In medicine, white coats are a representation of the current realities of science. They influence the present and portray a symbol for the future. The intersection in medicine, more specifically the relationship of physician and patient, is one that determines the ultimate success of the patient's willingness to trust the physician and allow for the development of mutual exchange. Like a true partnership, the ideal outcome for a patient is a successful treatment plan and for the physician, an obvious continual flow of new patient referrals. Over the years, I have had the opportunity to observe physicians in medical settings ranging from hospital to private practice. This witnessing allowed me to conclude that those in highly specialized fields (i.e. ophthalmology) had the true luxury of developing an exclusive relationship with their patients. While the goal of my article is to review the development of a successful patient/physician relationship, the definition of success is not based upon a financial context-only on the figures of the many patients who have undergone a rewarding transformation that enriched their health, confidence, and life.
In today's climate, the effect of globalization, health policy reform, and other promotions of national and international components have all caused a major separation and concern about the future of medicine and patient care. The economics of health care is quickly gaining the lead as a major player affecting the level of care acquired by patients in all specialties. Seemingly, mediocrity is an outcome that is apparent through medical practices all over the nation as a shift from best level of care is rapidly being replaced by growing concerns of overhead and bottom-line. Worse, patients consistently question and speculate many of their physicians, which further cause distinctions and lack of trust. Once these relationships are severed, they are rarely reconstructed. However, I have realized that through revolutions, an opportunity for enhancements and recreations for the better do become available and that this phenomenon is clearly visible through the philosophy of Dr. Arun C. Gulani, founding director of the Gulani Vision Institute in Jacksonville, Florida.
Over the years, I have independently reviewed other surgeons in Florida claiming superb results, unmatched skill, and an overall enlightening experience. These statements are consistently reiterated with high-level marketing techniques, fancy billboards, and seemingly overpriced infomercials. My background in Optometry has given me the privilege of communicating with patients before and after their procedures with some of these self-titled prominent eye surgeons. At first glance, these claims of perfection are only valid until a patient comes in with a slight complication. It seems to me that as soon as a case does not fit the one or two preferred procedures that their skills are limited to, the surgeon immediately relieves themselves of the patients typically, by referring them to a super specialist. What many patients do not know beforehand is that if they do not fit the pre-determined qualifications that these eye surgeons are limited to either due to lack of training or inability to perform, the patient does not have the ability to request a tailored plan for a procedure and are simply left without a solution. Regardless of each patient's concerns or reasons- vanity or necessity, all are placed on conveyor belts, are driven by old electric motors, and are manufactured in outdated factories with expensive art pieces and plasma televisions that externally package the mediocre process. I was starting to lose hope about the future of patient care as cookie-cutter eye surgeons concerned about their golf tournaments and personal vacations are growing in numbers and are destroying the core of patient care. The pursuit of the best possible outcome for each patient is rapidly diminishing.
I feel that patients who do not regularly investigate their medical provider are severely disadvantaged. Many times, the level of care and overall outcome of a procedure such as cataract surgery is leveled to a point that the patients become a number and are shuffled through without any proper planning or even follow-up treatments. So how is the philosophy of the Gulani Vision Institute so different? Simply put, the focus IS the patient all day, every day. The Gulani Vision Institute is a self-propelled machine unlike anything I have ever seen before. It started with a vision and has turned into a reality, which patients can come in and experience for themselves. As I began my observation about the Dr. Gulani's systematic approach, I initially thought that the only reason why he was able to distinguish himself was due to his unparallel skills, intelligence, personal touch and logic based surgical plans. I thought to myself that his drive for constantly improving surgical techniques and inventions of instruments, applications, and methodologies were the main reasons for his success. However, it was after I read his recently published article, " Think Outside the Cone: Raising Keratoconus Surgery to an Art" that I had a true aha moment. One of the elements in the article discussed the utilization of his 5S classification system. This creation allows Dr. Gulani to approach his prospective keratoconic patients by examining the 5S aspects of their vision elements in their eyes ie. Sight, Site, Scar,Strength, and Shape. This system further allowed him to advance his patients to a level of acuity that neither the patient, nor their referring eye surgeons may have thought was possible. Understanding the core success of the Gulani Vision Institute allowed me to create what I would like to call the G5 Approach- a unification of business, marketing, communication, ethics, and surgery. Based on my experience, it is this continous, inter weaved application that make this institute a self propelled engine resulting in innovation, word of mouth patient referral (globally) and consistent vision outcomes that raise the bar for the world of eye care itself.
At most medical practices across the country, the engine of the machine lies in the office staff. They are the first point of contact and serve as the individual representers of the entire practice. How patients are welcomed and treated will almost always determine if the patient will feel comfortable, open, and willing to trust the physician. Furthermore, the staff inadvertently determines the mood and level of relaxation just based on their attitude. I have been to offices where the medical receptionists are secluded behind what seems to be bulletproof glass panels. Once I knock in hopes that they will acknowledge my presence, they look at me and say, " Have you signed in?" and once I respond, they resume to their overwhelming workload. I feel uncomfortable and uneasy because I think to myself if this is how the physician treats his staff, how is he going to treat me? At the Gulani Vision Institute, the staff provides undivided attention from the moment you walk through the door and until the moment you walk out. Their demeanor represents confidence in Dr. Gulani and all his accomplishments. They have no incentives and do not serve as financial closers and therefore are able to portray an atmosphere free of pushy sales, over the top lingo, and pressures to "seal the deal". There are no sales or discounts and once patients understand what Dr.Gulani can do for them, they themselves express that every dollar is worth the investment. Dr. Gulani ensures that all patients have been repeatedly exposed to his way of thinking and therefore it is no surprise that once patients understand the procedure, they are willing to sign-off thousands of dollars knowing that they are making one of the best decisions in their life. To empower patients to that level certainly allows all the other elements of practice to gain even more momentum.
It is a common saying that when a product works well beyond its level of expectations, it does not require any hosts, any shows, and it will always sell itself. The Gulani Vision Institute is a representation of this context and interestingly, the patients who underwent procedures under the care of Dr. Gulani express to the world the magic that they have discovered. There is an internal sense of obligation in them to inform other individuals who are looking for help in the same manner as they did. They want to represent Dr. Gulani and after being moved by the entire experience, they want to reach out to other patients seeking help after being turned away by other eye surgeons. It is truly surreal to see post-op patients contacting Dr. Gulani to tell him that they have invited their family members and friends from all over the world to stay with them in Jacksonville so they can have surgery with Dr. Gulani. They firmly state that they warned their loved ones to not let anyone else touch them. People fly in everyday and regardless of whether or not they have family or friends in Jacksonville, they come in to experience the transformations just like all the previous patients. All patients willingly serve as non-compensated walking ads offering to discuss their procedures with local and national media, other patients, and even their own eye surgeons. Their dedication is intense, as I have listened to patients blast reports that undermine Dr.Gulani's capabilities. I recall observing Dr. Gulani and one of his post-op patients on my second day and I listened firsthand how this patient attacked an article on a blog suggesting that Dr. Gulani entices his patients with financial incentives to go out into the community and advertise their procedures. This patient was so disturbed about the outrageous claims about her respected eye surgeon that she spent almost the entire day dismissing the false claims by responding online on that forum. Not only that, incidentally another patient of Dr. Gulani's noticed it too and she too "blasted" that jealous individual who was trying to spread a wrong statement. Examples like this show that there is no need for reputation management services as patients have taken this initiative as a way to thank Dr. Gulani for giving them vision beyond 20/20. The ability to motivate all former patients WITHOUT incentives portrays the true devotion and dedication of the Gulani Vision Institute.
Communication, in my opinion, is one of the most important points of any practice as it serves as a foundation for trust, loyalty, and openness. However, communication is also one of the hardest accomplishments because it needs to be established at the very beginning in order to start building a trusting relationship. Dr. Gulani's approach begins with his website that educates prospective and current patients and confirms to each individual that questions are welcomed and that he will spend as much time as necessary to ensure that each patient fully understands every aspect of their procedures. Education is imperative in helping patients feel confident and it is no surprise that Dr. Gulani brakes down all aspects of patient's disorder and/or disease and provides relevant statistics that allow patients to gain trust in his abilities in ensuring a successful outcome. One of the first distinctions of the patient/surgeon rapport is the level of knowledge that new and current patients can receive about various options for vision corrective surgery. They can learn about new and emerging techniques and can view the before and after as well as patient testimonials. Like a true educator, all the lessons are available and demonstrated in such a way that those who are not M.D.'s can understand and repeat. From the very first consultation, Dr. Gulani approaches his patients in such a manner that is welcoming, heart-felt, and genuine. Personally greeting patients in his 7 star Lobby (not a waiting room, since no one really has to wait), dressed in his own designed, impeccable suits with artistic perfection at every level of deliverance, each patient receives his undivided attention, expertise, and promise to strive for the best-individualized outcome. From the moment Dr.Gulani examines his patients, he immediately begins to teach them about their individual situation, what can be done, level of success, outcomes of similar cases, and other options to provide a complete approach dedicated to the highest level of vision acuity. Furthermore, he reiterates these points throughout the examination and confirms to his patients that he is more than willing to address even the slightest apprehensions. Winning the trust and confidence is what Dr. Gulani strives for and is successful in accomplishing with each and every patient. He makes them repeat what they summarized and humbly states that though he shall aspire for perfection in every case, he is human.
The ability of surgeons to not allow their status to overrule their ability to be grounded and make the patient feel like they are on the same level is another major conflict in medical practices all over the country. Dr. Gulani's true passion for the well being of each and every patient is made evident through actions, as I have seen him turn away his patients from surgery to allow time for a thorough thought process. Dr. Gulani follows up with each patient no matter what part of the world they reside in by contacting him or her personally. In my opinion, he has created a site that allows patients to feel like it has been formed exclusively for them. More importantly, there is no sense of arrogance because Dr. Gulani feels honored that patients have selected him as their eye surgeon. He views this opportunity as a privilege and therefore treats all patients like family. He does not take advantage as he constantly enforces patients to research his credentials, testimonials, and outcomes.
As with any great motion picture, the best story line will build from previous events and a successful conclusion ties together the entire project from beginning to end. Like a great film, the overall picture that Dr. Gulani expresses to his patients allows them to build their knowledge about his way of thinking and their individualized course of action. Since Dr. Gulani educates his patients from day one, they advance to such a level that they could practically teach their procedures to other patients and even their eye doctors back home. His patients become partners with him as they journey to their vision goal with excitement building at every stage. This may explain why no patient at Gulani Vision Institute takes Valium before Lasik surgery. They all walk away from surgery revived as if they were on vacation. Patients know that there is no room for mediocrity as the only outcome that Dr. Gulani strives for is vision beyond 20/20. Refusing to succumb to the comfort of the accepted national norms where in many cases, Vision is as he says "Left on the Table", Dr. Gulani's approach ensures that from hospitality to surgery, you are always patient number one.