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A N.C. Eye Doc Passionate About Vision Health for Kids and Special Needs Patients

The vision health of children and those with special needs receives devoted, undivided attention at Special Eyes Pediatric Vision Clinic in New Bern, NC.

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THE IDEA

Special Eyes’ origins are traceable to a particular patient. In late 2014, Dr. Cathy Doty examined an 18-month-old boy who arrived at Family Eye Care in New Bern, NC, with an untreated strabismus that had notably delayed his general development. Troubled by the fact that his parents, as members of a public health scheme, had been forced to wait three months to see her — one of the few doctors in the area who accepted their coverage — Doty made the decision to dedicate herself to pediatric and special-needs optometry. Her partners were agreeable, and by May 2015 she had opened the business’s children’s facility, Special Eyes Pediatric Vision Clinic.

THE EXECUTION

Doty sees patients up to age 16 and special needs patients of all ages, offering comprehensive exams and emergency visits. “No two days are the same. Some patients come in on gurneys from residential facilities,” she says.

Staffing a niche practice presents unique challenges. “There are definitely some people who enjoy working with children, and the children can tell. I have provided some in-service training, and have put together [fitting] guidelines for our optical staff.”

Exam rooms are set up for comfort and fun. The décor draws largely on Doty’s own parenting experience, and audiovisual and sugary treats are deployed at strategic points throughout the process. “It is rare for us to need more than three adults to help us hold the child, but it has happened… I will do as much as the parents want me to do.”

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Doty has made it a mission to drum home to parents the link between vision health and behavioral issues. “Parents still believe when their children pass vision screenings at school and the pediatrician’s office, that their vision is fine. I see the ‘jaw drop’ reaction almost every day. Many of them have behavioral diagnoses and take heavy medications for issues that may have been related to their +6.00 OU prescriptions. If there are two things that I hope I can help change in this world, it would be: 1. All children deserve to have at least one comprehensive eye exam before they start school; and 2. Comprehensive vision exams should be part of the overall health evaluation of a child before they are labeled as ADD, ADHD, ODD, OCD, autism spectrum disorder, speech-delayed, or behaviorally disabled and placed on medications.”

THE REWARDS

Getting Dr. Doty to discuss herself is a challenge; this modest but highly accomplished and dedicated professional will turn the conversation back to the “critical issue of vision correction for the most vulnerable.” But she concedes being “blessed beyond measure to have a supportive husband, partner, amazing staff, and community.” She took a leap of faith, she says, “and God has provided. I can’t even put a price on what this has all meant to me personally.”

PHOTO GALLERY (14 IMAGES)

Do It Yourself: Pediatric and Special Needs Optometry

1. TR GO NICHE. . Make contacts with pediatricians, therapists, school systems, and other eye doctors, Doty advises. “They will ALL be happy that someone is taking the lead to focus on children and/or special needs patients.”

2. AS Set the scene. Parents of kids and special needs patients like to be reassured they will have a caring experience. Special Eyes created a Google tour on its Facebook page, showing exactly what patients can expect during their visit.

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3. COA spoonful of… The No. 1 attraction in Doty’s exam rooms is the treat drawer, which helps her gain leverage. Special Eyes also has movies loaded on its M&S charts, and the children pick what they want to watch during retinoscopy and dilation.

4. CIMom’s the word. Nine times out of 10, says Doty, “Mom is the medical decision maker for the family. An OD who is willing to see their baby, free of charge, and provide good preventive care has won the family in most cases, whether or not the doctor takes their insurance.”

5. GO Soft touch. Frame selection is key, of course. Special Eyes carries Kids Bright Eyes, Dilli Dalli, Miraflex, and Solo Bambini. “We also love Gwen Stefani, Funoogles and Lindberg which allow older children to personalize their looks,” she says.

 

ONLINE EXTRA: Interview with Dr. Cathy Doty

To start with, what is the relationship between New Bern Family Eye Care and Special Eyes Pediatric Vision Clinic? How many ODs and/or opticians does Special Eyes itself employ?

DR. DOTY: My husband, Dr. Shawn Doty, and I are partners with Dr. Mark Leary. The three of us owned two freestanding offices, Pamlico Family Eye Care and New Bern Family Eye Care, up until three years ago. We hired an associate in 2011, Dr. Kim Oncavage. So, there are four of us. We have two optical staff in Pamlico and four in New Bern.

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What was your motivation for moving into this niche?

As the practice grew and our doctors were booked months in advance, a little patient changed my life. This article ran in my local paper, and The Associated Press picked it up: www.washingtontimes.com

Your practice accepted InfantSEE patients prior to the opening of Special Eyes, is that correct?

Yes.

What were the factors in your deciding to join this program, and why don’t more practices do so, in your opinion?

I knew Dr. [W. David] Sullins, the optometrist and founder of this program. InfantSEE was one of his most important legacies to optometry and public health. I wanted to answer the challenge that former President Jimmy Carter gave to [the American Optometric Association] to end amblyopia. I attended the workshops that were provided at several meetings, and then I began to tell parents about the program. Word of mouth and social media helped grow InfantSEE. I think that it is an amazing opportunity for optometry to do the right thing, and start the conversation with parents about the importance of vision care for children. I may not find any problems with a baby’s eye health or development, but I can educate a parent on the importance of proper follow ups, signs and symptoms of problems, and common myths about “pink eye”, etc. I think that a lot of ODs are uncomfortable examining babies, don’t trust their retinoscopy, or in their mind they just need to fill those appointment slots with “paying patients”. Here’s the amazing thing: Nine times out of 10, it’s mom who brings the child. Mom is the medical decision maker for the family. An OD who is willing to see their baby, free of charge, and provide good preventive care has WON the family in most cases, despite whether or not the doctor takes their insurance. InfantSEE saves vision, saves lives, and can help position a doctor as an expert in their community.

Could you provide a few details about the kinds of patients you see? What sort of services are offered to special needs patients? Are these all children or does this include special-needs adults?

I see pediatric patients (0-16 years old) and ALL special needs patients. We offer comprehensive exams and same day emergency visits with pediatrician referrals. No two days are the same, that is for sure! Some of the patients come in on gurneys from residential facilities.

For a different article, an optician once described the process of fitting a child with frames as (sometimes) being like “wrestling a greased pig”. (She meant it affectionately.) How have you and your opticians learned to cater to kids in the exam room and in the optical? Have you/they received special training in this, or can they learn on the job? Are some people just better at dealing with kids than others? What are the main challenges?

There are definitely some people who enjoy working with children, and what’s interesting is that the children can tell. I have provided some in-service training for my staff at SpecialEyes, and have put together guidelines for our optical staff in the main New Bern office for fitting procedures. In our exam rooms, everything is set up for the comfort and enjoyment of the experience. If you check our Facebook page, you will see photos of the rooms. You can also take a Google tour, which helps families with special needs children to decrease their anxiety about the visit. We have movies loaded onto the M & S charts, and the children get to select what they want to watch while I am performing retinoscopy, or when they are dilating. The No. 1 attraction in my exam rooms is definitely the TREAT DRAWER, and I use it as leverage throughout the visit. It is rare for us to need more than three adults to help us hold the child, but it has happened. My rule is that I will do as much as the parents want me to do. If they are willing to help me obtain the information I need, then we can usually complete the exam.

Judging from what I’ve seen online, your practice goes out of its way to way to provide a comfortable environment for kids. Was this hard to achieve? How do they respond to the experience?

We receive many compliments daily about how bright and fun the office is. The décor was easy to design because I just used a palette of colors and themes that reminded me of when my children were small. After the first visit, they feel at home and know exactly where everything is. They know we are there to provide a thorough examination and serve them and their families.

How about the parents? What are they usually most concerned about? You must have to spend a lot of time educating them about the particulars of pediatric vision care?

I find that parents still believe when their children pass vision screenings at school and the pediatrician’s office, that their vision is fine. I see the “jaw drop” reaction almost every day. Many of them have behavioral diagnoses and take heavy medications for issues that may have been related to their +6.00 OU prescriptions. If there are two things that I hope I can help change in this world, it would be these: 1. All children deserve to have at least one comprehensive eye exam before they start school; and 2. Comprehensive vision exams should be part of the overall health evaluation of a child before they are labeled as ADD, ADHD, ODD, OCD, Autism Spectrum Disorder, Speech Delayed, Behaviorally Disabled, and placed on medications.

Do you sell Tomato Glasses or anything similar? Are you satisfied with what your insurance plans allow you to sell to kids in terms of frames? And what are your thoughts on children’s frames/lenses in general?

In terms of rubber frames, we carry Kids Bright Eyes, Dilli Dalli, Miraflex, and Solo Bambini. We also love the Gwen Stefani’s, Funoogles, and Lindberghs, which allow older children to personalize their looks. I have recently become very involved in our optical because I know what works. I think that insurance plans are not providing enough flexibility with younger patients who are growing so quickly. For example, it would be revolutionary for an insurance company to offer a “growth” flex plan, which allows a child to get new glasses in six months rather than waiting for a year. What 3-year-old child can wear the same pair of tennis shoes for a year? Overall, I am very disappointed with insurance plans when it comes to visual benefits for children and special needs patients.

Could you comment on the rewards for yourself personally, your staff, and the business? Both personally and financially?

As I told you, I am honored and humbled that someone thought I may be worthy of your time and print space. But this article does not need to be about me, or what I have done. Hopefully, this is a platform for more discussion on this critical issue of vision correction for the most vulnerable citizens in our country—children and special needs patients. I am just blessed beyond measure to have a supportive husband, partner, amazing staff, and community that have all supported this endeavor. It was a leap of faith, and God has provided. I can’t even put a price on what this has all meant to me personally.

What comments/advice/suggestions would you have for other independent ECPs thinking about pursuing this niche?

Just do it!!!! Make contacts with pediatricians, therapists, school systems, and other eye doctors. They will ALL be happy that someone is taking the lead in their community to focus on children and/or special needs patients. Who is better trained to take care of the eyes of these patients? NO ONE. Optometrists should be the leaders in this niche, and we need to cheer each other on.

After years covering some of the farther flung corners of the world of business journalism, Heath has more recently focused on covering the efforts of independent eyecare professionals to negotiate a fast-changing industry landscape. Contact him at heath@smartworkmedia.com.

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Best of the Best

An Iowa OD Who Developed an Industry-Leading Neuro Rehab Specialty

Offering glasses just wasn’t enough.

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DR. DEANN FITZGERALD STARTED practicing optometry in Cedar Rapids, IA, in 1984. In 2006, she founded the non-profit Spanda, Inc., which combines optometry with other healthcare specialties and took her as far afield as Kenya. Soon, she decided to expand Spanda’s activities to her own community. Spanda opened Cedar Rapids Vision In Motion (CRVIM), a vision wellness and rehab clinic, in 2007. What started as a 1,600-sq. ft location with an occupational therapist and a single employee now occupies 6,000 sq. ft and employs two athletic trainers, seven therapists and two ancillary staff.

THE IDEA

A Door Opens

Vision therapy was on Fitzgerald’s radar screen from her earliest days in optometry, but it took some time for her to embrace it. “I originally went to school with the thought of providing therapy but Cedar Rapids was very medically oriented, with the University of Iowa just 20 minutes away. Which made it very difficult at first to want to do therapy.” But by the 1990s — the “decade of the brain” — she sensed a door opening.

THE EXECUTION

Bridging the Gap

Dr. DeAnn Fitzgerald

CRVIM deals with a larger variety of diagnoses and issues than we can list. The services Fitzgerald’s team have developed bridge “the gap between assessment and treatment” for patients of all ages who experience visual processing dysfunction. In other words, “It’s a brain thing,” as the practice’s mantra states. Since 2010, CRVIM has also been teaching, offering instruction to OTs, PTs, ATs and others, passing on Fitzgerald’s “Train your brain to see again” gospel.

Patients find CRVIM in a variety of ways. “We have the general practice so sometimes people come in for routine care and find out that we do other services to help with various problems.” Of course, there’s word of mouth, as well as the training conferences to which the CRVIM team are now often invited as experts. “I have patients come from a nine-state area for our services. With the training conferences, we try to collaborate with other OTs and PTs.” Among the many hats Fitzgerald wears, she is vice president of the Neuro-Optometric Rehabilitation Association (NORA), an inter-disciplinary industry group whose mission is to see that patients with physical or cognitive disabilities as a result of an acquired brain injury get full ocular health evaluation and optimum visual rehab services.
Fitzgerald doesn’t have the luxury of patterning CRVIM after anything in the industry, “because it doesn’t exist. But I look at what’s possibly working and couple it with things that work — multi layered therapy or integrated therapy for quicker recovery — so we combine vision vestibular and auditory and proprioception all together for a more intense and passive therapy that works well.”

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THE REWARDS

‘The Last Resort’

Fitzgerald finds working with neurologically challenged patients — “giving them back their life,” as she puts it — hugely rewarding, but along with the highs there are tough moments. “These patients have a lot of depression and emotional issues that you have to cut through to get them better.”
Fitzgerald established baseline testing for 1,400 metro youth football players over a period of three years. At first many parents didn’t see the need, but by year three every one of the players came in to get tested. She eventually donated seven laptops so these schools could do their own testing. The Pop Warner youth football league last year rated these schools’ testing system as the best it had seen.
It’s an anecdote that illustrates the complexity, and the importance, of CRVIM’s activities. “We do get very complex patients,” says Fitzgerald, “because sometimes we are the last resort.”

Do It Yourself: Develop a Niche Rehab Practice

  • BONE UP. Be prepared to learn on the fly. Says Fitzgerald: “Optometric education provides the avenues to do rehab, but I have logged countless hours in classes and reading … on … concussion and brain injury.”
  • LOOK AROUND. Fitzgerald advises finding someone who is doing what you want to do­—and learning. “It’s the quickest way to get where you want to go…We have a lot of doctors visit our clinic.”
  • BE USEFUL. Get into the community, says Fitzgerald, and “instead of telling people what you do — ask them what they need. Then help make it happen — often that is the ‘in’ to getting partnered with them.”
  • HIRE CAREFULLY. Fitzgerald says one of her biggest challenges has been finding staff that are competent but also compassionate.
  • PREPARE YOURSELF. Rehab can be taxing for both patient and therapist. Fitzgerald says of her patients: “They have a brain injury. We have to gently get them out of their own way so they can recover.”

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Best of the Best

How This Colorado Practice’s ‘Office Culture Blueprint’ is Boosting Referrals

And how they persuaded their team to embrace a new mindset.

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EYE CARE CENTER of Colorado Springs, CO, has a large specialty contact lens practice that owes its success in part to the referrals it receives from ODs and MDs in Colorado Springs, Denver, Pueblo and as far away as California. You don’t maintain a referral-driven practice without top-level service, and with so much on the line, sometimes it pays to codify what’s expected of staff. But no one responds to a laundry list of rules. “We have found we have to re-educate ourselves and any new team members we hire,” says co-owner Sara Whitney, OD, and this realization recently led the practice to develop its own “office culture blueprint.”

THE IDEA

Translating a vague desire to get the best out of your team into a set of tangible principles is harder than it sounds. “We made a feeble attempt to create a culture statement a few years ago,” recalls Whitney, “and we never finished it because we didn’t really know how to implement it.” Practice founder and co-owner Dr. Reed Bro eventually came across the concept of “above the line behavior,” an approach based on personal responsibility. Whitney says the beauty of this concept is that it encourages “behaviors that create a positive event for the next person in the chain.” The goal is to “resist the temptation to blame…to complain for the sake of complaining, or become defensive.”

Dr. Reed Bro and Dr. Sara Whitney

THE EXECUTION

Whitney, Bro and office manager Mindi Andrade developed what would become the office’s cultural blueprint over several months. It takes its starting point from a few core beliefs. These are matched with a set of encouraged behaviors and desired outcomes. Your core beliefs, Whitney says, “are the reasons you decided to start practicing optometry or open a business.”

Once these basic elements were finalized, the managers initiated a transitional phase in which they used the vocabulary that forms the core of the blueprint in day-to-day interactions with one another and with staff. “We did not present the blueprint to the team until we were comfortable that we were able to personally apply the core beliefs to any situation,” Whitney says. They launched it at the beginning of January, when people are making resolutions and personal improvements. “We printed up the culture matrix on a card for each member of the team.”

Whitney says you can tell right away which staff will be on board and who will resist. “We lost three team members around the time the blueprint was rolled out. It may have just been a personal decision for the employee, but it can cause you to momentarily doubt your decision to demand these behaviors.” It’s important to be strong and stick to your guns at this stage, she says. Remember that the key beliefs you identified as the basis for your blueprint are important. “They are the reason you get up in the morning and come to work,” she says. “Expectations … make some people uncomfortable. They will resist change, and you have to let them move on.”

THE REWARDS

Whitney says the blueprint has delivered its targeted outcomes: an enhanced sense of community, patient satisfaction, trust, loyalty, adherence to treatment plans, and referrals. But there are personal benefits too. “I think those who have embraced this new mindset will be able to see it spilling over into their personal lives.”

Ultimately, Eye Care Center of Colorado Springs’ aim with the blueprint was to cultivate behaviors that grow the business, and so far, that aim is being met. Says Whitney: “We have developed the mindset that being presented with a challenge is our opportunity to get ahead of the problem and to possibly even be someone’s hero.”

Do It Yourself: Develop an Office Culture

  • DON’T RUSH IT. “Take time to define your beliefs over a period of weeks or months,” says Whitney.
  • WALK THE WALK. “Live out behaviors that support your beliefs,” Whitney advises. “You are the biggest example of your practice culture.”
  • TWO-WAY STREET. An office culture doesn’t have to be static: Survey your team periodically and ask for feedback.
  • COMMUNICATE. If you don’t, a blueprint is just a list tacked to a wall.
  • STAY STRONG. A change like this might cost you an employee. But stay the course or it’s not worth the paper it’s written on.

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Best of the Best

Maryland Optician Makes the Most of Its Expansive Front Window Space

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Visions Extraordinary Eyewear
frederick, md

WITH 60 YEARS of experience between them, Meline Baron and Phil Bromwell of Visions Extraordinary Eyewear know a thing or two about attracting clients. Lesson No. 1? Wow them with windows.

THE IDEA

The two, who’ve been a couple for 21 years, started Visionary Opticians 18 years ago, rebranded to Visions Extraordinary Eyewear in 1999, and  moved to their current location in downtown Frederick in 2003. With their tony new shop, a former shoe store, came more than 10 feet of glass windows facing the street. Time to get creative! Visions, which only carries one of each frame, prides itself on offering brands from around the world — Studio3 Occhiali, Ptolemy48, Wissing, Roger and Rain City, among others — collections not available at chains, and once they’re gone, they’re gone. “We don’t duplicate or repeat,” says Baron. In addition to an exclusive frame experience, they offer a wide selection of premium lenses from Varilux, Zeiss, Hoya, Seiko, Transitions, and more, with an expedient turnaround time thanks to an in-house lab manned by Bromwell. What’s more, they don’t do advertising or social media; those windows tell their story.

THE EXECUTION

“I change out the large window seasonally, although not necessarily with season-specific themes,” says Baron. “My current large window is focused around primarily four collections. The ‘F’ theme of Flowers, Foliage, Feathers, Fabric.”

Meline Baron is the brain behind her store’s window displays.

In fact, her current small spring window uses colorful tissue boxes adorned with cute flowers and birds. These are attached to the wall with push-pins, the frames displayed on top.

Looking back, Baron has her favorite windows. “I painted upholsterer’s springs for my ‘Spring For A New Look!’ window. Also, I’ve used my husband’s ties and ‘guy-centric’ books in my ‘The Guys Have It’ small window display, and colorful flip-flops to display sunglasses,” she explains. “And there’s the time I used bottles of Joy dishwashing liquid for my ‘The Joy of Spex’ window.”

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Props are occasionally reused, but in new ways. “Windows always evolve and things wear out, so I am always looking for new things to keep it fresh,” she says.

THE RESULTS

Baron describes her store as “very layered” and says she’s often surprised and tickled when the people she least expects notice stuff and comment. Customers often say they like the feel of the place. “Many visitors and customers comment that they love to come into the shop because there is always something interesting to look at. And the more they like being here, the more likely they are to find something else they want.” It’s a philosophy that works. Vision’s revenue went up 20 percent since moving to this location.

But for Baron and Bromwell, it’s time for a new adventure. The couple is looking to retire and has put Visions up for sale. The good news is that Baron is happy to continue consulting on the windows for the new owners!

Do It Yourself: Attract Passersby with Your Windows

  •  Look out for new  props. “I’m always thinking, ‘This is kind of cool,’” says Baron. “I can be seen in any kind of store taking off my glasses to see if they’ll sit on an object for a display.”
  • Pick a color and switch out seasonal props to extend a display’s life. November to February, Baron’s focus is red, using Christmas props until January, then Valentine’s props.
  • Think about lighting. Baron even changes the bulbs in the lights in the windows to keep it interesting.  And she is constantly stocking up on fairy lights at Home Depot.
  • Be organized. Baron rents a storage locker for her materials, and has a “tool box” full of push pins, screw-in hooks, a hammer, and plate racks to prop up signage and posters.
  • Use your displays to convert sales. Color themes plus a “Color of the Month” frame discount give Baron “a way of having a sale without seeming like a discounter.”
  • And a don’t!Don’t use anything that can melt! “I once had a zyl Traction frame and a Kawasaki frame with a plastic temple-tip fall off their perch and onto a light fixture and melt,” she says.

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