Finding Opportunity in a Simplified Supply Chain

Marketing, Merchandising, Resources

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We have been working on some interesting projects lately that have afforded us the opportunity to meet with a number of suppliers. These meetings reminded me of how important it is to understand the complete Supply Chain and further, the Value Chain.

To start, a supply chain is the process of all parties involved in fulfilling a customer request while a value chain is a set of interrelated activities a company uses to create a competitive advantage. As small business owners, ECPs want to understand both of these in order to identify opportunities themselves.

Let’s take the assembly of a pair of glasses as an example. The supply chain is familiar to all of us in the industry. We have the frame and lens manufacturers, the frame and lens distributors, the labs and then the opticals. There have been some fairly significant changes in recent history that have changed the supply change.

I would argue that the most significant change was in the lens industry with the introduction of Free Form equipment. It has allowed more customization in lens manufacturing. What does this mean for the optometrist? There is an opportunity here to differentiate by offering the latest in manufacturing technology. If your strategy is to offer the best technology, than this could be a key product to help you define your offering.

Frame manufacturing is also set to see a major change. Up until now, the vast majority of frames have been manufactured outside of the country. With the introduction of 3D printing, we are seeing the possibility of mass production of frames in our own country instead. Environmentally, there is an advantage to this type of manufacturing as it has the potential to reduce waste significantly.  For a practice that is strategically set up to cater to Millennials, this could be quite appealing to their target audience.

These are changes to the Supply Chain – the way in which the goods in the industry are made available to optometrists and opticians. Some owners are using Freeform lenses and 3D printing as a competitive advantage. Early adopters of this technology will certainly attract the more progressive consumers in the marketplace.

The Value Chain is a little bit different. To set themselves apart, these same companies may focus on offering better price, service or product in their category. Take a lab that offers overnight production of a lens product. Their value proposition to the marketplace is speed of service. This, however, does a cost a little bit more in both man power (imagine overtime hours, a second shift of workers and/or same day delivery costs). However, for a practice that wants to differentiate itself through fast service, paying a little bit more for this type of service from their lab makes sense.

The same holds true for frame manufacturers. One might offer frames at a lower price point but the trade off is the quality of the product.  If your practice’s strategy is to sell at a high volume, this frame manufacturer would be a good fit.

It’s an exciting time to be in the Optical Industry as offerings in both the Supply and Value Chains in the optical industry are creating many opportunities for ECPs to differentiate themselves and be supported. With an eye on your strategy, by ever aware of the changes and mindful of the opportunities.

KELLY HRYCUSKO

is the co-founder and managing partner of Simple Innovative Management Ideas (SIMI) Inc. and expert Practice Management contributor for Optik magazine. She can be reached at info@simiinc.com.

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Men Are from Mars, Women Are from Venus

Buying-Selling A Practice, Finance|Wealth, Practice

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I must admit that when this book first came out in the early nineties, I never read it. I still have not read the book to this day. The premise of the book was that most common relationship problems between men and women are a result of fundamental psychological differences between the sexes. Of course, there are differences. Men and women approach things completely different which is probably the reason I have never had the inclination to pick it up. Why read about the obvious??

Then I began thinking about practice values. All successful practitioners take the time to calculate the value of their clinic in the market. By determining this value, they know how much this specific asset is worth. Even if one is not ready to sell, having the valuation completed allows an owner to expand, grow and further increase the value of the practice.

Whenever I speak or write about the factors that affect value, I always make reference to the financials, the value of the actual assets in the clinic, whether the associates and staff are on contracts, the lease, and other factors. Whether you are male or female, as an owner these factors are the same and they definitely impact value.

However, when discussing values specifically with female owners it is a different conversation than with male owners. For instance, more women than men are actually surprised with the final value because the practice ends up being valued higher than what they originally thought. As women, I think we tend to underestimate ourselves and as such, the value in the business itself is not seen for what it really is.

Practice values for women will definitely be affected by age and stage. For example, if a valuation is being done during or after a maternity leave, financials are going to be affected. When we calculate value, we use a three-year weighted average. During this specific stage of life, because a woman will have worked less this means revenue is less yet expenses like rent or staff must still be paid, which means less profit or cash flow. What about when children are young and as a practice owner, practice hours must be juggled? I remember when my daughter was first born until about age 5 my time and earning capacity for my career was reduced because of the stage of life we were in. Remember, cashflow is a huge factor that affects value. Not to generalize but the birth of a child has less affect on the practice’s value when the owner is male. Another stage that potentially affects the value of a female owner is someone who is in her mid to late 50’s and is trying to manage aging parents? Again, these personal situations can affect the performance of the clinic for obvious reasons. I do wish to note that I am not saying managing elderly parents is exclusive to women, men deal with this as well. I am simply making a generalization.

The practice is a significant asset and also another child. What is key for female owners is that women must ask and know the value of their businesses. There will come a time when the decision to sell will be made. Hopefully, it will be part of the overall investment and retirement strategy. Unfortunately, there are many statistics confirming that women do not invest as much as men do.

When female owners do decide to have a practice value completed, please remember one thing. If any of these stages I have referenced required your attention, please do not be apologetic for where your value ends up. If you did take time off to raise a family or manage a personal situation, do not regret having a business that “could” be producing more. An appraisal will definitely cause any owner to reflect on their management and success to date. However, success is not only defined as the number of patients you saw or the level of revenue you achieved. Success is not one dimensional. The definition of success differs from one person to another. Taking care of one’s family, making money and maintaining your own sanity throughout are also clear signs of overall success.

The last point I wish to make, regardless of whether you are a man or woman is that you must be in charge of your finances and future. A huge step to accomplishing this is knowing the value of your practice.

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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Plan Ahead—You Never Know

Finance|Wealth, Practice, Resources

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Some of our clients are seniors and with every passing year we are saddened to hear of the illness and sometimes the loss of these highly valued clients and oftentimes they are personal friends. One such client comes to mind. He was still practicing, but reported having fatigue that day. His staff insisted that he go home and rest thinking he had a severe case of the flu. Unable to drive, his son took him home where he slept through the night. When he woke up he was still not well and his family took him to the hospital. He died that same day.

He was diagnosed with a severe case of cancer (stage IV leukemia) and there were no pre-indications that he or his family was aware of. If he did know, he did not tell anybody. If he did not know, it is probably because he was only 53 years of age, very fit, exercised regularly, led a healthy lifestyle and as a result had not seen his physician in some time.

More factors regarding his illness were later found but the bottom line is he was treating patients a few days before he died. As business advisors and brokers, we encourage our clients to examine their Will, update it regularly and designate a trusted family/friend/advisor to know where it is kept.

Next, we advise our clients to have an emergency plan for the business itself. We tell them that a Will looks after your assets after your death and distributes those assets as you have directed. In many cases, this process can take two or more months to be properly enacted by your executors. What happens to your practice/business tomorrow if you suddenly die today?

Do you have a specific individual who will take the responsibility of caring for and controlling the practice to ensure that it continues to operate? This means that patients are seen, staff, landlords, and suppliers are paid to keep the business running in a vibrant fashion. By doing so you prevent your practice from plummeting in value in your absence as the key producer?

Do you have a specific health care professional (HCP) or a group of HCPs who should be called upon to help you, your family and business advisors if an emergency arises to keep the business operating in an orderly manner?

Often, in the absence of any instruction of this nature, the staff or the family members—while in a state of shock or sadness—will shut down the practice and cancel patients’ appointments. They will have no idea when or how to re-open. Should something be said in the newspaper? Should there be an announcement to the patients? How is your practice to be run without you there to guide them?

Understandably, your practice will close for two or three days to allow family/friends/colleagues to grieve and to attend your funeral. BUT soon—it is business-as-usual for the sake of the business! It must be maintained and its value preserved. Subsequently that value will inure to your estate or to the executors in full form and fashion, as opposed to being closed and your practice starts to fail.

Why would you want to leave an asset in a state of rapid decline when all you need to do is have a Will for your business and/or an emergency plan that gives your family/executors/advisors specific instructions?

Here are the instructions you should have in place:
1. A locum be added into the business as quickly as possible.
2. A list of HCP locum names with phone numbers is available to call. Most brokers have locums at the ready for this purpose. An office manager or receptionist can be designated to do this task at this time. It does not have to be done by a lawyer or a family member.
3. The practice should be appraised immediately or if an appraisal is on file, that appraisal should be updated. Your accountant and your lawyer should have a copy of your emergency plan. Again, provide the names and contact information of the individuals designated to perform these tasks.

Delay of any of these steps reduces the operating value of your business. We (as individual advisers/brokers) would not want to leave our business in that condition. Most of us have children and grandchildren and others
to whom we wish to leave a legacy. We never want to leave a negative
declining asset behind.

Additional steps can be taken depending on the unique circumstances of
your practice/business. Consider consulting with a professional practice appraiser/broker to put an emergency plan and business Will in place. By doing so, you will preserve hundreds of thousands of dollars for your family, your church, and your charity.

TIMOTHY BROWN

is Chief Executive Office of ROI Corporation Canada’s national professional practice and brokerage firm.

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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Disruptive Coastal Contacts Founder Re-enters Eyecare Industry.

Practice, Products | Services | Industry News

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It appears that Coastal Contacts founder, Roger Hardy, is at it again.

After a five-year hiatus, which happens to coincide with the typical duration of a non-compete clause in a business purchase agreement, Roger Hardy, the founder of British Columbia based Coastal Contacts is getting back into the online vision correction device sector.

Hardy Capital, an investment firm founded by Hardy, announced the acquisition of LD Vision Group Inc., an online contact lenses seller headquartered in Toronto, with offices in Richmond BC and Buffalo NY. LD Vision was owned by a trio of brothers. Terms of the deal were not announced.

Hardy was the founder of the disruptive marketer Coastal which was acquired by Essilor in 2014 for $450 million and later renamed as “Clearly”.

Hardy Capital expects to announce broader expansion plans into the eyecare industry in the months ahead. The purchase of LD Vision Group is the second investment in the eyecare category by the group. In 2018, Hardy made a seed-stage investment in millennial sunglass online brand, Privé Revaux.

The LD Vision website touts “Easy prescription submission, fast prescription verification by real humans, and reduced clicks and pages to view from start to receipt…”

According to media reports, Hardy sees opportunity in online testing to generate eyewear prescriptions and eliminate the need for consumers to take more time-consuming test with actual doctors.

Notably, the Hardy expects to announce broader expansion plans into the eyecare industry in the months ahead.

View the Full news release here:
https://www.newswire.ca/news-releases/hardy-capital-acquires-ld-vision-group-880946491.html

More information on LD Vision Group.
https://www.ldvisiongroup.com/

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Eyes Wide Open

Buying-Selling A Practice, Practice, Resources

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Two pressing issues have surfaced in recent discussions with clients—and they’re both very important and closely related. It’s like the two sides of a coin. Heads deals with impossible promises while the flip side, tails, involves managing expectations.

IMPOSSIBLE PROMISES

A client I’ve known for years called to say that he had been approached by a corporate entity to buy his practice. Later, he called me again for a second opinion to make sure he was doing the right thing. The investor buyer had promised to pay the highest price for the practice compared to any other private-sale offers or open-market sales brokered by any firm.

So, is this a legitimate and fully defensible claim? The first and key thing to remember is that if a practice does not go to open market, the price paid by the buyer will be the highest offer that the seller receives, simply because the seller is not accepting other offers. In that respect, this purchaser made a correct claim.

On the other hand, the buyer also suggested that his/her offer would be the highest of any offer—but if a practice does not go to open market, then this is an absurd claim because it cannot be validated. Why? The reason is also simple: if no other buyers are given the opportunity to make an offer, how can anyone prove that the first offer was the best? Impossible promise!

This type of behaviour is prevalent because there is a limited supply of good practices for sale. Corporate investors are very flexible and have a dedicated senior management team soliciting and focusing on practice acquisition. On the other hand, in the traditional health care practice marketplace, the buyers are mostly professionals who are raising families and practicing in various locations. Typically they do not have the time or resources to invest when searching for a practice to buy. These buyers rely upon brokers to introduce them to practice sales opportunities.

MANAGING EXPECTATIONS

On the flip side of today’s eye care practice sales market, it’s about juggling sellers’ expectations. In the normal course of appraising and selling a practice, many parties are consulted. Early on in the process, the seller should seek legal and accounting advice on sale structure and allocation of sale price as shares or assets. In today’s multilayered corporate structuring, we are still finding old management companies, technical service corporations and multiple health care professional corporations, as well as sole proprietorships. Each of these scenarios has different and unique tax implications and, in some cases, complex legal implications.

Vendors often tell us that they’ve consulted with their advisors, so we proceed to the market (and we often consult with advisors at this early stage). However, as we near the completion of an offer to purchase or closing date of a practice sale, sometimes advisors will realize that there may be some last-minute opportunities to affect tax savings for the benefit of the vendor. In many instances, there is no harm to the buyer and, in some cases, there’s actually a significant benefit to the buyer. But the serious dilemma with bringing these matters to light in the final days and hours, is that advisors on both sides start seeking to re-negotiate a contract or even re-enter a conditional period—perhaps when all other conditions have already been removed—and this puts a transaction in serious jeopardy.

Our advice to both buyers and sellers of any type of health care practice is to begin consultations and preparations of tax and legal matters a year in advance of a possible sale and, at the very least, prior to the preparation of the appraisal of the practice. Any delay in making this investigation or process happen with your tax and legal advisors will likely cause significant delays, high fees and could jeopardize the sale of your practice. In short, poorly managed expectations.

IT TAKES TWO SIDES

It is important to not be misguided by an impossible claim to sell a practice at the highest possible price. Be levelheaded. Adopt a well-conceived, balanced and careful plan when you’re in the process of buying or selling a practice. And save that coin for your pocket.

TIMOTHY BROWN

is Chief Executive Office of ROI Corporation Canada’s national professional practice and brokerage firm.

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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Make Your Resume Shine for a Corporate Optometry Position

Human Resources, Managing Others

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Looking for a job in optometry doesn’t have to be difficult.

There are many opportunities, but finding the right fit is important for your job satisfaction. Finding corporate optometry positions that match your qualifications and are welcoming to new graduates is the easy part.

Making your resume stand out compared to other applicants is more difficult but doing so will give you a leg up on the competition.

LinkedIn is one social media network that excels in professional networking and job search and is widely used by recruiters. Creating your LinkedIn profile is great way to put your name out there for recruiters to search and find you, often even before an opportunity is posted.

The trick is to design your resume cleverly so as to at least get the initial call of the interview. The resume would basically serve as the foot in the door for you. It will give the recruiter a brief overview of who you are and your qualifications and achievements. Even the most subtle of changes or incorporation of words will make a difference in the eyes of the one reading your resume.

Details Matter
Each word, each colour and formatting choice used to create your resume has a larger impact than you could possibly imagine. For example, choosing a dark blue colour adds an element of sophistication and professionalism to your resume. Similarly, the colour red gives the impression of a person being energetic, vibrant, social, and confident. This is called “personal branding.” Because the colour of your resume is the first thing that attracts the eye of the recruiter, they will read on with the colour etched into their minds.

The next, and the most important, step to undertake is to customize the CV according to the job you are applying for. This does not mean that you have to misrepresent your experience or achievements. It does mean, however, that you align your CV with the job description. For example, if the job description says “we are searching for someone who is looking to provide highest quality of care to our patients” then you should write “detail oriented” in your skills section.

Also be aware of the jargon that is used in your industry. This will help you tremendously since it will give the recruiters the impression that you have already started to try your hand in the field. In addition, some recruiters filter resumes looking for specific keywords.

Geo-flexibility Helps
You should also show that you’re open to moving locations whenever required. A lot of times ODs are apprehensive about moving locations, and this might give you an advantage.

You should also let the recruiters know that you work well in teams and are a good leader when required.

With this information you should be prepared with a strong resume that will land you the corporate optometry position you’ve been searching for.

Happy job hunting!

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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To Purchase or to Open a Brand New Office: That is the Question

Practice, Resources

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We have helped a number of optometrists either start their own practices or take over ownership of an existing practice. Both come with pros and cons. How do you decide what the best route is for you?

An existing practice is appealing because the patient base is already existing. Appointments are already booked and there is a patient base to re-call from to keep the schedule more or less full. If the owner has done their due diligence leading up to the sale of the practice, then other pieces will be in place. The practice will have kept up with the latest technology, both in diagnostic equipment and their EMR system.

To attract top dollar on the open market, the owner will also have invested in keeping the office renovated over the years. They will have implemented a marketing plan that is making sure the right people are aware of all the office has to offer. An up-to-date website, a social media strategy and AdWord campaigns that are driving in new patients at a consistent rate of 20 per cent is all part of this.

However, if the practice owner has failed to keep the practice up date, there is a price to pay: a lower market value. The reality is that an office that is not keeping current and up to date is creating a gap in the marketplace that a competitor can fill. That competitor could be a brand new player that opens in the area or it could be an associate who decides to invest their money in a new space instead of renovating an existing one.

There are many factors that impact this number, but a start-up or new build generally costs anywhere between $300k and $600k.  On the lower end of the scale will be practices who have smaller spaces and number of lanes and use basic finishing materials and mainstream products. On the higher side, practices that have carved out a strategy based on investing in the latest technology, will open in a larger space with multiple lanes and use unique finishing materials and exclusive products.

On the other hand, if you purchase an existing practice, leasehold improvements on their own start around $125k and can go up from there. Now, the biggest thing is to figure out how much needs to be invested in and improved.  If you are generally looking at having to improve everything — from introducing an EMR to revamping the frame strategy, the worth of the practice diminishes substantially. While a case could be made for good will— in this day and age of digital marketing and referrals, that good will is not worth what it once was.

It’s an exciting time when you are venturing into Practice Ownership. It is important to look at all the opportunities and weigh them carefully — both from a financial perspective and a quality of life perspective. Both purchasing a practice and building a brand new one are great options — take the time to figure out which option makes the most sense for you.

CHRISTINA FERRARI

is the co-founder and managing partner of Simple Innovative Management Ideas (SIMI) Inc. and expert Practice Management contributor for Optik magazine. She can be reached at info@simiinc.com

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Staging a Unique Sports Vision Training Experience

Practice, Resources, Specialty Practice

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Dr Jennifer Stewart opened Performance 20/20 in 2016 to meet the needs of youth, recreational, elite, college and professional athletes in her area.

Sometimes the right second practice is not an optometric practice at all. But it’s made possible because of optometry.

This sounds a bit like a riddle, but it makes perfect sense to me. Two years ago, I opened Performance 20/20, a sports
training facility focusing on vision performance as a critical factor in sports performance. I divide my week between
one-two days at Performance 20/20 and three-fours days at Norwalk Eyecare in Norwalk, CT, where I have practiced as an
associate since 2008 and a partner since 2010.

This combines two loves of my life: training for and playing sports, and the joy of helping patients to see and perform better.

I still am passionate about providing primary care, but for me working with Performance 20/20 athletes—not patients—
along with a staff of sports trainers, completes the perfect picture. That, while training to run triathlons, and chasing after
two sons, aged 3 and 6.

Define your Purpose

Performance 20/20 allows me to apply my optometric training and clinical experience in vision perception toward improving
sports performance. But it is distinctly not an eyecare practice. There is no lane here, and instead of a white coat I’m in shorts
and a T-shirt.

Performance 20/20 is a sports training center where we help athletes to achieve full athletic potential by sharpening their
visual system and cognitive skills. Over 90 percent of the information we collect in sports is visual–so cognitive and
visual training is critical to improvement. We think of vision as what we see, but in sports vision it is what we perceive. It’s
about how we process visual information and what actions we take.

We’re not just training the eyes. We’re training our cognitive systems and motor systems to work better together. If you
can be faster at seeing sometime, processing it and making a better decision and action, you’re going to be a better athlete.

Our programs are designed to optimize visual acuity, sharpen coordination, maximize reaction times, increase peripheral
awareness, and expand depth perception. We utilize innovative training and technology to enhance the visual and cognitive
systems of all athletes ranging from youths to professionals. Our trainers will customize a sport specific plan to optimize
performance.

For the athletes we train and who recommend us to other athletes, we provide a unique sports vision training experience.

A Variety of Services

One key is to offer a variety of training options within a clearly defined pathway. We offer private, semi-private, and group
training sessions of up to 4-6 athletes at a time. We also work with teams and sports camps in larger group sessions.

In all of our services, we work in three steps:

ASSESS Establish a baseline.
We assess cognitive and motor skills and formulate a baseline to build from. We compare that baseline to their peers in sports skills and age groups.

ANALYZE Define purpose.
We ask the athlete: Why are you here? What do you want to achieve? With the baseline set, we can define goals in objective terms.

ACHIEVE Design a plan.
From this information, we can design a personalized improvement plan to achieve stated goals.

When we succeed in building cognitive skills and motors skills, we see enhanced performance. Athletes tell us that time
seems to slow down on the playing field. They are better able to concentrate and they make better decisions. Most of all, they
realize their performance has improved, and they enjoy playing the sports they love even more. It’s great to be
a part of that success.

Work in Free Space

One key to making rapid progress with athletes is to work in a free space where you can simulate their competitive
environment as realistically as possible. Unless you are training competitive computer gamers, conducting sports
vision training solely on a computer screen limits your ability to incorporate, for example,
exercises in movement and balance. With an open space, the athlete can move fully and naturally, as with the goalie pictured
here.

Further, an open space allows flexibility to set up sports-specific environments. We easily and readily can change
from ball game sports with targeted areas on walls, to skating, where training involves balance, focus and
concentration.

While we use computer screens, like the Senaptec Sensory Station, we have avoided mounting them on walls. Instead,
sturdy tripods provides the flexibility we need to set up for any sport.

Having said that, I know space is costly, I have colleagues who conduct training in a spare exam lane, but having more space
allows you to be creative.

 

Locate in a Sports Environment

From a business point of view, context and location are big contributors to our success.

When I was exploring a location for Performance 20/20, our real estate agent suggested Twin Rinks in Stamford, CT, a
mega-sports facility includes two NHL-regulation ice skating rinks and a host of training facilities. I had found a perfect
home. I rented a 700-square-foot space within a 10,000 square-foot facility that includes a strength and conditioning
center, a chiropractor, a physical therapist and many others.

The space is filled with athletes of all ages, from New York Rangers pro hockey players to youth sports. We have figure skaters on track for the Olympics, and lacrosse goalies looking to excel on their middle school teams.

Clear Windows Tell the Story

With our prime sports location, our windows help to tell the story. Kids and their families pass by and see athletes
working on visual training exercises, agility exercises, ball work on walls, etc.

They see the process and it generates interest. Many parents will poke their heads in to see what we do then schedule
individual or group sessions in coordination with practices and lessons their kids already have in the building.

Follow a dream

For me, Performance 20/20 fulfills a dream 10 years in the making. I ran Division 1 track and field in college, and I
continue to train for triathlons and road races.

In 2015, my husband and I took a leap of faith to follow our dream. He left his field of financial consulting to help me
plan and open Performance 20/20. We had a soft opening the following year and were in full swing by 2017. Today,
we have two to three sports trainers on board, and we have worked with youth, elite, college and professional athletes
in a wide variety of sports.

At the start, we built a “wish list” of equipment we wanted so as to be fully equipped. We soon saw that we didn’t need it all at once, that we could build as we go.

You truly can begin with just four empty walls and assortment of basketballs and tennis balls plus some charts commonly
used in vision training. Adding a system like the Senaptec Sensory Station is a big addition, but it can take your training
effectiveness up a notch.

We have looked at opening more locations, and our research indicates that we likely could do so in our same geographic
area. Choosing a site is sports-specific. Our first training center is located in a skating complex, and we work with a
lot of hockey players and figure skaters. We have looked at opening another center in a baseball training facility, where we
would have access to baseball, softball and lacrosse players.

It is important to note that referrals work both ways. I may mention to patients in my eyecare practice that I have a
sports vision training facility–but, more often, athletes training at Performance 20/20 or their parents will say, “Oh,
you’re an optometrist, can I come to you for an exam?” Many now do.

In sports and performance vision training, as in life, your passion drives your success. If you are doing something you
love and doing it to the fullest, good things happen.

JENNIFER STEWART, OD

is chief vision officer and founder of Performance 20/20, a sports and performance training facility in Stamford, CT.
Dr. Stewart is co-owner of Norwalk Eye Care in Norwalk, CT. She is a former Division 1 track and field athlete who still holds two college records. She is a competitive age group triathlete and competes in trail and road races. Dr. Stewart resides in Connecticut with her husband, who is an Ironman All World Triathlete, their two young boys, and their rescue dog.

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Myopia Control is Now Easier to Get Into

Differentiation | Business Strategy, Practice, Products | Services | Industry News, Resources, Specialty Practice

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According to the Brien Holden Institute the number of global myopes will reach 2.5 billion by 2020.  While the alarming incidence rates, severity and sight-threatening consequences are often reported in the context of Asian populations, Canada is not immune to the myopia epidemic. Myopia is not just an issue in the high Asian populations in our urban centers.

A Canadian pilot study in a suburban area by M. Yang et al. (Univ. of Waterloo) reports an increasing rate of myopia from 6% in 6-8 year olds and 29% in the 11-13 year cohort, and that 35% of myopic children were uncorrected.  Canadian Optometry needs to be ready to answer the call.

“MYOPIA AND OPTOMETRY: IT’S OURS TO OWN.
Scott Mundle, makes the case for Optometry to take the lead in Myopia Control before others do.

Click Here to View Article.

Historically, the treatment options included the use of specialized contact lenses using Ortho keratology, atropine eye drops and lifestyle counselling. Ortho-K has garnered loyal advocates and remains a very useful tool in the armamentarium of the eye care practitioner.

New Convenient Modalities are Welcomed Additions
More recently newer medical device options, specifically indicated for myopia management, offer more familiar choices device options in the form of spectacle lenses and soft contact lenses.  Do these new treatment options offer a possibility of broadening the number of optometrists that engage in myopia management? Only time will tell. But the addition of well researched, clinically effective, practical, and well-accepted modalities is a welcome development. addition.

Bifocal and Progressive spectacle lenses have, of course, been widely used by practitioners for many years, and there are many studies which have evaluated their efficacy.

Dr. Farah Sunderji, Calgary, has done an excellent job of summarizing the historical use and clinical results of traditional spectacle lenses in a recent article in Clinical & Refractive optometry.

Her review of studies using traditional bifocal and progressive spectacle lenses shows a limited efficiency in the use of such lens designs, except in a relatively small sub-set of children with near esophoria.

New Specifically Designed Spectacle Lenses Now Available
Dr. Sunderji also documents the extensive design analysis and clinical assessments of new lens designs for myopia management.

These new spectacle lens designs have their basis in the widely accepted causal theories of myopia, including the accommodative lag (AL) theory and the peripheral defocus theory that hyperopic blur on the periphery of the retina stimulates myopic onset and progression.

ZEISS MyoKids Pro, a customized PAL design specifically for myopia management, was developed from extensive design analysis of various PAL designs. This analysis points to lens design with more negative horizontal mean power gradients adjacent to the near zone are more effective. Also, beyond standard PALs, this new lens design coupled with advanced technology facilitates optimization for children’s unique facial characteristics.

ZEISS MyoVision Pro, based on the peripheral defocus principles, is a good choice for childing currently wearing single vision lenses looking for the easy wearing and adaptation properties of Single Vision Lenses.

The use of new spectacle lens designs provides a familiar and comfortable option to eye care practitioners wishing to engage in myopia control and offer an opportunity to bring more ECPs into the arena and supports long-term benefits to patients and their families.

FOR MORE INFORMATION:

New Spectacle Lens Designs Specifically for the Management of Juvenile-Onset Myopia
Farrah Sunderji, OD

This article is available as a complimentary COPE-Accredited Course online at Clinical & Refractive Optometry made possible by an unrestricted education grant from Carl Zeiss Canada Ltd.

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A Unique Perspective on Practice Appraisal

Buying-Selling A Practice, Finance|Wealth, Practice, Resources

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I was reminded of an article I wrote a few years ago about a unique situation. Our company was engaged to appraise the practice of an optometrist who was preparing for her retirement. While I was meeting with her, I mentioned that I needed a new pair eyeglasses and I also wanted to purchase a pair of prescription sunglasses.

I performed the appraisal when the practice was closed—which is the usual and customary process for all business appraisers—and while meeting with the owner I asked for her permission to book an appointment to attend her practice as a new patient for an examination and new glasses. She agreed.

Needless to say, when I arrived for my appointment during normal business hours the staff did not know who I was and that we had performed an appraisal for this practitioner. I had a wonderful experience as both a new patient and a purchaser of two pairs of glasses.

Then as now, it occurred to me that as a professional practice appraiser and broker— seldom do I meet the staff—nor do I attend the practice during regular operating hours for obvious, confidential reasons. I realized how much I had learned about the wonderful office environment that this owner had built and the incredible staff that she employed. I wish, as a broker, that my team could have this experience with every practice they visit.

From this visit, I had obtained two points of view—one as an appraiser/broker—the other as a patient. This was and still is an extremely rare circumstance. In completing the appraisal, it was now impossible for me to ignore the excellent service I had received as a patient. In addition, the staff provided me with the following:

• An email containing a simple, online patient survey within 24 hours of my appointment, which I completed,
• A second email thanking me for completing the survey—it arrived within minutes of the survey completion process,
• A third email asking whether I would like to be contacted in the future by email, telephone or by text message for upcoming appointments—I found this very useful as I prefer text messaging.

What incredible patient communications! All of this had transpired within 24 hours of my new patient examination. Needless to say, this remains one of the best patient experiences I have ever had in a professional health care practice.

My dilemma at the time was how do I ignore my experience as a patient when I finalized the appraisal as a professional? Frankly, I could not and did not. This practice was exceptional. I was thoroughly impressed—if all appraisers and brokers could have the new patient experience in their client’s practices they would know much more about how a practice operates and what the patient experience is like.

Essentially, I was an ‘undercover patient’ (much like retailers employ undercover/false shoppers to gauge customer service) and as such learned a great deal more than the traditional, after hours appraisal process.

My company to this day is still trying to decide how or even if it is practical to use ‘undercover patients’ to learn more about our clients’ practices in order to prepare a more empirical practice appraisal. Obviously, we cannot simply act as an undercover patient each and every time we appraise a practice. But I still think about it—maybe as a practice owner you should as well.

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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