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Up Front | Apr 2005

When Fear Is the Factor

Understanding how to deal with this key emotion.

Fear is a word that has a broad definition. In refractive surgery, it is often said that there are only two obstacles to patients' having a procedure: price and fear. I agree, and this month, I want to explore the topic of fear in greater detail.

GETTING PERSPECTIVE

Early research into consumers' behavior related to refractive surgery exposed three sources of fear in patients: a fear of pain, a fear of going blind or experiencing a complication, and a fear of the procedure's failing to address their particular prescription. These concerns serve as barriers in consumers' decision-making process and are completely justified from their perspective. Providers, while not dismissing these fears, tend to address them from their own clinical perspective. For example, they may describe complication rates to patients by saying, “this problem occurs in fewer than one in 1,000 cases.” Although such an explanation is perfectly logical, it is much more reassuring to the doctor than the patient. Instead, you as the clinician should address prospective patients from their perspective.

Understand that the seemingly irrational fear patients feel for the safety and security of their eyesight is akin to that which parents feel for their children. Parents keep close tabs on their kids' whereabouts in order to guard them against even the most remote threats, rational or irrational. Although today's parenting norms may seem like overkill when compared with a logical, data-driven 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 surgery 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 positive news stories had demonstrated the procedure's efficacy. As the media began to focus on negative stories, however, consumers' concern seemed to shift from efficacy (“Will this improve my vision?”) to safety (“Will I have long-term problems?”). The fear of a surgical complication prevented a lot of people from going forward with LASIK. In addition, an abundance of low-price advertising created a new fear: that of being ripped off by the high fees charged by premium providers or conversely by discount providers who might cut corners to offer such low prices. Either way, consumers were totally confused, and marketers know that such confusion leads to inaction.

CAN TECHNOLOGY OFFSET FEAR?

The beginning of a turnaround for LASIK began in late 2003, with both total procedural volumes and average surgical fees increasing nationwide. Technology has fueled this revival by reducing the potential for intra- and postoperative complications. Customized LASIK treatments, which are touted as more accurate and precise than conventional LASIK, are addressing the night-vision–symptoms bogeyman that previously scared off many consumers. The femtosecond laser, which removed the microkeratome blade from the LASIK equation, also appeals to consumers' desire for a safer procedure. Surgeons and LASIK counselors have seen how these technologies, when properly explained, go a long way toward lessening patients' fears and helping them move forward in the decision-making process. This is especially true for those surgeons who have adopted the Intralase FS laser (Intralase Corp., Irvine, CA). They report both faster decision-making by refractive surgery candidates and higher rates of conversion to surgery (based on data from my report, Measuring the Impact of Femtosecond Laser Technology on Procedure Volume and Pricing, April 2003).

THE ROLE OF THE PROVIDER
Forming a Relationship

Refractive surgery providers need to better manage the prevalence of fear among consumers. In Figure 1, a model of the decision-making process shows where fear comes into play. In the awareness phase, the consumer's emotional state is one of hope: he has seen/heard the ads, read the stories, and talked to friends who zealously endorse refractive surgery. Being rid of glasses is an extremely attractive fantasy. But, when that consumer picks up the phone to inquire about the procedure, a mental switch takes place. His fantasy is replaced by logic, and all his “what if?” questions are immediately front and center in his mind. All of the caller's mental and emotional barriers are in place, and he is seeking verbal cues that give him permission to say, “no thanks,” and end the inquiry. This context should help you understand why that most common of initial questions—“How much does it cost?”—is not really about price at all. Rather, it masks the real questions that have to do with fear.

Trust: the Antidote to Fear

It is critical that the first phone call allow the caller and the counselor to form a bondMost providers tell me that their goal during an interested individual's first phone call is to schedule a consultation. A better goal would be to create an environment that begins fostering trust between the caller and your practice.

As in all relationships, trust is earned, not automatically given. In a brand new relationship between a caller and a LASIK counselor, trust is the proper foundation for everything else in the discussion: technology, pricing, safety, etc. The counselor earns the caller's trust by being honest, straightforward, and forthcoming. This goal requires the counselor to do much less talking about the practice and the procedure and much more attentive listening to uncover the caller's needs and motivations.

Business relationships that succeed do so because the client feels special, as if he truly matters. This is the key for your phone counselors, because making a caller feel special will go a long way toward building trust and reducing his fear so that he feels confident in proceeding. Some counselors build relationships naturally over the phone, whereas others need some practice. This skill is critical in an environment where the phone is usually the first means of contact with a prospective customer.

Combating patients' FEARs Is YOUR CHIEF CONCERN

In summary, providers need to take the fear factor much more seriously when counseling patients, especially during the initial phone call and visit. Empathy helps. As we've all seen, a low price can't squelch high fear. Technology is a factor in decision-making, but its importance to prospective patients is secondary to a bond of trust between them and the provider.

Shareef Mahdavi draws on 20 years of medical device marketing experience to help companies and providers become effective and creative in their marketing and sales efforts. Mr. Mahdavi welcomes comments at (925) 425-9963 or shareef@sm2consulting.com. Archives of his monthly column may be found at www.crstoday.com.

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