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Knowing Your Practice Is No Longer Optional

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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.

Conclusion

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

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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.

Landmarks

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).

Conclusion

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

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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.

Conclusion

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

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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.

Conclusion

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.

Premium IOLs: It’s All About Timing

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Many baby boomers have spent the last few years denying that their gradual loss of vision is impairing their ability to enjoy daily activities. By the time these individuals muster up the nerve to respond to the advice of their primary eye care provider, friends, or family to do something to improve their vision, the last thing on their mind is surgical upgrades. Although patients once simply responded to their doctor’s orders, they are now presented with lifestyle lenses, out-of-pocket procedures, and a resulting multitude of decisions to make. In the mind of the consumer, refractive and cataract surgery are complex. Ophthalmologists therefore must use finesse when communicating information to patients about how to reduce their dependence on glasses and/or contact lenses.

Education and Communication

Communicating the technological merits of a procedure or a particular IOL in your advertising or marketing campaign may be far too much information for patients who are just beginning to consider their options. Conversely, if the vital components of a choice premium IOL are not broached until the time of the doctor/patient discussion, the patient is less likely to understand his options for advanced lens technology. The patient simply has not had enough time to process the information. Timing is critical.

Memory

In his book, Physician Success Secrets: How the Best Get Better, Greg Korneluk states that 50% to 80% of the information provided by clinicians is instantly forgotten by patients1 and only 50% of their recall is correct. If patients accurately remember only 25% of what you tell them in general, imagine how that percentage decreases when the information conveyed has little to do with what they expected to hear. It is no wonder that patients’ adoption of refractive IOLs is slower than the demand perceived by industry.

For patients to participate in the decision to restore their vision, the clinical and educational aspects of the process must be memorable or experiential. Like the dynamic structure (Figure 1) of a play, the conversation about a patient’s surgical options should be broken into stages. Not all information should be communicated during the initial exposition.

Exposition: The Cataract Call

A new cataract patient calls your office and says, “My doctor mentioned that I have cataracts and that I need to see an ophthalmologist.” In most cases, he will be scheduled for a cataract consultation with you or the optometrist, and he may be informed about paperwork or that his pupils will be dilated. Unless he receives an inkling of the important decisions awaiting him, his dramatic storyline has not begun. He will be far less likely to embrace the idea of advanced IOL technology at the point of service.

What if, as an alternative opening act, when the new patient calls, the staff offers him a cataract consultation but stresses that cataract surgery is a big decision because of the available range of visual options? What would happen if an employee also stressed to the patient the importance of his researching his surgical options before the consultation by visiting the practice’s Web site? What if the employee also mentioned that the patient would receive a packet of information on the decision-making process? In my opinion, these steps increase patients’ ability to participate meaningfully in their surgical care. Communicating too much information over the phone, however, could overwhelm the patient.

Conclusion

The decision to undergo vision-correcting surgery is a big one for patients. The range of technology available can confuse and frustrate them. By staging patients’ education like a theatrical production in which their initial interaction with your staff represents the exposition, you and your team can help patients make a quality decision on their care.

 

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

1. Korneluk G. Physician Success Secrets: How the Best Get Better. Boca Raton, FL: International Council for Quality Care; 2004.

How to Create an Exceptional Experience for Patients

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Adopting great customer service as an overall philosophy is key to your practice’s longevity in the LASIK market. Simply selling the red carpet treatment to your patients is not enough. It is essential for you to deliver excellent care consistently. This article addresses the gap between your practice’s image and reality, and it offers advice for optimizing every patient/doctor encounter.

Establish an Image

Decide how you want the public to view your practice (eg, technology-driven or one with a highly skilled physician). Then, make sure that image is present in everything you are marketing and advertising to your potential patients. Ensure that your practice’s services reflect your image and that every staff member upholds it. For example, if you promise patients personal care and one-on-one communication, then warmly greet every patient when he walks through the door.

Evaluate, Educate, and Empower

Today’s counselors must follow the lead of each patient rather than a standard protocol. Tailoring your message to individuals will maximize their experience at your practice. For instance, young, Internet-savvy patients may have conducted extensive research on their own. They may want a few specific answers from you before scheduling surgery. Other patients may look to you for step-by-step education. They will probably have more time to invest and will expect you to do the same.

Points of Contact

Your patients’ experiences boil down to how you make them feel throughout the process of vision correction. You should strive to impress patients from the point of contact and with every detail thereafter. From a caller’s time on hold to a handshake and a smile at the end of a visit, each of your interactions is an opportunity for you to acquire a new patient.

First Impressions

Your initial phone call with a potential patient is crucial. This first impression can either mean a new patient (and word-of-mouth referrals) or a missed opportunity. Hire positive, informative, sincere intake personnel. Train them to be proactive when addressing issues like technology, safety, and what makes your practice superior to the competition. By addressing LASIK fees early and offering competitive financing options, such as CareCredit’s no-interest payment plans, you can help ease prospective patients’ concerns about price and earn their trust.

The Consultation as an Interview

Try asking prospective patients a simple question such as, Why now? Give them the opportunity to tell their story and to share their motivations and concerns. By asking open-ended questions, you may get all the answers you need and allow patients to sell themselves on refractive surgery.

Be upfront about potential complications and carefully consider your words when discussing the procedure. At the John-Kenyon American Eye Institute in Louisville, KY, Manager of Refractive Services Markey Ratliff relies on scripted material (with a personal touch) to ensure the message is consistent with her practice’s image and the physician’s style. Words can allay fears. For example, you might say measurements instead of tests, procedure instead of surgery, and creating the flap instead of cutting the flap.

Deliver a Stress-Free Procedure

Your patients will look forward to surgery but also may feel anxious about it. Turn any negative feelings into positive ones with words and gestures of reassurance. For example, at Ms. Ratliff’s practice, she and her colleagues strive to deliver a soothing, spa-like experience with little extras such as blankets, movies, and music. If patients seem nervous, Ms. Ratliff offers to sit with them and hold their hand during treatment. After the procedure, she and her colleagues make sure to thank patients for choosing their facility and send handwritten thank-you cards.

Environment

Assess your marketing and advertising materials and compare them with those of other local practices. If several LASIK centers in your market push general features, such as personal care or technology, get specific about how your technology is superior and how you personalize each patient’s experience.

Spend half a day observing your practice from your patients’ point of view. What makes them smile? When do they seem frustrated? Is the atmosphere too clinical to put nervous patients at ease? Ask patients for their input on ways to improve everything from décor to waiting times.

 

Phil Jackson, the Director of Refractive Service at Associated Eye Care in Stillwater, MN, and his colleagues refer to the waiting room as the lounge. It has soft, relaxing chairs and is stocked with educational books instead of outdated magazines. A greeting system welcomes patients and keeps them informed of waiting times. Mr. Jackson has found that they really appreciate the extra effort.

Wrap-Up

Follow-up care is part of the total patient experience. Use questionnaires, focus groups, and testimonials to find out where your practice really excels and, more importantly, where it needs improvement. Then, follow through on making the appropriate changes.

 

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

How To Market Your Refractive Practice

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Are your marketing efforts producing healthy call volumes and a strong conversion rate? If the quantity of incoming, positive telephone calls could improve, then read on for suggestions on how to increase your refractive volumes with strategic marketing maneuvers starting at the practice level.

Start with What You Have

In terms of marketing dollars, it is far less expensive to attempt to convert a current caller into a potential patient rather than to motivate a new person to pick up the phone and contact your practice. It is also more cost effective to market additional procedures or continuing eye care to your existing patient database than to try to lure new patients to make an appointment at your facility. You can start, simply, by focusing your marketing efforts on enhancing your practice’s image and by establishing clear and memorable communications.

Identify Targets

Implement your marketing strategy, which should be based upon current research, such as market factors approximating consumers’ spending patterns and levels of discretionary income. Invest in the collection and evaluation of professional data and conduct training sessions to educate your staff about the minds of consumers.

Stay in touch with your patients by consistently requesting their feedback in order to be knowledgeable about their needs and to recognize areas in which your practice or team can improve. By understanding what your patients want, you not only can better meet their expectations for vision correction, but you can stimulate them to call in the first place.

Stage Memorable Experiences

Focus on exceptional experiences for your patients. Come up with ways to improve a patient’s experience before concentrating on expensive media advertising. Involve staff members in the strategic brainstorming process as characters in the production. Your employees who are truly invested in new ideas are more likely to contribute their thoughts and opinions for implementing and maintaining important protocols.

Start Marketing from First Contact

Take the “inside-out” approach by putting yourself in your patient’s shoes. Make sure, first, that phone calls correspond with your marketing messages. Imagine your disappointment if you received an impressive, high-quality brochure advertising a positive personalized experience, in addition to a knowledgeable, friendly staff, but instead you were greeted by a grumpy intake person who was reluctant to answer your questions.

The staffers in charge of initial, potential patients’ phone calls should have a warm and friendly personality, and they should be informative, persuasive, and confident. The training, support, and evaluation of these types of personnel are crucial to your practice’s growth. Consider using scripted material when training intake workers. Information that these employees should communicate includes countering cost barriers, promoting the surgeon’s experience, and discussing the values and benefits of surgery. Compensate these staff members well as they strive to grow your conversion rates.

Market During Head-to-Head Consultations

Face-to-face consultations should be a continuation of your marketing efforts. Think of the encounter with a potential patient as an interview or audition: prospective patients are looking to you for important information on a procedure and deciding whether to choose your practice instead of your local competitors.’ This visit is a golden opportunity for you to listen to and address specific obstacles to the patient’s committing to surgery and to provide highly personalized feedback and recommendations.

Address a Patient’s Fear Early

During calls and consultations, your staff must be able to anticipate and address patients’ fears before discussing prices or procedures and treatment. Your staff should emphasize your surgical skill level and bedside manner. They should get patients excited about the possibility of clear vision by asking them what they hope to accomplish with the procedure. Staffers should ask them to share specific concerns and then address each with positive answers that are well thought out.

It is an excellent time to elicit and address each candidate’s apprehensiveness and to discuss long-term benefits. Emphasize value; a procedure takes little time, but improved vision lasts for years.

Counter Cost with Financing

In our experience, the earlier we address patients’ concerns about cost, the less likely they are to sever the relationship during the consultation stage. Use patient financing as a marketing tool. Regularly evaluate your fees and financing plans. Talk to patients and record their feedback. If you are not currently offering a wide variety of payment plans with true benefits, search for different financing options that will assist patients with comfortably fitting vision correction into their budgets.

Marketing as a Collaboration

Your internal marketing plan must reflect a cohesive image for your practice. The philosophy behind your practice should be apparent in all aspects of your marketing and advertising efforts. Never underestimate the power of first impressions.

 

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

Establishing Core Values in the Workplace

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Core values are patient-centered principles that guide the actual tasks that we do. The goal is that every action taken will optimize the overall experience of the patient. Just as doctors take a Hippocratic oath to “do no harm,” our clinic’s team took an oath to deliver the best refractive surgery care and ensure the best experience for our patients.

The Vance Thompson Vision team agreed to abide by a list of core values that represents the unwritten or traditional rules within us all. It is our standard of behavior and what we expect from one another as a team. Our group has been doing what we do for a long time. We believe we know how to deliver care with the highest level of quality. As we grow, it is vital for us to impart those standards of excellence to our newer members. When every team member commits to a list of core values that they believe is consistent with how they would want to be treated, it maximizes the chance that it is exactly how they will treat our patients, thus making for a very positive patient experience. We did not want the continued growth of our practice to compromise the standards and atmosphere that have made us successful during the last 15 years.

Building the List

Our list of core values was based upon the philosophy of many cutting-edge companies from other consumer driven industries such as The Ritz-Carlton. We felt we had to start with industries that pride themselves on knowing their customers better than anyone. Then, we took our own thoughts and ideas about how we like to be treated and created our own list of basic customer service values.

Five Core Values at Vance Thompson Vision

  • “Our patients are our most important resource. They should be treated like guests and family visiting our home.”
  • “Each team member is empowered to look for ways to exceed the patient’s expectations and enhance their experience at all times.”
  • “Each patient should experience our undivided attention. Their preferred name should be used, they should be escorted at all times, and all attention should focus on them when they are present.”
  • “Each team member should look at each patient they encounter as an opportunity and privilege to affect their life in a positive way. Each patient should leave here feeling better then when they arrived.”
  • “Each team member should participate in a Cadence of Coverage that over-communicates responsibilities and workflow so that we can best meet the needs of each other and our patients.”

Employees’ Adherence

Each of our team members signs the Declaration of Core Values, which gives us all ownership in the aforementioned philosophy. It permeates every patient interaction in our office. Additionally, we feel it positively affects the way our employees treat each other in the workplace.

Rules Do Not Change — They Grow

We believe it is important for surgeons and office managers to realize that, just as the refractive surgery market changes, core values evolve. We review our list on an annual basis during an off-site retreat with our entire staff. Each person voices his opinion on each core value and helps decide on necessary updates, eliminations, etc. We really want to hear from all employees because it will affect the work they do in their job function.

“The process of upholding and devising proper core values never ends for an organization that continues to grow.”

The process of upholding and devising proper core values never ends for an organization that continues to grow. We are passionate about delivering the best service we can while continually learning from other companies.

Conclusion

It is important to recruit people who are willing to embrace our center’s core values and to be up front about what we are trying to achieve. One of Vance Thompson Vision’s 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. 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, but, more importantly, it puts premium patient care where it belongs — at the point of service.

 

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