Eyeworld

SEP 2012

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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70 70 EW REFRACTIVE SURGERY September 2012 Looking to LASIK again for practice growth? by Vanessa Caceres EyeWorld Contributing Writer lead to a logical, business-like answer," Mr. Pinto said. In addition to economic factors, the graying of the baby boomers plays a large role in LASIK market changes. As baby boomers are now in their late 40s to mid-60s, their desire for refractive surgery is not the same. Cataract surgery is more commonly on the horizon for baby boomers. Although Mr. Pinto does not see a return to LASIK's heyday, he believes surgeons can take some lessons learned and apply them to geriatric eyecare and disease man- agement. "We learned that patient satisfaction is key to practice success regardless of whether the patient pays directly or not. Another lesson is that all practices have a marketing plan whether they know it or not. If you're not conscious of how you pursue marketing, you'll get disap- pointing results, especially as the environment gets more competi- tive," he said. His final lesson learned helps to Economics, pricing, demographics are key C an ophthalmology expect another heyday in the LASIK market? If there is a resurgence, it may depend on your market area and demographics— and you'll have to work hard for that market, according to two ophthalmic consultants. EyeWorld asked John B. Pinto, president, J. Pinto & Associates, San Diego, and Shareef Mahdavi, presi- dent, SM2 Strategic, Pleasanton, Calif., if they thought the LASIK market has bounced back yet. Both highlighted the need for ophthalmic surgeons to rethink their marketing approaches to all kinds of proce- dures. Read on for details. Focusing energies elsewhere Mr. Pinto remembers when radial keratotomy reached the U.S. in the 1980s and then when LASIK was the new and exciting procedure of the 1990s. "I've seen the refractive sur- gery space wax and wane. It's come up with advancing technology and economic good times, and I've seen it retreat with dissatisfaction with various procedures like epiker- atophakia and economic bad times," he said. Right now, global economic challenges continue to affect the refractive surgery market, Mr. Pinto said. These continuing challenges affect unemployment rates and consumer confidence, both of which affect patients' interest in elective refractive procedures. "What this means is we're not going to have our accustomed springback from an or- dinary recession," he said. Surgeons that performed 30-50 refractive sur- geries a month are now seeing that volume cut in half—if they are even still performing refractive surgery at all, Mr. Pinto said. "Even a mild drop in case vol- umes can engender a death spiral where you don't have enough prac- tice volume to support direct-to-con- sumer advertising or technology upgrades," he said. Ultimately, he sees fewer ophthalmic surgeons fo- cusing on LASIK. Many are instead "discovering more interesting and profitable applications for their talents, particularly with premium IOLs, surgery centers, and optomet- ric/optical entries," he said. That said, Mr. Pinto still sees a prospective LASIK market for com- mitted surgeons. "For refractive surgeons who are intellectually and commercially committed to the game, there will continue to be market-by-market opportunities irre- spective of the broad U.S. economic malaise." However, "the level of commitment and risk tolerance required is an order of magnitude higher than what was obliged over the first 15 years or so of refractive surgery in America." When deciding how much to focus on the LASIK market, Mr. Pinto recommended that surgeons consider their personal and profes- sional interest in performing the procedure, what refractive surgery their competitors are performing, their level of risk tolerance, and the availability of resources to put into LASIK if they are in a group practice. "All of those things swirl about and guide cataract surgery marketing. "Cataract surgery is a kind of refrac- tive surgery, which will be reflected in patient demands. With premium IOLs, there is a shift to more patient shared payment responsibility. And for surgeons who are looking for the intellectual charge once furnished by their refractive surgery practices, there is more innovation and mental challenge to modern cataract sur- gery than ever before," he said. "In most client settings, we are now pushing practice resources into general/geriatric eyecare and underweighting corneal refractive surgery." Eyeing Generation Y Mr. Mahdavi said the LASIK market in 2011 and 2012 performed mar- ginally better than in other recent years. He also said that physicians seem to have learned the lesson that cheaper refractive surgery does not mean they will get more patients. "When LASIK prices go down, volume actually decreases. Nobody wants cheap surgery, although doctors seem to believe they do. They want value but not a cheap deal," he said. Surgery pricing, economic factors, and demographics all shape the demand for elective procedures, Mr. Mahdavi said. Like Mr. Pinto, he pointed to the greater demand for LASIK that occurred when baby

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