Dry eye patients walk through the doors of ophthalmology practices every single day. Some come because they’re symptomatic and seeking help. Others aren’t experiencing or complaining of symptoms, but the disease is brewing. In all likelihood, they are the largest patient segment in any eyecare practice.

At Bowden Eye & Associates, we consider it our duty to take care of them. In the past 5 years, we have ramped up our efforts in this area, much to the benefit of our patients and our bottom line.

Unfortunately, as I lecture and talk with doctors and their staff members from across the country, I hear the reasons why they haven’t increased their level of care for dry eye patients.

For example, “My patients won’t pay for anything that isn’t covered by insurance” or “I feel bad asking a patient for money.” While it’s true that many of the treatments we offer aren’t covered by insurance, it’s also true that patients will pay for what they want and what they believe is helpful to them. But first they must understand their options — and the value of each available option.

It’s up to the practice to educate them accordingly. Here I explain how our practice does this with great success.

Develop a Dry Eye Standard of Care

In recent years, we’ve been blessed with many new technologies that help us provide quality care for dry eye. On one hand, that’s fantastic; on the other hand, it means the practice must figure out how to put it all together and make it work to help patients.

The way to do that is to establish a dry eye standard of care. Practice leaders develop the standard of care, which consists of the clinical protocols — including both the diagnostic tools and therapeutic products that will be offered and how they will be used — as well as the processes for executing the clinical protocols.

Be Consistent

It’s important that the established standard of care be executed in the exact same manner for each patient. Doctors and staff should never judge a patient’s willingness or ability to afford any treatment. Recommended care should be based on signs and symptoms, the same among all providers, and presented to every patient.

Patients talk to other patients. We don’t want a scenario in which we have two patients with the same signs and symptoms receiving different recommendations. It’s much more effective to create synergy and consistency throughout the practice.

Consistency should be established, not only regarding recommended care, but also with regard to messaging. Scripting for front-end staff, technicians, and doctors helps to keep communications consistent.

Your messaging needs to be consistent, too, whether it’s on the website, in the waiting room, or in the exam room. When consistency in wording and images is taught to every person in the practice and maintained throughout the organization, patients are successfully “teed up,” so to speak, to schedule their procedures and purchase the recommended products.

I could give dozens of examples of how consistency works, but let’s look at the BlephEx in-office eyelid cleaning treatment. Because all of our technicians are knowledgeable about our dry eye treatment protocols and trained to use the same messaging, they’re able to talk about BlephEx as they’re working with patients. If they see eyelid debris or a crusty lash line, they mention that we offer a treatment for that, which can be performed during this visit.

Last month, roughly 30 patients of Dr. Bowden, our practice’s founder, had one of these treatments after a technician mentioned it. Patients feel better afterward and often come back requesting another treatment.

Present the Options and Benefits

As I mentioned at the outset, patients will pay for what they want and what they believe is helpful to them. Therefore, it’s not our job to sell things to them but rather to present the benefits of what we have to offer to help their condition and let them decide where to spend their money. Remember, dry eye patients aren’t like refractive surgery patients or premium cataract surgery patients; dry eye patients have discomfort and, in many cases, have been seeking relief for a long time.

When presenting options to patients, it’s helpful to use images. Show them pictures, for example, of manual gland expression versus thermal pulsation with LipiFlow (TearScience/Johnson & Johnson Vision) (Figure 1). Let them choose. We do this with femtosecond laser technology by showing patients what it looks like to have the laser create the capsulorhexis instead of a blade, so why not with dry eye?

Another example is the Moist Heat Eye Compress (Bruder) compared with less effective, potentially harmful options, such as hot spoons or a sock full of rice (Figure 2).

Videos are quite useful, as well. We show patients a video that explains the science behind the TearLab Osmolarity System — what it means and why we need this metric today, regardless of whether insurance pays for it or not — to see how we’re doing with their treatment plan. Again, use consistent imagery to help educate patients. Clear choices and benefit comparisons help them make better decisions.

Leave Pricing and Payment Out of the Exam Room

Designated staff members — not doctors — should speak with patients about payment for care. As with all other aspects of the practice’s established dry eye standard of care, the staff members should use scripts. In our practice, we present one price based on what a patient might need. We break it down into an approximate monthly payment, e.g., “For as little as $35 a month, we can make this available to you.” We ask them whether they have a CareCredit credit card, which is the financing option we offer. Sometimes they already do because they’re using the financing for other aspects of their healthcare; if not, it’s simple to get them approved for a credit line to cover what they need.

Doing Our Job To Better Serve Dry Eye Patients

Patients with dry eye have often been elsewhere seeking help, to no avail, before they end up in our exam chairs. It’s our job to capture them. Dry eye isn’t curable; it’s manageable. These patients will stay with us for a lifetime if we take good care of them by helping them manage dry eye. ■