Navigating Self-Pay

Revive your LASIK practice

Refractive surgeons share their tips for bringing it back from the brink after the recession.

By Robert Murphy

The US economy may be on the mend, but it’s not evident via LASIK surgery numbers: LASIK volumes are fewer than half those preceding the 2008-2009 recession. Top LASIK practitioners recommend a renewed dedication to marketing efforts to remind the public that the procedure is still here, and still valuable. But will that be enough? Some surgeons report their volumes are strong, if not matching those of LASIK’s 1995 to 2007 heyday. While conscientious marketing won’t recreate the boom years, it will keep alive a procedure that, they note, delivers excellent, life-enhancing visual outcomes with a safety profile that inspires confidence.

PLATEAU AFTER A PEAK

A casualty of the Great Recession

LASIK procedures in the United States peaked in 2007 at roughly 1.4 million, according to Market Scope, the ophthalmic industry market research firm. Then came the so-called Great Recession characterized by job loss, stock market declines and huge numbers of home foreclosures. LASIK volumes were another casualty, plunging by more than half and then plateauing to an estimated 650,000 last year, reports Market Scope.

Yet LASIK volumes haven’t bounced back with the US economy’s improvement. The unemployment rate dropped to 5.5% in February, according to the Labor Department, the same month The Conference Board announced that the Consumer Confidence Index rose sharply the previous month to its highest level since August 2007. Lower gas prices help to increase purchasing power.

Factor in a weak recovery

So why aren’t Americans resuming their love affair with refractive surgery? Because the economic picture is not entirely rosy. Even as overall employment has increased, wages have lagged. The number of adults who work part-time but are seeking full-time employment is 50% higher than in 2007, according to the Brookings Institution. Most of the jobs lost in the recession were high- and middle-wage slots, with the strongest job growth since in low-wage work in the retail and food service industries, according to The New York Times.

Compounding the low-wage picture is an onerous debt burden — especially the student-loan debt load carried by many in their 20s and 30s, precisely the population whom refractive surgeons wish to attract. According to a recent article in the Wall Street Journal, millennials have a negative savings rate.

THE MISSING MESSAGE

From buzz to crickets

But the lingering effects of the Great Recession may not be the sole cause of LASIK’s malaise: Many surgeons appear never to have resuscitated their marketing efforts. For instance, even among those millennials who might have the means to undergo LASIK, the level of awareness of the procedure remains low, notes Peter S. Hersh, MD, of The Cornea and Laser Eye Institute-Hersh Vision Group in Teaneck, N.J., and a professor and director of the Cornea and Refractive Surgery Division at Rutgers Medical School. “I think the degree of LASIK marketing has diminished,” Dr. Hersh says. “When LASIK took off it was one of the most interesting things that had ever happened in the field. There was a tremendous amount of interest among new patients because it was a new technology. A lot of awareness was fueled by fairly heavy marketing.”

There was a time when you couldn’t turn on a radio in the New York City area without hearing an ad for LASIK, says Eric Donnenfeld, MD, of Ophthalmic Consultants of Long Island in Garden City, N.Y., and a professor of ophthalmology at NYU. “This marketing has all but disappeared. Fifteen years ago some of the most successful anterior segment surgeons were giving up cataract surgery to concentrate on LASIK. Today the pendulum has swung in the opposite direction, and LASIK surgeons are now concentrating on cataract surgery.”

The change of focus to cataract surgery is one Linda Fahey, partner, Dark Horse Media, based in Tucson, has witnessed as well. “Our clients have kind of flipped their advertising from LASIK to cataract surgery with the intraocular lenses.”

Those active in LASIK marketing agree on its precipitous decline in advertising. Shareef Mahdavi, a partner at Strathspey Crown of Newport Beach, Calif., reports seeing far less from individual surgeons. At Jackson Eye Institute, Lake Villa, Ill., COO Pamela Jackson says the only advertising happening in the area are radio ads from the corporate centers — which focus on low price. “The only advertising you see now is the $299 an eye, which is a bait and switch,” she says. “And the Groupons too crushed the industry even further because the surgeon was doing it $500 an eye.”

That corporate model, utilizing direct-to-consumer advertising, has failed to deliver volumes, Mr. Mahdavi points out.

Neglecting the meet-and-greets

It’s not just a matter of media marketing. Successful surgeons know that reaching out to the patient community through seminars can generate demand as well. “Practices that were expending a lot of energy and marketing dollars and doing seminars educating the community in the early days” are no longer doing so, says Dan Durrie, MD, of Durrie Vision in Overland Park, Kan. His own refractive surgery volume increased 3% last year — not bad, but not the 10% annual growth he enjoyed during the boom years. “You do not see or hear information out there provided by the doctors as it was for a long time. There are doctors who have built their whole career on LASIK surgery and are not marketing at all right now; it makes a difference.”

Dr. Durrie, however, is not following their lead. He does “lunch and learn” seminars at businesses to keep LASIK in the locals’ minds.

Optometrists shift focus

Patient referrals from optometrists used to bolster LASIK volume, but according to some, their interest in refractive surgery has diminished. “In the earlier days, optometry was very much interested in endorsing refractive surgery,” Dr. Durrie says. More recently, he finds many would rather concentrate on newer contact lenses and performing examinations.

This is an area of particular concern to Randy Epstein, MD, of Chicago Corneal Consultants in Highland Park, Ill. “We are very involved in optometric comanagement,” Dr. Epstein says. “That’s the main focus of our marketing.”

YOUR NEW MARKETING GAME PLAN

How to turn this lackluster LASIK market around? These successful-against-the-odds practices recommend the following efforts.

Reach out — consistently

At the busy Mann Eye Center, which has five sites in the greater Austin and Houston areas, Marketing Director Joan Wahlman uses multiple venues to get the message out.

“We do the traditional radio stations, we do television, we do some things like Pandora radio,” says Ms. Wahlman, whose center operates in a thriving economy that took a relatively minimal hit during the recession — a period during which it did not reduce its advertising budget. Newspaper advertising is “minimal,” but “We’re on all the social media, we have webcasts, we have a big website, we send e-blast newsletters.

“We have an integrated plan when it comes to marketing and advertising. It’s always consistent, and I think that’s the key — you can’t start and stop.”

Try to speak their language

Given the millennials’ absorption of the Internet, you might think this is a natural avenue for marketing LASIK. Yet refractive surgeons report mixed results. New York City clinician Emil W. Chynn, MD, of Park Avenue LASEK, says his practice is present on the Internet. While his marketing manager likes Facebook for branding and reaching millennials, Dr. Chynn isn’t so sure. “It’s once in a blue moon that somebody says they got lasered here because they saw us on Facebook.”

Lake Villa, Ill., refractive surgeon Mitchell A. Jackson, MD, of Jackson Eye, and a clinical assistant at the University of Chicago Hospitals, agrees that traditional media will not work. Instead, the practice takes the less pricey route of direct marketing to its patient base. It has a Facebook page and website, and Dr. Jackson is considering expanding his online presence.

“Maybe we’re not getting the message to the younger generation,” he says. “I think we have to really pound Twitter, Instagram, Facebook. I think we have to do more of that stuff to get the message to the millennials that we’re trying to convert now. That’s how that generation sees things.”

Another aspect of speaking the language of this less-than-flush generation would be in emphasizing that your practice can make the surgery affordable through financing. Ms. Wahlman says the Mann Eye Center promotes its financing option “all the time.”

Don’t overlook low-tech

Don’t discount the value of low-cost in-house marketing efforts like brochures and posters. “We’ve done everything from radio to being on TV to the newspaper and trying to be available on social media,” says Roberto Pineda, MD, director of refractive surgery at the Massachusetts Eye and Ear Infirmary in Boston, and an associate professor of ophthalmology at the Harvard Medical School. But the lesson his practice has learned? “The best referral sources are usually from internal marketing. The most cost-effective marketing is to do heavy marketing right in your own office.” Yes, posters and brochures.

“We have people sitting around waiting for their eyes to get dilated,” Dr. Pineda explains. If they have to look at something, why not a video that explains refractive surgery? “A lot of people come to the Massachusetts Eye and Ear Infirmary and don’t even know that we do laser vision correction. That’s not a good statement for us. Patients should know that we offer that.”

Any refractive surgeon knows that word-of-mouth endorsements issued from happy patients is the best marketing of all. For Dr. Hersh, this means reaching out to former patients through email newsletters. “I think [refractive surgeons] should always reach out to patients they treated in the past, because it’s those patients who are going to talk about the procedure with their friends and family,” Dr. Hersh says. “There’s nothing like the patients we’ve seen who are 10, 15 years out, and are happy after all these years. I think that keeping in touch with them is quite valuable. A lot of the patients we get are from patients who we treated years ago.”

THE MESSAGE ITSELF

It’s not about you

Once you’ve decided on the venue and format, what exactly should be your message? Think about the person you’re trying to reach, Dr. Durrie says, and focus on conveying the benefits refractive surgery will bring them.

Dr. Durrie believes practices have not devoted enough time to understanding their prospective patients. “How does it benefit them? What are the needs being met by the surgery? It’s not about who has this laser versus that laser, or who does this procedure or that procedure,” he says. “I think that’s where we got into marketing how good the doctor was and how good the technology was, not thinking about what benefits do patients get from this. Do we make them want to spend their time and money to come see us?” Practices, he says, are beginning to realize they need to shift focus. “It’s not about us, it’s about them. And if we focus on their needs, this whole business and market will grow a lot better.” OM