How one surgeon approaches robotic cataract surgery conversations

Since I started offering robotic laser cataract surgery, I have always been straightforward with patients, but it surprised me how much they lit up when they heard me say during a surgical consultation, “I’m good, but I’m not as good as a robot.”

Now, the phrase is the cornerstone of my education and marketing strategy. For patients, it has dramatically shifted how they think about their options. For my referral network, it has strengthened their confidence in me and enhanced the ways in which they can support patients through the surgical process. This combination has led to increased patient conversion rates, even though we had adopted laser-assisted cataract surgery a while ago. Since introducing robotic messaging, more than 75% of my patients choose robotic laser cataract surgery, for which I use a robotic femtosecond laser cataract surgery platform (Ally; Lensar).

Why robotic messaging resonates with patients

Patients want to feel safe and know that the technology being used delivers precise outcomes. Robotic communicates this in a single word. It also takes the focus off the surgeon trying to sell something and frames the conversation around a technology that is objectively safer, more precise, and more consistent than manual cataract surgery. When I show patients side-by-side videos of standard and robotic cataract surgery, often the choice becomes self-evident. Even if cost is a consideration, many patients tell me, “If it’s my eyes, I want the robot.” This line of communication leaves them feeling empowered rather than pressured to make a decision.

One challenge in refractive cataract surgery is helping patients navigate their choices without overwhelming them. IOL selection aside, patients have procedural options ranging from standard cataract surgery to laser-assisted cataract surgery and now to robotic cataract surgery. I find it helpful to simplify the discussion into the following clear procedure tiers:

• Manual phacoemulsification cataract surgery. This is the standard procedure performed by many ophthalmologists in the developed world. It is safe, effective, and covered by insurance.
• Laser-assisted cataract surgery. This procedure involves the use of a laser for certain steps of the procedure, including corneal and limbal incisions, capsulotomy, and lens softening and fragmentation. The procedure involves an additional out-of-pocket fee.
• Robotic laser cataract surgery. The most advanced of the 3 procedures, robotic cataract surgery offers the highest level of predictability. It is also available for an additional fee.

Never push a patient to choose one option over another. Instead, give them the information they need to feel confident in their choice. Since we have adopted this tiered-procedure strategy, my practice has seen roughly a 15% increase in patients opting for advanced surgery compared with before.

Building a supportive collaborative care model

Patients do not make surgical decisions in isolation. Most consult with their optometrist, who then refers them to a surgeon. Building and maintaining a strong collaborative care model, therefore, is essential. My philosophy is simple: The better my referral partners understand an advanced technology like robotic cataract surgery, the better equipped they are to introduce it to patients (see An Optometric Perspective).

Implementing multiple touchpoints with optometric colleagues every year can be an invaluable asset for building not only relationships but also a supportive collaborative care model. By providing optometrists with valuable education, they, in turn, are better equipped to support their patients throughout their surgical journey. In my practice, we provide the following educational opportunities to our optometry partners:

• Biannual seminars. Educational seminars are hosted in-house. Typically, a seminar covers the latest technologies such as robotic cataract surgery. Each session includes an intimate discussion of whatever technology we are focused on, whether it is premium IOLs, dry eye disease therapies, a surgical procedure, or a new offering to our practice.
• An open invitation to observe surgery. Every referring optometrist has an open invitation to observe a live surgery, ideally with one of their own patients. Those who have chosen to observe surgery leave with a new appreciation for the technology.
• Videos and visual demonstrations. Seeing is believing. Since not everyone can attend live surgery, we also provide surgical videos that demonstrate the advantages and disadvantages of a technology.
• Ready-to-use patient education materials. Educational brochures and digital content help optometrists begin a conversation with patients before referral. Although many prefer not to go into granular details with their patients, they feel well informed if they are presented with specific questions. Additionally, having access to educational materials helps patients arrive at their surgical consultation informed of their options.

Messaging without pressure

One pearl I have learned is that honest marketing is more effective than promotional marketing. Patients sense when they are being sold something. Rather than overwhelming them with jargon or promises, focus on simple, transparent statements like the following:

• “This is the most advanced option available.”
• “It’s not required to have excellent results. You may still achieve them with traditional surgery.”
• “Here’s why I personally believe in the technology.”

Keeping the tone pressure-free helps patients feel respected and in control. The decision becomes theirs, not mine. Interestingly, when the pressure is removed, patients are even more likely to choose the advanced technology option. However, technology alone does not change practice patterns. Education does. When surgeons believe in the technology, staff echo that confidence, and referral partners stay informed and engaged—patients feel empowered to choose what is best for them (for more tips, see Five Lessons).

Jay Bansal, MD
E: [email protected]
Bansal practices at LaserVue Eye Center in San Francisco and Santa Rosa, California. He has no financial interest to disclose.