Optometry Practice Strategies For Reopening After Coronavirus

With the worst of the COVID-19 pandemic hopefully behind us, I had the privilege of interviewing respected colleagues about their plans to practice in the virus aftermath. A common theme is that these ODs will make greater efforts on behalf of staff and patient safety. There will be costs related to obtaining supplies and equipment for safety and disinfection. Moreover, reducing patient volume and enhancing physical distancing will decrease operational efficiency and hinder collections.

Dr. Ryan Powell, OD, who owns eleven locations in the Kansas City area shared, “A key element that we have been doing for urgent and emergent cases which will continue to do is our ‘questions’ before examination:

They must answer NO to all 4 questions. If they say ‘yes’ or ‘maybe’ to any of these questions, we will ask them to re-schedule.”

Dr. Powell continued, “We will continue following the protocols we implemented for urgent and emergent patients. Our front doors are all locked. We require patients to call for check-in from their car. We will dispense glasses and contact lenses in the parking lot. When our techs are ready to pre-test a patient, they will call the patient from the parking lot into the office. The patient is first taken to a sink and asked to wash their hands. We will require patients to wear a mask. Our team will all wear masks as well. Cleaning will occur in every exam room after every patient. We will not have any waiting room seating. We will wash all frames after they are tried on with dish soap and water. We have N95 masks for our team members and doctors.”

For her new specialty contact lens clinic in Las Vegas, Dr. Stephanie Woo, OD, shared, “We are reopening May 4 and maintaining a schedule of one patient per hour to allow for social distancing and complete disinfection between patients. For my previous office in Lake Havasu City, AZ, which was recently acquired by private equity, the staff ask patients a series of questions before booking appointments, and there is a staff member at the door in full PPE taking every patient’s temperature and handing out masks if they are not wearing them. Plexiglass has been installed at every counter. Staff are wearing N95 masks.”

Dr. Albert Chang, a partner at Family EyeCare Center in Silicon Valley, said that his group practice will implement a split-shift schedule to reduce traffic in the office at any given time to help with physical distancing. He added, “Our changes in response to COVID-19 have a safety component, but there is also a theatrical component to show patients that we care about them.” For example, while efforts to enhance sanitation may visually reassure our patients, they may not all significantly reduce contagion.

Dr. Susan Keene, owner of Envision EyeCare, in Tennessee and Virginia, is making many of the same implementations by other ODs. Even though she and her staff will be prepared to see patients, in her mind, “The big question is whether patients will feel comfortable seeing us.” She is taking note of how patients may express not feeling comfortable coming and is having her marketing agency craft messaging that speaks to those concerns for reassurance. She added, “Our schedules are already full, and patients want to come in. But will they want to spend?” Her practice developed a post-COVID-19 program with their spectacle lab, allowing Pair 50 to be used within 90 days for a family member. “We are trying to help our patients during these financial times. That said, it is important to realize that certain industries are doing fine, so we can’t necessarily assume that everyone seeks a financial break.”

Like other optometrists, Dr. Keene has observed increased activity during the coronavirus pandemic by online retailers, like Zenni Optical and EyeBuyDirect. It is not just online pop-up advertisements. Dr. Chang noted that his practice received an influx of contact lens verification faxes during office closure which got passively verified due to staff inability to respond. Dr. Chang said, “Over the past few months of the pandemic, our demographic has become even more habituated to buying online, including eyeglasses and contact lenses.” Like Instacart, Zoom Video Communications, and DoorDash, it seems that online eyeglass and contact lens retailers have benefited from a consumer shift toward their platforms during the COVID-19 pandemic.

Dr. Keene believes that with reopening, fewer patients will spend $800 or more for a pair of glasses. She says that although there will always be patients wanting luxury eyewear, there is an increasing consumer expectation of getting multiple pairs of eyeglasses for that price due to aggressive multi-pair promotions by online retailers like Warby Parker. Dr. Powell feels that like other practices, he can do a better job communicating the existence of value eyewear packages, like a complete pair of eyeglasses for $99, to capture a greater share of prescription fulfillment. Still, Dr. Chang adds that it is hard to provide eyewear packages for practices like his, which mostly consist of vision plan patients where the vision plan requires itemization of the various lens options.

How is the independent OD to compete with the sophisticated online platforms of online contact lens and eyeglass retailers? “There is an unfair playing field because independent optometrists have to buy protective equipment and disinfection supplies, see fewer patients, and continue managing the costs of maintaining a physical location while online retailers avoid many of these costs because they don’t physically interact with the patient,” according to Dr. Chang. A disproportionate portion of cost for providing care is imposed on the practitioner’s physical business, rather than the online retailers which cherry-pick profitable eyewear material sales.

Dr. Woo shared that, “The best practice may be to have your own online store on your website and send patients email notifications about your online store to make it easy and convenient to order and ship contacts.” There are contact lens order systems offered through the eye care practitioner, such as CLX (CLX System) and Lens Ferry (CooperVision), which can help. These seek to automate and increase capture of contact lens sales otherwise susceptible for erosion to the large e-retailers.

According to Dr. Powell, the COVID-19 pandemic underscores the importance for independent eye doctors to work together to develop a shared, enterprise e-commerce site with functionality that can compete with the major online retailers, rather than each practice having their own mediocre e-commerce presence. Dr. Chang agrees, mentioning that while his practice has considered building a Shopify-enabled online optical, he wishes that a major vision plan would build a shared online optical to support their providers without playing favorites. However, he laments that the vision plans favor using their own e-commerce websites to promote their own frame lines.

Although 2020 was billed as the year for eyecare, so far, it has hardly turned out that way. Still, the coronavirus pandemic will encourage ODs to explore telehealth and e-commerce, bringing new opportunities to our patients and profession. Drs. Powell and Chang agreed that coronavirus may challenge the ODs hoping to retire and sell their practice in the near term, yet it may bring up great buying opportunities for those able to acquire an optometric practice.

Another example of new opportunity may lie in California, where passage of Assembly Bill 443 in 2017 allows appropriately trained and certified optometrists to administer flu, shingles and pneumonia vaccines for adults. It is possible that this legislation may be construed to include any future coronavirus vaccine, especially if there is a call for “all hands on deck” to vaccinate the entire state’s population.

Meanwhile, it is back to business for many ODs, but slowly. “I think if we take proper measures, we can safely reopen. Everyone just needs to be diligent in considering the safety of themselves and those around them,” said Dr. Woo.