Minimizing Risk in Your Refractive Practice (Part 3 of 3)
Advice for ensuring your future success.
By William B. Rabourn

As a student of history, I can guarantee you that the economy will always have its ups and downs. The recent downturn that's negatively affected the refractive industry won't last.

President Bush is urging America to get back to normal. He's working closely with Fed Chairman Alan Greenspan to put the economy back on the fast track. Refractive surgery is certain to follow. When considering how to minimize risk in your refractive practice, it's vital that you consider where the economy and the industry will be years from now. So let's take a peek into the future of refractive surgery.

As an ophthalmic consultant, I'm excited about the future of refractive correction. In the two previous articles of this three-part series, I outlined how to successfully initiate and market a refractive practice. In this final installment, I'm going to provide sound advice that will help you create a game plan to enable your refractive practice to stay competitive well into the future.

ILLUSTRATION: GREG RAGLAND

Technology will advance

Consider for a moment how much the refractive industry has changed in the past decade. A host of procedures, including PRK, LASIK, LTK, LASEK and clear lensectomy, have revolutionized the industry. I don't believe that this rate of change will stop. Instead, I believe that it's likely to increase.

I strongly believe that the future of refractive vision correction will entail more than lasers. New technologies on the cusp of FDA approval offer capabilities that are, as of yet, unattainable through laser surgery. One modality that I'm particularly excited about is the accommodative lens, which can correct presbyopia, hyperopia and myopia. Intraocular techniques like this require a sterile environment such as an ambulatory surgery center. Make it a priority to obtain access to such a facility.

However, lasers will continue to be a strong force within the refractive correction for years, and perhaps forever.

I know a few ophthalmologists who still offer radial keratotomy exclusively over LASIK. Although I can't argue with their past track record of success and the savings on equipment expense, these ophthalmologists are falling behind the curve.

Not long ago, 20/40 was considered the gold standard of refractive surgery. Today, new technologies have brought that standard to 20/20 or 20/15. In a very short time, the gold standard for a refractive practice will be 20/10.

As technologies advance and patients become aware of these changes, they won't just seek better vision -- they'll want perfect vision, which isn't as likely with such techniques as radial keratotomy.

As essential as experience is, technology is becoming equally important. It won't be long before a relatively young ophthalmologist with the latest technology can offer more services with better outcomes than an experienced surgeon with outdated equipment. Indeed, it's happening already. However, an experienced ophthalmologist using the latest technology will always provide patients with better care and outcomes. That will never change.

Obtain an "evergreen" clause

Have you ever purchased an expensive computer, only to find that it was an outdated dinosaur just a year later? Future advances will quickly depreciate the value of your technology investment. I've worked with many ophthalmologists who've found themselves in this depreciation dilemma with refractive technology. Fortunately, some laser and diagnostic platforms now come with what I call an "evergreen clause."

Refractive equipment entails a huge investment of money and time. Learning a new platform takes time, and even the least expensive refractive laser isn't cheap by any standard, so it's essential to make the most of your investment. An evergreen clause can address this problem. Essentially, it guarantees your practice free technology and software upgrades for the life of your equipment.

Although this clause can't make your laser effective 100 years from now, it will significantly increase the amount of time that your equipment will be viable. Make evergreen a priority when researching any equipment purchase.

The benefits of branding

How you exit your refractive practice is equally important as how you enter. What will happen to your practice when you're ready to retire? What will happen to your patients?

I continually advise my clients to not just build a practice, but rather develop a brand of practice that endures even after you've stopped taking an active role. Brand association is relatively new to the medical industry, but not to your market. If you missed last month's article, I discussed at length the importance of branding. This month, I'll touch briefly on branding: how it applies to the future of your refractive practice when you're developing growth and exit strategies, and why these two strategies are essentially identical.

It's a well-known fact that strong brand association greatly affects consumer buying decisions, and this same methodology carries over into the refractive practice model. I recently spoke with a woman who had LASIK performed in Florida and who claimed that her procedure was performed at the same practice where champion golfer Tiger Woods had his procedure. This wasn't completely true, but she did have her procedure performed at the same national brand of practice where Tiger Woods had his vision corrected.

Not every practice can have a patient such as Tiger Woods be their spokesman, but every practice can develop a brand. Does your practice have more experience? Does your practice have the best technology and results? Has your practice performed LASIK on a local, regional or national celebrity? Are your prospective patients aware of the advantages your practice offers them? If your answer to my last question is no, then you haven't branded your practice successfully.

If I talk to my clients too much about branding, it's only because branding is critically important to the growth of their practices. Take time and put thought into both branding and growth. When you do, your branded practice will continue to thrive -- even after you retire -- because of its name awareness and patient-consumer identification.

Without successful branding, your practice isn't likely to experience significant growth, so consider carefully what you want your practice to be known for 20 years from now, and tell that story to prospective patients in a manner that's consistent, cogent and concise. If you don't take an organized approach to branding, you won't have a successful organization.

The critical path to growth

Many markets are quickly becoming dominated by one or two ophthalmic practices. In some cases, these practices may perform nearly half of all refractive procedures in their area, and they continue to thrive despite the recent economic downturn. In every case, they've achieved success through a single, solid growth strategy, which I refer to as the "critical path to successful growth."

This is how the critical path works: With a growing practice, once patient volume nears capacity, further growth requires additional surgeons. And once market research indicates that maximum patient volume for an area has been reached, the growing practice must search for "soft markets" with a high need for refractive surgery. It can then expand into those markets with new facilities, personnel and marketing dollars.

Growing and exiting

There's much talk in the industry of growth strategies vs. exit strategies. To me, they're essentially the same. If you've implemented a successful growth strategy, and have other ophthalmologists within your practice, your exit strategy will take care of itself: Patients will still choose your practice brand long after you retire.

Even if you're practicing on a small scale, at least one ophthalmologist will be available to provide your patients with continued quality care they associate with your practice as you reap the rewards of your many years of dedication.

Recognize your specific needs

In writing this series on minimizing risk within refractive practices, I've worked within the constraints of providing only information applicable to every refractive practice, regardless of demographics and economies of scale. Every practice is unique and has special considerations.

However, if you apply the guidelines that I've set out here and customize them to the individual needs of your practice, I can assure that your refractive practice will be successful, now, and for years to come. OM

William B. Rabourn is the founder of Medical Consulting Group, an ophthalmic consulting firm based in Springfield,Mo. He may be reached at 417-889-2040, or via e-mail at bill@medcgroup.com