I was interested to read in a recent edition of Optician how some practices are approaching the commercial pressures of the current trading environment. Without doubt these pressures can seem extreme and there is a likelihood that some practices may not survive. Those best placed to come through the latest round of adversity will undoubtedly be those with a robust business plan that has been stress-tested for exactly the type of situation we are experiencing now.

It was noticeable from the article that the author thought that a proactive stance was better than a reactionary business approach to ensure practices withstand further hardships. However, many of the changes being adopted were actually reacting to the current situation rather than having been thought through and seen to be part of a well thought out plan previously prepared for such an eventuality as being experienced now. Such an approach is not really surprising. At university, we are trained as optometrists. We leave with a degree that has taught us nothing of how to successfully run a business. For many that learning comes often as a result of sour, if not downright bitter, experience. I wonder, before the current situation, how many optometric businesses had stress-tested their financial situation by looking at, among other things, the impact of adverse events such as marked increases in overhead costs?

One of the most serious outcomes from these increased pressures can be the potential risk to patient care and sound, clinical advice. By far, the biggest source of our income is still from retail sales of product. There may be a temptation when times are difficult therefore, to possibly adopt a less than ideal stance in order to maximise that retail income.

However, this could be to the detriment of the patient’s best interests. I say this having recently witnessed or advised on two incidents that, sadly, may reflect this. In the first, a patient with a new prescription asked for new spectacles. A few frames were selected by the dispensing optician to try on. At no stage was there any discussion as to the make, quality, benefits or price of any of the frames. Eventually, with little advice or awareness of costs forthcoming, a frame was decided upon from the very limited choice of frames shown. Lenses were chosen on the grounds of previously wearing varifocals. No advice was given about the lenses and again no mention was made of price.

The result of all this was that the patient unwittingly found they had chosen one of the most expensive frames and sets of lenses available and, having already agreed to this, was eventually told the price of what they had chosen for the first time. Unsurprisingly, they were more than a little taken aback to find they had been steered into a pair of spectacles costing just under £1,000.

While this may be good for a practice keen to pay increased overheads, there is no way this approach can be good for the patient. In another example, a patient, with no issues other than lens coatings breaking down causing blurred vision through that particular pair of spectacles, wanted replacement lenses. That there was no actual sight problem was borne out by the fact that three other pairs of spectacles, all made to the same prescription, gave excellent unchanged vision. The patient was encouraged to have a new sight test, which resulted in a changed prescription being issued. The patient struggled with this new prescription but was told that they would eventually adapt to it. Being an intelligent person, on asking what would happen when and if they adapted to this new prescription when switching back to the other three pairs, they were told they would most likely not cope with them and that they would need to update those three pairs as well!

Can this action really be in the patient’s best interests when there was never a visual problem in the first place? Why were they not offered a re-glaze to the existing prescription that they had no problems with? The final straw for this patient was, on going to pay for the lenses, they found the price quoted had doubled as the original price quoted was for only one lens and, as the patient had two eyes, they would be needing two lenses.

These short term ‘fixes’ may prove economically beneficial to a practice in the short term but, without doubt, such actions will have a detrimental impact long term for both individual practices and the profession. There can never be a replacement for good sound professional advice whatever the circumstances. It is not the patient’s fault if a practice is suffering financially for whatever reason. It is more likely to be down to the lack of robust financial planning and financial plans.

It is incumbent on us all in these times to show true professionalism and always treat our patients as we would wish to be treated were we in their place.