It’s the end of a long day. You’re looking at your end-of-quarter optical tracking reports and the news isn’t good. Lab turn-around time has increased. Your optical sold fewer multiple pairs and add-ons (like anti-reflection coating) this quarter. The number of CR39 plastic lenses sold increased, and the number of thinner, high-index lenses sold decreased. On top of that, the number of patient refunds is up.

You’re dreading tomorrow’s meeting with your optician. What excuse will he come up with this time?

What’s really going on

Sound familiar? What you may not realize is that a poorly performing lab may have caused this situation.

I call it the "Please don’t scream at me" scenario. Your optician promises a patient that her lenses will be ready in 5 to 7 working days. The lab fails to deliver. The patient then "screams" at the optician: "You promised my lenses would be ready!" So, the optician "screams" at the lab: "Get my patient’s job done NOW!"

The next patient arrives and asks, "When will my anti-reflective, high-index lenses be ready?" Because your optician doesn’t enjoy being screamed at, he plays it safe and answers, "In about 2 weeks." So the patient decides to settle for "faster" CR39 lenses and postpones getting that extra pair.

No one gets screamed at . . . but your optical loses money. Meanwhile, the entire situation might never have occurred if your supplier had a better understanding of your patients’ needs and expectations.

Finding the right laboratory

Most complaints that you’ll receive from patients will be the result of disappointment that their "optical" experience didn’t match their "ophthalmological" experience. This is often a direct result of lab service problems.

If a patient you’ve been treating successfully for years has to wait to get her glasses because your optician returns them to the lab three times to correct lab errors, that patient is going to blame you. If you point out to the patient that your optician is just making sure that she receives properly made glasses, she’ll say, "Surely a doctor of your caliber can find a decent lab."

The moral? Blaming the supplier never works. You have to get your lab (or labs) on your team — or find different labs.

Your optical/vendor team

In the game of optical dispensing, what you need is a team of suppliers who know the rules, play fair and self-correct mistakes — even if you’ve caused them.

Like it or not, you, the doctor, play three roles in this game. If you want your optical to be successful, you’ll need to:

• Define your needs and set goals
. As the business owner, you have to decide what level of quality will keep your patients happy, specify the services your optical requires and determine how much you want to pay for those services. To do this, you evaluate your patients’ needs, using input from both your patients and your staff. You verify this information by using tracking reports to see what’s actually happening. (For help with tracking, see Dispensing Frontiers in the February, March and April 1998 issues of Ophthalmology Management.)
• Choose your vendors
. Once you know exactly what your optical needs to produce great results, you must decide which suppliers can best meet those needs.
Your first reaction may be, why me? Isn’t that my optician’s job? The problem with abdicating this role is that you’ll bear the responsibility for the results without controlling the circumstances that created them. And you’ll be hard pressed to resolve a problem when you really don’t understand what caused it in the first place.
This doesn’t mean you’ll be placing orders — that is your optician’s job. But putting yourself in the purchasing loop will keep both suppliers and optician accountable to you. After all, you pay the bills, you’re responsible to the patient, and you’ll be reported to the board of ophthalmology if there’s a serious complaint. The lab CEO has to know that.
Even more important, by participating in the decision-making loop, you change the nature of the relationship that results. You become the customer, not your optician. If the lab thinks of the optician as the customer, the optician can make choices that he won’t have to take responsibility for.
Of course, your optician should make suggestions about which vendors to pick, check price lists and perhaps even bid the top candidates. But you should be the one who sets the rules and decides which vendors are best suited for the job.
• Monitor the results
. To monitor the results, you need to develop a specific "purchasing protocol" for your office. The protocol should include a feedback loop that allows you to tell how well the system is working.
To manage this, you must take responsibility for keeping tabs on the members of your "team." This means knowing what each team member is responsible for and, as much as possible, making sure he or she performs as expected.
In your office, "team members" include your office administrator, your optician and your financial manager. At the supplier’s end, you may be dealing with a sales rep, a regional manager or owner, financial administrators and lab managers — not to mention the person who takes the orders.
Each one of these team members can affect quality, service and price. If the members of your team know that you’re paying attention, they’re much more likely to be accountable. And when you know who’s responsible for each segment of the buying cycle, you’ll eliminate "finger pointing" when your promises aren’t being kept.

Defining what you need from your lab

Patients expect the same caliber of quality and service from your optical that they’ve experienced in your medical practice. So the first step in creating your purchasing protocol for labs is to define the level of quality and service your optical requires.

The best way to do this is to survey patients about the service they’ve received from your optical. A short questionnaire asking patients to rate your level of service at the time their glasses are dispensed will tell you whether the promises your practice is making are being kept. It will also tell you a lot about what’s important to your patients, because most patients won’t even bother responding to a questionnaire unless they’ve had a very positive or negative experience relating to something that’s important to them. (That’s a good reason to take their comments seriously.)

Here are some sample statements you can ask patients to rate on a scale of one (true) to five (false):

• I can see more clearly when driving when I wear my new glasses than when I wear my old pair.
• I read better with my new glasses than with my old pair.
• My new glasses feel better than my old pair (they’re lighter, they don’t slip as much, they don’t pinch, etc.).
• I got my glasses when promised.
• The price I paid for my glasses was fair in today’s market.
• I would refer my friends to your dispensary.

Pre-pay the postage and have patients send the cards to your office administrator. Don’t have them send the cards to your optician. Make sure you see all the returned cards. The feedback will help you determine the quality, service and price standards your lab needs to maintain.

Choosing your laboratories

To decide which lab to work with, have your optician bid the top candidates by telling them exactly what you’re looking for in a lab supplier; then let them submit a proposal. When possible, you should talk to the owner of the lab about the level of quality your patients demand — and why they expect that level of quality.

Factors to consider:

• Ophthalmologic patient needs
.

Is the lab well-equipped to meet your specific needs? A given lab may not be familiar with the special needs of an ophthalmology practice. For example, a lab may boast of same-day turnaround. But if you fit mostly +2.25 diopter adds in 7X28 trifocals (a common lens for M.D. practices), and the lab doesn’t stock this lens, you might wait 10 days for the lab to get the lens from its supplier. On the other hand, the owner or lab manager may choose to stock more of these lenses if he knows he’ll have your business.

Pricing

. After examining lots of lab price lists over the years, I’ve found that the range of price differences among labs stays within 5%. This is for a standard mix of single vision, bifocal, progressive and trifocal lenses. Therefore, finding the cheapest price won’t make much difference in your actual bill.
Instead, quantity discounts are the key to cutting costs without compromising quality. You can get quantity discounts if you only work with one or two labs, because you can give them all of your business — and they’ll reward you for it. In fact, ophthalmology practices are gold mines for labs because of the high number of bifocal lenses they buy. (Labs don’t make as much money on single vision lenses.)
Of the three O’s, M.D.s usually pay their bills on time and aren’t as concerned about price. You can use this as leverage to secure a quantity discount; just guarantee that the bill will be paid by the 10th of the month. Also, check prices based on the mix of lenses used in your office. If you want to work with a lab because it gives faster service or is more accurate, but the lab charges 20% more than its competitor for a lens you fit every day, ask for special pricing on that product.

Extra services.

When the lab managers know they must bid the work, they’ll be more creative about offering extra services. When negotiating, I always include lab-sponsored quarterly continuing education for opticians, and lab participation in health fairs or trunk shows.
One lab paid for all of my door prizes at a new office grand opening. Another promised I’d be the first to know of any new lens technology, and they supplied 10,000 postcards to announce a new product when it appeared. (My patients had the cards in their hands the day my competitors first found out about the lens.) Another supplied free T-shirts for my entire staff to wear for an annual health fair.

Once the labs have submitted bids, accept two of them. If you have a main lab and a main lab "wanna-be," you’ll be able to keep both of them on their toes. For example, the speed of lab service will be affected when the lab’s machines need to be serviced. If one lab takes too long processing a job, you can cancel it and get it from the other lab without more delays.

Also, balance the mix of services so the labs have different niches. For example, you might choose a lab specializing in a progressive lens brand that the other lab doesn’t carry. This gives you access to more brands.

Monitoring the results

Next, you need to set up a system that will let you keep tabs on how well your promises for service and quality are being kept. Two effective ways to do this are by tracking remakes and getting postcard feedback from patients, as I described. Obviously, direct complaints from patients will also serve to alert you to a problem, but it’s far better to catch the problem before it reaches that level.

What do you do when you discover that there’s a problem getting glasses made as promised? Suppose patient feedback indicates that glasses aren’t being delivered on time. Discuss the situation with your optician. He may or may not know what’s at the root of the problem.

Don’t automatically assume the problem is the lab’s fault; it’s possible that the optician may be misquoting the amount of time promised by the lab.

If it appears the lab is to blame, call the lab manager (who may also be the owner) and ask what the problem is. Because you’ve made it a point to be part of the process, you already have a relationship with the lab manager. Now you can step in and talk to him, CEO to CEO. You have clout, so does he, and the result is that things get done! In short, you’re bringing your problem to the attention of the person who can solve it.

The problem may very well be short-term. The lab’s equipment may be in need of calibration. The lab may have had recent staff turnover, or it may have acquired a new account that’s overwhelming the facility with work. Once alerted that you’re dissatisfied, the lab should correct the problem. If it doesn’t, look for another lab.

Make sure you share the results of your tracking and patient surveys with your lab suppliers each quarter.

A winning combination

Your complaining patient was right. A doctor of your caliber can find and keep a quality lab supplier on your team. Just make yourself part of the process.

Find out what your patients need, choose your suppliers carefully and stay on the case to make sure promises are kept. If you do, your optical will run smoothly, and your patients will be as pleased with their glasses as they are with you.

Leona Meditz has 25 years’ experience in the optical industry. If you have questions regarding this article, please email her at leonam@cwix.com.