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Cover Focus | Nov/Dec 2021

Applying Your Refractive Surgery Business Model to Other Elective Procedures

Eight tips for success.

Patient engagement is key to the success of an ophthalmology practice. As a consultant, I look for ways to improve engagement by enhancing practice efficiency and revenue. Most importantly, however, I focus on helping practices enrich the patient experience. One place for growth in these areas is in fee-for-service or elective procedures.

A few things can stand in the way of a practice’s progress toward incorporating elective procedures. The first thing is fear—fear of change, of making the wrong decisions, and of being unsuccessful. Fear can overwhelm doctors, staff, and patients. The second obstacle is a lack of commitment to change. Tough decisions and a shift in practice culture may be required. Modifications may include staffing changes, payroll adjustments, marketing budget shifts, website updates, equipment purchases, alterations in patient flow, the addition of virtual visits, and, most importantly, the dedication of time to training for the entire office. Faced with a lengthy operational list, people may become paralyzed and pose excuses for why they can’t advance to the next stage.

Here are eight practical tips on how to break through these barriers.

1. Change mindsets to learn and connect.

Identifying patient needs and desires will help patients see the value of investing not only in themselves but also in your practice. In vision correction, the core challenge is helping patients give themselves permission to invest in themselves and in your services. If you cannot get a patient to see the value of a procedure, you will never get beyond hello.

If you do not offer what patients are looking for, they will go somewhere else. The convenience of obtaining much of their vision care and aesthetic services in one place appeals to people, and one-stop shopping is becoming increasingly available (for more on this topic, see “One-Stop Shopping”). Are you willing to lose business by not attempting to cater to your patients’ needs?

Start by listening to and talking with your patients. Survey them about the practice and their needs. Create lifestyle questions so that you can get to know the person in front of you and figure out what they want.

2. Never forget a face.

Refractive surgery can provide patients with the best vision of their lives. Its effect also extends beyond sight. After surgery, patients often become more physically active thanks to freedom from contact lenses and glasses. Many individuals also begin to pay more attention to their appearance, including their clothing, hair, and, particularly, face. Where did those wrinkles come from? How about the bags under their eyes that glasses used to cover?

There is no one better to inform patients about potential aesthetic solutions than the doctor they already trust in a practice they already feel good about. (That’s you!)

3. Identify key roles.

Job descriptions may have to change, and it may be necessary to create positions (eg, aesthetician, patient advocate, sales counselor, educator) depending on the services that your practice adds.

Do not forget that opticians can be great sales educators because they know how to connect with patients. Identify staff members who can embrace change and who relate well to patients, but don’t restrict your search to existing employees. You do not want to overload your current staff with more patients and less time. If your staff is overworked and spread thin, it will show. Productivity will decrease, and patients will lose confidence in your practice.

Also keep in mind that it takes a certain personality to ask patients to pay for noncovered procedures.

4. Set youreslf up for success by taking time for staff training.

Do not add services to your practice without properly training your staff—you need their buy-in. Take advantage of the training that vendors are willing to provide. Keep in mind, however, that it likely will be specific to their products. Consider also investing in training conducted by professionals who are dedicated to inspiring staff and teaching them how to improve the patient experience. Remember that training should be ongoing, not a one-time thing.

Potential topics to cover during training include the following:

  • Welcoming patients to the practice;
  • Connecting with versus collecting patients;
  • Listening to learn;
  • Listening more and talking less;
  • Responding to solve a problem;
  • Putting yourself in a patient’s shoes; and
  • Overcoming objections.

5. Do not do everything at once.

It can be exciting to expand your practice’s offerings to include aesthetics. Many products, lasers, and spa packages are available, and deciding among them requires research. When considering which big-ticket items to offer, it is advisable to start small by incorporating injectables, nonsurgical options, minor office procedures, and/or skin care products. These are easy to add and typically do not slow patient flow. Moreover, offering injectables entails scheduling maintenance visits during which your team can discuss additional services with patients.

6. Maximize your availability.

I often hear from practices that it is unnecessary to offer virtual consultations, meet and greets, or reviews of pre- and postoperative instructions. This stance squanders opportunities for your practice to engage with current and potential patients. Virtual appointments and consultations can be more convenient for them. These also free up the onsite schedule and are not constrained by patients’ location or your office’s square footage.

COVID-19 is another factor. Virtual appointments allow you and your patients to forego wearing masks while interacting with each other. This can make it easier to build a relationship. Some individuals, moreover, remain uncomfortable with visiting doctors’ offices in person.

Finally, if your practice is selling skincare and other aesthetic products, be sure to make online purchasing easy for your patients.


The use of facemasks makes people more likely to look in each other’s eyes while interacting, and it has caused or exacerbated various skin concerns and ocular surface disease. This presents an opportunity for your practice to begin offering dry eye services as well as skincare for the delicate skin around the eyes. (For more on these topics, see "Dry Eye Services: A Capital Investment and a Lucrative Revenue Stream,” and “Selling Cash-Pay Health Products in the Office.”)


Pull together your administrative team or hire professional consultants to plan beyond 30 to 90 days. Do you want to expand your practice’s services by hiring aestheticians who provide facials, waxing, microblading, eyeliner tattooing, lash conditioning and lengthening products, and laser procedures? Do you want to add an oculoplastic department? Start with procedures and products that address the area around the eyes and then consider expanding to other areas of the face.

Ensure that your practice is a place where patients’ voices are heard. Their participation is essential to the successful expansion of your practice’s elective offerings.

Christine Lapointe