Marketing Laser Cataract Surgery in Your Practice

When marketing femtosecond laser technology in conjunction with cataract surgery, it is helpful to reference past marketing principles that have proved effective in multiple industries. We look back to the 1980s when “the four Ps of marketing” ruled how one brings any product or service to the market. The four Ps — which stand for product, pricing, promotion, and placement — are a helpful way to look at this very complicated category.

What the Four Ps Represent

A product satisfies the consumer’s needs or wants. It is a tangible item or an intangible service. Every product follows a life cycle, and marketers must be aware of the life cycle of each product they are marketing. Attention must be given to the challenges that will arise as the product moves through the cycle (growth, maturity, and eventual decline). The product’s appearance, function, and method of support all contribute to the item or service that the customer actually purchases. The product bundle should meet the needs of the target market. Therefore, research is a key component of building an effective product that appeals to customers, or in this case, refractive cataract surgery patients, and avoids costly mistakes.

The price is the amount a customer pays for the product. Price determines a company’s profits. Marketers should be aware of how the product fits within its competitors as well as how the consumer perceives the overall value of the product. The pricing approach should reflect the appropriate placement of the product in the market. Price is the one “P” that generates revenue while the others incur costs. Effective pricing is important to success.

“Price is the one ‘P’ that generates revenue while the others incur costs. Effective pricing is important to success.”

Product promotion is any element that a marketer uses to dispense information about the product. This includes advertising, sales promotions, public relations packets, and word of mouth. The purpose of promotion is to bring people to an understanding of what the product is, what they can use it for, and why they want it. Customers need to know that the product will satisfy their needs, which in this case would be a final refractive outcome that maximizes accuracy and minimizes risk.

Place refers to guaranteeing that the product is located somewhere that consumers can conveniently access it. What the product is will greatly determine how it is distributed. Marketers must make sure that product distribution happens in such a way that it can be easily purchased by its target audience. If the product is sold to vendors, then they should also contribute to the overall view of how the final exchange of the product with the consumer should occur.

Let us look at how the four Ps relate specifically to the marketing of laser technology in cataract surgery.


How exactly the surgical practice is going to charge for the advanced technology used in laser cataract surgery is an important step, perhaps the most important one, in discovering how the center might find success. Much angst has been spilled related to the ins and outs of proper pricing. Pricing is not only a cue for quality but also for the correct or incorrect pathway as to how to bill for laser-related services. Some practices use this advanced technology, albeit elective, to “clean house” on all of their refractive, non-covered, or elective services. A good rule of thumb here is that whatever the center might be charging electively for the offering should be similar to what it charges for a similar offering across the hall. Another way to say it is that the pricing needs to make sense and be justifiable.


Where the practice manager and/or surgeon decide to place the device is a critical component in how it is marketed. The way one communicates and thus markets to prospective patients changes based on if the practice remains an office-based procedural center and thus patients are transported after the laser treatment to the surgery center or if the center co-locates the device next to the surgery center. Much time, energy, and planning must be spent to determine the correct choreography for the placement of this new technology. Placement affects the other three Ps.


What else might be included in a bundled package alongside the laser technology? This is an important question to consider when looking at implementing this new technology. Many surgeons agree that this laser technology works best when combined with other innovations that optimize the cataract surgical procedure. Those other technologies may include the use of wavefront aberrometry pre- and post-operatively, wavefront aberrometry for documentation of the implant’s power intra-operatively, or topography. These and many other non-covered services may be considered as part of the total elective or non-covered package. Practices may decide to rename the package related to its non-covered services.


Promotion is an important consideration when thinking of laser cataract technology, however, it should always be handled last. Excellence in promotion cannot be achieved until there is excellence in execution. This statement has never been as true as it is in regard to this very complicated surgical space. When the technique is finally ready to be promoted, the best first step is to create demand by going first to the practice’s patient base and core of referring doctors. Newsletters, webinars, symposiums, live surgeries, and mailers are all effective ways to achieve this.


By following these basic structural elements, the center will be able to create a profitable laser cataract surgery program that satisfies customers’ needs while continuing to propel the business forward. Although the four Ps inform the way the current practice is shaped for marketing laser technology, they are not the end of the road. Once the right product at the right price is attained and offered in the right place and promoted in the right way, the practice must continue to stay on top of market changes and adapt as necessary. An experience for patients must be created that is as premium to patients’ care as laser technology is to refractive cataract surgery’s accuracy. Technology continues to move surgical procedures toward more precise and predictable outcomes. The femtosecond laser is just one example of the creative ways in which laser technology continues to help patients. Marketing and innovative technologies are part of the business venture that never ends.


This article originally appeared in Cataract & Refractive Surgery Today. Click here to download a PDF version.

Make Demos and Documentaries

Some recent advice from ad man Ben Malbon:

“Make demos and documentaries, not ads.”

This is vital advice for all companies to consider, including LASIK and cataract doctors and those in the vision industry. What does it mean to make demos and documentaries?


Don’t tell me about your product — show me your product. Show me how it works, how it makes my life better. Show me how clear vision will affect my daily life. Show me how you make surgery as safe as possible. Show me how you improve my outcomes. Show me how I can afford LASIK. Let me see the laser, the lens, the after-care shields. Show me, show me, show me. A demo allows me to become part of the decision-making process in a way that speeds up and increases my conversion.


Don‘t tell me about your product — tell me about your customers, your patients. Tell me why they chose you and how you made their life better. Tell me why you exist, what drives you to be the best. Testimonies. Narrative. Drama, climax, catharsis, meaning. I want LASIK or cataract surgery because of who I will be AFTER surgery, not what kind of ASC relationship you have. A good documentary changes the way we look at the world. Rather than creating an “ad,” tell stories about clearer vision and share those stories with the world.

Nobody trusts advertising. Demos and documentaries build trust and brands.

You Want to Advertise? You Need a Marketer

Although, nationwide, refractive surgery volumes are still relatively flat, many practices are finding strategic advertising efforts have a positive impact on their clinical and surgical caseloads. Some ophthalmologists believe that achieving higher volumes should be as simple as calling the cable station and asking for a bundled advertising package. This approach is dangerous, as it may not be a strategy for sustained growth. Why? There is a vital difference between advertising and marketing.

No matter what business you are in, the purpose of an advertisement is to make a logical prospect try your offering… once. Your team’s ability to capitalize on that single opportunity, in my opinion, is what separates those who believe in advertising from those who say it never works. Marketing, on the other hand, should be defined as the work your team does with every patient, every day, to deliver value to patients, build a positive brand identity, and spread the referral net for the practice. Marketing is operational.

Advertising makes a promise. Operational marketing ensures that this promise is kept for every patient, every time. Strong marketing is the foundation of effective advertising.

Operational Marketing

Implementing operational marketing is not easy. Prior to placing any advertisement, the savvy practice will have harmonized and optimized its phone team’s skills, its communication standards for each patient’s visit, its education of patients, financing (including payment options), and the consultation. A practice harmonizes these encounters by planning what is performed at each stage of the process and ensuring that all is in line with what the patient/customer should experience and feel. Optimization entails enhancing each individual staff member’s performance at every one of these opportunities throughout the customer’s experience. Because every stage of the customer’s experience is important to the definition of marketing, those who are developing the advertising should understand these components as well.

Advertising is often the responsibility of one person or group, whereas marketing is the responsibility of the entire staff. Every individual in the practice organization must assist in the development of the customer’s experience at the point of service. If everyone is acting in harmony, external advertising efforts can be kept to a minimum.

After building a proper operational marketing program, your practice may be prepared to advertise your offering to the external market. You may be targeting a market segment, referring group, a certain area in the community, or simply the people who are already walking through the doors. The kind of advertising you want to implement will determine the type of person you hire to handle the task.

With these strategic notes in mind, here are the key areas you should consider when hiring someone to handle your marketing and advertising.

Key Areas to Consider When Hiring a Marketer

According to Cindy Haskell, the former administrator, now marketing consultant to Gordon, Weiss, and Schanzlin Vision Institute in La Jolla, California, the following are required of any internal personnel in the role of marketing director/coordinator.

  1. Build your brand. The individual is responsible for overseeing the brand and message in all areas of delivery. Your brand is defined as what your customers say about you. To grow your brand, it is crucial to have consistent messaging throughout the organization.
  2. Coordinate advertising and marketing. The individual is responsible for coordinating the day-to-day advertising and marketing activities. The marketing director is also directly involved in the development, implementation, and tracking of the strategic marketing plan.
  3. Prepare a budget and conduct an analysis. The individual must be able both to plan and place advertising across modern media and to analyze the reach and effectiveness of advertising efforts. It is impossible to change tactics if you do not know what is working … or not.
  4. Perform research. The individual must be able to gather and analyze data on competitors, the community, and the marketing industry to properly position the practice.
  5. Use current patients. The individual will create and maintain a robust database of former and prospective patients, gather video and narrative testimonies, and use these local stories to build the brand of the surgeon and the practice.
  6. Run internal campaigns. The individual will use operational marketing principles to create positive internal campaigns targeting specific patient demographics.
  7. Gain referrals. The individual will develop a strategy to maintain and increase referrals from current patients.
  8. Create the website. The individual will manage and update the practice’s website to ensure effective and current promotion of the practice and the fulfillment of appointment and information requests. Increasingly for all surgical specialties, the Web will be the most vital portal for information and engagement with prospective patients.
  9. Develop patients’ education. The individual will design, produce, and distribute educational materials for patients customized for the local practice. Great education for patients delivers on the advertised promise to give them the best possible treatment and experience.

By paying attention to the center’s day-to-day operations as an extension of the marketing plan, your center can be sure that your paid external efforts will be maximized. Creating a role internally ensures that what is said in the advertisement actually matches the experience. Collectively, this combined marketing-operations effort will create new leads whose experiences match your promise in your advertisement.


This article originally appeared in Cataract & Refractive Surgery Today. Click here to download a PDF version.

Your Patients and Customers Want Empathy

You might even say they need it.

I recently finished reading A General Theory of Love, which paints a poetic image of the science of love and human emotion. It’s a title I’d recommend anyone in the health care industry spend some time with. It was originally published in 2000, but its message is as pertinent as ever.

The authors hooked me when they recognized that the hard sciences are intricately woven together with the social sciences and humanities. They promised to take an artful look at the science of emotion through the lens of love, and delivered. It’s a somewhat radical notion coming from three M.D.s, but their call for empathy is well founded and offers insight into enhancing the patient/customer experience as well.

One of the most significant takeaways is just how vital human interaction and empathy are throughout the course of a human life. As infants, we thrive in close proximity to a motherly figure, and continue to depend upon emotional connections to those arounds us as we age. Without the proper limbic connections, the door opens for a whole host of developmental and health issues. And it’s devastating to find empathy faltering in the industry that has arisen to care for those issues and more: health care.

What’s more astounding is that so many studies have found that empathetic relationships are powerful healing agents in themselves and yet this often seems ignored. The authors share an anecdote that painfully highlights this:

A 1994 proposal in The Lancet, Europe’s most respected medical journal, advocated teaching acting techniques to medical students… providing physicians with the means to feign concern for patients, since their incapacity to care is too embarrassingly evident…

Here our finest doctors endeavor, without irony or shame, to pass off a good relationship as a kind of performance art.

We can all recall the empty feeling of dealing with a health care practitioner, or a customer service representative, who was only interested in the problem and not the person experiencing it. Thankfully many of us have also had the pleasure of a meaningful interaction in these situations, and how fulfilling that experience can be. If you are looking to enhance the experiences you provide for your patients/customers, empathy is a wonderful place to start.

Despite the focus on health care, I found a great amount to think about in my role as a designer. I’m committing to keep empathy at the forefront of my design decisions – to consider how I can help develop meaningful and genuine interactions. Won’t you?

The Power of a Name

In healthcare, we have access to more information about a person than almost any other industry. Yet, something as simple as a person’s name may be the most powerful piece of information we have to improve the experience we provide. Learning a person’s name, and using it well, is a powerful thing.

Have you ever received a mailing that looks like it was created just for you, then turns out to be a mass mailing with your name thrown on top? For one moment, you feel special and chosen. Then you realize it’s just another piece of junk mail, and you throw it away.  But more than that — for a moment, you feel something valuable has been mistreated. Your name has been mistreated, tricked, and you lose trust in whoever sent the mailing.

Consider, on the other hand, the true wonder when someone from your past sees you at the mall and remembers your name. “Dave, is that you?” It feels wonderful to be recognized, to be known, to feel that someone remembers you, knows you, and can relate to you. This builds and reaffirms trust. Don’t underestimate the power of a name.

Building trust is key in healthcare. Consider some of these practical ideas you can implement today:

  1. Know (and use) every patient’s preferred name. I once followed a cataract consult where, in the course of 45 minutes, three different people asked the patient for his preferred name three different times. He was learning to distrust us each time someone had to ask the question again. Having this information placed prominently on the chart can avoid situations like this.
  2. Have front desk people look ahead at who’s coming in, and be prepared to greet patients by name whenever possible. For many clinics, it’s possible to create pretty accurate guesses about names simply based on age and appointment time. Other clinics we’ve worked with have photo capabilities to pair with their management software. Whatever the tool, imagine the trust that’s built when a front desk staff member can greet the patient by name!
  3. The waiting room “cattle call” is one of the most inhumane moments of our work. We can do better. Instead, have techs approach a person in the waiting room, lay a hand on their shoulder, and say “Sue, we‘re ready for you,” rather than stand near the front of the waiting room and cattle call “Sue!”

Matt Jensen Marketing has created multiple systems with clinics where it is possible to do this regularly, with little to no extra time from staff, and it makes a world of difference to the patient.

Social Graces: 9 Keys to Using Social Media in a Practice Setting

Social media has changed the landscape of the Internet, and it has changed the way in which many industries conduct business. Health care is no different. Increased connectivity and peer-generated education have made it more important than ever for practices to expand their expertise into new mediums to help patients achieve their best possible outcomes. In the modern world, this means learning an entirely new approach to patients’ education, marketing, industry interactions, and management of the practice’s word-of-mouth messages. At the heart of this new challenge lies social media. This article is designed to help you get started using this tool effectively at the practice level.

Key No. 1: Understand What Social Media Really Means

When many people think of social media, they think of Facebook. Although it certainly is a great and important example, Facebook does not define the medium. A working definition of social media that helps create action at a practice level is as follows: social media is the ability of people to connect in ways that were never possible before and to share stories and content that create conversation and define their experiences. There are a couple key points here. First, social media enables people (your patients) who would never meet in real life to talk to each other about you. It connects people in meaningful ways, ways that were not possible just 10 years ago. This means that your patients may come into your practice with a knowledge of the industry—and you—that they could never have had without these new tools. Some of the information patients receive may be false and may make your job more difficult. Second, social media allows people to share stories and create a collective experience. In other words, Internet users are beginning to define businesses without the influence of traditional marketing. They are sharing stories that will define you. This obviously matters greatly to your practice.

Key No. 2: Be Authentic

Many people believe that, because they have created social media outlets, qualified leads will follow. Remember, most social networks were not created for conducting business. Simply having a Facebook fan page is akin to a guy in a suit and tie sitting in a corner at a fraternity party. He makes people uncomfortable. He is not there to party, and worse, everybody knows it. Make your postings relevant, real, and maybe even unpolished.

Key No. 3: Commit Time and Resources

As you jump into the work of implementing social media at the practice level, it is vital to remember that social media is social. It takes time and commitment to foster results in the social arena, just as it takes time in real life to create and nurture family relationships and friendships. There are no shortcuts, so plan on dedicating at a minimum 8 to 12 hours a week to your social media endeavors. Larger clinics may have staff members manage their social sites, but understand that a doctor’s presence within social media adds great value and will be crucial to your practice’s long-term success. For starters, commit one or two staff members to dedicate 2 to 3 hours each week to managing your social media and expand from there.

Key No. 4: Get a Plan

You have set aside the time to manage social media. What next? Many practitioners think to themselves, “I have a personal Facebook page. I will just create one for my practice and run it the same way.” This approach can produce very negative results. As in real life, social media relationships are not all the same, so you need to know why you are conducting specific activities online. For example, do you want to generate new leads? Run a promotional contest. Do you want to educate people? Write a blog, use Twitter to share interesting articles with your patients, or create a YouTube channel with educational videos.

What are you trying to accomplish by incorporating social media into your practice’s marketing plan? Make sure your social media plan clearly and succinctly answers this question.

Key No. 5: Understand the Tools

You have set aside the time, and you have a plan. What tools do you want to use? As discussed in Key No. 1, social media is much more than Facebook. If you want to blog, hundreds of tools are available, each offering different features and benefits. There are dozens of networking sites, hundreds of platforms for contests and promotions, and perhaps five or six good sites for sharing video; the list grows daily. Get to know the tools available and choose the ones that best fit your goals. (Because there are too many tools to explain here, jump to Key No. 8 if you are overwhelmed.)

Key No. 6: Implement Your Plan Across the Practice (Not Just on the Internet!)

At the practice that I manage, our Web sites exist as a static place on the Internet, where they function like an ad in cyberspace. People visit the sites, read some of the information, and then call (one hopes). Social media is vastly different. A major reason to invest time in social media is that you wish to be active in the conversations about you that are taking place on the Web. Right now, someone may be posting a review of you or your practice on Yelp or Google Reviews. Do you know what he or she is saying? You should. If someone says something negative, you want to be able to respond. If someone gives you a rave review, you want to thank him or her. If someone offers great feedback, you want to take it to your team and implement the change.

This is the point at which social media intersects with real life, and you and your team must approach every day knowing that each patient could be reviewing you right now. Social media presents an opportunity for you to ask your best patients to offer positive reviews about your practice across your social channels. Remember, your patients are telling your story; you no longer have control of the message. Getting your team to turn real-life interactions into social interactions is important.

Key No. 7: Learn to Measure

How do you know your social media efforts are working? I hope you are already asking this of your traditional marketing; social media is much trickier. Do numerous Facebook “fans” or individuals’ “liking” your practice mean you are a success? If your videos have been viewed 5,000 times, are your patients better educated? What do you do with bad reviews? What do you do with good reviews? Learning to measure your results and change course to achieve your goals is vital to any marketing effort but especially social media. A major reason is that, with social media, you are dealing with real people rather than print ads. You need to have a plan, commit the time, know what you want people to do, stay on message, and keep moving forward to be successful.

Key No. 8: Practice and Experiment

One of the best parts of social media is that you can practice your engagement with people and experiment with new tools relatively cheaply. Our practice decided to run a Facebook contest. We got it up and running, ran the contest, gathered results, measured our outcomes, and moved forward—all in 45 days. When you try new things, you learn. When you learn, you get better. You practice surgery, experiment with new lenses and tools, talk with colleagues, perform research, and gather new skills as a doctor. You will need that same innovative attitude for social media. One size does not fit all, so you will need to find the approach that works best for you.

Key No. 9: Get Help

You are not a social media expert. If you do not want to waste your time and resources, get some help. Find someone on your staff who can head up a social media initiative for your practice. Ask your marketing team’s members if they can create a robust plan, study the tools, and take action. Alternatively, partner with a new team to move forward with social media.


Across the Internet, conversations are taking place about LASIK, about cataracts, and about you. Many of these conversations do not include doctors, members of your staff, or anyone who will guide the discussants to your doorstep. If you follow the nine keys presented herein, you will be able to join the social media conversation with confidence and meet your goals: driving new patients to your practice, educating them, encouraging them, connecting them, and celebrating their stories.


This article originally appeared in Cataract & Refractive Surgery Today. Click here to download a PDF version.

Knowing Your Practice Is No Longer Optional

When most ophthalmologists hear the words performance metrics, they generally think two things: utilization and collection. How many patients per day do I see? What do accounts receivable look like? What are the practice’s monthly collections? Is there money in the bank to meet payroll? These measures are after-the-fact metrics. They do not provide information on attracting new patients, the fullness of the practice’s pipeline, effective conversion, or whether outcomes are attracting new prospects.

Some refractive practices have taken performance metrics a step further by looking at the level of patients’ interest and appointment progression. Someone on the staff monitors inquiries, consultations, and surgeries to track conversions at each step of the process. According to a second-quarter analysis by Market Scope, however, nearly half of all practices are not tracking new inquiries, inquiries to consultation, and consultations to surgery.1

Despite the constraints of today’s market, few centers track basic indicators of their practice’s health.1

How do you develop an informative, actionable snapshot of whether your practice is attracting the types of patients you want, whether they choose the vision services at which you are expert, and whether the financial result is sound? I recommend developing a performance dashboard similar to the one I have seen Kay Coulson, MBA, advocate at several practice workshops that I have attended. Ms. Coulson is the president of Elective Medical Marketing in Boulder, CO.

The Performance Dashboard

“I’m a numbers junkie, yet I quickly learned in consulting that synthesizing and condensing relevant information for surgeons is vital,” says Ms. Coulson. “The performance dashboard is something we developed to help our clients see, on a single page, whether the practice is headed in the right direction.”

A performance dashboard for a practice intent on growing its volume of IOL and LASIK procedures might look like this, according to Kay Coulson, MBA.

She continues, “I find surgeons want to know three things: are we attracting the right type of patient, are patients choosing the services I want to offer, and is the financial performance of the practice improving? There is no sugarcoating of results with a performance dashboard. You’re either attracting more inquiries or not. The right people are booking appointments or not. More people are moving to surgery or not. The fees they are willing to pay are good for the practice or not. At a time when it’s easy to become overwhelmed with data, paring it down to a snapshot that keeps everyone on track is paramount.”

Making Performance Metrics Work for You

How can you develop a performance dashboard that will help you monitor and improve your practice? Here are several suggestions.

No. 1: Start With the Initial Point of Contact — the Inquiry

Inquiries can be tracked in any existing practice management system simply by adding an appointment called an inquiry. In this way, when a new patient calls your practice, he or she is immediately booked for an inquiry appointment as well as the type of appointment he or she is requesting (e.g. annual examination, lens evaluation, LASIK consultation). If this patient cancels the appointment or progresses along an appointment path different than expected, he or she can be monitored and tracked.

No. 2: Use Appointment Types and Diagnostic Codes as Tools for Tracking the Practice’s Growth

Complete examinations, diagnosed cataracts, and resulting surgeries are reported quarterly, with comparisons to the same quarter from prior years. This information helps to account for the seasonality of procedures. It can also assist in the development of a new norm that takes into account the economic recession and changing health care structures.

No. 3: Measure the Financial Contribution of Your Key Service Lines

If you are trying to grow elective services, track their financial performance separately from insurance collections. This distinction will give you a clearer perspective on where the practice is growing and where poor performance has been masked.

No. 4: Align Spending on Marketing and Employees’ Compensation with Your Goals for Growing the Practice

It is not enough simply to spend money on marketing or to pay employees to show up for work. Over the next few years, you and other ophthalmologists will evaluate which payer contracts to pursue or renew; which new technologies for cataract, glaucoma, retina, or LASIK to adopt; and where to invest in facilities and people. It therefore makes sense to align your investment in marketing and people so that it is directly linked to the practice’s performance.


Develop a simple set of performance metrics today. Then, use them objectively, consistently, and rigorously in the coming years to grow your practice. These critical data are buried right now, but you can uncover them to effectively guide your practice’s future direction.


This article originally appeared in Cataract & Refractive Surgery Today. Click here to download a PDF version.

1. Market Scope’s Second Quarter Survey Report: Q2-2009.St.Louis, MO: Market Scope LLC; 2009.

Practice Profile: Vance Thompson Vision – Let My People Glow

Every organization has a structure that comprises how it accomplishes its tasks, how it engages its employees, and the type of managerial style used. Many businesses, including ophthalmology practices, use such structures to perform their day-to-day operations. Although it may not be intentional, a style eventually surfaces. There is the Matrix model, the Hierarchical model, the Flat model, and the Militaristic model to name just a few. If I had to choose an organizational model to apply to Vance Thompson Vision, a refractive and cataract center located in the US plains, I might label it the Group Hug model.

As a child, the life’s goal of Vance Thompson, MD, was simply to move to Sioux Falls someday and maybe drive a Chevrolet Suburban. He has handily achieved this and much more. In the past few years, his practice has added two surgeons, two optometrists, and numerous other staff positions. The practice offers world-class education to optometrists, has adopted new measurement devices for its team, and manages all of its own internal and external marketing. The achievement of these milestones has not interrupted a steady volume of refractive surgery or slowed an increase in the number of premium IOLs implanted. At the end of most days, however, Dr. Thompson can be seen fleeing the largest city in South Dakota in his 10-year-old Suburban for more open country, near Gregory (population 4,084), where his dogs can run and pheasants shudder with fear. He views his life in simple terms. Those who meet him quickly learn that his humble style and homeyness are infectious and serve to brighten the mundane.

Main Street Attitude

The small town, Main Street attitude is not only built into who Dr. Thompson is. It is also central to each member of the Vance Thompson Vision team, most of whom come from small, Midwestern farming towns.

Dr. Thompson is no longer the sole surgeon at Vance Thompson Vision, and he certainly believes that he is not the only leader. “We have created the kind of culture here where we really understand what drives each other,” he says. “We have to keep everything in balance. The practice needs to be more than just better for me; it needs to be better for the team and their families, too.”

“That is one of the major reasons I decided to partner with Vance,” says Alison Tendler, MD, a refractive and cataract surgeon with the practice. “We are not just about performing great surgery. That’s the easy part. We create better, more balanced lives for our patients and our team. Simply put, life is better being a part of this practice than it would be if we were not all together.”

Character Traits

One of the most important traits of a good leader is his or her ability to recruit top-notch talent. At Vance Thompson Vision, we have approached this task in unconventional ways. While many centers struggle to find ophthalmic technicians with experience, for example, we focus on the human interactions with candidates. “How [they] treated the front desk staff is far more important than if they can refract,” says John Berdahl, MD, another refractive and cataract surgeon at the center. “The people who work here are the type who sent cookies with their résumé and wrote a thank you note afterward. They are different from people everywhere else.”

The practice’s personnel have diverse backgrounds. Some came from the hotel and hospitality industry, some from the financial sector, and some from the marketing world. Others began in more formal health care settings. All share a common characteristic, however: they are in tune with the customer.

“One of our philosophies is to recruit talented individuals who naturally adhere to these core values, because those characteristics—unlike a knowledge of ophthalmology—are difficult to teach,” Dr. Thompson says. “The key is to provide a working environment that nurtures these core values. The benefit of defining our team’s core values is that it gets everyone moving in the same direction. More importantly, it puts premium patient care where it belongs—at the point of service.”

Continuing Education

In addition to finding talent, Vance Thompson Vision invests heavily in rounding out team members’ abilities, both technical and the so-called soft skills. Continuing education is constantly supported, and regular retreats are held with some of the county’s most accomplished thought leaders from various industries. In addition, daily and weekly spot checks are held in the form of “huddles” and meetings where there is ongoing tweaking of operations and the standards for the customer’s experience. The team shares a simple belief and desire to treat patients in a world-class manner.

The talent and dedication that differentiate the practice’s surgical team are shared by the optometrists, receptionists, coders, managers, technicians, and nurses. Their commitment to patients’ care is communicated by each of these team members in a harmonious fashion.


During the past two decades, several developments have set Vance Thompson Vision apart from other practices. The first is the advancement of technology. Obviously, the excimer laser’s FDA clinical trials and the adoption of laser vision correction were central in defining the future of Vance Thompson Vision. Moreover, it gave the center’s physicians and staff a mindset of being quick to adopt new technology. When femtosecond technology for the creation of the corneal flap became available in 2001, the practice was an early adopter. “Rapid adoption of proven technology has served to keep us out front, while endearing us to the providers who send their patients to us,” says Dr. Thompson. “Referring physicians know that, if there is an advancement of significance, we’ve got it.” Over the years, the center has participated in 30 FDA-monitored clinical trials.

Offering the latest technology to patients has also allowed the center to refrain from pricing wars. By offering what no other center has, pricing becomes a more neutral factor than without that differentiation. Price is and will always remain a barrier to refractive growth, however, so the use of easy payment options, for example, remains central to the success of a growing refractive surgery practice (see Refractive Surgery Financing Options).


What makes a practice successful may not keep it so. For this little center on the plains, however, what has made it successful is the foundation of what will carry it in the future. We remain committed to adopting new technologies in laser and implant surgery that create a real benefit for patients. We will also continue meeting together often, as if a family, to consistently stage experiences for our customers that are worth the price of entry. The future is bright—for the doctors, the team, and our patients.


This article originally appeared in Cataract & Refractive Surgery today. Click here to download a pdf version.

Here Comes the Sun: Marketing Your Premium Practice

Summarizing the last 24 months in song would be quite the contest. BJ Thomas’ “Raindrops Keep Falling on My Head” would be vying for a spot with Pink Floyd’s “The Wall” as the most appropriate song for the industry’s economic blues. Beck’s “Loser” would easily win out over a similarly titled anthem from the Beatles (“I’m a Loser”). Certainly, the last 24 months have been challenging for the refractive surgery industry. Some folks are still apprehensive about “getting back in the game,” in terms of creating demand through new or traditional marketing tactics. Many others have decided that George Harrison was right: now is the time to plan for sunnier days.

Major Marketing Decisions: The Four Ps

In the years leading to the downturn, major marketing decisions in premium practices typically fell into one of the following four categories known as the Four Ps of Marketing: product, price, place (distribution), and promotion. These variables were altered to best satisfy the practice’s customers in the desired target market. In most cases, and in the field of refractive surgery generally, emphasis was placed on these four categories to encourage a prospective patient to inquire about a practice’s offerings. As you read these definitions, pay special attention not only to their descriptions but also to the typical cataract and refractive practice’s handling of each marketing component.

Category Description Old Marketing Approach
Product The product is the actual offering or service made to the patient/customer. In the case of physical products, it also refers to any services or conveniences that are part of the offering. Product decisions include aspects such as function, appearance, packaging, service, warranty, etc. The surgery is the product.
Price Pricing decisions should take into account profit margins and the competitive landscape. In the world of marketing, pricing includes not only the list price but also discounts, financing, and other options such as leasing. Prices are lowered to increase demand.
Placement Decisions regarding placement are those associated with channels of distribution that serve as the means for getting the product to the target customers. Placement is classically regarded as “media outlets.”
Promotion Promotional decisions are those related to communicating with and selling to potential consumers. Since these costs can be large in proportion to the product’s price, a break-even analysis should be performed when making promotional decisions. It is useful to know the value of a customer in order to determine whether additional customers are worth the cost of acquiring them. Promotional decisions involve advertising, public relations, media types, etc. Promotion looks like refractive surgery sales.

The Industry

From an industry standpoint, laser vision correction volumes have been steadily decreasing as society has moved from the early-adopters stage of a product’s or service’s life cycle to the early-adopters/early-majority/middle-majority stage. Today, more than ever, patients (customers) are concerned about safety, value, and long-term stability. According to Market Scope’s quarterly survey of refractive surgeons, U.S. laser vision correction procedures declined 26.6% in 2009 when compared to 2008 [D. Harmon, personal communication, April 2010]. Although this shortfall has been met with consistent growth in the areas of IOLs and therapeutics (particularly in cataract surgery), offsetting the loss of total procedural volume and the resulting loss in net revenue will be a major challenge for refractive surgery centers in the years ahead.

The technology adoption life cycle

Moreover, an operational risk exists if this mix of growth in implants and therapeutics continues alongside decreasing volumes in laser vision correction. Basically, similar procedural volumes could result in far lower net revenue with which to run your practice unless a “refractive-style” model can be adopted in the therapeutic category.

Supplementary and Replacement Revenues

Marketing’s function is to assess the pros and cons of potential offerings and determine their ability to add value to the core mission of the vision correction industry. I mention this because the future vitality of refractive surgery lies in the industry’s ability to focus on its mission of improving vision across constituencies.Innovation rules. Practices cannot become distracted by offering other “replacement” revenues as their core business. Everything a premium practice offers must revolve around or be supplementary to the core function of correcting vision. Otherwise, a meaningful system of distribution no longer exists.

Within the confines of the mission I describe, new sources of revenue do exist. Nutritional supplements, aesthetic services, myopic treatments (not procedures),and new options for presbyopic correction can bolster the practice’s bottom line without disrupting the mission. Be mindful, however, of how consumers perceive your practice’s role in vision care and make every effort to hold that spot in their minds.

Mass Communication Is for Mass Production

Descriptions of where products or services are in their technology-adoption lifecycle are relics of goods-based economies. Goods-based economies performed best during the industrial era when phrases such as “product lifecycle” were used to describe consumers‘ purchasing tendencies across a uniform and lateral product line. Each product was made to be as identical as possible and kept as inventory until the time of purchase. Firms were more successful when they could mass produce uniform products. Customers were relatively satisfied because they had access to more offerings than ever before. The fact that an item was not exactly what the customer desired was superseded by the value and number of options available to them in the economy based on mass production.

“The concept of mass production is problematic in an economy that is now defined by customers’ experiences.”

The concept of mass production is problematic in an economy that is now defined by customers’ experiences and even more so in an environment of elective medical health care, where the push is to increase offerings to offset decreased volumes. As Joseph Pine III and James Gilmore state in their groundbreaking book The Experience Economy: Work Is Theater & Every Business a Stage, in elective health care, the intended aim is not mass production but mass customization, a strategy of uniquely serving each customer in an efficient way.1

Today, the elective health care industry is offering a transformational experience under the mass production model. I believe this is driving prices into the ground, expectations through the roof, and centers to their knees. Why? There is no reference, framework, or architecture to build from to make the experience of laser vision correction truly experiential in the mind of the customer. Even more difficult than staging a customer’s experience that is worth the price of admission is doing so in a consistent and efficient manner. I fear that our industry, manufacturers included, is still unsure of what truly motivates patients, resulting in the development of self-serving messages designed to increase marketshare, not grow the whole.

This is described by Pine and Gilmore:

We see many companies today floundering in how to market their offerings thanks to the demise of mass markets, the ineffectiveness (and unmeasurability) of advertising, and the seeming failure of using the WorldWide Web as an effective marketing vehicle. That’s why we also see a plethora of “adjective-based” marketing ideas; to name just a few, think of guerilla marketing, permission marketing, viral marketing, even emotion marketing and emotional marketing. Each type may have something valuable to say, but never really addresses the heart of the problem: People have become relatively immune to messages targeted at them. The way to reach your customers is to create an experience within them.2

Marketing Operations

Perhaps more important than your actual marketing message is the support you give it through marketing operations. The best advertisement can only make alogical prospect try your product or service once. If that consumer’s experience does not measure up to his or her expectations, the failure lies in the operations, not the advertisement. Special attention must be paid to the operational side of the practice to ensure that the experience is worth whatever was invested in the advertising budget.

Shareef Mahdavi, the president of SM2 Strategic in Pleasanton, California, said it best in a recent posting on the Premium Experience Network:

Unlike the traditional marketing or advertising budget, investing in the customer experience doesn’t require huge budgets…but does have two specific needs: your mind and your time. In fact, as the leader of your practice, it’s critical that you adopt a mindset of making the customer and their experience the key differentiator of your practice compared to other doctors of the same specialty in your area. Experience has shown that any attempts to improve the levels of service will generally fail if the physician is not wholeheartedly committed to the cause.

Time, not money, is the primary resource you will spend on the path to being world class in the eyes of your customer. With advertising, it’s the opposite. You spend significant amounts of money to generate awareness and interest in your practice and its services.But once that money is spent, it’s gone. With service, you will invest significant amounts of your time in your staff. But what you are building is a process to identify and address “service defects” and to enhance the overall experience. You are simultaneously building a culture among your staff that says “here is what’s important to our practice.” Realistically, you will spend money on training sessions, systems/hardware/software, and cosmetic improvements. But those investments are long lasting and do something advertising cannot: fulfill the hopes, desires and expectations of your customers above their role as your patients.3

In assessing your practice’s marketing operations, consider these questions:

  • Do you devote specific staff meetings (or separate sessions) to the topic of customer service?
  • Who is in charge of customer service in your practice?
  • How much are you spending each quarter on advertising/promotion versus improving levels of service?

Reserve time and energy to create your practice’s internal processes and structure, not just its external campaign. However, once the operations are in order, how should a practice go about creating its initial messages?

Creative Brief

The first and perhaps most important piece of your advertising communications is flagging your prospect.The best approach is to pay attention to the creative work plan, otherwise known as the creative brief in marketing circles. This document boils down the important details of an advertising message to be certain the message achieves the desired outcome. A creative brief is created by following these steps:

1. Why are you advertising?

It is critical to determine why the advertisement is being created. Otherwise, there is a tendency to throw everything but the kitchen sink into the message. If there are two reasons for creating the advertisement, develop two ads. Some reasons for an advertisement are:

  • The practice has a new technology that is safer and more accurate than a more traditional technology.
  • A new doctor is being added to the practice.
  • The practice has a new offering or is adding a new location.

2. To whom are you talking?

Here is where you define your target audience. For example, a practice might decide that its prime market for laser vision correction includes individuals aged 35 to 54 years, with 60% being women. Potential customers would be defined as those who would like to reduce their dependence on glasses or contact lenses but have not yet done so due to concerns about safety.

3. What do you want customers to think, feel, or do as a result of the advertisement?

Perhaps you want patients to understand how important laser vision correction can be to their quality of life. Maybe you want to appeal to their desire for spectacle independence during activities. Perhaps you simply want to position your center as the authority in vision correction. Here, this is all hashed out. However, keep in mind, the most effective use of your message is to communicate only one thing.

4. What one thing makes this offering different or better?

What is unique about this offering? Before youcommunicate with your prospective patients, be sure that you understand what the business world calls your unique selling proposition. This is what sets you apart from competitors in your category. It may be experience, technology, safety, accuracy, or exclusivity. Resist sales offerings here as they typically are not unique. The same promotion you run can be run by your competitor next week. Stick to what is unique.

5. The New Four Ps

After establishing the reasons for communicating and how these will increase reliance upon the practice’s marketing operations, the four Ps of marketing can be rearticulated in a way that instills a more customer-centric experience.

Category Description New Marketing Approach
Product The product is the actual offering or service made to the patient/customer. In the case of physical products, it also refers to any services or conveniences that are part of the offering. Product decisions include aspects such as function, appearance, packaging, service, warranty, etc. The patient is the product.
Price Pricing decisions should take into account profit margins and the competitive landscape. In the world of marketing, pricing includes not only the list price but also discounts, financing, and other options such as leasing. Prices are reviewed not only to understand profitability but to ensure an experience worth the price tag. Prices are increased as technology and offerings are increased.
Placement Decisions regarding placement are those associated with channels of distribution that serve as the means for getting the product to the target customers. “Media outlets” are replaced by networks. Rather than billboards, the patient/customer is the billboard, instantaneously sharing his or her positive or negative experience with his or her family and friends.
Promotion Promotional decisions are those related to communicating with and selling to potential consumers. Since these costs can be large in proportion to the product’s price, a break-even analysis should be performed when making promotional decisions. It is useful to know the value of a customer in order to determine whether additional customers are worth the cost of acquiring them. Promotional decisions involve advertising, public relations, media types, etc. Promotions are not sales based. They are seen as one of the last steps in increasing demand, after operational considerations have been taken into account.


Finally, remember to keep things in the proper order. When there is economic promise on the horizon, there is a rush to begin creating demand through marketing. This is a normal and natural business response. However, be certain your operational processes are in order before you begin to burden them with increased call volumes, visits from patients, and procedural volume. Otherwise, the demand created could manifest itself into an increase in substandard experiences. Now is the time to set the standards that will make your practice truly experiential in the future.This is because now, while volumes are rebounding, you and your team have time to choreograph what an optimal patient/customer experience should be like within your four walls. From there, determine what you want to say using processes like the creative work plan. This will ensure that what you say in your messages actually accomplishes what you set out to accomplish.


This article originally appeared in Premium Practice Today. Click here to download a PDF version.

1. Pine B J, Gilmore J H. The Experience Economy: Work Is Theater & Every Business a Stage. Boston, MA; Harvard Business Press; 1999.
2. Pine B J, Gilmore J H. Special Report: Experience Economy. Accessed April 1, 2010.
3. Shareef Mahdavi’s Premium Experience Network. Accessed April 15, 2010.

Marketing Solutions for a New Economy

Traditional marketing is simple: create demand, make the phone ring, and close the sale. Demand is typically measured by new leads, consultations, and surgeries. The tools with which we have created demand have been print, radio, television, and the web. The current economic climate, however, has sent many centers into a tailspin, and physicians and their staffs are wondering if their external efforts are worth the results. People are not calling like they once did, and if they do, they are not scheduling surgery quite as easily. Future success is tied directly to a practice’s ability to create a fabulous experience for patients within its four walls. To that end, before spending dollars on external advertising, it is important to look inside your practice to see what your patients are seeing.

The Reluctant Customer

Consumers do not want to be targeted, and they are more skeptical than in the past. Satellite radio, digital video recording, and social media are being adopted, in part, in order to avoid the interruptive messages created by the advertiser. Additionally, in today‘s world where people are working harder for less money, when a consumer decides to make a purchase, his or her expectations for value tend to be higher.

This economy has created a vicious circle where patients’ heightened expectations are met with even lower than normal customer experiences.

Meanwhile, many practices have dealt with the current economy by reducing their support staff and amenities; both can be detrimental to the experience of patients and their overall perceptions of value. In such cases, word-of-mouth referrals drop in frequency. Some surgery centers may respond with a more desperate style of advertising that can turn off potential patients.

When desperate advertising measures meet the growing expectations and the new skepticism of the consumer, a vicious circle begins. This is why it is vital to create experiences at the practice level that are actually worth the price of the procedure: “People have become relatively immune to messages targeted at them. The way to reach your customers is to create an experience within them.”1

Track Your Effort and Results

The most effective way to position your practice for future growth and stability is by enhancing the patient’s experience at each stage of the process. Waiting times, educational explanations, and the inclusion of their family members and loved ones in the conversation are far more important than they were just a few months ago. There appears to be little effort, however, to track current customers’ information that is useful for creating growth. In Market Scope’s second quarter analysis2, nearly half of all respondents stated they are not tracking new inquiries, inquiries to consultations, and consultations to surgery within their center. Metrics tracking is a basic business function that ensures the processes in place are functional and successful. How bad must the economy become before ophthalmic practices begin performing this task?

Even under the constraints of today’s market, few centers are tracking basic indicators of their practice’s health.

Utilize Customer Relationships to Increase Revenue

Inquiries that have not become scheduled consultations, and consultations that have yet to become scheduled surgery, represent easy marks for re-engagement. Instead, many surgery centers focus solely on new leads from external advertising. By utilizing a robust CRM (customer relationship management) software, practices can become relevant to potential customers who have already expressed interest in vision correction.

CRM technology not only lets you track conversions, but it also forecasts potential revenue within the surgical pipeline.

One difficult component to using practice management software, however, is learning to deal efficiently with all of the data created throughout the customer’s experience. A unique advantage to most CRM software is its ability to synchronize with practice management software. The former allows data collected during the patient’s experience to be used to create customized messages afterward. Each patient’s interaction is synchronized. As the practice schedules a patient from a consultation to surgery, the CRM gets updated as well, removing that patient from the consultation “bucket.” When the time comes to send a message to all potential patients who have not yet scheduled surgery, the practice need not worry whether or not the database is pure. In addition, practices have the ability to see how many opportunities exist within each status group.


Many opportunities are being overlooked at the practice level that can only be capitalized upon if simple tracking methodologies are put in place. The best first step to creating engaging and profitable experiences for customers is to pay attention to the most basic of operational standards. Look inside your practice and take advantage of the opportunities that already exist there.


This article originally appeared in Cataract & Refractive Surgery Today. Click here to download a PDF version.

1. Gilmore J, Pine B J. The Experience Is the Marketing. Louisville, KY: Brown Heron Publishing; 2002.

2. Market Scope’s Second Quarter Survey Report: Q2-2009. Manchester, MO: Market Scope LLC; 2009.