1. TODAY’S PRACTICE
When Fear
Is the Factor
Understanding how to deal with this key emotion.
BY SHAREEF MAHDAVI
Fear is a word that has a broad defini-
tion. In refractive surgery, it is often said “[Fear] drives the behavior of
that there are only two obstacles to
patients’ having a procedure: price and refractive surgery patients and
fear. I agree, and this month, I want to outweighs the rational data every time.”
explore the topic of fear in greater detail.
G E T T I N G PE R S PE C T I V E one in 1,000 cases.” Although such an explanation is
Early research into consumers’ behavior related to perfectly logical, it is much more reassuring to the doc-
refractive surgery exposed three sources of fear in tor than the patient. Instead, you as the clinician should
patients: a fear of pain, a fear of going blind or experi- address prospective patients from their perspective.
encing a complication, and a fear of the procedure’s fail- Understand that the seemingly irrational fear patients
ing to address their particular prescription. These con- feel for the safety and security of their eyesight is akin to
cerns serve as barriers in consumers’ decision-making that which parents feel for their children. Parents keep
process and are completely justified from their perspec- close tabs on their kids’ whereabouts in order to guard
tive. Providers, while not dismissing these fears, tend to them against even the most remote threats, rational or
address them from their own clinical perspective. For irrational. Although today’s parenting norms may seem
example, they may describe complication rates to like overkill when compared with a logical, data-driven
patients by saying, “this problem occurs in fewer than analysis of risk, just try telling that to a young mom or
dad. A similar emotional response (fear)
drives the behavior of refractive surgery
patients and outweighs the rational data
every time.
FEAR AND THE MARKET
I conclude that the dip in refractive sur-
gery procedural volume experienced in
the US from 2001 to 2003 had more to do
with consumers’ fear than anything else.
By 2000, consumers’ awareness about
LASIK was extremely high, and many posi-
tive news stories had demonstrated the
procedure’s efficacy. As the media began
to focus on negative stories, however, con-
sumers’ concern seemed to shift from effi-
cacy (“Will this improve my vision?”) to
Figure 1. The milestones for refractive surgery line up with the typical con- safety (“Will I have long-term problems?”).
sumer’s decision process. Each step is marked by a different emotional state The fear of a surgical complication pre-
of the consumer that the clinician needs to manage properly. vented a lot of people from going forward
APRIL 2005 I CATARACT & REFRACTIVE SURGERY TODAY I 91

2. TODAY’S PRACTICE
with LASIK. In addition, an abundance of low-price Trust: the Antidote to Fear
advertising created a new fear: that of being ripped off It is critical that the first phone call allow the caller
by the high fees charged by premium providers or con- and the counselor to form a bondMost providers tell
versely by discount providers who might cut corners to me that their goal during an interested individual’s first
offer such low prices. Either way, consumers were totally phone call is to schedule a consultation. A better goal
confused, and marketers know that such confusion would be to create an environment that begins foster-
leads to inaction. ing trust between the caller and your practice.
C A N T E C H N O LO G Y O F F S E T F E A R ?
The beginning of a turnaround for LASIK began in late
“Making a caller feel special will go a
2003, with both total procedural volumes and average long way toward building trust and
surgical fees increasing nationwide. Technology has reducing his fear so that he feels
fueled this revival by reducing the potential for intra- and
postoperative complications. Customized LASIK treat-
confident in proceeding.”
ments, which are touted as more accurate and precise
than conventional LASIK, are addressing the night- As in all relationships, trust is earned, not automati-
vision–symptoms bogeyman that previously scared off cally given. In a brand new relationship between a
many consumers. The femtosecond laser, which removed caller and a LASIK counselor, trust is the proper foun-
the microkeratome blade from the LASIK equation, also dation for everything else in the discussion: technology,
appeals to consumers’ desire for a safer procedure. pricing, safety, etc. The counselor earns the caller’s trust
Surgeons and LASIK counselors have seen how these by being honest, straightforward, and forthcoming.
technologies, when properly explained, go a long way This goal requires the counselor to do much less talk-
toward lessening patients’ fears and helping them move ing about the practice and the procedure and much
forward in the decision-making process. This is especially more attentive listening to uncover the caller’s needs
true for those surgeons who have adopted the Intralase and motivations.
FS laser (Intralase Corp., Irvine, CA). They report both Business relationships that succeed do so because
faster decision-making by refractive surgery candidates the client feels special, as if he truly matters. This is the
and higher rates of conversion to surgery (based on data key for your phone counselors, because making a caller
from my report, Measuring the Impact of Femtosecond feel special will go a long way toward building trust and
Laser Technology on Procedure Volume and Pricing, April reducing his fear so that he feels confident in proceed-
2003). ing. Some counselors build relationships naturally over
the phone, whereas others need some practice. This
T H E RO L E O F T H E PROV I D E R skill is critical in an environment where the phone is
Forming a Relationship usually the first means of contact with a prospective
Refractive surgery providers need to better manage the customer.
prevalence of fear among consumers. In Figure 1, a model
of the decision-making process shows where fear comes CO M B AT I N G PAT I E N T S’ F E A R S I S YO U R
into play. In the awareness phase, the consumer’s emo- C H I E F CO N C E R N
tional state is one of hope: he has seen/heard the ads, In summary, providers need to take the fear factor
read the stories, and talked to friends who zealously much more seriously when counseling patients, espe-
endorse refractive surgery. Being rid of glasses is an cially during the initial phone call and visit. Empathy
extremely attractive fantasy. But, when that consumer helps. As we’ve all seen, a low price can’t squelch high
picks up the phone to inquire about the procedure, a fear. Technology is a factor in decision-making, but its
mental switch takes place. His fantasy is replaced by logic, importance to prospective patients is secondary to a
and all his “what if?” questions are immediately front and bond of trust between them and the provider. ■
center in his mind. All of the caller’s mental and emotion-
al barriers are in place, and he is seeking verbal cues that Shareef Mahdavi draws on 20 years of medical device
give him permission to say, “no thanks,” and end the marketing experience to help companies and providers
inquiry. This context should help you understand why become effective and creative in their marketing and
that most common of initial questions—“How much sales efforts. Mr. Mahdavi welcomes comments at (925)
does it cost?”—is not really about price at all. Rather, it 425-9963 or shareef@sm2consulting.com. Archives of his
masks the real questions that have to do with fear. monthly column may be found at www.crstoday.com.
92 I CATARACT & REFRACTIVE SURGERY TODAY I APRIL 2005