A familiar moment:
You’ve just finished a meticulous refractive or lens replacement consultation.
Imaging is clear. Indications are strong. You know this patient’s life would be better after surgery.
Then they ask the question:
“How much does it cost?”
Your chest tightens. You say something vague, hand them off to someone else, and the authority you just built quietly leaks away.
Most private eye surgeons don’t struggle with sales because it is unethical or beneath them. They struggle because it is the one professional skill they were never trained to master, yet are suddenly expected to perform at a high level in private medicine.
When that skill is avoided, life contracts. When it is mastered, something unexpected happens. The discomfort disappears. And joy takes its place.
This article is not about tolerating sales, “getting comfortable” with sales, or becoming more persuasive. It reframes sales as:
a professional skill
a clinical responsibility in private medicine
and, for many surgeons, the final gateway to time, freedom, and joy in their work and life.
Why you have an identity problem with sales
Let’s start with the real forces shaping your relationship with money and “selling.”
1. Identity conflict
You trained for decades to be a clinician, not a closer.
Your self‑image is:
“I diagnose, I treat, I do what’s best for the patient.”
In your mental model, “sales” equals pressure, manipulation, and used‑car tactics. So when the conversation turns to price and commitment, it feels like stepping outside the physician role into a persona you don’t respect.
That identity clash is exhausting. Avoidance feels safer.
2. Peer pressure and reputation risk
Ophthalmology is a small, reputation‑sensitive world. No one wants to be the whisper in the conference corridor:
“He’s just selling premium IOLs now.”
“She’s turned into a marketer.”
So many surgeons over‑correct. They avoid visible sales structure. They soften recommendations: “Here are a few options… see what you think.” They let coordinators carry the emotional weight of the decision.
It feels virtuous. Commercially and clinically, it’s expensive.
3. Training and environment
Almost all of your formative years were spent in environments where:
someone else set the fee
someone else sent the bill
you got paid whether or not you ever discussed money.
Then you step into private‑pay refractive or premium cataract. Suddenly, every consultation is a high‑ticket, elective decision.
You’re being asked to perform at a high level in a skill you’ve never been trained in.
High status in surgery does not automatically confer competence in commercial decision‑making. Rather than admit that this is a missing skill, it’s easier to declare “this isn’t my job.”
4. Moral beliefs about money
Many good doctors quietly equate “charging a lot” with being less ethical.
You know, rationally, that the gap between your cost and your fee is what pays your team, funds your tech, and keeps the service safe and sustainable. But instead of seeing margin as the engine of quality, it’s easy to interpret it as greed.
So you hold fees down, avoid talking about money, and tell yourself you are being humble.
Here’s the uncomfortable line in the sand:
Avoiding money conversations is not humility. It is often unexamined shame, disguised as ethics.
And that leads directly to the ethical heart of this:
In private medicine, not developing the skill to discuss value and price does not make you more ethical. It simply shifts the burden to patients and staff, who are left to interpret vague recommendations without the authority to back them up. A clear recommendation is not coercion. It is part of professional responsibility.
How “no sales” advice muddies the truth
That internal knot is exactly what some ophthalmology business consultants now sell into.
You’ve seen the promise:
“No one in your practice needs to sell.”
“No scripts. No pressure.”
“Just guidance, never persuasion.”
It sounds noble. It is also misleading. Because in a private‑pay environment:
A £4,000–£8,000 decision is still being made.
Trade‑offs and risks are still being weighed.
Someone is still shaping how the patient understands their options.
If you don’t design that process, you don’t get “no sales.” You get accidental, amateur sales:
Whoever answers the phone frames the entire experience.
Surgeons hedge: “You could consider…” rather than “This is what I recommend.”
No consistent way of explaining value, money, or next steps.
Follow‑up on undecided but suitable patients is sporadic at best.
The “we don’t sell” narrative doesn’t remove sales. It removes structure, standards, and accountability.
And it tells you exactly what you want to hear:
“Your discomfort is proof you’re ethical. You never have to feel this way again.”
Comforting. But not true. And very expensive.
The real stakes: money, medicine, and life
Let’s quantify this in plain numbers.
Imagine a typical private refractive / lens replacement surgeon:
400 eyes per year
30‑year career
Charging £2,200 per eye when the market, your proof, and your outcomes could comfortably support £3,000+
That’s an £800 undercharge per eye.
£800 × 400 = £320,000 per year
Over 30 years: £9.6 million in revenue you never see
Now add conversion.
If your consult‑to‑surgery rate is 50%, but a structured decision process could reasonably lift you to even 60–65% without more marketing, that is another 40–60 eyes a year at premium pricing.
In my world, we see the same pattern everywhere: small changes in retention, conversion, or pricing create outsized changes in profit, because almost all of that extra revenue falls straight to the bottom line.
Similarly, if you run at ~10% margins and raise prices by just 10%, you almost double profit, because your costs don’t rise with the fee.
You don’t need heroic assumptions to see that “no sales” can quietly erase eight figures of lifetime opportunity.
On the patient side, it’s no better:
Many will pay more over a lifetime for glasses, contacts, and associated hassles than they would for surgery.
Many will accept poorer quality of life because no one ever stood squarely in front of them and said: “Based on your scans and your goals, this is my clear recommendation and why it’s worth the investment.”
Vague recommendations do not protect patients.
They confuse them and shift the emotional labor onto coordinators who lack your authority.
Avoidance is not virtue. It’s a skills gap that has been moralized.
What sales actually is (in medicine)
We need better language.
Sales, in a private medical context, is not generic persuasion.
Sales is the ability to recommend with clarity, proportionality, and conviction when the outcome justifies the cost.
Think of it through a simple value lens.
Every patient evaluating surgery is subconsciously weighing four things:
their dream outcome (what life looks like on the other side)
their perceived likelihood of achieving it with you
the time delay before they get that outcome
the effort and sacrifice they believe it will take (money, fear, downtime)
Those four variables together create perceived value.
Your job in consultation is to:
Clarify the dream outcome in terms that matter to them.
Increase their trust in the likelihood of success (honest data, proof, case studies).
Reduce perceived time delay (clear pathways, realistic timelines).
Reduce perceived effort and sacrifice (support, planning, financing).
That is not “being salesy.” That is just doing good medicine with better communication.
Once value is properly understood, appropriate pricing is not greed; it’s alignment. Competing on low price undermines perceived value and patient commitment, while premium pricing, backed by better outcomes and experience, often increases adherence and satisfaction.
Ethics are not proven by silence. Ethics are proven by clarity: standing behind a recommendation when you know it serves the patient.
The leap: from discomfort to joy
Here’s the good news.
You don’t need to white‑knuckle your way from disgust to tolerance of sales. Just as surgical competence removes fear in theatre, sales competence removes fear in the consultation room.
Once you understand the skill and practice it deliberately:
Anxiety is replaced with ease.
Avoidance is replaced with clarity.
Moral tension is replaced with professional confidence.
That’s the leapfrog.
You don’t creep from hating sales to half‑accepting it.
You master it to the point where the money conversation becomes just another part of the consult, and you handle it cleanly.
And when that happens, something else shifts:
Consultations feel lighter.
Decisions become sharper, faster.
Your calendar and cash flow stabilize.
You can finally start enjoying the life your work pays for.
Privilege without joy is unfinished success.
For many private eye surgeons, sales is the last meaningful upgrade left – not to the practice, but to their life.
A practical, ethical plan you can implement
Let’s make this concrete.
1. Do your own value math (once)
Behind closed doors, not with patients:
Work out realistic lifetime costs of glasses/contacts for your demographic.
Add quality‑of‑life gains: convenience, emotional confidence, occupational freedom, long‑term safety.
Factor in your real outcomes, enhancement policy, and accessibility.
This is your internal conviction file.
When you know, on paper, that the patient is better off clinically, financially, and emotionally, advocating for surgery at a premium fee stops feeling like greed and becomes a matter of integrity.
2. Redefine roles in the decision journey
Stop pretending "no one sells." Decide who does what.
Surgeon:
Diagnose.
Recommend one best option, proportional to findings and goals.
State the total fee range plainly.
Hand off.
Example:
“Based on your scans and what you’ve told me, my recommendation is [procedure].
The total fee for everything we’ve discussed is approximately £X.
If you were a family member, this is what I’d advise.
Sarah will go through exact payment options and scheduling with you.”
That is sales as clinical responsibility.
Coordinator/counselor:
Explore questions and concerns.
Explain payment options, logistics, and timing.
Agree on a clear yes/no or a dated follow‑up.
Ethics require clarity.
Vagueness just outsources decisions to the least empowered person in the room.
3. Standardize the consultation
If every consult sounds different, you have random sales, not “no sales.”
At minimum:
Use the same structure every time: history → goals → findings → recommendation → price → handoff.
Document 5–7 common concerns and your best, honest responses.
Create a simple follow‑up protocol for suitable but undecided patients (calls, messages, time‑bound next steps).
The teams I’ve seen grow most consistently aren’t necessarily better marketers. They are just relentlessly better at doing the “boring work” of follow‑up and nurture – the phone calls, reminders, and check‑ins that keep good candidates from drifting away.
4. Bring pricing into line with your value
Once the consult and recommendation are tighter, revisit your fees.
Start with modest, well‑communicated increases (10–20%) and monitor impact. In most professional service businesses with sound delivery, price optimizations of this size produce disproportionate gains in profit with minimal effect on conversion.
Remember: what you earn per patient can, in theory, grow without limit, while your ability to discount can only go to zero. The game is won by those who make each patient more valuable, not just by adding more patients.
5. Measure, review, refine
Track a few simple numbers:
Qualified consults per month
Show rate
Consult‑to‑surgery rate
Average fee per case
Watch how they move as you:
Clarify recommendations
State fees more calmly
Improve follow‑up
Within 6–12 months, the compound effect on your profit, schedule, and stress level will be obvious.
Where this ends
Sales is not a personality trait. It is not a necessary evil. And it is not something serious professionals “shouldn’t have to do.” It is a skill that helps patients.
Like every other skill in medicine, mastery replaces anxiety with clarity.
Clarity leads to better recommendations being understood.
Better understanding leads patients to choose the treatment that actually serves them best.
Only then do the secondary effects appear:
ease in the consultation
cleaner decisions
healthier margins
more time
and yes, joy in day‑to‑day patient conversations, whether they are about medicine or money.
For most private eye surgeons, this is no longer about “learning to sell” to grow a practice.
It’s about mastering the final skill that allows you to fully enjoy the life your work was supposed to buy.
