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How can ophthalmologists and practice staff deliver world-class medical consultations?

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How can ophthalmologists and practice staff deliver world-class medical consultations?

That will be the topic for discussion when Rod Solar of LiveseySolar Practice Builders presents a masterclass during the ESCRS Practice Management and Development Programme at the XXXII Congress of the ESCRS in London, UK, on Saturday September 13.

The day-long masterclass has been designed to help ophthalmologists understand the importance of the consultation process and, more importantly, that they deliver this message to their patients.

“Consultations involve the active and cooperative participation of every team member,” said Mr Solar. “Often, people hired into clinical positions in ophthalmological practices are not commercially aware and resist the idea of selling, even in a private setting."

Mr Solar suggests that doctors can increase their conversion rates by an average of 50 per cent after adopting his techniques.

“There are a number of questions that ophthalmologists need to ask throughout the consultation process,” he said. “They need to understand their patients’ emotional wants and rational needs. Patients will have questions about the costs and the risks of individual procedures and it is very important that the ophthalmologists and their practice staff are able to answer these questions convincingly,” he said.

“Today's patients are very knowledgeable and have high expectations of the service they should receive. During the masterclass, we will discuss how to greet your patients, how to make them feel at ease and how to understand their needs and wants, especially their emotional wants. Then, we’ll discuss how to build a scaffolding of logic to support emotional decision-making that sticks.”

For the ophthalmologists who are leading the practice, said Mr Solar, it is very important to have good staff with good social skills working in the clinic or hospital.

“You may be a great listener but you may not be good at answering questions succinctly or speaking about money or organising and following up on appointments,” he said. “That is why it is important to recruit staff that can help you deliver world-class medical consultations.”

While some ophthalmologists may argue that they do not need special training in delivering consultations, Mr Solar said there are key reasons that they should develop these skills.

“If doctors believe in what they are doing, they will want more people to benefit from it, with or without money as part of the equation. Some doctors may be in salaried positions where they do not get paid any more money for doing more procedures but if they see more patients, more people will benefit from the procedures the doctors are offering,” he said. “Their skills will also improve when they are doing more of what they are trained to do.”

One misconception that some ophthalmologists may have, said Mr Solar, is that training in delivering consultations is best suited to large practices. “I would argue that if you are on your own you must be a good communicator. Large practices have the luxury of spending a lot more money on marketing and they have a lot more patients coming through their practices. The smaller your resources, the greater the imperative to make the most of them, which means converting as many consultations into treatments as possible.”

Good consultations also save time, said Mr Solar. “Nobody wants to waste time, whether you are big or whether you are small. A lot of patients are expecting free consultations before they agree to a procedure so it is important that you try and convert as many of these consultations into procedures.”

Building trust

Arthur Cummings MB.CHB, FCS(SA), FRCSED, consultant ophthalmologist at the Wellington Eye Clinic in Dublin, Ireland, says good consultations are essential for a successful practice.

“The way you greet the patient, by looking at them and smiling immediately establishes a better rapport,” he said. “You have to connect emotionally with the patient. Instead of asking ‘Do you want to get rid of glasses?’ or ‘Do you want to see better?’ you must find out what is motivating your patients.

“They may tell you, ‘I want to be able to swim with my kids.’ If you probe further you may find that they can’t see their children in the swimming pool, so that becomes a security or safety issue for them.”

With every procedure, said Dr Cummings, there is an element of fear involved and it is essential to have a good relationship between the doctor and patient to build up trust. “That first consultation is crucial and if you don’t have a good consultation, you are not going to build up trust.”

Dr Cummings said it is also essential that every member of staff in the practice or hospital is part of the consultation process. “Everybody needs to be sharing the same message. They need to be positive and reassuring. When we recruit staff to our practice, one of the first things we look for is a positive attitude.”

Leader or follower?

Some of the best consultations are delivered by doctors who are good leaders and this is a theme that will also be discussed at a presentation on Sunday September 14, the day after the masterclass.

“Are you a leader or a follower?” is the question that Prof Keith Willey of London Business School will ask delegates. Leadership is not just about your own personal skills, said Prof Willey, but also about teamwork. “You must take responsibility if you decide to assume the main leadership role. Your staff will look to you for certain things and if you don’t deliver them, they will be disappointed and unhappy with their own role in the practice,” he said. “You must be able to get your staff motivated without coercing them. That is hard work and to do this you must build a good team.”

While the doctor who owns or runs the practice will inevitably assume the central leadership role, those who may consider themselves to be “followers” also need to assume some responsibility.

“If you are happy to follow the leader in your practice,” said Prof Willey, “you should also search for the leader who matches your expectations. There is a distinction between the individual leader and the actual act of leading,” he said. “Even if you consider yourself to be a follower, you can still develop leadership skills in areas you are comfortable in.”

Dr Cummings will also take part in the leadership discussion with Prof Willey. “I think an ophthalmologist must be both a leader and a follower,” he said. “In areas that you are familiar with, you can lead. In those areas that you are not familiar or competent, you become a follower. Also, if you find that you are leading all the time, you will be surrounded by people who agree with you all the time and never challenge you. Obviously if the ophthalmologist owns the business, they will drive the medical protocols and the route the practice is taking but you should be able to lead by consensus by involving your staff in the decision-making process.”

Introducing new technologies

Prof Willey will also discuss how ophthalmologists and their staff can introduce new technologies into their practices. “Again there are a number of fundamental questions that need to be asked before you introduce these technologies,” said Prof Willey. “Why are you introducing them, what are their characteristics and will your staff be able to use them? You will also need to consider what is the advantage of a new technology over an existing technology; can you trial it and are the results visible?”

Prof Willey recommends that delegates attending this module should read Diffusion Of Innovations, by Everett Rogers. Prof Rogers says that adopters of a new innovation or idea can be categorised as innovators, early, early majority, late majority and laggards based on a mathematically based Bell curve. Each adopter's willingness and ability to adopt an innovation depends on their awareness, interest, evaluation, trial and adoption.

“Everett Rogers’ theories can be applied to all disciplines, including ophthalmology,” said Prof Willey. “I would also recommend Geoffrey Moore’s Crossing The Chasm, which begins with Everett Rogers’ “Diffusion of Innovations Theory” and then goes on to discuss the ‘chasm’ between the early adopters of a product or technology and the early majority.”

Mr Moore points out that visionaries and pragmatists have different expectations and he explores these differences and suggests techniques to successfully cross the “chasm”.

The “chasm” can be crossed by those who choose their target markets and who understand how a product works and is positioned. It is also important, he says, to develop a marketing strategy, a distribution channel and a pricing policy.

More interaction

Other topics to be addressed during the three-day sessions include “Financial Basics”, “Don’t get sued” and “Cost effective ways to attract new patients”. For the first time, there will be two separate modules for doctors and practice staff with the ophthalmologists’ module taking place on Sunday, September 14 and the Practice Managers’ module taking place on Monday September 15.

“This is the first time that we have decided to hold separate modules,” said Dr Paul Rosen, chairman of the ESCRS Practice Management and Development Committee. “Since we established this programme in 2008, we have had an increasing number of practice staff taking part in the sessions and this year we decided we should directly meet their needs with a module which we hope will help them to meet their expectations in developing their skills.”

Dr Rosen said the ESCRS Practice Management and Development Committee also wanted to ensure that delegates were given time to discuss the topics presented in the question and answer sessions.

“We have allowed more time this year for the question and answer sessions,” he said, “because our audience includes doctors and practice staff from a wide variety of countries where there are different protocols in place. For that reason, we want our delegates to be able to discuss how the ideas presented at our sessions can be applied to their individual practices and the best way to do this is to allow them time to interact directly with our presenters,” said Dr Rosen.

Calling all marketing gurus

The ESCRS Practice Management and Development Committee is also excited to announce the first marketing prize to be awarded at this year’s meeting.

With a prize of a €1,000 travel bursary to attend the XXXIII Congress of the ESCRS in Barcelona, Spain in 2015, this competition seeks to highlight the innovative ways that ophthalmologists and their staff are marketing their practices around the world today.

“The winning submission will demonstrate a successful campaign that resulted in an increase in patient volume or practice revenue,” said Kris Morrill of medeuronet, who will be one of the judges for the competition.

Entries should consist of a three-to-four slide presentation that illustrates the campaign, costs, as well as the results of the marketing campaign. The submission deadline is Friday August 15. To enter delegates should contact Colin Kerr, ESCRS practice management and development project manager at:


Rod Solar:

Arthur Cummings:

Keith Willey:

Paul Rosen:

Kris Morrill:

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