Defining the New Four P’s: Passion, Principles, Process, and Partners

Human Resources, Marketing, Practice, Resources, Training & Onboarding

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Josée Falardeau jumped in and bought an independent practice one week after her graduation in 1992, and has been going full-steam ever since. She still finds time and energy to walk, run and cycle in the summer, and snowshoe, curl and ski in the winter. While the traditional four Ps of marketing are Price, Promotion, Product and Place, Dr. Falardeau shares her redefined four P’s for success in her two-location practice.


I’ve been practicing optometry since 1992 in Malartic, a little town in Quebec, in a practice I acquired one week after graduating from University de Montréal School of Optometry. At the time, the clinic had only two staff members. The previous owner retired immediately; we never worked together to hand over the practice. Fifteen years later, I acquired a larger two-OD clinic in Val-d’Or, a gold-mining and industrial city of about 30,000 in Northwestern Quebec. For nearly three years, I ran two different clinics in two different towns doing the job of three ODs.

Today, our team consists of four optometrists, an office supervisor, two receptionists, several dispensary assistants and a laboratory technician: over 20 in total.  While initially, the patient base reflected the age of the retiring optometrists, the practice now has a very diversified patient base, consisting still of the original older patients and now many younger families. We often see three generations of patients – a true “family-based” optometric practice.

Underline Passion with Principles and Process  

In a small, isolated city like ours, it may be easier to be close to your patients. It also means that word of mouth can make or break your practice reputation quickly! Our success is based upon three core principles: respect, honesty, and loyalty. We are totally committed to provide the best services and products for our patients based on their needs, but always anchored by our values.

Passion and principles, however, need to be grounded in an effective process to discover the patient’s needs and convert these into revenue opportunities. To do this, we ask all our patients to fill out a questionnaire, which helps us to assess their lifestyle and their visual needs. This questionnaire is a very important tool for us to begin and sustain our relationship with patients.

Our survey has been constantly fine-tuned over the years and evolved into specific questionnaires based upon age of the patients:  children, adults and seniors.  Since the patient’s activities may change over time and we need to be aware of these changes, the survey is taken on each visit. The patient questionnaire travels in each step of the customer journey, including into the examination room. The answers allow us to easily identify patients’ needs and fulfill these needs with the best available solutions that our key suppliers make available.


Partners in Practice

The eye care professional’s duty is to keep patients well informed about eye care diseases and about the various solutions, provided by our partners, that can help them to see better or be more comfortable.

Solutions like Crizal Prevencia®, Transitions®, and the Varilux® X series fit perfectly with this approach. We now commonly see visual fatigue for most people using digital devices and prescribe advanced single-vision design Eyezen™ lenses for these cases. In addition, we use Essilor’s Visioffice® for all measurements for all patients, to provide personalized lenses and a unique eye technology experience.

These advanced technologies provide added value by enhancing their lifestyle and vision. Our approach, backed up by products in which we have full confidence and know patients will love, builds loyalty, trust, and client satisfaction.

Our industry is constantly evolving, which makes keeping up with innovation and the latest technologies a critical success factor. We organize one to two-hour training and review sessions for optometrists and assistants every four to six weeks. Our key suppliers including Essilor and Opto-Reseau (our network group) are partners in this approach.  Training allows the team to be aligned in our values and goals, encourages their involvement in achieving our objectives, and most importantly provide the best possible solutions for our patients.

Participation in the Community

Reaching beyond the walls of the practice is also very important to me. We participate in fundraising with the Leucan Association for Children with Cancer, for the past three years sponsoring a Saturday afternoon children’s show at a local comedy festival that the children perform in. We donate 50 pairs of sunglasses to children under 12 participating in the show. We also maintain communication with our patients through our monthly newsletter, website, Facebook page, and patient recall postcard mailings. We advertise promotions on local radio, where I am also the talk show eye health expert.

We always stay true to our core principles and encourage the team to participate in the sales process. We leverage the resources and excellent technologies of our partners to provide patients the best services and advanced technology products with a satisfaction guarantee. When you believe in what you’re doing, it’s easy to share that passion with others.

 

JOSÉE FALARDEAU, OD,

Is the owner of Clinique Opto-Réseau Val-d’Or and Clinique Opto-Réseau Malartic. She can be reached at valdor@opto-reseau.com. At Opto-Réseau, our mission is to offer exemplary eye care and to provide the products that best suit the needs and the personality of each of our patients.

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Insight with Dr. Paul Gray

Insights

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Dr. Paul Gray is a partner in a large multi-doctor practice in Halifax, NS.

Paul has been active within the profession of Optometry, having

served as the President of the Nova Scotia Association of Optometrists and as

the chairman of the board of OSI (Canada’s largest group of Independent Optometrists).

Outside of eye care, Paul is extensively involved with the competitive motor sports community as

a driving instructor and a competitor.

Dr. Paul Gray

Insight Optometry, Halifax, NS

Doctor of Optometry, University of Waterloo, 1980

What business books would you recommend other ECP’s read?

Who Moved my Cheese, by Spencer Johnson and Kenneth Blanchard. This little gem is required reading for many of our docs/staff in our practice.  It’s a timeless business classic which uses a simple parable to reveal profound truths about dealing with change. At the risk of generalizing too much, it’s my sense that many ODs are less than forward thinking or proactive in their approach to change. Too often I witness reactionary strategies to trends that have clearly been established while growth or differentiating opportunities are lost. While I don’t consider myself an innovator, I would at least fall in the category of an early adapter and I believe that has served our practice well over the years.

What metrics in your practice do you use to gauge your success?

We have always used a variety of factors to help us in decision making and gauging the financial help of our practice.

As a member of OSI multi-services group, we utilize very capable Optosys 2 software for our EMR. The continued development of this software application has, in recent years included a KPI (Key Performance indicator) module which allows numerical and graphjcal analysis of the key indicators that Optometrists need with just keystrokes. It’s been a very helpful addition to our management. Some of the many things we track on a “per doctor basis” include:

  • all sales numbers
  • total patients, new patients/previous
  • production booked
  • No shows
  • Contact lens fits/new old
  • Conversion rate to in house dispensing
  • Multiple eyeglass sales, sun Rxs
  • External Rx’s sales from other eye docs
  • $$ generated per patient seen for full evaluation
  • all revenue generated for specific instruments (OCT, fields, topography, etc )

 

How do you hire new staff? What is the process and who does the hiring in your office?

New hires present from a variety of sources, and are generally internet-based as initial point of contact.  Our staff also act as ambassadors to source employee possibilities when they meet people in various environments who they think might be a good “fit” for our office. Potential employees are directed to our website to click on our application process. This is designed to screen out those who don’t necessarily aspire to our environment and are simply casting a broad net to secure employment that may/may not be a good match for them. We use a 3rd party group for this but it’s viewed as seamless through our web portal.  The current tool we are using is called “Talentsorter”,  (no financial disclosures) which assists in titrating our choices more specifically and helps determine a “fit score” for a given employment postion. Should a potential employee continue the application process (thus authenticating ambition/genuine interest) they are then contacted by a key staff member by phone.  We consider this initial touch point by phone as an important part of the interview process and current staff utilize a check sheet to judge phone manner, voice clarity, enthusiasm, use of the language, etc.  Based on the outcome of initial contact, 2 separate interviews are done at our office, the second one involving our office manager. Finally, the potential staff member is invited to spend a day with us to interact with their potential co-workers and understand the sort of environment they could become part of.

We tend to hire on attitude and “fit” versus specific skill sets for at least some of the positions in our clinic. Once a new staff member has competed their initial weeks, I will typically meet with them and do a more formal “doctor welcome” to get to know them on a bit more personal level, promote the concept of easy accessibility to management/docs, and share practice philosophy toward patient care. I invite them to take advantage of their opportunity to observe current “systems” through fresh eyes and to be comfortable suggesting better ways to do things should they have experiences that may assist our team.

Favorite past-time / hobbies?

I have had the privilege of being very active in the motorsport community earning National and International race licences with many podium finishes in over 400 competition events. These included a wide variety of open wheel, closed wheel, open cockpit race cars on dedicated road courses or street circuits. I have taught performance driving and race schools on a volunteer basis for almost 30 years.  Other passions include downhill skiing, martial arts, golf, sailing, and guitar.

Tell me something few people know about you?

I spent most of my childhood in the First Nations Cree community of Moosonee, Ontario.

What was the last gift you gave someone?

For me, when I’m able, it’s often the gift of time…working on a friend’s farm helping harvest a crop, repairing a barn, swinging a hammer.  Agreeing to welcome yet another Optometric intern to our practice. Listening… when needed.

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How to Convince Undecided Clients

Differentiation | Business Strategy, Practice, The Patient Journey

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One of the more difficult situations to handle is a customer who can’t decide whether or not to buy.  Their indecision can cause a lot of frustration for staff, particularly if other patients are waiting for help.  There are a number of strategies that can help alleviate the stress of this bottleneck.

The first step is to make sure that your offerings are clearly laid out, including costs.  Create pricing tools that offer choices in different categories.  For example, clearly show your customers the cost difference between lens technology and material options.  Highlight what other features are available, including photochromic material and anti-reflection coating.  With the choices clearly laid out, it will be easier for the client to select what makes the most sense for them, in terms of benefits and price.

Make sure your staff understands the difference between a feature and a benefit.  While anti-reflection is a feature that is offered on most lenses, the benefit to the patient is being able to see better, particularly at night, which is a common patient complaint. In their own words, staff can explain that by way of letting more light through to the back of the eyes, anti-reflection coating can actually help patients see better!

Story telling helps illustrate the benefits most effectively.  If your staff has a personal experience or anecdotal experience from another patient that helps highlight the benefit of a product, encourage them to share it with patients.

Offering a satisfaction guarantee can also help move the needle.  Patients who are well informed will make a great choice for themselves. Being able to make a clear, informed decision also reduces the risk of buyer’s remorse.

Demonstration can be an incredibly powerful tool. Have a pair of polarized sunglasses and a pair of tinted lenses for demo purposes only. Invite patients to take both pairs outside and see the difference for themselves. Experiencing the benefit for themselves can help the patient arrive at a decision.

If a patient is having trouble narrowing down their frame selection, there are strategies that can assist them in the process of elimination. Use a decorative shopping tray in which to place all the finalists. Which is your least favourite between these two choices? Is it fair to take that one out of the decision pile? Once you have narrowed the selection to two or three, sit down with the client to discuss primary and secondary pairs of glasses.

Contact lenses are a commodity product. They can be shopped and purchased easily from many different sources.  Price is usually a deciding factor. Be sure to inform patients about rebates, as many are unaware of them and it can be the reason they decide to buy. For convenience, also offer to ship the contacts directly to the patient’s home.

Most ODs are selling drops and vitamins as a convenience for patients. It is important to stock this product in different price points and break it down to a cost per day for the patient. Stocking these products also reinforces the importance of the recommendation. Like contact lenses, many of these products are a commodity, so offering selection and choice helps the consumer to feel more confident in their purchase.

Practitioners who offer specialty services like Vision Therapy or Customized contact lenses, can face skepticism and price objections. Particularly if the service is new to them, the patient may lack confidence in the effectiveness of the intervention. Testimonials on the website and in writing can help build confidence and make the decision-making process easier for the patient.

With all of these strategies, the key idea is choice.  Take the time to review all of the choices and you will encounter fewer indecisive clients.

 

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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When to Hire an Associate OD and How to Do It

Human Resources, Practice, Resources, Talent Acquisition

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You want to create greater access to care for patients, and you want to grow your practice. Those two goals can be achieved by hiring an associate OD, if the time is right for you financially, and if you know exactly what you want the new doctor to add to the services you already provide. My practice partner and I recently hired an additional associate to add to the two we already had on staff to create a five-OD practice. Here are key lessons I’ve learned about the right time to add an associate, and how to do it so the new hire enhances care and revenues.

Financial Tipping Point
We were at 80 percent capacity when we decided to add another associate. If you wait longer before adding another doctor, many current and prospective patients will look for another place to receive care, rather than wait until a doctor becomes available at your practice.

We have 337 exam slots each week. Some 270 of those were full 1-2 weeks out with many weeks fuller than that. The capacity problem we had related to patient-preferred times. We typically will have mid-morning times that remain open for the doctors. Our capacity fluctuates according to time of year, so during the summer months we were at 100 percent+ capacity, whereas some months were 80 percent.

I look at associate ODs as long-term practice investments. Associates are an upfront expense that are like an investment in stock. When you buy a stock you typically don’t get immediate cash returns. However, when you have a practice that’s already staffed, with fixed overhead expenses, adding an associate usually does not add proportional overhead costs.

We put a doctor on salary for the first year, and keep track of their percentage of production. Once they “pay for themselves,” we talk to them about transitioning to being paid based on production only. Our associates have found production-based practice to be the most rewarding both personally and financially. As an owner, I also like to see the doctors have buy-in, and feel like their prescribing habits and clinical care make a difference not only in the care they give, but also in the practice’s revenue per patient.

Dr. Fleming’s practice web site announces a new associate, Melia Nguyen, OD. Dr. Fleming says to carefully calculate your finances, and capacity for seeing patients, before adding another doctor to the practice.

Is This a Person We Want to Work With?
Bill Hybels, founder and pastor of Willow Creek Community Church, has written in his many leadership books about the importance of evaluating for character, chemistry and competency when hiring a new employee. When we look for a new doctor, the most important thing we think about is their character. This is what most helps us determine if the doctor is capable of serving our patients the way we want them to be served, and whether they are a person we would want to interact with everyday as colleagues.

Our practice culture emphasizes the importance of faith and family, so we look for people to add to the practice who also value those things. In the hiring interviews, we listen for evidence that the doctor prioritizes their family, and see it as a strength if the prospective associate notes involvement with a church or other house of worship.

Prepare to Serve a Diverse Community
The U.S. is becoming more diverse with communities across the country experiencing influxes of people with Hispanic and Asian backgrounds, among other immigrant groups. That means that it’s advantageous for our practices to reflect that diversity.

In addition to being impressed with her character and competency as a doctor, we consider the new associate we hired, Melia Nguyen, OD, to have a background that will help us serve our changing community. As an immigrant, who came to the U.S. with her family when she was 12, Dr. Nguyen understands the perspective of other recent immigrants, and can guide us in growing our practice’s reach into those communities.

Don’t Keep Your Search for An Associate a Secret
The more time that you have when looking for an associate the better. I think too many practice owners play a secret game in not telling anyone they’re looking for an associate until they’re about ready to hire. We almost made this mistake, and I would encourage those who have a 2-5 year plan of bringing in an associate that they begin telling people well in advance.

Think About Long-Term Goal: Will This Person Eventually Become a Partner?
We hire our associates with the idea that they will eventually be offered a place on our board of directors as an owner. It is not a prerequisite for an associate to have the desire to be an owner, but we like the mentality of an eventual owner-OD because it gives the doctor a greater personal stake in the success of the practice.

My partner in the practice, Jeff Yarrow, OD, and I are in the process of creating an organizational structure that will allow for the practice positions of CEO, CFO, and we will have a board of directors. Each owner will have a seat, and equal standing, on the board of directors.

Get to Know Prospective Associates
The hiring process we use to add an associate OD is similar to the process used when hiring support staff, but with a longer timeline, and more in-depth interviews, including video teleconferencing interviews, or video “chats.” The first step was a video chat with just myself and potential candidates, which served as an initial screening. From there, we narrowed the pool of applicants, and then had the other doctors in the practice participate in a longer video chat with the potential associates.

Prospective support staff are usually based locally, and so, can come into the office for a first round of interviews. Potential associates often are not based nearby, so the video chats were an important tool in getting to know them. It worked to our advantage in giving us a view of the doctor at home, or in the office where they currently practice. That “natural setting” environment gave us a glimpse into the person’s life. For example, during one of our interviews, an applicant’s dog ran into the picture. Seeing how she handled that situation gave us a sense of how she manages the unexpected. Her calm, graceful response allowed us to see another strength of her personality.

Use In-Person Interviews & Personality Assessments
Once we determined that an OD was a finalist to become an associate, we asked them to visit our office in person, and asked for references. We depended a lot on references, and time communicating with those references, to determine the clinical competency and character of the individual. The interviewee coming to our practice and interacting with our staff and doctors then allowed us to see if they would have good chemistry with us.

We also use the DiSC personality assessment to determine if a doctor will be a good fit for our practice culture, given the personalities of the other doctors and staff, and how we like to care for patients and conduct business. We want to know that the new associate OD would be comfortable with an open culture in which we regularly welcome, and solicit, feedback, and work together cooperatively to better the practice.

 

CHAD FLEMING, OD, FAAO,

Chad Fleming, OD, FAAO, is a partner with Wichita Optometry, P. A. in Wichita, Kan. To contact: optometryceo@gmail.com

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Insight with Dr. Vishakha Thakrar

Insights

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Dr Vishakha Thakrar is the co-founder of Vaughan Family Vision Care.

Expanding on her residency training, Vishakha has a heavy focus on

specialty contact lens fittings and dry eye.

In recent years Vishakha has served as a contributing editor for the journals

Contact Lens Spectrum and the Eye Care Review.

Dr. Vishakha Thakrar

Optometrist, Vaughan, ON

Honours BSc., University of Toronto, 1997

OD degree Ohio State University, 2001

Residency, Cornea & Contact Lens, New England College of Optometry, 2002

 

What is currently the most exciting thing in your field to help patients?

Corneal cross-linking, in my opinion, has had the highest impact on my patients.  When I started practicing 16 years ago, if a patient was diagnosed with keratoconus as a teenager or young adult, often this meant that he or she would be doomed to needing a corneal transplant one day.  Life is very different for a keratoconus patient today.  Corneal cross-linking can essentially save their vision if they receive the treatment early enough.

What is something you have done in your practice to set you apart?

My business partner, Dr. Angela Peddle, and I set out in 2011 to open a practice that focused on our residency training which included cornea and contact lenses, binocular vision, and vision therapy.  Practicing in the GTA, we recognized that the competition for primary care optometry was increasing dramatically.  There were opticals and optometry offices on almost every street corner, not to mention the number of big box stores and commercial settings.  We opened this practice to differentiate ourselves from the competitive environment, but more importantly to use our training to service our patients.

I am residency-trained in cornea and contact lenses.  I had a vision of having a practice with almost exclusively complex contact lens patients, and I am happy to say that I accomplished that dream.  Early on, I reached out to several ophthalmologists, particularly cornea specialists, and educated them on my training and my passion for scleral and contact lens fitting.  As a result, my contact lens practice continue to grow.

Over the years I have also advanced my practice by focusing on innovations in our field .  I opened a dry eye centre as a natural progression to my contact lens clinic.  My practice was also the first in the country to start using EyePrint© Prosthetic Scleral Lenses (Advanced Vision Technologies).  EyePrint© Prosthetic is a scleral prosthetic device that is created from 3-D printing to produce a highly customized lens.. The types of eyes that this lens can fit is amazing.  I use this technology on really complicated cases, for example –Stevens Johnson’s patients, ocular cicatricial pemphigoid patients, asymmetric grafts, and other patients with very irregular scleral and corneal topographies.

What advice would you give a new grad today?

I would advise a new grad to differentiate the way they practice from the time they graduate.  The environment of optometry has changed, and to help ensure success we must differentiate ourselves.  There is a great book by Jack Trout called Differentiate or Die that is a must read for new grads. In fact, this book lead me to opening my practice.

What is your definition of success or what habits make you a successful person?

Rather than giving you my definition of success, I will tell you a story. A patient presented to my office about 4 years ago with RK.  He had a retinal detachment 15 years prior in the right eye, and was correctable to 20/400 with glasses.  In the left eye, he was correctable to 20/50 so was just barely able to drive.  He had been seen by multiple doctors over the years who told him that he would not be able to see out of the right eye again, and essentially this patient had given up.  When he came to my office he wanted the left eye to be fit with a lens, but I felt that he had nothing to lose by trying to correct his irregular astigmatism in both eyes.  I fit both eyes with scleral lenses.  After fitting, he could see 20/50 in his right eye and 20/20 in his left eye.  I cannot express how happy this patient was going from 20/400 to 20/50.

Now after years of wearing the lenses, he is correctable to 20/25 in the right eye.  He considers scleral lenses to be a miracle.  He still cries when he comes to my office.  These are the types of stories that I hear every week, as does everyone who fits specialty contact lenses.

My definition of success is the ability to change a patient’s life for the better, and I hope that I do that every day. The best choice I ever made in my career was doing a cornea and contact lens residency.  This training gave me the technical skills to confidently manage corneal disease patients with contact lenses.  And seeing these patients for the past 16 years has given me the empathy to understand their physical and mental struggles.

It is incredibly powerful to put a contact lens on a patient who hasn’t seen in 5, 10, 15 years, and provide them with 20/20 vision.  Many patients feel that they have been given their life back.  In those moments, I am so grateful that I can help patients in this manner …and I think that there is little more that I can ask for from my career.

Tell me something few people know about you?

I studied French in Nice, France for a summer when I was in university.  Then when I was in optometry school, I did an externship in Guanajuato, Mexico where I replaced all of my 15 years of French education with Spanish. I’m not sure why I can’t just speak both languages….

 

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4 Holiday Promotions to Boost End-of-Year Optical Sales

Advertising & Promotion, Marketing, Resources

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The holiday season is approaching, and with it, ample opportunities to market the eyewear we sell. Here are four holiday promotions that we find build end-of-year sales and raise patient satisfaction.

Holiday Food Drive: Eyewear Discount with Donation

Cans collected in the office of Thomas Eye Center as part of a holiday food drive in which patients who donate four, or more, items get a discount on eyewear.


The purpose of this promotion is to help the less fortunate in our area, Athens, Ga., with the added bonus of letting our community know our values. Patients, especially Millennials, want to know the businesses they patron have values that align with their own, so a charity-related promotion during the holiday season can both bring patients into your optical to do a good deed, like donating food, and encourage them to keep visiting yearly for eyecare needs.
How it works: After donating four items to the drive, patients are given a discount of as much as 20 percent off eyewear.
Cost: Less than $1,000. The money we spend on the discounts will depend on how many patients donate at least four items to the drive.
Promote it: We tell people about the food drive when we call to confirm their appointments, and we also post announcements about it on our practice Facebook, Instagram and Twitter accounts. In addition, we feature information about it in our monthly e-newsletter, and also make a note of it on our practice web site.
Make it a Success: Staff needs to be engaged in the effort, meaning they need to also believe in the mission of the charity you are supporting, so they will be excited to talk to patients about it, answer their questions and encourage donations.

Thomas Eye Center offers a 30-percent-off sale around the holidays. The promotion makes it easier for patients to get the products Dr. Thomas prescribes, and it contributes to end-of-year revenue growth.

Frames Clearance: Boost Multiple-Pair Sales
This promotion, starting after Thanksgiving, offers 30 percent off select frames–those we want to sell to make room for new merchandise for the new year. Our hope is that patients use these frames as a second-pair purchase of sunglasses, or for a pair of back-up glasses.
How it works: We let every patient who visits our practice know about the sale, especially those who have been prescribed multiple pairs of eyewear by the doctor. The frames are grouped together in a particular area in our optical with signage, so we point out where the patient should look if they don’t ask about it on their own while browsing.
Cost: No additional cost since the products have already been purchased, and have not yet sold. So, we can only gain at this point in the year by finally selling them.
Promote it: In addition to doctor and staff talking to patients about it as an opportunity to have glasses for all the needs in their life, from driving, to sports, to computer work, the clearance sale should be announced on all of a practice’s online sites–practice web site and all social media pages. You also can let patients know via e-blasts and e-newsletters.
Make it a Success: Doctor-driven dispensing is key to this promotion, as the patient has to understand why they would want any more than just one pair of glasses. If the doctor can explain the benefits of additional pairs of glasses, and then mention the end-of-year sale, the patient is more likely to take advantage of the discounted eyewear.

Spectacle Lens Discount
When patients buy one pair, the second set of lenses are half price. During December they get an additional 20 percent off of the frame – even close outs. We need to move the frames that are dead weight, and taking up valuable real estate. Offering the lens discount, and giving the patient the ability to combine that discount with a discount on frames, gives less excuse not to buy.
How it works: We run the half-off second pair all the time – the additional 20 percent off, which we are offering this holiday season for the first time, hopefully will move some slow-selling frames.
Cost: No added cost, as no merchandise was especially purchased for this program.
Promote it: We have the frames displayed in a particular floor case with signage, along with promoting the sale online on the practice web site, social media accounts, e-blasts to patients and in the e-newsletter.
Make it a Success: Success boils down to employees taking ownership of the sales promotions and educating patients about them. An incentive program, in which opticians receive a bonus based on sales on an individual, or team, basis, can help.

An ad posted in the office and online, advertising the holiday gift card promotion that Thomas Eye Center offers.

Discounts with Purchase of Gift Certificates
It’s the holiday season, with patients searching for the perfect gift–something friends and family don’t have. A gift certificate to an optical, where they can finally buy that pair of designer frames, or sunwear, they always wanted, may be just the thing for the tough person on their holiday shopping list. So much the better if the giver of the gift card gets a discount on the gift card, or a discount on a pair of eyewear for themselves.
How it works: The way we do this promotion is by offering 10 percent off gift cards. If a patients buys a $200 gift certificate, they only pay $180, or they can opt for the recipient to have the additional 20 percent, and they would receive a gift certificate for $220.
Cost: The 10 percent difference between what the buyer pays and the recipient receives.
Promote It: We dress up a fancy embossed envelope and display at our check-out counter. We also post social media and practice web site shout-outs about it, and display our gift certificates under glass tabletops in our optical.
Make it a Success: Even if you have promoted the gift card discount program in multiple ways electronically ahead of their appointment, and mentioned it during their office visit, the patient still needs to be reminded of it when they are at the check-out counter.

 

STUART J. THOMAS, OD

is the owner of Thomas Eye Center in Athens, Ga. Contact: StuTh2@vsp.com

ELLEN BYRUM-GOAD, LDO

is practice manager. To contact: Ellen.Goad@thomaseyecenter.com

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Location, Location, Location: Start Me Up Webinar Part One

Buying-Selling A Practice, Finance|Wealth, Practice, Real Estate, Resources, Webinar

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Location is arguably one of the most important decisions that can make or break the success of your new practice. The following conversation among independent OD offices that have been recently establish is excerpted from the Start Me Up Webinar Panel hosted by Jeff and Tina Goodhew on October 18, 2018.

 Panelists:

   

   

Jeff Goodhew: Michael, as far as timing goes, what type of research did you do in finding your location in Edmonton?

Michael Kreuzer (Practice in Edmonton, AB, opening January 2018): It’s an interesting and complicated question because I had two other bids on places before finally determining my end location in the city.

Key things to me were a demographic that had a lot of growth and a lot of younger people moving to it. My current location is on a retail street which has experienced tremendous growth over the past 5 to 10 years The area is under-represented in terms of optometrists. Those were two key factors.

If you find a good commercial real estate broker they should be able to help you with identifying key market demographics. My broker for instance had sent me locations of other optometrists in the city within 1km to 5km radius away. Based on that information you can piece together a decent spot that you can stake for your own.

Another important factor in the location is price. In these high density urban areas in Edmonton there is a pretty big fluctuation in terms of the asking price per square foot. One key piece of information I got from my adviser was to keep in mind that a huge cost that you can control upfront is your overhead,  –  the cost per square foot. Being aware of that and not overspending on your real estate is a great way to get started on the right foot.

Jeff: Your broker obviously went above and beyond. You are saying your broker was the one that sort of mapped out where the competition was, not yourself.

Michael: I was aware of the competition but he definitely went above and beyond, and with that information it allowed me to focus my energy in other aspects of looking at places. That’s the benefit of having a great team from the start, you can piggyback off of the services of other professionals who are way better at this than when you are starting and you have panned in so many different spots. It was a really big help.

Jeff: Laurie, how did you choose where to open your practice back in 2015?

Laurie Capogna (Family Eye Care, Niagara Falls, ON): Niagara Falls isn’t all that large of a city, so I thought about using a real estate broker but in the end, I didn’t. I ended up myself driving around finding every vacant building that was available. I had a bit of a dilemma, at first I really wanted to buy a building. I’d never leased before, I’d always owned the building I was working out of. When I saw there really wasn’t anything available, I started looking into plazas, and I looked at the new ones and the older ones. Based on what was available I actually just took something that I liked and  because it was in the same plaza as a Shopper’s Drug Mart. [Leasing here] actually proved to be very, a very good decision because I can’t tell you how many patients come in say, “I love your location and I see you here all the time and I’m in this plaza all the time.” I didn’t realize the benefit to being in a retail location because I’d always been in a medical building before.

Jeff: Agata, you opened in a highly competitive neighborhood in Toronto. What did you look for when you opened your practice?

Agata Majewski (Owl Optometry, Toronto, ON): In the city, I think it’s very hard to find a place where you don’t have an optometrist next door. My location is at street level in a very family friendly neighbourhood. There are four or five schools surrounding me. I knew the area I wanted to be in and I was driving by and saw this space for lease, which was an old variety shop. It’s a small space but it’s street level and most of our patients are just coming in off the street, I didn’t have to advertise.

Jeff: Can any of you comment on opening a new practice in a medical building versus a sort of street level traditional retail location? Does anyone have an experience around that?

Ritesh Patel (See & Be Seen Eye Care, Liberty Village, Toronto, ON): While we were actually going through the process of where we wanted to open, we created a matrix, and the matrix consisted of the four or five things that were most valuable to us. One of the things on that list was being around family physicians and practitioners, because in Ontario you can consider them a “feeder system” to just have patients come through the door whether it happens to be a diabetic or red eye or annual exams, or children, whatever it may be. In our case we are retail ground floor setting in a relatively high traffic area, but we also happen to be in the same building as 12 to 15 family physicians as well. You don’t necessarily have to choose one versus the other.

Jeff: Anyone else have any comments on location before we go on?

Howard Dolman (Dolman Eyecare Centre, New Hamburg, ON): We are in a very rural setting, a small community and the vast majority of patients drive to our clinic, and so the amount of parking that you have in a rural setting is important as opposed to being in an urban setting where being closer to transit and having easy access for your patients to get to you. That’s certainly one consideration to think of in terms of location.

Tina Goodhew (Abbey Eye Care, Oakville, ON): If you are in the process of still trying to look at an area and you don’t have a broker yet, you can also check with city hall and they often have plans on what their growth and demographics of a neighborhood is.

One of the other tips we give you is to plot your competition. The final thought I have here is that even the location within your location is extremely important. What I mean by that is, we are in a mall that we have been in for 12 years but for 10 of those years we were at one side of the strip and two years ago we renovated and expanded and we moved to the centre of this strip that happens to be in front of one of the driving entrances, and we’ve found that out traffic has jumped significantly. People said that they didn’t know that we were in the mall previously even though we’d been there for 10 years! Again, location within the location is very key as well.

 

Click here to listen to the entire webinar 

 

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What Independent ECPs Can Learn from Online Optical Retailers

Differentiation | Business Strategy, Digital Marketing, Marketing, Practice, Pricing

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In recent years, several emerging vendors of optical goods have launched consumer advertising campaigns with claims that they deeply undercut the artificially high prices maintained by the optical industry establishment.

The marketing message of these “disputers,” as trend-watchers like to call them, is that they have the answer: eyeglasses or contact lenses at far lower prices, sold directly to consumers online. They are the consumer’s advocate, they suggest, while optical manufacturers and ECPs are price gougers.

There is a clear fallacy to this claim, of course, but manufacturers and ECPs have a hard time defending their price structures and looking on the level at the same time.

If you take the superior quality argument, you open yourself to criticism that a better pair of glasses can hardly be worth six or eight times as much as the low-cost alternative.

Alternately, if you try and meet low-ballers where they live, you descend to a commodity arena that won’t sustain your practice.

As they say in politics, “If you’re explaining, you’re losing,” and ECPs are challenged by that very dilemma.

Through the years, Review of Optometric Business has argued that the key is to establish a value-based relationship with your patients. We realize that is not easy, but it is imperative. Define what you stand for, explain the difference in the goods you prescribe, and be price-competitive.

But maybe those “disrupters” have a point.

That was the takeaway from a recent conversation with Michael Kling, OD, a highly progressive independent OD who has contributed many creative ideas to Review of Optometric Business. “The disruptors have figured something out about what people want,” he counseled me. “Often times, they have a better idea, and we can learn from them.”

So, before dismissing new and disruptive entries to the retail landscape, take a look at their value statements.

Warby Parker entered the optical arena suggesting that a virtual monopoly inflates the average price of eyeglasses. So, do they sell cheaper products or mark-up less? Not likely. Warby Parker is about buying eyewear in a new way, in a Millennial context, where the shopping process is…awesome. And where your parents don’t shop.

Take a look at the Warby Parker “story” on its web site:Hubble Contacts similarly markets around the concept that contact lens manufacturers conspire to keep the price of contacts too high. Are their contacts cheaper?

“We looked at their deal,” said an independent OD in a group discussion I sat in on recently, “and we’re less expensive than them.”

Again, it’s not about price, despite Hubble’s marketing message that says so. Its about the fact that Hubble offers a new, smarter way of buying: monthly automatic delivery, with an automatic subscription charge that is a line on your credit card statement that you don’t really feel. This is the way people (especially Millennials and Gen Zers) pay for mobile usage, music, razors, groceries, on and on.

Take a look at the “Hubble” story presented on its web site:

Clearly, both Warby Parker and Hubble have compelling stories. In both cases, their value statement is logical and simply stated. Is yours? Is your practice’s value statement working for you in this era of digital communications, online retailing and convenience of payment and delivery?

Optical is not alone in being challenged to defend its margins and delivery standards.

Dentists compete with low-cost alternatives to the premium InvisiLine system and the teeth whitening systems they offer. In hearing aids, low-cost alternatives are emerging, as well, though audiologists complain that those in need may be skipping a comprehensive exam to determine the health of their ears.

Take a look at another “story” about a consumer-friendly avenue to pay 75 percent below what audiologists charge:

Sound familiar?

The lesson: Understand the core appeal of the new retail reality: convenience, fair price, ease of payment and automatic delivery. Together, these factors provide a sense that you’re buying smarter.

The action point for independent ECPs: Compete!

Offer convenience by way of annual contact lens sales and home delivery. There are programs from contact lens manufacturers and OD alliances that help independents to be very competitive. And more such programs are emerging from within optical.

Offer a monthly payment plan or patient financing that eases any financial imposition on patients. Plans are available that shift the non-payment risk away from the ECP.

Define the value that you offer. Independent ECPs are gatekeepers of the most advanced innovative optical solutions that provide their patients with the best possible vision and ensure eye health. When patients seek out low-cost alternatives, ask them a set of questions: “All day long, you look at the infinity screen of a Samsung Galaxy, you work on a laptop with an Apple Retina 4K monitor, you watch Netflix on a 4-K Ultra HD TV…so why are you looking at the world through value-based eyeglasses and contact lenses with 1990s optical technology? Especially when I can offer you the best vision possible with the latest, most innovative optical products? May I show you the difference?”

Offer a great experience. In the end, it is the perceived value of the care and patient experience you deliver, in concert with premium optical solutions that are the best for the individual patient that will make the competitive difference. So, don’t dismiss your new competitors; learn from them.

 

 

ROGER MUMMERT

is Content Director for Review of Optometric Business. Contact: Rmummert@jobson.com.

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Quick Fixes: What Bothers Your Patients Most–And How to Address It

Practice, Resources, The Patient Journey

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Bad doctors and nurses aren’t the culprit for dissatisfied patients. Rather, it’s the patient experience that most point to when unhappy with a health-care experience, according to a study conducted by Vanguard Communications, and published last year in the Journal of Medical Practice Management.

Most patients rated their doctors highly, the study found: 61 percent gave five-star reviews, compared to only 23 percent who gave one-star reviews. When patients did leave negative comments, the researchers found that only 4 percent of their complaints were explicitly related to medical treatment. The other 96 percent focused on issues such as inadequate communication, wait times and disorganized operations.

It’s important we fix inadequate communication, unnecessary wait times and disorganized operations in the practice. Let’s consider them one at a time.

INADEQUATE COMMUNICATION
What is the main issue with inadequate communication? George Bernard Shaw nailed it when he said: “The single biggest problem in communication is the illusion that it has taken place.” Looking at malpractice claims shows that George’s statement is correct. A breakdown in communication between the doctor and patient is the “root cause” of malpractice claims. Right up there with this as a primary cause of malpractice lawsuits is the perception by the patient that the doctor is uncaring. It may not be that the doctor was actually uncaring; she may have just rushed the exam, and that led to a communication problem where the patient perceived the doctor was uncaring. Remember, from the patient’s perspective, perception is reality.

Getting patients to follow our treatment plan should be in our top goals for the exam. We are going to do a lot of exams over the course of our career. A doctor will have as many as 192,000 patient interactions over a 40-year career (20 patients/day x 5 days/week x 48 weeks/year x 40 years = 192,000).

With so many patient interactions, clear communication with patients is an essential tool for an effective doctor. There is a large body of research over the last 30 years showing the doctor’s ability to explain, listen and empathize has a significant effect on patient outcomes and patient satisfaction.

But how many doctors actually measure outcomes by measuring treatment plans completed? Practice management rule number one is measure to manage. If we want to improve our patient outcomes, then we should start measuring. Once we begin to measure, then we can begin to make changes to improve our outcomes. As we make changes, remember the importance of improving communications with patients as an effective way of improving outcomes. Work on what to say, how to say it, and in what order to say it.

UNNECESSARY WAIT TIMES
Is the doctor on time or routinely running 40 minutes behind? Where do the bottlenecks occur in the practice? What is the wait time in the optical? These are some of the questions that not only should we know the answer to, but we should also have active plans to fix when they are a problem. Patients hate waiting. Yet in most practices, patients wait. Let’s be honest, patients wait primarily because we do not want the doctor to wait. In most practices, the schedule is built to keep the doctor busy.

Patients also wait because we are inefficient or poorly staffed. Take a look this week at the efficiency of the flow of patients through the practice. Identify where and why patients wait, and fix the problems. It may take another piece of pre-testing equipment, an adjustment to the schedule, or another staff member to fix the flow. Make the fix to improve patient flow.

DISORGANIZED OPERATIONS
Analyzing the work flow in a practice is an important step for all practices because it improves efficiency and reduces disorganization. Here’s a simple process to follow to get this done:

1.    Break your work flow down into as many steps as possible. The more granular, the better.
2.    Lay these steps out using Post-it Notes.
3.    Look for exceptions, and create simple decision boxes to capture the variations.
4.    Look for ways to improve efficiency.
5.    Rearrange your Post-it Notes to show your new, efficient work flow.
6.    Implement your changes.
7.    Re-do this process every three months until you are satisfied you have the most efficient flow, then review it every six months to make sure it is still the best flow.

Focus this week on improving patient communications, reducing patient wait times, and making your practice operations more efficient to improve patient satisfaction and adherence to the practice.

 

References
i. http://ministry127.com/resources/illustration/the-biggest-problem-in-communication
ii. Huntington, B., & Kuhn, N. (2003). Communication gaffes: A root cause of malpractice claims. Baylor University Medical Center Proceedings, 16, 157-161.
iii. Beckman, H. B., Markakis, K. M., Suchman, A. L., & Frankel, R. M. (1994). The doctor-patient relationship and malpractice. Lessons from plaintiff depositions. Archives of Internal Medicine, 154(12) 1365-1370.
iv. http://healthcarecomm.org/about-us/impact-of-communication-in-healthcare/

 

MARK WRIGHT, OD, FCOVD

Dr. Wright is the founding partner of a nine-partner, three-location full-scope optometric practice. As CEO of Pathways to Success, an internet-based practice management firm, he works with practices of all sizes. He is faculty coordinator for Ohio State’s leading practice management program.

CAROLE BURNS, OD, FCOVD

Dr. Burns is the senior partner of a nine-doctor full-scope optometric practice that she built with her husband, Dr. Wright. She is also the COO of a state-wide nursing care optometry practice. Dr. Burns lectures nationally on practice management and staffing issues. Dr. Burns authored the Specialty Practice section of the textbook, Business Aspects of Optometry.

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Artificial Intelligence: Will It Have a Major Impact On Eyecare?

Practice, Resources, Technology

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Artificial intelligence is unlikely to produce a robo-eye-doc who will replace you, but it is likely to add a new dimension to the service we can provide to our patients.

AI-Powered Patient History Interview
I can foresee a future in which AI will be able to talk with patients about their reason for their visit when they book their appointment online. Advanced AI systems, with voice activation, would be able to talk to patients to take a case history, gathering the important information, analyzing it and then providing the doctor with a preliminary finding, which the doctor can explore in greater detail when the patient comes in for an in-person appointment.

 Click the image above to view two videos on how artificial intelligence might impact eyecare from a presentation given at the 11th Annual VM Global Leadership Summit that took place at Vision Expo East 2017.

Before the Patient Ever Gets to Office

When the patient makes an appointment, AI technology could take information-finding to the next level. The patient would not just fill out a form online prior to their visit detailing their health history and eyecare needs. It would provide an interactive interview.

The system would have a “voice” that would ask the patient questions, such as family history of eye diseases like macular degeneration and glaucoma, and then would ask the next question based on the response it received. For instance, if the patient said “yes” to having a family history of a particular eye disease, the system would then ask which relative(s) in their family had the disease.

Or the system might ask the patient if they participate in sports, and then if the patient said “yes,” the system might ask the patient to say which sport. Then, the system might ask the patient if they were interested in learning more about the sports sunwear the practice sells specifically for that sport.

The key to effectiveness will be the ability of the doctor and optical staff to sit down together and come up with the most helpful questions to input into the system to ask. It’s like the old saying, “garbage in, garbage out.” AI systems are, by definition, “intelligent,” but not so intelligent that they don’t require the inputting of the right information to use as foundation for its interaction with patients.

Click the image above to watch Andy Karp of Vision Monday and 20/20 magazine share his preview of new and emerging technology presented at the 2017 Consumer Electronics Show.

Lay the Groundwork for a More Productive Visit
Before the patient gets to the office, the transcript, in both written and recorded form, would be sent to the patient’s EHR file, with the eyewear-related information sent to opticians.

In addition to giving the doctor detailed information about family history that they could use to ask more informed questions of the patient, opticians would get a jump start on the sales process. They would know ahead of time to have a tray of sunwear specific to that patient’s favored sport ready to show them during their visit.

Interactive Displays in the Optical
The opticians will be better armed with information about each patient’s needs, and the displays themselves could “talk” to patients.

A patient could pick up a frame to try on, and when they pick it up, and when they put it back on the board, an AI system could say: “We have that frame in other colors” or “If you liked that frame, you may also be interested in X frame.”

The system could have an “Ask me a Question” button for every section of the frame board in which the patient can ask questions about the merchandise like they would type a question into Google, and then the system would either give a response or summon an optician to answer the question.

Data Interpretation Help
Diagnostic equipment produces data that historically the doctor reviewed and interpreted. AI would be able to analyze the data and would provide the doctor with a working diagnosis and treatment plan.

AI might be able to run more in-depth analysis on the data than a human doctor could. AI may be better at looking at images than a human doctor both in terms of speed and precision. This would lead to better patient outcomes and the ability to process patients more efficiently.

For example, fundus imaging. AI would be able to track subtle changes to blood vessels, optic nerves and retinal lesions over time. AI would be able to alert the doctor to these changes earlier. This is essential as early intervention often leads to better patient outcomes.

Boost Marketing Efforts
AI would be able to tap into your EHR data and look for marketing opportunities. It would then be able to generate marketing content to take advantage of that information, and would be able to tell you the ideal channels to broadcast those marketing messages based on information stored in the system on what’s worked best in promotion efforts for your practice and other practices.

You and your staff can already use your EHR to mine data to use for marketing your products and services. What AI offers is a helping hand doing that work. Rather than you having to search for, and then look through the data, yourself, an AI system could do that work for you. It might be able to automatically conduct searches for marketing opportunities, and then analyze the data on its own, to let you know, without searching yourself, of needed products and services that your patients may not be receiving as much of as they should be.

This kind of advanced, data-driven marketing would help build practices. Patients would more easily be given marketing messages that were most relevant to them.

How Expensive Will This Technology Be?
With all the great promise of AI technology, a question still remains of how costly it will be to purchase and implement.

It may be that as the technology emerges, it will be prohibitive for all but the biggest, and most profitable, practices, but that five-to-10 years after its widespread availability, it will become affordable for smaller practices.

The important point is to be aware of the coming opportunities to better serve our patients–and to develop plans to eventually optimize that technology so patients are better served, and our practices get a springboard to growth and profitability.

Have you thought about the role AI could play in our practices? What ideas do you have of how you could use this technology in your own practice?

 

 

JUSTIN BAZAN, OD

is the owner of Park Slope Eye in Brooklyn, N.Y. To contact him: dr.bazan@parkslopeeye.com.

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