Many baby boomers have spent the last few years denying that their gradual loss of vision is impairing their ability to enjoy daily activities. By the time these individuals muster up the nerve to respond to the advice of their primary eye care provider, friends, or family to do something to improve their vision, the last thing on their mind is surgical upgrades. Although patients once simply responded to their doctor's orders, they are now presented with lifestyle lenses, out-of-pocket procedures, and a resulting multitude of decisions to make. In the mind of the consumer, refractive and cataract surgery are complex. Ophthalmologists therefore must use finesse when communicating information to patients about how to reduce their dependence on glasses and/or contact lenses.

EDUCATION AND COMMUNICATION
Communicating the technological merits of a procedure or a particular IOL in your advertising or marketing campaign may be far too much information for patients who are just beginning to consider their options. Conversely, if the vital components of a choice premium IOL are not broached until the time of the doctor/patient discussion, the patient is less likely to understand his options for advanced lens technology. The patient simply has not had enough time to process the information. Timing is critical.

MEMORY
In his book Physician Success Secrets: How the Best Get Better, Greg Korneluk states that 50% to 80% of the information provided by clinicians is instantly forgotten by patients¹ and only 50% of their recall is correct. If patients accurately remember only 25% of what you tell them in general, imagine how that percentage decreases when the information conveyed has little to do with what they expected to hear. It is no wonder that patients' adoption of refractive IOLs is slower than the demand perceived by industry.

For patients to participate in the decision to restore their vision, the clinical and educational aspects of the process must be memorable or experiential. Like the dynamic structure (Figure 1) of a play, the conversation about a patient's surgical options should be broken into stages. Not all information should be communicated during the initial exposition.

EXPOSITION: THE CATARACT CALL
A new cataract patient calls your office and says, "My doctor mentioned that I have cataracts and that I need to see an ophthalmologist." In most cases, he will be scheduled for a cataract consultation with you or the optometrist, and he may be informed about paperwork or that his pupils will be dilated. Unless he receives an inkling of the important decisions awaiting him, his dramatic storyline has not begun. He will be far less likely to embrace the idea of advanced IOL technology at the point of service.

What if, as an alternative opening act, when the new patient calls, the staff offers him a cataract consultation but stresses that cataract surgery is a big decision because of the available range of visual options? What would happen if an employee also stressed to the patient the importance of his researching his surgical options before the consultation by visiting the practice's Web site? What if the employee also mentioned that the patient would receive a packet of information on the decision-making process? In my opinion, these steps increase patients' ability to participate meaningfully in their surgical care. Communicating too much information over the phone, however, could overwhelm the patient.

CONCLUSION
The decision to undergo vision-correcting surgery is a big one for patients. The range of technology available can confuse and frustrate them. By staging patients' education like a theatrical production in which their initial interaction with your staff represents the exposition, you and your team can help patients make a quality decision on their care.

Matt Jensen is the director of Vance Thompson Vision in Sioux Falls, South Dakota, and is a certified Experience Economy expert. Mr. Jensen may be reached at (605) 328-3903; jensenmp@sanfordhealth.org.

1. Korneluk G. Physician Success Secrets: How the Best Get Better. Boca Raton, FL: International Council for Quality Care; 2004.?