"What I’ve learned from refractive surgery is to seize good ideas but also be willing to adapt," says Dr. Eric Donnenfeld, a Long Island surgeon who’s been doing refractive surgery since 1985.

Dr. Donnenfeld offers the following advice to surgeons looking to grow their refractive surgery practices:

• Don’t get ahead of yourself.
He suggests becoming the expert on refractive surgery before becoming the surgeon. Soak up the literature. Take courses on how to do the procedure. Visit a successful surgeon and observe.
"Technique is important," Dr. Donnenfeld says. "But it’s just as important to know how to talk to patients. They can sense fear and uncertainty like a shark senses blood. You must have comfort, commitment and confidence."
He recommends tapping into the 200 to 300 potential refractive surgery patients in your practice before externally marketing and co-managing cases. "You don’t need to establish a network of 100 O.D.s to succeed," he says. "Success with your own patients will be your best growth-marketing tool."

• Prepare patients properly.
Dr. Donnenfeld spends 4 to 5 minutes with each patient before surgery – but only after they’ve been educated and oriented by staff, a video tape and literature.
"I sit down with patients and talk about how much it will cost, how much it will hurt, what the worst outcome could be and how well the patient will be able to see after it’s over," he says. "It’s these same four issues every time."
He continues: "I tell them, ‘The worse thing that can happen is an infection and you would need a corneal transplant. But I haven’t had that happen once in 6,000 cases.’ I tell them we have an imperfect flap in one out of 500 to 1,000 cases, but that it can be fixed. And that there’s a chance they will need an enhancement if they’re in the higher diopter range."

• Discourage patients who have unrealistic expectations.
"When a patient says he’s wearing RGPs (rigid gas permeable lenses) and he’s complaining of visual problems, the sirens go off," he says. "I’ll never satisfy that patient."