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How patients perceive your practice


Many of the traditional descriptions we use for areas of our practices have become outdated. As things change in our practices, we tend to force new methods and techniques into old categories.

Many of the traditional descriptions we use for areas of our practices have become outdated. As things change in our practices, we tend to force new methods and techniques into old categories. Sooner or later, things become antiquated. To more accurately reflect the way our office is currently organized, we recently created five zones. The most dramatic shift from the traditional is the concept of the front of the house.  

The front of the house (FOH) is defined as the part of a business where employees typically deal directly with the customers and the customers are in proximity with one another. In other words, the FOH is the area of the business that is open to the public. Because the entrance and exit are usually through the same door, the FOH provides the first impression of a business and the last. This term is used frequently in hotels, restaurants, and theaters.  

Build patient loyalty

In an eyecare practice, the FOH can be kind of a weird place. It is like a retail store with fine merchandise displayed in glass cases, inviting you to relax, look around, and shop. It’s also like a hospital registration desk with people in scrubs asking people to complete stacks of paperwork quickly so you can wait for someone to take you behind the door to some mysterious place. There are appointments being scheduled, phones ringing, insurance benefits being challenged, and financial transactions taking place.

As eyecare practitioners, we realize the importance of providing quality care to ensure our patients’ vision is protected and enhanced. We also understand that it is critical to provide eyewear that is of the highest quality. And our patients have to feel comfortable while in our practices.  

Has there ever been a patient who decided not to buy glasses in your practice because she was uncomfortable hearing another patient angry about his bill? Unfortunately, the answer is almost certainly, “Yes.”  

Because we all know that this is a critical part of our practices and is a challenge to solve, here are a few suggestions to at least take a step in the right direction.

Define the feel of the front of the house

Creating the environment is difficult, but it is impossible if you haven’t defined what that environment will be. If the culture of your practice is more medically oriented, then the FOH needs to feel efficient and complete. If providing eyewear is the top priority of the practice, then a pleasant shopping experience is essential.

Take the time to think about the atmosphere you want to create for patients as they walk into your practice. What do you want them to see, hear, and smell? How are they greeted and by whom? What are some of the activities they will see other patients doing? Visualize, then verbalize, and get input from everyone on the team. This is what we call “creating a vision” and is the fun part.  

Example: The FOH at Big Town Eye Care is an area of comfortable confidence. People who enter see controlled activity, including frame selections with many choices and questions about money being answered with a direct confidence. Everyone is smiling, friendly, and calm. There is a lot of activity, but it is controlled-not rushed-and no one is waiting to get the staff’s attention.



Remove distractions from your desired FOH feel

Usually, there is a big desk of some sort right in the middle of the FOH. A lot of things just naturally occur at this front desk that can disrupt the vision of your FOH. The most common and biggest distraction is the telephone.  

As a man, I am able to think about only one thing at a time, and I am easily distracted. If I am trying to decide between a $1,000 pair of frames and all I hear is someone calling tomorrow’s patients, I can’t concentrate.  

Hire and manage key employees

Move the phones away from the front desk.

Define which other tasks can be performed somewhere else. Insurance verification, routing slip creation, scanning papers into records, taking photos of patients, and many other tasks should be taken away from the front desk, if it is feasible. You will know you are getting close when you ask yourself, “Why do we need this big old desk anyway?”

Set expectations for frame and lens selection methods.

Look back at the vision you have created for your FOH and your practice overall. If you are a practice that thrives on providing quality products to your patients, you owe it to them to ensure they see the best you have to offer. If you stand on delivering the best care, you must incorporate systems to make sure everyone is fully educated about the differences in your offerings.  

While the personality of the frame stylist/eyewear consultant/optician is important, there must be a basic system that everyone follows. This basic system can be flexible, but must always include a clear demonstration of your best stuff vs. the “frames covered by my insurance.”  



Set expectations for check-in and checkout systems.

Write out every normal interaction that occurs in the FOH. Most patients have some sort of insurance that provides some sort of benefit, but not complete coverage. Many times, there is partial coverage or double coverage. The point is that it can be confusing. It is best to go over these details before the visit ever starts.  

Most offices also have paperwork to complete that helps the exam flow better and confirms some demographic information. Find the best way to ask for this information that leaves the patient comfortable while checking in. It is a balancing act of getting what you need and making the patient feel comfortable. This needs to be coordinated with patient care and always needs to be improved.  

Promote practice growth by investing in optical

With today’s technology, we should reduce as much time at check-in as possible. We can do this by gathering what we can before the patient arrives. Use available technology to gather medical information, insurance information, demographic information, and even a chief complaint before the patient ever arrives. Take as much stress as you can away from the FOH.

The variation in the insurance coverages is amplified when patients get to checkout. Regardless of how well you explain benefits, some hear only, “Everything is free today.” Glasses or contact lenses? Vision or medical? Deductible or wellness? Basic or premium? It can be so confusing. The answer is simply to be ready for every situation.

I recommend to presumptively bill every patient for everything that he needs (including a year’s supply of contact lenses). Apply all available benefits available and ask for payment. This is, of course, where the objections begin. So, have a planned response to each one. It is important to do this, because our patients are counting on our recommendations. Instill in your FOH that it is OK to ask for large amounts of money from patients, and it is OK for them to have questions about that. It is not OK to force the patient to pick and choose what he wants.

Implement the plan and set a time to review

The FOH is an area that naturally gets out of control from time to time. But it is arguably the most critical area and deserves significant attention. So, give it some attention now and again in a few months, then a few months after that, and repeat.

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