Yari has questions for Vance Thompson, MD: When to offer your patients premium lenses

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I'm Yari, and I have questions. And this is Dr. Vance Thompson, and he has answers. Let's see if they match. Hey, Vance, thanks for being with me today.
Yeah, thank you, Yari.

Congratulations on your appointment as president of ASCRS. I'm so excited to see what you do and how the organization flourishes under your leadership.
Thank you.

Well, today, my questions for you are about premium surgery. How can surgeons educate patients and really talk about the value of premium lens technology, and really deliver that range of vision for patients? And I thought maybe we'd start with, so you're an innovator. You've been working with these lenses for a very long time. What is your approach to offering premium technology to patients? Do you offer it to everyone? Do you offer it only to a select group of patients? What's your approach?

Well, you know, all of us doctors just simply want to answer our patients' needs, and do it in the safest, most effective way possible, and this is where patient education is so important. So, all of our patient education materials are fairly well-themed and coordinated, so the patients understand that they're going to be hearing about, in a sense, both technologies. Traditional, which we would call a monofocal implant, or advanced, which we would call a premium implant. And I think the best way to start is really, first of all, analyzing the patient and getting to know them, and analyzing their eye, and yes, they've heard about premium implant technology, but if they have AMD, or they have something with their eye that they're not going to have it, I want to be able to give them a good reason at the beginning of our conversation so that they don't feel bad that I left it out of the conversation. And still the majority of my patients do a monofocal implant. I'm about 60% monofocal, 40% presbyopia-correcting implants, but I start out with first, having them understand what their lens used to do, provide reading range and clarity, and then what it's lost, first reading range, and now clarity, and that's why we're here today. And you can replace one or both. And I think it's really important that patients understand first, the reason there's different technologies, because we're removing cataracts at a younger and younger age because our diagnostics are showing us that this is what's frustrating the patient, this early cataract is affecting their low-light image quality and their joy. And if you're taking out a 62-year-old's cataract and putting in a monofocal implant and giving them the reading range of an 80-year-old, well, they need to understand that there's something they're going to lose also. So sometimes, people get frustrated that the increase in clarity is also accompanied with this reduction in range. So, they really like to understand their options so that they can replace both issues, or one.

Great, I love that. So, when you are offering to patients, so you're offering it, if I heard you correctly, you're offering it to everyone that qualifies, it doesn't matter. You want to give them the opportunity to decide,  and you've got a host of tools for patient education. What about the rest of your team? How do you make sure your team is aligned and is sharing that same message of value of investing in vision, and the benefit of adopting a premium technology?

Great, well, that's where it all begins, you know, after the doctor educates themselves, they need to educate their team. And we spent a lot of time, to tell you the truth, on retreats and morning huddles, and a whole bunch of ways that we can educate our team. As far as the docs, we're all like-minded in how we approach cataract surgery, asking patients, "Do you want to do a lot with glasses, "or do you want to do a lot without glasses?" So we all have a fairly similar philosophy that we spend time with our team so that we know it's consistent in the organization.

That's great. So, what advice would you have outwardly for your colleagues that maybe are not at this point in time offering to all patients that qualify? What confidence or advice would you give them on gaining confidence or overcoming the barrier of reserving that and not offering it?

Yeah, well, studies show that over 90% of patients, probably even over 95% of patients, will follow their doctor's recommendation. That's how powerful it is. And studies also show that over 40% of patients are interested in presbyopia-correcting lenses for themselves. And so, when 10% of patients right now are getting a presbyopia implant, and over 40% of them want one, there's a disconnect, and I feel like it is doctor confidence. And the doctors I talk to, they're talented surgeons, they know how to take out a cataract, put in an implant. Where they start to get intimidated is the business of now going from third-party reimbursement to, you know, patients investing in their own healthcare. And with reducing reimbursements over the last decade, and this growth in premium, it's been amazing to me how being comfortable with the technology, and 40% of our patients choosing it, what it's done for the health of our practice, to, you know, fund technologies that even help our Medicaid patients. And so, I think the practice of the future is one that, you know, understands how to deliver both third-party pay and cash pay medicine, and the ASCRS recognizes that. We're at this annual meeting, where over 90% of what we learn is clinical and surgical, and less than 10%, maybe even smaller, is the business of what we do. And in medicine, we don't get taught the business of what we do.

Sure.

Yeah, and so, the ASCRS is having a course the last weekend of May on the business of refractive-cataract surgery, on the business of premium implant surgery, going through the whole patient experience cycle, with a lot of tools to help practices gain that confidence to close that gap between 40% of patients wanting it and 10% of them getting it.

That's fantastic. I think that makes so much sense. And as technologies evolve, practices need to evolve. You go to medical school for medicine, to be able to be that expert. So sounds fantastic that there's going to be programming to help build up that other skillset on the business side.

Right.

Fantastic. All right, so Vance, this my hardest hitting question for you of the whole conversation, so thank you and don't worry, you'll be okay. I'm curious, who's your phone a friend? When you have questions, when you need to think through something, who do you call?

Right, well, I'm afraid I call the same person that a lot of people call: Dick Lindstrom.

Yeah.

And you know, I have amazing partners, you know. I can call John Berdahl because we share an office. And I can call Mike Greenwood, Russell Swan, Brandon Bartman, Deb Ristvedt. I could go on and on. I have an amazing group of partners, but when we can't figure it all out, we call Dick.
Nice, I love it. All right, well, thank you so much, Vance. I think you did a great job answering my questions. I hope you guys agree that he did a great job. Thanks so much for joining us.