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Pearls for Marketing Premium IOLs
Lessons learned from the refractive laser marketing experience.
BY CONI SWEENEY FISHER, M.S., C.O.E.

Patient expectations have been fueled by the 20-year legacy of innovations in technology we have seen in the laser vision correction market, from PRK all the way through to wavefront-guided LASIK procedures. Patients' expectations for almost any type of eye surgery procedure have been shaped by the dramatic improvements in vision experienced by their friends and reported by the news media. Today's 70-year-old patients seeking cataract surgery have similar postoperative refractive expectations to those of 30-year-old patients who undergo LASIK — improved quality of life and decreased dependence from glasses for all activities.

When I embarked on my career in ophthalmology 30 years ago, I delivered aphakic spectacles to patients in the hospital after cataract surgery. These patients were happy to be able to see well enough to navigate their exit from the hospital room. This is no longer the case with patients who have cataract surgery; they lead full and active lives and they are increasingly demanding a full range of vision to support their lifestyles. For every aging baby boomer, overcoming the almost certain loss of accommodation is an important issue. For many, the advanced technology of presbyopia-correcting IOLs is the answer.

For the cataract surgeon, the influence of patient lifestyle and visual needs must be considered; the expanding number of laser options, the introduction of aspheric, toric, presbyopia-correcting and phakic IOLs makes the potential for excellent vision both a surgical possibility and a challenge. In all of these treatments, one challenge remains a constant: how can surgeons provide their patients with a full range of vision with maximum independence from glasses or contact lenses?

This article will discuss how to take the lessons that have been learned in the laser vision correction market to improve your bottom line through successfully marketing premium IOL technology to your patients.

Flexibility Key to Practice Success

Recent results taken from an informal survey of ophthalmologists that I conducted online showed that 88% of respondents are currently using or plan to use a premium IOL for their patients. Interestingly, the survey results indicate that one in five patients with or without Medicare coverage (Table 1) choose to upgrade to a premium IOL.

In my survey, surgeons report that an average of 66% of their patients are not candidates for laser vision correction. When asked about laser enhancement after refractive IOL surgery, the average response was 7% of patients undergo enhancement. For this reason, it is important to consider using a laser that can treat pseudophakia or work with a center that has one.

A refractive team is vital when counseling a patient for laser vision correction or a presbyopia-correcting IOL. Patients spend 84% of their time in your practice with your staff. The survey shows patient counseling is heavy on the surgeon counseling side; a move to a combination approach for educating these patients will not only save the doctor chair time, but also convey confidence in the staff. Do not overlook the importance of financing, as it will continue to play a key role in conversion, as seen in the survey results.

It is also interesting to note that 71% of those surveyed said that introducing these IOLs into their practice did not impact their LASIK volume.

The ophthalmic practice must be flexible in this constantly changing environment. Just as the laser vision correction patient profile changed from the early adopters to mainstream patients with myopia and hyperopia, today's typical cataract patient is evolving. Some of the tactics that have driven the laser market will drive the premium IOLs because today's baby boomers are wealthier, more sophisticated and more active — and they are willing to pay for their "personal" best vision.

Lessons Learned from Laser Vision Correction

Several key ingredients translate from laser vision correction to a refractive IOL practice:

■ Set goals. Understand conversion rates from call to consult and consult to surgery. What ages define the patients selecting specific surgery choices in your practice? What are the patients asking? If you do not measure, you cannot manage.

■ Facilitate referrals. An active optometric network should provide a wealth of patients. Cataract patients require referral. If you have successfully garnered the difficult laser vision correction "cream of the crop" referrals, the next step is easy. By educating your referring optometrists on the benefits to their patients of a premium IOL, and explaining the affordability through financing the procedure, you will get what I call a "pre-sold patient" upon referral (Table 2).

■ Listen to your patients. A good two-way dialogue is key to understanding your patients' needs. Ask them questions to determine their expectations and barriers (what obstacles exist), and then come up with a clear communication process that you and your staff can offer those patients.

With the addition of customized platforms to standard LASIK, the trend toward a high percentage custom mix developed slowly and increased only as doctors became more confident with the procedure and recognized the improved outcomes. We also saw early on that doctors were offering patients too many options. Leaving procedure choice decisions up to the patient does not inspire confidence; when patients are given options, they become confused and, as a result, they do nothing.

Many LASIK surgeons found it difficult to encourage patients to opt for a more expensive procedure, especially when they were getting great results with the standard procedure at a lower cost. Finally, the practice of discounting LASIK proved to be counterproductive because prospective patients became unsure as to the value of laser vision correction.

Doctor Knows Best

The good news is that recent surveys and focus groups show that a doctor's recommendation is the real trigger point in the decision-making process. When talking to patients about presbyopia-correcting IOLs, while it is important to discuss near, distance, and, of course, the intermediate vision concerns of patients, do not go into details regarding brands or technology unless specifically asked. Most patients do not understand nor care about these details, rather, they simply want to know what is best for them. Create a form for the purpose of determining the patients' needs; involve staff in discovering motivations and barriers. Remember to always focus on the benefit to the patient, not the merits of the technology.

Today's refractive practice needs to understand today's refractive patient. The patient seeking refractive correction tends to be more knowledgeable, cautious and discerning. This is partly due to negative media reports regarding LASIK, as well as the practice of deep discounting, both of which can make determining the true value of refractive surgery difficult.

Market Concisely, Wisely

Your marketing message must be concise and address what is important to these potential patients. The main points in this discussion should focus on safety, your confidence in the procedure, cost, financing options and results.

There are many communication strategies (Table 3) to use at various contact points in your practice. If you have an optical dispensary, use the opportunity to educate and "pre-sell" refractive patients — educate your referral sources. Although the Internet is widely used, many older patients prefer seminars and respond better to print advertising. In short, use every opportunity to promote your practice, particularly word-of-mouth advertising. When I review volume in a laser vision correction practice, if fewer than 70% of the patients are referred by word-of-mouth, a problem usually exists. If this is a problem in your practice, review your referral sources and focus on improving word-of-mouth; it is the key to most easily impact your bottom line. Encourage your patients to refer their friends and relatives; give them your business cards.

After the procedure, deliver more than you promised — excellence captures the word-of-mouth referral. Have you noticed that your LASIK patients are not quite as excited with 20/20 as they were 10 years ago? It is no different for today's cataract patients. You must exceed their expectations and under promise and over deliver.

Coni Sweeney Fisher, M.S., C.O.E., is business development manager for the VISX brand at AMO in Santa Ana, Calif. She can be e-mailed at Coni.Fisher@amo-inc.com.