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Eye Docs Focus on Marketing to Attract Lasik Patients.

AT THE LOWELL MEDICAL CENTER in Benton County, potential candidates for the hottest form of laser eye surgery can get an up-close look at the procedure: A television monitor in the waiting room enables them to watch the operation as it's being performed a few feet away.

Boozman-Hof Regional Eye Center Clinic in Rogers advertises the experience as a "live Lasik seminar," says Sheri O'Hearn, refractive surgery coordinator there. The seminars, which began about two months ago, have drawn an average of about 35 people. A few months earlier, Dr. Randy Ennen's Ennen Eye Center in Fort Smith had taken the same tack.

Such demonstrations are perhaps the most attention-getting of various efforts to seize a share of the market for Lasik, a procedure that lasts less than 30 minutes but can cost well over $1,000 per eye. With that sort of money involved, competition for patients can prove intense. The fact that that insurance rarely covers any of the cost also contributes to rivalry for patients' ears and eyes.

Ophthalmologists' marketing approaches in Arkansas tend to run the gamut from free sales seminars and radio and television ads to videos and billboards dominated by eyes that change color. Most practitioners have their own Web sites, such as and

And, of course, there are the live seminars, which conclude with the presentation of the patient himself -- mildly sedated with Valium for the standard 15-30-minute operation -- for audience questions.

How it Works

Lasik stands for laser in-situ keratomileusis. The procedure treats the inner tissue of the cornea and permanently reshapes that component of the eye to overcome nearsightedness, farsightedness or astigmatism.

The procedure is done on an outpatient basis. The eye is first numbed with eyedrops, and the patient is given a mild sedative. The surgeon uses an extremely fine blade, or microkeratome, to cut a thin flap -- 160 microns, about the thickness of three human hairs -- on the cornea's surface, then delves through the flap into the tissue with a laser to change the cornea's shape. After that, the flap is restored to its original position and smoothed over, taking about two days to heal around the edges.

The live seminars in Lowell began about two months ago, Boozman-Hof's O'Hearn said. Before that, the clinic relied more heavily on TV and radio advertising, but now it's cutting back on those media. Each seminar has yielded about five patients, more than the clinic was realizing with traditional seminars.

The live seminars that Ennen's clinic held last year were great successes, refractory consultant Alisha Wallace said, drawing standing-room-only crowds to the 50-capacity office and producing 50 to 65 patients. Ennen charges about $1,500 per eye for Lasik.

Boozman-Hof's charge is $1,800, which includes all fees, such as pre- and post-operative care, O'Hearn said. The laser that the clinic uses, and shares with about three other ophthalmology practices in town, is owned by Unity Health.

Fees of around $500 to use a surgical facility and $100-$150 to use the laser itself are typical for Lasik, though longtime ophthalmologists say the newest generation of practitioners are more likely to buy their own machines. That's about a $400,000 purchase, says Dr. J.E. McDonald II of McDonald Eye Associates in Fayetteville. And the microkeratome used to make the incision in the cornea costs some $55,000.

An ophthalmologist for 25 years, McDonald was one of the first in the country to perform Lasik, starting about 5 1/2 years ago. He has done the procedure on about 1,200 eyes. He also uses the operating facility and laser owned by Unity Health in Lowell.

Given the expenses involved, as well as the fact that the customer is being asked to pay for a purely elective procedure, marketing is now a fact of life, McDonald said.

"People would not know what Lasik is today if it weren't for marketing," he said.

McDonald started performing refractive surgery -- such as RK, radial keratotomy, where microscopic incisions are made around the center of the cornea to treat nearsightedness -- about a decade ago. At the time, getting the word out "was really a problem," he said. "It was really hard for me and every physician, I think, to begin thinking of marketing."

But there is a huge capital outlay involved in getting started, coupled with the laser manufacturers' practice of charging per procedure -- a high tech "vending machine," unique in the health care industry. It quickly became obvious that a high patient volume would be necessary. And patient volume required marketing.

For McDonald, that's helped generate up to 25-30 Lasik surgeries on any given Thursday, the day he performs the procedure, leaving the weekend for patients to recuperate.

In addition, with elective surgery, as opposed to a necessary medical procedure, patients must be informed beforehand as much as possible. That's another important function marketing campaigns fulfill, McDonald said.

Stacey Treat, whose duties as McDonald's director of patient relation ships include coordination of marketing, says the marketing cost to bring in one patient can total $150-$300 or more.

Taking Another Look

While insurance companies do tend to treat -- and thus decline to cover -- the procedure as elective, some insurers in California are taking another look, said Dr.

Vahid Feiz of Little Rock. Such companies have begun adopting at least partial coverage after weighing the cost of the surgery against the prospect of paying for decades of glasses or contact lenses, Feiz said.

The Harvey and Bernice Jones Eye Institute at the University of Arkansas for Medical Sciences in Little Rock brought Feiz in last year to start a refractory surgery center. He holds seminars once or twice a month, and the institute promotes the procedure through brochures, pamphlets, newspaper and TV ads and e-mails to other doctors.

The Jones institute's fee per eye -- $1,800, including all follow-up sessions and care for a year -- is about average for the area, though some clinics charge slightly more and others considerably less.

In Fayetteville, McDonald's clinic charges an "all-inclusive" fee of $1,995 per eye, Treat said. The fee used to be $2,200 but was reduced because of local competition.

"We're not the cheapest surgeon. We don't believe in nickel-and-diming.

"The scariest thing is, [laser eye surgery] has become commoditized," Treat said.

Mass-Marketing Vision Care

He compared the trend to Wal-Mart's addition of vision centers at some of its larger stores, raising mass-marketing of vision care to an entirely new level and driving prices down by buying glasses and contact lenses in such volume that single practitioners have difficulty competing.

"That's transferred over to eye surgery," Treat said. He dismissed televised viewings of the procedure as "a gimmick that's been done in larger cities," where Lasik centers can be found in malls.

Some clinics advertise prices as low as $999 per eye. But that tends not to include pre- or post-operative care, a preliminary exam or any needed retreatments or subsequent visits. Also, over-coming astigmatism or nearsightedness can carry an additional charge.

At one point, Treat said, the McDonald clinic concentrated its marketing efforts on radio and television. That gave way to free seminars, promoted by flyers inserted newspapers and followed up by a print ad, which worked well for a while before cost-effectiveness concerns arose.

The seminars went from drawing 40 to 50 prospective clients to attracting five to 10. If the larger gatherings spawn five clients, that's cost-effective, Treat said. As the numbers dwindle, though, "you start spending all this money, you get no return," he said.

Hampton Roy Eye Center at the Baptist Eye Center at Baptist Health Medical Center-Little Rock reports somewhat better results from its seminars. One held May 15 after being advertised with a flyer in the Sunday Arkansas Democrat-Gazette attracted 14 people. The session lasted about 30 minutes, including a slide show, comments by Roy, and group and individual question-and-answer sessions with the ophthalmologist.

About 70-75 percent of those attending such gatherings decide to proceed with either cataract or some variety of refractive surgery, Lasik included, said Roy's laser consultant, Patti Cahoone.

Roy's clinic charges $1,800 per eye. "There's a couple that's higher, a couple that's lower ... we try to be midlevel, but we're not going to lower our prices to compete," Cahoone said.

Along with TV and radio ads, Roy's clinic began attracting attention last summer with a billboard featuring eyes on which the color changed every few weeks. "We had several thousand calls," including some from clinics in other states expressing interest in using the same approach, Cahoone said.

At Arkansas Eye Surgery in the Baptist Eye Center, Dr. Frank Teed performs Lasik using the same laser as Roy. Teed's best-known advertisement may be a billboard on Interstate 30 in south west Little Rock featuring Matt Mosler, former co-host of KATV's Daybreak program.

Once they're in the office, "we show a video to every patient," said Jo Butler, who oversees advertising for Teed's clinic. "That's pretty much all they would want to see ... it's very informative."

Too, an "online seminar" -- the equivalent of a slide show, complete with audio -- is available on the clinic's Web site, www.arkansaseye .com.

Teed's clinic charges $1,495 per eye.

"We have an adequate profit margin in there," Teed said. "The patient is getting a good value ... we feel like we make up in volume what we lose in profit per procedure."

Dr. RandyBodiford's Bodiford Eye Center in Fort Smith, Clarksville and Grove and Vinita, Okla., charges only $999 an eye -- a price made possible in part by the fact that the clinic is buying its own laser, a VISX Excimer, said Pam Grabe, who oversees Lasik arrange ments there. An additional $150 en hancement fee is charged per eye if the doctor determines that further improve ment is possible once the surgery's full effect can be discerned. For $1,100 an eye, the enhancement fee is included.

Less Invasive Procedure

Another clinic buying its own laser is the Laser Vision Correction Center at the Eye Surgery Center of Arkan sas, in Jonesboro. That clinic charges $1,700 per eye, said Chris Blanchard, practice administrator. Laser Vision Correction Center's marketing cam paigns, mainly conducted on radio, are designed just to let "people to know it's available here, not just Memphis or Little Rock," he said.

For all the battles over the Lasik market, Teed sees another hot concept on the horizon -- Lasek, which is less invasive than Lasik and involves using a laser after raising the much thinner epithelium, which consists of the cornea's surface cells. With Lasik, the flap measures about 30 percent of the cornea's 550 micron thickness. The epithelium measures some 40 microns, one-fourth of the Lasik flap.

Using the same laser employed in Lasik, Teed charges $200 less per eye to perform Lasek, which he says re moves any possible complications from the lap incision.

"I think we'll end up doing half and half," he said. "I suspect that for a long time there's going to be a place for both of them."
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Title Annotation:Boozman-Hof Regional Eye Center Clinic
Comment:Eye Docs Focus on Marketing to Attract Lasik Patients.(Boozman-Hof Regional Eye Center Clinic )
Publication:Arkansas Business
Geographic Code:1USA
Date:Jun 4, 2001
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