When you gain experience and become comfortable with advanced IOL technology, you can match it to what patients want for their visual outcomes. With technology you believe in, you can be confident in recommending the best implant for your patients. For some, at the end of the consultation, after all the education and conversation, their best option may be manual cataract surgery with a monofocal lens.
But, starting with a refractive plan, as your go-to, first option, makes the conversion to laser cataract surgery and also premium IOLs, naturally increases.
Consistency and the refractive package
It is important to have a consistent message with patients. Most consultations are going to take about the same amount of time in terms of your education, patient questions and testings. Even if patients have multiple questions, answer what you can, and tell them they can write down additional questions for the surgery counselor for you to answer at the preoperative visit. You can feel comfortable sharing much the same message with all of your patients, and consults become smoother and a strong recommendation is easier to make.
Importantly, focus on offering laser cataract surgery, astigmatic correction and the range of premium implants as a refractive management package or charge a refractive management fee. Because you cannot charge patients a 'laser fee', as per most insurance guidelines, it is crucial you stay consistent and compliant with regulations. Use proper terminology for your paperwork and in your explanation to patients of what they are paying for, indicating that the additional costs — the laser, etc — relate to refractive fees and ensure patients understand that.
Tie it up in a bow
Even if you feel that the patient understands your recommendation, pause and summarize the information at the end of the discussion, quickly restating it. Phrase it candidly: “OK, to summarize, what I recommend is ... .” Here I review my vision plan and which technology I am going to use to get them to their desired outcome quickly. With that, patients are generally satisfied with the information, and feel good about going to schedule with the surgery counselor.
Stay tuned to this space for a deeper dive into tips for further patient education, pearls for success with laser cataract surgery and surgical case examples showing specific tricks I have learned.
Disclosure: Younger reports he is a consultant to Johnson & Johnson Vision.