A decade ago, baby boomers were between the ages of 30 and 50 years, and the flow of potential LASIK patients through ophthalmologists' offices seemed endless. Today, baby boomers are between the ages of 42 and 62, so most are presbyopic, and LASIK is often no longer indicated in these patients.

Because the next demographic generation, ages 30 to 41 and known as "Generation X," is much smaller in size than the baby boom generation, it is the following generation that is gaining attention from marketers. Known as "Generation Y," this generation  comprises people born between 1977 and 1995. "What is now starting to come to light is that Generation Y represents the next wave of LASIK patients and is equal in size to the boomer generation," says Shareef Mahdavi, president of SM2 Consulting in Pleasanton, Calif. "While they haven't gotten the same attention from refractive surgery, these teens and young adults are getting a ton of attention from retail marketers. Surgeons need to understand that one half of the LASIK-eligible population is in Generation Y."

John Pinto, of J. Pinto and Associates, an ophthalmic practice management consulting firm in San Diego,  says, "Refractive surgery is now in a modest to moderate retrenchment. The typical client practice has seen a roughly 10-percent drop in LASIK leads, consultations, and surgeries."

In addition to the aging of the baby boomers, there has been a steep drop-off in consumer confidence. "This will be transient (on the order of a year or two)," Mr. Pinto adds.

One thing refractive surgeons can do to expand their refractive surgery practices is to concentrate their marketing efforts on Generation Y.

According to Mr. Pinto, there are at least three challenges to serving this age group (18 to 30 year olds).

First, most refractive surgeons will not operate on patients who are younger than 21, and some prefer to wait until patients are older than 25 to ensure that their refractive errors are stable.

Additionally, contact lens wear and care is easier and more comfortable than ever before. "Many young patients are perfectly comfortable and can live active lives in contacts for a decade or more until they either get tired of the hassle or develop dry eyes as their tear film declines," he says.

Last, and perhaps most important, the cost of laser vision correction is steep compared to the alternatives. "LASIK is much more affordable for patients who are in their 40s and 50s and at the peak of their earning potential, compared to younger patients," he adds.

Reaching and attracting these potential patients requires a unique approach.

Understanding Generation Y

Patients in this age group grew up using the Internet, and they are technologically savvy. "Many Generation Y patients come to the office with lots of information in hand gathered from the Internet. Not all of the information they have is accurate," says Brad Ruden, owner of MedPro Consulting and Management Services in Scottsdale, Ariz.

Refractive surgeons and their staff members should take extra time to ensure that younger patients are not misinformed and that they have realistic expectations about surgical outcomes.

According to Mr. Mahdavi, this generation is better educated than the baby boomer generation. "Data are showing that seven out of 10 people in this generation will eventually have a college education, which is much higher than the norm among baby boomers," he adds. He also notes that Generation Y patients are much wealthier at this point in their lives than Generation X or baby boomer patients were when they were 18 to 30 years old.

Additionally, while previous generations typically rebelled against their parents, this generation often has very close relationships with their parents. "This is, in part, because they have been coddled all their lives. They didn't go outside to roam through the woods. They had play dates," says Mr. Mahdavi.


Marketing  to  Generation Y

The first step in attracting these patients to your practice is advertising. For patients of previous generations, this was typically done through radio or newspaper. William B. Rabourn Jr., managing principal of Medical Consulting Group in Springfield, Mo., says new advertising strategies are needed. "If a doctor thinks that he or she is going to reach this group through newspaper ads, he or she is making a huge mistake," he says.

Mr. Mahdavi agrees. "You don't advertise to this group in the newspaper and on the radio because they don't listen to the radio or read the newspapers nearly as much as they are on the Internet. They spend more than twice as much time per week on the Internet as they do on the telephone, and they spend more time watching YouTube than cable TV. They text their friends as much or more than they talk to them. These data points should help all of us understand how vital the Internet has become as an advertising medium," he says.

Internet advertising can be done in several different ways. Mr. Ruden says that some of his clients are setting up practice sites on myspace.com. "This is a free site where surgeons can post pictures and videos, and provide accurate information as well as patient testimonials," he notes.

It is clear that just having a practice website is not enough to attract these patients. "If you don't have a strong Internet presence, forget it," Mr. Mahdavi notes. "Your website has to have sections that will really appeal to this demographic group and their parents." He says that a great example of a website that will appeal to this generation is realitylasik (realitylasik.com). On this website, a young celebrity is featured, and there are episodes documenting the celebrity's preoperative, surgical and postoperative LASIK experience. There is also a section of the website where patients can search for refractive surgeons in their area and another section where patients can tell their stories (with photos or videos).

Younger patients like to make personal connections, so it is important for surgeons to include patient testimonials or message boards on their websites. They should encourage younger patients to post what it was like to have surgery at their office. "Community and social networking are really big with this age group, so the way to get the word out is not just having a website," says Mr. Mahdavi. "It is having a website that encourages community by allowing people to post messages and communicate with other patients."

Once surgeons have attracted younger patients to their practices, they need to make sure that the waiting room does not look like it is geared for baby boomers only. There should be reading material available in the waiting room that appeals to both groups. Additionally, practices could offer brochures for both patients and for parents of patients. Surgeons should let their older patients know that LASIK is available for their children and grandchildren.

Some practices even schedule all of their younger patients on one day of the week to make sure that the waiting room is geared toward younger patients on a particular day. Other possibilities include offering an iPod docking station or wireless Internet access.

Practices can even change the way they remind patients about their appointments. For baby boomers, practices can still leave reminder messages on home answering machines. For Generation Y patients, sending a text message to remind them of their appointment may be more effective.

While previous generations were attracted to informational seminars held in a surgeon's office, this strategy will likely fail with Generation Y patients. "It just will not work to try to get them to come sit in a room for two hours and then try to book them to a consultation," says Mr. Mahdavi. "Generation Y is very mistrusting of advertising and 'hard sell,' both the message and the messenger. The good news is that this demographic grew up hearing the word LASIK, and they have a very high awareness of the procedure."

He notes that most patients in this age group are not even coming in to find out if they are candidates for LASIK. It may take some creativity just to get them into the office. While many older patients make a doctor's visit the event of the day, younger patients want to get in and out quickly. One alternative to a traditional seminar is to offer rapid consults and group rapid consults. Practices can set up a time when younger patients can come in alone or with a group of friends to find out whether they are candidates for LASIK. "This is not a full consult," says Mr. Mahdavi "They can just come in for 10 to 15 minutes to find out if LASIK is an option. Offering group consults is helpful because these kids have dated in groups and gone to dances in groups, so they are more open to doing group activities. This is different from offering a seminar, because you let them form their own groups."

Young patients are also proficient multitaskers, so another approach is to offer additional aesthetic or cosmetic services in your office. Mr. Ruden says that this allows practices to keep these young patients coming back.

"The problem facing many LASIK-only centers is that a considerable amount of marketing dollars are spent getting the patient in the door and building trust for them to have the procedure performed. If LASIK is the only service offered, then the patient is lost to the practice after surgery," he says.

He notes that many general medical practices and refractive surgery centers have begun to include a wide array of aesthetic services that include wrinkle reduction, age-spot reduction, acne treatment, scar reduction, skin tightening, fat reduction and tattoo removal. "Acne treatment is a high priority among Gen Y patients, and, given the prevalence of tattoos in this age group, tattoo removal becomes more important as they mature and enter the workplace," says Mr. Ruden.

"Many of the savvy populace who are interested in aesthetic treatments are also interested in cosmeceuticals, such as anti-aging moisturizers, lightening serums and firming lotions. Offering these additional aesthetic services and products enables a LASIK-oriented practice to provide desired services to its patients while maintaining that patient relationship for a longer period of time."

He notes that recent studies have shown that 19 percent of patients purchasing aesthetic services and treatments are between the ages of 19 and 34 years. "The range of treatments can now encompass a patient's lifetime, so capturing a patient's loyalty at an early age can have substantial financial benefits for a practice," he says.

Mr. Pinto notes that many surgical practices are broadening their scope to include primary eye care, which will also retain patients. "As this happens, opportunities will arise to reach this population when they are in the office for their regular eye exams, rather than having to recruit non-patients into the practice," he says. "Additionally, comanagement with optometrists who care for the vast majority of healthy, young patients with a refractive error is key."


Patient Education

When discussing the LASIK procedure with younger patients, Mr. Mahdavi says that a surgeon's approach must be different than if he or she were talking to an older patient. Younger patients are very skeptical. Before they arrive at the surgeon's office, they will have researched the complications of LASIK, and they will have researched the surgeon.

"With Generation Y, surgeons will need to spend more time talking about the risks of surgery than they would with a baby boomer. When discussing the risks, ask patients what they are afraid of. Don't tell them. From there, the surgeon should act in the role of the patients' partner in helping them discover solutions. This means that surgeons will need to become much better listeners. You are not just competing with other doctors. You are competing with other big-ticket items for the patients to spend their money on," he says.

For this reason, it is important to offer financing options; however, Mr. Mahdavi notes that some Generation Y patients will receive LASIK as a gift from a baby-boomer parent.

When discussing LASIK, surgeons should also focus the discussion on customization and personalization. "Anything that smacks of mass is not going to appeal to Gen Y," Mr. Mahdavi adds. "They don't want mass. They want something that is just for them. It's nice that we now have a customizable technology that matches that need. We have a really good fit between what Gen Y wants and where the LASIK technology is today."