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Historical Data is the Future of Optometry

Eye scans and retinal images going back decades can help predict diagnosis and progression.

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OPTOMETRY IS BEING cast as a declining profession thanks to the advent of procedures like LASIK and “robot optometrists.” In 2017, the Secretary of Veterans Affairs David Shulkin, MD, suggested his healthcare directors get rid of optometry and audiology services. According to him, “LensCrafters on every corner” means the VA does not need to provide this service any longer. Whether it’s true or not, the perception that optometry’s days are numbered is evident in today’s generation of aspiring healthcare professionals; but despite the decline in applications, there is reason to be optimistic in about the future of optometry.

“The eyes are the window to the soul” may be more than a poetic turn of phrase. The eyes truly are windows into humans because, simply put, the eyes provide a non-invasive way to see inside people. This window could allow for early detection of Alzheimer’s disease and other types of dementia, by measuring the choroid. The identification of amyloid plaques early on offers a window to monitor disease progress.

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The growing awareness of the long-term effects of concussions presents another opportunity for optometry to have a positive impact. CTE or chronic traumatic encephalopathy, caused by repeated head injuries, is a cause for concern in many sports. The eyes may be a window into how bad a concussion is. More importantly, the eyes may be a record of brain injuries that can be decoded and evaluated. There may also be ways to evaluate if individuals are fully recovered from concussions or just becoming functional again while accumulating damage. The parents of young athletes will press hard for certainty on whether their child truly has recovered. Because CTE requires accumulation and time, there is an opportunity to limit the damage by recognizing the signs early on.

This is where historical data will play a part in an optometry renaissance. In practice management systems across the country, there exists an untapped wealth of eye scans and retinal images going back decades. Right now doctors have patients suffering from CTE and Alzheimer’s disease, who had pictures of their eyes taken throughout their lifetimes.

The historical data is a gold mine of information to be sifted through for early indicators of the diseases. With foreknowledge of diagnoses, the historical data can be targeted effectively, and paired with today’s automation, those images can be evaluated in large volumes to identify the early indicators.

The collective historical data of patients represents a lifeline to a profession that the U.S. government is beginning to consider potentially obsolete. The likelihood that additional diseases besides Alzheimer’s and CTE can be detected early through the eye seems strong. Given how much information can be gleaned from the eye, there are probably quite a number of diseases that can benefit from early detection methods. Those methods will in turn be applied to the historical data to detect additional diseases creating standard operating procedures in optometry practices for disease identification. In the 21st century, it seems ironic to consider 20th century history as the path toward the future, but in the case of optometry, it is.

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Anthony Watson has been actively coding for over thirty years. Currently the Programmer/Database Administrator at Marshall B. Ketchum University (www.ketchum.edu), home of the Southern California College of Optometry, in Fullerton, CA, he has been their “data wrangler” for the last five years. Email him at [email protected]

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Editor's Note

Small Changes Repeated Over Time Can Change the World

Better yet, they can benefit your business.

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I’M NOT REALLY an all or nothing sort of woman. I am a big fan of incremental improvement, the cumulative effect of making small but better choices over time … the do better today than you did yesterday school of thought. For me, done is better than perfect and waiting for perfect just means nothing ever gets done.

It’s definitely the approach I take toward the environment. I recycle at home. I own reusable straws. I mostly use eco-friendly cleaning products. I choose organic where I can, have reduced my consumption of meat and swapped what I do eat for free-range, grass fed or sustainably farmed whenever possible.

But I’m also “aging gracefully” with all the scientifically engineered help I can get, recently bought a big jug of chlorine bleach to combat the coronavirus, and will never be able to completely give up the cold, sweet chemical deliciousness that is Diet Coke.

The point is, I do what I can and I appreciate businesses that do the same. In our industry we have a growing roster of companies that are making small changes to improve their social good or environmental impact. Like Morel swapping out its old packing material for compostable peanuts and Eastman’s new Acetate Renew material made of biobased and certified recycled content soon to be available from Mazzucchelli. On page 24, we have a whole slew of brands giving back to LGBTQ youth, teachers, animals, and people in need; while Latest Releases (page 26) features a few eco-friendly styles new to the market.

These small steps are important for a long term improvement. Regardless of your political affiliation or where you fall on the issue of climate change, I don’t think anyone is effectively arguing in favor of poisoning the planet.
And it’s not just small changes to save the planet, they can save your business too. We’re living in uncertain times. Exert a little control over the fate of your business by checking out our Big Story — Recession-Proof Your Business — on page 34 for some ideas on how to combat the financial turmoil this global pandemic has thrown us all into. We only wish we had published it sooner.

Small changes repeated over time can change the world… and they can certainly benefit your business.

Best wishes for your business,

Five Smart Tips From This Issue

1. Few things are as feel-good as cute animals in glasses… and yep, there is a week dedicated to that. (Calendar, page 18)
2. After a slowdown in business, get buzz going again with a contest. We tell how to host one. (The Social Eye, page 18)
3. Forget monetary bonuses, give the people what they want: pizza and compliments. (Tip Sheet, page 50)
4. Wondering how to structure (or improve) your new staff onboarding program? Readers shared what they do… with lots more online. (Do You or Don’t You, page 66)
5. Cut the BS and make sure you aren’t just parroting nonsense. (Columns, page 62)

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Cameron Martel

Bad Reviews Don’t Have to Be Bad News

Here’s how to handle them to turn detractors into advocates and potentially earn new business too!

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GOOGLE, FACEBOOK, YELP!, Amazon, and seemingly every other online platform in existence have all made user reviews a focus of their strategy. This isn’t news to you.

Being on the receiving end of a bad review can sting, however you can leverage them to your benefit. Let’s look at how you can handle negative reviews and turn criticism into opportunity.

How Google Views Reviews

Google is on a mission to deliver a best-in-class experience to its users on all platforms.

Looking at search specifically, a great experience for a user involves having their questions answered in an intuitive and pleasant way. In this way, reviews mix with “traditional” SEO, as both SEO and reviews serve to help Google better understand the experience a business provides.

Contrary to popular belief, Google doesn’t immediately tank website rankings when they receive a bad review. If a sprinkle of bad reviews become a deluge, then you should be concerned about your SEO. But if that is the case, then I’d posit that your business has more pressing concerns…

What Bad Reviews Are (& Aren’t)

Focusing on how reviews mix with content, let’s clarify how Google treats bad reviews.

1. Bad reviews are natural and often unavoidable. Google is made up of people, and those people understand that you can’t please everyone.In fact, Google’s Quality Raters — people who review search results and provide Google feedback — are told that even the best sites/businesses get bad reviews.

2. Bad reviews are representative of a single experience, not your business in general. Considering that most people are rational and nuanced, it stands to reason that most people that come across a bad review or two take it into consideration but don’t place toto much emphasis on it. In fact, there is growing evidence that neutral and negative reviews with proper responses actually increase consumer trust.

3. Bad reviews are an opportunity to build trust. I am immediately distrusting of a business that has nothing but glowing four and five-star reviews. Nothing is perfect, and when I see an organization that is apparently flawless, my Spidey-senses start to flare up.

How to Respond

The only thing that customers value more than fair pricing and quality products is when a business treats its customers well. This doesn’t always mean a flawless first experience; it can also be how a business responds to a challenging situation.

There are a lot of ways to respond to a poor review. Before you do, consider leveraging these best practices:

1. Avoid generic or canned responses. Not only will your audience see right through it, but the best outcome you can expect is apathy. Nobody wants platitudes.

2. If appropriate, admit the mistake and provide next-steps. We all make mistakes, so don’t be afraid to own them. Humility is endearing and users will resonate with you for admitting fault. The key is to then provide the next step — “This is what we did wrong, here is how we will fix it.”

3. Be empathetic, not defensive. Getting defensive in your response is a surefire way to alienate the reviewer as well as show other users that your ego is more important than their satisfaction. Bad reviews can sting … it’s best to let the sting roll off your shoulders and to respond with empathy. In a situation where you weren’t at fault, don’t place blame on the customer (or anywhere else for that matter). Acknowledge the problem and focus on solving it; deciding who is at fault doesn’t matter to the denizens of the internet.

4. Drill into specifics. If the review doesn’t go into detail, in your reply ask the customer to reach out to you directly and provide them personally so that you can work with them. Not only does this give the original reviewer a direct line to get their problem solved, but it tells anyone reading the review that you care and want to make things right.

Reviews Are People!

And people respond best when engaged with respect and courtesy. Following the above tips, you’ll turn detractors into advocates (and win new business!).

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John Marvin

How Much is Your Practice Really Worth?

When someone wants to buy your practice make sure to take into account all of the intangibles.

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ANYONE PAYING ATTENTION over the last five years knows there is a significant amount of consolidation happening. An estimated 20 or more companies with funding from private equity firms are actively purchasing private optometry practices. The idea is that this will ultimately lead to a second round of acquisitions with potentially huge valuations.

This consolidation has produced a windfall for companies that professionally, and supposedly objectively, determine the value of a practice. I often get calls from doctors who want to retire and sell their practice to a young associate or entrepreneurial optometrist. I direct them to a handful of professionals I trust.

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Historically, there are three valuations for a practice: the value the buyer determines, the value the banker or lender determines, and the value the seller believes is correct. They all have competing interests. What’s happened in the past five to seven years is the addition of a fourth valuation: whatever a private equity funded company will pay for the practice. I have often heard that the value of anything is what someone is willing to pay.

Many are jumping at the chance to cash in, which usually requires the selling doctor to sign a three to five-year employment agreement.

There are essential aspects to a practice’s value that traditional calculations do not take into account. For people who have been successful in building a large optometry practice, some things are as important as money. For these entrepreneurs, there are other aspects to consider when determining the value of their practice.

Freedom

This might seem esoteric, but there is actual value to having the freedom to practice as you wish. Once you have sold the practice you no longer have the freedom to make equipment purchases you consider essential. You no longer have the freedom to take a vacation with your family on your terms. You no longer have the freedom to determine what products and services you will offer patients.

Connection to Community

When you own a practice, you are grateful for the people in your community who put their trust in you. You show gratitude by becoming involved in your community. You donate to fundraisers. You join civic organizations. You enjoy living in a community that expresses its appreciation for you, your staff, and the health and welfare you contribute. There is a value to your community connection. If you no longer own the practice this changes. It’s now the responsibility of the new owner to connect with their community. Your practice is one of many purchased by them, and they do not have the connection to the community you valued.

Relationships

When you own a practice, you have both independence and responsibility to form relationships. This includes relationships with your staff — and their families — and with your patients. You have staff members who have been with you for years and are invested in you and your commitment to providing care. Those relationships took time and energy and aren’t something an accountant can place a value on. When you no longer own your practice, the building of these relationships is out of your hands.

I could go on … and I bet you can too now that you’re thinking. When someone wants to buy your practice and attempts to determine how much it’s worth, make sure to take into account all of the intangibles. I would encourage you to place some value on things other than just EBITDA.

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