Surgeries Advised vs Surgeries Done: The Eye Clinic's Key Number

Ask an eye surgeon how many cataract surgeries they did last month and they will tell you within seconds. Ask how many patients they advised cataract surgery last month and the answer is usually a shrug. "Bahut saare. Kuch karwa lete hain, kuch nahi."

That gap between advised and done is where most of an eye clinic's growth hides. Not in more ads, not in a new machine. In patients who already sat in front of you, were told they needed surgery, and quietly went somewhere else or nowhere at all.

Why is "advised vs done" the key number?

My first book, Good Doctors Go Broke, has a full chapter on numbers, and it makes a point that matters especially for surgical specialities: for medically necessary surgeries, measure how many of the patients you advised surgery for actually went ahead. That is your real consult conversion.

For elective care, a healthy consult conversion is 30 to 50%. Cataract sits somewhere between elective and necessary, with long decision windows. LASIK is fully elective. Retina treatment is often necessary but cost-heavy. So track each separately, and judge each against its own trend.

Example: say your clinic advised 120 cataract surgeries in a quarter and did 54 of them. That is 45%. If 30 of the other 66 patients went to another hospital, and 36 have simply not decided, those 36 are your most valuable list. They already trust you enough to have come. A one-line sheet tells you who they are.

What should the sheet track?

Keep it simple. One row per patient advised, one column per stage. Resist the urge to add twenty columns on day one. A sheet the team actually fills in every day beats a perfect one that is abandoned by the second week.

A spreadsheet works. Your CRM works better if it already holds these stages. My book's rule applies either way: if it is not in the system, it did not happen.

How do you set it up in one week?

1. Day 1: agree the stages and reasons with your surgeon and counsellors. Use the same words everywhere.
2. Day 2: the surgeon marks "advised" on the file for every patient told they need a procedure. The counsellor adds them to the sheet the same day.
3. Day 3: pull the last three months of advised patients from your records, as best you can, and add them.
4. Day 4: assign every row an owner and a next step date.
5. Day 5: start calling the stuck patients from the oldest first, warmly, to ask what they decided and whether they have questions.
6. Day 6: prepare the first Monday review.

What does the Monday review look like?

Thirty minutes, every week, with the surgeon, counsellors and front desk lead. The same agenda each time:

• Advised this week, by procedure.
• Done this week, by procedure.
• Conversion trend over the last eight weeks, by procedure.
• Stuck list: every patient past their next step date, and why.
• Top reason for being stuck this week. Is it cost, family, fear, insurance?
• One change to try this week, owned by one person.

Change one thing at a time, as the book says, and watch whether the number moves.

Where do eye clinic patients usually drop?

Each procedure has its own leak points. Look for yours in the reasons column.

• Cataract: waiting for family, especially children in other cities; insurance confusion; lens price shock; "abhi theek dikh raha hai".
• LASIK: comparing machine names and prices; exam or job dates; parents not yet convinced; fear.
• Retina: cost of the series; travel for repeated visits; fear of injections.
• All procedures: no definite next step at the end of the consult.

When one reason dominates, you know what to fix. If "family" is the top reason, build family video calls. If "cost" dominates, look at how the estimate and payment options are explained. If "no next step" shows up, fix the consult ending. Our conversion systems work with eye clinics usually starts with this sheet, because it points straight at the leak.

What should you not do with this number?

• Do not pressure patients to move the number. The surgeon's job is honest advice. A patient who declines after an honest conversation is not a failure.
• Do not link counsellors' pay to conversion. Pay a fair fixed salary, recognise clear explanations and low complaints, and check conversations for pressure and regret.
• Do not chase people who said no clearly. Mark them declined and respect it.
• Do not judge one week. Look at the trend over eight to twelve weeks.

A rising conversion that comes from clearer explanations, better family involvement and booked next steps is good medicine and good business. One that comes from pressure will show up later in complaints.

How does this connect to your other numbers?

Advised-to-done sits in the middle of the eight weekly numbers from my book: enquiries, speed to first contact, booking rate, show rate, consult conversion, average ticket, cost per new patient and profit. If you only add one number to your Monday meeting this month, make it this one. We build these dashboards through our CRM and automation work so the sheet updates itself.

The short version

• Surgeries done divided by surgeries advised is the eye clinic's real conversion number.
• Track cataract, LASIK and retina separately, each against its own trend.
• One sheet: date advised, procedure, who decides, stage, reason stuck, next step, owner.
• Review it every Monday in thirty minutes and change one thing a week.
• Never move the number with pressure. Move it with clarity, family involvement and booked next steps.

See more about our work with eye clinics on our eye care page.