Why Patient Experience Is the #1 Untapped Revenue Driver in Eye Care

Summary

Podcast Summary: Power Hour Optometry – "Why Patient Experience Is the #1 Untapped Revenue Driver in Eye Care"

Podcast Information:

• Title: Power Hour Optometry
• Host/Author: The Power Practice
• Description: Join us for the latest ideas and innovations in the optometric industry.
• Episode: Why Patient Experience Is the #1 Untapped Revenue Driver in Eye Care
• Release Date: April 2, 2025

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Introduction to Patient Experience as a Revenue Driver

In this episode of Power Hour Optometry, host Eugene Schatzman delves into the often-overlooked area of patient experience within eye care practices. Eugene introduces Sharif Madhavi, a renowned expert in patient experience, whose extensive background spans consulting, practice management, and authorship of the influential book Beyond Bedside Manner. The episode aims to uncover how enhancing patient experience can significantly boost practice revenue by bridging the gap between patient expectations and actual service delivery.

Understanding the Problem: The Experience Gap

Sharif Madhavi opens the conversation by highlighting a critical issue in healthcare: the substantial disconnect between what patients expect and what they actually experience during their visits. He states:

“[03:15] Sharif Madhavi: ...the gap between what's expected by the consumer and what's delivered by the provider is so large that people are often frustrated and disappointed in what it means to go see the doctor.”

This gap not only affects patient satisfaction but also has tangible financial repercussions for practices, manifested in lower conversion rates for premium services and high-end eyewear.

The Seven Deadly Sins of Patient Experience

Sharif introduces the concept of the “Seven Deadly Sins of Patient Experience,” which are subtle yet impactful factors that can drive patients away:

1. Phone Interactions:

   • Issue: Patients encounter unresponsive phone systems, leading to frustration.
   • Example: A patient calls and either gets put on hold indefinitely or lands on voicemail.
   • Quote:

     “[16:05] Sharif Madhavi: Or it rolls into voicemail, right. Or it rings incessantly because, oh, we're closed from 12 to 1.”

2. Terminology of the Waiting Area:

   • Issue: Calling the reception area a “waiting room” implies that the patient’s time is less valuable.
   • Solution: Rename the waiting room to something more welcoming like “lobby” or “reception area.”
   • Quote:

     “[16:05] Sharif Madhavi: What does that communicate? It communicates you're going to wait and you're less important than the doctor.”

3. Physical Barriers and Clutter:

   • Issue: Outdated or unattractive physical elements, such as sliding glass doors or cluttered spaces, create negative impressions.
   • Example: Torn signage or unnecessary plastic screens.
   • Quote:

     “[19:43] Sharif Madhavi: Everything communicates. Your signs communicate. If it's torn, if it's improperly hung and torn, yeah, that's going to communicate something you probably don't intend.”

4. Unengaged Staff:

   • Issue: Staff members who are preoccupied, such as being on the phone or not smiling, make patients feel undervalued.
   • Quote:

     “[20:12] Sharif Madhavi: They're on the phone and they're not smiling. Who's more important? The telephone's more important than the person in front of me.”

5. Lack of Eye Contact from Doctors:

   • Issue: Doctors failing to engage with patients through eye contact can leave patients feeling ignored and dissatisfied.
   • Quote:

     “[21:50] Sharif Madhavi: There's no correlation between the time you spend with the patient and how satisfied they are. It's how you spend the time.”

6. Background Noise:

   • Issue: Excessive or inappropriate background noise, such as staff chatter or loud music, can disrupt the patient’s experience.
   • Example: Patients overhearing staff laughing or unprofessional conversations.
   • Quote:

     “[22:19] Sharif Madhavi: I hear chatter outside. I hear staff members laughing... they might be talking about the date they had last night or where they went.”

7. Inadequate Follow-Up on Feedback:

   • Issue: Practices not actively seeking or addressing patient feedback miss opportunities to improve.
   • Solution: Implement regular, meaningful feedback mechanisms beyond basic surveys.

Differentiating Customer Service from Patient Experience

Sharif emphasizes the distinction between customer service and patient experience. While customer service involves the activities performed for the patient, patient experience encompasses the emotional and internal response of the patient to these activities. He references Maya Angelou’s wisdom:

“[08:00] Sharif Madhavi: ...people don't remember what you did. They don't remember what you said. They remember how you made them feel.”

Eugene adds to this by highlighting that exceptional customer service is more than just friendly staff—it requires a comprehensive approach to creating positive experiences at every touchpoint.

Creating Signature Moments

A key strategy discussed is the creation of “Signature Moments”, which are memorable interactions that significantly enhance the patient’s perception of the practice.

Examples Highlighted:

• Celebratory Rituals: Practices like Vance Thompson Vision give patients a challenge coin post-surgery, symbolizing their life-changing experience and fostering a sense of community.
• Personalized Celebrations: Sharif’s practice celebrates patients’ new eyewear with personalized moments, such as taking photos and creating memorable milestones.

“[40:41] Sharif Madhavi: ...a signature moment is something that happens along the patient's journey that just stands out in their mind where the patient goes, that was really neat.”

Effective Communication in Sales Conversations

The conversation shifts to how effective communication can drive patients to invest in premium services without feeling pressured. Sharif advocates for a patient-centric sales approach:

• Ask Open-Ended Questions: Understanding the patient’s needs by asking, “What’s the problem you’re trying to solve?”
• Listen Actively: Emphasizing the importance of listening twice as much as speaking to truly comprehend patient concerns.
• Value Addition: Helping sales representatives become trusted advisors by providing them with insights to enhance patient interactions.

“[61:16] Sharif Madhavi: Listen twice as much as you talk.”

Practical Implementation and Case Studies

Sharif shares practical examples from his own practice to illustrate successful patient experience enhancements:

1. Renaming the Waiting Room:

   • Transitioned from “waiting room” to “lobby” to foster a more welcoming environment.

2. Eliminating Clutter:

   • Removed unnecessary brochures and diplomas, replacing them with patient-centric displays celebrating successful procedures.
   • Quote:

     “[48:28] Sharif Madhavi: ...patients don't really care about our diplomas. What they care about is their problem being solved.”

3. Signature Moment Examples:

   • Challenge Coins: Symbolize transformation and build a community among patients.
   • Glass Hanging Ceremony: Patients record themselves hanging their new glasses, creating an Instagrammable moment that reinforces their positive experience.

4. Enhanced Sales Processes:

   • Focused on educating patients about the benefits of premium procedures in a personable and supportive manner.
   • Encouraged asking patients for referrals immediately after positive feedback to leverage their satisfaction.

Leveraging Feedback for Continuous Improvement

Sharif underscores the importance of actively seeking and acting upon patient feedback. He shares anecdotes where simple questions like “How’s it going?” led to meaningful improvements, such as introducing healthier snacks or optimizing staff workflows.

“[30:52] Sharif Madhavi: What can we do better? Just the fact that you ask that shows that you care.”

Conclusion: The Competitive Edge of Exceptional Patient Experience

The episode concludes with a strong affirmation that enhancing patient experience is a “blue ocean” strategy—offering a unique competitive advantage in a saturated market. Sharif and Eugene agree that practices prioritizing patient experience are better positioned to thrive amidst competition from big-box retailers and online providers.

“[47:49] Sharif Madhavi: ...if you're a private practice optometrist who takes this seriously and recognizes how they can add value in different ways, not just from the services that they provide, but the overall experience will do quite well, will actually survive and thrive.”

Final Thought: By meticulously addressing each aspect of patient interaction—from initial contact to post-visit follow-ups—eye care practices can transform patient experiences into powerful revenue drivers, fostering loyalty and differentiating themselves in a competitive landscape.

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Notable Quotes with Timestamps:

• Sharif Madhavi: “[03:15] ...the gap between what's expected by the consumer and what's delivered by the provider is so large that people are often frustrated and disappointed in what it means to go see the doctor.”

• Sharif Madhavi: “[08:00] ...people don't remember what you did. They don't remember what you said. They remember how you made them feel.”

• Sharif Madhavi: “[16:05] Or it rolls into voicemail, right. Or it rings incessantly because, oh, we're closed from 12 to 1.”

• Sharif Madhavi: “[36:22] What can we do better? Just the fact that you ask that shows that you care.”

• Sharif Madhavi: “[61:16] Listen twice as much as you talk.”

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Actionable Takeaways:

1. Conduct a Sensory Assessment: Regularly evaluate what patients see, hear, touch, and smell in your practice to identify areas for improvement.
2. Rename and Redesign Spaces: Replace impersonal terms like “waiting room” with more inviting nomenclature and ensure the physical environment is clean and welcoming.
3. Eliminate Clutter: Remove unnecessary items that may detract from the patient experience, such as excessive brochures or outdated signage.
4. Create Signature Moments: Develop memorable interactions that celebrate patient milestones, enhancing their emotional connection to your practice.
5. Enhance Communication Skills: Train your team to listen actively and engage patients in meaningful conversations to better understand and address their needs.
6. Leverage Feedback: Implement systems to regularly gather and act on patient feedback, demonstrating your commitment to continuous improvement.

By focusing on these strategies, eye care practices can significantly enhance patient satisfaction and loyalty, ultimately driving increased revenue and long-term success.

Transcript

[Eugene Schatzman]

Foreign welcome to the Power Hour, Optometry's biggest and longest running show. I'm your host, Eugene Schatzman, and today we're diving into one of the most overlooked and most profitable elements of your practice, the patient experience. So to do that, I brought on the perfect guest. Sharif Madhavi is a patient experience legend. He's well known in ophthalmology circles. He, he's been on the vendor side, the consulting side, he's been on the practice side. He's literally written the book on patient experience. The book's called Beyond Bedside Manor, by the way. And it was written to help doctors understand the real gap between what patients expect and then what they actually experience in healthcare. And here's the thing, that gap is costing practices money. So think about whether you've run into these things in your practice. Patients shopping around for price. Maybe instead of choosing your practice low conversion rates for premium services or low conversion rates for high end eyewear, or maybe frustration with patients just not seeing the value of what you're providing. If anything like that has ever been your experience, then this episode is definitely going to help you sharpen the saw. In this conversation, Sharif gives us so much. We cover, for example, his seven deadly sins of patient experience that are quietly driving patients away. We talk about the difference between customer service and actual experience and why the whole concept of friendly staff is just not enough. We talk about his concept of signature moments that turn everyday visits into unforgettable loyalty building experiences. And we also talk about the single biggest sales mind shift that can get more patients saying yes to your recommendations without you having to feel pushy. And trust me, if you really tune in, you're going to walk away from this episode looking at your practice just a little bit differently. So before we jump in, quick reminder, make sure you're subscribed on Spotify, YouTube, Apple Podcasts, or wherever you get your shows so that you don't miss an episode. And you have if you happen to have questions or feedback, or if you want me to bring back Shareef for part two, which, you know, I honestly think we could talk about this topic for hours. Please, if you want me to bring Shareef back, write to me. Reach out to me directly@eugene shotsman.com or on the Power Hour website. And now let's get into it. All right, Sharif Madhavi, welcome to the Power Hour. I am so excited to have you on the show, Eugene.

[Sharif Madhavi]

It's great to be with you here and let's make this a great conversation.

[Eugene Schatzman]

Well, you know And I, I really just want to jump right into it because for people who know you, they know that you've had an incredibly wide career. You've done many more things than I think the, even the average person with one career does. You've been in industry on the industry side, advising industry vendor partners. You've consulted practices, you've done a lot of support and practice consulting. You've, you're running a practice currently. And you're also a pretty well known book author in the vision circle. So in my mind, you've got this really unique perspective and the conversation we're going to focus on today is patient experience. So I really, maybe the place to start is just ask you what is the problem that we're trying to solve in the context of all that?

[Sharif Madhavi]

Sure. And it's an important question for everyone listening because if you think about health care, it's roughly 20% of our gross domestic product. I mean, health care is a huge industry within the US and worldwide. And I say the problem is that if you look at it from the patient's perspective as a consumer, their expectations of what should happen in the healthcare experience and what actually happens are very, very far apart. And that gap, if you will, between what's expected by the consumer and what's delivered by the provider is so large that people are often frustrated and disappointed in what it means to go see the doctor.

[Eugene Schatzman]

I mean, you're so right. And we're going to get into the layers and layers of this program. And this is why I think you, you wrote your book Beyond Bedside Manner. And I think that the book outlines this situ, the kind of, the situation that we're in quite well. But I think let's actually zoom in and talk about what are the kinds of gaps in patient experience that we see in our vision practices. And I'm talking optometry, I'm talking ophthalmology. And you're just for, for the context, for the audience. You're really well known in ophthalmology circles when it comes to elective practice management, elective practice support, like LASIK procedures, for example. But some of the things we're going to talk about can certainly be applied to elective practice medicine in optometry, but certainly also like routine medicine. Right.

[Sharif Madhavi]

Like all the routine stuff, let's call it primary care. And yes, and the book was titled Intentionally because what we have is, I think we are in a state of denial. If you look at eye care providers and if you look at doctors overall, many of them are in a state of denial when it comes to what's important to their patient. They've tended to think about it through a clinical lens, like, I'm going to deliver great patient care. I'm going to help get the better outcome. And for an optometrist, that could mean, hey, great diagnosis, and then a really awesome pair of glasses that the patient sees 20, 20 or better at. For a surgeon, it could mean, wow, we got rid of that cataract, and now they can see again. Or in refractive surgery, they can see without glasses. So that's great to have that clinical lens. But what's happened? If you turn the tables and look at it from the patient's perspective, they're looking at it through a much wider lens. They are taking everything into consideration that the doctor thinks was, like, other stuff or optional. And I'll give you a couple examples, right? Doctors walk in through the front door of their practice every day, and they don't notice things like maybe the disheveled magazines, the stains, that coffee stain on the carpet just before you walk into the back. They don't notice that. But you know what? You know, who does? The patient. Most patients notice that stuff, and they start to form associations about the practice that have nothing to do with clinical care, but everything to do with, let's call it, this overall customer experience that's forming in their mind as a patient.

[Eugene Schatzman]

Well, you know, that. That's such a good point, too, Sharif. And this. This literally happened to me last night. I had a couple of people in from out of town, and we went out to a place I've been. They said, I really want to get the best burger in Cleveland. And I said, oh, I know the place. We got some really interesting gourmet stuff. And. And I had been there a lot in the past, and, you know, but then I go maybe once a couple times a year or something like that. But these folks really just wanted to taste a great burger. So I probably been about six months since I walked into this place. And I opened the front door, and when I opened the front door, there's, you know, like, a little lobby. And then you open another door and you go in and you see the hostess. And in that little lobby, you know, the drywall was scratched up. It wasn't. There was a hole in the drywall, but the drywall was scratched up. The little, you know, the window cling was kind of peeling, and it just looked, like, not great. And I thought to myself, man, like, I remember later thinking, wow, the food doesn't quite taste as Good. As I remember. And I was wondering, actually, as you were saying that I was like, was there an association there? Because I thought about it at the moment that I walked in, my first impression, my kind of overall impression. And this is, of course, before I saw the server, before I. Before I ate any amount of food. But my first impression just wasn't great. And it put me in a mindset that was like, ah, shoot. Like, I. Maybe I shouldn't have brought these people here.

[Sharif Madhavi]

Well, especially because the stakes were higher, right? You wanted to impress your guests, and you said, I know the place to go, and they. They disappointed your expectation from the very first moment. Actually, we call that in the book and in my training program a negative cue. And that is a concept and a term that was developed as part of the experience economy. And I owe, you know, a debt of gratitude to Pine and Gilmore, the authors of that book that was first published by Harvard business press over 25 years ago. But. But understanding this and understanding what you just went through, okay, which was negative, set the tone for everything, the ordering process, how the burger tasted, and it really, in a sense, in the background, you're a little disappointed, which is a bummer, right? Think about that now in the context of a medical experience. And I think what you. What you just described is much more the norm. I think it might be the exception. And, you know, maybe they just haven't gotten around to kind of repainting that surface and it's on schedule. Let's give them the benefit of the doubt at that burger place, right? Because they understand this. But, you know, it's interesting, I come back to this term of there's just denial. And I can't tell you the number of doctors I've met who said, oh, you know, we do good at customer service, right? Like, we've got that base covered. And I go, really? And I start asking a few questions, and then you realize that their perception of what's going on is probably not the same as their patient's perception. So let's get on with.

[Eugene Schatzman]

What are some of these questions that you asked, Sharif?

[Sharif Madhavi]

How do you get feedback from patients? How do you know? How do you know your service is good? Okay. And how do you define customer service? What does that mean to you? And they inevitably go, well, we've got a really nice staff, right? People tell me how friendly my staff is, and I go, that's good. Being nice and friendly is important. It's necessary, but not sufficient. Right? You've got to do a lot more. You need to have the systems and the structure in place so that, you know, you are on a consistent basis delivering exceptional customer service. Because all of that forms these impressions that create this overall. Overall experience that the patient walks away from. And, you know, you can really. You say, well, what does that really mean? You know, isn't just good, isn't an experience, is really good customer service. And Eugene, I'd say, no, no, it's something different. Service. Service is kind of what you do, right? It's the activity performed on behalf of the customer, the core service. Right? We did an eye exam, right. We did a diagnostic test. We sent them a super bill. Whatever, whatever it is, experience is how you do what you do. And the difference there is that experiences happen as the recipient inside of us. Services are outside of us, but experiences are inside of us. It's literally how we were made to feel. And so oftentimes, when I'm giving a talk or a lecture, I will open or close with that quote from the poet Maya Angelou, right? And I'm going to just paraphrase it here. But people don't remember what you did. You know, they don't remember what you said. They remember, you know, they'll forget those things, but they'll never forget how you made them feel. That's everything. If I had to boil it down to one phrase, that's kind of everything about where my career has taken me in terms of understanding this and why it's so important. And just to kind of go back to what you said earlier, right? Whether it's a. Whether it's a routine eye exam or, or a sophisticated custom lens replacement surgical procedure or anything in between. How we make patients feel at each step along the way is often going to be the determining factor of, first of all, do they come back? Right? Do they come back as consumers have choices. Secondly, what purchase decisions do they tend to make, right? And you think about it. If you feel great about something. And let's just all take a step back and think about our own experience as a consumer. If we are so enamored with the environment and with our interaction with the staff, with the team, whoever we're interacting with, and any hotel, restaurant, retail, store, something that's designed as an experience. Our guide, our tour guide, if we're so enamored, we really don't care how much it costs, right? We're just.

[Eugene Schatzman]

The bill doesn't matter at all.

[Sharif Madhavi]

It doesn't, it doesn't, you know, and in fact, there's another, you know, Gilmore lives in Cleveland and so Does John De Julius, another one of my mentors, John de Julius is like all about, hey, the experience is so great that price is irrelevant. That's what we should aspire towards, right? And the opposite of that, which is commoditization. Hey, how much is it? Why is it so expensive? I can get it cheaper down the street in the world of optical bogo, Buy one, get one free. Right? And that's a big. That's a big deal for today's optometrist. I know we're going to get into that later. I want to help address the eye doctor and how they can really understand what's my view. I'll share my view of what's going on in the world around them and how they can respond because I think it's important for them.

[Eugene Schatzman]

Well, and I agree completely. I think, you know, I just want to highlight the distinction that you made. And I really, I think it's so important, and I wrote it down because I think it's a great quote that I later attribute to you is the idea is that services are what you do on the outside and experiences how your patient feels on the inside. And thinking about how are they going to feel about this is such, it's such a different mindset shift. Instead of thinking, what am I going to do? Thinking about how are they going to feel so that I can do what I need to do. And this is like that. That's a really, in itself, a super interesting insight. The other thing that you said that, you know, and I maybe like to get into some tactical things here with this in mind is, is that I heard you say the word exceptional customer experience. And my impression is that when people talk about the staff are nice, that's not exceptional. That's basic. That's like what I expect. I don't expect to go into any place, be at a restaurant or a eye care place or a library. I don't expect to go into any place and expect the staff to be mean to me. So my expectation is that the staff are nice. That's baseline. That's like literally like, if you can't meet that expectation, then you got really, really big problems. What makes it exceptional is something different. It's not just that the staff are nice. It's the core of doing business. And, you know, we're marketers. We write a lot of, write a lot of marketing copy. And nobody ever, nobody has ever asked us to write marketing copy. Says our prices are pretty low, but our staff are super mean. But like, you just, you know, like, that's okay because, you know, our prices are really low. Nobody, Nobody ever thinks about that. It's like, you know, service and quality is just a baseline. Nobody expects to say, oh, our, you know, our service, our service is mediocre and our quality is kind of crappy. But hey, man, we got great deals and, and come on in. So the. I'm just drilling the point home that when we ask people what makes you different, one of the things, what makes you exceptional, Right? That's the, That's a good synonym. It can't just be service and quality, because service and quality to some level are really just table stakes.

[Sharif Madhavi]

You know, it's interesting as you're talking about that and you're acting for tactical things. You know, we have the seven deadly sins, right? Okay, let's apply that. Let's kind of take that same concept into the, Into a typical medical encounter, right? And I'm going to. I'm going to give you seven. I'll give you seven. Right off the bat, I just kind of thought about as we were, as we were thinking about one is you pick up the phone and, you know, you call somewhere and either they pick up the phone and say, doctor's office, please hold. Right. And this happens to this day, this.

[Eugene Schatzman]

Time, all the time.

[Sharif Madhavi]

Or, or it just rolls into voicemail, right? Or it rings incessantly because, oh, we're closed from 12 to 1. We don't answer the phone. I mean, that's okay. That's number one. Number two. And I'll. I'll ask doctors this. What is the phrase or term you use to describe that first room that patients walk into when they enter your office? And I ask people, do you still call it a waiting room? Okay. And if you do, that really tells me a lot right there. That tells me that you maybe don't care as much as you should about your patient's perception of your practice. Because words matter, phrases matter. And if you say, please have a seat in our waiting room, what you're telling people is, you know what? You're going to wait. And me as the doctor, I'm more important than you as the consumer. And in today's modern era, no, I think the patient's time is just as valuable as the doctor's time. Right? But, Eugene, when you and I first started, I'm sure we could agree that was not the prevailing sentiment. Hey, I'm a doctor. I went to school. I got trained. I'm busy. I've got all these patients. And you'll wait until I'M ready to see you.

[Eugene Schatzman]

And before we go to. Because you already gave two. Before we go to the rest of the seven, I just want to make this point. It's an amazing opportunity to differentiate because that is if you're listening to this and you own a private practice, this is a really big opportunity to differentiate on just positioning yourself as. I value my patients time, my experience. I live in Cleveland. I have the Cleveland Clinic. I have been to the Cleveland Clinic countless times. And every single time I feel, I feel like the doctor's time is extremely important. And my time, and we counted in seconds at the Cleveland Clinic and my time is extremely unimportant as a patient. I'm just there as a cog. And you know the doctor is going to give me is 3 minutes and 21 seconds and he's going to do that or she is going to do that when it's convenient for them. And I'm going to show up, I'm told over and over, you show up 15 minutes early, you do whatever and then you sit in the waiting room or you sit in the, in the procedure room and you sit there and you sit there and you have no clue when the doctor is going to come in, but they're going to come in when it's convenient for you, for them. And there's not even anything to entertain you while you're doing that. So I completely agree with your point because I think the way a lot of our medical system is set up, especially the larger and the more corporate it gets, it is absolutely designed with an eye towards efficiency. So if you are the private practice owner who's listening to this or you work in a private practice, this is such a huge opportunity to differentiate because they can't shift that overnight at the large corporates.

[Sharif Madhavi]

Right? That's right. But you can change the name of that room tomorrow. You can go in there and say we are no longer calling it a waiting room. We're going to call it our lobby, our reception area, our guests receiving what, Whatever it is. And if your practice is themed, choose something that's in line with your theme, which is a whole nother topic. We could dive into and spend an entire hour on that. Let me go to number three, Eugene. The, the sliding glass. You walk in and there's that sliding glass. You know, it's like a counter and they slide the glass over frosted glass. Okay. But there's. And so a lot of places have gotten rid of that. Some still haven't. Okay, but here's the, the modern Day version is, oh, we put this plastic screen hanging from the ceiling, kind of a plastic clear screen for Covid. And we still have it up. And it does absolutely no good. But they still have it up. Right? Okay, so that's one right there. Just a physical, like a visual cue. That's just awful.

[Eugene Schatzman]

And it's worse, by the way, if there's like, signage hanging on those screens or on that glass. I've been to a practice once where, like, it was just plastered with paper that said, no, we no longer accept such and such insurance. We are not available between such and such time. Cash must be present or payment must be made on day of whatever service. And it's like these, like these signs that, you know, again, how do they make you feel? Is the question we should be asking.

[Sharif Madhavi]

Correct. And, and here's a lesson just for everyone. Just another statement. Everything communicates. Okay? Your signs communicate. So if it's torn, if it's improperly hung and torn, yeah, that's going to communicate something that probably you don't intend to communicate. Similarly, this is the fourth one. You walk in and instead of like someone standing up and welcoming you with a nice smiling face, they're on the telephone. And they just. They lift their finger like, oh, just hold. They're on the telephone. Who's more important? The telephone's more important than the person in front of me. That's a sin. Okay, so that's really kind of two. Right? They're on the phone and they're not smiling. And the not smiling could be your. Anyone on the team. Right. Not just your receptionist. Here's another one, big one. Biggie. Doctor not making eye contact. So you've waited all this time, right? You've gone through the testing. You had to repeat things that should have been in their electronic health record or that you were telling for the eighth time something about your history. Doctor comes in, no eye contact. They're either too busy typing on a computer because they didn't think they should have a scribe, or they're just not. They're not thinking, I need to be. Look, I need to be engaged with this person. Because we know from the data there's no correlation between the time you spend with the patient and how satisfied they are. It's not the time you spend in total amount, it's how you spend the time. Regardless, you can be with someone three minutes and they. If they feel like you're. They're the only person in your world, they are deeply satisfied, you can be with them for 15. And if you're locking off, and they. They feel like you are not paying attention to them. You failed. You failed. You failed to meet an expectation. And the excuse is, well, I'm so busy. I got to get to the next patient. Okay? And I get that. I hear that. I just don't buy it. Okay? I go buy it. And what is it? What do they say on some of those app dating apps? Swipe left, swipe right. I'm gonna swipe left, right? Or. Or, you know, let's even go. Let's just deviate for a moment. I went to the Internet to try to find an optometrist, and I saw your rating, and it was 1.8 stars. I'll just go look for the guy who has got four or five stars. I don't need. I got choices. I have choices as a consumer. All right? And the last one. The seventh one. Not the last one, the seventh one. Noise. Background noise. So I'm an example of that is I'm sitting in the exam room, and I've done this, by the way, I love if I can do it myself, a secret shop, not a member of my team. But if I can go do it, I just love it because I'm taking notes while I'm waiting for the doctor. And if I'm in that room and I say, oh, the doctor will be with you shortly. Okay? So they've set an expectation, and first of all, shortly. I could think 30 seconds, but it might be 10 minutes. But I hear chatter outside. I hear staff members laughing. They're talking to each other. They're laughing. They might be talking about, you know, the date they had last night or where they went, you know, where they went out, what bar they went to. I don't want to hear that, because what I'm thinking is, oh, they're too busy to see me, but they're not busy enough to socialize. Okay. Common. This happens all the time. Okay. So I hope those examples are helpful.

[Eugene Schatzman]

No, that's fantastic. And you know what's. What's interesting about, especially about that last one, is that you. Sometimes people don't. You know, I've heard this described as, you know, onstage and backstage. Right? And the onstage stuff, people don't realize what else is on stage, Right? So I've been in treatment rooms where it's just, you know, like, there's just clutter. Like, somebody got a new chair, like a, you know, like a new rolling chair that the doctor would sit on, and somebody got a new chair, and it's sitting in A box. And it's clearly, you know, just like in that room. And it's like, you know, that's a, that, that's one piece of something that's on stage. But to your point is what the staff do that you can still hear, that's still on stage, right?

[Sharif Madhavi]

That's correct.

[Eugene Schatzman]

And I, I've even been at a place where like the, it's a really high end practice and the soundtrack happened to be the doctor Spotify list or something. And there were some stuff that came onto that Spotify list. I was like, are you sure? Like, are you paying attention to this? Like, this is what you want to be playing for, for a room full of multigenerational patients and like, really, like, are you sure?

[Sharif Madhavi]

Well, Eugene, and you and I, we're just, we're just two people. We're just consumers out there in the world who are making decisions every day about how we spend our time, how we spend our money. And think about it. We just, we're just having this conversation. But we represent, I think, the sentiment of most customers. Now. Some don't care. Some people don't care. They just want the lowest price and whatever. There's, I think 10 to 20% of the population literally buy on price. And I'd contend that, you know what, that's not your, that's not your customer. Let them go. Don't try to chase them. Okay? But I think 80% kind of care about this, about this issue that we're talking about and being prepared and. Well, first of all, just being aware, okay? Awareness is the first step in making change. Just kind of going in and doing an honest look. We call that a sensory assessment. In the book where you actually. And you brought up sound, right, The Spotify. But it's. So we've talked about what you see, what you hear. Okay. But there's also what you touch. Our surface is clean. Okay. There's also what you smell. What, what's, what is. And so, you know, the, the enlightened practice, if you will, realizes that go. I can just buy a, like a collection of those little bottle droppers that have really nice scent. Take a drop out, put it on a little tissue, stick it in the waste basket at the beginning of the day, boom, problem solved. Oh, it's beautiful. Eucalyptus. And people aren't going to always notice it, but you know what they're not going to do? They're not going to smell something bad or off. Right? So that even yourself, the musty carpet.

[Eugene Schatzman]

Sometimes you don't have control over that you got to get like, you know, some.

[Sharif Madhavi]

You should change it. You should change it if it's really musty. It's a long term thing. That's just part of, that's part of keeping up. But you know, if, if, if someone's listening to this and going, I don't know, it really doesn't matter. Guess what? Someone else in your community says it matters. Okay? They're taking the step. They are going to over time become the preferred provider, the one that people go to because collectively go. It was a great experience.

[Eugene Schatzman]

Right. Well, and it's. I really want to go back to this insight that you had in the beginning, which, how you made them feel. But you and I are sitting here, you know, we're, we. You're running a practice. I help practices. We overanalyze the stuff. Every time I get to go be a consumer in the world, I'm thinking of it from one, my lens as a consumer. But two, I'm thinking of it as like, oh, like, well, can this business do better? And how. I just can't turn it off. Neither can you. The reality is that most patients aren't really sitting there thinking about that, but they are feeling it. Because you don't really control how you feel and nor do you try to take the time to articulate how you feel. You just know that something was good and something was bad. Like it was, it was off, it was, or it was great. I can't really say that that eucalyptus that I smelled in that little garbage can thing that you just said is really the thing that, that made me feel great, but I just felt good when I was there. Like, it was great. Like I, yeah, I spent some money, but it was fantastic. Alternatively, it's the. I felt unimportant, you know, and then all the other stuff starts getting to me. And then like, I, maybe I'll describe the fact that the doctor was abrasive, but really it's because I had to wait and because I had to say the same stuff over again. And I heard the staff laughing in the hallway and I was wondering if they're maybe laughing at me or something. And then I heard. And then I had a. And then I had an awkward interaction with somebody on the way out because they were on the phone and they lifted their finger for me to wait. And as all the things that happen outside the appointment that just made me feel a certain way. And so when the notice comes in, it's time for your exam. And like, you know what? Like, I'm not Really excited about not feeling great again. So, like, maybe I'll go back, but I'm not going to go back now. And, you know, or maybe I won't go back at all. You know, that's the. That's. That's one of the things that we think about on the subconscious level is really fascinating.

[Sharif Madhavi]

You know, you're right. And you can't. You don't know and you don't predict. It's hard to predict sometimes what people are really thinking. And the antidote to that is simply to ask. Now, you can ask in formal surveys, and I think that's a good thing to do. And there's plenty of survey tools out there to get the data. But there's no substitute for just asking the question, how are things going? You know, and it's amazing what you can learn. And just two quick stories I'll share with you. Cause I asked this question. I like to walk around the clinic. We have a busy clinic, three surgeons, you know, and it's great. Sometimes it can be chaotic. And I asked someone who is in our lounge, our lounge, where we call it the refresh lounge, and we have snacks. I said, hey, how's it going? He goes, you know, pretty good. But I gotta tell you, you don't have any healthy snacks. And, you know, we had chips and, you know, stuff like that. And I thought to myself, oh, my gosh, we don't immediately talk to our office manager. So we blended in some healthier, you know, nuts, kind of organic things, lower sugar. Just because I think he was right. And look at that. First of all, we had snacks, right? And you think, oh, we should get an A score, A plus, because we offered snacks to our patients. We thought that was good enough. No healthy snacks. And we even looked into fresh fruit. But that really. That there's a logistics problem of that. You don't want, you know, a brown banana showing up there the next day. So there's certain limits or certain things you can do. Of course, cost is a consideration here as well. But he brought that to our attention. And then I'll tell you, there was another patient who had been in, who was actually a personal friend of the practice owner. And I said, how's it going? He said, great. He said, but may I give you some feedback? Ask permission. May I give you some feedback? He knew my role in the practice. Sure. He said, hey, you're not organized well enough in this when the tech comes in. He drilled down. And he was a businessman, right? Successful businessman. So he drilled down and I'M like, wow, someone valuable brought that to our next team huddle and said, team, I want you to work on this, on solving this issue. And it was something about the, it was something in the choreography that was a little off in the handoff between technician and doctor. And we got it, we got it fixed. And so those little nuggets are invaluable, but I would have never known them had I not asked the question, how's it going?

[Eugene Schatzman]

So do you suggest that there's somebody at some point in the experience asks every patient, how is it going? Or what's the right question?

[Sharif Madhavi]

It doesn't have to be every patient necessarily, but I think, and again, this comes now down to culture. If the culture is one where we say patient experience is important, in fact, it's the most important thing. Right? Because you use that term differentiation when we were talking just about this opportunity around how you rename the waiting room as a differentiator. Think about the practice as a whole being differentiated because we're not going to focus based on being the low price leader. You cannot compete with Walmart and the big box stores. Right. As an optometrist, we could based on our great technology. Oh, we also use the advanced equipment, but guess what? Other people can copy that with enough money, resources. And we're not going to talk about how skilled we are as a differentiator. Oh, we, you know, we've been doing this for so many years. We've done, you know, 200,000 patients have had new vision with us through glass. People don't care. They expect that. But patient experience, the experience they have. This is what I call blue ocean, wide open field and territory. Because so few are doing it. And so it's almost like this. We're just trying to quantify it. If you make a 10% improvement in the overall experience and could measure it, I think you get a 40% return on investment, maybe a 400%, because going to the doctor overall, just in medicine overall is not a good experience. Okay? So any moves that an individual practice makes to make it better are very likely at this moment in time to be noticed and to be appreciated. And you're right, maybe it's not like, oh, wow, I smell eucalyptus in this room. That's not the point. The point is, collectively the practice is doing more and more and thinks about it this way. We're never going to say, mission accomplished. We're always going to be trying to make things better. We're going to seek feedback from our primary constituent, the patient, to do that. But guess who else can help you? Your sales reps. Because the sales reps in industry play such a. They play a great role. Right?

[Eugene Schatzman]

That's a really good point.

[Sharif Madhavi]

And I ask, I ask the ones that come in and we don't have a lot of time to spend with reps. And I tell reps routinely, don't bring in a box of donuts and think you've done your job, that we don't need the donuts, we need advice. So if anyone is listening who is in industry on the sales or marketing side, the training, the book and the training offer is valuable for you because you can become an agent, an agent of customer experience, of patient experience. You can start to observe and if you have the relationship with that practice, you can offer them feedback. Hey, here's a Dr. Smith. Here's a few things I noticed. Could I share them with you and share observations and guess what? Your value as a rep just went way up. You moved from order taker into maybe towards trusted advisor. Oh, I love that in their mind. And so that's where you become valuable. And so I asked reps to say, tell, how are we doing compared to other practices you go visit. Are you seeing something somewhere else that we should be paying attention to?

[Eugene Schatzman]

Oh, I love that.

[Sharif Madhavi]

I want them, I want them as a resource. And, you know, of course, you know, we have, we tend to have. I was a rep once myself, right. And I wanted to have great relationships with my customers. Right. It wasn't, I mean, yes, we can take them to dinner. That's great. Right. But that's not the point. It's how do we make their life better? How do we add into, into how do we add into what they're doing? So how they do what they do can be done at a higher level.

[Eugene Schatzman]

Yeah. You know what I love about some of the things you just said? So I'm going to kind of back up on one point and I had an idea for our audience. I'm just going to share it. You know, if you're, if you're a practice that obviously a patient gets glasses, they have to come back. When they come back to pick up their glasses to collect their feet for their final fit, why not use that opportunity to ask, you know, we're just, we're really interested about, in your experience, can you tell me a little bit about your experience? And if the patient's like, everything was great, ask one more question to make sure that it's not like a, how you doing? Good. Okay, bye. This is a, you know, Just ask one more question. I don't know, log that feedback. You can, you can record that feedback. But, but one more idea behind that is that if they are really happy, here's how you monetize that really, really quickly. Immediately ask for the referral. Right. We teach referral systems all the time, but this is a great place when somebody has given you positive feedback and say, well, you know, that opinion matters to us so much and thank you so much for sharing that. I'll definitely let the team know. By the way, we always continue to grow through word of mouth. Is there anybody that you know of who could benefit from a similar experience that you had here in your network? I'd be happy to reach out to them, give them a little bit of a gift for, for the introduction and that sort of thing. Like, I don't know exactly that, the exact mechanics, but leverage that conversation for instant roi, but also for the valuable feedback you're going to produce. If somebody had a less than great experience.

[Sharif Madhavi]

May I offer the question to you, that follow up question, please. What can we do better?

[Eugene Schatzman]

Right.

[Sharif Madhavi]

What can we do? What can we do to make your experience better? Just the fact that you ask that shows that you care.

[Eugene Schatzman]

Right?

[Sharif Madhavi]

Right. Now if you take it and you actually act on it. Yeah. Even better. And maybe you can't ask, oh, you know, I wish there was a limo service that brought me to and from your house. Well, right, we're not going to do that. We can't do that. Okay. That would make it better, of course, but that's just not realistic. Right. But just asking the question, it starts to signal, wow, this place really cares about what people think. They really want to make it better. You're going to get an A for.

[Eugene Schatzman]

Effort and think about it. Sharif. This is, you know, and I, it kind of dawned on me as I was thinking about your point and we think so much about, we talk so much about the experience during the actual eye exam. Right. That the, there's the experience with the tech, the experience with the doctor and the experience in the optical and whatever. But sometimes we think about like the follow up experience, the actual delight the consumer needs to feel at the point of receiving the product that they've just paid hundreds of dollars for. We think about that. We may not really fully think about that experience. How do you truly make that experience delightful and then leverage that delight, you know, to your point, by even simply, simply showing how much you care and really being deliberate about that particular experience. So, you know, just one, one point, one suggestion.

[Sharif Madhavi]

Well, and I'll just. If I could piggyback on that. Eugene, you know, you could turn the new prescription eyewear fitting session into what we call a signature moment. You can, you can make it celebratory. And I'm kind of thinking why not that instead of making this routine thing. Hey, your glass is great. Oh, yeah, we got the PD accurate, you know, blah, blah, blah. Okay. That's just the basic core stuff. What do you like really celebrating? Like, wow, you look great in those glasses. How do they feel? Fit good? Yeah. How are you seeing? Great trick. Could we take a picture of you? Click. That we're going to send to you right of in your. Your new look. Like my new look, right? Create something. A signature moment is something somewhere in the, in the overall experience. And you're absolutely right. It's not just during the exam. It's before. During and after the visit are all potential for this. But, you know, you can create a signature moment that is something that's just a little more memorable, a little more unique, a little different than what they might have had when they went to the kind of discount bogo box store place, right?

[Eugene Schatzman]

Oh, I love. I want to come back to these signature moments right after the break. And actually I, I'm going to ask you after the break because you run a very successful practice with a very impressive conversion rate to premium cash pay procedures. And I'm going to ask you about some of the things that you've learned over the years that gets patients to spend cash out of their own pockets on premium vision correction procedures. We're going to come back and right after the break we'll discuss that topic.

[Allie]

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[Eugene Schatzman]

All right, I'm back with Sharif Madhavi on the Power Hour, and I am just. We're having a blast. And this. We ended previously on the signature moment concept. And I actually want you to zoom in and explain that one more time. And then I think it might make sense for people to hear what you're doing in your practice to get these really, I would say, industry leading numbers that get patients to take action on very sometimes expensive treatment plans that ultimately give them amazing outcomes.

[Sharif Madhavi]

Well, let's kind of rephrase what a signature moment is. Let's just define that. And basically, it's something that happens along the patient's journey. It could be before, during, or after their visit, their appointment with you that just stands out in their mind where the patient goes, that was really neat. They. It wasn't expected. Right. It left a highly positive. Made a highly positive impression that stuck with them because, remember, experiences are felt internally. Right. They're in the heart and in the mind. And so if I thought about, you know, some of the best ones I've seen, because there's some really good ones I really like what One of my. One of my favorite practices, Vance Thompson Vision, which is based out of Sioux Falls, South Dakota. And when I first started working with them, Vance had one location and 26 employees. And now they're closing in on 500 employees. And they're across, you know, six states in the upper Midwest. And just a beautiful story. And one of the things they did is they created actually a coin. And they had this coins made as a physical thing that they gave to a patient after they had refractive surgery, whether it was to replace cataract or for LASIK for laser vision correction. And they gave it. And it was a symbol that that person could carry with them that talked about the transfer that symbolized the transformation in that patient's life as a result of being able to see better. Okay. A physical thing. Right. And we know the Marines have this. I think Alcoholic Anonymous have this, right? Where there's a. There's a coin, there's something along.

[Eugene Schatzman]

Yeah, it's a club. It's a. I think it's called a challenge coin or something.

[Sharif Madhavi]

Challenge coin. So this is not. They didn't invent the coin idea. And the best thing, they just wanted.

[Eugene Schatzman]

Their patients to be in a club, which is such a smart idea because you now belong to a community. And with refractive surgery, it's a one and done type of thing. You're not coming back every year for something. So, you know, the best thing you can do is just evangelize the fact that this was a really good place. And so how do you do that? You put them in a community.

[Sharif Madhavi]

And I got to tell you, you asked about the practice that I help lead, and that started. That was kind of a. I mean, that's a whole story of even how that started. Because I would have never predicted in my career, Eugene, that I would have gone back inside, if you will, having spent, you know, so many years on the outside being in industry and leading the marketing team at Visx, when LASIK was launched to consulting to companies and to practices. And this opportunity came up with just an exceptional human being who also happens to be a refractive surgeon and is in my area, literally in my town. And we sat down one day and he told me his goals and hopes and dreams and said, I can help you and I'll partner with you to help you. And that was five years ago. And we have now more than doubled the size of the practice we offer. Not just lasik, but the full range of refractive procedures, including that evo ICL from Star Surgical and custom lens replacement. Our term for refractive cataract surgery. Right. Some people think of it as refractive lens exchange, which is fine, but we just use that other term. And the results have been staggering, what we've been able to do.

[Eugene Schatzman]

And that's a 10K plus procedure for anyone who's.

[Sharif Madhavi]

Yeah, yes. In fact, 14 to $16,000. Absolutely. For both eyes, life changing. And people sign up and they want it because we talk about the benefit and, you know, the whole. When you're in a practice that doesn't accept insurance or Medicare or have any kind of recurring revenue from annual exams or a glaucoma check, you're living out there on the frontier in terms of healthcare and medicine. It is a hard place to be. Because in elective, someone said to me the other day, you can't predict your business. It's very hard to forecast your business. It really is.

[Eugene Schatzman]

You're not like, you know, I would say the guy in Sioux Falls, it might be kind of easier. And I'm not. I don't know well, but I imagine that there's not like a clamoring of providers for refractive surgery in Sioux Falls. However, I know in your area, you guys have competition on every Corner. So it's kind of not only are you providing life changing procedures, but you're having to compete with other people who also try to elevate the way that they run the business.

[Sharif Madhavi]

Correct. And I would, I would frame the competition not so much as the other providers, because if they're doing a good job with good care, that's fine. I have no problem with that. Right. Refractive surgery is very under penetrated versus its available market. Right. And I don't even think we compete with glasses and contact lenses. I don't think so. The optical industry is going to do just fine. It's just we offer a solution for people who don't want to wear those. Right. Who said, I'm sick and tired of these or I have dry eye or whatever the reason that motivates them to come in. And I think what we're really competing with is three things. We're competing for their time. Okay. We're competing for their attention, and we're also competing for their pocketbook, for their money. So time, attention and money are the three things. So our entire practice is designed with that in mind. And our surgeon, Craig, he said, like we talk regularly with the whole team about every person walking through that door is because they want to be here, they don't need to be here. Right. If you're sick, you need to see a doctor. Right. If you've got a pain that won't go away, you have a medical need. What we have is more of a want. So we are required in order to succeed. We need to design everything around this thing called a patient walking in our door. And the end of everything that we've done is intentionally designed that way and choreography is that way. But if you're in an optometric practice, it's no different. You know, yes, you might have, you might be able to predict your revenue a little better, but, but thinking about your practice differently and literally walking in the patient's shoes or proverbially putting on, you know, the glasses they wear, seeing it through their lens, not just your lens, can really be the start of change. And that was what the book was all about. The book was really getting doctors to understand why patient experience is so important and that it can become really a competitive advantage, a true differentiator in a crowded landscape. Yes, we have other providers doing refractive surgery, but my gosh, a private practice optometrist has all the advertising day and night. You know, again, the bogo or the, you know, get it all for 99 bucks and get it in half. An hour. And all this kind of stuff, which can be appealing to certain people and can really kind of mess with your head. But, but, Eugene, I've been in this area long enough. I've seen these phases come and go. And, you know, it was 20, 30 years ago. It was the rise of the big box optical. Right now it's the Warby Parker online, Zenny, you know, all those things. And, and I have a feeling that the optometrist who takes this seriously and recognizes how they can add value in different ways, not just from the services that they provide, but the overall experience will do quite well, will actually survive and thrive.

[Eugene Schatzman]

I totally agree with you, Sharif. I want to maybe zoom in a little bit more on these nuances of differentiation, because you're right, I think, about how we're wanting to make patients feel, and we want to make them feel like this is an exception, an exceptional experience. And so what are other. Whether you do this in your practice. I mean, you mentioned snacks in your practice. Challenge point. You know, give me some examples of things that truly create the exception, not the rule, for, for some patients, and whether it's, you know, whatever practices you've seen them, that truly create that feeling.

[Sharif Madhavi]

Now, I'll give you a couple that are applicable here. One is that when people walk into the practice, and when they used to walk into our practice before a remodel that we did, one of the things they'd see early on is a wall of diplomas, all the college and the university and the doctor degree and all the certifications from the companies and all this stuff. Okay, and what does that communicate? It communicates how good we are. All right? But you realize when you look at it from the patient's perspective, they don't, I mean, they don't really care. Yeah, they, they, they kind of assume it in the way that they assume when they walk on an airplane that the pilot knows what he or she is doing. Right. They're certified. What they really care about is their problem. I'm not seeing. Well, and so the, the change that we made was we got rid of all those diplomas and we put a whole gallery of photos of the doctor and the patient, individual photos celebrating after they had a procedure. And that's one of our signature moments. And we literally hug. I mean, patients are so elated when they can get up off of a chair, whether it's lens or laser based. They can get up, they walk. I mean, they ask questions like, is it going to hurt? They ask all these questions ahead of time. Oh, you know, am I put under is a general anesthesia. And we educate them. But when they get up and they go, oh, my gosh. And then we put on the dark glasses because their eyes are light sensitive, but they're like, doctor, Some of them cry, hug the doctor. We capture that moment. And that's up on the wall. That's what replaced. So we said, it's not we're so good, it's you're so amazing. That's the subtle message we want to send. Okay. And that's kind of when they come in, anyone comes in. And so we don't stop and point it out, but they pass by it. And we know a lot of them see it. Okay. Another one is we have a ritual. We have a wall, just a short little, like, niche, maybe six feet wide, and we strung cables across it. And people hang their glasses there post procedure. Not. I mean, when they come back for the one week or the one month, we invite them to do it as a ceremony. And we'll take out their phone and we'll record it for them. Hanging their glasses one last time. And we donate those. We get those to the Lions. Right. Lions Club. And then it says, you know, a top, best decision ever. And the name of our center, Laser Eye Center Silicon Valley. And it's a. We call it an Instagram moment. Okay, so those are just two examples of things we talked about. An optometrist's office like, hey, celebrate that moment when they're putting on their new prescription. Yeah, celebrate that. Okay.

[Eugene Schatzman]

Yep.

[Sharif Madhavi]

Yeah, it takes an extra couple minutes. Yeah. But it can become priceless. And not for every patient. Some people are going to go, oh, that's cheesy. Your staff will say that at first. Oh, that's cheesy. This is resistance to change. Right? Oh, we don't do that. Oh, we're professionals. Oh, we're an eye doctor's office. And I go, nonsense. You are competing for the time, attention and money of your. Of the consumer. They have choices. And the more you do to do these little things. These little things. And little things can be positive. They could also be eliminating the negative. Right. I mentioned this thing, sensory assessment, just going through and observing what's going on. Go, wow, we need to get rid of that clutter. I was visiting a practice last month and literally he's giving me an after hours tour and he saw a brochure rack with a company's brochures and he just took the brochures out and threw them in the can. He goes, clutter Clutter. And he's right, he's right. And I understand the sales reps want you to hand their brochure out to every patient. I get that. And pretty soon, you know, you've got those wall racks that have like 50 brochures. Like, yeah, yeah, those are, I think those are useless. If you're going to use a brochure, it should be individually handed to a patient for that specific need somewhere in the exam. Right. And I know these are little things and people might think they're silly, but they're not silly to the patient.

[Eugene Schatzman]

I got one more for you that I kind of have to know because obviously you're doing something right in your sales process when you guys are talking to patients about spending a lot of money with you. So what is that experience like? Now I'm going to give you the antithesis of that experience that I saw once in an ophthalmology practice, a very, very successful ophthalmology practice otherwise. But one of the challenges they had was premium, essentially premium IOLs for their cataract surgeon. And I was watching this and I was like, this is totally makes sense exactly why you have, you have this challenge. Because the patient would go in and they do all the tech stuff, right? All the assessments. And one of the things they would do is the visual field. And the visual field would be done on the Humphrey HFA in a dark room. And so the patient is sitting in a dark room. Now they can get their old, older patients, they can't see they're in a dark room and the person doesn't even turn the light back on. And they pull out a glossy, you know, like basically a glossy laminated sheet. And they say to the patient, okay, Mrs. Smith, so the doctor can have choice A, choice B, and choice C for you. This one is $500, this one is $2,000 and this one is free. Which one would you like? And they hold this stupid thing up. It's like, and the conversation is so silly and the patient, you know, like, even if there are benefits on that sheet, it was like you can't see them because, you know. And so I think about that experience and it's almost like the antithesis of what a good experience is. And I, and I, the audience has heard me talk about this as I believe that good sales is not self serving to the practice, it's serving to the patient. Because if you're really providing a valuable solution that you, and hopefully everybody listening believes that their solution is, is good for the patient, not just good for the practice, but it's good for the patient, then it is your, your, your obligation, your responsibility, your truly like your responsibility to your patient to make sure that they understand the benefits of what you have. And that mindset, I just think is so oftentimes absent from practices and, but there must be something that you, that you recommend that you guys do that makes the patient feel, feel really good about the sales conversation.

[Sharif Madhavi]

We are obsessed with treating every patient as a potential paying customer. We're obsessed with it because we get it, because we have nothing to fall back on. And being an elective, being purely elective again is just walking on the tightrope, the high wire, whatever analogy you want to use. It is incredibly exciting and gratifying. But if you look at it from a, a traditional reimbursed medicine standpoint, that would be, that could be terrifying to someone. And I think the example you gave of the patient that was left in the dark. I think literally and figuratively when it came to the benefits of a refractive option for their one, they're only going to do cataract surgery once. You can't make this decision after you have it done, that's really a service failure. And that's very common. Maybe not that story, but others like it. What it represents is a failure to communicate. And that I believe is the single most rate limiting factor in the adoption of any technology, but particularly self pay ones. It's the failure of the provider side, and I mean the doctor and the entire team to effectively communicate the benefits and the value of this procedure option to the patient. It's nothing more, nothing less. And the results speak for themselves. The, the ophthalmic industry is just bummed out that it's, you know, the penetration of this is only, you know, 10 to 20% of the available people that could have it done. And it's not realistic to think everyone would have it done because not everyone can afford it. But we see practices where it's 40, 50, 60% of patients are choosing the premium option, the self pay option. Why? Because those practices have figured out how to effectively communicate and you know, the reason that drove the book and now the training program is very simple. The potential of elective is so much greater than what's being realized, Eugene. It's so much higher that again, if we can solve this patient experience gap, if we can reduce and eliminate this gap, many more people will go forward with saying yes to the recommendation and spend on these high ticket procedures. Right, and spend in an optometric practice on these expensive eyewear. Because I know, you know, eyewear now, if the frame is a really super frame and a neat brand, that can be well under the four figures. Right, Right. It can be four figures. It's not, it's not in the hundreds. It can go over a thousand now. So you've got to have the environment, you've got to have the whole system, structure and culture set up to succeed in this area. Because what we know from experiences, people are willing to pay more money for a better experience. Period. Okay. We also know, Eugene, you and I like data. We're data driven. If you look at the acsi, the American Customer Satisfaction Index, which reports every quarter, they have a chart that shows how their index of 35 companies that are known for high customer satisfaction outperforms the S and P index by something like, you know, 20 times 15 to 20. It's some ridiculous outperformance of S&P 500. And S&P 500 has done well. So we know, we know that shareholders also value this. Shareholders value what customers value. And I just, I don't think there's any two ways around it. And it's really. It's a, it's a, it's something. It's an a point of view. That's. I've been. That's been informed over the course of my career. Because when I was running marketing at Viz X, I was frustrated. Why, why did we peak at 1.4 million procedures a year? That's silly. I mean, gosh, there's 3 to 4 million patients a year who drop out of contact lenses. You know, most of those should be having this done because they liked the idea of not wearing glasses. It's just that contacts didn't work after a while.

[Eugene Schatzman]

Well, and Shareef, what you're saying, and I think this is so important, and I talk about, you know, exam only rates in optometric practices. People are probably sick of me talking about exam only rates. But, you know, this is also true for your dry eye treatment. You know, if you identify somebody as a potential candidate. This is also true for your patients who need myopia management scleral lenses. That. The analogy I wanted to give to what you just said is that I read about this and it's just so fascinating. There's a guy who sold. There's. There's a guy. I don't know if you know about this, but there's a guy. I think his name is Joe. And he was the most successful car dealer salesman in the world of all time. He is in the Guinness Book of Records for selling the most number of cars in a year. And his whole approach. And I think he sold Chevy's or something. His whole approach. When they asked him, why are you so much better than everybody else? Everybody qualifies the customer, right? When they walk in the dealership, like, every other salesperson is thinking, oh, that guy, you know, he's dressed like a bum or whatever, like, he's not going to buy anything. Oh, those two are. They're too young, they're looky lose, you know, or whatever. They even have, like, terminology for. For. For these people who aren't going to buy anything. And his whole thing was, you know, he sold like, four to six cars a day. Right? And the way that he did it is he just believed that every single person needed what he was selling. And he treated everybody like a qualified customer, whether they were or not. He just made them feel like he really wanted to be there and he wanted to sell them a car. And he ended up being the most successful car salesman at all times with that particular mindset. The problem is that that mindset is super hard to train with everybody, right? You start with this mindset of, okay, I want to make my patients feel really good, and I truly believe they need all the stuff. But, you know, then you got a whole staff of people that need to be brought with you in that same boat.

[Sharif Madhavi]

It was the very first question you asked in our conversation today. What's the problem? Right. What that salesman is probably doing. And I tell you what our team does, our counseling team, is we ask, we go. I mean, and the doctors ask it as well, obviously. Hey, what's your problem? What's the problem you're trying to solve? What's frustrating you about your current solution and vision? Right. Just asking that question and others will help get that patient to open up and talk. And the more they talk, which means hopefully you're listening, the higher your chances of success are. The more you're talking, and the more they're listening. I'm sorry, the more you're talking and that puts them in listen passive mode, the less successful you'll be. Right? God gave us two ears and one mouth for a reason.

[Eugene Schatzman]

I love it.

[Sharif Madhavi]

Listen twice as much as you talk.

[Eugene Schatzman]

Sharif. We could probably talk about this for another two hours. I'm going to invite the audience. If you guys want me to bring Sharif back, I'm happy to do that, but we're out of time for today. I'm so grateful that you took the time to share some of your insights and some of your experience with us today. Just an amazing conversation. Thank you so much for being on the Power Hour today.

[Sharif Madhavi]

You are welcome. Thank you, Eugene.

[Eugene Schatzman]

Thanks for listening to today's Power Hour episode. The Power Hour is actually owned by the Power Practice. Power Practice is a premier consulting group who helps practices achieve freedom of time, confidently solve practice issues, and grow their practices. They do this by having coaches and OD consultants, people who have actually done it, been there, and they're ready to help. You want to learn more? Go to powerpractice.com there's a bunch of free tools there. You can also get a whole bunch of information and decide whether it's right for your practice. Again, if you're looking for more time, you're looking to solve complex practice issues or grow the Power Practice might be right for you. Go to powerpractice.com to find out more.