ASK THE CAREER COACH

Paving Your Way to Premium IOLs

Part 2: Consider these operational and staff-related issues as you move forward.

By William B. Rabourn Jr.

Q: If I want to start offering premium IOLs as part of my cataract surgery practice, how would the business model have to change?

A: In the last issue, I provided part of the answer to this important question. I explained two ways you must adapt in order to succeed with premium IOLs, in particular those designed to correct presbyopia.

First, you must become proficient in using the lenses. This includes gaining a solid understanding of how they work and understanding both their benefits and their limitations. Second, you must be able to effectively communicate with your patients, so that their experiences and vision outcomes meet their expectations. Key aspects of communicating with patients about premium IOLs are discussing their cost and learning to identify appropriate candidates.

Here, I complete the answer to the question with an explanation of two additional steps you must take to succeed with premium IOLs: adjusting the day-to-day operations of your practice and educating your staff to foster long-term success with premium IOLs.

Reconfigure Operations

Before you begin offering premium IOLs, you'll need to organize your practice's day-to-day operations so you can process patients more efficiently.

Working with premium IOLs will require you to devote additional time to patient education and selection. You'll need to help patients understand the difference between standard IOLs and premium IOLs. Once you've done that, you'll need to go one step further and explain how each premium IOL differs from the others. A staff member can educate patients initially, but you'll need to spend adequate time preoperatively to get a full understanding of your patients' vision needs, decide if they're good candidates and determine which lens will serve them best.

This increased time commitment necessitates a new and carefully planned scheduling and patient flow arrangement. You may want to speak with colleagues who've added premium IOLs to their practice. Ask them what works and what doesn't. You could seek guidance from ophthalmology practice managers, who may be able to help you restructure your daily operations and offer advice to help you avoid snags they encountered when premium IOLs entered the picture.

Offering premium IOLs also requires additional insurance documentation. Each Medicare patient choosing a premium IOL must sign an Advance Beneficiary Notice (ABN). The ABN states that Medicare won't cover the extra charges associated with a premium IOL procedure. It further states that the patient will be personally responsible for paying those charges. Make sure you thoroughly explain the ABN to patients. Once they sign it, one copy must be given to them and one copy must remain in your files. Your staff must be ready to handle the administration of this extra documentation.

Preparing the Staff

To properly equip staff members, you must educate everyone in the practice about what to say and what not to say when patients ask questions about premium IOLs. For example, never say anything negative. If a patient is interested enough to ask a question, they deserve to get a complete and educational answer from you or your staff.

You also should train employees to help set patient expectations and determine which patients are appropriate candidates. Everyone can contribute to the success of premium IOLs in your practice if you educate them about the benefits and limitations of these lenses.

At the same time, if everyone handles premium IOLs, no one will take the lead. Therefore, I recommend designating one person to oversee this segment of the practice. This person should be responsible for the overall success of premium IOLs in the practice, much like a refractive surgery coordinator is for LASIK.

The designated premium IOL coordinator should be responsible for ensuring that the practice is properly equipped, staffed and trained for patient processing. He must ensure that the tools are in place to offer patient education. He may provide the bulk of the education and counseling or be responsible for making sure patients are referred to the person who's responsible for education and counseling. The IOL coordinator should track premium IOL performance in the practice, including related expenses and revenue, how many patients are choosing a premium option, their vision outcomes, their feedback about their experience and which lenses are working best for the practice overall.

Final Piece of Advice

I'll leave you with this thought: Talk to every patient about premium IOLs. Never assume someone wouldn't be interested or couldn't afford the option. Patients talk to one another. The fastest way to get yourself and the practice into trouble is for patients to find out they weren't offered the same opportunity as their neighbors. Even patients who may not be candidates for premium IOLs should be told about them. Educate patients about these lenses, and if need be, explain the reasons why premium IOLs aren't right for them. Consider this part of your comprehensive patient education plan. When patients are properly educated, they feel more confident about your recommendations and their decisions. And most importantly, the decisions are theirs.

On the Road to Success

Speaking of decisions, are you ready to bring premium IOLs into your practice? If you coordinate the transition carefully, they can add value to the practice, while also meeting the needs of more patients. nMD