CONTACT LENS

We have all been impacted financially in our practices by large mail order contact lens companies," acknowledges metropolitan Washington, D.C.'s Daniel Poth, O.D. "But the real question we must ask ourselves is: Are we dealing with the patient's perception of price or convenience?"

To answer that question, more and more optometrists are creating practice-building successes, failures, and future plans with everything from zip code-directed mail order and their own mail order companies, to mail order companies for other doctors, and computer-directed mail order shipments of lenses on their web sites.

Still others offer delivery of contact lenses by "snail mail," courier, and overnight delivery services, or even at drive-up windows. To find what works best, we asked six seasoned optometrists--doctors who've been in practice from between 12 and 50 years--to discuss their forays into the mail order contact lens field.

CONTRIBUTING TRENDS

There are, in fact, several trends that are contributing to the rise in mail order. Dispensing contacts only at a follow-up appointment has been a slowly disappearing trend. And, the expiration date on contact lens prescriptions has been extended for many practitioners by state laws. Also, there's been modification of the frequency for follow-up care.

Doctors also say they are anticipating hoarding by paranoid-about-Y2K patients. Other markets are already responding to that previously unforseen impact of the millennium moment. For example, pharmaceutical giant Eli Lilly plans to increase its supply of insulin for the fourth quarter of 1999 from a 30-day to a 45-day supply to meet possible hoarding demands by diabetics. And, office supply chains already report increasing sales of storage containers and computer supplies by hoarders.

Will our patients want to hoard contact lenses? Some of the nation's optometrists say they are, indeed, preparing to meet a possible demand for contact lenses at the turn of the 21st century.

GREG MCGREW, O.D.

t a solo practice in historic Leesburg, Va., Greg McGrew, O.D., is taking advantage of an influx of many new permanent residents into what is now a growing, high-tech area.

During a six-year period, recalls McGrew, "Val Pak coupon mailers were a successful mail order practice builder for years one through three, but when there was a declining profit return over the next three years, I searched for new avenues." After analyzing this type of mail order business, McGrew, a solo practitioner for a dozen years, concludes, "The influence of managed care led to its declining source as a money maker."

To remedy that, McGrew now has plans to set up a Web site for his office. He will specify mail order contacts for existing patients who have had an exam with a six-month follow-up. "Our patients will be able to participate in an e-mail plan for disposable contacts, but we will have a one-year cut-off limit," says McGrew. After an annual exam, the patient's prescription will be renewed. The doctor's goal is meeting the convenience needs of patients.

WILLIAM RAMSAY, O.D.

Ft. Myers, Fla. optometrist William Ramsay is a staunch Web site advocate and uses this medium in a variety of ways to increase patient awareness about his practice. He explains his contact lens care as ranging from providing Vistakon's Acuvue bifocal disposable contact lenses as a "new medical device," to ortho-k. He repeatedly states that "your eye health is our top priority."

Patients can obtain Ramsay's free e-mail newsletter and then order contacts by e-mail. Since a majority of his southwest Florida patient base is seasonal residents, he fills prescriptions worldwide and ships lenses, especially during the non-season.

For the patient interested in price, Ramsay uses rebates with manufacturers' coupons. As he explains in his e-mail newsletter, "Our prices are usually better than elsewhere, including mail order." Depending on the contact lens manufacturer, he charges between $2.50 and $10 per six-pack box of disposables. His mail order lenses include conventional and disposables, toric, and tinted disposables.

In addition to a transient residential population, Ramsay emphasizes that his mail order marketing programs are for his own patient base. Those programs, he adds, also provide a means of competing with the chain stores.

BARBARA ANAN KOGAN, O.D.

Washington, D.C. is similar to the Sunbelt in that a portion of the patient base is temporary residents. This includes those on overseas assignment for the State Department and international businesses. It is not uncommon for O.D.s to receive panic phone calls or e-mails for replacement or spare contact lenses from these patients. This is especially so for the high myopes or toric lens wearers.

With e-mail as a two-way communication source, the patient can request which lens or lenses are needed, and the optometrist's office can notify the patient by e-mail when the lenses are shipped.

My own practice was four blocks from the White House, and I sometimes heard from overseas patients needing an extension in their six-month or annual follow-up exam. Plus, nearly all patients were compliant about their contact lens care when returning to D.C.

Providing this mail order service was also a referral source for other colleagues at the site where the patient is temporarily located, many of whom later return or relocate to Washington.

Many Capitol Hill patients become added to this temporary resident mix when Congress is in recess, as both legislators and their staffs often return to their home states. After a recent election, they also may lose their jobs and relocate. So, even your base patients are often on the move.

To speed up delivery, it is advisable to have the patient's credit card number on file. It is also not uncommon for a colleague or family member to hand deliver the mail order request after going to the location of the patient.

PAUL KLEIN, O.D.

According to Ft. Lauderdale, Fla. optometrist Paul Klein, he and his partners "tried a doctor-directed mail order company for contact lenses at least six or seven years ago where we would mail patients their lenses for other doctors." The prescribing doctors then would be credited with the payment less a service charge. "Doctors were reticent about releasing contact lens prescriptions," Klein recalls.

Now, the South Florida optometrist has a convenience program for his own patients. Here's how it works: "We have the patient's credit card on file and through a computer program from Vistakon, we can offer either a full annual supply of disposables to be mailed or have the lenses shipped every three months." This internally- directed program also offers competitive pricing, according to Klein.

What about Internet sales? The concept of e-commerce raises doubts with Klein, as he cites the amount of set-up costs to design a web page for mail order contacts. He also believes there is "extreme hesitancy from banks to finance an e-commerce mail order company because of its risks."

DANIEL POTH, O.D.

As president of Hour Eyes Doctors of Optometry's 13 offices in Northern Virginia and 12 in Maryland and the District of Columbia, Poth finds direct mail a good solution to the mail order craze.

"We tried developing a mail order company of our own for a while," explains Poth, "but most patients had an 800 number with a large mail order company."

Instead, says Poth, "offering promotions though direct mail is a more effective way to reach residents in zip codes near the office." He says he found it important to include copy in the direct mail order advertising about combining the convenience of the offices providing optometric care and the types of contact lenses.

While primarily using mail order for disposable contact lenses, Poth's Hour Eyes offices also include various promotions for tinted and planned replacement lenses.

WAYNE WOOD, O.D.

One of the most creative concepts of meeting a patient's perception of convenience occurred several years ago when Jacksonville, Fla. optometrist Wayne Wood constructed a drive-up window on to his existing office for contact lens dispensing. Wood's drive-up window joins those for dry cleaning drop offs, banks, fast food restaurants, and drug prescriptions from pharmacies.

In addition to patients coming into the office to pick up their lenses, Wood, a practitioner for 50 years, offers three additional dispensing conveniences--courier service, conventional mail service or overnight delivery services.

"We do not openly do mail order advertising to non-patients," explains Wood, "because it is unethical, and ocular health cannot be checked. The fit of the contact lenses cannot be evaluated, either."

Though their strategies vary, all of the six optometrists profiled above have taken the mail order concept and adapted it to their own practices. That's the key, say experts. Something like mail order can work. But it has to work in a way that's both comfortable for you--the eyecare professional--and convenient for the consumer--your patient.EB

Barbara Anan Kogan, O.D., practiced in Washington, DC for 13 years and has a Web site describing specialty optometric care for ortho-K, bifocal contacts, computer and learning-related visual problems.