Beating the Bear While Building a Refractive Surgery Practice

Four successful refractive surgeons share their creative strategies for profitability in the current LASIK market.

By Erin Murphy, Contributing Editor

In an elective refractive surgery practice, peaks and valleys are the norm. Practice owners know their goal isn't to ride out the stock market's next dip. Building a lucrative practice that flourishes long term means making it strong enough to weather economic fluctuations.

We interviewed four successful refractive surgery practice owners who have devised winning formulas for growing their practices in spite of uncertain economic times. As elective vision specialists, they rely on patients' out-of-pocket spending, and lately, they've seen purse strings tighten as consumer confidence wanes. Still, they know that people who want the best in eye care are willing to pay for it. They also know their success hinges not only on producing excellent visual outcomes but also on creating an exceptional experience for patients.

Here's how these practice owners have taken on the changing LASIK market.

From Bull to Bear

"The market data show LASIK volume is down 25% compared with last year's volume, and I think that gap will continue to widen before it shrinks," says Stephen E. Pascucci, M.D., owner and medical director of Eye Consultants of Bonita Springs, Bonita Springs, Fla. (bonitaeye.com), a boutique-style practice that specializes in LASIK, CK and premium IOLs. "Many people who are interested in LASIK can't afford it right now, or they're reluctant to make a commitment due to finances.

"As generation Y (young adults ages 14–28) comes into the marketplace, however, LASIK growth will pick up," Dr. Pascucci continues. "These people grew up with technology, and they embrace it without fear. So I think the latest in LASIK technology will appeal to them. I see them as LASIK's savior going forward."

"We've grown over the past few years, primarily because of referrals from patients and the technology we use. The Allegretto Wave® excimer laser system (Alcon Laboratories, Ft. Worth) has reduced the need for enhancements and has provided patients with better quality vision." — Paul Mann, M.D.

Jimmy Jackson, O.D., co-owner with Keith Miller, O.D., of InSight LASIK in Lafayette, Colo. (InSightlasik.com), agrees that generation Y will refuel LASIK growth. Drs. Jackson and Miller handle the business and comanagement aspects of the practice, in which two primary care ophthalmologists perform LASIK, PRK and CK.

"I wish I knew everything that influences the LASIK market," Dr. Jackson says. "After 17 years, I do know that the best indicator of LASIK volume is consumer confidence. Fear and spending are closely tied, and the peaks and valleys in the LASIK numbers mirror the public's confidence in the economy. Consumer confidence is at a 16-year low, and in uncertain economic times like these, people hunker down and cut spending."

For these two practices and many others, the key to continued profitability in refractive surgery lies, first, in delivering the best visual outcomes, which prompt more referrals from patients, and second, in converting as many good candidates as possible to happy patients.

"We're in a very competitive market," Dr. Jackson says. "It takes a great deal of money, time and energy to get a potential patient to contact us. When the phone rings, we must do a great job of converting that call to a consult. When the patient attends the consult, we must do a great job of converting that consult to surgery. Patients have a choice, and we must earn their right to be trusted with their eyesight. Our goal is for every patient to have a superior clinical outcome and experience superior customer service at every step. Our motto is, ‘Perfection is good enough.’"

Impact of Technology

In addition to striving for the best visual outcomes and high conversion rates to spur growth, doctors are depending on the latest technology and referrals from patients. In fact, referrals are a recurring theme among successful elective vision specialists, especially since people are tightening their purse strings and practitioners are spending less on marketing.

"As generation Y (young adults ages 14 to 28) comes into the marketplace, … LASIK growth will pick up. These people grew up with technology, and they embrace it without fear. … I see them as LASIK's savior going forward." — Stephen E. Pascucci, M.D.

Paul Mann, M.D., of Mann Eye Institute and Laser Center in Houston, Texas (manneye.com), whose father started the practice 30 years ago, is a comprehensive ophthalmologist, performing both LASIK and cataract surgery. His practice has succeeded, even as others have struggled.

"We've grown over the past few years, primarily because of referrals from patients and the technology we use," he explains. "The Allegretto Wave^® excimer laser system has reduced the need for enhancements and has provided patients with better quality vision. Many patients see better than 20/20, and they have better night vision than those who were treated with older laser platforms. Patients with excellent vision spread the word."

Dr. Jackson also emphasizes that while it's important to use the best technology, giving patients the best surgical experience ever is crucial for success. "Technology does matter. We can educate the public about the benefits of new technology and demonstrate its clear advantage. But success is a combination of high-tech and high-touch," he says. "Our belief in investing in technology is married to good, old-fashioned customer service."

In short, the impressions you make on a patient can mean the difference between success and failure. "What patients remember are their visual outcomes and how they were treated," Dr. Pascucci explains. "Most patients choose a practice based on someone's recommendation and their own perceptions once they walk in for a consultation. They look at the entire experience, from entry to graduation. That's why we've concentrated on how to create a positive experience for patients."

Stay Focused

Avery D. Alexander, M.D., medical director of Alexander Eye Institute in Appleton, Wis., one of the leading elective refractive surgery practices in the country (alexandereye.com), says he, too, relies on technology, referrals and quality customer service to grow his practice, but he also depends on a more philosophical factor: dedication.

"I was a successful comprehensive ophthalmologist," Dr. Alexander says, "but refractive surgery is what I love to do, and I wanted to pursue it, regardless of the income. I believe if you're too focused on making or maintaining a certain amount of money, you can get sidetracked and think short term. You have to believe in what you do and have some faith that you'll have a rewarding career."

Dr. Alexander, who decided in 1998 to dedicate his practice exclusively to refractive surgery, strongly believes that successful refractive surgeons make LASIK a high priority. "Some people just put a toe in the water [of refractive surgery] and continue to do everything else, but LASIK demands a commitment," he says. "It's very competitive and demanding on several fronts. Patients' expectations — and demands — are high, and competition from corporate and private practices is fierce. Being focused enables you to anticipate patients' needs and desires, even when it means putting what's best ahead of what's fastest or easiest."

"After 17 years, I do know that the best indicator of LASIK volume is consumer confidence. Fear and spending are closely tied, and the peaks and valleys in the LASIK numbers mirror the public's confidence in the economy." — Jimmy Jackson, O.D.