Potential Silver Linings in the Gray COVID Cloud

Challenges from the COVID-19 pandemic will be analyzed and scrutinized for years to come. However, through these challenges come opportunities.

For our practices, one solution is to become as patient-centric as possible. This is not to say that our patients’ needs haven’t been primary in our practices, but rather that we can become a valued resource beyond what we have previously provided in eye care.

COMMUNICATE, COMMUNICATE, COMMUNICATE

Perhaps at no time has communication been more important. It is not enough to take the steps to create a safe environment for your staff and patients. You must also inform them about what you have done or plan to do to promote safety. All steps should be clearly noted on your website, in a mass email to your patients, and on visible signage in your office (Figures 1 and 2). Patients will appreciate your efforts, and this, in turn, will help to quell their anxiety. Keep in mind, for some patients, a visit to your office may be among the first excursions they take.

EMPATHIZE, EMPATHIZE, EMPATHIZE

We all know the anxiety people are feeling during this pandemic. Recently, a patient of mine who is a psychotherapist working with trauma patients described it quite well. She said that with COVID-19, no one knows where the risk is, so our central nervous systems are “on fire” and we are in perpetual fight-or-flight mode.

Knowing this can help us relate better to our patients, understanding that their needs may be greater, their anxiety higher, and their patience thinner than normal. The best approach is to meet people where they are and come from a position of empathy. If they feel safe in your office, that fight-or-flight rheostat may be turned down. Always find ways to show respectful concern, not only for patients’ physical well-being, but also for their mental and emotional states.

LISTEN, LISTEN, LISTEN

One of the common problems for practitioners historically has been time management. Insurance reimbursement and practice models have required us to see more and more patients in order to meet financial demands. During COVID-19, many practices have modified their schedule templates and are seeing fewer patients per day. Therefore, we need to revisit our business models and seek ways to increase our per-patient revenue in order to sustain our practices.

Take advantage of the increased time you now have with each patient. Get to know them better. Show your interest and concern by checking in to see how they are doing. Use this time to listen. The stories I go home with at the end of my workday are not about diagnoses I nailed, but rather about interesting conversations I’ve had with patients.

In addition to building better bonds with our patients, we now have the chance to gather more information from which we might be able to provide solutions to their problems. By meeting the needs of the patients we serve, we can at the same time help to meet the fiscal needs of our practices. By spending more time with each patient and practicing active listening, we can identify opportunities that we might otherwise have missed.

PRESCRIBE, PRESCRIBE, PRESCRIBE

The amount of time spent on electronic devices today is staggering. It is urgent for eye care professionals to provide expert opinions on how to minimize adverse consequences in adults working and children learning remotely.

Eyestrain, fatigue, fluctuations of vision, sustained distant blur after near work, redness, dryness, epiphora, muscle tension, fatigue, and decreased comprehension and retention are all signs or symptoms that can be direct results of this lifestyle. Patients may see eyestrain and other ailments as a price of modern living, but checking for these problems must be a significant part of our history, exam, and professional recommendations.

Eyestrain

I discuss ergonomics, lighting, the need for frequent breaks (the 20-20-20 rule), and the use of blink exercises, lubricating drops, and computer glasses. I educate parents about the short- and long-term impacts of device use on their children, including increased dry eyes and the potential impact of blue light. As a result, we have had a dramatic increase in optical sales, as even mild prescriptions can help to reduce eye strain, and coatings that block UV light, glare, and blue light can help reduce discomfort while also protecting the eyes. There are many so-called blue light glasses available online, but I remind parents that, unless it is so specified, they cannot verify how much blue light is being blocked. In addition, these glasses do not contain any prescription to help balance the eyes, and the quality of the lenses is often poor.

Contact Lenses

Contact lenses have attracted attention during the pandemic. For a brief time in the early days, the US Centers for Disease Control and Prevention recommended that patients not wear contact lenses. This was quickly found to be unnecessary. The key has become the type of contact lens prescribed. Prioritizing comfort and hygiene is more important than ever.

Our goals, therefore, are to provide optimal performance and health and to reduce the frequency with which patients touch their lenses and their eyes. Current circumstances heighten the need and benefit of moving patients to daily replacement contact lenses.

My lens of choice has been the Acuvue Oasys 1-Day with HydraLuxe Technology (Johnson & Johnson Vision Care), which includes the highest level of UV-blocking and offers stable performance throughout the day. Dailies Total1 (Alcon) is another brand that has performed well under current circumstances.

An interesting twist (not in the daily replacement category) is the Acuvue Oasys with Transitions Light Intelligent Technology (Johnson & Johnson Vision Care), which blocks about 15% of visible light (primarily in the blue wavelength) indoors. This could be a novel and timely benefit of this relatively new contact lens on the market.

Some rules have been softened during the pandemic. We can extend contact lens prescriptions for patients unable or unwilling to come to our offices. Additionally, many companies and distributors are offering free shipping to patients, adding to their convenience and allowing our offices to save time and reduce patient flow into our practice.

In our office, we have tried to be as understanding and accommodating as possible. We believe this goodwill on our part will lead to greater loyalty and referrals from our patients. We have already gained new patients who tell us that their previous doctors wouldn’t extend their prescription but also couldn’t schedule them for an examination.

Additional Resources

Companies such as Johnson & Johnson Vision Care have offered helpful resources, introducing services such as LensAssist, a virtual training platform with free live chat support; an Eye Care Provider Locator, making it more convenient for patients to connect with practitioners; and a rewards program offering patients added savings. These tools aim to ensure that patients’ safety, comfort, and accessibility to proper care remain top priorities.

Other companies are offering expanded benefits including more liberal rebates on dispensing annual lens supplies. This should consistently be our recommendation when we finalize a contact lens prescription. Dispensing an annual supply increases replacement and recall compliance, supports optimal eye health and safety, and saves money for patients. When we prescribe lenses, we say to the patient, “We are now approving you for a year’s supply of contact lenses. This will give you all the lenses you need between now and next year’s exam and is the most cost-effective way to buy your lenses.” Alcon offers an excellent program called Marlo, which allows patients to order contact lenses over time, receive free direct express shipping, and still participate in available rebates.

EXPAND, EXPAND, EXPAND

Telemedicine

This is a quintessential time to broaden the services you provide to better meet the needs of your patients. If you do not already use a telemedicine platform, you should consider doing so. This will increase your availability, allowing you to see some of your non–office hour emergency patients remotely. Some people are uncomfortable leaving their home at this time, and a telemedicine visit can save both you and the patient time while avoiding the potential risks of coming to your office.

Additionally, some platforms, such as EyecareLive, allow you to charge a patient’s credit card at the end of the visit or get their insurance information to be submitted when the office is open. Think about the times when you have provided care on weekends by phone, helping patients but not typically being able to charge for your time and expertise. Now you can.

Some platforms also allow you to remotely e-prescribe, perform some dry eye evaluations and Amsler grid monitoring, check acuities, and provide routine contact lens follow-ups. Knowing they can reach you when needed can strengthen your relationship with your patients. And handling tasks remotely can help to reduce congestion in your office.

Specializing

If we are seeing fewer patients per day to reduce congestion, this presents an opportunity to explore specialty areas and add services such as myopia management or ocular surface disease treatment. Such premium service offerings can enhance referrals and also provide needed income.

If you add a specialty service, remember to let the world know about it. Whether through verbal education of patients in the exam room, printed materials, information added to your website, staff education, social media, or all of the above, let your patient base and your community know what you are capable of doing.

BEGIN, BEGIN, BEGIN

There’s an old adage that fits the current situation: “Begin. The rest is easy.”

In this article, I have offered ideas for several ways to boost practice health as we move forward in—and, eventually, after—the COVID-19 pandemic. For some of these, you can start as soon as you finish reading this article. For others, it will take a little time to write a list of goals. Once you do, you and your staff can prioritize, brainstorm, and develop action plans.

Most of us can make valid claims about our top-notch customer service. Through this horrible period of time we can expand to become even more patient-centric, going “From Good to Great” as Jim Collins described in his best-selling book.¹

That COVID-19 gray cloud can, indeed, have a silver lining. We just need to seek it and act on it. Good luck, and stay well.