Navigating Self-Pay

Learning the art of self-pay

LASIK, dry eye products, premium IOLs, unlike bread and milk these items do not sell themselves.

By Whitney Hauser, OD

When you walk into your practice tomorrow morning, imagine you are somewhere else, a high-end clothing store perhaps. Imagine that your employees — especially your technicians and front desk team members — are highly trained sales personnel. Imagine that everyone knows how the merchandise is made, how to fit a man or a woman, and who to call with problems.

Would this scenario seem quixotic if you substituted the clothing for a dry eye treatment, and your staff as the deal closers?

This scenario is anything but Disneyesque. If you are covered front to back, this sales strategy can provide better than a 45% conversion rate — but everybody in the practice has to be involved.

It just sat there

A relatively large practice in central Pennsylvania, in business for 20 years, had bought a dry eye treatment system to go along with its premium IOL business.

In the beginning, this practice probably thought their products would just sell themselves; it wasn’t until both ophthalmologists in the two-surgeon practice embraced the premium IOL that the conversion rate started to climb above the initial 19%. The surgeons prioritized the product and made phone calls to prospective clients: the conversion percentage rose to 90%.

But its dry eye treatment, LipiFlow (TearScience) was a different story. No one knew how to sell it.

The practice called in our team in December. The surgeons wanted to know about my front-to-back marketing strategy, and how I was able to get patients to buy a premium dry eye product 68% of the time.

Tossing out the surgeons

The answer was easy, but following through? A different matter altogether.

Selling elective products involves the entire staff. They must promote all day, every day; no tepid temperatures. It is all in or all out.

The first thing we did was talk to the support personnel, making sure the surgeons and optometrists weren’t around. We educated them on the eye’s anterior and the mentality of the dry eye patient.

These patients seek treatment because they are frustrated, we said. And even though dry eye rarely causes vision loss, it affects the vision by making it blurry. It’s a chronic, extremely annoying disease that is anything but benign. Its demographic inclination is middle-aged women. Treat them well, and they will be lifelong patients, we said.

Dry eye patients are more motivated to convert because of their discomfort. Glasses might be a nuisance, but this disease? People have quit jobs because of their frustration.

The way to work

Our selling method is all about working smarter, not harder. A single elective procedure can trump a plethora of small changes. Will “smarter work” offset decreasing reimbursements? Unlikely. How about elective procedures? Maybe so. Patients often see elective procedures as risky business while physicians may see an uncomplicated way to improve quality of life.

Consider likely stumbling blocks to adding elective procedures. The first is expense. Adding equipment, inventory and staff are costly with no guarantee of return. A conservative, deliberate business plan can mitigate those risks. A less predictable factor is the economy’s health; a more manageable factor is how patients react to an elective offering. The latter requires care and finesse.

Cost, patient anxiety and complications

If patients are going to spend for an elective procedure, they want to be convinced they will get the most for their money. Doctors, however, are wary of sounding like salespeople. A 2014 survey reported 47% of ophthalmologists discuss cost “only if the patient brings it up.”¹ But keeping mum about money doesn’t negate the issue or add procedure volume. Physician recommendations, particularly in elective procedures, can seal the deal. Talking about cost while making a recommendation can minimize the price issue.

Anxiety can have a powerful effect on patients. They may fear the loss of control, pain or an unexpected outcome.² Fear of the unknown is tempered by patient education. But do not mistake informed consent for patient education.

And do not confuse your idea of a complication with theirs. You think, “problem in the operating room,” while they think, “the surgery date conflicts with my vacation plans,” a complication you can easily fix. When a patient pays for additional services the expectations of custom care increases. Doctors who see that sense of entitlement as opportunity will be most successful in providing elective procedures. Catering to and anticipating patients’ needs leads to their satisfaction and the practice’s increased net worth.

Market research

Any new treatment requires diligent market evaluation before launching. If your current demographic doesn’t support the new service, why put in the time, energy and marketing dollars to recruit those patients? Market analysis should be analytical, not anecdotal. Run reports from your EMR to determine which patients you see most often and for what diagnoses. Consider connecting with a local marketing company that has its finger on the pulse of your area. It may cost some money, but it’ll be significantly less than a piece of equipment. OM

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About the Author
	Whitney Hauser, OD, is clinical development consultant at TearWell Advanced Dry Eye Treatment Center, assistant professor at Southern College of Optometry and founder of Signal Ophthalmic Consulting. She is a consultant to TearScience. Her email is whauser@signalophthalmic.com