We refractive surgeons must provide our patients with an experience that separates us from the surgeon down the street. We can impress patients during every facet of their experience, beginning with the initial consultation. They should leave our practices saying, “Wow! I’ve never been treated so well at a doctor’s office.” I read a statistic that stated that patients will choose a physician for their elective surgery within the first 15 seconds they sit in the chair because of the surgeon’s demeanor and ability to connect with the person. We surgeons used to be able to promote our technology (the fastest laser, the latest tracker, etc). Technology still sells to some degree, but the surgeon and staff are the main determinants of where a patient will choose to undergo surgery.

THE PERSONAL TOUCH
Right now, my practice treats around 1,500 cases per year. Today, the bulk of our practice is word-of mouth-referrals, and approximately 20% of our patients are referred by optometrists.

My staff and I treat our patient consultations as more than just screenings. We conduct in-depth consultations in which we examine every aspect of a patient’s history and lifestyle that would be significant in the health of the eye and in refractive surgery. Throughout the testing process, we explain to the patient what we are doing and why so that he or she fully understands the purpose. Explaining the examinations and testing to patients as we go helps them feel confident in our abilities when it comes time for their surgery.

We make sure our patients do not feel like they are being rushed in and out like they are on an assembly line, because we do not want to give the impression that we will operate on anybody who walks through the door. We want patients to feel that we are prudent in our recommendations for surgery. We mention to them that we turn away approximately one or two out of every 10 people who want surgery because they are not good candidates. Another reason we may turn someone away (that we do not usually share with patients) is that he or she has unrealistic expectations for the surgery.

I personally consult with every one of my patients. My staff and I do not conduct a screening exam to determine which patients should come back and see the surgeon, because we want to convey that we value our patients’ time. Instead, we conduct an in-depth consultation for every patient who is interested in refractive surgery. We strive to show a sincere interest in why the patient wants to have surgery and to be warm and reassuring. I ask questions like, what is your profession? What hobbies do you enjoy? Is this something that is meaningful in your life? Tell me what your expectations are following surgery.

I also see each one of my patients on the first postoperative day and then usually again in 2 weeks. After that, patients will see either me or our in-house optometrist during the next year. Many surgeons dismiss the happy patient after the 3-month visit. I think the failure to bring patients back for several visits misses an important practice building opportunity. These visits reinforce their good result, and they are more likely to talk with the people around them about where they are going and why. I think this practice is a good marketing tool.

TECHNOLOGY AND OTHER SELLING POINTS
We will openly discuss our laser and other technologies if patients specifically ask about them. Because most patients these days are well informed, we usually mention the type of laser we use and our results. We have used the Allegretto Wave and Allegretto Wave Eye-Q excimer laser (Alcon Laboratories, Inc., Fort Worth, TX) for 7 years. If patients are interested in our statistics, discussing them may help to differentiate us from another practice.

I believe there is value in both internal and external marketing, although I think internal marketing is more effective. We mail our patients brochures and videos that explain what we do. We also have a Web site because consumers are Internet-savvy and like to research elective procedures. We designed our Web site to reflect what visitors will experience in our office. Starbucks is a good example of what I mean by the experience. People can buy a cup of coffee anywhere, but the experience at Starbucks keeps them going back. Starbucks is not just a coffee shop, and a physician’s practice is not just an office. The patient has to come away feeling that he or she had something that was different or unusual, and again, the most important part of that in elective surgery is the interaction with the entire staff.

I also believe in offering financing. In this slow economy, refractive surgeons are competing for discretionary dollars against things that we didn’t compete with before, and financing helps us to be more competitive. Also, it is important that we send the message to consumers that in these challenging times, investing in themselves is the best choice they can make.

SUMMARY
Satisfied patients are our greatest source of new patients. They will openly tell friends, family, and coworkers about the positive experience they had in our office, which brings in more patients who expect the same treatment and positive experience. Beyond that, we surgeons can distinguish ourselves through good visual outcomes.

Michael Gordon, MD, is a partner at the Gordon Binder Vision Institute in San Diego. He is a consultant for Alcon Laboratories, Inc., and an investigator for WaveLight Laser Technologie AG. Dr. Gordon may be reached at (858)455-6800; mgordon786@aol.com.

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I realized this morning that the presidential candidates' rhetoric is similar to the dialog about LASIK that takes place in this country every day— during inquiry calls, between counselors and patients, and in advertising. Senators McCain and Obama keep telling us how they are better than the other guy, when what we’d like to hear is why they’re good for us! We promoters of LASIK do the same thing.

SINGING THE SAME SONG
Practitioners are constantly selling themselves to potential customers. “We’ve got extensive experience. We have great technology. We deliver good results.” When LASIK was new, providers capitalized on the message, “I’ve performed more surgeries than him.” When the difference between 2,000 and 10,000 procedures lost its motivating power, providers shifted to technology. “Mine is better than hers.” Over the years, the claim of better technology has referred to different capabilities: expanding from myopia to hyperopia, from no astigmatism to lots of astigmatism, from surface to sub-flap ablations, from traditional to customized, and from bladed to bladeless. Nevertheless, this ratcheting up of technology hasn’t grown the LASIK market one bit. All the technological innovation that has excited us over the past 10 years has been lost on consumers, because year after year we continue to hover around 1.4 million procedures and a price point locked around $2,000/eye. Yet, the surgeon’s investment in that technology has cost plenty, so you’re not actually realizing any additional profit per procedure.

SELL THE SIGHT
Let’s go back to the root of what we sell. I use the word sell rather than offer here purposefully, because when patients choose to open their wallets and spend elective dollars—not insurance dollars—for better vision, they are buying an improved quality of life. They are not thinking, “It might work.” They expect permanent, glasses-free vision. Yet, how do most practices communicate their visual results? By talking about their surgeon and their laser. These are the means by which you deliver vision. They are not results!

A prospect’s ultimate fear is, “Will LASIK make me blind?” The answer is, unequivocally, “No.” Until our advertising campaigns and staff members are able and willing to answer that question, the market can’t grow. Your best response is to publicly provide the visual outcomes of the cumulative patients you have treated. Prepare a physical handout that details the results that you achieve for your patients with your laser, so that the prospective patient sitting in your consultation lounge can clearly see that LASIK is safe, effective, and life-changing (Figure 1).

How do cosmetic surgeons promote their practices? They share their results! At every consultation, they show before and after examples of noses, chins, breasts, and tummies. They do not share clinical trial data or results from another surgeon. Cosmetic surgeons would not succeed if they didn’t show prospects the physical evidence of their work. They will talk about their experience and occasionally mention technologies or techniques that allow them to deliver results, but mostly, they promote the actual proof of what they deliver. Of course, cosmetic surgeons have informed consent that tells patients what could go wrong. They do not, however, decline to show pictures of representative results simply because one surgery might not turn out perfectly.

STRATEGY FOR SUCCESS
The single best way for us to grow the LASIK market is to deliver 20/20 vision 100% of the time. Or rather, 20/Happy, which I call Patient-Preferred Vision, 100% of the time. That might be 20/20 distance or 20/Happy monovision, or -1.00 D bilaterally for a 45-year-old woman on the cusp of presbyopia. Success with LASIK is that simple... and that complicated. Until you can accurately collect, record, and utilize your data so every potential patient who walks in the door knows exactly what he or she can expect from you, you are no better than the surgeon down the block.

You sell vision. You should want to know, honestly, how well you do it, strive to improve, if necessary, and be proud to share those results. As with our presidential candidates, LASIK prospects don’t care about you versus the other guy. They care about proof … of how well you deliver vision.

Kay Coulson is the Founder of Elective Medical Marketing (www.electivemed.com), a consulting group based in Boulder, Colorado, that helps surgeons build their elective vision service lines. Ms. Coulson may be reached at kay@electivemed.com.

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