Staff are a critical part of every practitioner's success. This month, Shane Foster, OD - a 2019 Best Practices honoree - shares his insights into training a best-in-class staff.
How important is staff training in supporting the contact lens recommendations you make? Why?
My staff plays a crucial role in the contact lens fitting and sales process. When staff members are properly trained and utilized, the doctors’ chair time with contact lens patients is greatly reduced. Having the whole staff educated and involved allows multiple points of contact where the patient can be exposed to education on contact lenses. Hearing consistent messaging throughout the patient experience helps the patient feel confident in our contact lens recommendations and comfortable in the level of care they receive from our practice.
Which aspects of the contact lens fitting and prescribing process are your staff heavily involved in? What is your approach to training them and keeping them current on contact lens features and recommendations?
After completing the refractive testing and ocular health examination, I discuss with the patient the reasons I would like to fit (or refit) them into a particular lens modality. I reference their individual refractive and ocular health needs when making a recommendation and tell them the technician will go over all the details.
At that point, the technician presents the patient with a document detailing the cost of a fitting, the supply cost, available rebates, and any applicable coverage from their vision plan. Only the fees for the preferred lenses are presented at first. If the patient has concerns with the cost or modality, only then does the technician present information for an alternative modality.
When the patient elects to proceed with the fitting, the technician calculates the appropriate contact lens powers from the doctor’s refraction, using CooperVision’s ToriTrack Calculator if necessary. In my office, we have one or two preferred brands based on performance, patient cost, and profit margin, so the technicians always know which brand to select first.
The technician places the initial lens on the patient’s eye, lets the lenses settle for a few minutes, and then measures visual acuity. We have also trained our technicians to observe lens fit with the slit lamp. This has saved our doctors immense amounts of chair time. If the initial lens is performing well, then the technician proceeds with care and handling instruction as needed and dispenses additional trial lenses. I see the patient when they return in one to two weeks for their contact lens follow-up appointment to do an over-refraction and confirm adequate lens fit and good ocular health. After I finalize the contact lens prescription, the technician discusses supply cost again and encourages the purchase of an annual supply.
Do you train all staff (ie, including front desk, etc) about contact lens features and benefits? If not, how do you prioritize individual staff member training?
All staff members are trained on our practice’s overall philosophy with regard to contact lenses, but generally only technical staff are expected to know the details. For example, our front office staff and even our frame room staff understand that our office’s policy is to fit each patient in a daily disposable lens whenever possible. Everyone in our office understands that daily disposable lenses offer the healthiest way to wear soft contact lenses and the benefit of a fresh clean lens every day. However, when it comes to understanding the Rx parameters available in a specific lens, which lens offers the best oxygen transmissibility, or which lenses we have in stock, our technician staff members are the experts in that area of knowledge.
How effective is your staff in speaking to contact lens features and reinforcing your recommendations on a day-to-day basis in your practice?
Since all of our doctors and staff have been trained on our contact lens fitting philosophy, the messaging carries throughout the entire office. From the front desk staff who schedule the patient and inquire about current contact lens modality to the technicians who explain the specific clinical reasoning for a certain lens, we are all committed to providing our patients an exceptional level of care. The key to getting buy-in from staff (…and doctors!) is to make sure everyone is wearing a preferred product. All of our doctors and staff wear daily disposable contact lenses (including toric and multifocals when appropriate), and we always encourage them to try the newest products when they hit the market. When you personally experience the benefits of a product, it is much easier to convey that message to the patient.
Do you encourage your staff to seek certifications/licensures/ etc in the area of contact lenses? Which ones and why?
We certainly encourage all of our staff members to seek more education in their area of expertise. We invite all staff members to the East West Eye Conference each year and pay for their registration, travel, and hotel expenses. We also attend other educational events throughout the year presented by the Ohio Optometric Association and Vision Source. As for contact lens technicians, we encourage them to get certified by the NCLE (National Contact Lens Examiners). While it is not required, pursuit of this certification shows a technician’s desire and motivation to learn more about the profession. The practice covers the cost of the exam and any study materials, and when the NCLE certification is obtained, that staff member also earns a wage increase.
Please share any additional advice or recommendations for practitioners who want to further involve their staff in the contact lens fitting process.
Training staff to make an initial lens selection or even evaluate lens fit with the slit lamp does take a lot of hands-on training time, but the time spent doing it has a great return. My contact lens technician has become an integral part of the process and saves the practice a significant amount of doctor chair time. This independence builds staff confidence and helps encourage retention while also elevating the role of the technician in the eyes of patient. Our patients have begun to ask for our contact lens technician by name, and they trust her decision-making and respect her expertise. In my practice, this was also the first step in delegating even more to our technicians, including dry eye testing and some patient education. We hope this will allow our doctors to become more efficient, see more patients, and generate more revenue.