I've been hearing a lot about LASIK volumes lately. Reports of surgeons' monthly averages being off one third or even two thirds are not uncommon, a far cry from the rapid growth of the past few years. At the same time, the economy is teeter-tottering right before us. What's going on here?

IT'S NOT THE ECONOMY
There is no question that a faltering economy is going to impact LASIK volumes across the board. However, the main reason being given for the stagnant growth is that LASIK is a consumer product, subject to the same up-and-down cycles as other big-ticket items. Apparently, cars, personal computers, and now LASIK are all subject to the same forces of the national economy. This doesn't ring true; LASIK is too new and lacks the sufficient penetration necessary to be called ?mainstream? just yet. Compare LASIK with the auto industry. My next-door neighbor, who owns a GM dealership, is smiling for the first time in months. Why? Because even in this slow economy, October was the best month for car and truck sales in over a decade. It was zero-interest financing, not dire need, which caused so many to spend more than forty grand for a brand new Suburban.

IT'S ABOUT FOLLOW-UP
Rather than point the blame at external forces, this current lull in consumer demand should cause refractive surgeons to look within their own four walls. Want a key reason why LASIK volumes are so low? Just look at the lack of attention paid to those who have previously expressed some level of interest. If you were in sales, your manager would call this “poor follow-up.” Most practices that offer LASIK can be classified into one of two camps: they either fail to follow up with interested patients altogether or they fail to do it well.

THE LAW OF THE HARVEST
Farmers have long known the effort it takes to produce abundant crops at harvest time. There is a long waiting period between planting and harvesting full of specific activities needed to help crops grow. Imagine the farmer who tills the soil, plants the seeds, and then comes back sometime later expecting a bumper crop—not gonna happen. But this is how most LASIK ?farmers? approach interested patients—by failing to stay in touch with them—and it violates what real farmers know as the law of the harvest.

Admittedly, administrators from some of the highest-volume LASIK practices and centers in the country have indicated that they were simply ?too busy? to contact people who had expressed interest in the procedure. Incredibly, if the patient didn't sign up soon after the initial contact, he was forgotten. Those were the days of ?easy pickins? for LASIK farmers. They could rattle off the number of surgeries they had performed and (sometimes) the number of leads they had generated, but they had no idea what was happening with everyone ?in between.? Those days are over; it's time to pay attention to everyone in between.

BECOMING A CUSTOMER
Suppose you considered every person who asked for LASIK information as a customer from that very first moment (rather than when they had the procedure). This slight shift in attitude would cause you to focus much more intently on everyone who enters the system, and to keep track of where they are in the decision-making process toward undergoing LASIK. It is far less expensive to keep a customer than to obtain a new one. That's why it's so important to keep track of every patient who calls, regardless of their level of interest the first time they call or see you.

One practice on the West Coast figured out early on that it was costing them approximately $200 in marketing for each eye that underwent LASIK. They began sending postcards to those who had expressed interest but had not yet had the procedure. The postcards were creative, simple, and spaced out over several months. Total cost per customer? $4. Over time, this practice has nearly eliminated front-end marketing (paid advertising), and now focuses on back-end marketing (conversion of existing leads from referrals). My guess is that most practices can't or won't do a similar tactic because they are ?too busy.? It's unbelievable just how many practices are willing to spend the $200 to generate the lead, but can't see their way to spend a couple of bucks to turn it into a procedure.

The way to create these results is through a well-organized lead-tracking system that automates the process of follow-up. With a PC and a $100 software program, you can let go of index cards and scraps of paper with names and phone numbers. The only thing that is automatic, however, is the reminder of what needs to happen and when (send thank-you letters, call to confirm surgery date). Effort is still required to capture and enter the data, print and sort letters and labels, and make the phone calls. This requires commitment from the top (that means you!) and adequate training on how to use the software.

HIGH PERSISTENCE, LOW PRESSURE
Those who have lead-tracking and follow-up systems often become frustrated because they don't see every patient saying ?yes? after they receive that magical follow-up letter. You won't see plants grow right after you water them—it takes time and patience. The goal of follow-up is not to instantly book surgery, but to help that prospective patient move at least one step closer by addressing needs.

Good follow-up can be characterized as “high persistence, low pressure” that is spread across several media (newsletter, phone call, e-mail) and leaves most of your prospects feeling good. Such persistence may sound pushy, but the problem plaguing the industry is too little information rather than too much.

It's a new year, and perhaps some of you farmers out there will resolve to offer better care to your crops before trying to harvest them. Follow the law of the harvest, and you won't go wrong.
Next month, we'll tackle the tricky area of technology and why it often backfires as a marketing tactic.
Shareef Mahdavi is a business consultant focused on helping clients improve their marketing. He formerly headed the marketing efforts of VISX, and is based in Pleasanton, California. Mr. Mahdavi may be reached at (925) 425-9963; smahdavi@attbi.com