Price: The Competitive Dimension You Cannot Ignore

Marketing, Pricing, Resources

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By Syl (Silvano) Ghirardi

Syl is a retired Industry Executive and former Optician, previously a C-Level executive with
major International vision care companies in both contact and ophthalmic lenses. Syl keeps
a keen eye on the market and is always willing to share his opinions!

The Canadian optical landscape is changing rapidly. Foreign retailers are pushing into the market. There is inexorable consolidation with independent practices selling to retailer groups. Existing optical chains are merging and the mega-merger of industry giants looms. All of this is happening concurrently, not to mention the disruptive dimensions of the digital realm.

What does it all mean, and what conclusions can be made about the future competitive environment, particularly for the independent ECP? Are these changes benign, or are they worrisome to independent eye care practitioners? If you believe the latter, what are the strategic responses? Let’s look at a few of the major changes and project their likely impact.

Foreign Encroachment on the Canadian Market
According to Retail Insider (R-I), Canada’s largest online retail industry publication, international eyewear retailers are entering Canada in unprecedented numbers. The latest, Michigan-based optical retailer SEE (Selected Eyewear Elements) with 40 US locations, opened its fist Canadian location in Toronto this summer. SEE will tout in-house designed fashion-forward styles without the haute-couture price to encourage multiple-pair sales as fashion accessories under the slogan “hip without the hype”.

The Australian banner Bailey Nelson is also entering the Canadian market in a big way, with plans for 50 new Canadian store openings in the next several years. Bailey Nelson recently (Spring 2017) opened one location in Vancouver’s high-rent retail area and promises two new Vancouver locations and one Toronto area store in the fall. Most of Bailey Nelson’s collections retail between $155 and $185 per frame SV lenses and AR coating included. UK-based Ollie Quinn entered Canada earlier this year with ten locations. Ollie Quinn simplifies the price decision for customers: every frame is $145 (online).

The strategy for each of these new entrants: simple and affordable pricing and technology-friendly ordering offer a clear appeal to the millennial market.

Domestic Players Gird for the Fight
Canadian players were certainly not sitting on their hands. Both FYidoctors and IRIS are making acquisitions of various independent practices across the country. FYidoctors have moved to enhance their Quebec presence under the “VISIQUE” banner, consolidating a newly-minted retail brand presence. In July, New Look Vision Group, which had already begun to expand its national footprint with acquisitions of Vogue, I-Vision and Visions One Hour, made its biggest leap with the announced plan to acquire the 150 store chain IRIS, The Visual Group.

Will Intensified Competition Raise the Market?
As a foundation for growth, the major players are all shoring up their brand identity to take on the retail leaders. It is not unreasonable to assume the players are girding for a battle for the hearts, minds and wallets of Canadian eyewear purchasers. While it is nice, in theory, to dream of increasing the purchase frequency by reducing the purchase cycle and selling more multiple pairs, no marketing programs so far have substantially moved the market needle in these two metrics. Market share may shift a point here and there between players, but lifting the tide for all boats to rise has proven elusive.

What is more likely to happen? Market players will engage in a battle for the patient and the prescription through two of the oldest levers in the commercial world: advertising and price. Use of these levers on a large and sophisticated commercial scale can result in extreme competitive pressures for the independent practice. Pricing promotions will bring more visibility and awareness to the price differential between retail and independents and vast omni-channel ad spending will encourage patients to take their freshly written prescriptions to the websites and stores of the leading retail brands.

Competitive Strategy is a Choice
Most marketing experts agree: price, service and quality – choose two of the three to excel and be close on the third. For independents there is, in practical terms, little choice. Small businesses that try to win on price are likely in for a very rough ride, leaving it critical to provide exceptional service and quality products to stay viable.

While the focus in most discussions is about “service” and “quality” – the third component of competitive strategy is that price must be close. What is close? While it is somewhat arbitrary, I believe in the 15% rule of thumb, e.g. a 15% competitive premium is sustainable so long as quality and service are demonstrably superior. Unfortunately, many independents are quick to ignore this advice, arguing that closing the price gap is nothing more than a trap to reduce profitability. The underlying problem being, as valued customers purchasing higher-end progressive lenses drop out, incoming new patients are insufficient in numbers and value to make up the difference.

Closing the price gap requires careful execution and maybe even disrupting the comfortable supplier relationships that you or your staff have become accustomed to. But ignore the advice at your peril!

Regardless of the answers, choosing a deliberate strategy is a critical choice in any business – no less so for eye care professionals, where over 50% of revenue is still derived from dispensing eyewear. If a significant proportion of customers are walking out, script in hand, and looking for eyewear elsewhere, a strategic rethink and asking yourself hard questions about pricing is an imperative.

 

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Employment Checklist: See a Millennial OD’s Criteria for Joining a Practice

Human Resources, Talent Acquisition

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Much has been written about Millennials, those of us born between 1982 and 2002, in how to attract and keep us as patients. But what about attracting Millennial ODs as associates?

I am a freelance optometrist in California, seven years in practice, and I also have been a full-time associate OD. In that time, I have developed the following checklist for evaluating employment opportunities.

Online Reviews
When thinking of joining a new practice, I first look at online reviews on Yelp. I do not always judge the practice by these surface impressions, but it’s a good place to start when you have never been to an office.

What patients have to say about their experiences says a lot about a practice. Not all reviews are representative of how an office operates, but you can see patterns that may indicate a problem, such as online reviews consistently noting long wait times, or frequent mentions of unfriendly staff. I also Google the owner-doctor to see how patients feel about their exams.

One office I applied to had six reviews only, and four were awful, but were also from years ago. I couldn’t take the reviews seriously because they were so outdated and so few. I ended up working at that practice for five years, and helped them promote use of Yelp to patients, so their reviews would be more current and positive.

Patient Flow
After reading online reviews, I always schedule a working interview. This is important to find out if the office will match your style of practicing. If, after spending the day practicing in an office, I realize it’s not for me, there usually are no hard feelings if I decide not to come back. Working interviews are paid, with the rate negotiated between applicant-OD and practice.

I recently started working at a new practice a few times a month, and I was not happy with the flow of patients.

I felt like I was unable to connect, and give my best optometric guidance, with the large number of patients scheduled. For that reason, I politely declined the offer of a full-time position. There is nothing wrong with a practice that chooses to see a large volume of patients. I respect that mode of practice, but I know it’s not a good fit for me.

A working interview also is helpful from the practice’s perspective. It gives the practice a chance to see if the doctor is able to connect with patients, and how well the doctor gets along with the other doctors and support staff. Key questions to ask about a prospective associate or freelance OD: How knowledgeable is the doctor about products? Can the doctor handle the office and patients when the managing doctor is not there? And, importantly, does the prospective associate treat the practice as their own?

Salary Potential
I set my own per diem. I usually do not budge. It is important for doctors to know their worth, and not settle for less. If an office is not willing to meet our pay standards, then most of us feel it’s OK to move on to other options. I usually ask for a bonus structure, as well. I want the practice owner to feel like I am contributing to production.

Bonuses help motivate us. I find myself educating patients more about spectacle lens upgrades at offices that offer a bonus structure.

For example, an arrangement could be made in which bonuses for associates are given for days the office makes over $3,000 in production. For instance, $3,000 in production practice-wide would mean a $50 bonus for the associate, and every $250, the bonus goes up another $50.

Schedule Flexibility
I used to work weekends for many years. However, when I got married, I noticed I wasn’t able to spend much time with my husband, so I made the decision to only work four days a week. At that point in my career, I knew I had a lot to offer the offices I worked at, so I asked for a raise to compensate the lost day. In the end, it worked out great, and I feel refreshed after my weekends. It may be harder to find jobs that are only weekdays, but for me, it’s worth it.

ARIAN FARTASH, OD

is a freelance optometrist in California, who has also gained expertise in social media marketing. To contact: arianfartashod@gmail.com

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Promote Plano Sunwear to Capture Sales Year-Round

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

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Editors Note:

According to VisionWatch Canada (published by The Vision Council) reports, 87% of US consumers wear plano sunglasses, versus only 62% in Canada, a significant difference. It is not a seasonal aberration. The 62% penetration level has held fairly steady through each of the four seasons, since the VisionWatch Canada data started tracking data in 2014.

Learn more, read the  C’MON, EH! CANADIAN SUNGLASS WEAR LAGS BEHIND! article.

Plano sun may jump out at you as a summer-based sales opportunity, but as we head into fall, it’s important to remember, it’s a year-round chance to protect your patients’ eyes while boosting optical revenues.

Sunwear offers a dual opportunity: protect eyes from ultra-violet radiation and blue light, while enabling the wearer to have fun making a style statement. How many fashion pieces offer the wearer both health benefits and style savvy?

Source: VisionWatch, The Vision Council

But despite this great opportunity, many independent optometric practices are still missing out on plano sun sales. The top sellers of plano sunwear, according to The Vision Council’s VisionWatch statistics are sunglass specialty shops, followed by drug/grocery/mass/warehouse clubs, department and specialty stores, optical chains, and sporting goods stores. After all those sellers, come independent opticals, capturing $155 million in sales of plano sunwear in the first quarter of 2017.

Compare that to the $1,703.6 million in plano sun sales captured by sunglass specialty stores. The only plano sun sellers tracked by VisionWatch that ranked lower than independent opticals were flea markets/street vendors.

To help turn that sales-losing trend around, I spoke to my optician friends, and together we came up with this list of plano sun sale promotions and marketing strategies that work:

Discount for Contact Lens Annual Supply Buyers: Offer “25% off non-prescription sunglasses with purchase of a year supply of contact lenses.”

Market to LASIK Patients: “Same-day discount on sunwear for LASIK patients.”

Advertise Wide Inventory: “We sell 150+ sunglasses in our office, and we offer the service of cleaning and free adjustments. Stop back by every 3-4 months for tune-ups to make sure your sunglasses fit comfortably. Purchasing sunglasses from us means also purchasing high-quality customer service.”

Promote Memorable Optical Displays: Post photos of your sunglasses on display in your optical on Facebook and Instagram, with a message like: “Check out our ‘Wall of Sunglasses.’ Drop by and find your perfect pair.”

Offer Superior UV Protection. “Do you know if your sunglasses protect your eyes from the sun? If you buy from us, we guarantee UV protection. Know what you’re getting–and protect your vision.”

Prescribing in the Exam Room Means Selling in the Optical
Let’s back it up to the exam room. Knowing your patients’ sports, hobbies, the amount of driving they do in a week, travel patterns, dry eye problems, sensitivities to sunlight, and their personal style, is the first step. Uncovering those personal details, and prescribing accordingly, makes your optician’s job easier.

Prescribing sunwear should never be about selling; it should be about presenting solutions and improving lives. When you invite a conversation about the patient’s biking, golf game, love of hiking or fly fishing adventures–whatever takes them outside and on the road or trails–you are showing the patient that your prescription is a customized solution, especially for them.

Suggest a Sunwear Demo in Hand-Off
When you hand-off to your optical staff, suggest a demo of the lenses you have prescribed, such as a polarized pair of sunglasses for driving, or a wraparound pair for golf.

Train Staff to Speak Like Plano Sun Experts
Have you had a sunglasses meeting to be sure all your staff is on the same page about selling sunwear? Are you absolutely sure your staff has expert knowledge of tints, ideal lens color choices for sports and other technical details?

Tints. Opticians should be conversant about the benefits of the many different tints of sun lenses. They should be able to match the ideal tint with the patient’s favorite outdoor hobbies and sports.

Driving Sunwear. Be sure opticians can discuss how the right pair of “drivewear” sunglasses can make accidents less likely, and can make the experience of driving safer and more comfortable. Point out the benefits of polarized sunglasses in deflecting glare while on the road, and how polarized lenses compare to photochromatic lenses like Transitions.

Impact resistance. Prepare staff to explain to patients why it’s important that their sunwear be able to withstand impact, and how high-quality sunwear meets FDA standards for impact resistance.

Wraparound protection. The optician should be able to explain how wraparound protection offers a greater UV shield to the eyes, preventing UV rays from getting in at the sides of the eyes.

Blue light protection. Opticians should be educated about what harmful blue light is, and why sunwear that protects against both UV radiation, in addition, to blue light, is important.

Editor’s Note: Comparison of Canadian and American Plano Sunwear Market

 

 

 

 

Source: VisionWatch Canada Q1 2017, The Vision Council

Learn more about the 2017 Canadian Market Overview. Data provided by VisionWatch Canada, distributed by VuePoint IDS with consent of the Vision Council. 

 

 

COLLEEN HANNEGAN ABOC CPO

is a licensed optician, and owner of Spirited Business Advisor, a consultancy that works with small businesses, including independent eyecare practices, on how best to serve customers and generate profitability. To contact her: colleenhannegan@yahoo.com

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Insight with Dr. Gerry Leinweber

Insights

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Gerry is a partner/founder in a multi-doctor, two-location practice in Red Deer / Sylvan Lake, AB.

He has decades of patient care and practice management expertise and is always

willing to impart his wisdom onto others. Gerry is the founder of iXperts a practice management

consulting company and a co-founder of Canadian Vision Care which provides eye care

to under served patients in the Montego Bay area of Jamaica.

 

Dr. Gerry Leinweber

Doctor of Optometry

Doctors Eye Care

University of Waterloo 1980

Red Deer & Sylvan Lake, AB

 

What is something you plan on implementing in your practice this year?

Two technologies. First the California model of the Optos. Finally great colour, and great resolution. Expensive, but worth it. We had not bought before despite great wide angle, the quality of the image was not detailed enough for the macula and disc and most eye disease is at the posterior pole. This California model is the real deal. I would still invest in an OCT and HRT ahead of an Optos, but best is to have them all.

The second (and about $120,000 less expensive) technology and ultimately much more profitable for any office is the Digital Concierge. I have been developing this app over the past few years in my own practice. The intuitive software runs on an iPad. It can do pre-test, communicate (theoretically) with any practice EMR, allows for seamless capture of case history, lifestyle history and presents targeted relevant product marketing plus health messaging to the patient. More often than not the full range of recommendations are never delivered to the patient due to the time pressure we face during the eye examination process. The Digital Concierge will provide each patient with custom recommendations or what I call a vision wardrobe. Near field communication means as patients travel through the office, targeted messaging is delivered based on where they and who they are.

What metrics do you track in order to gauge your success?

I am careful not over analyze my practice metrics. Four key metrics suffice to keep a pulse on the health and direction my practice is going in. 2 metrics I call lead metrics and 2 would be lag metrics. The lead metrics I track are staff morale and NPS (net promoter score). Staff morale is tracked with anonymous surveys of the team to have them rank the practice managers on issues of; trust, respect, empowerment, etc. NPS is used by big business and simply asks patients on a scale of 1 to 10 how likely they would be to recommend our practice to someone else. The lag metrics I track are gross profit (Practice Gross Income less Cost of Goods) which is really the only metric staff can influence. Obviously we track net profit (Net profit is Gross Profit after all expenses and amount a practice would pay for OD services) as this is essential and is impacted more by owners than staff.

What advice would you give a new grad today?

Two things. First, be aware of the dreaded disease of “Doctoritis.” Be open to learn from older OD’s and from your patients. You really don’t know what you don’t know when you start. Second, be a strong independent, AND learn how to be interdependent with fellow OD’s. Our profession is challenged by many forms of “dependency” from multi-nationals to “side by side” opticals next door to wholesale companies that are also your retail competition but claim they are not. If a relationship with any other business or person doesn’t allow you to recommend treatments and products you feel are best for your patients, you likely have a dependency that is not healthy. Something might look good in the short term, but ultimately is going to impact negatively the Dr/Pte relationship. And when there is low or no trust in the Dr/Pte relationship, everyone loses. Build trust by doing your best for each patient, not what is best for some supplier, or yourself. Your long term success and what is best for you in the long run is to build trust and mutual respect. Both take time and effort. But they are worth it.

What business books would you recommend other ECPs read?

Amanda Lang, former host of the CBC show The Exchange, has a new book out titled “The Beauty of Discomfort: How What We Avoid is What We Need” This book comes at a critical time in the life cycle of the profession of Optometry. We have a profession that is decades old, stable and reasonably profitable – this makes Optometry a target for upstart companies to offer the same kind of services and products that we do but in a non traditional model that often times is immediately embraced by consumers. To combat this, we need to learn to tolerate and then embrace discomfort which ultimately becomes the foundation for change. In her new book, Lang goes into more detail on how we can go about embracing discomfort so that it makes us more resilient and more successful in our practices.

Favorite past-time/hobby?

Most people know I am an avid pilot. Most recently I have been building a motor glider. A motor glider is a fixed-wing aircraft that can be flown with or without an engine.

What is something you believed to be true for a long time only to find out you were wrong?

There are lots of times where I thought something to be true only to find out that I was wrong. I consider myself to be pretty self-aware which experts in EQ say is a very important attribute to success not only in business but life in general. For people who know me I am passionate about many things and will argue one side with an intensity the some might interpret as arrogance. Prove me wrong and I am completely open to admitting my mistakes, learning from that and moving on. I don’t let my ego get in the way. The recent purchase of the Optos is a great example.  (:

What was the last gift you gave someone?

The last gift that I gave was a book written by Dr. Jason Fung, a Toronto nephrologist that takes care of diabetic patients with kidney damage most often caused by diabetes. Dr. Fung’s book is called the Obesity Code. The basic thesis is that weight gain and subsequent weight loss is hormonally controlled. With insulin being the key hormone in that process. Insulin production and ultimately insulin resistance is what leads to weight gain and controlling insulin production via diet and fasting is the best way to manage weight. It takes the eat less exercise more paradigm and flips it on its head.  

What would you do if you won 10 million dollars? What would you do with your practice?

I would continue to practice in Red Deer, AB and I would give all of that money to the eye care clinic that I have been building in Montego Bay, Jamaica through the charity, Canadian Vision Care. The new clinic is called a Community Vision Centre of Excellence and I would ask every OD in Canada to consider volunteering for this exciting project. Mobay is a short plane ride for most of us, and the lessons you will learn clinically are priceless.

 

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Develop a New-Hire Training System for Staff Consistency

Human Resources, Managing Others, Talent Acquisition, Training & Onboarding

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Satisfied patients who return and refer others, and the retention of employees, are two separate goals that have something in common: Effective new employee training can help you achieve both.

My 2 full-time doctor practice, which has 10 support staff members, takes a structured approach to training new employees. This helps keep turnover low and customer service high. We have an annual employee turnover rate of about 5 percent compared to the Management & Business Academy average of 20 percent annually.

To keep turnover low and ensure successful onboarding, my office manager and I are both involved in the training. I am usually more involved in the initial process, and my office manager and other support-staff members are more involved in training new employees in the specifics of their job roles.

According to a 2016 study by the Society for Human Resource Management, employers can expect to spend between 6-9 months of an employee’s salary to replace a new employee. Forbes estimates the minimum cost to be one month of salary (and in some cases as much as seven years!). In a typical optometric office, I would expect that figure to be closer to three month’s salary, or about $7,600.

Dr. Cass (center) with members of his staff. Dr. Cass says a structured new employee training program ensures that every new hire is able to provide a consistent patient experience.

Show New Employee Patient Experience
New employees in our office are introduced to each staff member and given a tour of the office.

The tour walks the new employee through the process that the patient would go through, so the employee can understand the part their job plays in the process. I then personally visit with the employee and explain our practice history, mission statement and philosophy.

The new employee is then paired with the employee who has the most experience doing the things the new employee will be doing. The first day is typically spent with the new employee watching the experienced employee while taking notes. Questions are strongly encouraged and time is taken to thoroughly answer any questions.

Provide Job Aids
The new employee is given printed copies of:
An employee manual
An office manual
Compliance manual (Privacy, Security, OSHA)

They also are given a checklist of tasks they will be expected to learn during training and specific training guides for their position. Click HERE to see an example of one of these checklists.

For further help, we give employees training guides related to tasks required for different patient encounters. For example, here are some guides we gave the technician we just hired (Click on these links for complimentary PDFs).

Comprehensive Exam

Contact Lens Follow Up

Dry Eye Exam

Set Probationary Period
During the first week the doctor, or office manager, meets with the trainer and the new hire at least once per day. The checklist is reviewed daily the first week. After the first week the doctor and office manager check in with the employee once or twice per week until the checklist is completed and the employee’s work is reviewed and spot-checked.

We consider new employees probationary for the first 90 days, but have not had to let someone go during the probationary period thanks to our thorough hiring process. We usually have employees integrated well within the first 30 days, and are refining the training process during the next 60 days.

Elicit Feedback from New Employee
We recognize that employees come to us with unique experiences, knowledge and perspectives. We actively seek feedback from the employees and suggestions for ways to improve our processes. We also give employees a significant amount of freedom in how they complete tasks related to their job. We want them to be trained well, but we also want them to make the job their own.

Taking the time to properly train and onboard staff is well worth the effort. Your practice can only be as good as your staff. And as good a doctor as you may be, it is important to keep in mind that your staff members are the first voices your patients hear when they call, the first faces they see when they arrive, and the last interactions they have before they leave.

 

PETER J. CASS, OD

is the owner of Beaumont Family Eye Care in Beaumont, Texas, and president of the Texas Optometric Association. To contact: pcassod@gmail.com

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Google Redesigns Glass for Industry-Specific Applications

Practice, Products | Services | Industry News, Technology

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After two years of development, Google is releasing a re-engineered version of Glass designed specifically for use in the workplace, according to Vision Monday. The tech giant made headlines earlier this week by announcing that the new eyeglass-mounted wearable, called the Glass Enterprise Edition, is now available to businesses through a network of “expert partners” that have participated in the development process.

“Workers in many fields, like manufacturing, logistics, field services and health care find it useful to consult a wearable device for information and other resources while their hands are busy,” Google said in a statement. “That’s why we’ve spent the last two years working closely with a network of more than 30 expert partners to build customized software and business solutions for Glass for people in these fields.

There are currently more than 50 customers using Glass including AGCO, DHL, Dignity Health, GE Aviation, NSF International, Sutter Health, The Boeing Company, and Volkswagen according to Google.

The Glass Enterprise Edition differs significantly from Glass Explorer, the consumer version that Google pulled off the market a couple of years ago following consumer concerns about styling, privacy and pricing. One of the most important differences is that the Glass Enterprise Edition is designed to be attached to frames, rather than be incorporated into a frame.

The new units also have more power, improved battery life and better processing power so it can support people using multiple applications at once. Other upgrades include an improved camera that takes clearer pictures, including in low light, and connectivity with other devices, such as keyboards. Glass uses a custom build of Android and only comes with a camera app that allows users to take photos or videos and features voice commands and control capabilities.

Google said Glass devices and software are sold and supported exclusively through the Glass Partners network. The Glass Partners will provide pricing based upon customer needs. The cost can vary based on level of software customization, customer support and training required.

Glass is the product of several companies that are part of Alphabet, the sprawling holding company Google formed in 2015 that also houses Nest and Google itself. The Glass product team will spend a lot of their time at Google X, a “moonshot factory” which has labs, hardware expertise and a number of pioneers in wearable computing.

The team will also work closely with the Google Cloud team as well as Google’s hardware organization which is still supporting the consumer version of Glass.

 

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3 Ways to Encourage Employees to Take Initiative

Human Resources, Managing Others

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“There are three types of people in this world: those who make things happen, those who watch things happen and those who wonder what happened.”
– Mary Kay Ash, Founder of Mary Kay Cosmetics

Your employees may be qualified for their jobs, and full of potential, but they can still use encouragement from you, their boss, to take initiative.

Recently, I walked into the exam room and noticed a new paper towel dispenser. Our previous model had a tendency to get jammed, either producing a wad of too many towels or shreds of not enough. But this new contraption was motion sensitive, delivering a perfect single sheet on command. A little thing, sure, but nice. Sure enough, the other exam rooms had new dispensers, and so did the bathrooms. Assuming my husband and partner had ordered them, I thanked him for the upgrade. But he shook his head and said it was our new office manager who had ordered them and installed them. And she did that all…unprompted.

When I thanked her, she shrugged and said that she noticed it was a problem and fixed it. Not to be dramatic, but this display of action made my heart swell. Because doesn’t it seem so hard to find employees who take the initiative on their own? Motivated employees who look for ways to help outside their normal job duties is an attribute that can turn a decent employee into an amazing asset. Do certain people simply possess this personality trait? Or is there a way we can train our employees to take the initiative?

Defining Initiative
“Work behavior characterized by its self-starting nature, its proactive approach and by being persistent in overcoming difficulties that arise in pursuit of a goal,” is how researchers Michael Frese and Doris Fay define initiative. In other words, to show initiative, you do things without being told. You act instead of react. If you want employees who can think on their feet and take unprompted action, here are a few guidelines to help develop initiative.

Foster a Supportive Environment with Open Communication
Employees need to feel comfortable in their work space. They need to feel like they are part of a team. As a leader, the boss may have more experience and knowledge, but employees need to understand that their input is valued. Make an effort to let employees know you’re excited to hear their thoughts. Create a process for employees to submit ideas even if time for a face-to-face meeting is limited. If an employee knows their boss is supportive, they will be more willing to take steps without constant verbal approval.

Encourage Safe Failure
It takes courage to show initiative, especially if the employee fears their superior will disagree with their actions or suggestions. If employees work in a practice where the doctors are always micro-managing them, they will be averse to taking new action without supervision. Motivate employees to take action with continual support and encouragement. Let employees know that after they are fully trained, they have the go-ahead to make decisions within their job description to address problems. Then, once they successfully handle a sticky issue, or take the initiative to fix something on their own, compliment them. Successful endeavors provide a learning experience and will build confidence.

Let your employees know that taking the initiative doesn’t always involve solving problems. Initiative also involves looking for ways to help. For example, if there is a stack of referral letters that need to be scanned, an employee who accomplishes that task without being asked to do so should be praised. Sometimes a simple thank you is enough to teach that initiative is expected and appreciated.

Educate Your Employees How to Spot Opportunities and Potential Improvement
Employees who show initiative do so by identifying opportunities that their colleagues have missed, and then act upon those opportunities. Instruct your team to be on the lookout for areas within your practice that could use improvement. Tell employees to think about the following:

What would our patients want us to improve?
What small problems could grow into bigger ones if left unchecked?
What slows our work flow or makes it more difficult?
What is frustrating or irritating within our office to either the patients or the staff?

Tell your team to look for these things, and once identified, recognize them not as problems, but opportunities to improve and grow.

Employees should be encouraged to take initiative to resolve problems or improve quality of service within your practice.

Some people innately take initiative, but others need to be gently prodded, taught and rewarded for taking risks they may fear. When employees are independently resourceful, even in small ways, take time to recognize and commend the effort, and hopefully that will set forth a path for all employees to take extra steps for the benefit of the entire practice.

 

How do you empower employees to take the initiative? How do you help employees feel safe enough to follow their instinct in making your practice better?

JENNIFER JABALEY, OD

is a partner with Jabaley Eye Care in Blue Ridge, Ga. Contact: jabaleyjennifer@yahoo.com

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Is Independent Optometry Still Desirable?

Differentiation | Business Strategy, Practice

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Editor’s Note: The Future of Independent Optometry in Canada

While US and Canadian markets have their differences, the migration of independent practices to “corporate entities” such as Iris and FYIdoctors is undeniable. The players may be different in the US but the forces of change are very similar.

Dr. Chou’s title question, “Is Independent Optometry Still Desirable?” is likely a passing thought, or more, for many.  We invite you to a discussion of this topic in a Canadian context. If you’ve considered the move or have made the move to a corporate entity, what are the factors that have made you question the value of remaining independent?

Scroll down to the end of the article to view and add your comments.

These days, the light drawing newly minted optometrists to practice ownership may seem more like a distant flicker. With the financial realities of heavy student debt and supporting a family, the path to ownership is strewn with obstacles. Still, many of us aspire for “independent optometry,” lured to this concept like moths to the porch light. Indeed, it’s been a worthy and fulfilling journey for most, and I’ve experienced this firsthand. But today, I take the position that, at least for some, it’s no longer all that it’s cracked up to be.

As a profession, we struggle with some fundamental issues. One is: What is “independent optometry?”

Our esteemed colleague Mark Wright, OD, FCOVD, defines independent optometry based on the ability to make changes. For example, you are “independent” if you can set your own work hours, decide which third-party plans you accept, what fees you charge, the décor of your practice, what products you use, which staff you hire, and so forth. Who wouldn’t want these things? After all, freedom is a deep-rooted, celebrated American value. “Independence” seems synonymous with virtue, placed on a pedestal for all to marvel and move toward.

But does the privilege of making changes to your practice come at such a high cost that you become enslaved to your business?

In the report, “Private Equity and the Investment Effect,” I mentioned that I transferred ownership of my practice to a larger one in a private equity-affiliated deal. After 16 years of ownership, I now am an employee. I have ostensibly relinquished the ability to change the business. But, oddly, while I no longer pass Dr. Wright’s litmus test for being “independent,” I feel more independent in many respects. How is this possible?

I’ll tell you why.

Today, I am much more diversified against the financial risk posed by ill-guided online and remote refraction, online eyewear, and the de facto consumer ability to buy disposable contact lenses without a valid prescription. The office lease is no longer secured in my name with a personal guarantee. If a disgruntled former employee files a frivolous and unsubstantiated wrongful termination claim, the time expenditure and exposure to financial loss falls on someone else’s shoulders.

Further, I can take extended time out of the office without the discomfort of high fixed-overhead expenses mounting in my absence. If there is a staffing-related problem, I’m not burdened with smoothing it out. Maintenance interruptions, from the printer breaking down, to a plumbing leak, to the security alarm getting triggered after hours, are out of my hands. Network security, and complying with increasing regulatory requirements, are managed by someone else.

This isn’t to say there is a complete absence of stress, however.

I’m still learning as corporate changes are implemented, and to be sure, some of these changes – including conversion to a new electronic health record that is used mostly by physicians – have alienated loyal and longstanding staff. (The EHR functionality relevant to optometry seem like they were developed as an afterthought, and I am still reserving judgment on whether this EHR can maintain workflow efficiency for most optometric practices.) Additionally, despite the absolution of business management responsibilities, I have found it difficult to watch someone else take them over if performed without the previous level of skill, time expenditure and attention to detail. But for most urgencies (e.g., plumbing leak), any member in our office just notifies the director of operations to get it fixed.

In short, I can be a doctor.

As an employee, the concept to aspire to is that I can direct my attention toward caring for the patient, with minimal outside distractions. No longer must I direct a large part of my time and attention toward managing IT, regulatory compliance, risk management, human resources, advertising and public relations, accounting, business development, buying and inventory management, billing and collections, and so on.  It’s not that I hate all those things. In fact, I enjoyed, and was good, at some of them. For those doctors who enjoy the business aspects more than clinical practice, the CEO approach described by another esteemed colleague, Neil Gailmard, OD, MBA, FAAO, is a sound and worthy model to pursue.

I believe that many optometrists will still experience the greatest feeling of independence from practice ownership. Yet for other optometrists, the right employment arrangement will provide the greatest freedom. There are merits to each modality, and what’s best depends on individual circumstances and personal preference. Fortunately, there are good opportunities for ODs to go from employee to owner, and vice versa. For OD-owners looking to transition to employment, private equity-affiliated consolidators offer a relatively new alternative to exit ownership – yet this path requires careful planning to reduce the risk of post-transfer surprises.

BRIAN CHOU, OD, FAAO

Brian Chou, OD, FAAO, is a partner with EyeLux Optometry in San Diego, Calif. To contact him: chou@refractivesource.com.

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Optometry Giving Sight’s Our Children’s Vision Program

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Here’s a sobering thought. Seven hundred years after glasses were invented, there are still children in the world suffering from severe vision loss—simply because they have no access to a pair of glasses. And once children develop even a common eye condition such as myopia (shortsightedness), life for them will no longer be the same.

 

That’s why Dr. SooJin Nam from Eyecare Kids is so passionate about children’s vision. Good vision allows children to experience all the joys of childhood—identify colours, count objects, see shapes, play outdoors, recognize loved ones’ faces.

 

“As a behavioural optometrist, I am fortunate to be in a position that allows me to help children with real vision problems,” say Dr. Nam. “Every optometrist knows the importance of good vision and the impact it has on children. It is our desire that all kids have access to eye care and glasses in order for them to achieve their best.

 

Dr. Nam has proudly introduced Optometry Giving Sight’s Our Children’s Vision program into her practices because it’s easy to implement and it’s a great way to have fun with her patients.

 

“When our little patients come to us and we see how their quality of life improves tremendously because of what we do, we desire it for every child with a vision problem,” she said. “Our children are our future, so I see nothing more important than giving them the best chance in life.”

 

Dr. Nam implements the program by making a donation for every pair of glasses sold in her practice. Optometry Giving Sight provides marketing items including posters, counter cards and social media materials to promote their generosity to their patients.

 

After every glasses purchase, the patient receives a small card emphasizing that because they purchased glasses there, the practice will make a donation to help a child in need to receive an eye exam and a pair of glasses.

 

Optometry Giving Sight also provides tear-off sheets to give to each patient to remind them of the importance of an eye exam for the children in their lives. The sheet has an area for the practice to stamp their contact details to invite patients to call to set up an appointment for their own children.

 

The benefit for practice participation in the program is two-fold: a large amount of positive publicity as patients see the practice making a difference in the lives of children around the world, and every patient is reminded of just how important good vision for children is and to make eye exam appointments for their own children.

“Optometry Giving Sight’s ‘Our Children’s Vision’ campaign support materials are available to any optometric practice in Canada. If you wish to use OGS materials as part of your social marketing program to support your practice, please contact Corinne Waldon at canada@givingsight.org or
1-800-585-8265 ext 4.” 

 

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Success Steps: How to Reduce Contact Lens Dropouts

Practice, Products | Services | Industry News, Resources, The Patient Journey

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Contact lenses can be a lifestyle-enhancer for patients and a profitability-builder for practices. You can maximize patient satisfaction, and the potential to grow your profitability, if you find ways to help patients to succeed in contact lens wear and not drop out.

Studies show that contact lens patients return more frequently for office visits and contribute more revenue over time than do eyeglasses-only patients.

In addition to working part-time at We Are Eyes in Boca Raton, Fla., I teach at Nova Southeastern University College of Optometry. In most typical primary care practices, approximately 30-40 percent of patients will be contact lens wearers. At NSU, I work primarily in the contact lens clinic, so 90 percent of my patients are contact lens wearers. Recent studies reveal that the typical contact lens drop-out rate in the U.S. is approximately 10 percent, but it can range up to 60 percent.

How Much Are CL Dropouts Costing You?
It is challenging for the typical optometric office to determine the financial impact of contact lens drop out. Many doctors rarely calculate it. But if you do the math, there is significant money at stake when a patient drops out of contact lenses.

For example, contact lens examination fees for standard hydrogel, or silicone hydrogel, lenses typically range between $60-$100, and average revenue for an annual supply of contact lenses range from $100-$500 per year. That adds up to a revenue loss of $160-$600 per year per patient.

So, if you take into account the entire lifetime of a typical contact lens wearer, every time a patient drops out of contact lenses, a practice could be losing upwards of $20,000 -$30,000. If five patients drop out, this could add up to $100,000 for the practice. In addition to that, if a patient is dropping out of their contact lenses because they are unsatisfied with the doctor, or the lenses that the doctor prescribed, a practice could potentially loose their optical business and referrals from friends and family also.

Curb Discomfort: Ask the Right Questions
The most common reason for contact lens drop-outs is discomfort, mostly related to dryness. Patients also drop out because of blurred vision, the cost of the examination and supplies, the inconvenience, or fears of complication from wearing contacts. And many patients won’t tell the doctor exactly why they are dropping out.

Therefore, the first step in preventing dropouts is asking the right questions of every contact lens wear. The only way you can prevent contact lens drop-out is by identifying the problem to begin with.

Never ask: “How are you doing with your contacts?”

Never ask: “Are you doing OK with your contacts?”

Always ask: “How do your contacts feel at the end of the day compared to the beginning of the day?”

Always ask: “How can I make your contacts even better?”

Stay Ahead of Discomfort and Complications
Once you have asked the right questions, the next step in preventing drop-outs is by making improvements before complaints occur, or get worse. Even if a patient denies discomfort, I always try to prescribe something new to each patient. Contact lens technology is constantly evolving and improving. There is a strong likelihood that there is a better contact lens available today, compared to the last time the patient was examined. If a patient is already wearing the newest lens, then I re-educate them about the most appropriate artificial tears to use. I prescribe a specific re-wetting drop and a specific dosing, even if the product is available over the counter.

Prescribing daily disposable lenses is another way to reduce contact lens drop-outs. Many long-time contact lens patients are unaware that single-use lenses are the standard, not the exception, now. There are many daily disposables to choose from for spherical, toric and multifocal patients. Single-use lenses are ideal for the part time wearer, but for the full-time wearer, as they can provide superior comfort and convenience.

When offering daily disposables, focus on the benefits, rather than the technical features. Educate patients on the health benefits, minimized risk of infection and complications, and superior end-of-day comfort.

Most manufacturers will provide diagnostic lens sets at no charge. So, there is no initial cost to an OD to educating, and enabling patients to experience, new lenses! I can’t think of any other situation in optometric business where there is no initial financial investment needed. But ODs have to be willing to use the newest lenses and prescribe them to their patients with confidence. And ODs have to know that contact lens technology is constantly evolving. In a year, there may be yet another lens that they have to learn about and be willing to try.

Address Dry Eye
The majority of patients, who drop out of soft contact lenses because of lens discomfort, have dry eye. So, managing underlying dry eye is critical. Eyecare providers should recommend a specific brand-name artificial tear and a specific dosing, along with other vitamin supplements, as part of the treatment regiment.

There should also be a discussion regarding environmental factors that can lead to dry eye, such as ceiling fans and air conditioning vents blowing directly toward the eyes. And even if a patient does not need prescription-strength medications for dry eye, they should be monitored closely.

But continued monitoring is even more important if a contact lens wearer needs to be on a topical medication for dry eye such as Xiidra or Restasis. A re-evaluation and re education every 3-6 months can significantly prevent contact lens dropouts.

When it comes to dry eye from more chronic, severe ocular surface disease, scleral contact lenses can revolutionize a practice. I have many patients with severe Sjogren’s disease that cannot tolerate standard contact lenses. Patients with true keratitis sicca often see better with scleral lenses. Scleral contact lenses correct for a patient’s refractive error, but can act as a shield from the elements to protect the cornea from dehydration.

In addition, the sterile saline used to fill the scleral lens before it is inserted acts as therapeutic tear reservoir. This can heal a patient with significant corneal superficial punctate keratitis or filamentary keratitis.

Prescribe Multifocal Contact Lenses
Many presbyopic patients believe that if they have to wear glasses over their contacts to read and work on the computer, then they might as well just wear glasses full time. This is the reason many presbyopic patients drop out of contact lens wear. For that reason, multifocal technology can also help to reduce dropout rate.

Patients should be educated that multifocal contact lenses have improved dramatically recently. They provide a better range of vision compared to monovision, and now even single-use multifocal lenses are available. For part-time wearers, daily disposable multifocal lenses can provide comfort, better ocular health and vision, as well as convenience.

THUY-LAN NGUYEN, OD

Thuy-Lan Nguyen, OD, teaches at Nova Southeastern University College of Optometry and works part time as an associate at We Are Eyes in Boca Raton, Fla. To contact her: TLNGUYEN@nova.edu

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