- Increasing confidence to give patients what they want
- A pathway for financial sustainability
- Establishing a strong foundation
- ‘Don’t undersell your services’: Refractive cataract pricing
- A “team first” patient experience
- Internal and external marketing strategies
- The implant journey
- Ways to drive growth
- Diagnostic and IOL option deep dive
- Approach to patients
- Tools and the team
- Managing difficulties and a focus on dry eye
Increasing confidence to give patients what they want
Vance Thompson, MD, and William Wiley, MD, provided introductory remarks, setting the stage for the BRiCS Summit, which took place October 3–5 in Chicago, Illinois.
What the course really boils down to is increasing confidence in the premium IOL practice through education, resources, and networking connections. Both Dr. Thompson and Dr. Wiley said they experienced an increase in confidence with premium refractive cataract surgery after the first 2024 BRiCS Summit, which actually equated to an increase in conversions to premium IOLs.
“I thought I was pretty good at offering premium cataract surgery,” Dr. Wiley said. When thinking about why his conversions went up within the last year, he said, “the reality is, it was the confidence I got from this course … about giving the best care for our patients. When you have that confidence, it really does translate to giving patients what they want.”
Dr. Thompson said his premium IOL utilization numbers went up 5–8% in the year after the first BRiCS Summit. Studies show more patients want the vision that advanced technologies can give them than are actually receiving them in practice. “I believe this has to do with practice confidence,” Dr. Thompson said. “Increasing that confidence … and nailing some of these business things that we can stumble on and disappoint patients in their experience will close the gap.”
Source: ASCRS
A pathway for financial sustainability
Dr. Wiley reviewed how today’s cataract surgery’s finances “just don’t add up.” From increasing overhead costs to the expectation for advanced diagnostic technology that help deliver the best care, the cost to provide cataract surgery has gone up while insurance reimbursement has gone down.
The patient-pay pathway that’s possible with premium IOLs is an opportunity for financial sustainability in cataract practices, he said. How to implement this pathway is what attendees of the BRiCS Summit learned over the weekend.
“With premium IOLs, you can now rebalance the scale,” Dr. Wiley said, adding later that the goal of the course is for all attendees to leave with the confidence to create financial security for their practices.
Establishing a strong foundation
Carrie Jacobs, COE, led a panel that established the foundation for the BRiCS Summit course, talking through the patient experience cycle.
The patient experience cycle includes every touchpoint the practice staff and doctor have with the patient, from the initial call to the previsit education to the in-clinic greeting to testing to consulting to coordinating their surgery to the extending of care.
Ms. Jacobs emphasized that the doctor only has about two touchpoints in this cycle while the rest of the practice team has six touchpoints. This is why the BRiCS Summit model encourages both a physician and their practice implementor to attend.
Ms. Jacobs and the panel talked in depth around each critical touchpoint of the patient experience cycle and how each presents an opportunity for education about refractive cataract surgery. In the end, at each touchpoint, we’re not trying to get the patient to “upgrade” or “convert” to the highest priced thing, Dr. Wiley said. “The best term would be ‘patient acceptance of the doctor’s recommendation.’”
‘Don’t undersell your services’: Refractive cataract pricing
Refractive cataract surgery is unique in that there is a portion of an insurance-covered procedure that patients can opt into paying themselves for a vision experience that they want.
A 2005 CMS ruling unbundled the presbyopia-correcting IOL and services related to presbyopia-correcting IOLs from insurance reimbursement and allowed them to be paid for out of pocket from the patient.
Matt Jensen and a panel presented on the services this might include and how to create a pricing structure for it. Panelist Richard Tipperman, MD, said that what patients are paying you for is not just advanced technology but more so your experience and your judgement. “They’re coming to you because they want you to do the surgery,” he said. “Don’t undersell the services you provide. … It’s really a priceless thing that we give them.”
In addition to not underselling one’s services—which includes the use of advanced technology, great customer service, and great vision after surgery—Mr. Jensen said practices must be good at communicating about pricing. He said it’s important to not talk about insurance-reimbursed cataract surgery as “covered” because there is often still a co-pay or deductible required.
The panel also discussed how they set their refractive cataract surgery prices, what the hurdles are to pricing, and how to overcome them.
A “team first” patient experience
A session on the first day of the meeting featured the “team first” patient experience and why it works. Dr. Thompson began the discussion, emphasizing how his practice, Vance Thompson Vision, really focuses on love and creating a work family.
Other panelists in the session included Mr. Jensen, Patti Barkey, COE, Deborah Davis, COE, and Jaime Johannesen.
Ms. Barkey said that customer experience is everything, but she added that outcomes are part of the experience as well.
Dr. Thompson went into detail on some of the ways his practice specifically caters to the patient experience, particularly ways to remove barriers between staff and patients. Dr. Thompson stressed that he considers the people he works with to be the “true DNA” of his practice.
The discussion also shifted to the customer experience, with emphasis on knowing both what the customer values and what the customer expects. Dr. Thompson highlighted some key motivating factors.
Ms. Davis also highlighted what to do when you get bad reviews, noting that she will personally address these and follow-up with the patient. This goes a long way with patients, she said. Having a system to monitor your reviews and quickly addressing bad reviews is important, she said. If you don’t address them, patients may think you don’t care, she said.
Similarly, Mr. Jensen stressed the importance of having someone monitor your social media if you have these platforms.
Internal and external marketing strategies
Jennifer Loh, MD, led a discussion with Dr. Wiley, Mr. Jensen, and Ms. Jacobs about marketing strategies that practices can employ.
Dr. Loh stressed that patient experience goes a lot with marketing strategies, and she detailed both internal and external marketing strategies that can boost patient engagement, retention, and acquisition in an ophthalmology practice.
Internal marketing involves marketing within your practice with your current patient base to encourage building loyalty, enhancing the patient experience, and driving word of mouth referrals.
Staff can be important as brand ambassadors and can be trained and empowered to represent the practice positively. It’s also important to encourage staff to build strong, personal relationships with patients. In addition to staff as brand ambassadors, Dr. Wiley said you can empower patients to talk about your practice. Panelists also discussed their pearls for internal marketing.
External marketing, on the other hand, involves strategies aimed at attracting new patients to your practice through various channels. Dr. Loh mentioned specific tools and channels to do this.
Dr. Wiley emphasized that social media is a tool that can help humanize you to both the public and your staff, and it also helps you connect with a variety of people. Meanwhile, Ms. Jacobs noted the value of online reviews and the importance of taking the time to ask your patients to leave reviews.
Integration of both internal and external marketing is important because consistent messaging across internal and external efforts strengthens brand identity. Practices can use patient success stories from internal marketing in external social media.
Source: ASCRS
The implant journey
Dr. Thompson moderated a session about patients moving through the implant journey with other panelists William Trattler, MD, Nicole Fram, MD, and Dr. Tipperman.
During the session, Dr. Fram shared how she first approaches a patient, introducing herself when she comes into the room and making it clear that she’s going to reference the patient’s chart to make sure she’s up to date with the patient’s history. She also utilizes an AI scribe.
Dr. Thompson went over some dos and don’ts during the surgery experience. There can be a communication disconnect that can occur between doctors and patients, he said, and it’s the doctors’ responsibility to bridge that gap. He added that the team having eye contact and helping the patient feel cared about is important.
Discussion also shifted to the postop period, with panelists noting the importance of keeping postop instructions simple.
Ways to drive growth
Dr. Trattler, Dr. Loh, Mr. Jensen, and Ms. Davis highlighted some ways to drive growth in your practice, notably discussing referral networks. Some of the key pillars they discussed were building a strong referral network, enhancing your reputation within the community, developing community within your colleagues, and optimizing communication.
Building and strengthening a referral network involves engaging with primary care physicians, optometrists, other ophthalmologists, and/or medical specialties (like rheumatology, endocrinology).
Several panelists discussed how they have hired a physician liaison to help interface with and manage their community network. Dr. Loh called this representative in her practice her “one-point stop for referrals.” Mr. Jensen added that a liaison can speak on the practice’s behalf with the community and patients.
The panelists also discussed other tools and technology they use to encourage referrals, as well as the difference between a referral network and a comanagement network.
Diagnostic and IOL option deep dive
Following a rapid-fire session that presented several case scenarios and asked attendees to hold up cards for which IOL they would recommend, Dagny Zhu, MD, and Dr. Tipperman moderated a session focused on diagnostic tools that can help match the patient with the best implant.
The session covered the different technologies—and the nuances within different technological categories—that can help deliver premium outcomes. In addition, the moderators and panel also described the value of modern-day formulas that incorporate AI and tools that help facilitate patient education and streamline IOL selection.
A later presentation discussed the different advanced-technology IOL options from the enhanced monofocal IOL to EDOF to trifocals and the Light Adjustable Lens (RxSight). Dr. Zhu, who co-moderated the session, also said it’s important to understand the influence that IOL material can have on the patient’s vision and experience long-term as well. The session included several case examples and considerations for IOL selection in these scenarios.
Approach to patients
Robert Weinstock, MD, led a discussion on the fundamental approach to patients, noting some keys to help physicians choose the right option for their patients. The patient’s health and safety are the number one priority, he said.
Dr. Weinstock also detailed how the physician often must do “detective work” to figure out a patient’s history of glasses, contact lenses, and any prior refractive surgery, as well as change to refraction from cataract formation and activities, lifestyle, and how patients use their eyes on a daily basis. He noted that sometimes patients forget that they’ve had LASIK or don’t know to mention it.
Dr. Weinstock and other panelists also discussed finding the right solution for the patient and making a confident recommendation.
Ms. Barkey, commenting on the cost associated with some of these lens options, said that it’s important to try to pre-educate the patient on financing and the lens options available in the office. You want the patient to make the decision about where to invest in their future vision. You want the patient to know where they want to be when they get in front of the surgeon, and the surgeon can decide if they agree with this plan.
Dr. Weinstock stressed the importance of a team approach. If you want to build refractive practice, you have to have staff engaged and understand what you do, he said.
The session also highlighted some “magic questions” that physicians use to assess patients and determine their goals and needs.
Tools and the team
The rest of day 2 at the BRiCS Summit was formatted into several breakout sessions, both CME and non-CME, as well as two additional general sessions.
The “What’s in your toolbox?” general session reviewed key elements within each step of the patient experience cycle. “You want to ensure all the necessary tools are readily available to you and your team. You don’t want to miss your opportunity to make the play,” session moderator Ms. Davis said.
Ms. Davis referenced the BRiCS Resource Library, which includes tools for each step of the patient experience cycle. “We collectively, all of the faculty, donated the forms we use in our practices to the Resource Library,” she said. “They are critical to your success, and they are a great gift for you to have that.”
Another presentation focused on staying connected with patients in the postop period. The panelists in this session described the steps and techniques they take to make sure the patient still feels seen, heard, and cared for in the days, weeks, and months postop.
“This is a team approach. In office, we used to put everything on the surgical scheduler. … If we really want to do it right, we want to care for people, we need to learn from the people who are doing it the best,” Dr. Fram said, adding that all members of the practice team need to take part in making the patient journey better.
Managing difficulties and a focus on dry eye
Dr. Zhu, Ms. Barkey, Dr. Tipperman, and Ms. Johannesen discussed how to manage difficulties, and the types of difficulties physicians might encounter in the premium patient journey.
When patients pay out of pocket for these premium procedures, Dr. Zhu said there are higher stakes and higher expectations, and she added that you can do a perfect surgery and have an imperfect result.
Getting into discussing routine and complex problems, Ms. Barkey noted that you’re going to have problems, but it’s what do you do when the problem happens and how you handle it. She also emphasized the importance of listening to the patient, so the patient feels heard and understood.
You can proactively prepare for things like managing expectations and satisfaction, cancellations, and complications. The panelists also shared 10 tips to managing unhappy patients.
Saturday’s BRiCS program wrapped up with a discussion on tear film optimization. Dr. Fram led the session, highlighting treatments and diagnostics for dry eye and ocular surface disease.
Editors’ note: The speakers listed their financial interests within each session. Find all of their financial interests here.
