Yari has questions for Arjan Hura, MD: Turning team shortcomings into strengths

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Hi, I'm Yari, and I have questions. And this is Dr. Arjan Hura, and he has answers. Let's see if they match. Hey Arjan, thank you for joining me today.

Good morning, Yari, thank you so much. It's always a pleasure.

You know, I'm so excited about what we have coming in our space and there's been so much momentum building on the premium channel that I just have a lot of questions about how you as a practicing physician are talking to patients about premium. How do you communicate the value of investing in their vision? So, I wanted to get your take: How are you talking to patients about, you know, investing in premium technology?

That's a great question. I think everyone sort of wants to understand how they can improve their patient access to premium technology and how they can get more patients to invest in that technology. But I think it's important before we go down that route to acknowledge two things. One, not everyone is a candidate for premium technology.

Fair.

And so, patients who have preexisting ocular pathology, glaucoma, macular degeneration, dry eye, if they're more than just mild, if it's anything towards moderate severe, a lot of the times, a lot of these premium options that we'll discuss, they just don't work that well. As patients build up is high expectation in their heads, they get this technology and then they're unsatisfied or unhappy afterwards. And a lot of that can be avoided, which is proper patient selection. The second thing is, not everyone wants premium technology and options. And so, there can be a bit of a mismatch. If all the patient wants for example is to get cataract out and see better and they're happy wearing glasses or contacts afterwards, if the person who's talking to them is really trying to pitch them the benefits of the technology, and that person's not listening to the patient, there's going to be this disconnect where the patient feels like, well, you're not listening to me, you're trying to force this on me. It's almost like a used car salesmen type of feel. So, I think it's always important to go forward with these things with good ethics, doing what's right for the patient. The patient should always come first. But, if the patient is open to it, that's when I think there's a lot of benefits to exploring this technology, yeah.

So that's great, really uncovering those personal motivations for why they're in your chair makes total sense. How do you do that in an efficient manner?

Yeah, that's a great question because these ophthalmic visits sometimes are quite long, right?

Sure.

We get automated measurements in clinic, then you get a refraction, then sometimes you get corneal imaging, and then depending on what the refractive procedure's going to be, you might get biometry after that as well. There's a lot of patient counseling, there's so many different procedures, which is a great thing. But figuring out how to do that in an efficient manner, is good not just for the patient but for the staff as well. And I think there's a lot of things that can be done before the patient ever even enters the clinic. And so, depending on the practice, depending on the environment, depending on the patient population coming in, there's a lot of benefit I think to utilizing pre clinic visit education. And whether that's in sending the patient videos beforehand, sending them informational pamphlets, or just sending them links to websites that you've created that have the educational content there. It allows the patient to almost do some homework so that when they come in, they've already had one round of priming. And then from there on, I think it's really important that, not just the techs or the surgeon, or the optometrist, I think it's important that everyone is educated in the clinic to some degree. So, if a patient, they're being walked up to the front desk and they remember a question they have all of a sudden, maybe the surgeon or the optometrist isn't there but someone else can answer that. And so we try to really cross-train our staff in all areas so that the patient feels like everyone is very knowledgeable about everything.

I think that's great. Two things that really struck me from what you just said that I want to kind of highlight here, is number one, that prework that you send to patients. I think is so important because everyone has access to Dr. Google.

Yep.

And, if you send them information, they're for sure getting the information that is the most relevant. You never know what you're going to get when you roll the dice. You know, except for the algorithm, what Google does. But, you know, this way you kind of ensure they're getting the right information to come armed with.

Yeah, and it might seem daunting, it might seem a lot of work, but the good thing is, if you're not motivated to create your own content you can partner with industry. And almost every big company that's offering some form of refractive technology, they have videos that they've made. And so, you can customize them a little bit to your liking, and if you like them, then you can send those to patients. Or you can do everything from the ground up.

Yep, that's great. I think the other one beyond that that I wanted to also touch on as well that you mentioned was, just that importance of your staff being able to handle questions. Do you ever do a secret shop? Do you ever, you know, have people check out how your team is doing and make sure everybody's on the same page?

It's so funny you ask that, literally one year ago at ASCRS, I was previewing some AI technology and some future things that can be done in terms of patient relations, and we secret-shopped my practice on the spot.

 Oh, no way.

And the results were very revealing. And literally, 36 hours later I went to the staff, and I said, "Okay, this is what happens. None of you knew this took place, but I secret-shopped our own practice and these are the modifications we're going to make." So, I think there's a lot of value there. Just having that mindset of growth and never resting on your laurels and always being motivated to continue to improve in all aspect of the practice I think is very beneficial. Because the nature of refractive surgery is that it is very dependent on technology. And technology is always changing and always growing. So, there's always going to be a new IOL that comes out. There's always going to be a new version of a laser vision procedure that comes out. It's important for the surgeon not only to be educated, but for the staff to be educated as well. And I think, looking at every aspect of the process of the patient journey, whether that's just the education, or, how people are responding to patient calls over the phone. How emails are being responded to. That's all very beneficial in uncovering areas of weakness that could be improved. And sometimes you have to secret shop and not let your staff know what you're doing.

Yeah. I'm sure they were a bit surprised when they found out after the fact. But did they find that empowering? How did you make sure that that didn't make them feel like they were somehow being judged?

I was so impressed with my staff because the immediate reaction wasn't, "Oh why did you do that?" It was, "Okay, here's a solution to what was uncovered." And then within 24 hours, we had implemented it.

That's great, yeah, make sure it's solution oriented, not, you know, "Why did you do this?" More, "Let's be better."

And then to your point, I think it's important to, when you uncover a weakness or you find something that could be done better, you know, this is just basic human relations. I think it's important to tell people like, this is, it's good that we discovered this problem. It's not an indication that you did something wrong, or you made a mistake, or you screwed up, but here's an opportunity for improvement, let's work on this together to shore up this weakness and turn it into a strength.

Yeah, absolutely. I think you know; crisis is an opportunity or challenges are opportunities to refine and get better at how we do things. So, I'm curious about the, you know, digging directly into the patient conversation, there's a lot of different … you offer a lot of premium technologies. Are there any specific ways in which you'd describe the value to patients and why that investment in their vision makes sense and is going to pay the dividends for them?

Yeah, that's a good question. Let's take the example of a multifocal IOL. Most people are utilizing a multifocal IOL to get a patient out of glasses or contact lenses. Now a patient may not understand the value of that, in you simply saying, "Okay this is going to get you out of glasses or contacts." That might not quite register with them. And so, I think it's important as a physician to really do a good history, and that way you're talking to the patient, you're figuring out what they do on a day-to-day basis. Do they read with their glasses on, glasses off? For most of their life are they glasses free, and then when they enter their 40's and 50's then they became dependent on glasses? What do they do for work? What are their hobbies, what are their passions? Walk them through their day. And as they’re visualizing what they do on a day-to-day basis, they may appreciate, “Okay, it might actually be beneficial to be out of glasses. I thought I'd be okay with it before but, now that we're talking about it, you know I really do enjoy swimming a lot, and it is a pain having to wear contact lenses because they may come off and then everything is blurry, so that would be nice.” And so, I think just doing a good job taking a basic history, it's so simple. It's the first thing you learn about when you're learning basic patient interactions in medical school. Sometimes you just want to get through it quickly, just to talk about the surgical aspects, but really, just getting to know the patient and taking the time to do that. I always tell my staff, it's okay if we're running a little bit behind because I'd rather we give every patient a premium experience.

Sure.

Because if a patient feels rushed or a decision is come to and then after surgery the patient's not happy because that wasn't the right technology for the patient, those just prolong clinic visits, and now all of a sudden, you're really getting behind. You have a lot of unhappy patients. It makes sense just to do everything right off the bat.

Love it. So many great pearls. Thank you so much for sharing. I have one last question for you. It's the hard hitting one. Do you listen to music while you're doing surgery? And if so, what?

It's so funny, I get this question almost weekly in the operating room.

No way.

Because sometimes I'll work with different anesthesiologist, different circulators, and they'll say, "Dr. Hura, what would you like to listen to?" And I'm just so focused on surgery, I almost block out whatever is playing. It brings me out of my flow state and then I'm like, listening to things. So, I tell the staff, whatever you want to listen to. Because if the staff is happy, the day's going to go smoothly, the patient flow will be great, and we'll just keep moving along.

Teamwork makes the dream work.

That's right.

I love it. Well, thank you so much. I think you did a fantastic job answering my questions. Really appreciate you being here today. I hope you all agree that we got some great answers to these questions. Thanks for joining us.

Thanks Yari, appreciate it.