Contact Lens Solution Recalls Spark Calls For New Safety Regulations

Over the summer, a Food & Drug Administration (FDA) advisory panel recommended that contact lens solutions be subjected to more stringent testing than what is currently required. The recommendation came after several brands of contact lens solution, including Bausch & Lomb’s Renu with MoistureLoc, were tied to potentially-blinding eye infections.

Bausch & Lomb issued a worldwide recall of Renu with MoistureLoc Contact Lens Solution after it was linked to hundreds of cases of Fusarium Keratitis, a rare, but serious infection of the cornea that has the potential to cause blindness. Risk factors for infection usually include trauma (generally with plant material), chronic ocular surface diseases, immunodeficiencies, and, rarely, contact lens use.

Fungal keratitis is a condition more prevalent in warm climates. First-line treatment includes topical and oral antifungal medications. Patients who do not respond to treatment usually require surgical intervention, including corneal transplantation. These infections are not transmitted from person to person.

On April 10, 2006, the FDA and the Centers for Disease Control (CDC) issued public health warnings concerning serious fungal infections associated with contact lens solution use. The CDC stated that it had interviewed 30 patients suspected of having fungal keratitis. Of these 30 patients, 28 wore soft contact lenses and 26 used a Bausch & Lomb ReNu contact lens solution in the month prior to the fungal infection diagnosis.

On April 13, 2006, Bausch & Lomb, Inc. recommended that consumers switch to another lens care solution and asked all retailers to remove U.S. manufactured Renu with MoistureLoc from their shelves. On May 2, 2006 the CDC announced that the number of confirmed fungal infections rose to 88 cases. Just three days later, on May 5, 2006, the CDC revised the number of confirmed cases to 102.

On May 12, 2006, the CDC made another upward revision in the number of confirmed fungal eye infections to 122 cases. On May 15, 2006, the FDA issued a press release stating: “Based on this scientific and epidemiological data suggesting that Renu with MoistureLoc may increase susceptibility to Fusarium, Bausch & Lomb has decided to permanently remove the Renu with MoistureLoc product worldwide.”

Bausch & Lomb, Inc. and the FDA both acknowledged that there was a problem in the chemical properties of Renu with Moisture that prevented the disinfectant in the product from killing the Fusarium fungus. Testing had had confirmed that the Renu with MoistureLoc solution allowed a polymer film to form around the Fusarium fungus that made it resistant to the disinfectant in the product.

Renu with MoistureLoc was just one of several contact lens solutions linked to serious eye infections. Last year, at least 21 cases of infections involving the water-borne Acanthamoeba parasite were linked to Advanced Medical Optics (AMO) Complete MoisturePlus solution, prompting the Santa Ana, California-based company to recall the product.

That AMO recall followed another issued in November 2006, when 2.9 million packets of AMO Complete MoisturePlus Multi-Purpose contact-lens solution and Active Packs were recalled after lots sold in Japan were found to have bacterial contamination. The recall included 183,000 Complete MoisturePlus units sold in the United States. AMO traced the contaminated units to a plant in China and found that Ralstonia bacteria had compromised the disinfectant in the solution and were eating away at the oxygen in the bottles.

Since the outbreaks and recalls, critics of contact lens solution makers have contended that current testing methods are not enough to insure the products’ safety. That argument gained added weight earlier this year when researchers at the Center for Medical Mycology found ReNu with MoistureLoc was unable to resist contamination because the strain of Fusarium responsible for the 2006 outbreak had the ability to form biofilms.

Biofilms are clusters of microbes held together by a glue-like matrix. This structure made the Fusarium extremely resistant to contact lens solutions and the body’s own immune system. Unfortunately, contact lens solutions are not required to be tested against microbes with the ability to form biofilms. In fact, Renu with MoistureLoc and other contact lens solutions are tested against a rare type of fungus obtained from a patient in Nigeria in 1970s, which critics say has no real-world applicability.

In the case of the recalled AMO contact lens solution, there is no requirement at this time for solutions to be tested against Acanthamoeba. Following the 2007 recall, researchers found that AMO Complete MoisturePlus had no ability to kill the parasite.

There Will NEVER Be Enough Time in the Dental Office

Here’s what I mean by this. 2 things that I hear over and over are:

1. “My staff says that there just aren’t enough of them to implement this new idea. If we just had more people, then maybe we could do it,” and
2. “My staff says that there just isn’t enough time to do this.”

Well, I have two words to describe what I feel when I hear this. The first one is “bull.”

Listen, this falls back on the doctor in this way. Most doctors just don’t give their people enough guidance to know what they are supposed to do next. They also don’t give them priorities to know what they need to do first and what absolutely must get done before the end of each day, week, or month. In this way it isn’t really the staff person’s fault that they feel this way. They probably don’t have enough time to get everything done considering that they place the same priority on every single thing they do. Also, many times they put too much priority on a little thing that doesn’t add any real value to the office.

You think that I’m kidding, but I have seen it too many times. A person left to their own devices will fill their workday with the absolute easiest tasks and leave the hard tasks unfinished or half done. They will also become very creative with reasons that justify their lack of follow through and completion. This is where the doctor must step in at LEAST one good time, set up standards, policies, and the like, and establish a strong chain of command with accountability at each position.

This is certainly easier said than done, but it has worked every time I have seen it tried.

Let me go over a couple of warning signs that you might see if your practice is being affected by this disorder. You may diagnose a crown on a patient and leave the room convinced that the patient is going to stay to have the work done. After a little while you don’t see that particular name on the schedule any more. When you inquire about the patient, your staff person might say something like this, “Oh, we didn’t have the time to get that worked in today, but they are coming back tomorrow.”

Well, what if tomorrow never comes?

Another might be a continuing care hygiene list the never gets called. Yes, it is something that they all agreed they needed to do, but when the day was finally over, time just ran out before they could get it done. If you inquire as to why it never got done, you might hear that insurance was getting behind, new patient packets were getting low, the file room was a mess, or any number of lower value tasks that the staff decided to do instead of call continuing care.

The truth is that calling patients was more painful and the other tasks were easier. Without a clear way of monitoring things, the staff will never choose the tasks on the top of the doctor’s to do list.

If you can find out what secrets are motivating your staff, then you can finally unlock the door that’s holding back your whole practice.

The Secret to More Patients

A Case Study for Marketable Results Reviewing two similar dental offices, which practice achieves the best marketing results? Dr. Wise and Dr. Downing manage dental practices just three blocks away from each other. Their practices are nearly identical. Both have 10 years of clinical experience, use state-of-the-art equipment and offer equivalent pricing.

Where the two dental offices differ is in their respective marketing approaches. Dr. Downing pays for advertising using a bevy of expensive directories and publications. Dr. Wise relies primarily on patient referrals and one promotional product to market his practice, a magnet.

Dr. Downing spends tens of thousands of dollars per year on marketing. He has a big Yellow Pages ad, is listed with 1-800-DENTIST and advertises periodically in the local newspaper. When patients visit his office, Dr. Downing exudes amicable, professional dental care. Once a year, he sends each patient a reminder postcard. Dr. Downing interacts with his patient three times:

o Patient appointment

o The office visit

o Reminder card

Dr. Wise allots less than $10,000 annually to marketing his practice. Rather than invest more money in expensive advertising, Dr. Wise’s marketing strategy involves perpetual persistence:

o When the patient sets the first appointment, Dr. Wise’s office follows up the call to get the information needed to complete the new-patient questionnaire in advance.

o Next, a patient orientation package is mailed along with a copy of the completed medical questionnaire.

o Four days prior to the new patient’s appointment, Dr. Wise leaves a personal voicemail reminder.

o Upon the conclusion of the office visit, the patient receives, Dr. Wise’s signature gift box, filled with the following items: a toothbrush, spool of floss, travel-size tooth paste and a toothbrush clip-magnet.

o Following the dental appointment, Dr. Wise’s office thanks the patient for their visit and includes a survey.

o When patients refer his services, Dr. Wise rewards patients for making the recommendation by sending them a gift.

Doctor Wise interacts with his patients six times. That’s three more contacts than Dr. Downing employs.

Which dentist procures the most new patients?

Which marketing strategy returns the highest return on investment? Who do you think loses fewer patients? Despite Dr. Wise’s lower-cost marketing strategy, his patient base outnumbers Dr. Downing’s. From patient retention and a higher return on investment, to the procurement of the most new patients, Dr. Wise’s perpetual persistence reigns supreme. In fact, last year, he acquired three times as many new patients as Dr. Downing.

Interaction, Interaction, Interaction.

While Dr. Downing makes contact three times, the patient interactions are not any different from the support or encounters experienced with other dental practices. And despite the seemingly excessive interactions between Dr. Wise’s office and his patients, it pays off in the end.

Here’s how and why:

Doctor Wise’s perpetual persistence approach conjures trust, loyalty and showcases exceptional patient support. Each interaction demonstrates a commitment to exceptional service:

Interaction #1 – The Medical Questionnaire

By surveying patients, Dr. Wise learned that most patients prefer to complete their paperwork at home. Many perceive the form as “too time consuming” to complete during the visit. To improve patient satisfaction, Dr. Wise has office personnel complete patient’s medical questionnaires by phone.

Interaction #2 – The Patient Orientation Package

Dr. Wise mails an orientation package to welcome new patients. The kit features useful dental information accompanied by a copy of their completed medical questionnaire. The completed form gives the new patient a chance to add or amend any information. The patient orientation kit instills patient trust that Dr. Wise’s office is professional and devoted to quality dental care. Since the practice started mailing new patient packets, the number of appointment cancellations has been reduced substantially.

Interaction #3 – The Personal Appointment Reminder

When Dr. Wise’s office leaves the appointment reminder message, it demonstrates a commitment to reliable dental care.

Interaction #4 – Distinctive, Branded Giveaways

To distinguish his practice from other dental offices, Dr. Wise equips new patients with a gift box opposed to a gift bag. By using a different encasement for the dental supplies, Dr. Wise’s giveaways brand and set his practice apart from the competition.

Interaction #5 РThe Appreciation Communiqu̩

As a follow-up to the patient’s appointment, Dr. Wise uses the appreciation letter as a form of market research. The letter requests that the new patient provide feedback on their experience so they can receive even better service in the future. The thank you note again exemplifies Dr. Wise’s devotion to customer excellence and supports the exceptional patient experience.

Interaction #6 – The Referral Reward

At Dr. Wise’s office, referring patients receive a $5 Gift card from Starbuck’s Coffee. However patients who provide on-going regular referrals or those who refer large cases get specials gifts – anything from a nice pen or travel alarm clock to a new iPod. You might think this is excessive, but gifts like this are more than paid for by a single additional referral. What’s more is that each time the patient uses one of these gifts, they are reminded of what a great dentist he is. Rewarding existing clients for making patient referrals conveys an appreciation for patient loyalty and inspires future referrals. Not to mention, maintaining patient allegiance is as important as cultivating new customers.

At the end of the day, Dr. Wise wows and dazzles new patients with attentive customer service. It’s not because he doles out nifty gift boxes and gift certificates. It’s the exceptional patient experience. Aside from extraction, cosmetic procedure or other dental services, it’s the cumulative patient contact or interaction that provides the patient experience.

Perpetual persistence is the tool and strategy multi-millionaires apply. Ask any uniquely successful individual the secret to their success, and they will purport perpetual persistence among their keys to success. At least, it’s what Oprah Winfrey, Warren Buffet and Bill Gates claim. Whether it’s the persistence of knocking on doors for new business or perpetually following a proven market strategy, this strategy provides dependable, consistent results.

Perpetual persistence is a marketing methodology that not only cultivates new patient relationships; it ensures the retention of new patients. How will you implement it in you practice?

Six Tips for Excellent Customer Service — Expand Your Local Business With No Extra Cost

Recently my dentist recommended that I see an orthodontist for a consultation, and not only did I learn about having my teeth straightened, but I also witnessed the absolutely brilliant, excellent customer services offered by this outstanding local business! If you own a business that offers a service to your clients, some of these excellent customer service tips may be helpful in expanding your client base.

My dentist gave me two recommendations for orthodontists. The first one had a business card; the second one had a quarter page flyer with directions to the office and a website address where I could learn more about the doctor and his services. Which one do you think I chose? Hands down, the doctor that had the website made a big impression on me. Without even needing to pick up the phone, I got all my questions answered in five minutes.

Dr. Jameson’s website had not only a friendly, professional design, but helpful information geared to all their patients needs. Included in the site were all the questions a new patient may have, such as office location, costs, pictures of ‘before’ and ‘after’ treatments, length of treatments, photos of the doctor, staff and office, and an “about us” section that included the doctor’s credentials. They also included information addressing patient concerns such as the sterilization of equipment, and fun photos that created a personal touch. They even offered a section where you can download the new patient information sheets, to save you time. I was sold when I read on their site that they have a commitment to seeing their patients within 10 minutes of their arrival!

I called to make an appointment and found the office staff to be friendly and helpful. They offered a free evaluation to see if their treatment would benefit me. A week before the appointment they sent me an information packet that included some new patent information sheets, a letter that spoke about the values that they run their business by, and also a DVD! The ten minute DVD was fun to watch and gave me an introduction to the office. It included patient testimonials and information about orthodontic treatment, and even showed some clips of the doctor at his ranch with his horses! I was very impressed.

The night before my appointment, I almost fell out of my chair when the doctor himself called me! He asked if I had any questions, and said he was looking forward to meeting me. In all my five decades on the planet, a doctor has never called me personally to welcome me!

The day of the appointment arrived, and because the doctor and staff had done such a great job of preparing me, I was not nervous or apprehensive. The atmosphere at the office was professional and friendly. They gave me a short tour of the office before taking photos of my teeth and beginning the evaluation. During a brief time when I needed to wait, I was shown a film about new developments in orthodontic treatment. In addition to the usual magazines in the waiting room, they offered tea, coffee, bottled water and cookies.

By the time the doctor came in to see me, I felt relaxed. My evaluation was completed quickly and sadly, my teeth were not candidates for orthodontic treatment. I was genuinely disappointed that I would not have the opportunity to enjoy the care of this outstanding doctor and his staff!

How can your local or service business take a lesson from Dr. Jameson’s excellent customer service? By providing outstanding care from the moment your client inquires about your service, you will gain their trust, loyalty, and appreciation. Best of all, a happy client or customer will refer others, thereby expanding your business with no additional marketing costs on your part.

Six Tips to Successfully Expand Your Client Base

  1. Anticipate the needs of your clients or customers before they arrive. How are they feeling when they contact you? What are their concerns, questions, fears and desires?
  2. Map out ahead of time the exact sequence of steps your customer or clients goes through when they contact you.
  3. Address your client’s needs at every stage of their process through your service from beginning to end. This will communicate caring and build trust and confidence.
  4. Use tools and technology to communicate information as well as your values. Offer the personal touch, don’t be afraid to share warmth and be a real person.
  5. Freely share information, take the time to educate your clients about what they will experience and what they can expect through coming to your business.
  6. Create a warm, inviting, and comfortable office. This will benefit both your clients and staff, who will be more relaxed and also be more productive. Care for your clients and customers, offer them excellent customer service, and they will come back and bring their friends!

What is the Difference Between Practice Management Companies and Coaches?

For 2 years I worked for the top rated consulting firm to the natural health care profession. I learned so much and my life has been different ever since then.

I am grateful for the experience.

Having seen the practice management side and the coaching side I see some similarities and many differences especially monetarily. This article is based on my experience with 2 practice management companies, not all of them. However, I have heard they are similar to other companies in many ways. Let’s begin with what you as a alternative medicine doctor can expect when you are looking for a solution form either of the practice management companies I worked for.

Both have a low barrier to entry offer. Have you ever been offered on a website a “FREE PRACTICE ANALYSIS”? DON’T ACCEPT THIS OFFER UNLESS YOU WANT TO BE SOLD! This is their way of trapping you in a 30 minute sales conversation. I know because I was the guy that would call you and do it. My goal was to get you to spit out what it was about you that was ruining things for you so that you would feel bad and sign up for a $50 intro seminar or a $1000 new patient course.

Once you are at the seminar or course you would get the information that was promised but it didn’t end there. Before the end of your course or your weekend seminar you would be forced to sit with a new sales person who would go through another analysis that you filled out as part of your registration packet. Ever wondered why you were filling out so much crap just to go to a seminar? This time you would spend at minimum 30 minutes with them again the focus is to make you feel ruined again but on a deeper level. I even saw some men cry during this experience! I also saw people get mad. It ran the gamut on emotions. Sometimes you would spend a couple of hours through this process. What is on the hook for you and for them? Company #1 – $6-9k PLUS (approx.), Company #2 – $10-$35k PLUS (approx.). They really want that money. They feel it is OK to hard sell you too. After all, your purpose is worth it right? In fact, here is their definition of hard sell, which coincidentally is L. Ron Hubbard’s definition: “Hard Sell means insistence that people buy. It means caring enough about the person and not being reasonable about stops or barriers but caring enough to get him through the stops or barriers to get the service that’s going to rehabilitate him.” Yes, they both use Hubbard’s stuff and will try and interest you in Scientology. Maybe this solves your mystery of which companies I am talking about. There are maybe a dozen companies out there who use Hubbard’s stuff.

Many people through this process became clients and paid a lot of money to get the result they were looking for which is what everyone is looking for in natural health care – help as many people as possible and make as much money as possible without betraying your own integrity to do it. But it doesn’t stop here.

With both of the companies, once you are a client they sell “advanced services” that are not part of what you get for being a regular client. These are higher ticket items that require a high level of trust. Makes sense. Most people wouldn’t buy these right away although that may have been all that they needed. You will go through the process their way, not yours. They are in control, do not doubt it for one minute. I was told by my former employer that each client is worth about $35k to the company. This made me want to start my own company when I heard this. I saw how much money the owners were making helping people and thought if they could do it, I could do it better. I always felt it was inefficient even though it was effective but kept going because I was continually sold on the “purpose”.

You will continue to be sold by them in hopes that you will remain a client. My viewpoint on this is if you never graduate, there is a problem… Similar to this is the statement that I have heard from PTs that “chiros never discharge their patients” which we know isn’t possible/true thanks to the word “never”. There comes a point when the patient has solved the problem that they came in for. Same goes for practitioners with practice management companies. I do see the viewpoint of wanting a client to stay forever.

What about coaching? How is it any different?

Again I will only speak to what I have experienced. You may have a different experience. If so, email me as I am curious about it. I have met many coaches and they usually follow this schematic or something similar:

Just like the practice management company, coaches have a low barrier to entry offer viz. a free report or mini course or even a free teleseminar. Most of them do not offer a free practice analysis to get you into a sales conversation. Instead by opting in to their list for the free report, they will continue to give and give until you gain enough trust in them to want to have a sales conversation about hiring them as a coach. Some have free weekly teleseminars continually on different topics as well so that the doctor can get help now and see that what the coach is offering is effective before they buy. Many coaches offer a free session as a way to sell you on becoming a client. This is ineffective as a starter. Some trust needs to be earned first. I myself offer a 20 minute laser session to those who have completed the 1st 2 lessons on my mini course but only if they have completed it, sent it to me, scheduled a time and sent me their most pressing problem in their practice 24 hrs. before the session. If I feel like they are an ideal client I will have a simple sales conversation with them. If not I refer them to another coach. I don’t know how the other coaches do their sales conversations or if they have criteria for their ideal client.

Once a practitioner has gone through the low barrier offers they can expect to be offered 3 months of coaching for about $500 per month at some time and usually a discount is offered if they pay in full. This is different with each coach. Some may not be ready for coaching so they are offered an information product for around $50- $500. Those doctors who are strongly committed can be offered up to 15 weeks for a full program. Such is the case with me. That runs around $2500. But that is the highest offering I have. My practice is a little different, one of my low barrier to entry offers in email coaching which runs around $250 a month for as along as the client wants.

If I don’t graduate them then I know I am ineffective. If I keep them around for only income reasons I am out of integrity. Many coaches have had clients for years as have practice management companies. My doctors for example come to me because they want to be booked solid with new patients so I better help them do so or I should be fired and then corrected so I don’t continue that way.

In my experience, behind every problem in practice is a personal problem. If something isn’t getting done – it isn’t that someTHING needs fixing, it is that someONE needs fixing. Therefore, I do not have “advanced services” offered as another solution to my income or theirs. It is handled as part of the basic coaching whether that is email coaching, the 3 month program or the 15 week program. The person gets helped and then he or she helps the practice. They animate the practice, not the other way around.

I have not seen a coach suggest or even push a spiritual or religious bent on their clients. That doesn’t mean for certain that it doesn’t happen. It just means I haven’t experienced it. The coach usually waits for their doctor to ask them about one in particular or may even ask the coach what they use or recommend. Coaches do less pushing than consultants which is a huge difference between the two. I have also found consulting to tell the doctor what to do rather than coaching where the coach makes a suggestion but let’s the doctor find out for themselves.

It would seem ineffective to me as a doctor to sign up for a year of consulting to solve a problem(s) that could be solved possibly by just one session! Do you agree?

This article is my experience. Yours can be different and may be so. You can find out for yourself and you should. It is always wise to look at both sides rather than just accepting one viewpoint.