Eight years ago, my multisubspecialty practice, Southern Eye Center in Hattiesburg, Mississippi, began to offer premium IOLs. We initially had a premium IOL conversion rate of approximately 10% to 12%. When we changed our approach to include integrated education, however, that percentage increased. By 2010 into 2011, our premium IOL conversion rate was 35%—more than double the US national average.
Premium lenses can provide patients with excellent vision across a wide spectrum of distances. But the cost of premium IOLs is one barrier to their adoption for patients and for cataract surgeons. Therefore, it is important that we help patients understand the advantages of these implants. Implementing a comprehensive educational program for staff and patients can increase conversion rates and patient satisfaction.
In our practice, we found that patients typically had concerns and questions regarding presbyopia and the benefits of the newer IOL technologies designed to treat this condition. Cataract patients wanted to know what the new lenses did that the old ones did not. They were also concerned about value and were hesitant to embrace an emerging, more expensive technology. Surgeons also had some apprehensions, such as adopting the technology and managing potential side effects, the increased chair time, and associated financial issues.
Informed patients who understand the value of premium IOLs are more likely to invest in the technology. Therefore, when deciding to offer premium IOLs, it is imperative that the practice commits to supporting the physicians and the staff with proper training. Our increased conversion to premium IOLs is because we have educated our entire staff—93 employees—on the value of informing patients of their surgical options and the benefits of these lenses. The staff is involved in patient education and their decision-making process, and our patients have responded to this approach.
Patient education includes everything from their initial phone call into the practice to their surgical evaluation. We have found that it is helpful for patients to hear the information at least three times before they decide on a lens.
Breakdown of a Five-Step Process
Step No. 1. Our consultants schedule patients for surgery and follow up by mailing them our comprehensive cataract information packet that includes a patient DVD, a menu of cataract options, an About Your Examination sheet, and a financing brochure. The DVD introduces our practice and provides patients with a virtual tour of what they can expect when they come in for their procedure. It also allows patients time to consider their cataract treatment options and provides the opportunity for them to share the information with family members and friends.
The cataract options menu explains in simple language the need for lens replacement after cataract surgery and outlines the three main options (packages) we offer. By listing the benefits of each lens option, we begin educating patients even before they get to our office.
Step No. 2. The scheduler calls the patient to confirm the appointment, reviews the lens options, collects insurance information, and informs the patient of potential outof- pocket costs.
Step No. 3. About 1 week prior to the scheduled appointment, a refractive counselor contacts the patient to review the options menu and associated costs and to discuss financing options. Patients can elect to apply for financing at this time.
Step No. 4. During the preoperative work-up, the technician reviews the cataract lens menu with the patient. To check for astigmatism, topography is performed before the surgeon’s evaluation. A technician talks with the patient to ascertain his or her specific visual goals, including tasks related to the patient’s work, hobbies, and other interests. This helps the staff obtain a clear understanding of what the patient does on an everyday basis and how these activities impact his or her vision. Choices for selecting a lens to best fit the lifestyle are then considered.
Step No. 5. Next, the patient is evaluated by the surgeon, who then makes a lens recommendation. To enhance the value of a premium lens when one is selected, we incorporate it into a package that includes topography, astigmatic correction (if required), and postoperative laser vision correction to treat any residual refractive error. The package approach sends a clear message to patients that we will use all available technology to ensure they are completely satisfied with their vision.
The approach we have incorporated at our practice gives patients the information and time they need to make their decision. Hearing the message numerous times before they see the surgeon, patients better understand the value of premium lenses. Our experience also has shown us that the unhappiest patient is the one who has been oversold. When patients are undersold and then we overdeliver on results, they are happy and tell us we have exceeded their expectations (Figure 1). These happy patients also spread the word to their friends. This results in word-of-mouth referrals and a happy, healthy practice.
Kiper C. Nelson, MD, is in practice at Southern Eye Center, Hattiesburg, Mississippi. Dr. Nelson states that he has no financial interest in the companies or products mentioned. He may be reached at tel: +1 601 705 0460; e-mail: firstname.lastname@example.org.
- Kent C. Conversion rate: Converting patients (despite the economy). Review of Ophthalmology. 2011;18(7)30-40.