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Consider effect on practice, patients before converting to premium IOLs


The conversion of cataract surgery patients to premium IOLs is a modern focus in the eye-care industry. Surgeons considering this business sector should be involved heavily in the initial planning phase. Staff members should have a thorough understanding of the process and should be able to explain fully with patients. The change should come gradually with proper patient education using the IOL Counselor, pamphlets, and thorough discussion with the physician and counselor.


Houston-Just as "a rolling stone gathers no moss," a premium IOL business should have the potential to gather no "moss" (problems) if rolled into a practice effectively.

Joan Wahlman, marketing manager for Mann Eye Institute and Laser Center, Houston, and president of J.D. Health Care Consultants, Houston, TX, highlighted the proper steps to convert cataract surgery patients to premium IOLs, a modern focus in the eye-care industry. She explained that the shift has benefits even when the staff, and sometimes patients, are resistant to change.

"The new technology is designed to improve patient quality of life," Wahlman said. For the patient, it changes his or her life; for the practice, it has significant influence, such as increased financial stability.

The surgeon has many concerns in the initial planning phase, the first being the variety of lens choices.

"Not every doctor wants to implant every lens. Not every doctor is comfortable with implanting every lens," Wahlman said. "[The doctor has] to take the first steps to make the decision."

A surgeon also has to recommend patients for the type of lens chosen, and a particular lens will not be the right fit for everyone. Therefore, the surgeon must choose a protocol for each lens implant candidate.

Chair time will increase because of the change as well. Technicians need to obtain much more background information on patients to determine whether it is the right procedure for them.

If practices aren't already performing refractive procedures, they should decide whether they want to start. As far as the staff, they are likely to be skeptical and resistant to change at first.

"[The impact on the staff] is the hardest thing we have to deal with," Wahlman said. People become used to their jobs and doing them efficiently, so when problems arise with new technology they become frustrated with the complexities said Wahlman.

This frustration can cause staff members to be fearful of patient reaction and uncomfortable discussing the increased cost of these procedures.

For patients, these new procedures allow them to go sans bifocals, which is a concern of the more youthfully minded cataract population. Some may be apprehensive, however.

"They understand that this really is a decision that's going to affect them for the rest of their lives," Wahlman said.

With life-altering decisions come high expectations from patients.

"Our goal is to meet those expectations and to realize that the trust they place in us equals the outcome to their surgery," Wahlman said.

Getting the ball to roll

"Success begins at the top," Wahlman said. Surgical goals, such as the number of procedures a practice wants to perform, should be established. Wahlman said one practice she worked with increased that goal every month. Candidacy guidelines were another factor that started out rather acute and broadened as they progressed.

Part of implementing change throughout a practice is communicating the process and goals to every staff member.

"We go over all of the new technology and all of the new updates every quarter," Wahlman said. "We have educational sessions. We have our doctors do the presentations, because I am a firm believer that it begins at the top."

A lesson learned by one practice, Wahlman said, was that it started out by trying to explain the vision with the staff but made the mistake of not simplifying it for them. For the staff to be able to explain this vision to patients, they have to understand it and know what to say when patients have questions.

Not only did Wahlman learn to plan for staff questions, she also had to plan for surgeon preferences.

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