Building a Successful Refractive Surgery: Targets Acquired

Medical school and business school are two very different things, but running a clinic is by definition running a business. So, while the subjects doctors learn in med school are crucial to the understanding of their work, they’re only half the battle in many cases. And although most doctors don’t set out on their career journey thinking they’ll be businesspeople, that’s often where they end up. 

Thus, understandably, many doctors could use some business advice, and that’s why we’re here today. Media MICE CEO Matt Young hosted a discussion entitled “How to Build a Successful Refractive Practice,” with some actionable takeaways and nuggets of insight. 

Of course, it wouldn’t be a panel discussion without panelists. These were:

  • Dr. Andrea Russo, medical director of the Centro Oculistico Bresciano in Brescia, Italy
  • Dr. Anton van Heerden, director of Armadale Eye Clinic in Armadale, Australia, among other titles
  • Dr. Claudine Pang, consultant ophthalmologist and medical director at Asia Retina in Singapore and co-host of the panel discussion
  • Dr. Maghizh Anandan, a refractive surgeon at Optegra Eye Health Care in Derby, U.K.
  • Dr. Vardhaman Kankariya, a refractive and cataract surgeon at Asian Eye Hospital and Laser Institute in Pune, India

With our introductions out of the way, let’s get going. You can find the full video below, followed by the rest of the article.

Get Investments and Know Your Value-Add

What do you do when you don’t have money and you’re starting a clinic? This is a common problem, but Dr. Andrea Russo shared how he got started from scratch. 

Dr. Russo started a collective with two colleagues who invested in him, allowing him to pay a small amount to begin. A doctorate is a valuable investment draw, so reaching out to financial institutions, colleagues, or even venture capitalists can be a solid move. Whatever the case, getting the start-up cash you need to begin is the first step to a successful practice. 

But how on Earth do you operate a private practice when your country offers free nationalized health care? That’s the case for Dr. Russo, whose main competitor is Italy’s national health system. 

To stand out, he said, you have to have the absolute best tech and provide serious added value over what patients can get from the free system. For Dr. Russo, that means reinvesting to upgrade equipment — in his case, the Visumax® femtosecond laser (Carl Zeiss Meditec, Jena, Germany), the MEL 90® excimer laser (also Zeiss), the LUMERA® microscope (also also Zeiss), CALLISTO eye® Computer assisted cataract surgery, and the IOLMaster 700® (also also also Zeiss). 

As he put it, “The best technology is now here in my practice because I want to be sure to offer the best to my patients. The best for your patients is the best for you as a doctor. Patients will refer more patients and you may become a key opinion leader.” Valid point, Dr. Russo. 

Breaking into Markets and Allying with Optometrists

Building a Successful Refractive Surgery: Targets Acquired
There are many paths to opportunity, but navigating those routes takes some creativity.

Dr. Anton van Heerden’s clinic had an interesting beginning. As he explained, the status quo in Melbourne was firmly entrenched — ancient and well-established practices dominated the market. So, they had to offer something different. In his case, the clinic decided to offer both SMILE® (small incision lenticule extraction) and PRESBYOND®, which gave them a definite leg up on the competition. 

Marketing SMILE was built in, and Dr. van Heerden took good advantage of what was available. Australia, and Melbourne in general, has huge amounts of international students, many of whom are Chinese. SMILE surgery is very popular in China, so the marketing was already built in. 

Additionally, working closely with optometrists and forming a pleasant working relationship has helped his practice considerably. He’s had many referrals from more rural areas of Victoria thanks to his optometrist contacts, and he encourages patients to go back to referring optometrists for further checkups. He also suggested offering SMILE surgery to optometrists — at a very discounted rate. Those same optometrists will likely further refer patients your way, making everyone happy. 

Dr. Pang’s Rules for Building a Practice

Looking for a well-thought-out bullet list of rules for building a practice? Look no further. Dr. Claudine Pang is all over this one. 

  1. Talent. You need to attract talented people in their respective fields — the more talented, the better. There’s a simple way to do this: good remuneration. Pay well to attract top talent and ensure their personal development.
  2. Team. As she said, “I believe that a doctor is only as good as his or her team. If the doctor rolls out really good treatment but there’s poor supporting staff and poor customer service then the entire patient experience is compromised.” A team needs to be coherent and match the doctor’s high standards. Dr. Pang tries to involve her team in meaningful projects outside of work to help build team spirit. 
  3. Technology. Dr. Pang concurs with Dr. Russo that technology is the key to a good practice. We can leave it at that. 
  4. Training. Dr. Pang trains her team regularly in equipment use, maintenance and customer service to ensure a consistent high standard of care. 
  5. Customer service. Simply put, when patients feel like they’re the most important person in the clinic, they’ll be happy. 
  6. Value-add. Look for ways to add value to patients’ lives. Dr. Pang recently created a mobile app to help people conduct self eye assessments, make reminders and more. Such an app really helps with marketing and helps separate her from her competitors. 

Building a Clinic in the UK: Working with the NHS

The NHS is a big deal in the U.K. As Dr. Anandan noted, around 90% of all medical treatments in the U.K. are performed by the NHS. 

The system works a bit differently there than many other countries. As Dr. Anandan pointed out, optometrists work as the first point of contact for patients who will go on to ophthalmologists — working effectively as primary care physicians for the eyes. 

Dr. Anandan began working with the NHS as a cataract surgeon in 2010 before beginning his refractive practice. Working with the NHS helped Dr. Anandan build trust with optometrists who felt confident in further referring patients his way. Like Dr. van Heerden, most of Dr. Anandan’s patients are referred by optometrists. So, a good working relationship is key. 

Dr. Anandan also has a very unique setup — he owns his own clinic, but it’s housed in a private eye hospital in Derby. Again, working relationships have been key for Dr. Anandan. 

When it came to equipment, Dr. Anandan didn’t have to overthink it. “It was fairly straightforward to go with Zeiss for most of the equipment. Zeiss probably has the broadest vision portfolio amongst all the other providers.” Having SMILE and PRESBYOND helped Dr. Anandan offer significantly more than many other ophthalmologists in his area, and the broad range of IOLs including torics and AT LISA didn’t hurt either. Dr. Anandan also pointed out that the Zeiss FORUM and the EQ Workplace planning tool as well as the support team have been hugely helpful in managing his practice. 

How Ophthalmic Surgical Tools Broaden the Market

Building a Successful Refractive Surgery: Targets Acquired
Tapping into new markets can be a bullseye for a refractive practice.

Dr. Vardhaman Kankariya brought up an excellent point — one of patient psychology. As he pointed out, there’s a huge untapped market of potential refractive patients who have been sitting on the fence for many years. SMILE offers them an opportunity to help them off the fence and get the refractive surgery they have been unsure about. 

Compared to LASIK, Dr. Kankariya sees a big difference in the way patients view SMILE. The short recovery time combined with the lack of a flap makes reluctant patients much more willing to get laser surgery. 

He also noted that the average patient’s mindset has changed over the years, and now they act more like consumers. In that case, they’re seeing procedures as business — and are looking for procedures that are extremely safe. 

Dr. Kankariya also suggested there are millions of untapped presbyopia patients that can be treated by refractive practice. He’s absolutely right: Being able to successfully dig into this market would be an absolute goldmine for any refractive practice. 

A Brief Look at the Future and Social Media

All in all, the future looks pretty bright for refractive surgery. As Dr. Anandan said, people are considering their health more than before. Many patients are working from home and are more aware of their eyesight, for example, and are more willing to spend up to make sure their eyes are in top condition. Now is a good time to reinvest in a clinic in the form of marketing and retooling to keep ahead of the curve. 

As for social media? Most doctors concurred that Google was the most important medium for patients. Dr. Russo suggested age-targeting social media platforms, with Facebook for older patients facing cataracts or presbyopia, and Instagram for younger patients looking at SMILE or LASIK. Dr. van Heerden even has a TikTok account, though he swears he doesn’t know how to use it. This may be an odd question to end on, but we will: What does having to have a TikTok account mean for the future of ophthalmology, and medicine in general? We shudder to think.

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