I’ve worked with a boutique refractive practice in Los Angeles for several years. Always technologically advanced, they’ve historically struggled — like most elective practices — with national economic swings, intense competition and occasional missteps in service or communication. During the last two years, we carefully refocused the team, zeroed in on the right LASIK customer and clarified a true practice-differentiation strategy. During this renaissance, procedure growth kicked into another gear. How? We found Millennials (and they found us). This synergistic acceleration has been powerful. What specifically made the difference?

Improvement Metrics

Reviews, reviews, reviews

First, the market you could be missing. Almost 50% of the 87 million Millennials in the United States (aged 20-39) are myopic — double the rate of myopia of their grandparents. So, how is LASIK, one of the most effective corrective procedures ever pioneered, chosen by fewer than 350,000 people annually?

Because, for the Millennial audience, reviews matter. Opinions of friends and peers exert significant influence.

LASIK decision-makers and influencers use Yelp and other online review websites. According to internet traffic data provided by the website Quantcast, Yelp skews heavily to 25-to-34-year-old females with college or graduate degrees and those with household incomes of over $100,000. The site also has strong racial diversity: Caucasian, Black, Asian and Hispanic.

In the last year, our L.A. practice has added almost 100 new online reviews, mostly on Yelp. Largely through the effort of one driven, attentive patient coordinator who asks every single patient to write a review, Yelp has become as important as Google in generating new surgery patients. At the patients’ one-day visit, she asks them to write a review after she determines they are happy with their results and experience. Upon graduation from follow-up care, she asks again. Her ownership of this program has generated significant practice success, and she takes great pride in watching new reviews roll in.

A LASIK patient tells me reviews were critical to her decision. “Cost mattered, but I especially wanted to personalize this experience. I wore contacts and had chronic irritation, and I sorted through reviews to see who had the same problem. We’re the generation using Rent-the-Runway, Blue Apron and Uber. We buy individualized solutions. I care what others like me have to say, especially with something as major as LASIK.” (Note, based on this comment, reviews may be evolving from star ratings to sortable identifiers very soon.)

The practice cares deeply about reviews. Staff members acknowledge them all, whether good or bad. They respond to poor reviews immediately and privately, and all staff, physicians included, alert the review coordinator about anyone who might be dissatisfied.

E-mail circulates telling staff how many new five-star reviews the practice received that month.

Strategy time

If you don’t have a specific review strategy, it’s time to make one. Identify one or two primary review sites to build critical mass, assign a staff member as review champion and put that person in charge of asking patients for reviews. Carefully vet personnel who will respond to reviews promptly with proper tone, clarity and grammatical accuracy — the surgeon should be involved but is probably not the best person to draft a final response. Then, share successes and fix the flaws with your staff. A bad review won’t kill a practice, but ignoring a grain of truth in caustic reviews will do damage.

Fee alignment

I’m a huge advocate of reasonable LASIK fees. “Reasonable” is defined by customers, not manufacturers or surgeons. In 2014, my company, Elective Medical Marketing, conducted a national study on LASIK attitudes and awareness among Millennials. The study, conducted privately on behalf of a client, revealed Millennials’ belief that $887/eye was a reasonable price for LASIK. This compares to a reasonable fee of $1,023/eye from identical research we performed in 2000, meaning Millennials expect to pay less for LASIK than Baby Boomers. The decline of today’s LASIK market is largely due to fee misalignment with the Millennial audience.

Am I advocating you charge $887/eye? Of course not. But recognize that every dollar you charge in excess of what your target audience deems reasonable, and beyond what other surgeons in your market expect, must be earned.

We employ an elastic fee policy with the Los Angeles practice. Tiered for keratome and femto flap-making technology, we adjust fees periodically based on conversion. The ideal conversion for a successful LASIK practice results in every inquiry yielding one surgical eye. This conversion is per a formula employed by Elective Medical Marketing: 1 inquiry x 75% conversion to consultation x 75% conversion to surgery x 1.8 eyes per person = 1.01 surgical eyes.

If conversion climbs higher, prices can be raised. If conversion falls below, fees may be too high. However, fee changes should be the final step in conversion improvement — first, fix all other lapses in customer service and surgical outcomes.

The current structure in the L.A. practice is $1,250/eye for a keratome procedure, $1,600/eye for a femto procedure. About 60% of our patients choose the femto option, because they have heard it is better or safer, but we carefully explain the outcomes are identical with both technologies. This way, patients in consultation with the surgeon can make their choice based on personal comfort and preference, not in fear of an inferior result. Scare tactics surrounding safety with one technology versus another are overstated in a practical sense, and the Millennial audience is sophisticated in demanding proof before overpaying.

Highly motivated

This practice’s lead surgical counselor says, “Millennials are highly motivated. They come in ready for surgery now. They’ve done their research. They’re often ready to fast-track consult and exam into a single visit, and want surgery immediately. I find I’m the one slowing them down sometimes.”

We’ve worked in this practice to recognize patients who want to move quickly and separate out those that need more decision time. One size does not fit all. Millennials’ decisions are a collaborative effort. Parents, friends, co-workers, patient reviews, a practice website and authoritative independent sites all factor into whether they move forward with LASIK after they leave the office. We’ve worked hard with the staff on listening, establishing rapport, not interrupting and being friendly, especially as it relates to phone and counseling technique. And, when they leave without scheduling, we have a strong reminder system that ensures they will receive follow-up. These skills sound rudimentary, but often they create the difference between a highly individualized experience versus a stereotypically medical one.

Millennials are today’s LASIK candidates, tomorrow’s presbyopia prospects and your future cataract patients. You can build a strong, vibrant, elective vision practice with them as your foundation, if you respect generational uniqueness. OM

About the Author

Kay Coulson is president of Elective Medical Marketing, a Denver-based practice-development and marketing consultancy that helps surgeons grow their elective vision service lines.