• Boost Practice Efficiency, Part 10: Integrating the Optical Dispensary

    By Leslie Burling-Phillips, Contributing Writer

    This article is from January 2009 and may contain outdated material.

    Many ophthalmology practices include an optical dispensary, but only a few of these are performing to their full potential, said Arthur De Gennaro, president of Arthur De Gennaro & Associates, a consulting firm that specializes in dispensary issues. When it comes to the capture rate—which is the percentage of patients who have their prescriptions filled at their provider’s office—dispensing ophthalmologists lag behind dispensing optom etrists, but this does not have to be the case.

    The Key Word: Integration

    Whether you are considering the addition of an optical dispensary or are seeking to improve one that is already in operation, integrating the medical practice and optical dispensary into a seamless business—rather than two separate entities that operate in isolation—will be the crux of your dispensary’s success.

    Integrate the dispensary into your practice. “When the dispensary is fully integrated into the practice, it thrives because the ophthalmologist begins to view the eyeglass purchase as an integral part of the examination process,” said Mr. De Gennaro. Indeed, when Robert Gollance, MD, co-owner of The Eye Institute in Wayne, N.J., revamped and integrated his dispensary two years ago, the effects were immediate.“One of the most important features is the doctor’s involvement with patients with regard to the eyeglass products that will best serve their needs. How this is presented is very important,” said Dr. Gollance. And when the doctor puts an emphasis on the use of quality goods, the natural progression is toward the dispensary.

    Work as a team with your staff. It is important to foster a team environment where the ultimate goal is excellent patient care—an environment in which each team member is an equally contributing participant in the overall patient experience. This creates the foundation needed to efficiently run a dispensary. “All service is delivered through people,” said Mr. De Gennaro. “Evaluate the skills of your staff members on a regular basis and remediate those who are lacking. You can have a building, equipment and glasses, but nothing can happen without the people. It would then seem reasonable that you should invest large quantities of time, energy and money into finding the right staff, setting high work standards, effectively training and directly supervising them—which means ongoing coaching—and paying them fairly.”

    Think of your patients as eye health consumers. A basic premise of dispensary integration involves viewing your patients in a different way. “When you see your patients as eye health consumers, you are able to interact with them more efficiently,” said Mr. De Gennaro. Further, “eye health consumers who purchase eye care or eyewear have a unique set of expectations for their visit. They have expectations about the length of their visit, and about both the quality of care that they receive and the quality of caring—i.e., customer service—that they receive. In some cases, those expectations are met. In others, they are not. And often, they can be exceeded. Savvy businesses manage their patient’s experiences with follow-up phone calls and questions about the products and services they received and respond accordingly to remedy anything that isn’t working properly.”

    View the eyeglass purchase as an integral part of the examination process. “You have to talk to your patients and tell them why they should have their spectacle prescription filled at your dispensary,” said Dr. Gollance. “I spend a few minutes discussing their visual needs—prescription analysis—and communicate that what we do here is more than a prescription. At the conclusion of our visit, I escort my patients to the optician where we discuss the patient's eye care needs. I also guarantee that they will be happy with our service and products. Essentially, I convey that they are getting value that they would not get elsewhere.”

    Who Dispenses

    • The capture rate for spectacle patients in ophthalmologists’ dispensaries is almost 30 percent lower than the rate in optometrists’ dispensaries.1,2
    • Optometrists have a capture rate of almost 85 percent. Only 14.3 percent of patients who receive spectacle prescriptions from their optometrists take them to another optical vendor to have them filled.3
    • Optical dispensaries account for about 30 percent of the total revenue in a dispensing ophthalmology practice.2


    1 American Academy of Ophthalmology. Biannual Survey [unpublished proprietary data]. San Francisco: AAO; 2007.

    2 Jobson Optical Research. MD Dispensing Survey 1999/2000. New York: Jobson Medical Information LLC; 2000.

    3 American Optometric Association. Caring for the Eyes of America 2008. St. Louis, Mo,: AOA; 2008.

    Educate Yourself

    Learn how to operate a retail business. Opticians are typically trained in the technical, rather than the operational, aspects of the business. “The average optician has never built a price list, conducted a marketing campaign, established a frame inventory or been responsible for gross profit control. Too often the ophthalmologist simply hands over the business and instructs the optician to run it. This is a prescription for failure,” warned Mr. De Gennaro.

    Seek information from a variety of sources. One of the simplest resources to tap is industry trade publications. Peruse them regularly for tips on operating an efficient dispensary and to stay up-to-date with eyewear trends.

    A wealth of information also can be garnered from professional organizations. Networking with your colleagues can prove invaluable. “The American Academy of Ophthalmic Executives (AAOE) has a listserv for members where optical questions can be posted. I, along with other consultants, monitor the list and are available to answer questions,” said Mr. De Gennaro. The AAOE and other associations offer seminars and courses.

    Dr. Gollance discusses optical care with opticians in areas far enough away not to be his direct competitors. “I am always looking for something new,” he said. “When I see an attractive-looking dispensary, I always go in and look around—this includes when I am traveling in Europe. If I find a new product line that I like, I stop and ask what the optician thinks about the product. I also spend time online reviewing manufacturers’ Web sites. It is imperative to know what products are available and to keep up with the latest trends.”

    Know the products your opticians sell. Part of integrating the dispensary is becoming familiar with the products your opticians sell so you can discuss and suggest the most appropriate products for your patients. “There’s no substitute for educating yourself,” said Dr. Gollance. “Not all of our patients have glaucoma or cataracts. Many have visual needs that require glasses. The ophthalmologist should be prepared to discuss the finer points of frames and lenses. If you are not able to do this, why should a patient come to you for eyeglasses?”

    It is also important to become familiar with the equipment that your opticians use to sell your products. For example, Dr. Gollance initiated the purchase of a Smart Mirror. This includes both a camera and a display monitor. Although the device, which some practices find time-consuming, is not widely used, Dr. Gollance believes that it improves his patients’ satisfaction with their selection. “It is much easier for them to look at four frames at once than having to remember what each of the frames looked like,” he said.

    Learn how to market your dispensary. “One of the biggest hurdles we had to overcome was getting over the perception that everyone had about the cost of spectacles at our dispensary being more expensive than at the larger competitors in our area. When I discussed this with my optician, I found the assumption was contrary to the fact—our products were actually less expensive than those of our competitors,” said Dr. Gollance.

    Challenging Changes

    For Dr. Gollance, the changes in how he operated his dispensary were considerable. “It was not like we made a small change to what we had been doing for many years. It was nearly a complete restructuring,” he said.

    Consider hiring a consultant. Outsourcing the creation or restructuring of your dispensary is an expeditious way for a small business to gain the knowledge necessary to successfully operate a dispensary. “Hiring a consultant to manage your project can be beneficial because outsourcing has a beginning, middle and end. These parameters ensure that the project is completed or that the person responsible for conducting the outsourcing is responsible for teaching you the required skills. You can then apply the newly learned skills and do it on your own in the future. Outsourcing in ophthalmology practices is more common than in most medical fields. It works well,” said Mr. De Gennaro.

    New Guide to Dispensing

    There has been a lack of good information on how to build and operate a dispensary business. For years, the Academy has received requests for a single, comprehensive resource, which is why I agreed to writeThe Dispensing Ophthalmologist,” said Mr. De Gennaro. This recently published how-to guide addresses all the major areas of dispensary life, from conception, through operation and ongoing management.

    The Dispensing Ophthalmologist (Product #012179) costs $99 for members and $135 for nonmembers. It is available at www.aao.org/store.

    Contact Mr. De Gennaro via the AAOE Consultant Directory.