Cataract Surgery Pricing based on Surgical Skills and Not based on lenses Implanted
There is a trend to price our cataract surgery based on the lenses Implanted- This undervalues the skill of the surgeon, why not seek a alternative way to price the surgery based on skill and expertise of the surgeon.
Hospitals have to sell skills sets not lenses or equipment.
Create your packages in the following manner..
1. Cataract surgery (RCS) by Phaco.
2. Cataract surgery(RCS) with better contrast & night vision
3. Cataract surgery with Astigmatism reduction.
4. Cataract Surgery with autofocus near vision.
MANUAL SICS : If you are doing manual SICS have a separate Low cost package for that. Offer this if you feel pt is poor and will not be able to afford your phaco packages..
Advanced Cataract Surgery: Sometimes you will come across difficult cases like a small pupil, unhealthy corneas, hard cataracts, shallow AC, Have a package where you charge 50% more for difficult cases..
COMBINED RCS: Charge 75% of the second or 3rd procedure if you r combining 2 or more procedures.. like pterygium, trab, etc. If you r combining with Vitrectomy or VR surgery, charge 100% for the combined procedure..
Advanced cataract surgery WITH Laser NUCLEUS MANAGEMENT: If you have access to femto laser cataract surgery, and pt has a very hard cataract, you can offer another package..
RCS with nucleus softening/management.
Advanced cataract surgery WITH Laser ASTIGMATISM CONTROL & Nucleus Management: if you r using femto to make in addition corneal incisions, and soften the nucleus...
Please post your views in the comments so we can finalise on the terminology to base the cataract surgery on Surgical skill and not on Lenses
Very nice point raised by Dr Saravana - Request everyone to post their comments12 June 2020 01:52 AM
Message from Dr Muralidharkrishna- There are wonderful SICS surgeons who give best vision without Phaco. So no question of labelling SICS as low cost package. Let it be cataract surgery whether to do Phaco or SICS rests with the surgeon based on complexity of cases. Second point for FLACS better not to mention as additional benefit for hard cataract as in brown and black cataract. and intumsescent cataract. It hardly cuts but scratches the lens. It can be projected as cataract with more accuracy guided and aided by Laser12 June 2020 02:36 AM
A modular method would be a good model to follow. I tell patients something similar. Fix surgeon (x) ot charges (y) and consumables (z)- this is standard and add to it the iol, instruments and add ons like hooks if needed. That way patient is clear that for skill and facility I am paying. So they will hopefully in the long run even understand the importance of skill rather than the iol. So if it's sics - x+y+z+ iol cost. Phaco - x+y+z+phaco charges+iol cost. I learnt this from a general surgeon. My charge is x, ot charge is y, procedure can be done using 3 different techniques or instruments - each costing a, b and c. Advantages/benefits and disadvantages of all 3 are explained in a manner so as to not confuse the patient and give a clear unbiased picture. So x+y is fixed, chose any of a, b or c based on your personal informed choice. He applies this for simple ingrowing nail to cholecystectomy to amputation. If patient asks for a discount, we should be clear that discount will come on the a b or c and not from ot and surgeon charges. This will impress upon the patient the importance of skill and clinical decision of the doctor and shift their attention away from the iol. Of course when the patient asks us for help we must chose the middle path and offer b assuming it is the market standard, not being the highest or lowest offering, something mid way between both. Of course complex cases the surgeon charges can be higher for the extra effort or step we take to ensure the case is done right and without trouble.12 June 2020 08:45 AM
Good point. I had advocated the same in the OPD group. As to Dr. Kailash's point, it's the ideal way to go but sadly there are doctors in our own fraternity who publicize based on lens (Only Lens Charges will be charged) and even offer discounts on premium IOLs. Till mass publicizing and this perverse advertising doesn't go, patients will keep focusing on the lens and sadly, nowadays all of them already have an established idea of the lens being the main component.14 June 2020 08:40 PM