Whenever I go to the movies, I feel bad for the kid who works the counter at the concession stand. Apparently they’re all forced to deliver the same spiel to each and every person, hawking some fast food special that the theater assumes—based on zero evidence—customers will consider a newfound delicacy.

“Welcome to Regal Cinema,” the listless teen will say with unconcealed boredom. “Would you like to try our jalapeño and onion pretzel bites with Chili Cheez Whiz?” No, thanks. That sounds revolting. More importantly, it’s not what I just waited in line 15 minutes to order. I know what I want—your tepid sales pitch is definitely not it.

Is this how you feel your patients will react if you mention some of the pricier products you dispense at the practice? It’s a common refrain: despite relying on optical dispensing to generate the bulk of their practice revenue, optometrists have an uneasy relationship with the ‘sales’ encounter.

But too much deference to a perceived impropriety might actually deprive a patient of an outcome they hoped to achieve by visiting you in the first place.

So, what does the movie concession kid get wrong? At least three things. First, he assumes I want his recommendation. I do not. In what way is he an expert on the matter? Second, he fails to customize the experience to me.

A one-size-fits-all sales pitch shows obvious lack of concern for the individual’s unique needs and interests. Third, he does not convey value. Nothing he tells me convinces me that adding another item or switching my order is in my best interest.

Optometrists, by contrast, are experts whose recommendations are highly valued, and who devote the entire encounter to identifying the patient’s unique needs. So, I think it comes down to that third item—the ability to communicate value—that separates high-volume practices from the less robust ones.

As emphasized in this month’s feature on competing with online retailers, perceived value is the key driver of buying decisions. Patients will price shop if you’ve given them no compelling way to differentiate your services from cut-rate discounters.

That also might explain why ODs don’t do better with daily disposable lenses, recommending them for only about 15% of their single vision soft lens fits, according to data from Kantar Media Healthcare Research’s 2013 Eyecare Readership report. When the convenience and health benefits are communicated clearly, patients will be receptive and it won’t feel like a sales job.

You’ll find plenty of creative ideas from your colleagues in our Dispensary Report this month. For instance, Justin Bazan, OD, uses a UV meter to test the safety (or lack thereof) of the patient’s sunglasses as a way to stress the value of better products. And Lorraine Labiento Smith, OD, noticed that petite women kept trying on the kids’ frames at her practice—so, she started promoting that!

Opportunities for healthier patients—and revenue—abound once you give up the notion that ‘sales’ is a four-letter word. Thumbs up to that. Make some popcorn and dig in.

Eye-opening Data
Just how routine is “routine dilation”? It varies considerably. When asked how often they dilate patients during comprehensive exams, the optometrists polled by Kantar Media diverged widely in their practice patterns.

The mean response was 55.6% of exams, but the distribution follows a bimodal curve, with peaks at both the 21-30% and 91-99% ranges. Just 7% of respondents said they dilate 100% of their patients. Note that the question specified ‘comprehensive’ exams.

In our own recent survey of Review of Optometry readers, we found greater affinity for routine dilation in patients with diagnosed cases of glaucoma or diabetes. Readers told us that 74% dilate such patients at least annually and another 20% do so commensurate with the level of disease severity.

It’s encouraging to see that optometrists recognize the importance of routine dilation in the presence of pre-existing pathology, but a sizable number are still not on board with routine dilation being part and parcel of a comprehensive exam.

To rediscover your enthusiasm for this essential service, and improve your technique, be sure to check out “Put the ‘Fun’ Back in Funduscopy”  this month. It’s the second installment of our series on the ‘lost arts’ of optometry. Enjoy!