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by Rich Daly EyeWorld Contributing Writer S urgeons interested in expanding the vision treatment options for their patients to include premi- um refractive options face a variety of obstacles. "There are obstacles but there are ways to overcome them," William B. Trattler, MD, Miami, said during an EyeWorld CME Edu- cational Symposium, "Crossing the Finish Line: Launching Your Premi- um Technology Practice." One of the biggest obstacles to surgeons gaining access to new tech- nology options Dr. Trattler has seen is a lack of influence by individual surgeons over capital purchase de- cisions at their practice. Such a lack of influence over capital equipment decisions was cited as the leading barrier by 15% of attendees at the symposium. Although he only has a 1% ownership stake in a diverse mul- tispecialty practice, Dr. Trattler has had success in convincing its leaders to undertake capital investments in technology he thought would help his patients. How did he do it? "I had to make a case that bring- ing the technology into the surgery center would be financially positive for the center," Dr. Trattler said. He explained how each type of technology the surgery center adds could increase case volume, which it needs to stay profitable. For instance, when his surgery center agreed to bring in a femtosecond la- ser-assisted cataract surgery system, it was credited with a 17% increase in overall cataract surgical volumes in the first year and another 15% increase in the second year. The in- creased volume was enough to cover the cost of the new technology. "You won't be successful if you are not passionate about the tech- nology for you and your patients," Dr. Trattler said. Surgeons can gain that comfort through training offered by the device manufacturer's certification process, where the first cases are proctored at an open access center. Additionally, Dr. Trattler suggest- ed finding mentors who they can observe and ask to observe their first cases. Increased comfort for surgeons with premium refractive technology can come by first focusing on the technology most likely to provide positive results. "If you are ready to build a premium technology practice, the low-hanging fruit is toric IOLs," said Elizabeth Yeu, MD, Norfolk, Va. Toric lens recipients are some of the happiest IOL recipients postop, but surgeons have succeeded in tapping only 7% of the potential popula- tion, according to financial market research firm Market Scope. Dr. Yeu suggested starting with easier cases, including patients with Overcoming obstacles to premium options Dr. Trattler says one of the biggest obstacles he has seen to surgeons gaining access to new premium refractive technology is a lack of influence by individual surgeons over capital purchase decisions at their practice.