BLOG: Four lessons about communicating the message of advanced implants
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This year marks 20 years since the first effective presbyopia-correcting lens implants were introduced to the U.S. market. And 18 years ago, a CMS ruling allowed us to offer these extra-cost implants to patients with Medicare.
We’ve learned many lessons in that time, not only about how to succeed surgically but also about how to communicate with patients about the prospect of these lenses. Here are the four most important lessons I have learned in this time.
- Talk with everybody. If history has taught us one thing, it’s that patients don’t want to be sold to, but they do want to buy. Once patients understand that their lens implant will “set” their vision forever, at least 80% want to hear what their options are, according to multiple market research studies. Don’t shortchange patients by skipping this conversation based on your assumptions about the patient. Even patients who are not candidates deserve to know that the “advanced” category of lenses exists but that it would not be a good choice, given their visual limitations.
- Discuss options, but not too many. It’s a mistake to try to explain every different lens option and tell the patient, “It’s up to you.” The patient trusts the doctor to do the surgery. He or she certainly trusts the doctor to recommend one or two lens options, possibly with different costs, to meet future needs. Making a recommendation is much easier if you have some background information on the patient’s visual lifestyle and desires. This could be the Dell questionnaire. Several commercial products allow even more detailed insights into this, and in the near future, systems like Alcon’s SMARTCataract platform will even make recommendations based on AI guidance.
- The doctor should discuss cost. Let’s face it, these lenses are expensive, and for most patients it’s a significant financial decision. But their lens choice also has a significant lifestyle impact. Understanding cost is as important to the patient as understanding the benefits and limitations of the lenses they are considering. By far, the doctor is the most credible source of information in the office, and hearing approximate cost figures from the doctor allows the patient to process all the information at one time.
- Be unapologetic about limitations. Unfortunately, we have no perfect lens implants, and we have very few perfect eyes to implant them in. Patients need to understand what their IOL and what their own eyes are capable of. “Your eyes are not 22 years old, so you’re not going to heal like a 22-year-old,” I often say to patients. I frequently show them their OCT or topography images to let them understand and “own” the comorbidities that could affect their outcome. I tell every patient there can be no guarantees of outcomes with medical procedures, and they should expect a year of healing before they get to see their “final” vision. They will appreciate your honesty and remember this conversation after surgery if they are having challenges.
To patients considering cataract surgery, the conversation about visual expectations is just as important as the one about risks of surgery, and if one word best describes the tone that should govern both discussions, it’s honesty. To be sure, there are many other lessons about using advanced lens implants that lead us to the high success rates patients enjoy today. For so many of our patients, these steadily improving technologies work “miracles” that they will enjoy every waking moment of every day for the rest of their lives.
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