Interactive Refractive

mdobkowski January 24th, 2008

Lasik Price and Lasik Pricing Related Problems

Over the past ten years LASIK has become a very common form of laser vision correction. Millions of people have had successful LASIK eye surgery. More than 1 million Americans will most likely undergo LASIK surgery this year, and the majority will get improved vision. This relatively safe procedure can be very effective when provided by an experienced LASIK surgeon. With the success of this procedure has also come attempts to create the southwest airlines business model for LASIK. Although these corporate centers are not always successful, the state of the LASIK eye surgery business has moved closer to commodity levels. But has LASIK eye surgery become a commodity? Is this a good or a bad thing for prospective LASIK patients? What will this mean to the independent ophthalmologists and the small practices?

By definition a commodity is a homogeneous and undifferentiated product sold largely on the basis of price. Commodities are sold on price not on features and benefits or the quality nature of a product. Has LASIK eye surgery entered this realm? It is hard for me to grapple with the concept that this type of eye surgery has really met this level. It is hard for me to ascertain that someone would choose a low price for eye surgery over a quality surgical option. It does happen, however; the LASIK eye surgery business is not at the commodity stage yet! Some corporate LASIK centers would like prospective patients to think that getting LASIK is like buying sugar or electricity, however; the reality is that quality practices can still differentiate! Despite the surge of illegitimate LASIK advertising claiming “LASIK as low as $199.99″ or other bait and switch advertising techniques we somehow find the state of this medical procedure not in the depths of commodity, but in a position to add further differentiation. Although discount providers often advertise that LASIK is available for only a couple hundred dollars, many ASCRS members and leading market research experts, note and debate that the actual price of LASIK from a discounter averages $1000.00-$1500.00 per eye for the conventional procedure and in many cases higher than that for custom LASIK. (ASOA LASIK Marketing Roundtable ASCRS 2006)

There is no corporate center that has completely turned their business model into the southwest airlines of LASIK eye surgery. In fact many of these corporate centers have difficulty and have posted low earnings in years past.  The question for your practice becomes do we just surrender or do we differentiate and compete? As an Internet marketing consultant I hear a lot of stories about selling LASIK based on pricing and how unfair this is. The good news is that you still have time to differentiate your practice but the bad news is that you have to deal with misleading advertisers because Federal and State regulation is rare.

Misleading Advertising

Both Federal and State regulators have taken some action against misleading advertisers, but enforcement and regulation seldom occurs. It takes a lot of time and resources to pursue legal action against a corporation and not many doctors have this kind of time. The fact of the matter is that LASIK is surgery! Patients need a quality surgeon with experience and one that can determine candidacy! It still baffles me that lasik is still done on patients who are clearly not good candidates.

For More Information regarding deceptive LASIK advertising watch! Please visit www.savelasik.com

Can your LASIK Practice differentiate itself from the competition? TIPS for differentiating your practice

There are other differentiation ideas so check back with our website on a regular basis for NEW articles relating to differentiating your LASIK business.

1. Using Your Patients To Differentiate

Ophthalmology Social Search 101

In Internet marketing we are seeing increased results and awareness of social search usage. Social search can be detected on blogs, facebook, and even the new Kristin Cavaleri website developed by VISX (If you have not seen this it is a must see). I am often surprised to see very few patient stories on websites of refractive practices. This is a surefire way to differentiate your practice! Oftentimes practices will even have a book of letters at the practice. These patient testimonials need to become part of the overall differentiation strategy and eventually used on the Internet. With the increase in reality shows, and social networking it is important to grasp the value of a system geared toward attracting patients through this medium. There is a reason that word of mouth referrals dominate lead generation for practices all over the country.

2. Using EyeOR or Intraocular Refractive Surgery to differentiate your entire refractive surgery business!

Differentiate your practice with unique procedures

If we want to be able to offer refractive surgery to all perspective patients we must realize that LASIK alone will not get us there. For many years now the refractive surgery business has been under siege by price discounting corporate lasik centers driving this surgery to a near commodity level. The features and benefits of laser vision correction have become blurred. Product differentiation has been difficult for many practices to achieve. Bait and switch low priced advertising has been effective in attracting patients and the playing field has weak enforcement mechanisms to prevent this style of marketing. The overall effect is the commoditization of refractive surgery. With the advent of Intraocular multi-focal lenses,  practices now have a new opportunity to differentiate their offerings. SEE:  www.eyeor.com

3. Doing what is best for the patient!

Refractive surgery candidates come in many shapes and sizes with varying levels of age. Each candidate has a unique situation. Lasik is not right for everyone. By having a wide base of surgical choices for your patients you can open the door to a new value proposition. The new position is quite simple. Provide surgical solutions that are the best for each patient. If the patient is 50 years old they might consider refractive lens exchange, If the patient is very myopic with a thin cornea but young maybe consider the new Visian ICL. Practices can do a good thing for their patients by offering multiple solutions for their unique situation. As a surgeon you can feel good about suggesting the best procedure for them not the most convenient. This is the first step to differentiating your refractive surgery business.

4. Create a value proposition and differentiation statement

Practices need to review their current communication strategies and create a differentiation statement that will surely be different than others. Does your practice have a value proposition? If not you should consider spending a little time to create such a document and furthermore educate and train your practice employees as to the merits of such communication. If your team understands the goals of the practice and has methodology for implementing these ideas you may be surprised that your internal patients converting to LASIK increases or that your word of mouth continues to grow.

You may understand that LASIK isn’t a commodity and you may also know what separates you and makes you different from your competition. Have you ever asked your practice employees what the main points of differentiation for your practice are? Have you ever invited your techs and COTs to a marketing meeting that discusses the practice value proposition and differentiation statement? Your staff has direct contact with patients and routinely has the opportunity to educate patients and interject their opinions on the matter. If your employees are not empowered to do this then they will fail at delivering this information. A simple marketing meeting with a marketing manager may make a tremendous difference and as the practice makes progress in this area good things will happen.

5. Develop a great and informative ophthalmology website

Developing a nice website with great information, patient education, and easy to navigate page structures can not only help you find new patients, but it is a great method of practice differentiation. If you are a practice that uses state of the art technology but has a very ugly website, you have a double standard in effect. The patient will actually question the technological capability if you present a poor practice website just like they would if the office was dirty and messy. For a small cost any practice can have a nice and functional website. What you choose to do to promote the website is a whole other story (SEE Building Brand New Ophthalmology Websites Article)

There are many other differentiation ideas so check back with our website on a regular -basis for NEW articles relating to differentiating your LASIK business.

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Page Topics Include: Is LASIK a commodity?, LASIK pricing, LASIK commodity, alternatives to misleading LASIK advertising, differentiating your lasik practice, 5 differentiation TIPS for lasik practices, In office surgical suites, intraocular surgery suite consultants, LASIK patient testimonials, LASIK pricing

According to the FTC, an advertisement is deceptive under the Federal Trade Commission Act if it contains a material representation or omission of fact that is likely to mislead consumers acting reasonably under the circumstances. Advertisers are also responsible for claims that are reasonably implied from their statements. These rules apply to all advertisements, including consumer testimonials. In addition, advertisers must be able to substantiate all objective claims they make about a product or service.

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admin March 7th, 2007

STATEMENT OF PURPOSE

These guidelines are designed to assist ophthalmologists in providing
truthful, informative advertising of refractive surgery. In addition to
their ethical obligations, ophthalmologists must be mindful of the
legal obligations they have in connection with the promotion of their
services.

These guidelines are not intended to address every  possible
advertising claim that could be made in  support of refractive
surgery. The guidelines address  specific types of claims that
could confuse  consumers, and/or have been subject to FTC
review.  Examples of permissible claims, as well as claims 
that might be considered to confuse or mislead consumers, are provided.

LEGAL FRAMEWORK

The Federal Trade Commission Act, as well as similar state laws,
prohibits false and deceptive advertising. Advertising that is
literally true, but which conveys a misleading impression to reasonable
consumers, may be unlawful. Claims made implicitly in
advertising, as well as explicit claims, can give rise to deception.
Deception can also occur through the omission of information if the
absence of the information causes the advertisement to convey an
inaccurate impression about a material fact. Thus, ophthalmologists
should insure that statements made directly or by implication in
informational, promotional and advertising materials are accurate and
do not deceive consumers.

One issue of current interest concerns the advertising of "off-label"
surgical applications using an FDA-approved device (e.g. LASIK). The
decision to use the excimer laser outside the scope of the approved
labeling is considered, by the FDA, to be a
"practice-of-medicine" issue; that is, the FDA has recognized that
"Good medical practice and patient interests require that physicians
use commercially available drugs, devices, biologics according to their
best knowledge and judgment." Physicians should be aware, however, that
advertising of off-label use, while not specifically prohibited, is
also not protected under the "practice-of-medicine."

Definition of Advertising: In addition to print, radio and television
ads, other material such as patient informational brochures, seminars,
and videos may be considered advertising for purposes of these laws.
Privileged discussions between physicians and their patients are
generally not regulated by the FTC, but may have other legal or ethical
implications. Although seminars and brochures may be considered
advertising by the FTC, physicians do have a responsibility to
adequately inform patients about alternative therapies.

Accountability: Physicians and other advertisers are legally
responsible for the truth and accuracy of their advertising, even if it
is prepared by an ad agency or other third party.

Substantiation: Medical advertisers, particularly with respect to
surgical procedures, are held to a higher standard than those who
advertise consumer products. The FTC requires that advertisers have a
"reasonable basis" for advertising claims at the time they are made.
With respect to health and safety claims for surgical procedures such
as RK and PRK, this will usually require "competent and reliable"
scientific evidence which may include, depending on the claim, the
physician's own outcomes alone or in combination with other clinical
studies. Such clinical evidence is generally considered to be stronger
if the study has been peer-reviewed and/or replicated in other studies.
The advertiser must have adequate substantiation for a claim at the
time the claim is made.

Informed Consent: Advertising need not, and as a practical matter
cannot, incorporate all of the elements of appropriate informed consent
disclosures. FTC staff has stated that certain advertising claims may
require disclosure of material information appearing in informed
consent forms (see below, Example 1, SAFETY CLAIMS). Also, advertising
may not contradict disclosures of risk made in informed consent forms
and informed consent forms will not compensate, legally or ethically,
for misleading statements made in advertising.

Testimonials: A patient endorsement or testimonial will be construed by
the FTC as a representation that the particular patient's experience is
typical or representative of the experiences generally achieved by the
physician's patients, unless there is a clear and conspicuous
disclosure to the contrary. In addition, physicians should be aware
that some states prohibit the use of patient testimonials by physicians.

ADVERTISING CLAIMS

Prospective refractive surgery patients have differing needs and
expectations and may experience differing surgical outcomes.
Accordingly, advertising claims are not a substitute for discussions
between the ophthalmic surgeon and a prospective surgery patient
regarding the patient's own needs and expectations and the range of
possible outcomes.

EFFICACY CLAIMS

Example 1: Printed at the top of a newspaper ad is the banner:
"Throw Away Your Glasses!" A reasonable consumer may infer from this ad
that he or she will be permanently free of all forms of corrective
lenses (for presbyopia and hyperopia as well as myopia) as a result of
the surgery. Even if the ad makes reference to nearsightedness, there
is a substantial risk that a significant number of consumers would
infer from the ad that if they underwent the procedure, they would
achieve 20/20 vision and would be free of glasses, including glasses
for reading or occasional use. Since the surgeon cannot guarantee that
the prospective patient would be
permanently free from all glasses, the claim is subject to legal challenge.

Example 2: A print ad headline states, "Throw Away Your
Glasses," or features a drawing of spectacles within a circle with a
line crossed through it. Other text within the ad states that
Refractive Surgery "may correct your nearsightedness and astigmatism
and may eliminate your need for glasses or contacts." Although the use
of the word "may" is intended to qualify the "no more glasses" claim,
the claim is likely to be understood by consumers, in light of the more
prominent headline or drawing, to be as unqualified as in Example 1. To
avoid confusion, the overall message of an ad should not be
inconsistent with the "fine print" qualifiers. A further modification
of the above claim, such as: "may correct your nearsightedness and
astigmatism and may allow you to function without glasses or contacts
for many activities," avoids possible ambiguities about the need for
reading glasses or glasses for occasional use.

Example 3: A radio ad includes the text: "See naturally with
refractive surgery!" The reasonable consumer would interpret "seeing
naturally,"or similar terms such as seeing clearly to mean "seeing
without glasses." Again, this kind of claim should be avoided for the
same reasons as for Examples 1 and 2, above.

Example 4: An ad picturing a smiling patient and physician
states: "If you can read the small print, but can't see well at a
distance, visit Drs. Smith and Jones to learn more about RK (or PRK)–
our typical nearsighted patient — after refractive surgery– no longer
needs glasses for many activities." Such an ad is acceptable. It
suggests that RK or PRK will treat only nearsightedness and informs
consumers about the possible need for glasses for other activities.

Example 5: An ad states: "98% of our patients see 20/40 or
better postoperatively — good enough to pass a driver's test in most
states!" Since the ad explicitly claims a result for a particular
physician group's patients, the physicians will need a study or
analysis of patient records to substantiate the claim. In addition,
this ad might be understood by some consumers to mean that since they
can pass a driver' s vision exam, they might not need to wear glasses
for other activities. This potential problem with the ad could be
eliminated by a reference to the fact that patients may still need or
desire glasses for some activities.

SAFETY CLAIMS

Example 1: An ad states: "Find out more about PRK — the safe
and easy alternative to glasses!" The terms "safe" and "safe and easy"
have attracted the concern of the FTC, as have promotional materials
that fail to disclose certain risks that may be considered to be
important by a prospective patient. Generally, it is not appropriate
for an ad to state that RK or PRK is safe and easy. Any ad that
suggests that RK or PRK is safe should include a qualifying statement
such as: "Like all surgery, RK (or PRK) surgery has some risks; we will
discuss these with you during your consultation."

In addition, it is the position of the FTC staff that advertising
containing certain claims may also need to contain relevant disclosures
in order not to be considered deceptive. An FTC staff document relating
to RK and PRK advertising expresses the following admonition:
"representations made about safety or efficacy of RK or PRK may, in
certain circumstances, require disclosures of material information
about health risks or limitations associated with the surgery to
prevent deception. For example, an advertisement containing express or
implied representations that the surgery is safe may also need to
contain information about any significant risks associated with the
surgery, and for PRK, with the particular laser in use."

Example 2: A print ad states that, "unlike other procedures, PRK
laser vision correction doesn't involve knives or cuts to the eye."
Although it is true that the Excimer laser does not use a blade to make
incisions on the surface of the eye, the statement could be misleading
to consumers by suggesting that PRK is a non-invasive procedure. It is
not appropriate to claim or suggest, expressly or through use of
euphemisms such as "treatment," "therapy," or "vision correction," or
"enhancement" that RK or PRK are anything other than invasive surgical
procedures.

While differentiation between refractive procedures may be appropriate
in order to inform consumers, it should done in a way so as not be
misleading; both RK and PRK are surgical procedures and this should be
made clear to the reader of the ad.

Example 3: An ad states: "The Food and Drug Administration Has
Determined That the Excimer Laser We Use Is Safe and Effective for PRK
Laser Surgery." Such an ad is not acceptable. The Federal Food, Drug
and Cosmetic Act forbids references to the FDA-approval status of any
medical device in advertisements.

PERMANENCE AND PREDICTABILITY CLAIMS

Example 1: An ad states: "Achieve permanent vision correction
with refractive surgery!" A reasonable consumer may assume "permanent"
to mean that their post-surgical refractive result will remain stable
throughout their lifetime. FTC staff has raised questions with issues
of the possibility of regression, drift, and possible instability
long-term, and has objected to permanency claims because of their
belief that studies of modern refractive surgery techniques available
at the time of their review did not adequately substantiate such
claims. At this time, physicians considering making claims of
permanency or predictability should be aware that this advertising will
be carefully scrutinized by the FTC. Accordingly, physicians should
avoid permanency claims unless they are able to substantiate the claims
on the basis of their own surgical outcomes alone or in combination
with current scientific evidence.

Example 2: "Visit the Smith Laser Center and leave with 20/20
vision!" This ad is problematic. A reasonable consumer could interpret
this advertisement to mean that the surgeon can guarantee,
pre-operatively, exactly what the patient's surgical outcome will be,
i.e. that refractive surgery results are predictable. To advertise
surgical predictability, physicians must be able to substantiate that
surgical outcomes are predictable in virtually all of their cases.

The use of ranges, e.g. "80 percent of our patients have 20/20 vision
following surgery," is acceptable if the surgeon can substantiate the
claim.

SUCCESS RATE CLAIMS

Example 1: "90% of RK (or PRK) patients achieve 20/40 vision or
better." If this claim is based on a clinical study, the surgeon making
the claim will need to assure that the study is scientifically reliable
and that he or she is performing the same procedure using the same
protocol as that involved in the study. If these criteria are met, the
claim would be acceptable as long as the surgeon's own outcomes did not
vary significantly from the reported results.

"PAINLESS" CLAIMS

Example 1: An ad states: "PRK surgery is a safe and painless
procedure." A reasonable consumer could understand this statement to
mean that the entire experience — preparation, surgery, and recovery
– is painless. Patients undergoing refractive surgery
typically experience some pain and discomfort for a short time
following surgery. Patients are often given prescriptions to deal with
pain or discomfort. In these circumstances, "painless" claims are
almost certain to be considered false or deceptive.

________

As with any other surgical procedure, new information and technology in
refractive surgery can be expected to evolve over time. Accordingly,
these guidelines are subject to periodic review and revision to ensure
that they reflect the latest information and
technology in refractive surgery.

These guidelines were developed and endorsed by:

American Academy of Ophthalmology
Approved, Board of Trustees, February 1997

American Society of Cataract and Refractive Surgery
Approved, Executive Committee, February 1997

International Society of Refractive Surgery
Approved, Board of Trustees, March 1997

Outpatient Ophthalmic Surgical Society
Approved, Board of Trustees, February 1997

Society for Excellence in Eyecare
Approved, Board of Trustees, February 1997

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mdobkowski May 21st, 2006

By Michael Dobkowski

Choosing a credible SEO company in ophthalmology is critical to your life as a practice. The importance of this will continue to grow, as the Internet becomes the clear driver of refractive patient volume within marketing. Making a mistake on this level could land you a lawsuit or the act of getting black listed by the search engines. After several years of the ophthalmology web development companies (Ones present in industry shows) figuring out SEO, most of the legitimate companies have learned to practice white hat techniques. It is not worth the risk for either these companies or the doctors to try and cheat the search engines. The concern lies more with practices working with companies that A. do not understand ophthalmology, B. do not have a clue about SEO.

Inexperienced companies might committ a black hat SEO technique without even knowing it. LASIK tends to be the most polluted aspect of ophthalmology search engine positioning. Currently today there are several bogus lasik websites that have no clear goal but to gain position and deceive the search engines. This is like driving 85 miles an hour. Sooner or later these sites will be discovered. The increasing amount of link farms in lasik is concerning and leading to cluttering of page 1 results on google. Sometimes it is hard to find one website on page 1 for a term that is a practice site not a directory or a link farm.

Michael Dobkowski is an ophthalmology practice marketing consultant for Glacial Multimedia Inc. If you need assistance with an Internet strategy please contact us 207.878.5900

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