At Issue: Contact lens practitioners have mixed responses to issue of stocking lenses

Issue: March 1999

A: No

James D. Atwood, MD: It is no longer necessary to stock contact lenses in your office. Today, patients much prefer the convenience of having lenses directly shipped to their home or office. If you provide this service to your patients, the need to have lenses on site for immediate sale to patients is much less. With the advent of disposable lenses, more office space must be devoted to the storage of trial lenses. Therefore, you would either have to get a larger office to accommodate all of the trial disposable lenses and the inventory of stock lenses for sale, or you can eliminate the stock lenses for sale. If you intend to eliminate your stock lenses, you should send a letter to your patients advising them of this change in office policy so they understand they will have to wait 1 to 2 days before they receive more lenses

James D. Atwood, MD, a mobile contact lens specialist, is president of Contact Lens Consulting and Education Worldwide. He can be reached at 1595 La Sierra Dr., Sacramento, CA 95864; (916) 847-8288; fax: (916) 485-8812. Dr. Atwood has no direct financial interest in the products mentioned in this article nor is he a paid consultant for any companies mentioned.

A: Yes

Cheryl Vincent, OD: I think it is to our advantage to inventory contact lenses. Our patients appreciate this, and purchasing alternatives become less of an issue. If we inventory our “work horse” lenses, higher volume discounts are sometimes achieved and we can be more efficient with storage requirements. Each practitioner must decide if the cash outlay is worth the advantages gained with having contact lens inventories.

Cheryl Vincent, OD, can be reached at 310 West Lake Lansing Road, East Lansing, MI 48823; (517) 337-8182; fax: (517) 332-0038. Dr. Vincent has no direct financial interest in the products mentioned in this article, nor is she a paid consultant for any companies mentioned.

A: Depends upon practice size

Christopher Snyder, OD, MS, FAAO: Through “trial” disposable and planned replacement soft contact lenses we have seen how expeditiously and efficiently patients can be initiated into an exciting and successful contact lens wearing experience. That “same day excitement” makes everyone feel like a winner, and having lenses and stock replacement lenses on-hand has become a service expected by many. The decisions of what lenses to stock and in what quantities are a function of the type and amount of contact lens business done in the practice or practice group. For basic lens designs, such as soft spherical contact lenses and many of the planned replacement toric lenses, most practices will do well to stock trial lenses for expedited initial dispensings. (Even basic rigid gas-permeable, or RGP, lens designs are amenable to this type of stocking for initial fittings as well as basic lens replacements.) Very large and busy practices may find that stocking spherical lenses for dispensing is cost effective. But for most practices, the better way to deliver a patient’s regular yearly supply of lenses is to have those lenses drop-shipped from the manufacturer or delivered by a distributor or buying group. When the source is local, same-day delivery is the standard and, otherwise, express delivery works well. This is particularly true for disposable lenses, both from a space and cost standpoint, because of the quantity of lenses required for a comprehensive and complete stock. For more complex designs, as with some toric soft and special RGP lenses for initial fitting and dispensing, expedited overnight deliveries are the standard service in many practices.

In practices that focus heavily on specialty contact lens fittings and care, lens stocking may be viewed differently. For example, active fitters of bifocal contact lenses must have a generous stock of lenses on hand to optimize success from the vision refinement and delivery perspectives. Large practices that are busy in RGP and toric soft lens fittings/dispensings may also find it worthwhile to stock larger supplies of lenses for these same reasons.

Whatever practice protocols are adopted, a primary goal should be that the patient can expect to get what he or she needs quickly and conveniently. Simply said, the capabilities to dispense contact lenses from an on-hand supply and to provide for expedited delivery, when appropriate, are extremely important components for providing excellence in patient service and, in so doing, for remaining competitive in the eye care delivery marketplace.

Christopher Snyder, OD, MS, FAAO, is a professor of optometry at the UAB School of Optometry. He can be reached at 1716 University Blvd., Birmingham, AL 35294-0010; (205) 934-6768; fax: (205) 934-6758; e-mail: Csnyder@Icare.opt.uab.edu. Dr. Snyder has no direct financial interest in the products mentioned in this article, nor is he a paid consultant for any companies mentioned.

A: No

Douglas R. Weberling, OD: Ten years ago my answer would have been an unequivocal “yes” to optometrists having large inventories of contact lenses. At that time our replacement inventory value was in excess of $50,000.

Today our inventory of contact lens stock is approximately $5,000. This seemingly radical philosophical change was a result of many hours of study.

Initially, our accountant brought to my attention the actual cost of having this large inventory and its effect on our practice’s bottom line. With the changing environment in our profession we noticed our net income declining. We were receptive to his advice, but wondered how to implement it without hurting the convenient service our patients were accustomed to.

We found that by using the direct mail service available from most contact lens companies our patients were even more pleased. It costs us nothing to ship and saves us staff time in ordering and dispensing.

Not having a large inventory has enabled us to be more proactive in supplying our patients with the newest contacts that become available. Previously, we were required to use our existing stock or suffer the financial consequence of “dead stock.”

We have found it is more important to have a large trial fitting set available. This enables us to give the patients a pair of lenses to use while they wait for their home delivery shipments. We can also be more price competitive with retail outlets because we don’t have money tied up in inventory. The staff time savings allows us to perform more value added services for our patients.

Despite a 90% decrease in contact lens inventory from 10 years ago, our contact lens practice has more than tripled in size. New storage areas for our practice are another benefit.

Douglas R. Weberling, OD, can be reached at 1701 Euclid Avenue, Bristol, VA 24201; (540) 466-4227; fax: (540) 466-3934. Dr. Weberling has no direct financial interest in the products mentioned in this article, nor is he a paid consultant for any companies mentioned.

A: Yes

Harue J. Marsden, OD, MS: Patients have come to expect to leave the eye care office with lenses. For this service to the patient it becomes necessary to stock contact lenses. But there are other issues involved. If the patients in your practice tend to purchase clothing without trying them on, then fitting lenses empirically may suit your practice. Current multi-packed soft lenses and computerized topography rigid lens fitting programs have simplified empirical fitting of contact lenses. Modern technology would support an argument not to stock lenses, which would provide your office with space not filled with contact lenses and the financial commitment of inventory.

If your patients prefer to try on their clothes to ensure a proper fit, you may find that they also prefer the diagnostic contact lens fit. For rural practices where lenses may take days or weeks to arrive at the office, being able to dispense a lens from stock provides a great convenience for the patient. For other practices, there is an immediate sense of value to the visit because the patient has a tangible commodity to take home with them. Unfortunately, eye care services are perceived as having less value than the lens products.

Being able to dispense from stock may decrease the number of office visits required. If you are able to dispense at the contact lens evaluation and follow-up at a later visit, a minimum of two visits is required. With lenses that are ordered empirically, the patient must return for a dispensing visit and then for a follow-up visit, requiring at least three visits. The value of stocking or not stocking lenses will be practice dependent. Even if lenses are ordered empirically, the practitioner should be able to make adjustments based on clinical impression of the fit, whether soft spherical, soft toric or rigid gas-permeable lenses.

Harue J. Marsden, OD, MS, can be reached at the Southern California College of Optometry; (714) 449-7433; fax: (714) 992-7811; e-mail: hmarsden@scco.edu. Dr. Marsden has no direct financial interest in the products mentioned in this article, nor is she a paid consultant for any companies mentioned.