The Dynamic Dispensary
by
Shane Kannarr, OD
The dispensary is the major profit center for most optometric practices. On average, the
dispensary will provide half to two-thirds of the revenue in a typical practice1. While the
dispensary is undoubtedly a key component of most practitioners’ incomes, surprisingly,
this income producer receives a minority share of the practice’s management time. With
a few small, easy-to-make-changes, the dispensary can become dynamic.
Dynamic can be defined as “characterized by energy or effective action.” If every
member of the office staff works to create an effective experience for the patient, several
positive changes can occur almost immediately.
In fact several key points drive the dynamic dispensary-communication, knowledge,
solutions, credibility, and reinforcement. Each will be discussed in more detail, but all
must come together for the dispensary to reach its potential.
Communication
To properly address a patient’s eyewear needs, a variety of information must be gathered.
Of course, this must include obvious information such as prescription medications taken,
ocular health, as well as any insurance benefit. When making the proper
recommendations for eyewear, doctors and staff also should inquire as to hobbies,
occupation, and any work requirements the patient may have. A patient checklist,
questionnaire, or exam form aids in gathering this information. At each phase of the
exam, staff should be seeking information and communicating it to other staff members.
For example, a patient might say, “My husband and I are going on a cruise, so I need to
get my eyes checked first!” which might mean the person is in need of sunglasses or
perhaps contact lenses. If the staff person scheduling the appointment does not
communicate this information to other staff members, the patient’s needs may not be met.
Several options exist to communicate information among office staff. For example, most
computer-based patient systems allow for the input of notes from the time the patient
record is entered. A note page at the back of the hard copy paper chart allows this
information to be jotted down. If all else fails, there is the marvel of modern technologythe brightly colored Post it® note.
The doctor is the primary driving force for most prescriptions filled in the dispensary. It
will make the optician’s job easier if simple comments made by the doctor to the patient
are added to the patient’s chart. The doctor should include recommendations in the
patient plan or on a lens menu brochure. Additional comments from the patient can be
included on the notes page in the computer, or in the back of the chart. A simple question
such as, “Last time you were in you were getting ready to take a cruise, How was it?,”
will not only make the patient feel like they have had a more personal experience, but
also make the patient more forthcoming with information during the next visit. Such
patient notes play an important role in patient relations.
Knowledge
The information available to patients today is overwhelming. Each staff member must be
knowledgeable about eyewear options that are available and may be beneficial to
patients. During pretest procedures, a patient may let a technician know they would like
photochromic lenses because their occupation requires them to spend much of their time
on the road. If the technician simply gives a quick “okay”, it will affirm to the patient
this is a good choice. However, staff will have missed an opportunity for the doctor or
optician to discuss with a patient the benefits of polarized sunglasses, as well as the
option of photochromic lenses. The entire staff’s knowledge of patient options and needs
is the key to successful patient care.
Solutions
The purpose and goal of the dispensary is to provide solutions to patients needs. Yet,
another word for solutions is sales. Patients have selected your optometric office to
provide the benefits of enhanced quality of life. Patients expect the staff and doctor to
gather and assimilate all the information he or she has provided before entering the
dispensary, to help them select the frames, lenses and lens coatings that meet their unique
needs. A sales approach to patient care, done in an ethical manner, includes the staff
accurately gathering and communicating information, and sharing knowledge by
providing appropriate solutions to the patient’s needs.
It’s often said that an optician simply should provide options and not worry about
patient’s funds. That does not mean staff must be cost conscious for the patient, but
rather they should be alert to any indications that the patient may be acting guarded or
seem to be overwhelmed by the information or the cost. It is important for all staff to
know that eyewear may represent a significant portion of the patient’s income. Often the
examination fees and eyewear costs can total over $500. If this is the case, the staff
should offer more affordable alternatives. In all cases, the optician needs to be sure to
educate patients about the advantages and disadvantages of alternative solutions.
Credibility
Credibility is easily established through knowledge of individual patient’s needs and
offering options to meet those needs. Office staff must be aware that each patient
overhears the conversations of other patients. If these conversations sound like a fast
food server’s script, that is how the patients will perceive them, as well. Other keys to
credibility are backing office products and not trying to sell patients the same products
year after year-especially if they have been dissatisfied in the past. An office will lose a
patient quickly if the staff convinces them to try the exact same progressive he or she
disliked the first time they tried it. (The office may try again if big changes in technology
occur that improve the original product. Just make sure the patient is aware of the
changes.) If a patient tries an option and it fails to address specific needs then a refund is
in order. Or glasses need to be made. Patients may not feel like the office has a vested
interest in their care if they perceive the office is profiting from their failures. The shortterm gain might be enticing, but the long-term cost to the practice is immeasurable.
Reinforcement
A truth often overlooked is that sticker shock does not set in when items are initially
purchased. Sticker shock occurs when the patient picks up the product. At the fitting
visit, the optician and many times the doctor,describes the benefits of each feature (e.g.,
the anti-reflective coating decreases glare, the progressive lens provides a clear view at
all distances, and so on.) Then a week to 10 days later the patient returns to pick up
his/her purchase. In the interim, perhaps their spouse has questioned them about the cost
of their new eyewear, or they have had a lot of bills come in, and the office requires the
balance be paid when the spectacles are dispensed. Then, the typical optometric office
adds the kicker. “It may take several days to get used to this progressive!” or “Only
clean your lenses with this cloth or they will scratch!” or “Well, the semi-rimless frames
are thicker on the bottom!” Wrong! A better approach is to reinforce the benefits of the
product the patient has purchased; not to end on a negative note. Reviewing the benefits
and product quality is imperative so the patient can positively perceive the value of their
purchase. Because the optician and the staff have made certain they have provided the
patient the correct options, the conversation should sound something like, “Your new
state-of-the-art eyewear will provide clear vision at all distances. The anti-glare coating
will allow you to see the clearest, most vibrant image possible. Your high quality frame
really accents your features well so it not only looks great, it fits you beautifully.”
The patient should also leave the office with literature stating all the benefits of the
glasses, including the warranty. The take-home piece will prevent sticker shock now and
in the future as well as help reinforce the value of the product purchased. The patient will
also be aware of the benefits the office has provided and will share these benefits with
friends and family. This will soon establish the reputation of the office in the community
as providing the state-of-the-art care that every office strives to provide, and which often
goes unnoticed by the patient.
The Dynamic Dispensary combines communication, knowledge, solutions, creditability,
and reinforcement. The staff communicates with each other and the patients to identify
patient needs and wants. The staff will use their knowledge to determine the best options
to meet their patients’ needs and educate the patient as to why these are the best solutions
for them. Staff communication and knowledge will help the staff’s credibility with the
patient who will then realize the staff has the patients’ needs at heart. At dispensing, all
selected eyewear options and benefits should be reviewed and reinforced by the optician,
allowing the patient to leave knowing they have received the necessary items to see the
world at its best.
The aim of each patient encounter is a unique experience where the patients’ needs and
wants are addressed and satisfied. The patients will appreciate positive, personal
attention, and the office will gain the reputation of being second-to-none in eye care. The
patients will likely remain loyal to the office even in the face of changing insurance plans
or price competition. Happy patients and busy schedules will keep your staff feeling
professionally rewarded and content.
The Dynamic Dispensary is the patient experience every office should be striving to
attain.
1.
Key Metrics of Optometric Practice. Practice Advancement Associates: Management &
Business Academy for Eye Care Professionals. Naperville, Illinois, 2007: 7.
“The Dynamic Dispensary”
To receive one hour of continuing education credit, you must be an AOA
Associate member and must answer seven of the ten questions successfully. This
exam is comprised of multiple choice questions designed to quiz your level of
understanding regarding the material covered in the continuing education article by the
same title.
To receive continuing education credit, complete the information below and mail with
your $10 processing fee before December 31st of this year to the:
AOA Paraoptometric Resource Center, 243 N. Lindbergh Blvd, St. Louis, MO 63141-7881
Name __________________________________ Member ID number _______________
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Select the option that best answers the question.
1. What portion of an average practice’s income is derived from the dispensary?
A. One quarter to one half
B. One half to three quarters
C. One half to one third
D. One half to two thirds
2. Which of the following is not a key point of the Dynamic Dispensary?
A. Communication
B. Loyalty
C. Knowledge
D. Credibility
3. Information gathered is only helpful if it is:
A. Going to increase the sale
B. Interesting to the staff
C. Specifically about eyes
D. Communicated throughout the staff
4. Which of the following is not mentioned as a key to building credibility?
A. Build relationships with the patients
B. Stand behind the products the office sells
C. Know the patient’s previous successes and failures and do not resell failed
products
D. The patient leaving with something that restates the benefits of their glasses
5. Another word for sales, according to this article is:
A. Spiffs
B. Income producer
C. Solutions
D. Purchases
6. Sticker Shock most often occurs:
A. At dispensing
B. At the purchase
C. When the appointment is made
D. 2 weeks after the patient has their new glasses
7. Several ways to gather information include:
A. Check list
B. Questionnaire
C. Verbal
D. All the above
8. Reinforcement is
A. Making sure the patient remembers the benefits of their new lenses at dispensing
B. Being familiar with the products
C. Making sure the patient gives credit to staff’s advice
D. Passing information from one person to the next
9. A printed piece to provide to the patient at dispense will:
A. Prevent sticker shock now and in the future
B. Reinforce the value of the product to the patient
C. Encourage the patient to promote the benefits of the office
D. All of the above
10. First and foremost, sales should:
A. Get the maximum benefit for the patient
B. Get the maximum benefit for the office
C. Be done in an ethical manner
D. Promote the latest products