Trying to incorporate refractive surgery into a practice or building a solely refractive clinic presents many challenges. However, you can succeed with the right program. We offer strategies, tips, and advice for open-access laser users, who use the laser but have little or no financial risk in its operation or that of the facility.

The Marketplace
Most laser vision centers in the United States today share a common weakness: They are for open-access users who have little or no incentive to perform a high volume of laser procedures. It is this phenomenonmany users, few procedures-that has kept the growth of laser vision correction well below industry projections.

This has occurred for several reasons. One is the notion that laser vision correction is the answer to the ever-shrinking cataract dollar, an idea that is not a major source of motivation. Many who are certified to use an excimer laser are aggresisive cataract surgeons who have continued to streamline the efficiency of their practice while expanding into other areas, such as optical dispensing. They explore co-management and other optometry venues to increase patient volume and provide additional sources of patient care. Thus, it is the rare practice that has enough staff, time, or motivation to incorporate a major laser vision correction endeavor into an alreadystressed schedule.

Another challenge is the daunting task of converting a pathology-based practice into a sales-oriented retail space. Inexperienced management, unmotivated staff, and expensive advertising budgets can leave today's practice sitting on the sidelines of modern refractive surgery, even with the availability of open-access lasers.

Defining the Patient
It is important to understand the pattern of laser vision correction growth before you begin to develop your own program. New technologies and increased competition often create confusion in the marketplace. Prospective patients can be flooded with technical terms (e.g., excimer laser, PRK, LASIK). That's why it's important to use one general term, such as laser vision correction, so patients don't have to sort through the medical jargon.

Laser vision correction has been described as an "evangelical" procedure; patients who have it often talk very positively of their experience. Thus, word-of-mouth is a valuable tool that, when combined with a good marketing plan, results in consumer response. Word-of-mouth educates; marketing motivates.

Advertising
Several simple techniques can be used to develop a conservative, yet dynamic laser vision correction program. The first important step is don't advertise, at least not right away. The temptation to spend funds on newspaper or radio advertisements must be checked until a cohesive internal marketing and training plan is implemented. A good strategy is to develop a patient education program and a well-thought-out strategic plan before spending even one advertising dollar.

The cost of advertising varies depending on the market. Although it is best to start out with a conservative budget, make sure that it is large enough to enable you to reach the widest possible market the most number of times over the longest period. A slow approach allows your staff to become accustomed to dealing with refractive surgery patient inquiries and processing.

Patient Education and Tracking
There is a marked distinction between marketing and patient education. The goal of marketing can be summed up as "making the phone ring." Marketing efforts are to generate interest about laser vision correction. The goal of patient education is informed consent, and the importance of meeting this goal cannot be overstated. You must make sure that all patients considering laser vision correction are aware of the potential risks and rewards.

Two often-quoted reasons people give for not choosing laser vision correction are fear and money. Financing plans should be offered up front in your internal and external marketing efforts. Giving patients the financing option will ease their concerns about this potentially uncomfortable subject. You can address the fear by providing a sound patient education program that clearly addresses the risks while highlighting the benefits of the procedure as well as the benefits of having it done at your practice (e.g., physician experience, extended follow-up visits).

Patient tracking can help streamline your clinic operations by eliminating redundant entries. Many contact management software programs are commercially available to gather such information and sort it. These programs can be customized to detail essential information about the activities of potential laser candidates.

An Open-Access Alternative
Staff training and motivation are essential to your success. Without a knowledgeable staff, who will answer patient inquiries? Scheduling practice downtime for training is expensive. However, training will benefit your practice by clearly defining the parameters of your laser vision correction endeavor.

Start with the basics. Here are some suggestions:

• Explain and illustrate the advantages of laser vision correction and why you want it to be an integral part of your practice.
• Clearlydefineyour procedural goal for the next year and how you intend to achieve it.
• Show your staff the economic benefits of treating patients with myopia and astigmatism; it is naive to expect staff to abruptly change without seeing a direct benefit to their paycheck.
• Adopta certain"look" to your practice. Just as your optical shop promotes frames and contact lenses, your reception area and examination lanes should promote laser vision correction. Laser and promotional companies offer highquality educational materials including posters, videotapes, and information packages.