Joe Ayling What are your priorities as the new chair of the AIO?
Christian French My main one is raising public awareness. Everyone in optometry knows what independents are and what differentiates them from a multiple. But I think it’s important that the public are aware of the difference as well. With our Eye Promise coming out, another priority is to really make the public aware of this quality mark for optometry. There isn’t one for an eye exam, and if you speak to people on the street about the difference between eye exams, some people are unaware of how or why one eye exam may cost more than the other.
For independents particularly it’s important to be able to show they are providing an eye exam of a certain standard. And that’s where the Eye Promise and all the guarantees attached to that come in. This originated as the Independents Code, but was a bit over-machined for the purpose. The Independents Code was attractive to practitioners but the man on the street would look at it and think ‘what on earth is that going on about?’
But the Eye Promise is something really simple, a bit like the Red Tractor assurance for meats, so that you can just look at it and know it’s of a certain quality. It also means independents can take part in a national campaign without being tied to a brand.
JA How do these align with your priorities as a practitioner?
CF Being in practice you get a real range of patients. You get some who are very aware of the difference between an independent practice and going elsewhere, and you have others that come because that’s where they’ve always been. If you wake up with toothache you go to see the dentist, whereas a lot of people who wake up with a red eye or an uncomfortable eye will still go and see their GP. It’s about educating the public that the optometrist should be the first port of call. We’ve got the equipment and with some of these Mecs schemes we have a better system for looking after those patients.
JA How has your practice established links with other healthcare professionals?
CF They have evolved over time. Because it’s got back to the health visitors that we see most of the newborns and infant patients in the area, we just carry on this continual referral with them (we still need to book babies in for appointments). It’s the same with the GPs. If we tell them that we’ve got an OCT, or a hypertensive retinopathy screener, they will refer to us. For example, at one GP surgery, the moment a patient is diagnosed as hypertensive they get sent down here for a full exam, then we send a report back to say whether there are any hypertensive changes in the retina.
The advertising and public awareness about Mecs is definitely going to make a huge difference. Once those schemes are up and running across the country, to be able to say this is an NHS funded scheme where if you wake up with an eye problem, rather than seeing your GP you see your optometrist. This is somewhere the AIO can come in and say our members are taking part in a Mecs scheme and as an organisation market it. This is where independents don’t have the time, finances or the man power to take up a national campaign.
It’s just like the Shop Local campaign – it doesn’t direct you to one particular shop, it just raises the awareness of local businesses. The public attitude is changing and people are more interested in local businesses now.
JA So how can independent practices not just survive but also thrive?
CF The ones who are directly competing against the multiple model are always going to face a tougher challenge. There will always be patients who want to go for cheap specs and a quick exam, and always patients who want a bit more time, with a full range of diagnostic tests, and they know they will pay a bit more for that.
I think it’s about identifying the target market and serving the best purpose for them, rather than trying to cover all bases. Here [at Davis Optometrists] you tend to get the people who may have a slightly complex condition or prescription who will need a bit more time investigating. We offer a 45-minute eye exam, including OCT which we’ve had over the past few years, so we can reference and compare these. You can’t do a full eye examination, plus take an OCT and interpret and explain it back to the patient in 20 minutes, or at least not without making the patient feel extremely rushed.
We are very careful when we are talking about the NHS fee, because it is very misleading when people call it a free eye test. It isn’t technically free because the NHS is paying for it. This was something we brought up with the GOC in its review of business standards – there needs to be a bit more clarity on that.
It’s important patients are aware you can go absolutely anywhere, including an independent, to get an NHS funded eye exam, and that independents are just as affordable as multiples.
JA How should independents view larger multiples they may be sharing a high street with?
CF Ultimately there are always going to be independent and multiple practices. There is no point in trying to push one or the other out of the market because there will always be demand for both and it is about finding that middle ground. They are serving different patient bases and ultimately everyone is offering eye care and spectacle sales to patients.
But we have to educate patients that while an eye exam in itself is important, the long term follow up is even more crucial. Seeing the same optometrist and building up that relationship is the only way that subtle changes over time can be efficiently detected.
JA But how can they compete with the marketing prowess of the multiples?
CF One of our members recently pointed out that when you attract a new patient in, whatever you have done to get them there it has been more successful than the multimillion pound Specsavers, Boots or Vision Express campaigns splashed around buses, newspapers, radio and television. That’s where independents should look at the positives and see that their patient still comes to their practice. An independent is never going to afford an advertising campaign on TV or newspaper, but remember you are not trying to get people down from Aberdeen to Market Harborough – you need to advertise locally.
Here, we don’t tend to advertise a great deal but work by word of mouth recommendation. If a patient is happy and wants to recommend you to other people, then that is worth so much more than an advert in the newspaper. We also take part in business networking events to talk about the frames on offer and the clinical services we offer. So people just need to think more locally.
JA Is technology a friend or foe of the optical profession?
CF Again, it’s about patient education. With OCT and fundus photography they are fantastic pieces of equipment but they still need to be interpreted by someone. We need to show the patient that the longer appointment time means you can take the image and sit down with the patient to explain to them what it is showing. We can compare it with the year before to find if there has been any change, and that is the bit they are happy to pay for.
It is equally about explaining the importance of being in front of a dispenser or optical assistant, and the value of when glasses are measured up they need to be fitted properly. There is no comparison between a three-year dispensing optics degree and just looking in the mirror to measure your PD. A lot of this comes down to public awareness and this is something I really want to push with the AIO.
We’re a very long way off the position of just going into a room, sitting in front of an autorefractor, an OCT and computer and just interpreting all that. I’m sure with very straightforward patients that would be absolutely fine, but as soon as you introduce a binocular vision anomaly or unusual pathology that’s when you need that human element to interpret and put all that information together.
When you have a small business against a large corporate multiple, the multiple is a bit like the oil tanker or cruise ship, being very prominent on the landscape. But actually they are not as able to as quickly adapt to changes. Whereas with a small independent, when a new bit of technology comes out you can take that into your business, adapt and move on.
I think independents do themselves a disservice because they are much more adaptable to local changes. If there’s a local scheme you are much more able to take on a new service and add it onto what you do in next to no time.
JA Does OCT remain a unique selling point for independents now it is becoming widely available throughout Specsavers’ practice network?
CF The good thing independents have is they’ve been using it for a long time. One of the main perks of OCT is it can pick up minute changes over time, but you can’t just materialise this amount of data. You have to take it for that long for it to be worthwhile. Plus in a 20-minute eye exam when is the time to go through and explain all the details of it?
Because patients have often never heard of OCT, when they see the [Specsavers] advert on the TV they are going to assume this technology has just arrived and that Specsavers are the pioneers of it. But this is where it is very important that AIO make the public aware there are thousands of OCTs in practices already.
It is important to make the public aware it is not new technology as such just because it has been taken on board by a multiple and advertised. It has been around a little while.
JA What is a fair price for a private eye exam and how much should GOS fees be?
CF It’s a difficult question because you’ve got regional differences. There’s no point in charging London prices in Cornwall if the demographic can’t afford that. It would be nice if the GOS fee covered the true value of a professional exam.
The problem is in other countries there’s a completely different view of the perception of optometry. In America you can spend $120 on an eye exam with an optometrist who doesn’t necessarily even have any frames. It is much more on a par with dentistry with a check of the eyes and a prescription to take away. Here, the public are used to it being free or extremely cheap.
To suddenly expect a change in mentality where they are paying professional fees of £70, £80 or £90 is unreasonable.
For some members their bread and butter income is GOS from eye exams and spectacle vouchers, but others are private only, so we’ve got the whole range. But it’s important to represent both because the AIO is not trying to tell independent practices how to run their businesses. It’sabout supporting them in whatever way they do run their business.