Your Guide to Multifocal Contact Lens Fitting with Jocelyn Leung, OD

NextGenOD, PathFinders

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Dr. Jocelyn Leung is passionate about contact lenses. Here she discusses how she implements multifocal contact lenses into her everyday practice to provide patients with vision that fits their lifestyle.

Jaclyn:  How do you identify successful candidates for multifocal contacts?

Jocelyn: Once patients reach presbyopia, possibly getting eyestrain and headaches, you can have the conversation about multifocals.

If the patient is already a contact lens wearer, fantastic. Patients who wear contact lenses are used to not wearing glasses and want to maintain this lifestyle. Glasses are inconvenient for any athletic activity, traveling, especially nowadays with the masks causing constant fogging!

I discuss the options with the patient: glasses over contacts, monovision, or multifocal contact lenses.
Before a multifocal fitting, I set expectations and let the patients know that they won’t necessarily have 100% clarity of vision but will get convenience. I usually say that they can achieve about 80-90% of what they would be able to see with glasses and gauge the patient’s response.

Patients who prioritize convenience over perfect vision are ideal candidates. It is important to make sure that the patient understands the way multifocal lenses work and what is optically possible.

Jaclyn: How is the conversation different if the patient is not a previous contact lens wearer?

Jocelyn:  Multifocal contact lenses are a good option for presbyopic patients whose end goal is to be glasses free, even if they have not previously worn contact lenses. The process does take a little bit more time, with teaching insertion and removal and educating on contact lens hygiene.

It really depends on the patient’s personality and visual demands. Last week, I fit a patient who has never worn contact lenses but did not want to wear glasses anymore due to the mask and fogging. She was very, very happy with her lenses right off the bat and I finalized her prescription with only one more visit.

Jaclyn: Can you walk us through your process of fitting multifocal lenses?

Jocelyn: I first discuss the process and fitting fees with the patient. On average it is going to take three visits and some time to find the right prescription. I let the patient know that it’s very likely they won’t be fit on the first try, and then if they are fit earlier, they’re even happier.

I look at the prescription and what lenses the patient has worn in the past. Using a brand or modality similar to what they’re currently wearing can help ease the transition. I usually stick with DAILIES TOTAL1 as my number one go-to option for multifocal lenses.

The fitting guide, which is individual to every brand and contact lens, is very important. My tip is to find two or three multifocal lenses that you like and memorize those fitting guides. Then if you need to pivot, you can look up the fitting guide for the other tertiary lenses.

Grab your first trial lens and have the patient try the lenses on in the office. It does take some time for the lens to settle and for the patient’s brain to adjust, so let the patient know that you do not expect perfect vision right now.

Make sure that the patient is functional before they leave the office: meeting the driving standards, comfortable seeing far away, and can read their phone. Then you can send them home with some lenses.

I do a one week follow up, but the patient can take two to four weeks to adapt. I like to see the patient at least every week, maximum two weeks, for a follow up to get their feedback. Otherwise, the patient may try the lens, forget about their vision, and not be able to provide you with comments. If there’s something the patient isn’t happy with, they need to vocalize that to you. You need to ask the right questions and be able to adjust from there.

At the first follow-up appointment, I get feedback on the comfort and vision at distance, intermediate, and near. I do use a reading card for a metric number at near, but I do not base my success on a number. I am not aiming for a certain visual acuity. I am aiming for what the patient is happy with because everyone has different visual demands.

We see if the patient wants to improve their distance or near vision and make sure that the comfort of the lens is good. We can then do an over-refraction to see what adjustments need to be made.

After a few appointments, if we find a lens that the patient is happy with, we can finalize the prescription. If the patient still is not getting comfortable vision, we can give it another shot for a few more weeks before switching to monovision or back to glasses if necessary.

Jaclyn: Can you give us some insight into your discussion on fitting fees with the patient?

Jocelyn: I always discuss fees first so there are no surprises. If financials are a deciding factor, then we only discuss options within their absolute cutoff budget.

We can always educate and bring awareness to our patients on the options available. However, if the patient is very happy with over-the-counter readers or taking their glasses off to read, they likely won’t be convinced to try multifocals. It’s what they’re used to and that’s what they’re happy with. To try multifocal lenses, you have to be enthusiastic and engaged in the process.

If the patient is willing to give multifocals a try, that’s when we can add the most value. I’ll explain that a contact lens fitting is a process, and the fitting fee is a one-time fee that covers trial lenses and multiple appointments.

As long as the patient understands that we are putting in the effort to try to get them the best vision possible, they will be more open to that fitting fee. Depending on the clinic, fitting fees may also cover appointments for any sort of infections or emergencies related to contact lenses. This gives the patient reassurance that we’re going to be there every step of the way.

Jaclyn: Great, thank you so much for all your tips on being more successful with our multifocal fits!

JACLYN CHANG, OD

Editor NewOptometrist.ca

Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with NewOptometrist.ca.

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The Potential of Artificial Intelligence in Optometry

Practice, Technology, The Patient Journey

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Artificial intelligence is a branch of computer science that uses various techniques that aim to mirror human intelligence. One AI technique is machine learning, which relies on vast data sets to learn and predict results without human intervention.

Artificial intelligence has slowly made its way to optometry as well. It is unlikely that AI will ever replace an optometrist but it does have the potential to ease many aspects of their jobs.

This doesn’t mean that robots will be running around in our healthcare facilities; rather, AI focuses on a large amount of patient data to give insight into diagnosis and treatment methods.

Let’s look at how it has the potential to change an optometrist’s practice.

Streamline Management
Software is coming to the market that provides autonomous management of tasks related to patients. Repetitive tasks like scheduling, billing, and follow-ups can be done on the fly and updated in patient records as new information is received.

This improves organizational productivity for many optometry practices, making them more efficient leaving more time to focus on patient care.

Early Detection
One of AI’s advantages is that it can process vast amounts of data more quickly as a computer is doing most of the legwork.

This especially comes in handy when processing optical coherence tomography (OCT) images, retinal images and dry eye. It can look for patterns within these images that optometrists might miss because of the subjective nature by which these images are analyzed.

Diabetic Retinopathy
Machine learning can monitor these images over time and see if any changes are occurring that lead to eye diseases that manifest progressively.

FDA-approved AI systems are already appearing on the market that analyze fundus photography to detect elements of diabetic retinopathy such as hemorrhages, aneurysms, and other lesions.

It can detect these changes early on, leading optometrists to formulate a health plan with the patient. Additionally, this system requires minimal training and can outperform humans.

Glaucoma
Technology to detect other ocular diseases such as glaucoma by fundus photographs, optical coherence tomography (OCT), and visual fields is currently in its early stages.

AI is beneficial for open-angle glaucoma cases where symptoms don’t typically exhibit themselves. Since glaucoma can’t be cured, early detection may help manage the disease to prevent it from getting worse to the point of severe vision loss or blindness.

Dry Eye
There is also new AI technology emerging  in the dry eye arena.

When it comes to talking to patients about their dry eye disease, a picture is worth a thousand words. Conversations become easier when you can show a patient an image of their ocular surface. Suddenly it all clicks (pun intended).

AOS is one company that takes it a step further with innovative technology. The platform automatically grades an image for Bulbar Redness, Injection and Lid Redness. In Staining mode the software counts punctate of a fluorescein image. It can also convert a fluorescein image into 2D and 3D which brings a real wow factor.

The images show patients proof of their condition and the analysis provides context. It’s much like the difference between stating a fact and telling a story.

We can now give meaning to symptoms felt and seen in the eye. And it’s especially useful for assessing progress during follow up appointments. Lower redness numbers or lower punctate counts tell me and the patient we are on the right track.

AOS analysis improves patient education which helps boost compliance. Better compliance leads to better outcomes and that leads to happy, loyal patients.

Reduce False Positives
False positives occur when a test result shows that a disease is present when it is not in reality. Here AI can help as well.

By looking at vast amounts of medical data regarding symptoms that a patient presents, AI can predict the likelihood of a disease or condition being present.

As a result, patients can save time by avoiding unnecessary consultations with their optometrist or an ophthalmologist and save money on unnecessary medications.

In Optometry and Beyond
Artificial intelligence is showing its potential in many medical fields other than optometry, including oncology, dermatology, pharmacology, and genetics.

Though still in its infancy, improvements in this technology will help doctors verify their diagnoses and interpret data faster independently.

This does not mean that a doctor’s work will become redundant, as AI algorithms are not yet 100% accurate. There will cases when a doctor’s insight will be invaluable in diagnosing diseases.

Consider AI a tool to benefit the health care provider and the patient.

MARIA SAMPALIS

is the founder of Corporate Optometry, a peer-to-peer web resource for ODs interested to learn more about opportunities in corporate optometry. Canadian ODs and optometry students can visit www.corporateoptometry.com to learn more.

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Finding a Job and Navigating Contracts

NextGenOD, Perspectives

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Finding your first (or even second or third) job within the optometric profession can be a challenge for new optometrists. Dr. Jocelyn Leung walks us through the process from interviewing to contracts.

Jaclyn:  When you graduated, how did you go about finding a job? Can you touch on your interviewing experience?

Jocelyn: When I graduated, I found the Ontario Association of Optometrists to be a good resource. At the University of Waterloo, there is the student association that had job listings and an interview day. Word of mouth can also be a strong connection.

Most clinics start off with a phone interview. That’s when you can ask your questions to learn more about the office: How many doctors are there? How many exam lanes? What type of equipment does the clinic have? What are the hours? Does the clinic dispense? What are they looking for in an associate?

Before this phone interview, I would suggest checking the clinic’s website or social media. As much as they are interviewing you, you are also interviewing them to make sure that it’s a good match.

For an in-person interview, it’s helpful to go in on a working day. I always like to shadow so I would ask the hiring doctor if I could come in 30 minutes to an hour before the interview. Every practice runs differently; with a different number of staff and different procedures.. It is important to see how the staff interact with each other and with the patients.

The one-on-one interview with the hiring owner is when you get to know each other on a more personal level and see if your personalities and interests match long term.

Jaclyn: Looking for a job all starts with location. Did you mostly look at job postings in Toronto?

Jocelyn:  Yes, my family and friends are in Toronto and my partner also secured a job in Toronto. I value my personal life and that was something that I was not willing to compromise; my support system is very important to me.

Some people think Toronto is very competitive and you won’t get the same salary as you would in a different province or even in the suburbs. Generally speaking, that is true. However, I believe that if you find the right place for you, and you hustle and work hard, then it will all pay off in the end.

Jaclyn: What advice can you offer to new graduates on contracts and negotiation?

Jocelyn: Contracts are a bit scary at first. Before signing a contract, you want to get an idea of other contracts in the area. Contracts definitely vary from one area to the next.

In general, there are two compensation models: the dispensing model and the retail model. Depending on the model, compensation is based on a percentage of exam fees, a percentage of the gross revenue, or a percentage of the profits.

Within the contract there is always fine print, such as non-competes or non-solicits. Double check these and make sure it’s something you’re okay with. Bring up any questions or concerns in a very respectful way. If you feel like you are not fairly compensated, or you want a specific term modified, always bring it up, because you should know what your worth is and then do the best you can to meet in the middle.

Jaclyn: Yes, it is also important to know that just because an opportunity has come up, it doesn’t necessarily mean that you need to take it or it’s the only one out there.

Jocelyn: Exactly! When I graduated, everybody was looking for a job at the same time. Depending on when your board exams were, you would want to start practicing in August or September. Practice owners don’t work on our school schedule – they hire when they want to hire, and that can be all 12 months of the year.

You have student loans, you have the pressure of securing a job, and you are eager to enter the workforce, but I think it’s worth waiting and finding the right spot. Don’t sell yourself short just to secure a job.

Jaclyn: Great advice! Thanks for all your insight into the job hunting process!

JACLYN CHANG, OD

Editor NewOptometrist.ca

Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with NewOptometrist.ca.

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What’s your Greatest Asset?

Building Wealth, Finance|Wealth, Resources

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Roxanne Arnal, Optometrist and Certified Financial Planner© has made her article available in audio format.

Click the play button below to listen.

 

 

Dr. Roxanne Arnal, CFP®
Have you ever thought of it?

You’ve spent 6 or more years in post-secondary education. You may be riddled with student debt, you may have a mortgage, kids to feed, a business to run. But what truly is your greatest asset? Let’s take a look at some of the most likely contenders.

  • Your vehicle
  • Your home
  • Your income
  • Your business
  • Your investments

This seems rather timely to me as spring is when both our auto and home insurance renewals arrive. And like most of you, I complain about the steady increase in premiums and then….pay them. It got me to thinking “Am I spending my premium dollars appropriately?”

Consumer Product Extended Warranty
First off, let’s hope you didn’t select the product coverage that the sales clerk at your local electronics store tried to sell you at check out. This type of consumer insurance is a great profit builder for the corporate entity. Why? Because in most cases, you will never claim on the insurance. You will lose the receipt, forget you have it, or quite frankly never need it. In addition, as a proportion of the cost of the actual product, it’s crazy expensive. And last, but not least, would the loss of the device cause dire, or even serious, financial ruin?

Auto Insurance
Auto policies typically include liability protection. And I would never advise you to drop that critically important piece of your asset protection portfolio. But if I look at that portion alone on my current renewal, the cost runs just over 50% for $2,000,000 of coverage. The balance of my premiums provide coverage to replace my vehicle in some form or another. So I’m paying just over $500 a year to replace a vehicle valued at $38,000. Hmmm. Needless to say, this isn’t my greatest asset. (Note: my rates reflect years of clean driving, multi-policy and age discounts. We won’t discuss what my 18-year old son pays for liability alone!)

Home Insurance
Then there’s our home. Here, a very small portion of the premium goes towards liability coverage. The remaining premium, just under $3,000 covers my “stuff”. So for $3,000 a year (and growing), I have potential coverage of up $2,000,000. Again, not the best value for my money, but the loss of our home and the stuff inside it would definitely have a serious financial consequence for us.

Your Income, Your Business, Your Investments
That leaves us with your income and your investments. For ease of illustration, I’m grouping your business in your investments and trust that in all cases you have sufficient liability coverage.

Whether your greatest asset is your income or your investments is really dependent on where you are in your career. For simplicity sake, this chart shows a rough estimate of your lifetime earning potential, based on your current age, and cross referenced with your growing investment portfolio. As you inch closer to retirement, your investments grow while your anticipated lifetime active earnings taper down.

 

 

*  See assumptions below.

You Are Your Greatest Asset
Without the ability to earn an income, you wouldn’t have any of the material things we’ve spoken of here. It could become impossible to keep your business, and build your investment portfolio. Considering this, how many of your premium dollars are going toward managing the risks placed on your greatest asset – you? Without protecting what you have worked so hard to achieve – your education, your business, your wealth portfolio – what exactly are you protecting?

Asset Protection Portfolio
An asset protection portfolio involves so much more that liability protection. It is critical to ensure that you have reviewed and aligned your premium dollars and behaviour to protect what really matters. Not sure? That’s just one piece of being your personal CFO that I review with you.

Call or email today to start your review.

*   Graph assumptions:
Work from age 26 to 65, starting at $120,000 per year, remove 2020 Ontario taxation and self-employed CPP amounts. Maintain these rates into the future. In year two, contribute 18% of previous years pre-tax income to an RRSP. Apply tax credits for RRSP contributions, basic personal amount & Canada Employment amount only. Increase pre-tax salary by 3% per year. Invest 30% of annual after-tax income in monthly installments, earning 5% compounding annual rate of return.

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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Perspectives on Myopia Control

NextGenOD, Perspectives, Products | Services | Industry News, Resources

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By Jaclyn Chang, OD

I recently had the chance to discuss how myopic control can benefit our patients with contact lens residency trained optometrist, Dr. Rosa Yang.

Here is the conversation.

Dr. Rosa Yang

Dr. Yang pursued a post-graduate residency program in Cornea and Contact Lenses at the University of Waterloo.

She is the recipient of the Sheldon Wechsler Contact Lens Residency Award from the American Academy of Optometry and was awarded First Place in Clinical Poster from the Global Specialty Lens Symposium.

Dr. Yang has particular interests in myopia control (including ortho-K), dry eye and corneal disease management.

 

Jaclyn:  What myopia control options are available?

Rosa:  There are several options including the MiYOSMART spectacle lenses by Hoya, MiSight soft contact lenses or off-label use of soft multifocals, Atropine, and ortho-K.

As a clinician, I think it is good to be aware of all the options so you can choose the most appropriate option for your patient.

Jaclyn: How do you choose one myopia control option over another for a patient? Is it very individual to that patient’s comfort level and particular case?  

Rosa: I don’t want to oversimplify, but, yes, there are selection criteria where we weigh one option over another. These include prescription, the parents’ budget, and the underlying eye condition.

A big factor is also how comfortable the patient is with handling contact lenses. Do they want to handle the contacts themselves or is it something that the parents might want to be more involved with? For the latter, ortho-K might be the better option because it’s mainly done at home at night.

For a patient who doesn’t want to wear hard contact lenses or glasses, and if the parents are hesitant about putting their kids on a medication (Atropine), soft contact lenses are the option we would be considering.

The only FDA approved soft contact lens for myopia control is MiSight, but it is limited by the fact that it is not available with astigmatism. In patients who have astigmatism, multifocal soft contact lenses can be used to implement the peripheral defocus effects.

Jaclyn: Under what circumstances might you select specifically designed spectacle lenses (like  MiYOSMART) for the patient?

Rosa: Some patients have been wearing spectacles and would like to continue wearing them. For them, it makes sense to keep them in myopia control lenses like MiYOSMART.

There are also patients who are uncomfortable pursuing contact lenses (i.e. they have trouble handling CLs, they are poor CL candidates) or the parents are uncomfortable having their kids on long-term atropine drops, then we would consider spectacles.

MiyoSmart lenses may also have larger prescription ranges than the contact lenses.

Jaclyn: When would you initiate myopia control treatment? Do you monitor until you see progression or initiate at the onset of myopia?

Rosa: Currently there is no consensus amongst clinicians, but when I see evidence of fast progression, then I initiate myopia control. Average progression is -0.50D per year, so anything above that might urge me to start myopia control; sometimes you may want to monitor a little bit more to see.

There are also clinicians that see myopia control as a preventative treatment that should be used more widely, especially considering the global myopia pandemic, so it’s a grey area.

Jaclyn: Are there certain things that we can say to our patients to help them better understand the importance and benefit of myopia control treatment? How can we help them understand the health implications associated with myopia?

Rosa: This is a very good question, because this is a topic that I discuss with every parent when we talk about myopia control. I tell them that the reason we pursue myopia control is not just the high prescription itself, it’s not just the inconvenience of having really thick glasses, it’s the ocular health implication.

“When you have a high prescription, the eyeball is usually more elongated, which means that the tissues in the eyeball get stretched out and are thinner; this predisposes them to certain ocular health complications, some of which are vision threatening. There is a higher risk of retinal detachment, maculopathy, and glaucoma.”

When I emphasize this, parents usually understand. With myopia control, it’s very important that parents understand what you’re doing, why you’re doing it, and how you’re doing it.

Jaclyn: Thanks for that – hearing the way that other doctors counsel always helps me with how I counsel my patients. Education makes such a big difference to patient care. 

Rosa: Yes, exactly, with myopia control, sometimes parents wonder why their child’s prescription still increases. That’s why with myopia control, it’s very important to have a consultation.

The management we’re doing is not to stop myopia, it’s to slow down the progression of myopia; regardless, the child is still going to progress.

Another thing to realize, for example, with ortho-K, is that some parents may think that once you wear the ortho-K lenses, that the prescription is completely gone, so explaining the process and treatment is very important.

Jaclyn: Thank you so much Dr. Yang! This gives our audience some things to think about and implement into everyday practice. 

Previous discussions with Dr. Rosa Yang: 
Pursuing a Contact Lens Residency: 

JACLYN CHANG, OD

Editor NewOptometrist.ca

Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with NewOptometrist.ca.

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One Year Later

Human Resources

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There is no doubt the world changed a year ago. The life we took for granted came to a screeching halt while we waited in helpless disbelief to hear how this pandemic and its incredible impact created stress and anxiety literally by the hour.

The pandemic forced the closure of schools, places of worship, community centres and businesses. Isolation was thrust upon us as we were prevented from seeing those we love and forced into mandated social-distancing and or self-isolation for our collective protection.

Take the positive from COVID
Despite the negative impact of COVID-19, we must however, recognize the positive that has also risen out of this crisis. If we look closely, there have also been many opportunities to reflect upon and be grateful. We have been forced to slow down which has allowed us to take a step back and appreciate so many things we took for granted.

Prior to March 2020, how many of us were close to burning out thanks to the pace we were running at? Being forced to spend more time together particularly from March to June, enabled us to focus on and breathe new life into the key relationships that we may have taken for granted. While we may not have been able to visit those we love, we were given the gift of time with the people in our home or bubble.

Viewing Trust Through Your Patient’s Eyes
As a practice owner, perhaps you view patients through new eyes. Upon reopening offices and during these past two months, the response of patients returning to your office should make doctors and their teams feel grateful. People are entrusting you with their health despite the fears swirling of additional strains and the stress of waiting for a vaccine.

Hopefully now, patients are truly appreciated as they place trust in the hands of those who rely on their office to continue supporting themselves and the team that works in it. Many practice owners may have also seen certain suppliers acknowledge the hardship experienced, extending flexible terms or payment plans.

For many, COVID-19 has given tremendous courage. The courage can be seen in the simplest of forms such as taking on a new activity, or reflecting on one’s self. It can be seen in the parents and teachers who are working so hard to preserve the mental health of our children. It has even caused those who are working as associates to take the plunge and pursue ownership.

It either accelerated the desire to be the owner or was the final push to pursue this. Either way, people are buying or starting practices. Again, with the gift of time, many of us have been blessed with the need to slowdown and re-evaluate our choices and the way we approach things.

Our thoughts are hopefully more purposeful and with intent as opposed to simply reactionary. My new favourite quote is from Nelson Mandela – “may your choices reflect your hopes, not your fears”. I recite this everyday multiple times.

COVID-19 despite the tragedy and hardship many have experienced, has also brought out the best in humanity. It has made those of us who are fortunate to look around to those in need and extend a helping hand. More businesses are publicizing donations to charities in exchange for virtual registrations, while others are quietly donating food to help feed the hungry. It has also encouraged many of us to listen more and talk less.

Grateful for the Simple Joys
Perhaps one of the best things of COVID-19 is that it has hopefully made us all more grateful. Remember the simple joy of meeting a friend for coffee in a café, lunch in a restaurant, attending your place of worship and so much more. I for one have so much to be grateful for. I am truly blessed with the most supportive husband and daughter, the ability to do what I love on an even greater level and the new people I have met because of this pandemic.

As one who appraises and sells practices, I have the privilege of listening to people as they share their hopes and dreams. COVID-19 has made us more vulnerable and human and for that I am truly grateful.

Jackie Joachim, COO ROI Corp

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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Insight with Roxanne Arnal

Insights, Resources

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Roxanne Arnal originally hails from Winnipeg, Manitoba

She is a past-president of the Alberta Association of Optometrists and
the Canadian Association of Optometry Students (CAOS)

Roxanne successfully grew an independent Optometric practice in Alberta before leaving the profession to become a Certified Financial Planner® focusing on optometrists and their families’ financial requirements.

Roxanne Arnal

Doctorate of Optometry from the University Of Waterloo (1995)

Certified Financial Planner®

 

Why did you choose your field?
I always wanted to be a doctor and learned early in undergrad that medicine and medical school was not a lifestyle I wanted. Helping people and teaching has always been a natural tendency of mine. If I had not gotten into Optometry school, I was going to become an accountant. So I guess it’s really no surprise that I’m a financial planner. Helping people, educating them, and using numbers…this is what I was created for.

What is the biggest struggle in your career?
Helping people understand that not all financial planners are the same. Unlike optometry, there is no title protection, no title requirements nor clear definitions. It really is alphabet soup of credentials which ultimately  leads to increased public confusion. Most of the professionals I speak with don’t really understand what I am able to bring to the table and the breadth of service I offer. I have a very unique skill set and am well groomed to be your family CFO.

What is currently the most exciting thing in your field to help patients?
Tax integration. Very few professionals have a current and comprehensive grasp of building tax efficiencies for today and their future. Integrating your business and personal finances within the Canadian tax system is the geeky fun of planning work I love.

What is something you have done in your practice to set you apart.
I specialize in optometrists. We are a unique and highly educated bunch, who spend most of our days in a little dark room. Having lived through the various stages of practice, I understand the opportunities and pitfalls.

What advice would you give a new grad today?
You’ve lived the past several years as a student, so treat yourself to a little grad gift, then continue to live like a student! You’d be surprised how quickly you can pay off your student debt with this attitude. Yes, you may be able to write off your loan interest, but it’s a devil on your back that feels much better to shed as you move forward and build your business ownership.

Always give patients no less than you would give your mom (assuming you love her).

And – purchase your commercial space as soon as you can. You have to pay rent anyways!

What do you believe is the key to success?
Love people! Take a genuine interest in their lives, listen to their concerns, and help them to the best of your ability.

What is your favourite saying?
“You don’t know what you don’t know – until it’s too late.” We all make mistakes, some more costly than others and I made my fair share. The more I learned in my new field, the angrier I got about all the missed information I didn’t get from my advisors. I am determined to ensure my clients don’t have to learn the hard way by answering the questions they didn’t even know they should have asked.

If you could take one album, one book, and one luxury item to a desert island, what would they be?
Adele 25 – Hello? Lots of quiet time for me to convince the local wildlife I sound as good as her!

Think & Grow Rich by Napoleon Hill – an older book, but lots of content to keep you thinking and tips to tap into your imaginary friends for company.

My bed – because a good nights sleep is essential to reset my attitude.

What is your favourite TV show/Netflix series?
Grey’s Anatomy – I’m not sure why.
Suits – probably for the same reason I like Grey’s

Last time you laughed?
All the time, but most of those wouldn’t be funny to anyone else. But the other night we were attending a virtual Wine Tasting event hosted by our local Co-op Liquor Store. Really, a good excuse to drink 3 bottles of wine on a Friday night in quarantine.

Using an open zoom meeting format, you get to “enjoy” everyone else’s experience too. Now you have to understand, we live in rural Alberta, so watching the various screens is really only a bit more elevated than an Optometry School Wine & Cheese event.

I’m not sure how our sommelier, Amy, manages to maintain her professionalism. Wine number 3 was paired with a salami, and the instructions go like this: “Take a sip of your wine, now eat the sausage and tell me what’s going on in your mouth?” My husband, Ken, had to step off screen. Enough said.

Last Indulgence?
Glass Sculpture from Murano, Italy.

What is your favorite food?
I’m a foodie – new and interesting. We are currently expanding our vegetarian menu, but my top comfort foods will always be pork ribs and beef stew.

What was the last gift you gave someone?
Nerf guns – last family gift to open at Christmas held 4 Nerf guns and a package of extra bullets. The battle ensued. It was such a blast.

How have you changed since high school?
I’m more cautious. A wise man told me “it’s because I have more to lose now”.

Something few people know about you?
I LOVE puzzles. Especially traditional piece puzzles and number puzzles. I just love figuring out how all the pieces fit together. Just like a good financial plan, I love picking apart and looking at all the different pieces to find the best way they fit together and create the perfect picture for my clients.

If you had a time machine, what year would you travel to and why?
2000 – the year our first child was born. I love babies and would love another chance to raise her. And I wouldn’t hire a nanny this time (that didn’t happen til 2003 mind you).

Describe your perfect day.
Sightseeing on a clear sunny day in Europe with my family & our optometry travel group. Ending the day with a 10 course chef’s table tasting menu with full wine pairing.

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Optometrists Needed Across Canada – Sublease Opportunities

Career Options, NextGenOD, Sponsors

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This is a sponsored post from BAILEY NELSON. 
At Bailey Nelson, it’s our mission to work with innovative and caring optometrists who ensure all patients enjoy a friendly, stress-free experience worth remembering.

We’re looking for passionate individuals who are highly invested in making a difference for their patients.
Is that you?

We make it easy to run your practice.
• A fully equipped exam room plus pretest equipment
• Online booking and recall systems
• EMR system
• Support staff for reception & pre-testing
• Onboarding, support and training
• Tools to optimize traffic and expand your clinic  

Eyecare the way it should be
Founded in Bondi Beach in 2012, Bailey Nelson has quickly grown into a global brand led by an incredible team with boutiques in Australia, London, Canada and New Zealand. Buying glasses should be one of life’s pleasures. And we’ve created a formula to make it one.

We start with a process that’s clever and honest. And we hire people who are passionate and genuine. It’s not rocket science. It’s just caring enough about what you’re doing to do it right.

Sound like a fit?
If this sounds like the perfect fit, we would love to hear from you!

Laurie Lesser, O.D.
Eyecare Director, Canada/UK
Phone: +1.236 412-9911, 954 401-2476
Email: laurie.lesser@baileynelson.com
Web: www.baileynelson.com

Click here to find more detailed information. 

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Aussie Chain Bailey Nelson Plans 50 Stores in Canada

NextGenOD, Practice, Products | Services | Industry News, Sponsors

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Bailey Nelson (BN), the Australia-based optical upstart (2012) has set their focus on expanding presence in the Canadian market, according to an interview with Nick Perry, co-founder and managing director of North American business.

The chain plans to grow to “50 stores over the next few years”, Perry disclosed in an interview with  Strategy C-Suite. In 2014 the company opened its first Canadian stores under a licensing agreement, but made the decision to close them three years later.

The company re-entered the market later that year (2017)  as fully corporate owned stores in 17 locations with plans for an additional 3 stores before end of June. Seven stores are in the lower mainland of BC, 5 in Alberta and 4 in Ontario.

Every Bailey Nelson store to have an OptometristThe new locations will be in Victoria, Toronto and London Ontario. The Canadian market presents some challenges compared to Bailey Nelson’s sun-blessed (or cursed) Australian home-base. The chain has strength in the sunwear market and benefits from the Australian government’ generous coverage of eye examinations, which serves to reduce the purchase cycle.

According to Perry the company will need to overcome these obstacles by working with North American eyewear designers and focus on consumer education. “One of the opportunities for us is to educate our consumers on how important regular eye health assessments are in terms of your overall well-being and that they should engage with us on a professional and more regular basis”, said Perry.

On the chain’s strategy, Perry indicated they will:

  1. Focus on Optometry – have an OD in every store
  2. Build engaged and staff that are passionate about vision
  3. Deliver quality differentiating product

Bailey Nelson is seeking Optometric leasehold partners in many cities across Canada.
Click here to find more detailed information. 

View full article on Perry’s discussion with Strategy C-Suite. 

 

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Zero to Five Pathfinder: Spotlight Courtney Fan, OD

NextGenOD, PathFinders

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NewOptometrist.ca puts the spotlight on Zero to Five Pathfinders

PathFinder Spotlight:

 

Courtney Fan, OD

Undergraduate Studies
University of Waterloo Biotechnology/Chartered Accountancy

Post Graduate
University of Waterloo Masters of Accounting

Optometry:
University of Waterloo – 2018 Graduating Class

Tell us about your education background. You have an interesting path to optometry.
I went to the University of Waterloo for my undergrad program in Biotechnology/Chartered Accountancy, which is a split co-op program. I learned both science as well as accounting at the same time.

I knew I wanted to go into healthcare, but I also wanted to try out other new things. The UW accounting program looked great.

And graduating from my Biotechnology/Chartered Accountancy Program, I did an extra year of Masters of Accounting at UW, just to finish all the accounting courses.

This also gave me the time to make sure that I wanted to go into optometry for sure.

Why was optometry appealing to you?
After shadowing multiple doctors, optometrists and other health care providers, I really felt like optometry was a great profession for me.

I wanted to have a work-life balance. And I thought that optometry was a great fit.

Let’s go back to your 4th year rotations. Tell us about them.
One of my rotations was in Salt Lake City, Utah. I was there for four months as part of my ocular disease, therapeutics rotation under Dr. Robert P. Wooldridge.

His clinic was built on a lot of glaucoma patients, dry eye, as well as macular degeneration. He worked with ophthalmologists as well. It was a really great experience.

I also worked in Sarnia and Mississauga.  One of my last rotations was in Kingston, Jamaica, where we did exams and worked with Marilyn Smith, Optician from UW. Marilyn hosted the entire program, and we were able to provide services to Jamaicans. It was a really great experience and a little bit different than some of the practices that I worked at in Ontario!

What about after graduating? Bring us up to date.
After graduation i moved to the small town of Tillsonburg in SW Ontario (near London) as a full-time associate optometrist at “Optometrists On Broadway”.

It’s been great ever since; the clinic is super busy. We have an OCT, fundus photo, visual fields, just to name a few of the available equipment. I can practice to the full extent that my Ontario optometry license allows.

After almost three years of working full time, and working through the pandemic, things are still pretty good. We get a lot of seniors, a lot of people who still want to be seen because they have eye issues. We have been keeping busy throughout the pandemic.

Have you been able to draw upon your clinical disease rotation experience now that you are in practice in Ontario?
Definitely. The practice in Utah was mainly focused on glaucoma patients. We did a lot of OCTs, photos and visual fields.

I learned a lot about how to best manage and treat patients, even though a lot of times the drugs were not the same, the concepts were all the same.

I was able to witness surgeries for the glaucoma patients and do a lot of the follow ups that an ophthalmologist would usually do in Ontario. In Utah I was able to see them firsthand.

The surgeon would have had the patient come back to our office the day after surgery, and we would see a lot of inflammation, things in the eyes that we normally wouldn’t see in a one week or a six-week post op follow up.

I definitely learned a lot through all of my rotations.

In what ways do you now have the freedom to do your own thing compared to your clinical rotations? How is it different? 
Yeah, there is a funny story. In Utah we were able to remove concretions in patients, and we always try to gain as much experience as possible. All the interns were fighting to get these experiences, but not everybody had a concretion, but we all tried to at least remove one.

Coming back to Ontario, I did not realize that we were not allowed to remove concretions. There was just a little bit of pushback in terms of the things that I could practice as an intern versus now.

On the other hand, I do have a lot more freedom to do things the way that I would like them to be done.

For example, back in my other rotations, my supervisor might follow up in six months or every year. If I feel uncomfortable leaving certain diseases, I can follow up more frequently.

I do have the freedom to see patients as often as I want to make sure that things are going as smoothly as I would like or as I have planned.

What specifically were you looking for in a Job? And did you find it?
Yeah, for sure.  I was looking for something that was full scope practice and gave me the freedom and autonomy to practice the way that I wanted to.

While I was job searching, I was mostly only looking for full time positions, so that I can follow up on my own patients and build a patient base. It was important for to find a full scope practice with all the technology that I would like.

Also, it was important for me to find a really positive working environment and have everybody was working together as a team.

What about your longer-term plans? Do you have any ideas of what type of practice you want to ideally be in? 
I’ve definitely thought a lot about owning my own practice.

My fiancé is also an optometrist, so it would be a dream for us to open our own practice and have that autonomy to do whatever we wanted and to practice the way that we think is best. We are thinking that it will be in the next five years.

Okay, that’s awesome. Let’s do some of the fun questions.
Honestly, I forget what I do for fun, because now that we’re just staying in all day. I’m thinking, “What did I do before with all my time?”

At the end of the day, I just want to relax and just give myself some alone time. After work I used to go to the gym every day, but now I just do a little light workout at home.

Recently, I started playing the guitar. My fiancé recently got me a guitar for my birthday, so I’ve been practicing.

I used to go skiing in the winter. In the summer I love to travel and spend a lot of time outdoors hiking.

It is important to make sure that we get enough vitamin D, because every working day we don’t get to see the sun too much in a dark room. I try to make sure that my lifestyle is healthy and active and balanced.

Is there any advice that you’d want to offer to new graduates? any insight you can offer into to help others?
I think one of the things that I want to tell new grads is  “Don’t lose your passion for what you love, and what you love to do.”

A lot of times we get caught up in our life just trying to make money, trying to pay back our student debt. But I think it is also important to remember what made you so excited to be an optometrist in the first place, what really excites you!

Okay, awesome. That’s really good advice. It was really nice to catch up in this way, because I didn’t know what you have been up to now that we are both busy working every day.

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