The other day, I had a patient that had a lot of questions about price. In general, I try to avoid this discussion because something feels "icky" to me about a doctor talking money with a patient. I've done everything I can to avoid the misconception that I ever recommend a treatment because of money.Although it is understandable to consider all angles as a buyer of anything expensive, the truth is the cost of a procedure has 0% to do with the medical side of the practice. An eye is either an amazingly good candidate for LASIK, a candidate with some extra details to discuss (e.g. "you might take an extra day to get to 20/20 afterwards because of such and such"), or not a candidate. My definition of non-candidacy is always the same: "Would I do LASIK on this person if they were a family member?" If the answer is "no" or "hmmm…maybe?" then I tell that person they should not get laser vision correction.
But money is important because we need it to live since the year isn't 10,000 BC. Then I would say wheat is important. So money questions need to have good answers. And this nice lady had a lot of money questions. In particular, she wanted me specifically to answer why LASIK here at Hunter Vision costs more than most of the other LASIK places she's looked at. It meant that I had to articulate the reasons in a way that I don't normally, and it turns out it was helpful for me as well. Sometimes it's a good exercise to explain something you understand to another person, because it makes you more aware of the details yourself. This is understood by anyone who's had a 4-year-old ask them why fish can breathe underwater.
The main point, I realized as I talked to her, was helpful enough to both of us that I thought I'd write it out here in a blog. It costs a certain amount to run a business because things like office space and great employees and equipment cost money. Lasers, for instance, have costs measured in hundreds of thousands of dollars, and then measured in thousands of dollars to use each day even after you own them. In order to be able to pay for all of these "fixed costs" (is that the right word? I think it is. I should ask Josh.) the money coming in has to be at least equal to them. Gosh, this is boring me to death. I would have made the worst businessman. Just read this last paragraph and we can move on to better blogs about interesting things like how eyes work.
When Josh and I opened Hunter Vision, there was the choice to have me, as the surgeon, involved in details of helping patients and the general experience here, or to hire people to do all that while I just fire the laser. If you hire people to do that, as is common in most of medicine, you can see way more patients and charge them some percentage less because there are so many of them. But, I want to be there for people. That's why I became a doctor. So I spend a lot of time with each patient. I'm the one that personally and neurotically checks each measurement that will determine their treatment. I make sure each patient can email me or call my cell phone at any time they need. I sleep less, but sleep better when I —the guy doing the surgery—am crafting every step before, during, and after surgery. And you know what? People see better because of that. There is a level of nuance that can't be delegated. The only downside to it is that we can help fewer people because I only have 24 hours in a day. But wow, do I feel better about it than having discount prices because we pushed as many LASIK and cataract patients as possible through our clinic.