I was recently in an office that had a screen with patient education slides playing on a loop. I took note of one that said “Up to 30% of new prescriptions are never filled.” The slides were about general health, and I assume the information was about prescription medications and not eyewear.

30%?! At least one in four patients who goes to the doctor for some reason and receives a prescription never takes the next step to actually get the medication. Why would this be?

Did your brain jump to “cost”? It’s an easy excuse. I’m sure that deters some but is not the case for many.

Having observed in many optometry offices, here are the things I see that keep a patient from filling an eyewear prescription.

Optometrists write a prescription and create doubt about the need for it in the same sentence. “Your power changed a little bit and new glasses would help you see clearer, but since you wear contacts most of the time, you can probably get away with wearing your old glasses but I’ll give you this just in case.”

Features are discussed instead of benefits. Is a patient more likely to spend money on something that “uses intense pulses of light to stimulate the glands and reverse the truncation so these white squiggly lines I’m pointing at will look more like the other picture?” or something that “will stop your eyes from burning, and have the added bonus of helping with that redness on your nose and cheeks”

Patients are overwhelmed by choices and do nothing. “I’ll write the prescription so that you can fill it for distance only if you want to keep doing that, and then just take them off when you’re reading, or you can get a bifocal with a line, or you can get progressive lenses, there are many different kinds that they’ll go over with you, or really you could even get contact lenses and just wear glasses from the drugstore to read”

The doctor’s prescription or recommendations are given to the patient, but not followed through on by the staff. The doctor may recommend supplements in the room and may hand the patient off to their optical staff, who helps the patient with glasses and then hands them off to the front desk… Like the classic game of “Telephone” information is lost.

Or staff members hear the recommendation, but are focused on the easiest rather than the best encounter. “Were you going to order those contacts today? You’re not sure? Okay, well you can just call us back if you decide to order them. Bye!”

To combat this, optometrists need to give a clear recommendation in the exam room, discussing a prescription, product, or procedure’s benefits rather than features.

Address vision, comfort, and eye health.

Listen to the patient’s concerns, figure out what the best solution is for their issue, and tell them in straightforward language what will fix their problems.

Practice the baton pass with your staff members – repeat the patient’s main concern, and tell the staff member (in front of the patient) what you’ve recommended, and what the benefit will be. “Jada was saying that her vision wasn’t as clear as it should be. I found a prescription change and wrote new prescriptions for her contacts and glasses so that her vision will be nice and clear again”

Emphasize with staff that once the doc writes the prescription, they are in the role of a pharmacist, filling the prescription and educating the patient about the medication (or in our case, eyewear). It’s hard to imagine someone at a pharmacy counter asking “So did you want to get those pills?” yet we hear “did you want to look at glasses?” all the time in optometry practices.

Teach staff to handle any obstacles that come up along the way– if a solution is out of a patient’s budget range, staff needs to be aware of options for financing or a “next best” answer.

And docs– continue your care after the patient leaves the exam room. Take a look afterward to see what the outcome was. If you recommended something and the patient left without it, chances are they’re going to have the same problems they came to you for in the first place. Follow up a month later, ask how they’re doing, and allow the continued complaint to be another opportunity to present the solution.