses and the financial obligations, as well as be capable of ordering the lenses.

Secret #4: Improved Patient Flow Comes From Delegation

While the optometrist is the one who makes the diagnosis and decides whether specialty contact lenses ought to be prescribed, many tasks can be safely and effectively delegated to the technician in order to reduce chair time. For example, prior to your encounter with the patient, your technician can collect most of the vital data that you’ll need to make a final lens selection.

Staff can also play a useful role in making sure inventory is appropriate and fitting sets are within reach. Once the patent is fit, technicians can deliver appropriate patient education and discuss proper lens care. They can also help patients learn how to insert and remove lenses.

Contemplate Delegating More

Secret #5 Technicians can be liberating if you delegate components of the specialty contact lens visit.

Many experts are proponents of greater delegation to staff, involving a select few in more of the fitting and follow-up portions of the exam. Without a doubt, this reduces the doctor’s chair time, but it is a professional decision that can be uncomfortable for some doctors—albeit very successful and liberating for others.

Those who are eager to delegate more can enlist trained staff to gather most of the data, review the lens types and even place an initial trial lens on the patient’s eye. Likewise, the technician can over-refract and record acuity for your subsequent review.

Your primary fitting responsibility then, would merely be to check the lens at the slit lamp. In such cases, assuming the patient has good acuity, no complaints, and a normal slit lamp exam, the technician can also conduct the lion’s share of the follow-up visit responsibilities.

Make It Worth Your While

Secret #6: Specialty contact lens fittings benefit your practice and your patients.

Chair time is best measured by outcomes, not minutes. If a commodity design takes you only two minutes to fit, but does little to satisfy the patient, your time was not well spent.

In this regard, specialty lenses are not a scheduling liability; rather, they are advantageous because they permit you to charge a premium fee for your time and expertise, while providing outcomes that usually can’t be achieved with a commodity design. With good time management and appropriate staff utilization, specialty lens fittings can benefit your practice as well as your patients.

Amy Hellem is an independent writer and researcher who specializes in ophthalmology and optometry. Previously, she served as editor-in-chief of Review of Optometry and Review of Cornea & Contact Lenses and directed the custom publishing division for Review of Ophthalmology.