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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.”

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.

Best of the Best

Sports Vision Training Can Be a Game-Changer for Your Practice

These Ohio vision therapy specialists demonstrate how they help see their athletes succeed and their practice grow.

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Vision Development Team founder
Dr. Alex Andrich

AT THE VISION DEVELOPMENT Team in North Royalton, OH, founder Alex Andrich, OD, and his wife Patti, an occupational therapist and a partner in the practice, offer standout vision therapy, treating kids with learning disabilities, brain injury patients and those with stress-related vision problems, to name just a few. But one aspect of their practice that really sets them apart is their top-flight sports vision training, which has helped Cleveland-area athletes of all ages, from school kids to adult professionals, address vision problems and improve their performance.

THE IDEA

Sports have always been a big part of the Andrichs’ lives; the couple met on Ohio State University’s alpine ski racing team. Alex also has a background in competitive beach volleyball and race-car driving, while Patti trained with the U.S. Olympic gymnastics squad. This competitive exposure allowed them to see how small improvements in skills can translate into big gains in performance. With vision being such a big part of sports, it was a natural fit for the couple to open a practice specializing in vision training.

THE EXECUTION

The practice as it exists today was built on Dr. Andrich’s background in VT. “Sports vision training is vision therapy practiced at the highest level,” he says. He took courses in advanced VT techniques and eventually obtained board certification through the College of Optometrists in Vision Development (COVD). He also says the education and training offered by organizations working in vision therapy such as the Neuro-Optometric Rehabilitation Association (NORA) and the Optometric Extension Program Foundation (OEPF) provide excellent models on which to build vision training.

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A typical VT case would be a child with eye-tracking difficulty causing reading problems, but as Andrich explains, “When a successful outcome is achieved the child can read better — but they can also hit a baseball better. Utilizing the latest vision therapy tech has also helped to advance my sports vision practice.”

“We go beyond looking at the eyeball and treat vision as a whole-body sense,” says Andrich. “In baseball it is important to see the ball clearly but the visual system tells the motor system critical information about ‘where’ and ‘when’ so the motor system can respond accurately.”

For the past year, Andrich has served as vision coach for the Cleveland Indians, a role he also performs for the Cleveland Monsters hockey team and the Gladiators, the city’s arena football team. He’s responsible for the refractive and ocular health needs of the athletes, but a big part of what he offers has to do with performance. Depending on the sport, he will test the athletes on up to 20 visual performance skills, then put together a training plan for each athlete. “All athletes require core vision skills like eye tracking and eye teaming, but certain sports like baseball require really fast visual reaction and processing speeds, whereas a hockey player benefits from good central/peripheral vision integration,” he says.

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The practice’s large, high-ceilinged therapy room gives the team room for on-site vision training using sports equipment.

THE REWARDS

Dr. Andrich says the main reward he derives from being a sports vision training practitioner is seeing his athletes succeed. “The best athletes set themselves apart by the amount of work they put into their sport,” he says. “Sports are competitive by nature, so the elite athlete is always looking to improve performance. Improving vision skills gives them a competitive advantage and success on the field.” And off the field, having sports vision as a part of his practice has definitely allowed it to grow, he says.

Do It Yourself: Practice Sports Vision Training

  • NETWORK. Get involved with colleagues who are doing sports vision by joining the International Sports Vision Association (sportsvision.pro).
  • START SCOUTING. Offer vision screenings for local high school and college or university sports teams.
  • BONE UP. Enroll in training that can lead to certification. Outfits that deal with vision therapy, including NORA (noravisionrehab.org) and COVD (covd.org), are ready to help.
  • CHAIR CHAT. The OD should ask each patient that comes through his exam lane about sports participation to start a dialogue.
  • GOT GEAR? Andrich has invested in eye-tracking and performance-testing equipment, including virtual reality.

 

PHOTO GALLERY (3 Images)

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Best of the Best

Spice Up Your Frame Selection with This Strategy That Probably Never Occurred to You

It gives patients a reason to visit based on product assortment rather than discounts.

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PERRY BRILL, GENERAL MANAGER at Brill Eye Center in Mission, KS, was looking for something new to base the practice’s marketing effort on, and knew that having new brands always generates more excitement than just saying you’ve got a refresh. Always one to shy away from typical optical business plans, he hit on a novel concept.

THE IDEA

Tired of brands wanting 30-plus-piece orders, he decided to try bringing in micro-collections of 10-20 pieces every month to create some email and direct-mail hype. He wanted experience with more brands quicker than his usual once-every-six-months, large brand buy. “A retailer should always have a flavor of uniqueness. Restaurants have seasonal menus and opticals should have seasonal eyewear. Give patients a reason to visit based on product assortment rather than discounts,” Brill says.

THE EXECUTION

Perry Brill

To curate a micro-collection of eight to 15 pieces, Brill says, connect with “ma and pa” frame vendors, who he says are just happy to have representation of their eyewear in any city. The easiest way to find these vendors is to go to Vision Expo, find the smaller booths and ask their minimum purchase. “Don’t expect the booths to be fancy!” he says. “Just observe the eyewear for quality and personality before making judgments. Most people will be super transparent and love your idea of creating seasonal collections.”

Brill says a small micro-collection should cost between $500 and $3,000. So far, he’s been impressed with the number of luxury or quasi-luxury brands that let him dabble with smaller orders. Being in the Kansas City area, he says, “It’s pretty easy to have exclusivity, with everyone selling bread and butter.”

The small collections now represent 10 percent of his inventory, which he figures is about right, as he wouldn’t risk going deep into the more obscure pricey stuff anyway. “I’m okay if it doesn’t sell quickly since the investment was slim.”
Micro-collections that have worked well for Brill include:

  • Ethnicity: “Asian and global fitting with acetate built-up pads and special wider temples. Don’t need a ton of frames but enough to tackle difficult-to-fit. Opticians need to up their game with fitting standards. The moment you solve frames on cheek issues — patient for a lifetime.”
  • Lucas De Stael (shown): “Ultra luxury for the high rollers and lover of texture and design. Made of leather, stone or cork. Retails for $1,000-plus.”
  • Sospiri: “Ultra luxury for the fancy woman who wants to shine — literally. Most jeweled frames are tacky; these are classy. $1,000-plus. People that want jewels want it! They will go find it if you don’t have it.”

THE REWARDS

Brill says the main benefit of ordering micro-collections is they give you a reason to engage with patients via social media and email. In such a competitive environment, and having access to great independent collections, it’s fun to test the waters with new product all the time, he says. And from a patient perspective, Brill believes that when they walk into an office they always want to see something new. “Carrying the same branded collections is easy, but having lots of collections gives patients choices and a tour around the world of independent eyewear. My optical is used to rapid change and every optician always wants to show what’s new.”

Do It Yourself: Micro Order Luxury Frames

  • PRIDE OF PLACE. Label an area in your optical with catchy signage that says something like: “New season eyewear, feel invigorated.”
  • DON’T SWEAT THE… “Don’t think too hard,” says Brill. “If the frames are bad sellers, the risk was low and you don’t need to worry about returns.”
  • HAVE FUN. “Go funky, always!” is Brill’s motto. This is your time to try wacky new inventory you would never go 50 frames deep in.
  • TAKE YOUR TIME. The key to selling such frames is sitting the patient down, explaining to them the brand story and frame characteristics.
  • GET THE WORD OUT. Inform your patients you have something cool and new in stock. “Thank goodness for email campaigns,” says Brill.

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Best of the Best

This Office Manager Got Her Staff to ‘Own’ the Patient Experience. Here’s How…

She came up with a nine-step program for employees.

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CINDY BRUNER, PRACTICE manager at Professional Family Eyecare, which has offices in Coldwater, St. Mary’s and Greenville, OH, says new employees will never add to what they already know if you don’t set expectations when they start; otherwise you set them up to fail. As she sees it, it’s her job to help them understand this. “When you have long-term employees it’s easy to become ‘Magoo’ and do and say things without realizing how they’re perceived by customers, and by … teammates.” Managers, in her view, should “help staff understand that as co-workers we are customers to each other, not just the patient.” To accomplish this, she created her own training program for implementation at the practice, “9 Steps to a Phenomenal Patient Experience.”

THE IDEA

A few years ago, Bruner came across a book titled 10 Steps to a Phenomenal Patient Experience: Customer Service Secrets for the Eye Care Team by Sharon Alamalhodaei, COMT. After getting the nod from owners Dr. Jillynn Bruner and Dr. James Dickman, she combined what she learned from this with resources picked up at a Patient’s Voice skills clinic to create a list of steps that fit the culture and patients at Professional Family Eyecare. As a final touch, Bruner incorporated the “Love Dare” concept, borrowed from the marriage counseling book of the same name based on a set of 40 daily principles. “Instead of 40 days,” she says, “I broke the steps down into nine weeks. My owners described their vision of what they want their practice to be known for and with my 25 years of hospital management training I pulled my resources together and away we went.”

THE EXECUTION

Staff and doctors were given a quiz to ascertain their perceptions of how customer service impacted business. Then she handed out a “Commitment to the Practice Standards Accountability” form. Staff were asked to return this with statements explaining how they would contribute to the standards outlined on the form.

According to Bruner, the nine steps are: 1. Who’s the Boss? 2. Give Patients more Than They Expect . . . Respect 3. Handle Difficult Patients & Situations with Finesse 4. Be Ultra Aware of Time 5. Be Extremely Knowledgeable and Professional 6. Use Amazing Phone Skills 7. Be ‘On’ Stage 8. Listen to and Learn from Patient Feedback 9. Work as a Team!

Every Monday for nine weeks, staff were sent the steps in an email and at the end of each they signed an agreement to “uphold/own” the Phenomenal Patient Experience. Later, staff were given an “Own Each Patient’s Experience” accountability form and given seven days to document examples they utilized from the nine steps. Their Team Lead had to sign off.

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Getting staff to cooperate with something new is “always an eye roll” Bruner says, but it soon became part of the work process.

THE REWARDS

Implementing the plan was “most definitely worth it” Bruner says. “I was told by a wise doctor that if you take care of your patients, they will take care of you. This is true; if you give the patients a phenomenal experience, they will return and … share their experience with others.” The result is new and returning customers, which helps financially but also “sets our expectations of how we want our customers treated.”

Bruner urges managers to spend time with staff and let them know it is their job to “own each patient’s experience.” This “builds satisfaction, loyalty and referrals by creating a positive patient relationship. Staff learn to listen before responding,” she says. “That’s what patients truly want — to be heard and understood.”

Do It Yourself: Implement a customer experience training program

  • RECRUIT THE DOCS. Employees may be reluctant at first; having the doctors participate helped her staff buy in, Bruner says.
  • INTEGRATE. “We have monthly staff meetings and there is always a customer service topic following the program implementation,” she says.
  • TWO-WAY STREET. As a manager, be open to whatever new ideas, behaviors and skills suggest themselves as a result of the program.
  • KEEP IT UP. Bruner feels such programs are most useful when done once a year with staff.
  • UP FRONT. Bruner has all new hires participate in the program immediately and lets them know that this is part of the “behavior” portion of their 90-day evaluation.

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