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Ophthalmic LensesTry This Industrial-Strength Dispensary BoosterThis checklist will improve your success with PAL prescriptions and please more presbyopes in your practice.Helen Bennett Contributing EditorFifteen years ago Harry Beck, O.D., decided to open a solo practice in Osceola, Wis., a growing town of some 3,000 people about 40 miles east of Minneapolis. But Dr. Beck didn’t just hang a shingle, cross his fingers and wish real hard that patients would come in. Instead, he took a patient up on his suggestion: Dr. Beck went to a nearby industrial park and circulated his name to all the businesses there. That one move has been instrumental in boosting his practice. It has grown a steady 10% a year since then, and 30-40% of his practice stems from industry-related referrals. Today Dr. Beck’s practice has a direct billing relationship with 11 industrial accounts, and is a provider for six other companies who have contracted with two nearby optical labs for their occupational eyewear programs. Setting up such a program is a great way to promote your practice, and it’s fairly easy to do. But to do it right, you need to educate yourself and your employees. Here’s how Dr. Beck did it, along with some tips you should know about safety and patient education. Industrial Contacts For Dr. Beck, it all started with a letter—a one-pager that he sent to human resource and safety managers at area businesses to introduce his practice. He followed up by scheduling meetings with them. Once he got in the door, Dr. Beck focused on three things: displaying frames and discussing their costs; defining how the companies wanted to run their eye safety programs; and determining how much they wanted to pay for employees’ safety glasses. For his occupational safety eyewear accounts, Dr. Beck provides eye exams (typically covered by vision care plans) and dispenses eyewear “just like for any other pair of glasses.” He relies upon Twin City Optical in Minneapolis “almost exclusively” for his safety lenses and frames. Dr. Beck works with a variety of industrial accounts. They employ from eight to nearly 350 people. They include manufacturers of fire trucks, wire, pillow materials, wood fixtures for stores and hockey sticks, and a book distributor. Snowmobile manufacturer Polaris is his largest account. In addition, he contracted with six other occupational accounts through Twin City Optical. As the provider for these accounts, Dr. Beck doesn’t have to handle any paperwork. Twin City Optical directly bills the industrial accounts for the materials, then reimburses Dr. Beck for his dispensing fees. Contracts are not much of an issue; Dr. Beck doesn’t have any with his accounts, even though each has its own safety needs and administrative policies. He doesn’t require exclusivity of services. “If we take good care of these employees, we can help them with their other eyewear needs, too,” he says. “It must work because we’ve had a lot of good referrals through different businesses as a result.” Lab as a Liaison You can set up an occupational account by using a wholesale optical laboratory as your go-between. Typically, the lab provides the safety lenses and frames, and handles all billing between the industrial account and your office. The lab might also provide literature for patients. You can either bill your professional services directly to the industrial account or get reimbursed by the lab. Here’s how Essilor Laboratories of America (ELOA) set up its industrial “go-between” accounts through Twin City Optical. Joe Marcella, Twin City Optical’s director of industrial sales, contacts an optometrist to see if he or she would be interested in fitting safety eyewear and what kind of dispensing fee the doctor would charge. The industrial account supplies requirements for frames, lenses (which may include progressives), side shields (permanent or detachable) and materials (plastic, polycarbonate and sometimes glass). ELOA carries more than 350 styles of safety eyewear for all types of industries, through major suppliers such as Titmus, Hudson and On Guard. Mr. Marcella says about 10% of industrial frames still use glass because it doesn’t scratch. The balance is split between plastic and polycarbonate, with polycarbonate favored slightly. “Every industrial eyewear program is set up with the needs and/or requirements of the particular industry in mind,” Mr. Marcella says. “We advise them on the American National Standard Institute (ANSI) Z80.1 standards, and inform them that they must comply with these standards.” (ANSI Z80.1 provides domestic standards for impact and shatter resistance that ophthalmic lenses must meet.) ELOA also assists O.D.s who want to contact prospective industrial safety accounts on their own. “Optometrists in many areas have taken a proactive role in signing up with industries themselves,” Mr. Marcella says. “If the O.D. doesn’t have much direct competition in the community, then it’s a relatively easy thing to do. However, if there’s competition, many O.D.s don’t realize how price-competitive industrial accounts can be, and they end up quoting prices that are too high. If we can act as a liaison on their behalf, then both sides benefit—because if we don’t have optometrists to fit our safety glasses, then we don’t have a program.” School of Hard Knocks Knowing the facts about eye injuries and safety eyewear will help you promote your occupational practice. So, staff education plays a role. Some 2,000 industrial eye injuries occur each day in the United States, “primarily because people aren’t wearing eye protection,” says Boston ophthalmologist Paul Vinger, a clinical professor at Tufts University School of Medicine. The Polycarbonate Lens Council reports that almost 200,000 eye injuries occur each year in the home. Much of the so-called safety eyewear patients can buy over the counter isn’t very safe at all. It helps, too, if you thoroughly understand your own product liability exposure. Of course, your “duty to warn” applies with any product you dispense. Nonetheless, you do have an obligation to inform each patient of all his or her eyewear options—whether or not that patient is an employee of an industrial account. This is especially important in occupational settings where the chances of eye injuries are greater than in the home. (For more on duty to warn, see “Web Guideposts on Eyewear Safety,” page 44.) Since the 1970s Dr. Vinger, an outspoken critic of safety eyewear, has conducted his own research into eyewear safety. He’s found that polycarbonate is the only material that consistently meets ANSI impact-resistance standards for industrial use. “Right now, there are manufacturers who definitely comply with safety standards, but there is also a great deal of performance eyewear currently on the market that isn’t safe,” Dr. Vinger says. So, learning about impact standards for lenses is important for you and your staff if you’re going to educate patients about eye safety. “Sadly, the consumer can’t tell the difference between what is and what isn’t safe,” he adds. “The bottom line is, whatever people wear in front of their eyes shouldn’t break.” How do you know if a product is as safe as the manufacturer claims? Again, education is key. “Unlike European countries, where mandatory third-party testing is the law, any provider in the United States can make a claim and market a product as to its performance and conformance to standards,” says Dale Pfreim, president of ICS Laboratories Inc., which provides testing services to optical labs. He says mass merchandisers—particularly home improvement and sporting goods retailers—often sell “protective” eyewear that doesn’t meet ANSI Z80.1 standards. “Each optometrist needs to educate and stimulate awareness in his/her patients about eye safety not solely in causative work environments, but also in the home and during hobbies/recreational activities as well,” Mr. Pfreim adds. Of course, it’s unrealistic to expect you to test every product. “The courts have ruled that eye-care professionals have a responsibility to ensure their patients are able to make informed decisions about lens materials under the ‘duty to warn’ ruling,” says Joe Bruneni, executive director of the Polycarbonate Lens Council and member of the Eye Protection Council. However, there have been some cases in which workers lost eyes and said they would have ordered polycarbonate lenses if only they had known about them. “Doctors have a professional and legal responsibility to advise their patients about appropriate eyewear for all activities, and no doctor should stick his/her neck out by doing anything other than what the rules call for,” Mr. Bruneni says. Adding industrial safety accounts can help boost your practice by driving new patients into your office and building a new network for referrals. However, to make it work—and to protect yourself and your pateints—you and your staff have to get up-to-date about safety standards, which products meet them, and which don’t. u
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Setting Fees: Keep It SimpleWhen it comes to setting fees for your occupational programs, Dr. Harry Beck advises you keep it simple. Here’s how he administers his industrial accounts in his practice.An assistant keeps one folder for each company. Each folder contains information about insurance coverage and safety requirements. Small companies usually get billed once a month. Larger companies, such as Polaris, receive multiple statements per month. Paperwork for the industrial accounts is kept separate from all other records. He charges these accounts a $60 exam fee. Dispensing fees for regular safety glasses are $15-$20 and $12 for standard industrial frames. Prices of frames vary with the type of frame. “My fees are the same whether it’s an individual or industrial account,” Dr. Beck says. “I’ll add a few dollars onto my cost of frames to cover handling and mailing costs, and add the dispensing fee on top of that. It makes it very simple that way.” Dr. Beck won’t make deals or give his services away. “A few times I was asked to provide discounts on dress glasses or offer family discounts just to secure the industrial accounts—and I refused every time,” he says. “I’m providing a professional service at a modest fee, so I shouldn’t have to give my services away. No one should be expected to do work for free.” You may have to negotiate some discounts for the professional services related only to the occupational component—the exam for the covered employee and the safety eyewear—in return for a guarantee that you’ll see a certain number of patients. “For example, if an O.D.’s refraction fee is usually $65, he/she may get only $48 for the industrial account,” says Joseph Bruneni, executive director of the Polycarbonate Lens council. “But that shouldn’t deter the doctor from pursuing the account because he/she ends up getting a lot of exposure and business through these types of safety programs.”—H.B. Rk, Ab |
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