Eyeworld

16 Ophthalmology Business • December 2016 This, he said, helps the patient realize the magnitude of the proce- dure and this decision. "They realize it's a big decision because they're going to have cata- ract surgery once in their life. This is the one time they can get the most functional vision or the best vision," he said. Takeaway Overall, Dr. Bafna said making changes to bundle fixed-price services based on outcomes as well as using selective language and involving the family more has improved his con- version rate. "Prior to making these changes, we were around 15% to 17% for up- grades … now we're closer to 35% to 40%. We've doubled," he said. Dr. Bafna noted, however, that this increase isn't 100% due to these changes. "It's partly because technology is continuing to improve, and I think patients may be more aware of what's going on," he said, adding that he finds it encouraging that despite increasing his prices, overall conver- sions still went up. "That's why I felt like the changes did have an effect." "Eight years ago it was pretty common for people to say, 'Doc, are you sure? My insurance probably covers it—I have good insurance.' You never hear that from people anymore," Dr. Tipperman said. "Instead you hear, 'My neighbor had it. I know I have to pay for it. I'm OK with that.' I think people have become better educated about what are out-of-pocket expenses and what are covered expenses." OB Editors' note: Dr. Bafna has no financial interests related to his comments. Dr. Tipperman has financial interests with Alcon (Fort Worth, Texas) and Diopsys Inc. (Pine Brook, New Jersey). Contact information Bafna: drbafna@clevelandeyeclinic.com Tipperman: rtipperman@mindspring.com so can the people closest to them. Both Dr. Tipperman and Dr. Bafna said they've noticed older patients being more reluctant to spend money on themselves. "Oftentimes if you have the patient alone, it becomes more of a monetary decision. If a significant other or spouse or child is there, they'll be more likely to say this is the right thing for the patient," Dr. Bafna said. "That's the family being the person's advocate and helping them make a better decision," Dr. Tipperman said. 6. Spread out education Even though he avoids going into all the different technologies and details of refractive cataract surgery, the in- formation patients need to make an informed decision can still be a lot, Dr. Bafna said. This is why he spreads out this education. "If you try to give all this educa- tion in one sitting, it's too much for the patient to absorb. You'll find that they don't have time to appreciate it," he said. In his practice, patient education starts with an informative packet sent to their home. They'll then learn more when they meet for a con- sultation and more still when they sign up for surgery. Dr. Bafna said he might even have a counselor reach out to patients ahead of surgery to see if they have further questions. "By increasing the education process, that increases the number of conversions because it gives patients the chance to digest the information, figure out what they want, ask ques- tions, and go from there," he said. 7. Give them time Dr. Tipperman said he tells patients to take time to make a decision after their initial consultation. "This is a decision that will impact how you see for the rest of your life," he tells his patients, as he advises them to think about it. Austin, Texas, Dr. Bafna said he tells his patients that the femtosecond laser can soften the lens like a cookie that has been dunked in milk, giving them the visual picture of it making it easier for the pieces to crumble. Dr. Bafna describes cataract sur- gery as a whole as an opportunity. "When someone presents for cataract surgery, there are different ways you can talk about it. You can talk about it as a pathology … but I like to present it as an opportunity to the patient. You have an opportunity to make a decision that will help you gain more freedom in various activi- ties," he said. Dr. Tipperman said it's also important that all staff members speak the same language—from the physician to the technician to the scheduler. 4. Put the cost in context Dr. Tipperman gave the example of an $180 Prada T-shirt. While expen- sive for a T-shirt, when it's on display next to an $18,000 purse, it suddenly seems less expensive. This is a fram- ing effect, Dr. Tipperman said. "The idea of framing effects for ophthalmology and advanced technology lenses is to [help patients understand when they] ask how much it costs. It's less than half of what a hearing aid costs. It's less than what a dental implant would cost. … It's about what cable TV will cost for 6 months, but then the cable is free for the rest of your life. "You're going to have cataract surgery on one of your most precious sensory organs … and you obvious- ly want to get the best vision you can out of surgery; do you think it would be worth spending less than a 6-month cable bill to get good vision for the rest of your life? Suddenly, it doesn't seem like a crazy purchase anymore," Dr. Tipperman said. 5. Bring in family Just as putting the out-of-pocket costs in context gives patients perspective, continued from page 15

• Cover