EyeWorld Asia-Pacific June 2014 Issue

24 June 2014 EWAP FEAturE Ultimately, “it’s the consumer who delegates what new technology stays around,” said Pit Gills, MD , president of St. Luke’s Cataract & Laser Institute, Tarpon Springs, Fla., U.S. Not everyone is as quick to praise the latest technologic advances. John Doane, MD , in private practice, Discover Vision Centers, Kansas City, Mo., U.S., does not have a laser in his practice. “We have no unbiased data at this point to definitively show there is any visual benefit above the status quo,” he said. “We know of no model that allows for the provider and the center to profit purely from the femto laser, and I personally do not know any center that has not seen its premium IOL margin cannibalized by the choice to offer the femto.” Dr. Doane’s words may be harsh, but “if the laser provided a better visual outcome,” he’d likely have been using the technology for years. He believes that as Carl Sagan stated, “Extraordinary claims should be backed by extraordinary evidence.” Dr. Thompson also leans a bit more conservatively in his marketing approach. “We have not promoted the laser as providing better visual outcomes,” he said. “We do feel comfortable telling patients that it is more precise in incision creation and capsulorhexis ‘roundness,’ size, and centration. I still have a huge respect for the manual techniques, and I do both.” Dr. Thompson cautioned surgeons to err on the side of conservative when discussing the potential for improved visual outcomes. “More time is needed before I’d be comfortable making that claim,” he said. “Right now, 60% of my patients choose traditional cataract surgery and 40% choose ReLACS, but they appreciate knowing their options and being included in the decision.” Dr. Gills doesn’t directly market the femto laser, either. “The technology sells itself,” he said. “Most of our patients want the femto if they can afford it.” St. Luke’s keeps the femto laser right outside the OR to minimize the amount of time the laser adds to the overall cataract surgery. “If 30% of our patients are femto, the OR runs smoothly. Our speed is impacted if it’s more than that,” he said. Conversely, “I won’t do a lens- based surgery unless I’m using thelaser,” Dr. Gordon said. “It’s the best option for any patient. If the patient has a cataract with no need for astigmatism correction and only wants insurance to pay for it, I’ll send the patient to one of my partners. A full 80% of our lens surgeries are done with the laser.” Dr. Gordon’s Baby Boomer patients—who had undergone laser vision correction 10 or 15 years ago—“are all coming in now wanting to know what the latest technology can offer them.” In Florida, Dr. Gills takes a slightly different approach, by categorizing people into what their needs are and how flexible they are regarding postop spectacle use. Where to start Dr. Gills said rather than promote or market the femto laser itself, his practice markets technology in general. “We reinforce that the practice is up to date on technology and call it ‘bladeless cataract surgery’,” he said. “It goes along with our general push of experience with the best technology.” Mark Kontos, MD , in private practice, Empire Eye, Spokane, Wash., U.S., and Hayden, Idaho, U.S., introduces the concept of advanced cataract surgery early in the patient evaluation. “We integrate the laser into that overall conversation by noting patients have the option of going beyond conventional surgery,” he said. “We want them to maintain some independence in the decision, so we discuss the three options we currently have. First, the ability to see but still rely on glasses for some tasks; second, the ability to see without glasses for distance but need them for near; and third, the most independence from glasses we can offer. The femto comes into play with both of those last options.” For some patients, that may mean conventional surgery with a conventional lens and a laser for AKs, he said. Dr. Thompson cautions physicians that refractive surgery marketing is “much more common and considerably less complex” than refractive cataract surgery marketing, adding he does not feel comfortable marketing the laser against traditional cataract surgery. “I prefer to educate patients about their options in how cataract surgery is performed, what enhanced intraoperative aberrometry can do, how their implant choice will affect their spectacle use postop. We let patients know we perform all options at our center.” In his practice, the staff was particularly excited about being one of the first to have the femto laser and “the whole office feels like we’re doing the most advanced cataract surgery possible and we’re very proud of that.” Marketing to ODs Dr. Kontos said his practice has always been a “historically strong optometric referral practice” beginning in the 1980s. It made logical sense, then, to start their marketing efforts with educating the ODs who would be referring patients. “We brought in people from other areas who also had experience with the laser. We invited ophthalmologists as well as our referring partners; we had about 110 optometrists in the audience at our first continuing medical education event. We used it as a kickoff to show what we’re doing and how the patient could benefit, and what to expect during the co-management period.” Dr. Thompson queried referring doctors to determine what type of cataract surgery they would prefer. “More than 200 of our referring doctors wanted laser- assisted cataract surgery instead of the traditional options,” he said. That, in turn, made “selling” the laser considerably easier. Dr. Gordon also thinks seminars are an excellent starting point in a marketing campaign. “Seminars continue to work if there’s something truly new in the office,” he said. Marketing - from page 22