How to Make it a Success in Your Practice, Part 2

By Jeff Hopkins

Release Date: November 1, 2017

Expiration Date: June 27, 2019

Learning Objectives:

Upon completion of this program, the participant should be able to:

  1. Understand the ways to ensure success with digital measuring systems.
  2. Know the telltale signs of poor implementation.
  3. Define the usage protocol for measurements and how to demonstrate other lens attribute benefits on behalf of the customer.

Faculty/Editorial Board:

Jeff Hopkins, is marketing director for GsRx in Scottsdale, Ariz., and a journalist with an extensive background in the optical industry.

Credit Statement:

This course is approved for one (1) hour of CE credit by the American Board of Opticianry (ABO). General Knowledge Course SWJHI013

In Part One of this course, we discussed the benefits of digital measurement devices, along with the types and options available. If you read that one, perhaps you reacted the way that as a kid you reacted to a toy commercial in early December—gotta have it!

But by early January, what had happened to that toy? You played with it, showed it to your friends... and now it’s in the back of the closet. The only reason you think about it at all is that you’re still playing with the box.

And so it can be with measurement devices: After the initial rush of excitement, tablet-based systems may end up in a drawer, used only to binge-watch “The Walking Dead” when things are slow (I’m kidding—no optician would do this) and installed systems may sit forlornly in a corner of your optical, ignored like a kid in eternal time-out.

There’s good reason to worry about this: a survey of practices with digital measurement devices showed that only 49 percent were actually using them on a regular basis. And that’s just those who admit that they’re not using them. The actual number may well be higher.

This is not to discourage you from getting a measurement device—you really ought to have one in your practice. But just as having that toy didn’t fulfill your childhood dreams and usher in a lifetime of happiness, the fact that you have a measurement system doesn’t, by itself, do anything for your business. To get the value out of it, you have to prepare carefully and work to integrate it into your practice.

Having spoken to a number of practice owners whose devices were either lying fallow or had been returned to the manufacturer, I’ve heard some of the ways that things can go wrong. Let’s review the biggest ones.


This is probably the most common reason the measurement system project fails. With standalone devices, the story often goes like this: The practice owner goes to a trade show, where manufacturers frequently offer specials on big-ticket hardware. It looks great, does a lot of useful things, is easy to use and makes a strong statement about the practice. Sold!

But once it’s installed, the staff doesn’t use it. They may just be comfortable with the way they’re taking measurements now. Or they may see it as a threat. Taking fitting measurements is a skill: It takes time to learn how to do it well, and it’s very important that it be done right. Staff members may react to the digital device the way medieval copyists reacted to the invention of the printing press: as a replacement for skills they have worked so hard to acquire. And that’s not an attitude that will create success.


Suppose the staff likes the device; they’re convinced of its accuracy, and they like the patient presentation; everybody’s on board. But after two weeks they’re not using it. Why not? Maybe things got busy for a few days, and nobody wanted to take the time to walk the patient over to the measurement system; or the tablet-based device got shoved in a drawer, and you don’t want to waste the patient’s time while you look for it.

You can call this the force of habit. You really do intend to establish a new routine, but when things get a little stressful it’s hard not to return to the old way of doing things, especially since manual measurements have been around forever. Or you can call it lack of integration into the practice flow: The standalone device is in a tight corner or all the way across the room, another dispenser didn’t put the tablet back where it belonged; for whatever reason, it’s perceived as a speed bump in the dispensing process.


While digital measuring systems are generally easy to use and very fast once you get used to them, the operator plays a key role in capturing the measurements. These may include highlighting the edge of the frame, the center of the pupil and the outer edge of the cornea for vertex distance measurements.

If training consists of one quick demonstration or if staff members decide that the system is going to be intuitive so there’s no need to pay attention to the presentation, frustration is bound to follow. And in the early phases of learning a new routine, frustration often leads to abandonment. I get frustrated with my computer almost every day though you’ve probably never experienced this. But however much I swear at my computer, I have to use it—I can’t go back to the old way. With fitting measurements, you can always go back to the old comfortable way, which never leads to frustration unless the Sharpie has dried out.


I dwell on the problems because it’s absolutely necessary to anticipate them or the integration of the measurement system won’t be successful. So let’s talk about how we can head them off.


As every lens company rep knows, it’s hard to get a new product seated in a practice. You can convince the doctor that your product should be the practice’s go-to lens. But the optical staff is making the day-today decisions about what lenses should go on a patient’s face; and if they don’t like the lens, most likely it’s going to be a no go. It’s the same situation for digital devices, except in this case, you have to pay for it whether you use it or not.

That means that the staff must be in on the selling process. They should hear the sales rep’s whole presentation about what the device will do for the practice, and the description of how it works. After the sales rep leaves, all the people affected by the purchase (owner, manager, optical staff) need to discuss the pros and cons, and arrive at a common decision. If most of the key people don’t agree that it would be advantageous, don’t do it.

This accomplishes two things: First, the staff gets a sense of what the device can do for the practice and how to work with it. Second and even more important, everybody buys in. If the staff participates in the decision, they “own” it and will be more likely to make the device work well in the practice. It doesn’t guarantee success (see the comments on habit above) but it makes success more likely.


One important decision to make about freestanding systems is where to place them in the optical. And “in the optical” is the first requirement. Putting it anywhere else greatly increases the likelihood that it won’t be used. Also, you want all the other patients in the optical to see the process—it reinforces the high-tech image of your practice, creates interest and so forth. And even within the optical, it needs to be in a place that’s easily accessible, and where using it is not going to get in the way of patients shopping for frames. That just provides another reason not to use it.

Freestanding units are often placed against a wall, but most don’t have to be. (It’s not a bad idea to brace it to the wall if you live in earthquake country.) Where else it might go depends on how your optical is laid out—just remember that there needs to be room for the patient to stand about 3 feet away from the unit without bumping into anything or anyone. All measuring devices will operate in normal light, but it should not be placed where the sun or other bright light will shine on the front of the unit, as this can interfere with the camera and the measurement process.


After the device is delivered, installed or downloaded, as the case may be, a training session needs to be scheduled with the vendor’s rep—even if the device comes with some kind of self-tutorial. And ideally, the training session should be set up this way:

The entire optical staff should be present. If just one person gets the training and trains the others, there’s always the possibility that something will be lost in translation, as in a game of telephone. Also, the training carries more authority if it is conducted by an outsider. And while you’re at it, bring in the techs and the receptionist, just in case they need to help out sometime.

The doctor(s) should be there. There is a tendency among doctors to keep their distance from the optical and everything that goes on in it. This is unfortunate, however much the optical staff might prefer it. The doctor(s)/practice owner(s) should not only attend the training, but participate in it as well. This shows that they recognize the importance of the device and are committed to its use.

Don’t hesitate to schedule a follow-up. If usage is slacking off, bringing the rep in for a refresher is a great way to remind the staff of what they’re supposed to be doing.

By the way, having a measurement device doesn’t mean that staff members don’t need to know how to take manual measurements. For a number of reasons, a device might give inaccurate measurements, and some experience is required to detect that. And while it’s never happened to me, digital devices of all kinds will occasionally stop working—and the backup system is you.



This is a fancy way of asking the question “Do you use it on all patients, or just certain ones, and how do you decide?” which is clearly too long for a subhead.

The consistent measurement accuracy we described in Part One and the need to make device usage a habit argue for using the device on every patient, no matter what. This also allows you to demonstrate your insistence on providing the best possible service for every patient.

However, this might not be practical in all situations. It’s probably easier with a tablet-based system, where you don’t have to leave your desk area, than a standalone unit across the room. But even then it’s going to take more time than a ruler measurement, and when you’re talking about a standard single vision lens, it may not seem worth it.

Some practitioners use it mainly for stronger prescriptions where an accurate reading of pupil center is especially important. Others use it only for customized lenses. This approach assures that it’s used on the patients who get the greatest benefit. And using it only on patients buying customized lenses also provides an opportunity for some salesmanship.

Let me give you an example of what I mean. In addition to a first-class section, most airlines have levels of distinction based on how much the passenger has flown on that airline. Naturally, all these people get to board the plane ahead of people like me. These passengers also get to stand in a special line, with its own velvet rope. This bit of theater is designed to make them feel special and everybody else envious. And it works, even on people like me who like to pretend they’re above that sort of thing.

Using your centration system only with patients who buy customized lenses is like letting them walk on the special carpet. The difference is that it’s not an arbitrary (i.e., fake) distinction, because it provides a real benefit. It helps to demonstrate why these patients are paying a premium price and help them see the specialness of their purchase. The envy comes in when other patients ask why they aren’t being measured with the machine, and you say, “It takes extra measurements that are only needed for advanced customized lenses.” This might give you the opportunity to upgrade them to a customized lens.

But there’s another way to approach it: Suppose you take the measurements before the patient selects their lenses. In that case, it makes sense to take all the measurements for all patients, or at least for all progressive wearers. Make sure you tell every patient why you’re taking those measurements: Because the best lenses need the greatest precision, and the additional measurements are needed in case the patient chooses a customized lens that offers the best visual experience, etc. That allows you to start a discussion of customized lenses without sounding “salesy.”

By the way, even if you don’t normally use the system for standard single vision lenses, you should always use it for free-form single vision. Even if the lenses can’t be customized for position of wear, precise location of pupil center is essential if the patient is to get full visual potential of the lenses.


As the previous section implied, knowing what to say to the patient about the device is almost as important as knowing how to operate it. Remember that one of the benefits is the statement it makes about your practice. To get the full value for the money you spent on it, you need to make sure every patient knows what it’s doing for them.

The script doesn’t have to be written out and memorized (and shouldn’t be—it will make you sound like a robo-call for bargain vacation packages). Just focus on the key talking points: 1. It is the most precise way to measure, and precise measurements will help you see better, 2. It takes additional measurements for lenses that are highly customized for your prescription and wearing parameters, and 3. It helps you get the best viewing experience, and that’s why you’re taking that additional step.


Car salespeople have an easier job than eyeglass dispensers in one important way: They can take the buyer for a test drive. The eternal challenge in talking to patients about premium lens options (designs and treatments) is explaining the difference between good and better, or adequate and great, because the patients won’t really recognize the difference until they’ve bought the eyewear. Absent a side-to-side comparison, it’s easy for a patient to dismiss an upgrade in design or treatment as perhaps a good thing, but not a big difference maker.

We hope that patients will trust in your expertise as you recommend what’s best for them—they certainly should, because you’re the expert. But as the alleged old Russian saying has it, “Trust, but verify.” (Personally, I think Russians would come up with a more interesting saying than that. This is the country that gave us Tolstoy and Dostoevsky, after all.) The point is that trust is nice, but if you can back it up with an impactful virtual demo, it’s just that much more effective.

Many demo systems have impactful demonstrations in spades. They may include illustrations and animations that demonstrate:

  • Effects of photochromics in various lighting situations
  • Thickness of different lens materials based on the patient’s own prescription
  • The effect of AR on patient appearance, as shown on a photo of the patient
  • And of course, side-by-side images of the patient wearing various frames

These demonstration features are not only effective in themselves, but they also reinforce a key point you want to make: You are offering your patients the most advanced vision technology. What better way to sell a high-tech product than a high-tech demo?


When I was in high school, I decided I wanted to make a living as an actor (fact: over 50 percent of graduating high school students plan to become actors, writers or rock stars), so I began college as a theater major. Sometime in my freshman year, the head of the department took me aside and said, “You shouldn’t become an actor unless you are totally committed to it, because that’s the only possible way to succeed.” At which point I realized that, by golly, I wasn’t totally committed to it, so I switched majors, clearing the way for Tom Hanks’ illustrious career.

Why do I say this? Well, in addition to wanting you to know that I consider myself a pretty decent (if not fully committed) actor, I’m trying to make a point about measuring systems: If you’re not committed to using them day in and day out for a substantial number of patients, don’t get one.

If you do commit to it and make it a central part of your dispensing process, it will give you a great return on your investment. It may not show up on a spreadsheet, but ECPs who use them have easier upselling, fewer redos, an enhanced image for the practice and above all, happier patients. And that’s an accurate measure of practice success.