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Prescribe starter kits as carefully as lenses
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In my 16 years of practice, I can think of no better time to prescribe contact lenses. Judging by the 30 million North Americans wearing contact lenses, I dare say many of our patients agree! Despite the adversity - increased competition, managed care, refractive surgery - the contact lens industry continues to thrive. And for good reason.
First, there are disposables. No other development has done more to expand the contact lens universe. With each passing year, we witness more disposable lens options: expanded prescriptions, tints, torics and bifocals. Arguably, conventional soft lens advances are equally impressive. We have soft materials that resist deposits, minimize dehydration, correct high cylinders, provide presbyopic solutions and even counter spherical aberration! And let's not forget our rigid gas-permeable (RGP) developments. With enhanced materials, designs and manufacturing strategies, RGPs perform better than ever before.
Undoubtedly, our advances in lens care are every bit as impressive. A mere decade ago we only dreamed of all-inclusive multipurpose solutions, highly efficacious nonpreserved systems and liquid enzymes. Today, each is a reality. Indeed, it has become incredibly easy for patients to care for their lenses.
Whereas manufacturers have contributed significantly to contact lens practice, clinicians have done their share as well. We continue to learn, adopt emerging technologies and successfully integrate them into contact lens practice. Through these joint efforts, industry and clinicians have made prescribing contact lenses an incredibly efficient process. Just ask the millions who attest to the safety, efficacy, convenience and value of their contact lenses.
Despite these triumphs, there remains at least one controversy. An issue that lacks systematic approach, in which clinicians grope for the right answer and in which patients are simply confused. An issue recognized as anything but efficient: the issue of the contact lens solution starter kit (CLSSK). Ah yes, the kit.
In this age of increased competition and exceptional products, it is understandable why manufacturers are so quick to provide CLSSKs. With clinicians caring for such a diverse patient population, it is equally understandable why we accept CLSSKs. Unfortunately, the eagerness to supply and willingness to accept has resulted in a sizable surplus of CLSSKs! Of course, the "glut" of CLSSKs yields no real winners.
It's doubtful that providing an abundance of CLSSKs does much to significantly alter a clinician's impression of and desire to recommend a given product. Likewise, it's unlikely that dispensing numerous CLSSKs to a given patient significantly enhances the patient's opinion of their eye care provider. Sure, patients will accept all the samples we give them, but do they consider us better clinicians for it?
Furthermore, dispensing a variety of CLSSKs is tantamount to asking our patients to self-prescribe. In fact, perhaps the only winners in this "CLSSK bonanza" are those patients who enjoy many samples!
So, what should we do? Undoubtedly, CLSSKs are essential to any contact lens practice. And, much like contact lenses and professional advice, they should be dispensed appropriately. It is imperative we dispense a CLSSK to each new wearer. It is also reasonable to dispense a CLSSK at annual follow-up, to re-establish the tenets of comprehensive lens care. And it is necessary to dispense an alternate CLSSK to patients with symptoms, complications related to lens care and for those desiring something different (it is better they do so under your supervision.) Of course, it is not appropriate to dispense multiple CLSSKs at the same visit (they are not intended to be a year's supply) or to bundle CLSSKs for resale.
If the CLSSK madness continues, industry forfeits valuable dollars to underwrite its cost - dollars better used for developing new products, supporting clinical education and reducing solution costs. In essence, we all lose. To me, the solution is obvious. Evaluate your prescribing habits, guide your representatives and use your CLSSKs wisely. Either we regulate our CLSSK consumption or someone else ultimately will. Sound familiar?