Groupon for Surgery: A Bad Idea

Like many of you, I get a daily Groupon e-mail and will often take a look and see what special deal is being offered.   I admit to being intrigued by the upcoming Tomato Battle taking place in my town next weekend (modeled after the annual rite in Bunyol, Spain), but I’ll leave it up to a few thousand others to enjoy that event.


While I have serious reservations about the longevity of the business model (which were confirmed by Groupon’s recent financial reporting), this type of offering has struck a nerve with deal-seeking consumers whose spending patterns have been permanently altered by the economic battering of the past few years.  For consumers, Groupon (and its cousins on Living Social, Schwaggle and the hundreds of other deal sites) can be an enticing way to try or buy something for the first time.


For providers – and I am speaking directly to those of you who market your services – Groupon can be a risky proposition for the business.  There are countless examples in the media of the restaurant or bakery being overwhelmed by Groupon redeemers.  They simply didn’t have or plan capacity to meet demand.   In some ways, that’s a high quality problem for a business owner.     And for providers of annuity-type, non-surgical medical services, such as facial aesthetics (eg, Botox, teeth whitening), enticing a first-timer with a good deal makes sense.   What I am concerned for are those services that are in the “once-in-a-lifetime” category, such as LASIK.


Grouponing LASIK is a bad idea for one simple reason: No opportunity for repeat business!   You’ve given away the farm to someone who will only pay you one time.  And if it’s word-of-mouth you are hoping for, you need to recognize that what you are doing is stimulating consumers to talk about the great deal they got on LASIK instead of talking about the miraculous improvement in their vision.


I could dive right in to economic principles to support my assertion, but choose to limit them to their punch lines:


Don’t treat LASIK like a commoditized good.  There’s no “supply” of LASIK that risks becoming obsolete on the shelf  (such as last season’s trendy sweater) or spoiled (like those gourmet cupcakes).


Discounts don’t work to increase demand for LASIK.   Historical trends over 15 years demonstrate an inelasticity of demand, as decreasing prices have correlated with decreasing demand for the procedure.

For  a “one time” procedure, all a discount does is lure a person who has been actively considering the procedure; he or she would eventually have a sufficient trigger and pay the going rate.  The LASIK example illustrates how providers mistakenly believe they can attract the much larger market of spectacle and contact lens wearers; history has shown they aren’t motivated by low price.


My view is that demand for LASIK is going to improve steadily over the next few years.  See my commentary “Is LASIK Dead?” to learn more.  (Thank You Note: I’m gratified to see this was the most widely read article in the August 2011 issue of Cataract and Refractive Surgery Today).


Doing a few hundred extra LASIK cases at half the price does little to boost the bottom line.   But it does a lot of damage to the long-term pricing integrity of that provider and continues to foster the myth that LASIK is a commodity and can be had for cheap.


In short, leave the grouponing to repeat-visit offerings where the goal is to stimulate a trial or sample purchase, and don’t undermine your long-term brand or market position by using groupon as a promotional tactic.  The risk of backfire is much higher than any possible short-term reward.

Is LASIK Dead?

Is LASIK Dead?A long-term perspective on this elective surgical procedure.

I have had the privilege to help commercialize laser vision correction for nearly 2 decades, beginning with the excimer laser’s FDA clinical trials and the international experience of the early 1990s…

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Ideas in Action: Babysitter Knows Best

December 2008

Babysitter Knows Best

You are What You Charge For

Figuring it out


In the world of commerce, there is a perplexing problem unique to those in the business of providing services (as opposed to tangible goods) to customers: how to value the specific service you offer. It’s tricky, because the temptation is to try to compete with similar providers on the basis of price, subscribing to the age-old adage “may the lowest bidder win.” While this might feel good to the customer (at least temporarily), it has the opposite effect on the provider. Most of what I hear from providers amounts to seller’s remorse: “I gave it away to get the business.” As a result, the service provider typically feels cheapened and compromised.


Babysitter Knows Best

For a moment, let’s visit a specific service provider that those of us with young children need from time- to-time: the babysitter.

Many of us recall as children those special occasions when time was spent with a babysitter while our parents went out for the evening. A generation later, my wife and I are probably even more dependent on this specific service to give us a few hours of much needed “R and R” away from our posts. As the person responsible for paying for this service upon our return, what typically happens next is a stroke of service provider genius: When I ask a new babysitter, “how much do we owe you?”, my question is answered by a shy glance to the kitchen floor and a gentle, “oh, whatever you think is appropriate.”

This vignette illustrates several aspects about defining value for services. The sitter doesn’t want to undervalue her services and therefore allows the customer to decide (an interesting strategy, indeed!). Mom and Dad are painfully aware of the difficulty in finding a trustworthy person to be with the kids (note to my mother-in-law: this only happens when Gram and Papa aren’t available). We don’t want to offend this precious resource, so we pay more than the going rate, especially if we sense it’s been a fun experience for our kids. We are also investing in futures, wanting to be at the top of this sitter’s client list when we will again need her sitting services.


You are What You Charge For

So, what value do you place on your services?

The answer to this question lies in the maxim offered by authors Pine and Gilmore in their book The Experience Economy: “You are what you charge for.” The fees you establish for your services are a direct reflection of what you believe those services that you provide are worth. A shrink (a.k.a. psychiatrist) might further interpret that those fees are an “indication of self” — self-worth, self-esteem, or self-loathing — but I’m not going there.

In a recent lecture, LASIK surgeon Steven Dell challenged colleagues on their pricing for refractive surgery: “Do you know what plastic surgeons charge for a ‘buttock lift’?” Curious to find out, I have learned that surgeon fees for this procedure average $3,700. If you add in the hospital fees, the cost to a consumer for having their derriere put back in place exceeds that of having their unaided vision restored.

You heard it right: we (meaning the entire marketplace) place greater value on the appearance of our backside than on our ability to see the world without corrective lenses. If you the cosmetic aspects of both procedures, one can sum it up as this: people are willing to pay more for how they sit than how they see. In my humble opinion, something’s wrong with that equation!


Figuring it out

It can be tough work to re-evaluate how you determined your fees in the first place, but that’s where the solution to this problem resides. Observe the world around you and you may notice what I’ve found to be true: It’s not about the money unless you make it about the money. The more common and generic your offering, the easier it is to compare on the basis of price alone. Conversely, the more unique and customized your offering, the harder it is to compare and the more valuable it becomes.

For a good example of this, check out the January 2007 issue of Cataract and Refractive Surgery Today and my column called The Secret Success of Starbucks. (hint: it’s not about the coffee).

Until next time, Happy Holidays! And enjoy that peppermint mocha!


Shareef Mahdavi
President, SM2 Consulting

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Staffing for the Premium Patient Experience

Staffing for the Premium Patient ExperienceYour employees are key to your strategy.

When developing a premium patient experience, surgeons need to pay attention to four critical variables: price (what you charge); quality (as defined by the patient); experience (of your patient while under your care); and your staff (those individuals responsible for staging the experience)…

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