Have No Fear, LASIK is Here

In this episode, George Waring IV, MD; Sondra Black, OD; Gary Wörtz, MD; Blake Williamson, MD; William Wiley, MD; and James Loden, MD, share common demographics of patients who receive LASIK in their practices. Each physician then shares advice on how to attract these patients and ease concerns over safety or cost of the procedure.

This podcast is an editorially independent program supported with funding by Johnson & Johnson Vision.

Editor’s Note: At the time of the podcast recordings, Sondra Black, OD, was an Independent Consultant. Dr. Black is now Head of Professional Development and Education for the Commercial Division of Johnson & Johnson Vision.

Ranna Jaraha: This is an editorially independent program supported with funding by Johnson and Johnson Vision.

Ranna Jaraha: Hello and welcome to our second installment in a special series on LASIK surgery. We're going to take a look at the patients who are currently opting to get LASIK surgery. What are the different patient profiles of those who show interest, and how can physicians effectively communicate with them? My name is Ranna Jaraha, and I'll be asking several physicians to share their knowledge on the topic.

Ranna Jaraha: First, we have Dr. George Waring from Waring Vision Institute in Charleston, South Carolina.

Dr. Waring: Hello, and thank you for inviting me today.

Ranna Jaraha: Next, we have Dr. Sondra Black, optometrist and industry consultant in Toronto, Canada.

Dr. Black: Hello, Ranna.

Ranna Jaraha: We also have with us Dr. Gary Wortz of Commonwealth Eye Surgery in Lexington, Kentucky. Welcome, Gary.

Dr. Wortz: Thanks, I'm happy to be here.

Ranna Jaraha: Dr. Blake Williamson of Williamson Eye Center in Baton Rouge, Louisiana.

Dr. Williamson: Hello, y'all.

Ranna Jaraha: Dr. Bill Wiley of Cleveland Eye Clinic in Brecksville, Ohio.

Dr. Wiley: Hello, everyone.

Ranna Jaraha: And finally, we have Dr. James Loden of Loden Vision in Nashville, Tennessee.

Dr. Loden: Happy to be here.

Ranna Jaraha: Thank you all for joining me. In the first episode of this series, we talked about the exceptional outcomes we get with LASIK surgery and the data that supports it. Today, we're going to talk about how we convey those great outcomes to our patients. To start with, let's get an idea of who the LASIK patient is today, Dr. Waring, let's start with you. What are the demographics of your LASIK patients?

Dr. Waring: We really can group our LASIK patients into two demographics. The first are patients in their early 20s who are just reaching ocular maturity and usually have strong vision correction needs and close family members who have had LASIK in the past. These are patients with high myopia or high amounts of astigmatism whose parents had LASIK and know how much it improved their quality of life, and they want the same things for their kids. It's a lot like what people do with braces in planning the investment for their kids' health and wellness.

Then we have a second group of patients who are in their 30s to 40s, young professionals that are starting to feel established, and they have a few more financial resources, and they're looking for options to improve their lifestyle. They're more active. They have friends who have had successful experiences with LASIK, and they're at that stage where they want it, too.

Ranna Jaraha: Dr. Wortz, what have you seen?

Dr. Wortz: We seem to have that same bimodal distribution. We do have those recent high school grads and college graduates who are in their let's say early 20s, and then we seem to have another peak of patients who are maybe in their mid 30s to early 40s. I think it just has to do with who's paying for it. If their parents are paying for it or they're getting some help paying for it, they're typically younger, and a lot of times that's because their parents have had LASIK and had such fantastic results. They know they wish they'd done it sooner, so they're investing in their kids' health and productivity as with Dr. Waring's patients.

Ranna Jaraha: So, is this bimodal distribution the same for all of you? Dr. Wiley?

Dr. Wiley: Our patients are really fairly evenly dispersed all the way from young patients who have just reached ocular maturity to patients in their 50s or 60s and probably need a refractive lens exchange. We also started seeing an increase in patients in the millennial age group, and I think this age group can be really value-driven, and they're starting to look at long-term vision demands and understand by investing in their eyes now, they'll be less reliant on contacts and glasses, which carries significant expense over time.

I definitely have seen an increase in younger patients whose parents have had LASIK and now providing it for their kids as soon as they reach ocular maturity. You have a family that brought all five kids in to have LASIK as soon as they're old enough. I kept thinking, "Another kid?"

Ranna Jaraha: Dr. Williamson, what about you?

Dr. Williamson: I also see that same bimodal distribution, and I tend to see more female than male patients coming in for LASIK. I'd say about 65% of my LASIK consults are female to 35% male.

Ranna Jaraha: So, whether there are clusters around certain age groups or a more even distribution, you're all dealing with LASIK patients who vary from 18 years old to late 40s. What are some of the organizational things you've had to do in your clinics to attract these patients? Dr. Loden, why don’t you go first?

Dr. Loden: The number one thing a practice needs to do is make sure they know how to answer a phone in a timely manner and get a patient scheduled. If the phone doesn't get answered quickly or the caller is put on hold for a long period, then you have lost that potential patient. It doesn't matter how good your external marketing is or how attractive your website is. You may have spent $200 in marketing to get that phone call and then you didn't pick it up, and you won't really know how efficient you are unless you can track it. Track these incoming phone calls. You have to do it. So, that's the first step. I probably wasted several million dollars in marketing over the early years of my career because we weren't answering the phone well.

Ranna Jaraha: Dr. Wortz, what is your approach?

Dr. Wortz: One area we're really focusing on is patient convenience and throughput. We have a LASIK screening program where if someone is interested in LASIK, they can come in and get a general topography and pachymetry and refraction done for free, and we can tell them in about 10 minutes if they're a good candidate or not. Then if they are within the parameters, we can schedule them for the longer examination. We're really just trying to be more respectful of the time they're with us while also establishing a connection with them. They'll hopefully allow us to finally perform their surgery.

Ranna Jaraha: Dr. Black, do you have any comments?

Dr. Black: Another thing, the surgeon, the co-managing optometrist, and the surgical counselor can't be wearing glasses and not be prepared to talk about it. The first thing a patient will think is, "Well, if LASIK is so great, why didn't they get it?" This should be addressed before the patient asks. Explain to them why you are not a candidate or why you didn't have surgery. Even having your staff in glasses is a huge mistake, which is why we always offer LASIK to all of our staff after they've been with us for at least three months.

Ranna Jaraha: Everything that's been mentioned so far has helped to build a foundation for what I want to focus on in this installment, and that is a theme of getting over fear, fear of surgery and fear of paying for it. How do you present LASIK to your patients? Do you lead your conversations with the exceptional technology and outcomes? Is this current generation of LASIK patients afraid of the idea of a laser on their eye? Dr. Williamson, what do you think?

Dr. Williamson: Maybe my grandfather's generation was afraid of a laser in their eye, but our current patients take for granted that their eye will be operated on with a laser, and you actually have to explain it to them when that's not the case. I think that they inherently understand that a laser surgery will be more precise than a manual procedure, so they're really attracted to that precision rather than being fearful.

That being said, we don't lead the conversation ever by talking about the technology. Most people really can't relate to that, and really what they want to know is that they're going to be able to see and do things without glasses or contacts, as well as be reassured that complications are exceptionally rare.

Ranna Jaraha: Dr. Wortz, what have you observed about LASIK patients' decision-making process?

Dr. Wortz: It's my personal philosophy that patients make decisions emotionally and then rationalize them logically. Most of the time a patient has already had some emotional connection with the idea of how life without glasses would be and how much better it's going to be than life is currently for them, and I do believe that's the case for most patients.

So, step one is to show people, really showing them the desired state, showing them that the freedom they will experience with LASIK when they're no longer tied to packing their contact lenses and packing cleaning solutions, or even worrying about what happens if they lose a contact lens at the beach, not even knowing which way the shore would be, let alone trying to watch their kids. So, it's really trying to show them what life is going to be like when they are free of glasses.

As an example, I recently performed LASIK on a patient who is a part-time firefighter. Shortly afterwards, he responded to a structural fire and had to go into a house, and he told me afterward that it was really the first time he could see clearly under his mask because wearing his glasses, they would always fog up, and he can't wear contacts because they dry out, and he said it was really amazing how much better he was at performing his job as a firefighter because he could see.

So, I think our job really is to communicate the emotional value to a patient of what life without glasses will be like. and that's really step one. Step two is really answering their questions with scientific data should they want or need it. Those studies are great, but I don't think that there are many people out there other than perhaps engineers who want to read the studies. So, most people want to know they can trust you. They want to look you in the eye and feel that they'll be safe in your hands, and although I think the data is very important, it's frequently not part of my overall conversation with patients.

Dr. Loden: There's always some storyline with patients. They don't like putting their contacts in their eyes. They're contact lens intolerant. They scuba dive, and there's a risk a contact will come out while they're in the water. They sweat a lot and don't like the feel of glasses on their face. You have to find each person's motivating factor and concentrate on that. For young mothers, they get up in the night, and they have to find their glasses before they can help their kids. You have to find that story and tell them how LASIK will improve their lifestyle. Most of the educated consumers coming into my office know that we provide entirely bladeless technology. We've been marketing that for 12 years. Now we stick to lifestyle messages.

Ranna Jaraha: Dr. Black, where do you side on this?

Dr. Black: I do agree that patients have an emotional desire for life without glasses or contacts. That's what brings them in. But I do think it's important to mention technology and differentiate our practice in that first conversation. The younger generation of LASIK patients have absolutely no problem going for multiple consultations, so I found it really useful to differentiate us by hitting on that technology point straight on.

I always tell them that there are two steps to the procedure; one is the creation of the flap, and the other is the treatment of their prescription. The creation of the flap can be done with either a microkeratome or a blade, but now we use the laser. Then I explain that we're going to treat their prescription with a custom wavefront technology that's going to measure their prescription at 1200 different points and measure all the irregularities in their visual system and reshape their eyes to provide them with better quality vision, particularly related to night glare.

We think that everybody knows these things, but they have no idea that there are technology differences that relate to the cost differences.

Dr. Wortz: This is the digital generation, and I like to present LASIK as the digital solution to their vision problem. Glasses and contact lenses are like the analog version of vision correction, and LASIK is the digital solution.

Ranna Jaraha: So now that you've appealed to their desire for lifestyle improvements and mitigated any fears about the surgery itself, how do you help your LASIK patients get over any cost hurdles? We know that this is a generation that spends their money cautiously, and because they have lived through several recessions, they're likely saddled with debt even though they have a good income. Dr. Black, what’s your approach?

Dr. Black: You have to gauge each patient, but there are some patients that need to know the economics of LASIK versus glasses or contacts. There was a recent study that compared the cost of contact lenses to the cost of LASIK. It found that if you wear a regular soft lens, LASIK will become more cost beneficial after eight years, and that's reduced to seven years if you use a daily wear lens.

So, there's a tipping point where LASIK is actually cheaper than contact lenses, but most patients just want to know how they individually are going to be able to pay for it, and with most, if you just mentioned the financing options, they'll start to think of ways they can pay for it, such as putting it on a personal credit card with a better interest rate, but you have to have the financing so that you can mention it and get them thinking.

Ranna Jaraha: Dr. Wortz, what do you provide in terms of patient financing?

Dr. Wortz: We have found it really essential to have a solid financing option as many of our patients do use it. People don't save money like they used to and don't even necessarily think about overall price. Now, most people think in terms of how much disposable income they have in their cashflow and if they have the excess to make the payments.

We have a variety of credit options for our patients with different time points and interest rates, but we try to get them to interest free loans that won't cost more than about $250 a month. We feel that's an amount that most people can afford.

Ranna Jaraha: Dr. Williamson?

Dr. Williamson: We never judge what someone has or doesn't have financially. That's really not our job. Our job is just to recommend options to achieve a visual goal, and for the financing part, I just let all of my LASIK consults know upfront that we have options for them that for the price of a cell phone bill per month, they can have the best vision they've ever had, and that's financing, right? So, to support that, we use CareCredit. We also use Alphaeon Credit, and we're even considering working with GreenSky, and we found that with these services, most of our patients can get some type of credit option to be able to finance the procedure that they'd like.

Ranna Jaraha: And that concludes our second installment in this series. Thank you to our participating doctors for their comments on patient communication and leveraging a sense of no fear as it relates to LASIK surgery. Thank you to all of our listeners for tuning in. This is an editorially independent program supported with funding by Johnson and Johnson Vision.

In our third and final episode, we'll hear about how to effectively reach patients who are considering LASIK through powerful marketing and strategic social media tactics. Be sure to tune in.