Paul M. Stubenbordt focuses his blog on what steps a practice can take to optimize traditional and Internet marketing, public relations, social media as well as non-traditional marketing tactics that can help maximize your current practice development program.

The importance of a great surgical counselor in your cataract practice

One of the most valuable employees in modern ophthalmology is the surgical counselor. Not having the right person could cost your practice by not optimizing patient conversions for premium IOLs, blepharoplasty or refractive surgery.

I spent the early part of my career as a surgical counselor and have trained dozens nationwide. I have personally seen how the right surgical counselor can ultimately change a practice. Although I recommend hiring a surgical counselor with an extensive sales or customer service background, most practices hire from within. This is normally OK, but it can take a while to teach “communication” vs. an overview of ophthalmology to a new surgical counselor. Sometimes, surgical counselors hired from within can never fully grasp the art of speaking to patients, and in this case, I recommend placing them back in their previous position and hiring/promoting someone with potential.

A case study

I recently visited a practice in Florida that had two surgical counselors, one of whom was recently promoted from technician. He was very excited and felt confident with his background that he could do a good job. His intent was good, but after listening from one room over, it was obvious he needed help. The first patient I heard him speaking with was a cataract patient. This patient wanted a multifocal IOL and was deemed a good candidate by the surgeon. The patient walked into the counselor’s office and said, “I want the multifocal IOL. The doctor said I qualify!” The new surgical counselor said, “Well, let’s go over your lens options. There is a variety including the toric lens, which can help with your astigmatism, thus improving distance vision, plus this option is less expensive.” When I heard this, I almost fell out of my chair! The surgical counselor went on to explain, “Do you drive a lot at night? If so, multifocal lenses can cause a lot of nighttime glare.” Although the surgical counselor tried his best to inform the patient of “cheaper” options and the “risk” associated with multifocal IOLs, this particular patient did his research and chose the multifocal implant.

During the consultation, I had an audio device in the room recording every word. After the patient left, the surgical counselor and I went over the recording and without me saying a word, he knew what he did wrong. He said, “Oh my gosh, the patient said he wanted the multifocal! I’m didn’t even hear that!” I discussed the importance of “listening” and how it pertains to gaining patient trust and confidence. I explained that when seniors sense the slightest amount of hesitation or lack of knowledge, they lose confidence.

We spent the next hour going over how premium IOLs can really change someone’s quality of life and how we’re not “selling.” We’re helping people realize they have worked hard and they deserve to do this for themselves.

Lastly, we role-played various scenarios such as a truck driver who needs cataract surgery and an active 66-year-old tennis player who doesn’t like using reading glasses at lunch with her friends. Eventually, it “clicked” for this surgical counselor. In just 3 months, he increased his conversion rate and was confident when he spoke with his patients.

Tips for new refractive counselors

  • Use a lifestyle questionnaire. This lets the patient tell the office and surgical counselor if a premium IOL is for him.
  • Listen to the patient.
  • Use financing as a tool to make upgrades affordable.
  • Don’t go overboard in trying to “sell” these lenses. I always tell patients if it’s something that fits their budget, it’s something they should strongly consider.
  • Make sure the patient realizes it’s something he will use every waking moment for the rest of his life.
  • Get educated on all of the IOL options.
  • Know the IOL benefits and side effects.
  • Role-play! This is critical to getting a smooth approach down pat when talking with patients.


You don’t need a salesperson. You need someone to help your patients overcome their hurdles and choose a procedure that will help improve their life every waking moment for the rest of their life. Having the right, well-trained person in the surgical counselor seat can mean a healthier bottom line for the practice and, most importantly, happier patients in the community.