Who Wants LASIK?
Surgeons and refractive surgery marketing experts say that the LASIK market has changed since the procedure’s inception. Surgeons now have to keep their eyes on a new demographic, even if its constituents aren’t clamoring for LASIK right now.
Though 35- to 42-year-old patients are still the most common group that gets LASIK, industry experts say it’s time to address millennials. “The 22- to 28-year-old age group is the fastest-growing and largest group of potential LASIK customers in the country,” says Mike Malley, of CRM Marketing in Houston, which designs refractive marketing strategies for 35 practices. “They have the same distribution of refractive error as any other group, meaning more than half of them are potential LASIK candidates. So the question becomes, ‘Are they having LASIK?’ And the answer right now is they’re not. Some of our college and post-college focus group studies have told us that millennials are aware of LASIK and would like to have it done, but it’s just not on the top of their to-do lists. These individuals are out of college and saddled with education loans, and are primarily in a car-buying mode and possibly thinking about getting married. In their minds, LASIK is a distant seventh or eighth in importance. Even so, they are candidates, and the likelihood of them having it done is fairly strong—but it will take two or three years.”
• External marketing. “Though the millennials are aware of LASIK and would like to have it, they’re simply not having it done,” says Mr. Malley. “So, the core group actually having LASIK right now is the person in the 33-to-43 age group, split evenly between male and female, who has both the money to afford LASIK and frustration with their vision. They have a desire to make a change and are making it. We’re actually seeing conversion in clinics increase because people coming in want to have it. They’re doing their research on-line and coming in and having it done.”
The act of reaching potential patients, even in lean times, through both traditional and new media, is what Eye-to-Eye Consulting’s Cory Pickett, based in Midland, Texas, calls “filling the funnel.” “Even if you get patients to come to your office to inquire about LASIK, you’ll lose some by them simply not showing up, you’ll lose some because they turn out not to be good candidates, and you’ll lose others because they don’t have the financial means to afford the procedure,” Mr. Pickett says. “If your funnel is big, though, you’ll eventually pick up your share of patients for LASIK. But if you just restrict yourself to a small portion of the population, then the return on your marketing dollars won’t be as successful.”
“Because of the differences between millennials and older patients, we have to have a bi-level marketing strategy now,” Mr. Malley says. “For the 33-to-43 age bracket, you need a message to the effect of, ‘If you’re frustrated with or intolerant of contact lenses, or even your reading glasses, here’s why our clinic is the answer.’ But, at the same time, you have to influence the millennials with campaigns on websites such as Instagram, Twitter and Pandora, the last being a non-traditional radio approach. Millennials are more influenced by educational information than they are by purchasing offers. For example, to influence them, you’re better off saying something like, ‘Visit our site to download the latest report that shows LASIK is safer and more affordable than contact lenses in the long term,’ rather than, ‘Save $500 on LASIK.’ They’re not so much in a purchasing mode right now as they are in a fact-finding one.”
• Internal marketing. Experts say you can also harness one of your greatest assets: your current patients who already feel comfortable with you. “A lot of the practices we work with offer both LASIK and cataract surgery,” says Mr. Malley. “And often their cataract practice is bigger than their LASIK one. What many don’t realize is they can market LASIK to the cataract population internally—but with a message aimed at their children and grandchildren. Also, if you happen to have a contact lens practice, offer every one of those patients a LASIK pricing offer limited just to your practice’s current patients.”
Handling the Call
Advertising, promotion and word of mouth may get your phone to ring, but how your practice handles that call could be the difference between an opportunity to speak to that patient in-person or having him go elsewhere.
Mr. Pickett says it’s worth making sure the person who answers your phone has the time, information and demeanor necessary to get a patient interested in seeing you. “Trying to have your front-desk person answer the phone and discuss LASIK while also check-in patients is the wrong way to go,” he says. “However, it still happens all the time. For instance, one practice I work with had noticed their LASIK appointments were limited despite a good number of calls. They gave me permission to call their number several times as if I were a patient. Over several calls, I experienced having my call blown off, having someone take a message and then never call me back, being put on hold for 10 minutes, having the person on the other end become evasive when I asked a question and, finally, having the person be overly pushy.”
Mr. Pickett says if you think your staff might be mishandling calls, or overburdened by handling LASIK prospects on the phone throughout the day, it might be worth looking into commissioning a call center.
“You give the call center all the information on LASIK that you would want given to prospective patients, and they’ll input it into software that operators can use to answer patients’ questions,” Mr. Pickett explains. “When the person asks a question, the operator clicks on it on their computer screen and can phrase the answer the way you want it phrased. They’ll even have operators with accents specific to the part of the country where your practice is located; if you’re in Texas, for example, the operator will have a slight drawl. The patient doesn’t know that the person answering the phone is in a different part of the country, just that the call is being handled professionally. If a patient has a very specific question that only applies to him and the operator can’t answer it, he can put the patient on hold and buzz your office to have someone speak to him.”
Mr. Pickett says that, if your staff isn’t great on the phone, a call center can often be worth its fee. “The payment for this service is usually based on the number of calls, but it can be $1,500 to $2,000 per month,” Mr. Pickett says. “The cost depends also on the kind of coverage. Some only do it for evenings and weekends, while some take calls seven days a week. Though the cost usually equates to one LASIK patient per month, after working with them for around 10 years, I’ve found them to be worth more in terms of what they give you in return.”
Procedures and Prices
The experts on the refractive frontlines say it helps to diversify your offerings to give patients options. There are also two approaches to pricing LASIK, each with pros and cons.
• Procedure variety. Mr. Pickett says he encourages the practices he works with to offer as many surgical options as possible, as long as the surgeon is comfortable doing them. “It can help to have a physician in your practice who implants phakic IOLs,” he says. “That opens that up as an option so you’re not losing the phakic IOL patients. Just the other day, one practice I work with had to refer out two women who weren’t LASIK candidates but were candidates for phakic lenses. Granted, if you don’t have a lot of high myopes in your patient population you may not have a lot of experience with phakic lenses, but I’ve found that most of the practices I work with have most, if not all, of the refractive surgeries available. For instance, when the presbyopic corneal inlays become available to us, every practice is going to want to offer them because almost every patient over 40 will be a candidate. In a similar vein, we did a large campaign for a practice’s presbyopia-correcting IOL services, and it wound up generating a lot of LASIK business because patients didn’t realize we couldn’t correct astigmatism with just the lenses.”
Mobile, Ala., ophthalmologist Richard Duffey, who not only performs LASIK and cataract surgeries but has also tracked surgeons’ practice patterns for years under the auspices of the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery, says LASIK and refractive cataract surgery are becoming increasingly intertwined. “I think that continuing to stay active in LVC has enhanced my premium IOL and refractive cataract surgery practice,” he says. “I fall back on the technology of LVC—both LASIK and PRK—to fine-tune the less-than-perfect results that we occasionally get with premium lenses and femtosecond cataract surgery.”
• Tiered pricing. Tiered pricing involves having a low price for LASIK based on a low refraction, no astigmatism and minimal follow-up, and then having one or more tiers above that as the cases become more complex. Experts say tiered pricing and one-price-fits-all approaches have advantages and disadvantages.
“When a patient calls about LASIK, eight times out of 10 his initial inquiry consists of, ‘How much is LASIK at your practice?’ ” says Mr. Malley. “He usually doesn’t ask about the doctor’s reputation, the technology or the results. So, if your response is, ‘Our fees start as low as $995 per eye, and when you come in we’ll determine what your final price will be,’ you’ve done the perfect thing. We feel the clinic is a better place to discuss pricing than over the airwaves.”
Mr. Pickett says tiered pricing makes sense because patients have a consumer’s mindset. “When they buy a new truck, they want to be able to choose the leather seats, bigger engine and/or bigger wheels,” he says. “This is opposed to going into the dealer and finding there’s only one model there that has all the options on it and is expensive. They like to feel if they choose to pay some more, they get some more. So, have options in your practice, such as maybe a base price with add-on options for the patient that lets you raise your price without costing you a lot. I’ve seen this be very effective. One tip to be successful with this is not to have a huge range, such as $299 to $2,999. Instead, offer something where there are a small number of specific plans. For instance, have one plan with a specific amount of follow-up care and duration of the enhancement period, followed by a plan with a longer amount of both, et cetera. Patients will usually choose the option with more value. For instance, we did a test in one refractive practice where we offered either microkeratome or femtosecond LASIK, with the former being $1,000 less. In one year, only one patient chose the cheaper microkeratome procedure.”
Surgeons counter, though, that if you’ve got an established reputation in your community, offering a single price cuts through potentially confusing options while still bringing in patients. “I used to use tiered pricing, and used it successfully,” says Dr. Duffey. “But when one of my younger partners came in, he thought it was too confusing for him to use to start his practice. So, we looked at the average of what we charge for LASIK, and for each of our other procedures, and set each procedure’s price at its average. I’ve found that it’s easier now, and there’s little question in anyone’s mind. I used to believe that I could have a low-end price there and get patients to our weekly practice seminar or into the clinic. Once they saw our quality, consistency and equipment, I reasoned, they’d choose us, even though we might have a higher price for their particular case. However, now that we’ve been in the community so long, the public knows that we have the best quality and what we stand for.”
• Credit plans. Options for paying for a refractive procedure can sometimes help get someone off the fence and over to the LASIK side. “I think financing options can help a great deal,” says Mr. Pickett. “CareCredit, which has been the main one out there, and a newer one, Alphaeon, both have plans set up for vision procedures. There may be practices out there that are hesitant to offer the financing because they don’t want to pay the financing charge to the company. But if money is the barrier that’s stopping a patient from having the procedure, I think you’re doing yourself a disservice by not offering financing. If you don’t offer financing, you’re limiting yourself, especially in markets where the local economy may be down and patients don’t have $4,000 in disposable income to pay for LASIK outright, but they can afford $150 per month. In our experience, the practices that are offering financing are seeing 40 to 50 percent of patients finance it, and that’s OK. Again, it’s about filling the funnel. By offering financing, you’re giving yourself a bigger funnel to work with.”
Food for Thought
In addition to the strategies outlined above, experts say there are other areas of your practice you can focus on to enhance your LASIK volume.
• Patient counselors. Though some practices may not use a counselor, experts say having the right person can pay dividends in terms of conversion rates. “Marketing can get people interested in calling you on the phone, but you also have to focus on meeting the patient’s needs and moving him through a process many practices don’t like to acknowledge: the sales process,” says Dan Durrie, MD, of Overland Park, Kan.
• Patient education. Mr. Pickett says this is where you can really separate your practice from the competition. “This is something I love to do because when I’m talking to a patient and explaining the surgery, I’m banking on none of the competitor practices doing it the way I’m doing it,” he says. “Most of these patients will visit more than one practice, and sometimes yours is the first they visit, so you want to make a positive impression on them. You want them to say, ‘These people know what they’re doing; this is where I want to have my LASIK.’ ”
Making use of technology can boost the education process, too. “Companies like Eyemaginations and Patient Education Concepts have software that can educate patients in ways that are light years beyond our old flip charts and eye models,” Mr. Pickett says. “And these approaches can often be customized to each patient. You can even have presentations in which you come in at the end and discuss your different LVC plans.”
• “New and improved.” Though it may be asking a lot of surgeons to purchase equipment during a flat LASIK period, Mr. Malley says the excitement that surrounds the announcement of anything new can actually bring some patients out of the woodwork. “The ray of hope we saw this past year was the LASIK practices who have experienced the most growth out of all the practices we serve—not the highest volume but the fastest rate of growth—were those who introduced the newest LASIK technology,” Mr. Malley says. “Their volume increased by 10 to 20 percent. There appears to be a group of patients who are waiting for the next generation of technology designed to possibly make LASIK ‘safer, faster, better or with improved outcomes.’ I’m not sure how large this group is, but they’re out there.”
Mr. Pickett says that, in the end, there is no one solution to decreased LASIK volume, but rather a string of incremental improvements. “All of these steps you take add up,” he says. “If each measure you take generates one to five patients per month, then before you know it you’ve got 20 extra patients and you’ve had a successful month.” REVIEW