The Secrets of $299 LASIK

In the late 1990's, LASIK's meteoric rise in popularity attracted a number of corporate entities into the marketplace, and along with them came aggressive advertisements for discount surgery. Initially at $999 per eye, then $749, $499, and $299, the lowest advertised price for LASIK in the United States is currently only $99 per eye.

These advertisements have been blasted by many traditional private practices as an embarrassment to medicine (though some have joined in) and have been criticized by consumer advocates as nothing more than a classic bait-and-switch, but they have been enormously successful in driving patient volume, so let's take a closer look at how the process works and why it is so successful.

In reality, the odds of paying $299 per eye for LASIK are about the same as finding Bigfoot or the Loch Ness monster. The discounted prices are essentially non-existent. For example, a former surgeon at a well-known, nationwide discount center is on the record stating that out of the 15,000 procedures he performed, only one was at the advertised rate¹.

The real reason for "teaser price" ads is that they make the phone ring. Laser vision correction is a highly competitive field, and virtually all practices keep track of advertising costs per lead. Because few people can resist the temptation of a potential bargain, many will respond to discount ads even though they know there must be a catch. As such, "going the discount route" becomes a cost-effective means of attracting patient inquiries.

While attracting leads is one piece of the discount puzzle, the scheme would rapidly break down if a much higher price were given over the phone. In order to avoid quoting an exact amount, discounters use a tiered pricing system based on the patient's prescription. Therefore, the patient has to come in for measurements before the real price can be determined. Known in industry lingo as a conversion from inquiry to consult, getting the patient to come in is most of the battle, as 70-80% of eligible candidates who show for a consult will book surgery.

Only after arriving for the consultation do most patients learn that the true price is much higher - often the same or more than what other local providers charge. For example, according to a South Florida Business Journal report, the national operations director of a well-known discount center stated that their average customer paid close to $1800 per eye, even though the advertised price was only $299. And the $99 per eye practice mentioned earlier offers procedures as high as $2500 per eye.

In order to successfully up sell, discounters must provide a compelling reason for the dramatically higher price. Some of the more common ones include:

Astigmatism: Tucked into the fine print on many teaser ads is a disclaimer that the advertised price is only available to patients with no astigmatism. Because modern wavefront testing will uncover astigmatism in almost everyone, this effectively eliminates the discount. In addition, most patients only have a vague understanding of astigmatism, so they are willing to accept it as "something bad". In reality, modern lasers correct all but the most extreme astigmatism with little difficulty. All the surgeon has to do is enter a different number into the laser's computer.

Technology: Virtually all discount centers have two lasers, an older model that is only capable of previous-generation conventional treatments and another with modern, state-of-the-art, wavefront-guided custom technology. Not surprisingly, the low price is for treatment on the old laser.

Ala-carte fees: In order to quote a lower price for the procedure, many discounters itemize the preoperative examination, medications and postoperative care separately. So, even though the procedure itself may technically be at or near the advertised price, the total bill is much higher.

Postoperative care: According to an investigative report by KVBC-TV in Las Vegas, their reporter was told by a well-known discount center that she would get better postoperative care if she paid more.

Retreatment coverage: In order to see more clearly, some patients require a second procedure a few months after the first. Coverage for these "retreatments" or "enhancements" is often included in the price at other practices, but it is an additional charge at the discount centers. An uncovered retreatment could cost as much or more than the first procedure, so coverage is an important consideration.

Many surgeons who compete against discount centers think to themselves, "If I came in based on a $299 ad and they told me the price was really $1800, I'd walk out!" Sometimes they are right. Some patients do walk out. However, many are so excited to enjoy the benefits of LASIK that, faced with the disappointment of going back home, starting all over with a new doctor search, calling for an appointment and taking another day off work, they simply capitulate and have surgery with the discounter. Often, the decision is facilitated by commissioned "patient counselors" who use high pressure sales tactics common among car dealers, such as price offers that are "good for today only"² and fake meetings with the manager³.

Recently, a new variation of the teaser price concept has surfaced - an offer to "Cut any advertised LASIK price in the USA or Canada in half". Interestingly, the company's web site goes so far as to state "We cut our own regular prices in half."

In many ways, this offer functions much like a teaser price. Telephone price quotes are not given. Patients must go in to the center to verify that their outside quote can be halved, and the fine print leaves plenty of room for interpretation, stating, "Half price does not apply to any post operative care, upgrades, surgery center fees, medications, supplies, re-treatments, or advance treatments. This offer subject to change without notice."

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