Investing Basics: 5 Essentials

Everyone makes it sound so complicated. From “just start here with XYZ online brokerage” to a myriad of books, articles and opinions. But what are the basics?

Start at Home

Investing in your home — Don’t Over Glam

Start at home can mean two things. The first is about investing in your own home. You need a place to live and you might as well create some equity out of that expense. Keep in mind that real estate isn’t always a great investment. Like everything else, the price you pay matters. You will also need to ensure that you maintain that property for it to hold its value. And you need a buyer. Something is only worth as much as someone else will pay for it. Don’t over glam as you risk pricing yourself out of your market area.

Invest in What You Know

Invest in What you Know — You Know Optometry

This is the second point of starting at home. What do you know about?

Optometry is a given. So invest in your own practice. Here you will have control over the decisions that will directly impact your bottom line. You know it and can control it.

Invest in Profitable Businesses

When it comes to investing in an optometry practice or in owning marketable securities, you always want to own businesses that are profitable. In practice you can turn a fledging private business around and make it profitable. In publicly traded securities you don’t have that kind of control or impact, so it’s vital that the business is profitable and run well.

Profitable businesses have sufficient cash flow to pay their debts (yes, successful businesses know how to use leverage to their advantage), are able to roll profits into expansions and growth, and most importantly, can pay their owners a dividend. It’s vital that you get paid for taking on any risk of business ownership. Seems so basic that most people forget this tenant of investing!

Invest in Sustainable Businesses

Green sustainability aside, a sustainable business is one that is durable and can stand the test of time. These are businesses that, quite simply, are difficult to live without, difficult to compete with, and difficult to replicate.

In Canada, think of CN Rail – it moves, literally, boatloads of goods across a vast distance very efficiently. It would be ridiculous to think that a competitor could easily come in and create a competing railroad today.

Price Matters

As mentioned with real estate, price matters at all times when buying investments. The price you pay for your optometric practice should be manageable and easily recouped by profits over a period of typically 5 to 10 years. The price you pay for marketable securities is also key to seeing growth. No business out there is worth an inflated price.

Think about multiples. You often hear that practices are selling for 3-5X EBITA (earnings before interest, taxes and amortization). This same factor applies to business stocks. It’s common on the stock market to pay over 100X earnings. In fact, at the start of the tech buzz, CISCO was priced at valuations over 200X P/E (price to earnings). CISCO has gone on to be a great business worth owning – but if you bought it at these ridiculous prices, you are still down on your investment. No business is worth an outrageous price.

You can also think of P/E as the number of years it takes to recoup your investment. If something is trading at 200X P/E it will take you 200 years of current earnings to break even. I know I won’t be around long enough to see that happen!

In Summary

Investing shouldn’t be a game you play. It should be done with intention and knowledge. Knowing what you own and why you own it is the basis of all good investments.

Advisory

As your Chief Financial Officer, I am here to help guide you through the various areas of wealth creation. Helping you understand your money and assisting you in making smart financial decisions about your debt repayment, insurance protection, tax management and wealth, are just some of the ways that I work as your fiduciary.

Have more questions than answers? Educating you is just one piece of being your personal CFO that we do. Call (780-261-3098) or email (Roxanne@C3wealthadvisors.ca) today to set up your next conversation with us.

Roxanne Arnal is a former Optometrist, Professional Corporation President, and practice owner. Today she is on a mission of Empowering You & Your Wealth with Clarity, Confidence & Control.

These articles are for information purposes only and are not a replacement for personal financial planning. Everyone’s circumstances and needs are different. Errors and Omissions exempt.

ROXANNE ARNAL,

Optometrist and Certified Financial Planner

Roxanne Arnal graduated from UW School of Optometry in 1995 and is a past-president of the Alberta Association of Optometrists (AAO) and the Canadian Association of Optometry Students (CAOS). She subsequently built a thriving optometric practice in rural Alberta.

Roxanne took the decision in 2012 to leave optometry and become a financial planning professional. She now focuses on providing services to Optometrists with a plan to parlay her unique expertise to help optometric practices and their families across the country meet their goals through astute financial planning and decision making.

Roxanne splits EWO podcast hosting duties with Dr. Glen Chiasson.

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Applying Emotional Intelligence in an Eye Care Practice

Human Resources, Managing Others

Eye Care Business Canada is pleased to welcome a new contributor, Jade Bodzasy, Founder of Emotional Intelligence Consulting Inc. Certified in Rational Emotive Behavior Techniques (REBT), Jade possesses a unique skillset that empowers individuals to gain profound insights into the origins of their behaviors, as well as those of others. Jade is a dedicated coach and consultant for optometric practices with over 20,000 hours of expertise focused on customer relations, work structure refinement, training method development, and fostering improved work culture within optometric practices.

Jade’s aspiration is to unlock the full potential of optometry practices, enhancing their efficiency through the strategic integration of emotional intelligence methodologies. Her contributions promise to shape a more harmonious and thriving landscape within the realm of eye care business.

In optometric practices, providing exceptional patient care goes beyond clinical expertise. It requires eye care professionals to effectively manage patient expectations and build strong relationships based on trust and empathy. For the talented individuals that are able to pull this off, they know it builds on the success of their clinic.

One crucial skill that can greatly contribute to this is emotional intelligence (EI). Emotional intelligence refers to the ability to recognize, understand, and manage your own emotions and those of others. By harnessing the power of emotional intelligence, eye care professionals can navigate emotionally charged situations with patients, enhance patient satisfaction, and ultimately improve patient outcomes.

What is the Foundation of Emotional Intelligence?
Self-awareness is the first pillar of emotional intelligence. It involves recognizing and understanding your own emotions, thoughts, and behaviors. In the context of eye care, self-awareness is crucial for effective patient communication. Eye care professionals who are self-aware can better manage their own emotions and reactions, allowing them to respond to patients with empathy and understanding.

By being aware of your own biases, triggers, and stressors, you can avoid projecting your own emotions onto patients and approach each interaction with a clear and open mind. This is the first step in understanding how to manage your patient’s experience.

“When we are aware of something, we can change it if we want to. If we are unaware we cannot make a change.”

It can be challenging to become aware in an area that you feel as though you are already confident in. However, it’s beneficial to be in the mindset of “We can always learn something new” and this allows for awareness opportunities so that you can improve.

Now how do you increase your self-awareness?

You can engage in reflective practices such as journaling or awareness exercises. Taking the time to reflect on your emotions and experiences can help you gain a deeper understanding of your own emotional responses and how they may impact your interactions with patients. This practice is a form of self-feedback and can provide valuable insights into areas for growth and improvement.

Now that I am Self-Aware, what do I do?
Self-management is the second pillar of emotional intelligence. It involves the ability to regulate your emotions in a healthy and constructive manner. In the eye care industry setting, self-management is essential for maintaining professionalism and providing effective patient engagement. Eye care professionals who can effectively manage their emotions are better equipped to handle challenging situations, such as delivering difficult news or managing patient frustrations. They can remain calm, composed, and empathetic, even in high-pressure environments. When you can implement these skills, you start to see how this is going to drastically change your patient’s experience in your clinic.

Here is an interesting way to view this whole self-management concept.

Angry Patient asks, "Where are my Glasses" There is a patient that is wildly frustrated because they thought their glasses would be ready in two weeks time and they are not.

They are being very vocal in a loud way about how this has caused them a great deal of frustration and is a huge inconvenience.

You have three staff members you can pick from to handle the situation, one is a front desk Administrative assistant, the other is an Optician, and the last one is the Clinic Manager.

Which one do you send into the frustrated patient situation?

We all tend to ask ourselves this question to find our answer “Who’s Manager, or Who’s worked here the longest?” and although sometimes this works, it’s often not the best option.

Try asking yourself this instead “Who has had the most experience with remaining calm and empathetic in these situations?” That person is likely your staff member with the highest amount of self-regulation. This means they will be your best option for turning this situation around.

Whether someone knows all the lenses, understands the in’s and out’s of your operating systems or has the highest IQ, none of that will help them if they cannot regulate themselves in a high stress situation.

To calm someone down, you first need to calm yourself down.

One strategy for self-management is increasing emotional resilience. This involves recognizing emotions as they arise and taking steps to regulate them. In a challenging situation like the one above, take a moment to acknowledge to yourself that you are having an emotional response and choose whether or not it is beneficial to the patient if you react to it.

It is also important for eye care professionals to take care of their own well-being, ensuring they have the support and resources they need to manage stressful situations and not carry those forward with them into other moments.

Look for Jade’s continuing series on how Emotional Intelligence can be applied in your practice setting. Learn More about Jade’s consulting service by visiting her website.

Jade Bodzasy

Jade Bodzasy, Founder of Emotional Intelligence Consulting Inc., is a dedicated Coach and Consultant for Optometric Practices. Her extensive background includes over 20,000 hours of expertise focused on customer relations, work structure refinement, training method development, and fostering improved work culture within Optometric practices.

Certified in Rational Emotive Behavior Techniques (REBT), Jade possesses a unique skillset that empowers individuals to gain profound insights into the origins of their behaviors, as well as those of others. Leveraging her certification, she equips optometry practices with invaluable resources and expert guidance to establish and sustain a positive, healthful, and productive work environment.

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Optometry EHR Systems. How to Select the Best System for You

Practice, Technology

As an independent optometrist, selecting the right optometry Electronic Health Records (EHR) system for your practice is a critical decision that can significantly impact efficiency, patient care, and overall profitability. This post is the first of a series addressing optometry EHR systems. The first blog post deals with the which criteria to use in making a selection.

In subsequent posts we’ll address the best practices for making a selection and address the all important task of on-boarding staff to a new optometry EHR system.

We also ask you to provide some information about your current system and which others you might have considered. You can do so by participating in the survey.

At the conclusion of the series, a winner will get a $50 e-gift card selected among the survey respondents.

With numerous options available in the market, it’s essential to carefully evaluate and consider key factors before making a final selection.

Functionality and Usability.
When evaluating optometry EHR systems, functionality and usability should be top priorities. Optometry practices have unique requirements, and it’s crucial to ensure that the chosen system meets your specific needs. Consider the following factors:

Comprehensive Optometry Features:
Look for an EHR system that offers specialized optometry functionalities, such as integration with diagnostic devices, customizable templates for eye exams, and support for visual acuity testing and refraction measurements. These features will enhance efficiency and streamline your workflow. Some systems are general medical systems that are made over. Be certain that the systems that make your short list are specific to Optometry.
Intuitive User Interface:
Opt for an EHR system with a user-friendly interface that is easy to navigate. A clean and intuitive design can reduce training time and minimize the risk of errors during data entry and retrieval.
Interoperability:
Choose an EHR system that integrates with other healthcare providers’ systems, such as primary care physicians and ophthalmologists. Seamless interoperability facilitates efficient information exchange, streamlines referrals, and improves patient care coordination.

Data Security and Compliance
Protecting patient data is of utmost importance in today’s digital landscape. Optometry practices must adhere to strict privacy regulations and maintain the highest standards of data security. Consider the following factors:

Privacy Compliance: In Canada, the equivalent to HIPAA compliance is the Personal Information Protection and Electronic Documents Act (PIPEDA) and various provincial privacy legislation. While the specific requirements may vary by province, optometry practices in Canada should prioritize EHR systems that adhere to privacy regulations. These include features like secure data transmission, audit trails, access controls, and encryption of patient information.
Data Backup and Disaster Recovery: Look for an optometry EHR system that provides robust data backup and disaster recovery mechanisms. Regular backups, off-site storage, and redundancy measures are essential to protect against data loss or system failures.
Data Ownership and Accessibility: Clarify the ownership rights of patient data and ensure that you have control over your practice’s data at all times. Additionally, consider the accessibility of the EHR system from various devices and locations to support remote work and provide flexibility for your practice.

Cost and Vendor Support The financial aspect and the support provided by the EHR vendor are significant considerations in the selection process. Evaluate the following factors:

Total Cost of Ownership: Consider the upfront costs, ongoing subscription fees, implementation fees, and any additional charges associated with the EHR system. Compare the pricing models of different vendors and ensure that the system aligns with your budget.
Training and Support: Determine the level of training and support offered by the EHR vendor. Adequate training is crucial for a smooth transition and effective utilization of the system. Look for comprehensive training materials, online resources, and responsive customer support.
Scalability and Future-proofing: Evaluate the scalability of the EHR system to accommodate the growth of your practice. Consider the vendor’s commitment to continuous updates and improvements, ensuring that the system remains up-to-date with changing industry standards and requirements.

Selecting the right EHR system for your independent optometry practice requires careful consideration of key factors such as functionality, data security, cost, and vendor support.

By following best practices, thoroughly evaluating potential systems, and effectively on-boarding your staff, you can ensure a smooth transition to an optometry EHR system that enhances efficiency, improves patient care, and drives overall practice profitability.

Take the survey now.

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Great Leaders Trust Their Instincts

Leadership, Managing Others

Many practice owners underestimate their abilities as entrepreneurs. Practice stats, financials, HR issues, marketing and other tasks let alone patient care and management, overwhelm some people. Some will tell me they are terrible at business and choose to let someone else handle it.

Practice owners are much better at business than they believe. The reality is that practice owners are business leaders. Therefore, practice owners are faced with important decisions daily. You determine strategic direction, guide hiring, set practice priorities, the list goes on. People make decisions using two different processes; the first is based on logic and facts, and the second is based on intuition. This is where I feel practice owners do not give themselves enough credit.

Obviously, we must look at the facts. But have you thought to yourself when you do see the facts, “I’m not surprised, I felt that was not right at the time…”

We do not want to trust our instincts as much as we should because it means we must pay attention to our emotions. Oftentimes we need to remove the emotion from a difficult situation.

Why Don’t We Trust Ourselves?
Controlling emotions is more important when it comes to reacting to a situation. But what about when making decisions? What if you have the facts, but there might also be competing or incomplete information? In these cases, trusting in intuition becomes a valuable leadership competency. As Bill Gates says, “often you have to rely on intuition.”

Sometimes, people do not want to trust their intuition. It is important to discern between intuition and fear. We have all faced a situation where we were simply afraid to take action. Fear tends to be accompanied by bodily sensations, you may feel tense, panicky, or desperate. Fear has a pushing energy, as if you are trying to force something, or selecting an option because you want to avoid a threat, rejection, or punishment.

Fear also tends to be dominated by self-critical thoughts that urges us to hide, conform, or compromise yourself. Intuition on the other hand has a pulling energy, as if your choice is moving you toward your best interest, even if that means pursuing a risk or moving more slowly than others. This is usually accompanied by feelings of excitement and anticipation or ease and contentment.

Physically, gut feelings tend to cause your body to relax. With intuition, your inner voice is more grounded and wiser, like a good mentor. And remember, using intuition does not mean you have to make a quick decision. An intuitive decision can still take a few days.

Whenever I have important decisions to make, I do trust my instinct or my gut. Try asking yourself:

Do I pay attention to my first reactions about a given issue?
When I am faced with a decision, do I consider my feelings in addition to the facts?
Do I check in with my gut feeling after summarizing the pros and cons?
Do I pay attention when my gut sense is at odds with the available information?

To help use your intuition more, simply slow down. We answer our texts and emails far too quickly. We may feel compelled to make a quick decision despite being extremely tired. It is hard to slow down given the pace we are all running at. But taking a step back is important and necessary to access intuition.

The next time you are faced with an important decision, take some time to get out of your head and away from your office. Go for a walk. Do not feel the need to respond quickly. Just sit with the decision, ponder alternatives, and try brainstorming new solutions. As you do so, tune in to your emotions and evaluate your reactions to understand how intuition might be leading you in this situation.

What about the time your intuition failed? Did it really fail? Or did you let biases get in the way? There will be times when intuition leads you astray because mistakes can be attributed to unconscious biases. Biases are cognitive distortions that manifest in personal preference or misleading assumptions.

Have you noticed when you decided too quickly or were overconfident, that is when things went wrong? Whenever you let your biases interfere with your decisions, they skew your objectivity leading to the wrong decision. Your gut did not let you down but rather you chose to listen to your personal opinions that influenced your judgement.

Anchor Your Intuition with Core Values
The next time you have a decision to make, try and engage your intuition. It is always important to remind yourself about your core values and what is most important to you. Examples include service, stability, family, or calmness. Perhaps you are feeling agitated after a long day at work when nothing went your way. Your core values can help you pinpoint the source of your frustration and understand it more clearly. Using your values, you can check-in to figure out what feels off internally and gain perspective on the situation. Remember, your core values represent what is most important to you so do not be afraid to fall back on them.

I am confident that people who pride themselves on having a strong intuition, honed through years of experience, helps guide their decisions. Others will be ambivalent about relying on their intuition to make important choices because they are concerned that their gut reaction is inherently biased or emotional. This latter group is no doubt responding to the oft-given advice that we should use formal data and analysis to “check” our intuitions.

So, who is right? Should leaders make decisions based on their gut feeling, or should they not?

Please do both. Facts speak loudly and clearly; they cannot be dismissed. But remember to listen to your inner voice. Go to a quiet place, clear your mind, remove fear and biases, and truly listen to your instincts. They will not lead you astray.

A challenge for you after reading this article is to take a moment today or tomorrow to reflect on what your top one to three values may be. The next time you find yourself struggling to make a decision, ask yourself, “which action or decision brings you closer to those core values?” Going within can help dissolve the internal tension that leads to mental loops.

Finally, keep in mind that intuition cannot flourish in busy, stressful environments. Give your mind space to wander and make connections. Remember, while intuition is not perfect, it is also a decision-making tool you are underutilizing, at the moment. Trust yourself a little more and you will be surprised to find that your gut is a more powerful decision-making tool than you may have realized.

You are a practice owner and entrepreneur for a reason. Embrace this role. Sometimes a big challenge is the dislike one may have for leadership. The more you fight it, the harder it can be.

Implement systems that help you manage effectively. Always remember, you are not in this alone. There are resources available if only you choose to reach for them.

JACKIE JOACHIM

Jackie has 30 years of experience in the industry as a former banker and now the Chief Operating Officer of ROI Corporation. Please contact her at Jackie.joachim@roicorp.com or 1-844-764-2020.

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Socrates Triple Filter Test: A Primer for Good Office Culture

Independent SightLines

Ahh the thoughts that go through my head in a day! I am thankful nobody is a mind reader (at least as far as I know!).

Every day there is a battle in our minds to stay on task, to be positive, to be kind and to be grateful and mindful. Some moments of the day our thoughts can flash to frustration, anger, negativity, gossip and resentment. We are human after all and it is difficult to control every thought and make it a positive one, even for those who are consciously being mindful to keep their thoughts focused and positive. The good news is that our inside thoughts do not automatically come out via our outside voice.

We all know team members, including doctors, that have a very low filter from their mind to their mouth. If they think it, they say it! Of course, this isn’t conducive to a great team culture. Being unfiltered brings mean spirited words, negativity, gossip and discomfort for the listeners.

Ultimately a lack of filter can be a catalyst for others to have no filter, leading to general office tension and low morale.

Socrates Triple Filter

Socrates said if what you’re about to say isn’t true, good and/or useful, then don’t say it! It is incredible how much more productivity and positivity results when the triple filter test is utilized to filter one’s thoughts before the words come out; this takes discipline.

Culpability of the Listener

We teach our team members that if they happen to be listening to one staffer complaining about another staffer they are contributing to office dysfunction through the act of listening.

We encourage the listener to ask the speaker to approach the staff member with whom they may have an issue directly rather than through a third party. If necessary, we ask them to approach a manager or leadership team member to discuss the facilitation of face-to-face dialogue.

When an offender of the “triple filter test” is called out by a colleague, then we are more likely to see better office dialogue centered on patient care and process improvement rather than gossip, hearsay and unproductive conversation.

Accountability via Compensation

We ask each of our staff to touch base quarterly with a manager or leadership team member for a coaching session. This is an informal way to check in with each staffer and remind them of the importance of not participating as a listener in counter-culture dialogue. We make it clear that poor verbal control is a barrier to raises and promotions. Linking compensation to more professional conversations is very important to a good office culture.

It’s All in Your Tone

Studies have shown that it mostly matters “how you say it” versus “what you are saying”. Even when the content is muffled to the point of incomprehensibility, people can detect in the tone whether that person is a “good” or “poor” manager.

Tone is absolutely crucial to how well feedback, advice, and training are received. A kind tone of voice communicates respect, appreciation and a willingness to help. Employees enjoy working for an enthusiastic, upbeat manager whose words and body language are congruent.

Avoidance Isn’t a Solution

The “silent treatment” is a very good way of increasing tension and pressure during a negotiation, but it has no place in a culturally strong office environment. We ask our team members to sort out issues directly and quickly.

Harbouring resentments and ill well are almost always felt by other staff members and notably, by the patients. Staff of clinics with low morale and poor culture are more likely to leave their jobs and work elsewhere.

One of the best retention strategies is to have an office that communicates well, works together and filters their thoughts into optimized words to create a culture of respect.

View all of Dr. Miranda’s Independent practice Insights.

DR. TREVOR MIRANDA

Dr. Miranda is a partner in a multi-doctor, five-location practice on Vancouver Island.

He is a strong advocate for true Independent Optometry.

As a serial entrepreneur, Trevor is constantly testing different patient care and business models at his various locations. Many of these have turned out to be quite successful, to the point where many of his colleagues have adopted them into their own practices. His latest project is the Optometry Unleashed podcast.

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Impact of Increasing Interest Rates

Accounting Basics, Building Wealth, Finance|Wealth, Real Estate

Has the constant increase in rates for the past 6 months created serious indigestion for you? No doubt anyone looking at selling or buying a practice is feeling nervous.

Let’s look at the overall effect of higher interest rates.
1) As interest rates increase so does the cost of borrowing. A cautionary tale is to not be carrying any credit card debt if possible.

2) Does the hike in interest rates affect practice values? Technically no. When we appraise an office, we assume it is debt free. As much as we do not agree with valuing a clinic as a multiple of EBITDA, interest is added back, so again, the increase does not affect the value.

3) Will a buyer be influenced by interest rates? Absolutely. Let’s say for example a practice is valued at $1 million. Because a purchaser must borrow from the bank, debt servicing must be considered. Depending on cash flow, the buyer may not get 100% financing. This does not mean that the practice is overvalued. It simply means that for a buyer to purchase this office, they must either put some of their own money into the transaction or offer a lower price at the clinic.

4) Do higher rates affect spending? In normal consumer spending it would. Many of us would think twice about certain investments or luxury purchases. However, if you have been associating for years and want to be an owner, interest rates are just a part of doing business.

Regional Differences
I am certainly not an economist nor qualified to make such statements. From all the articles I read though, it is interesting to see how nationally, interest rates affect the individual provinces. British Columbia and Ontario are hit harder but this is due to the aggressive housing market experienced in prior years. The Prairies are doing well – commodities continue to be in demand (energy, crops, to cite a couple). Atlantic Canada is also holding well because quite frankly, they have been used to tough times in the past. But poor Quebec, it looks like it is heading for a recession due to an aging population and lower immigration level.

Economists say we will be in a mild recession. I think we already are. However, we’ve gone through this before. Anyone remember 2008? I was a banker at that time, practice values continued to increase and as a lender, we continued to provide financing.

There have been 11 recessions since 1948, averaging out to about one recession every six years. It is important to remember that recessions are part of the economic cycle.

A Silver Lining
As tough as they can be to experience, they also offer important economic benefits. As a practice owner, a recession will hopefully encourage you to be creative – look for ways to be more efficient and save on costs. Review your existing customer service policies – can you make patients feel more appreciated.

While recessions are painful, remember they are only temporary interruptions to the economy with an improvement to follow.

JACKIE JOACHIM

Jackie has 30 years of experience in the industry as a former banker and now the Chief Operating Officer of ROI Corporation. Please contact her at Jackie.joachim@roicorp.com or 1-844-764-2020.

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5 Tips to Financial Freedom

Building Wealth, Finance|Wealth

Adulting 101 is a big course. It’s lifelong and something we continue to learn about and grow from our experiences. Regardless of where you are on your career path, here are five tips to attaining financial freedom.

Cash Flow is King

You need to prioritize your cash flow. There is no single good answer for everyone on what that looks like, but it is a combination of debt repayment, savings, and living within your means today.

When we focus on savings, we are really focussing on time – the time needed to compound the growth of your money for your future use.

Money is a renewable commodity, but time isn’t. The sooner you figure out that you don’t want to actively work forever, the sooner you can start to put your money to work for you. Time is your friend when it comes to compounding. The sooner the better!

Opportunity cost is key here. You are always trading something. Is that daily latte worth having if it means you’ll have to work until you’re 65 or older? That money will better serve you in the future if you start putting it to work now.

Organizing your Debt

Paying yourself first is key. Paying debt is critical to your long-term success. The general rule of thumb is that debt repayment should account for no more than 30% of your cashflow.

Student loans, mortgages, and car payments are all included. So, if you are well surpassing this 30%, it’s likely time to revisit your strategy. Are you too aggressive at debt repayment at the expense of growing assets? Are you in a house that is way above what your income can support?

And don’t get me started on credit card and other consumer debt. If you can’t afford to pay cash for it now, you certainly can’t afford it when the bill comes with its 20% interest rate!

Insurance: Needs and What to Avoid

Remember, you are the goose that lays the golden egg. Therefore, you need to protect your ability to earn an income. Taking care of yourself and your family is key – and it helps you sleep well at night.

Insurance is an extremely large topic that we have touched on several times. Some key points from the past:

creditor insurance protects the lender
renewable and convertible are your friend
partial and residual will serve you well
insuring items that are easily replaced is not the best use of your cash
protect from liability

The key to know here is that not all insurance is of equal value.

Of late I’ve been getting more questions around permanent life insurance. Yes, this can be an effective strategy but, as cash flow is king, you need to prioritize those dollars allocated to insurance premiums. Using life insurance as an investment tool should generally only be considered after you have exhausted all other saving vehicles.

Plan for the best, prepare for the worst.

Minimize Taxes

No one likes taxes and, if you take a salary or make installment payments, you may assume that you are covered off here. The reality however is that those amounts are based on either the current tax tables or your past payments. They don’t reflect the lowest amount of tax you have to pay.

There are many opportunities to lower your current and future income taxation; different savings account types, the use of health spending accounts, and debt swap are just a few options. Dividends vs salaries. Share sale vs asset sale. Investing personally vs in a corporation. Buying real estate vs marketable securities. TFSA vs RRSP. They all have different tax implications that you need to understand.

Understanding your after-tax rate of return also matters. If your marginal tax bracket is 50% and you earn a 10% rate of return on your investment, your after-tax rate of return is only 5% if this is an Open account. But it is 10% if the investment is held in a TFSA.

Spend some time reviewing your last year’s tax return (personal and business) with your CPA and CFP to develop a plan to reduce your tax bill this year. Lots to talk about and lots of opportunity.

Save for Retirement

I struggle with the word retirement and really do prefer financial freedom. Regardless, you can’t cover your living expenses if you haven’t created an income stream that doesn’t involve you working day in and day out.

There are many ways to build up net worth and you need a plan that includes some liquidity. Building a practice is great, as is commercial real estate. But these are illiquid and are often not as easy to access when you need the cash flow as you expected. It’s important to have liquidity in some of your investments. You just never know when your dream around the world cruise might come on sale!

When is the best time to start investing? 20 years ago. The second best time though is NOW.

Advisory

As your Chief Financial Officer, I am here to help guide you through the various areas of creating your financial freedom plan. Helping you understand your money and assisting you in making smart financial decisions about your debt repayment, insurance protection, tax management and wealth creation, are just some of the ways that I work as your fiduciary.

Roxanne Arnal is a former Optometrist, Professional Corporation President, and practice owner. Today she is on a mission of Empowering You & Your Wealth with Clarity, Confidence & Control.

These articles are for information purposes only and are not a replacement for personal financial planning. Everyone’s circumstances and needs are different. Errors and Omissions exempt.

ROXANNE ARNAL,

Optometrist and Certified Financial Planner

Roxanne splits EWO podcast hosting duties with Dr. Glen Chiasson.

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Diversity and Inclusion in Eye Care

Independent SightLines

Canada is an intricate textured tapestry of different cultures. Each patient is unique and presents with different preferences and lifestyle choices. In today’s optometry world (and all healthcare in general) it is important to make every patient feel welcome and included.

I was born in a small town in Ontario, Canada to immigrant parents (from Goa, a Portuguese colony now part of India). My hometown was predominantly of homogeneous Caucasian descent and my darker skin stood out as an obvious difference from others in the community. “Where are you from?” would be standard line from people that had just met me, implying that I was from another part of the world given the physically obvious differences. “I’m from Canada and my parents are from Goa!” I would proudly state. I was aware of my ethnic heritage that came with mainly culinary differences from my peers, but I identified as Canadian just like they did. The implication here is that you get to choose your “tribe” and group that you identify with. While it is easy to be prejudicial given the “look” of someone, they may not identify themselves as part of the stereotype.

In our Optometry offices, we are working towards understanding diversity and being as welcoming and inclusive as possible. I feel it is totally fair game to inquire about somebody’s ethnicity. It is better to ask than to presume. Questions like “What’s your family background?” “Have you lived locally very long?” are acceptable when it comes from a place of inclusiveness. It is helpful as an eye doctor to understand family heritage as some ethnicities are predisposed to certain ocular diseases. Allowing for these inquiry conversations is an important part of “case history” and allows better investigations into potential threats to the patient’s vision.

Gender Identifications

During our online “Intake” process we allow patients to select their gender. We do not presume gender. We ask every patient what their preferred name is and use that name instead of “Mr. and Mrs.” We have done away with “men’s and ladies” frame sections and have used consultative questioning to elicit the patient’s style preferences. Learning more about the patient to better assist them with their frame choices is well received. Presuming gender may lead to hurt feelings and the patient feeling our doctors and clinic are “out of touch”. Being a clinic that is friendly and welcoming to everyone will earn a reputation for kindness and professionalism and also referrals.

Frame Choices for Everyone

It is important to have an eyewear gallery that has frames that suit the patient’s style choices as well as their face shapes. Certain sized frames and nose bridges are required for a frame to adequately fit some patients, so a deep selection is important. Eco-friendly frames, Indigenous created frames and brightly coloured frames are all part of a good selection that is inclusive and relatable to all our patients.

Ageism

As I become more “experienced” as a practitioner (28 years in practice as an optometrist), I have met so many amazing senior aged patients. Every day I am impressed and in awe of my senior patients. Many display a much younger spirit and ability than younger patients. I tell patients that it is my goal to have their good vision outlive them. It is absolutely possible to have 20/20 vision or “perfect” eyes and be 100. I have learned not to prejudge a patient based on their age. I certainly don’t want to be prejudged when I am a spry senior. Be understanding and kind and allow all elderly patients the opportunity to do tests that they can manage including visual fields testing for glaucoma. New technology such as head mounted testing devices will also assist those with limited mobility and posture constraints.

Training for the Team

Our team meets every week to discuss ways we can improve and learn. We survey every patient after their full exam and relay any patient recommendations for improvement to the entire team. If there were any less-than-ideal interactions, we learn how we could handle them better next time and contemplate strategies for service recovery.

Society is changing and so must we. The golden rule used to be “treat people how you would like to be treated”. We feel that is now archaic and the new platinum rule should be “treat people how they would like to be treated!”.

DR. TREVOR MIRANDA

Dr. Miranda is a partner in a multi-doctor, five-location practice on Vancouver Island.

He is a strong advocate for true Independent Optometry.

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3D Scan Technology vs. Clinic Methods: U de M Study Results Published

Differentiation | Business Strategy, Practice, Technology

Findings from a recently published empirical peer reviewed study conducted by the Université de Montréal (UdeM) unveils that the advanced technology Topology, used by New Look Vision Group, is the leading technology-supported purchasing method online.

Topology is a technology that uses the latest advances in 3D facial scanning and augmented reality to enable customers to take the necessary ultra-precise measurements needed to produce high-quality glasses.

The article, which has been published in the Journal Optometry and Vision Science, surveyed 30 people over 50 years old to test complex progressive prescriptions. It compared how three online eyewear retailers’ technology-based services (New Look powered by Topology and two major online eyewear retailers) fare against the U de M School of Optometry store. The research parameters primarily included the accuracy of the measurement, fitting and comfort upon delivery, and overall satisfaction.

The findings from the study uncover positive advancements in online prescription eyewear purchasing and identify Topology as a leading tool. Notable highlights include:

The quality of Topology’s measurements – namely pupillary half-distances and ocular height – is comparable to the measurements taken in person by UdeM eye care professionals.
Topology is the only technology that takes measurements for the production of personalized lenses (requiring a greater number of accurate measurements) when buying online.
Topology’s measurements are more accurate, allowing for clearer vision compared to two major online eyewear retailers.
Topology was ranked higher than the two other major online eyewear retailers by eye care professionals for frame adjustments to fit the wearer. In fact, with Topology, a personalized adjustment is made before shipping. New Look Vision Group is the only retailer to offer this service.
Overall, customers who use Topology technology to purchase prescription glasses online can benefit from an experience that is close to an in-person purchase in store.

The preliminary study results were released in November 2022 prior to publication.

The researchers concluded. “Basic lens centration measurements obtained with Topology compare well with those of opticians, but some aspects of the methodology for measuring personalization parameters could be improved. In comparison with two established online vendors, resulting measurements with Topology are more consistent. Initial wearer satisfaction with Topology eyeglasses was also better.”

“I am thrilled that an independent study confirms that New Look Vision Group’s app, which was conceived from a partnership with Topology, is the most accurate on the market. This represents years of extensive testing and a significant advance that will give confidence to people wishing to buy prescription glasses online, while providing an alternative solution with the same quality as in-store purchases.” says Jean-Michel Maltais, Senior Vice President Omnichannel, New Look Vision Group.

“This new technology from Topology represents a significant advance in the industry, compared to the traditional model of buying glasses online. The basic parameters allowing the production of quality progressive glasses are comparable to those obtained in-store. It is also likely that the higher visual comfort provided by Topology, compared to the other online retailers evaluated, is due to its ability to take measurements for the production of personalized lenses. This technology presents online eyewear shoppers with numerous advantages compared to what existed before and performs better on many levels.’’, mentions Nicolas Fontaine, Optometrist and University lecturer and researcher at the Optometry School of Université de Montréal.

“People are increasingly looking to online methods of shopping, and the app represents a new type of interaction with your mobile phone. It uses the latest 3D technology to scan 30,000 data points on a person’s face, taking ultra-precise measurements. This level of precision ensures a high-touch consumer experience, custom-fit frames (customer’s choice) and optimal comfort”, says Dr. Schwirtz, Optometrist and Vice President Innovation within the New Look Vision Group.

Digital health technologies are improving access to healthcare services for more people than ever before. Consumers now have more reliable options to choose from, and the comparative study by UdeM shows that New Look Vision Group’s app powered by Topology, which is available from its banners New Look, IRIS and Greiche & Scaff, is helping to transform the eye care industry by allowing customers to confidently shop for prescription eyewear from the comfort of their own home.

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A Guide to Overcoming Optometry Board Exams: The Last Hurdle

NextGenOD

Congratulations, aspiring optometrists!
As you begin the second half of optometry school, you are likely starting to feel the weight of not only making sure you make it through all your courses and clinic rotations, but also passing the board exams.

These exams are crucial milestones in your journey towards becoming licensed practitioners. To help you navigate this challenging process, we have compiled a comprehensive guide with key tips and resources to aid you in your preparation for the optometry board exams.

While optometry board exams in both Canada and the United States share the common goal of assessing your competency in the field, there are some notable differences in their structure and content.

In the US
The National Board of Examiners in Optometry (NBEO) administers board exams in the US. The exams consist of three parts: the Applied Basic Science (ABS) Exam (Part 1), the Patient Assessment and Management (PAM) Exam (Part 2), and the Clinical Skills Examination (CSE, or Part 3).

Part 1 focuses on your fundamental knowledge of ocular anatomy, disease, pharmacology, optics, and more. It ties together all the coursework you have gone through in your didactic lessons.

Part 2 evaluates clinical decision-making skills, much like seeing patients in clinic, where you are provided with a series of case presentations and questions are asked based on each case that assesses your knowledge of ocular and systemic disease, as well as patient management and care.

Finally, Part 3 assesses your practical clinical abilities in a series of four stations, each testing a different set of clinical techniques. These exams are designed to ensure that you possess the necessary knowledge and skills to practice optometry independently.

In Canada
Ten provincial optometry regulators such as the College of Optometrists of Ontario (COO) and the College of Optometrists of British Columbia (COBC) conduct the exams under the auspices of the Optometry Examining Board of Canada (OEBC).

The board examinations in Canada consist of only two components – one written, and one practical.

The written exam assesses your theoretical knowledge in areas such as ocular disease, pharmacology, and optometric procedures.

The practical component, called the Objective Structured Clinical Exam (OSCEs), evaluates your clinical skills, with a particular focus on critical thinking, communication, and patient management.

It is essential to familiarize yourself with the specific requirements and exam formats established by the regulatory bodies in the province or state where you plan to practice. Be sure to consult official resources and communicate with your faculty and mentors to obtain accurate and up-to-date information on the optometry board exams in your desired jurisdiction.

Key Tips for Board Exam Preparation:

Start Early! Begin your preparation well in advance to allow ample time for review, practice, and consolidation of concepts. For example, for the NBEO, three to six months is typically recommended prior to your examination date. For some optometry schools, you may not be able to take time off prior to your exam date, so more time should be allocated in advance to account for ongoing midterms, clinical evaluations, and other commitments.Some students may consider taking written exams at the later date that is offered to allow for more time to study; however, consider that the earlier you schedule your exam, the more time you have to account for unforeseen circumstances, such as needing to retake or reschedule an exam.

Both the NBEO and the OEBC offer multiple examination dates:

Click to view the NBEO schedule (USA)
Click here to view the OEBC schedule (Canada).
Create a Study Plan: Develop a structured study plan, allocating time for each topic based on its weightage in the exams. Break down the material into manageable sections to avoid feeling overwhelmed.Many boards preparation programs create daily schedules for you to follow, but keep in mind that you may need to adjust this based on your own schedule and to account for areas you may find more challenging.Moreover, optometry school is a busy time in your life, and it’s key to incorporate ongoing events such as midterms, conferences, or social events into your study schedule so you can recognize which weeks you should be packing in your studies and which weeks you may need to prioritize other commitments.

That being said, keep study schedules realistic – if you know you can’t review 50 pages in a day, don’t set yourself up for failure right from the start!

Don’t Study Alone: Collaborate with your peers to discuss and review topics, exchange study materials, and challenge each other with practice questions. Particularly for practical examinations such as the NBEO Part 3 and Canadian OSCEs, it is crucial to practice and engage in roleplays with your peers to identify areas of difficulty or to have others point out areas of improvement.Aim to schedule practice sessions with your peers! You may find yourself exposed to more points of view and different ways of presenting information which can be helpful not only in your practical exams but also as a future practitioner.
Make Boards Prep a Daily Habit: Consistent practice with sample questions and mock exams will help you build confidence, improve time management, and identify areas that require further attention.No one starts out completely ready to tackle board exams – rather than intelligence and talent, boards prep is ultimately a journey of preparation! Boards preparation should also be part of your daily time spent in clinic at school – remember to ask your professors and clinic supervisors whenever you are encountering a new difficulty or hurdle with a patient. Your time spent in clinic will pay off in the exam room!
Seek Mentorship: Reach out to professors, optometrists, or alumni who have successfully passed the board exams for guidance and mentorship. Their insights can be invaluable in understanding the exam format and content, particularly as the NBEO and OEBC may be vague in their rubrics or their guidelines.Students who have recently taken their board exam will have a fresh recollection of their experiences, but take others’ advice with a grain of salt as everyone’s studying process is ultimately unique and something that may work for another student may not be ideal for you!

Using Available Resources:

Textbooks and Study Guides: Many students opt for their old lecture notes, or classic textbooks such as the Will’s Eye Manual which are excellent resources to reinforce your understanding of core concepts.Moreover, podcasts can be excellent guides for students who are commuting to clinic externships – Eyes for Ears by Dr. Ben Young and Dr. Andrew Pouw provides a comprehensive review targeted for ophthalmology board exams but provides many clinical insights to optometrists!
Boards Prep Programs: Numerous online platforms offer comprehensive study materials, practice questions, and interactive learning modules. OptoPrep (optoprep.com) and KMK Optometry (www.kmkoptometry.com) are two popular platforms that provide tailored board exam preparation services. They offer subscription-based access to their resources, including study materials, practice questions, and simulated exams.
Exploring these platforms can significantly supplement your preparation.

Leveraging Published Case Studies and Topic Reviews: In addition to textbooks and online resources, incorporating published case studies and topic reviews into your board exam preparation can significantly enhance your understanding and application of optometry concepts.

Your time spent first-hand with patients in clinic is invaluable for boards preparation, but ultimately a limited exposure to all the conditions and management strategies in the field. Therefore, it is highly recommended to immerse yourself with more case studies and topic reviews to solidify your knowledge for topics you may not have had the chance to experience in clinic.

CRO offers original case reports and topic reviews.

One valuable source of such materials is the Clinical & Refractive Optometry (CRO) Journal,

This journal provides a wide range of free articles covering salient topics in optometry. The articles in the CRO Journal present real-life scenarios, clinical challenges, and topic reviews that can improve your critical thinking and problem-solving skills. By reviewing these case studies and topic reviews, you can gain insights into the practical aspects of optometry and apply theoretical knowledge to realistic patient scenarios.

The CRO Journal can serve as an excellent complement to your study materials, allowing you to broaden your understanding and stay updated with the latest advancements in the field.

Students can create a complimentary student account which also provides access to the self-testing quiz included with selected courses. (Contact support@CROJournal.com).

Preparing for optometry board exams requires a disciplined approach, a solid study plan, and access to reliable resources. By starting early, engaging in study groups, exploring online platforms like OptoPrep and KMK Optometry, enrolling in review courses, and leveraging published case studies and topic reviews, including those found in the Clinical & Refractive Optometry (CRO) Journal, you can develop a comprehensive understanding of optometry concepts and sharpen your clinical reasoning abilities.

Remember, success in board exams requires a multifaceted approach that combines diligent study, practice, and the exploration of diverse resources. With careful preparation and a proactive mindset, you are well-equipped to excel in your optometry board examinations. Best of luck on your journey to becoming licensed optometrists!

Related Read
Alex Hecht, UW Class of 2021 Shares her journey writing the NBEO exams as a Canadian OD student.

Writing NBEO Exams as a Canadian Optometry Student

JENNY LEE, OD

Vision Science Assistant Editor, CRO Journal

Jenny Lee is an onboarding resident with the University of Waterloo School of Optometry and Vision Science.

She is a recent 2023 graduate and is passionate about pediatrics and vision therapy.

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Investing Basics: 5 Essentials

ROXANNE ARNAL,

Applying Emotional Intelligence in an Eye Care Practice

Jade Bodzasy

Optometry EHR Systems. How to Select the Best System for You

Great Leaders Trust Their Instincts

JACKIE JOACHIM

Socrates Triple Filter Test: A Primer for Good Office Culture

DR. TREVOR MIRANDA

Impact of Increasing Interest Rates

JACKIE JOACHIM

5 Tips to Financial Freedom

ROXANNE ARNAL,

Diversity and Inclusion in Eye Care

Gender Identifications

Frame Choices for Everyone

Ageism

Training for the Team

DR. TREVOR MIRANDA

3D Scan Technology vs. Clinic Methods: U de M Study Results Published

A Guide to Overcoming Optometry Board Exams: The Last Hurdle

JENNY LEE, OD

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