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INVISION’s guide to dressing store windows, squeezing the most out of your day, managing presbyopes, telling a joke, milking a sales rep and a whole, whole lot more.

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We recently consulted members of the eyecare community and a handful of business experts, asking them to tell us about some aspect of the business they’ve got down really well, and to boil that activity or practice down to its key components. What started out as a list of standout skills soon blossomed into an ECP’s guide to … pretty much, everything! Well … to a whole lot of really cool stuff, anyway. We’re pretty confident that reading this you’ll learn a few new tricks, and see at least a few of your current methods in a new light. We challenge you to implement one or two of these 23 practices — at least in some form — before the year is out.

HOW TO ENGAGE AUTHENTICALLY WITH YOUR COMMUNITY

Julie Kubsch, Specs Around Town, Bloomington, IL

Julie Kubsch, owner of Specs Around Town in Bloomington, IL, believes that if you engage with as many people as possible you’ll find someone who needs or wants your services — or who will know someone that does. Among the groups and events she has found most rewarding are: Bloomington-Normal Sunrise Rotary (“‘Service above self’ is the motto of Rotary and if you live it, it’s amazing what you can accomplish,” she says.); McLean County Chamber of Commerce (networking events); local radio station WGLT/NPR (“a perfect avenue for reaching clients that are fun, unique and love supporting local businesses”); and the downtown Bloomington business owners group’s monthly happy hour, hosted by a different business each time (“Nice resource to discuss downtown concerns, learn of other businesses in our area and creates a sense of family in regard to small, independent businesses.”) While financial benefits are the ultimate goal, Kubsch says, “hearing a comment like ‘Every time I ask someone where they got their glasses they say Specs Around Town!’ is good for the heart and soul.”

HOW TO MAKE THE BEST SANDWICH BOARDS

Heather Harrington, Elevated Eyecare, Denver, CO

By her own estimation, Heather Harrington at Elevated Eyecare in Denver, CO, makes the best sandwich boards in the business. We took her at her word and asked her to break down her approach — and the feedback.

  • INSPIRATION: Harrington gets hers from patients, the time of year, “and our office’s love for the overall health of the eye and clarity in vision.”
  • KEEP IT FRESH: She changes hers up twice a month or so.
  • MATERIALS: Harrington prefers chalk, with everything drawn in freehand.
  • LOCATION: In addition to placing them outside the business, she always posts all boards to her socials. “Of course!” she says. “Lots of hard work and thought goes into the boards for the month.”
  • RESPONSE: “Nothing but great things!”

HOW TO MAKE YOUR WEBSITE SERVE YOUR BRAND AND YOUR BOTTOM LINE

Selina McGee, OD, Precision Vision, Edmond, OK

Dr. Selina McGee at Precision Vision in Edmond, OK, has an eye for design but not the skills to translate that into a website. For that, she relied on marketing partner Gunnar Hood at WSI-Summit. (See what you think here www.pvedmond.com). She focuses her advice thus:

  • Find a web designer who can translate your ideas into reality.
  • Choose an appropriate platform: Precision Vision’s site is hosted on an SaaS platform called Duda, selected by Hood. “We like it because it is hassle free, supports SEO really well and accommodates all of our design needs.”
  • Use web analytics tools. Google Analytics, Google Search Console, heat mapping and other tools help monitor site performance, search engine optimization and social media reach.
  • Set goals. McGee’s were for the site to function as an extension of the office experience; to be phone-friendly; and to educate.
  • Include educational content. This captures views from beyond your area. “An article about bumps on eyelids is ranking well nationally.”
  • Don’t tinker constantly, McGee says, but consider a change if your site no longer reflects your brand and message, or isn’t meeting patients’ needs.

HOW TO KEEP YOUR WINDOW DISPLAYS FRESH

Jenni Leuzzi, Mill Creek Optical, Dansville, NY

At various times, the display windows at Mill Creek Optical in Dansville, NY have been graced by stuffed cows wearing shades; chickens eggs hatching kids’ glasses; a tipped-over picnic basket full of suns; and a vintage Fisher Price display. Here’s what owner Jenni Leuzzi focuses on:

  • For inspiration, in addition to holidays and seasons, Dansville has a full calendar of festivals and events. Check your town for something similar. She combs magazines and Pinterest, while some occasions suggest themselves: On Harry Potter-related dates: round frames in the window.
  • She stores a lot of props for re-use. Among these are old wooden boxes and crates, which can be draped in material. Items are found everywhere: “Garage sales, antique shops, Home Goods, Amazon, my basement…” Always be looking for something that can be used… or re-used.
  • The goal is to draw attention to your shop; don’t let your display become part of the unchanging scenery of the street. Leuzzi redoes her windows every three or four weeks.

HOW TO DEMO PRODUCTS & SERVICES ON FACEBOOK LIVE

Nancy Rausman, managing editor at EyeCarePro (eyecarepro.net), a consultant for the optical industry, says Facebook live is a great way for practices to build relationships, share expertise and products, and show the personal side of their business.

DO:

  • Provide value. Keep the focus on demonstrating services or displaying eyewear.
  • Write a compelling description. Before your audience decides whether to join you, they will read this.
  • Test lighting, sound and picture by selecting the privacy setting “only me” (in the “share with” section select “more” and scroll down).
  • Interact with your audience. Tag friends and patients to let them know the talk is happening; respond to chat; welcome people by name.

DON’T:

  • Forget to publicize your talk in advance.
  • Be overly promotional. This isn’t a commercial. No one wants to listen to 10 minutes of self-praise.

 

HOW TO EFFECTIVELY COMMUNICATE CHANGES TO CUSTOMERS

Marc Ullman, OD, Academy Vision in Pine Beach, NJ

During summer, Academy Vision in Pine Beach, NJ, takes off every other Friday. Here’s what Dr. Marc Ullman and the team do to keep people from driving all the way there only to find them closed.

  • Two or three weeks in advance, a message is posted alerting customers on Facebook, Google, the front door and website, and the phone message is updated.
  • The message itself is typically worded along the lines of: “Hello our amazing patients, the staff at Academy Vision will be taking time to enjoy our families this week.”
  • Messages are pinned along with all events to the top of social pages.
  • The door signage is professionally done. “It’s important to show we care about how you view our office, and the importance of spending time with family.”
  • Ullman reminds ECPs that “not everyone is on social media” — be prepared to field a few complaints.

HOW TO HIRE RIGHT EVERY TIME

Diana Canto Sims, OD, Buena Vista Optical, Chicago, IL

“Bringing new staff on board is pricey and time consuming; we have found our system works wonders funneling in the best candidates,” says Diana Canto Sims, co-owner of Buena Vista Optical in Chicago, IL. Here’s her rundown of the process:

  • A link is posted to an application with an invitation to schedule a phone interview at a day and time chosen by the candidate from a number of pre-determined slots. The slots are chosen ahead of time with a program called Acuity Scheduling. The application functions as the candidate’s resume.
  • For those who pass the phone interview, a face-to-face interview with a tour of the facilities. When they are also given a “logic and reasoning written test.”
  • Paid working interview. Conducted after they have passed the face-to-face. “We see their work ethic, reliability, team-playing ability and how they treat patients.”
  • Lastly, a candidate is selected from those funneled to the top. Some final advice, allow for trial and error, says Canto Sims. “It took us 11 years to perfect.

HOW TO START AN ABO TRAINING PROGRAM IN YOUR AREA

James Armstrong, Alberta Eye Care, Portland, OR

“Since opening our optical almost seven years ago, the most obvious challenge has been finding and retaining staff, particularly qualified opticians, and our office was not alone,” explains James Armstrong of Alberta and Cathedral Eye Care in Portland, OR. The shortage in the labor market has led to higher turnover and overhead costs, so Armstrong reached out to Portland Community College, and pitched the formation of an ABO training program in their medical career training department. “The idea was met with enthusiasm, but obstacles also presented themselves.”

  • Be able to demonstrate the demand in our local market.
  • Find an instructor. “It took two years of networking and reaching out to industry partners before the connection was finally made that led to finding Andrew Bruce, a master optician with decades of optical management experience, as our instructor,” shares Armstrong.
  • Know how to navigate the classic optometry vs. ophthalmology politics. “PCC has had an Ophthalmic Medical Technician program for years. I argued adding the ABO training program could only strengthen the college’s position in the eyecare field but those running the OMT program were concerned our program would potentially steer candidates away, or lower the future job prospects of the OMT graduates.” It took six months for Armstrong to convince everyone involved that opticians are not technicians and vice-versa. “What seemed like an obvious argument to myself and everyone else in our industry proved to be a very challenging hurdle for this program to overcome.”
  • Be patient. “Three years after I approached PCC about this program, Optician ABO Prep is officially a go and accepting students for January 2020!”

HOW TO WORK FASTER

Caitlin Wicka, San Juan Eye Center, Montrose, CO

Caitlin Wicka of San Juan Eye Center in Montrose, CO, isn’t sure why her ability to work with multiple patients at one time is so rare. Here’s what she does know about squeezing the most out of a workday:

DO:

  • Give trays to customers shopping for frames. “This allows them to look while you help change a nose pad or dispense.”
  • Offer guidance on store layout before a customer begins browsing.
  • Use the Ultrasonic cleaner as a way to make time to help someone else.
  • Look up insurance and patients before you sit with them.
  • Know your inventory and what you can order relative to the Rx you’re looking at.
  • Slow down, if it means making fewer mistakes.
  • Get your workspace set up with the tools that you most commonly use.

DON’T:

  • Chat with patients. “Let them talk to you, don’t talk at them.”
  • Deal with vendors/reps ahead of customers. “If a rep comes in, get them to help your patient look for glasses.”

HOW TO ANNOUNCE A FIRING TO THE REST OF YOUR STAFF

The basic rules of firing apply here. Firstly, do it quickly. Secondly, provide enough information to demonstrate the decision wasn’t arbitrary, but not so much detail that you look like you’re trying to embarrass someone. Be low-key, brief, stick to the facts and avoid emotion. Alison Green, author of the “Ask a Manager” blog, offers the following sample script for an email that she recommends be sent to the whole staff on the day of the firing.

”Unfortunately, Jane’s last day with us was today. We wish her the best of luck, and we’ll be moving quickly to hire a replacement. Until her replacement is hired, please see Fergus with questions about teapot research and Lucinda for any other questions.”

Green adds that “Your staff will generally understand that you’re not going to share every detail with them in cases like this,” while reminding managers that the key is to ensure that your staff understands how performance problems are handled.

HOW TO HANDLE AN EMPLOYEE WHO WON’T TAKE THE HINT

Back to “Ask a Manager” blogger Alison Green for this one: She advises that in fact it’s not your job to manage an employee’s reactions; if they don’t get it, it might be time to show them the door. “If an employee’s refusing to hear clear warnings, you don’t have to keep hammering the point home.” But before you pull the trigger, she does advise that you revisit the language you’ve been using with the employee. Have you been clear? “Sometimes managers think they have, but when we dig into exactly what they’ve said, it turns out that their wording has been mushier than they thought. In particular, managers are sometimes reluctant to say words like ‘If you don’t do XYZ, I will need to let you go.’” So, don’t be fuzzy. A manager/owner’s responsibility in this situation isn’t to keep issuing warnings — it’s to ensure that their warnings are clear. If not, Green says, “It’s time to move to a conclusion.”

HOW TO GET WHAT YOU WANT, AND NEED, FROM A SALES REP

Lorie McBroom, Bakersfield Eye Care, Bakersfield, CA

5 Bakersfield Eye Care in Bakersfield, CA, had tried several colorful frame collections that didn’t do well, so adding Etnia Barcelona felt like a bit of a gamble. Optical manager Lorie McBroom recalls telling the rep, “‘I love the brand, but it would be amazing if we could have 90 days to try it out to see how it would work. And the rep said, ‘Let’s make that happen.’” The line was a hit. “It’s worked out for us, as well as for our vendor, just to ask for the things that you want.” Something else McBroom has learned is that reps are a great resource for recommendations beyond their own brands. A good example of this is Matsuda, one of the first high-end lines they added. Its rep wasn’t familiar with Bakersfield, but another salesperson — who’d already brought Etnia Barcelona and Garrett Leight to the shop — vouched for what Bakersfield Eye Care was up to. By the time the Matsuda rep finally visited in person, “we had already sold through most of our Matsuda we bought at Expo, including a show-stopping frame that retailed for over $1,500,” says McBroom.

HOW TO SELL FROM THE CHAIR

Chris Lopez, OD, Roberts Eyecare Associates, Vestal, NY

To the eye docs reading this: We get it — you’re NOT salespeople. But there are ways to boost eyewear sales from the chair without feeling like you’re selling, and without dragging discussions of fees/costs into the exam room. Here are a few, provided by Dr. Chris Lopez of Roberts Eyecare Associates in Vestal, NY.

  • A key point from a sales point of view comes after refraction. Says Dr. Lopez, “If there is a moderate-significant refractive change, I demonstrate the change for the patient using their current prescription and the new one with the phoroptor. That’s a main selling point.”
  • Ask patients about their lifestyle. What recommendations present themselves? Says Lopez: “A prescription is what I deem necessary to provide the patient with the sharpest and most comfortable vision possible. A recommendation is what I think the patient could benefit from but which is not necessary.” ODs are within their rights to make both, he says. Discuss your recommendations as you walk patients to the handoff.
  • Ask all presbyopic patients if they’ve heard about multifocal contact lenses, an option that can get them out of reading glasses or bifocals/PALs. Many Baby Boomers and younger presbyopes are very conscious about their appearance. Being able to solve their near vision problem and helping them look young will make you a hero.
  • Raise the potential benefits of anti-fatigue lenses and daily disposables with appropriate patients during the exam. “With more and more patients reporting eye strain or tired eyes towards the end of the day, anti-fatigue lenses have earned a spot in my patient education armamentarium,” he says. “And I put any young patient (children and teenagers) into a daily disposable contact lens if it’s a new fit. It’s best to start healthy habits from the get go.”
  • “Always. Always. Have I said ALWAYS yet? I always ask patients at the end of the exam if they have any questions for me, or if there is anything that I haven’t answered for them. It gives them an opportunity to express all of their concerns and it allows you to once again educate and solve problems.”

HOW TO OFFER FREEBIES THAT MAKE YOU MONEY

Nancy Revis, Uber Optics, Petaluma, CA

“We are known to have fun free stuff,” says Nancy Revis, owner of Uber Optics in Petaluma, CA. She studied graphic design and marketing, so fun giveaways come naturally. “I had matchboxes made with our logo. Nice pens with our logo. We had beer coozies made that say ‘For your beer goggles.’ We always have fresh red vines and have a kitchen-size fridge full of beer and sparkling water. We have mints and chocolate all over the shop … especially mints because we are all in each other’s faces, so that is important.” Revis isn’t above setting the occasional sugar trap, either: “Now the little kids remember that I have red vines on the coffee table so they drag their parents in when they are walking by. I have totally sold sunglasses from them being dragged through the store for candy.” Selling suns doesn’t get any sweeter.

HOW TO BOOST WORD OF MOUTH BY DELIVERING A ‘WOW’ EYE EXAM

Robert M Easton, Jr, OD, Oakland Park, FL

Dr. Robert Easton in Oakland Park, FL, offers comprehensive eyecare and, when indicated, topography and a wellness OCT at no extra charge. Patients are shown the results in the exam room on flat screen HDTVs. He points out that topography is an excellent way to pick up a range of disorders. And “if a patient has a family history of glaucoma and/or deep cups, and/or high normal eye pressures, I want to be sure their Ganglion Cell Thickness is normal and I’ll run an Optovue Wellness exam. Furthermore, before I refer a patient for cataract surgery or Lasik I run an Optovue Wellness exam to rule out any retinal issues prior to surgery.” He adds that patients are more likely to accept treatment recommendations when he blows up their tests on a flat screen TV. “Because I do this as part of the comprehensive eye exam, I do not charge the patient. Many patients have referred their family members because of our thoroughness.” Business is so good, in fact, Easton doesn’t advertise.

HOW TO MANAGE FIRST TIME PRESBYOPES/PROGRESSIVE WEARERS

Kim Hilgers, Monson Eyecare Center, Owatonna, MN

A “no surprises” approach for first time progressive wearers is advocated by Kim Hilgers at Monson Eyecare Center in Owatonna, MN. Here’s her advice:

  • “I start by explaining that the ground won’t be clear when they look down because the viewing area is only 14-18 inches in the distance. I talk about steps and curbs (and vacuuming) being a challenge. I like to make a drawing to show them the reading area isn’t all the way across the lens.”
  • “The OptiKam has an amazing virtual lens demonstrator that the patient can hold and see more realistically what to expect.”
  • “Varilux Physio and Physio Drx are my go-tos. I’m kind of obsessing about Varilux X series right now for higher presbyopes.”
  • “I would say 95 percent of first-time progressive wearers are first-time presbyopes. I implore my doctors to speak to them about this as early as possible in their journey of presbyopia, to make MY job easier.”

HOW TO FIND/MAKE THE BEST USE OF AN OPTOMETRIC EXTERN

Mark Perry, OD, Vision Health Institute, Orlando, FL

Whereas internships are usually narrowly focused, months-long paid arrangements involving an employment agreement, and specific duties, externships (the word combines “experience” and “internship”) last a day to a few weeks, are unpaid, informal, have no major deliverables and often involve a student shadowing a doctor or simply observing what goes on. Dr. Mark Perry at Vision Health Institute in Orlando, FL offers the following advice to those thinking of bringing one (or more) on board:

  • Be dedicated to the profession, willing to instruct and help them adapt to patient encounters — lead by example!
  • Make sure your office is accommodating (and busy enough) to the optometry school, as well as the student (medical model of practice, latest equipment, etc.).
  • Start with your alma mater — contact the director or manager of the externship programs.
  • Be prepared to spend time with them.
  • Get staff to embrace and engage with the students.
  • Be prepared to learn from them!

HOW TO HANDLE VERY YOUNG CHILDREN

Nikki Griffin and Sara Mabie, OD, EyeStyles Optical and Boutique, Oakdale, MN
Nikki Griffin, owner/optician at EyeStyles Optical and Boutique in Oakdale, MN, fits babies as young as three months, so she knows a thing or two about doing it well. Her advice for opticians:

  • Fit them for now. Not yesterday, not a month from now.
  • If you don’t have the right size, admit it and refer to someone who does. Otherwise you’ll drive those people online.
  • Watch for endpieces that stick out too far.
  • Fit a frame to sit high.
  • Toddler tip: Use two penlights to get a PD. One to shine on their eye and another for them to shine at you.

Lastly, for optometrists looking to work with more kids: “Think like a kid,” advises EyeStyles’ OD, Dr. Sara Mabie. “A toddler might see a symbol of a rotary phone in a turtle. Be flexible — sometimes even getting on the floor for the wiggle worms. Have a variety of bright flashing toys to pull out, not a creepy puppet. Their attention span is short so change objects often. Oh, and keep moving!”

 

HOW TO GIVE AN EDUCATIONAL TALK

Taylor Little, OD, Eye Care Center of Colorado Springs, CO

According to Bob Levoy, author of 201 Secrets of a High Performance Optometric Practice, “the average optometrist has all the qualifications needed to become an effective public speaker. It’s really just an extension of in-office patient education.” By getting on the speaking circuit, you’ll be harnessing the power of your knowledge to bring in new patients. One doctor who’s already using this approach is Dr. Taylor Little at Eye Care Center of Colorado Springs, CO. Dr. Little urges other ODs to:

  • Decide on your expertise and have a direction before you start organizing your lecture.
  • Look for smaller events that need volunteers first.
  • Practice aloud beforehand.
  • Utilize pauses.
  • Choose a way to increase engagement with questions or surveys.

Levoy reminds ECPs not to turn the event into an advertisement. “The optometrist whose only motivation for public speaking is to obtain new patients will come across as self-serving … Establish yourself as an ‘authority,’ not as someone who is ‘looking for business.’”

HOW TO TELL A JOKE

Sometimes the route to “Yes” is through a customer’s funnybone. But before you clear your throat and dust off your knock-knock jokes, here are some thoughts from the guys in white jackets who know how to be funny:

  • Be self-deprecating, but don’t overdo it. In his sales blog at yesware.com, a sales productivity platform, Lou Carlozo counsels that sales humor at your own expense is safe, but don’t make yourself appear incompetent. You can joke about your hairline but don’t undermine your product line. He adds that self-effacing humor builds trust to show the real human being behind the salesperson; it creates a sense of authenticity.
  • Queens, NY-based standup comic Hari Kondabolu had this to say to The New York Times’ tip columnist Malia Wollan on the topic of joke-telling: “People should not be able to telegraph where a joke’s going.’’ Kondabolu says stock or street jokes — the kind you read in a joke compendium — are almost never funny. So, work on your ability to slip jokes naturally into conversation (i.e., don’t start with “Want to hear a joke?”).
  • If you must tell a joke involving an animal, ducks make for the funniest quips, according to a global survey done by scientists at the University of Hertfordshire, Wollan reports.

HOW TO BANISH BAD VIBES

Morgan Bartel, Collins Diamonds, Liberal, KS

Morgan Bartel, the owner of Collins Diamonds in Liberal, KS, told our sister publication INSTORE that “It’s store policy that we have no bad attitudes, conversations regarding politics, religion or anything that could cause any negative vibes. We believe in the law of attraction, which means that whatever thoughts/words we put out there or allow to be said within our store bring about either good or bad feelings. We have given numerous customers the opportunity to step outside and rethink their attitude. Some have immediately changed their tone, while others took their given opportunity, started looking at the bright side and then re-entered our store with a much more positive spirit!”

HOW TO FIRE A CLIENT

Tania Sotelo, Balfour Vision Optix, Brentwood, CA

It’s smart to set and maintain a chain of command and have a policy on what to do with people who disrupt your business. Staff tasked with carrying out the order should make it clear to the patient that it’s the doc’s call, and invoke their name, ideally in a brief conversation or call, but it can be done in an email. “Dr. Smith feels it’s time for you to find a new doctor, as we don’t seem able to meet your needs in our office,” Tania Sotelo of Balfour Vision Optix in Brentwood, CA, says. “We have a letter we mail to them stating we unfortunately have not been able to meet their needs and feel it’s best for us to terminate the business relationship,” she says. “We give them a 30-day notice for emergency services only and offer help finding another doctor if needed.”

HOW TO DEAL WITH A NATURAL DISASTER WITH HEART

Texas Smith, OD, Dr. Texas L. Smith & Associates, Citrus Heights, CA

Northern California’s Camp Fire killed 85 people and destroyed nearly 19,000 homes last year. Survivors who made their way to Dr. Texas L. Smith & Associates in Citrus Heights, CA, were seen and given Rxs for free. The idea began when VSP started providing vouchers for eye exams and glasses after the fire. “Several patients came in with the vouchers and I would ask them if anyone in their family needed eyecare,” explained Smith, who later reached out to VSP for more vouchers, and eventually just began providing survivors with needed care and Rxs at no charge. Smith has a history of quietly giving back. He has volunteered eyecare for homeless veterans, which, as a Vietnam vet himself, he says is “a no brainer.” He also volunteers with the VSP Mobile Clinic at Loaves and Fishes in Sacramento. “Optometry has been very good to my family so I need to pay it forward. Just doing my best to make a positive difference,” he says. Fires, hurricanes, floods, earthquakes, it seems Mother Nature has no shortage of disasters. Are you doing your part?

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Endings: Owners Share How and Why They Closed the Curtain on Their Eyecare Businesses

No two exit strategies are exactly the same.

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They say all good things must come to an end. In this industry, we often focus on the numbers when it comes to the sale or closing of a business… What sort of revenue did they have? What kind of deal did the owners get? How much did they sell for? But for business owners, there is an entire emotional and psychological journey when they are exiting the businesses they have poured money, sweat, and often, tears into.

No two exit strategies are exactly the same, and in the following pages we profile four business owners who have transitioned, or are looking to transition, out of ownership. What was their motivation? What did the process look like for them? How did they communicate their exit to their patients and staff? How did leaving their business make them feel? And what do their lives look like post-ownership?

LIFE SOMETIMES HAPPENS

Bryan Finley, LDO | Island Opticians, Palm Beach, FL | DATE CLOSED: May 2016

Bryan and Amie Finley

The original founder of the business, Stuart Villars, worked at Lugene Opticians on Worth Avenue, the luxury-shopping destination in Palm Beach, until they closed unexpectedly. Shortly after, he opened Villars Opticians on Peruvian Avenue, one block north of Worth. The business moved twice, but always stayed on Peruvian. In 2010, Mr. Villars decided it was time to relax a bit, and listed the business for sale. I was living in Oklahoma but saw the listing at a continuing education event I attended for licensing requirements in preparation for a move to Florida. I contacted Mr. Villars about purchasing it but, unfortunately, my then wife wasn’t interested in moving to Palm Beach, even though it was a tremendous opportunity. Mr. Villars sold the business to Christopher Moné, who renamed it Moné Optical Gallery.

After a short time in Florida, my marriage ended and I moved back to Oklahoma. I met Amie and we married. Again, I was looking for work opportunities in Florida when I saw a listing for a Moné Optical Gallery in Palm Beach. I told her: “No way, surely not!” She was excited about the prospect of owning our own business, so we contacted Chris Moné and struck a deal. We took over ownership and re-opened as Island Opticians on our first wedding anniversary, providing independent eyewear to the people of Palm Beach.

Although a bit stressful due to seasonality (Palm Beach has about 2,000 year-round residents but swells to 9,000 in winter), we loved our little 300 sq. ft boutique … But then life started to happen. Three months after opening, one of our daughters told us she was going to have a baby. Then, four months after that, another daughter called with the same news! Suddenly, we were going to have grandkids 1,500 miles away. Not long after the grandkids were born, our parents started having some medical issues. We tried traveling back to Oklahoma frequently to see the kids, grandkids and parents, but eventually we decided it was important and necessary to be near our family on a regular basis, so we made the difficult decision to sell the business after only two years.

We listed the business for sale on several optical forums and sites. After several inquiries, we reached an agreement in principle to sell to an optician, so we finalized all of our moving plans. One month before the sale was to be finalized, our buyer and her financier went in a different direction. Suddenly we had no buyer and no backup plan. With no time left to find a new buyer, we went into liquidation mode. We quickly had mailers printed to send to all of our clients and potential customers, with an aggressive going-out-of-business campaign. Everybody loves a good deal, even affluent people, so we were able to sell the majority of our product in one month. I ended up staying in Palm Beach a few weeks longer than Amie; she had already committed to a start date on a new job.

Since we were an LLC, the transition was fairly simple. We just had to notify the state that we were ceasing operations. As for communicating our plans to employees — no employees, so that was easy!

The first lesson we learned was: Have a good long-term plan and plenty of capital! Realize that starting or selling a business, should the need arise, doesn’t happen quickly; have patience. Be flexible. At the end of the day, integrity is the most important thing you offer as a proprietor.

Our advice for others is to have a Plan A, Plan B and Plan C!

QUICK Q&A

What was your greatest concern about giving up ownership?
Would we recover our investment? Would we ever have such a unique ownership opportunity again? After being owners, could we be happy working for someone else? Can we trust someone else to take care of our long-time clients?

Is there a patient encounter that stands out when they found out?
Many clients called in that last month to express their disappointment. Tears were shed. Mr. Villars, upon hearing the news, called to express how crazy he thought we were, but I think he was mostly sad to see the business close. One client offered to buy the business if we’d stay!

How would you describe the emotions you went through?
It was a bit heartbreaking. I felt like I was letting Mr. Villars down, and I was sad that my “retirement plan” wasn’t going to come to fruition. But we were both excited to spend more time with family.

Would you do anything differently?
I wouldn’t have been in such a hurry to sell.

What did you do to help overcome doubt?
We just reminded ourselves of the importance of family, and that things don’t create happiness.

How do you feel about the outcome?
We’re okay with how things have turned out, and plan to return to Florida, but as retirees instead of owners! We miss owning Island Opticians, but there is a certain level of anxiety that comes with ownership that we don’t miss.

Now what?
We tried working in private practice again, but just couldn’t get past knowing how to get things done better than our employers, because we’d been both opticians and owners. So, we decided to become brand ambassadors for some of our favorite independent lines. We still work together and are able to plan our travel schedule around our family activities. We do things a lot differently than most frame reps; we bought an RV that we live and travel our six-state territory in. This way, we’re “home” every night. We’re still technically owners as independent contractors, but have a little less anxiety now!

 

HANDING OVER YOUR BABY

Shimul Shah, OD | Marysville Family Vision, Marysville, OH | DATE SOLD: September 2018

The practice began as an ophthalmology practice. I purchased it in 2012. I practice general optometry and the patient base is very family oriented.

Accepting it was time to end ownership was a slow, painful realization that finally took a friend telling me that I would be just signing up for years of being unhappy and financially unsettled if I didn’t. It took a lot of introspection to realize I wasn’t able to accomplish what I wanted. I am very risk averse when it comes to money, and the one thing you need in growing a business is the ability to invest in it financially.

I had started asking around a little but was not actively looking for an exit strategy. When two different people gave me the same name to reach out to, I thought I should give it a try. I was hesitant to make promises and was willing to hold off until I knew that the practice, patients and my staff would all be treated with care.

A lawyer generated a Memor­andum of Understanding to get my intentions on paper and list what I wanted and was not willing to budge on. An accountant helped come up with a price and negotiate the sale. The biggest help was my family, who served as my sounding board.

Shimul Shah, OD

When it came time to communicate the change, I spoke with each employee and made sure they knew that a part of my agreement with the new owner was their position, the hours they would be working and the pay. I needed them to know it was something I had to do for myself and that I had made every effort to make sure they were taken care of.

We sent emails to all patients letting them know the business was turning a page but the doctor, staff, products and service were not changing. They seem accepting of what has occurred.

One surprise is that I find myself slightly disconnected from the profession at the moment. I went to a conference recently where I found myself wanting to attend and listen to practice management talks but didn’t know how I could implement anything now that it wasn’t my position to worry about those things anymore. I want to refocus on patient care, but changing gears has been challenging.

The process of deciding to give away ownership of something is a grueling one. I had to really think about my life and what I wanted out of it, and whether the good outweighed the bad. I learned on a deeper level what my strengths and weaknesses were and how each contributed to the conversation, and the ultimate decision, to start placing my efforts elsewhere and to pass the practice on to more willing and able hands.

My advice to others is to have good advisers in your corner. Be specific and diligent about what you want, but know that without compromise you will probably never find anyone that’s good enough to take over your “baby.”

QUICK Q&A

What was your greatest concern about giving up ownership?
Being an employee in a space where I’m used to being in charge. Secondly, I was nervous I would lose the passion I’d had for the practice’s success.

Is there a patient encounter that stands out when they found out?
Every encounter I’ve had has been positive and supportive! I don’t think patients care so much about the behind-the-scenes stuff as long as there is continuity of services.

How would you describe the emotions you went through?
I felt a myriad of emotions ranging from failure to anxiety, sadness, and excitement. At times, I felt I was abandoning my patients, staff and Marysville. At others, I felt like I was letting down all the people that had so much faith in me. Now that it’s over, I feel peace, stability and anticipation for the future.

Would you do anything differently? No.

What did you do to help overcome doubt?
I reminded myself that the current situation was unsustainable. I could potentially keep going for another six months, maybe even a year, but ultimately that would just be delaying the peace of mind I was so desperate for.

Are you happy with the outcome? Yes

Now what?
My plans include making more time for traveling, cooking, reading, and spending time with friends and family. I may get involved in the political and legislative branches of optometry and see how I can use my talents to help optometry grow in a different context.

 

PRIVATE PRACTICE TO PRIVATE EQUITY

Carol Record, OD | Drs. Record & Record | Charlottesville, VA | DATE SOLD: February 2016

Steve Record and I graduated from SUNY Optometry in 1982. It was the heyday of extended wear contact lenses and retail optometry was just beginning to advertise for eye exams, eyeglasses and contact lenses. We moved to upstate New York and worked retail optometry as our first jobs. We saw many patients and fit lots of contact lenses. We wanted to work in private practice and eventually own a practice, but not in upstate New York. The population was not growing. We felt we needed to move south to a town that was experiencing growth; preferably a college town.

After exploring established practice opportunities in Virginia, none seemed quite right. Once we accumulated enough capital to open a practice we moved to Charlottesville and opened cold. We opened in August 1983 and were the first in town to advertise our services for eye exams and contact lenses. Looking back, it is hard to believe we survived and actually made enough to pay our bills. Fortunately, we were able to live off the income we made from optometric employment and both had part time jobs working one hour away. Within five years we gave up all outside employment.

Our practice grew from zero patients, to two offices, four doctors, and over twenty employees. We embraced medical eyecare, added new equipment each year, and were fortunate to experience growth every year we were in practice.

Before we knew it, our children graduated college and we were advised that we had enough money saved to retire whenever we wanted. We were in our late 50s. I still had the mindset of growing the practice, perhaps adding an additional location, but Steve wanted to retire and I did not want to do it alone. We sought the advice of Al Cleinman of Cleinman Performance Partners to map out our options. We learned there were fewer buyers able to purchase a large practice as a whole. The better option was to sell each location. We were also informed it usually takes a few years to sell, so we retained him to help us transition our practice.

Selling a practice takes time and there are lots of facets to it. Finding a buyer willing to provide a fair deal is perhaps the hardest part. Legal and accounting documents will be needed. Will you work for the new owner? For how long? What will your employment contract look like? What will you do with the real estate? We were lucky to have an unsolicited offer from MyEyeDr that we could not walk away from. Cleinman, having brokered many practice sales, knows a good offer from a bad one and advised us as such. He also walked us through the details, along with our attorney, financial planner and accountant. From the time we decided to look for a buyer to the time we actually sold took about 2.5 years and MyEyeDr purchased all the assets.

We have many colleagues who are transitioning their practice. In all cases, the employees are informed of the sale of the practice once it is definite that the deal will go through. In our case, we informed our employees one month prior to closing. Since Steve and I were employed by MyEyeDr, MyEyeDr informed our patients of our new affiliation. As it came closer to the time when I would retire, I thanked my patients, hugged them and told them it would be the last time I saw them professionally. Often it was my retired patients who said “You can’t retire. Who am I going to see for eyecare?” Most patients thanked me for their care and congratulated me.

I consult with doctors at least once a month about practice transitions. The first thing I tell them is “no matter who you sell your practice to, your practice will change.” Second, I inform them that “the best deal for your practice is the deal that is best for you.” Everybody’s situation is different. The longer you work in the practice after the sale, the more valuable the practice is.

For the doctor who is unsure they should sell their practice I’d ask first, “What do you plan to do after? Will you continue to work? Will you change careers?” If you plan to retire I can assure you, you will be surprised at how busy you will be. Volunteer opportunities abound. New hobbies and games are ready for you to explore. New friendships will form, and the extra free time you now have will let you experience life’s moments with greater joy and enthusiasm.

QUICK Q&A

How would you describe the emotions you went through during the process?
I was consumed by worry about giving up control… but I found it quite liberating to see patients and go home. Once I left the office, work was behind me.

Would you have done anything differently?
I speak at Cleinman’s Practice Transitions Conference and have learned a lot about transitioning a practice. There are various options you and your new owner may have that I was unaware of. This type of meeting did not exist when I sold. I wished it had. The transition will go a lot smoother if you allow someone who has experience in practice transitions help you.

What did you do to help overcome doubt?
I reminded myself that the business of health care was changing and eyecare was no exception. Colleagues I respected and considered good businessmen were also selling their practices to private equity. Health care professionals may not think of their practices as businesses, but they are and business models change.

Are you happy with the outcome?
If you are anything like me, your practice is something you are very proud of. It is very emotional to give up what you have taken years to build, you want to be sure your patients will be cared for the way they need to be taken care of. Fortunately, the next generation of optometrists are very bright and take very good care of patients. Throughout the sale process, even up until the last week, I wondered if I was making the right decision. My husband encouraged me it was the right thing to do. Now, I am so happy I sold.

How are you spending your time post-ownership?
I have been fortunate to continue my optometric affiliations by serving as secretary treasurer of AOA’s Optometry Cares Board, co-chairing the HEHC community grant program, speaking on optometry topics, and up until last fall, serving on the disbanded Essilor Advisory Board. Not a day goes by however, where I don’t think about starting a venture to bring new optometric services to the members of my community.

 

LEAVING A LEGACY

Michael Cohen, OD | Four County Family Eye Care Center, Winslow Township, NJ | Sold business: TBD

our County Family Eye Care Center opened on Sept. 11, 1973 in the Winslow Professional Center of Tansboro/ Berlin/ Winslow Township, NJ, three months after I graduated from Pennsylvania College of Optometry. My father, Dr. Philip Cohen, learned about the center from a patient of his who was friendly with the building’s owner. We decided it looked like a good place to open a new optometric practice, signed a lease, and began planning to lay out and equip the office.

My wife and I made address labels on a typewriter and had announcement cards printed. We mailed out thousands of cards and on the day we opened, I prayed for good business. In those days, if I saw one or two patients a day, I considered myself lucky. I spent most of my time watching General Hospital and writing a digest for my wife, who was keeping us afloat teaching at a local school. I grossed $33,000 that first year. No insurance. No credit cards. Cash only. I made patients’ glasses by hand in my optical lab.

A couple years later, the owner lost the building in a bankruptcy. I decided to look for real estate to purchase and build a new office on. A patient and local realtor, Ursula Christinzio, found me a location nearby; a vintage 1850s farm house sitting on 1.5 acres on the highway at an intersection with a county road. I opened Four County Family Eye Care Center on June 1, 1979.

I’ve been in optometric practice in Winslow Township for 45 years offering comprehensive eye exams, diagnosis and treatment, and contact lens and eyeglass fitting. We counsel patients about LASIK and do the follow-up care, treat glaucoma, and make referrals to many ophthalmic sub-specialists in the region. I have three full-time staff and three part-time. My office manager started working for me at 17 years old; she is now 47. People tend to stay on for years; it is better to pamper your staff and keep them happy, than it is to abuse them, lose them, and train new people!

Michael Cohen, OD

I realized it was time to think about ending my ownership and retiring when my wife informed me that she hates the cold and would like to spend winters in a warmer clime. Also, I noticed that most of my patients my age are now retired and very few of my peers were alive and well and still running their own practices.

My ideal exit strategy would be to find an honest, talented, skilled, clever, caring, and compassionate OD who would be willing to purchase both the real estate and my practice and allow me the luxury of still seeing patients.

I worry that, if my staff get wind that I am thinking about retiring, they will look for employment elsewhere. Hiring and training staff is costly, time-consuming, and fraught with peril. Also, is it fair to hire someone when you are planning on leaving? When I have confirmation I am throwing in the towel, I’ll meet with my employees and lay my cards on the table.

I lead a very busy life now. Selling my property, as well as my practice, is time-consuming. I’ve spoken to a number of professional practice brokers, all of whom concur my gross revenue does not justify them getting involved. They all said I should sell it myself and I would like to continue seeing patients for two more years, provided my health holds up.

Every day, my long-time patients query me about my plans. I’ve been honest with them. I’d love to slow down but I don’t see any way out. Everyone encourages me to stay on … then they tell me how much they enjoy their retirement. My advice to other ODs looking to transition out of ownership is to try and build a business that has sufficient gross revenue to justify a professional broker skilled at doing all of the things that I must now do myself.

QUICK Q&A

How would you describe the emotions you are experiencing as you begin this process?
I am feeling quite inadequate to meet this challenge. I have a fear of failure.

Is there anything you wish you had done differently to prepare for this?
I did it my way! I have always been true to myself, my family, my staff, my patients/friends. If I have to turn off the lights, lock the doors, and not look back, I really have no regrets. I’ve helped a great many people over the years.

What do you do to help overcome doubt?
I talk to friends who are older than I am and find out how they were able to live so long and so well. I attend religious services weekly to meditate through prayer. I’ve discovered that Tai Chi and Quigong help me divest myself of my monkey brain. I call this my standing meditation. I occasionally use a therapist friend to bounce ideas off, when I cannot seem to move a big rock that is blocking my progress.

What would make you happiest with the final outcome?
I would love to see someone take the baton and run with it after I am gone.

How do you plan on spending your retirement?
Workout at the gym ten hours a week, travel to new places, spend time with my children and grandchildren and maybe spoil them a bit. Find people less fortunate and extend a helping hand. Go to synagogue on Saturday mornings, read the classics, watch great shows, eat great food at the best restaurants, and take in some Broadway shows now and then.

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Cover Stories

Escape From Insurance: Words of Wisdom From Eyecare Practices That Made the Leap

They left managed care and went to private pay.

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If you feel you’ve reached a point in your practice where you no longer want to be held captive by the low-margin traffic generated by insurers, you may be wondering how to break free. We reached out to eyecare businesses to find out what steps they took to throw off the shackles of dependency on vision plans. None of these tips will work unless you’re able to engender patient loyalty — and you don’t need us to tell you where that comes from ­— but here are eight tips to help you plot your escape from insurance.

1 Secure sources of self-pay patients that continue to deliver. Buena Vista Optical in Chicago, IL, is taking what co-owner Diana Canto-Sims calls “pro-active baby steps to transition away from vision plans.” After they run quarterly reports of the vision plans with the lowest reimbursement, they’re on the way to finding self-pay patients to replace those patients the next quarter. Among the places they have found them are career days at local schools — they send every student home with information including a package of exam and glasses for first-time patients with no vision plan — and collaborations with organizations that reach out to the uninsured, such as the consulates of Latin American countries. (Buena Vista has a fully bilingual staff). “These organizations are very appreciative that we collaborate with them and they send us self-pay patients weekly,” she says.

2 Brace for a pre-cutoff influx; remind patients to check their medical coverage. Whelan Eye Care in Bemidji, MN, quit taking VSP almost two years ago. Bridgett Fredrickson warns ECPs that there will be patients that get upset. “We are honest and tell them to check with their medical insurance as it may cover their exam as well, or they are always welcome to self-pay and we give them a 20% discount for same-day payment. Remember, she says, that you will need to send all of the current households a letter letting them know that you are no longer going to be accepting their insurance with an effective date and they need to receive the letter at least 30 days before that effective date. “With this, expect an influx of patients that want to get in before that date,” she says.

3 Phase your plans out. Dr. Robert Easton Jr. has had a solo practice in Oakland Park, FL, for 37 years. One year his CPA told him “that since I was providing comprehensive eyecare, my vision plan base was increasing faster than my major medical, PPO and Medicare patient base. We were concerned that vision plans were taking over my practice, which could eventually put me out of business.” After careful analysis, Easton eliminated the three lowest-paying plans first and kept the other two as a cushion. As the other two continue to become more corporate in nature and their low reimbursements fail to meet his cost of doing business, Easton plans to eliminate those one at a time.

4 Get your team up to speed. Jenna Gilbertson says dropping VSP was the best decision McCulley Optix Gallery in Fargo, ND, ever made. However, she cautions, “Before you ever send the termination letter to the insurance company, have a plan in place. Make sure all staff is on board. Have scripts for what to say. And have a plan for your patients. Be over-prepared for every situation. We ran role-plays with our staff, and had them think of all the questions a patient might ask.” They marked everyone who was pre-appointed on the schedule. They then went through each of those patients to see who had a calendar year plan, and called those patients, explained the situation, and rescheduled them for before our termination date. Yes, it meant the doctor had to work extra days and times, “but it was totally worth it to make those patients happy,” she says.

5 Keep a list of complaints about the plan you’re dropping. Last year Focus Eye Care in Hackensack, NJ, made the decision to jettison Davis Vision. Prior to this, the largest employer in the area had switched from VSP to Davis, while a big-box retail chain associated with the latter began advertising discounts. Before Focus could make the split it endured a period in which patients had a long list of complaints about jobs that were now going through Davis. Managing licensed optician Vlad Cordero took notes: “We used the list of complaints to train our front desk and optical staff on how to handle objections when Davis members call in to schedule an appointment or inquire about eyewear.”

6 Find a niche, or team up with an OD who has one. “The most important key to dropping insurance is having a niche,” says Dr. Pauline Buck, a vision therapy specialist at Behavioral and Developmental Optometrists in Miami, FL. “I was building that practice up while slowly dropping off insurance panels.” Next is the hard part. “You really need to get out into the community and speak about your specialty. I host quarterly lectures with dinner in my office for other professionals… The cost of the dinner is offset by a single referral.” Finally, “for non-optometric professionals who would like to break the bonds of insurance I highly recommend approaching specialists and seeing how your services can help them… I refer out 80 percent of my glasses prescriptions,” she says.

7 Help patients collect out-of-network benefits. The Visionary in Allen Park, MI, took a long look at their profit margin with EyeMed and decided it was time to split. They knew they had patient loyalty on their side. And, says Annette Prevaux, “We make it easy for patients to get their OON reimbursements by having the forms ready when they come in.” She expects to keep about 60 percent of her EyeMed patients.

8 Switch to independent brands; consider an OON service. Krystal Vision in Logan, UT, is in the process of dropping most vision plans. According to Travis LeFevre, being insurance-free goes hand-in-hand with carrying independent brands. “It’s an easy jump to make once you look at your margins while taking insurance compared to cash pay and filing a simple claim for the patient out of network,” he says. He cautions that “creative marketing is a must to stay relevant after dropping managed plans.” And after initially being unimpressed, Krystal Vision now uses Patch, an “online insurance assistant” that helps ECPs and patients negotiate out-of-network benefits and claim them digitally. LeFevre says Patch is now offering a better product than it did three or four years ago. “It allows us to know the exact amount of a customer’s OON benefits for their vision insurance. It gives us a breakdown … depending on the plan and insurer. Another useful part of Patch is the ability to accept payment for VSP and Cigna claims; this allows us to give the patient the reimbursement savings up front rather than making them wait [for the] check in the mail.”

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How to Improve Your Kids Business

6 experts explain how to win them over early.

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Transforming the medical side of your practice is obviously not a step to be taken lightly, particularly if you’re looking at expanding your treatment of children. The challenges are many, but the rewards can be great, personally and financially. To help those of you thinking of boosting your optometric offerings for kids but wanting to know what that could entail, we assembled an impressive panel of experts in pediatric eyecare, and its related specialties, for a rundown of the main areas you should be looking at. If children are the future, and the future is now, what are you waiting for?

Specialty
PEDIATRICS

EXPERTS:
Dr. Dominick M. Maino, professor, Illinois College of Optometry/Illinois Eye Institute, associate, Lyons Family Eye Care, Chicago, Il; and Dr. Nathan Bonilla-Warford, OD, Bright Eyes Family Vision Care, Tampa, FL

ASSOCIATIONS OR GROUPS AVAILABLE:
College of Optometrists in Vision Development (covd.org); Optometric Extension Program Foundation (oepf.org), Binocular Vision, Perception, & Pediatric Optometry (BVPPO) Section of the American Academy of Optometry; Optometric Extension Program (OEP) Foundation

Dr. Don Teig

TRAINING OR CERTIFICATION NEEDED?
Dr. Maino:Not necessarily needed but a residency in pediatrics/binocular vision would make you stand out from the crowd. A Fellowship in COVD would do the same thing.

Dr. Bonilla-Warford:Generally, yes, additional training is beneficial outside of typical optometry training. A one-year optometric residency in pediatric vision care is an excellent way to become specialized. Beyond that OEP offer courses that cover the clinical care of infants and children as well as the practice management of the specialty.

SPECIALTY EQUIPMENT OR TOOLS REQUIRED?
Dr. Maino: Yes, but most ODs have much of what they need already.

Dr. Bonilla-Warford: The retinoscope is standard equipment, but many optometrists are not comfortable with it. Practice! Also, the pediatric-sized trial for refraction and probing refractive error without a phoroptor. A digital randomized visual acuity chart with movies for fixation and pediatric option acuity symbols. The Lang stereo test is a simple tool for assessing stereopsis without polarized glasses. Prism bars and loose prisms for binocular testing. And toys, finger puppets for entertaining little ones. They make a little booster for exam chairs that are perfect for kids who are independent enough to not sit on a parent’s lap but are still small.

Matt Oerding

ADDITIONAL EXAM LANE OR TESTING SPACE NECESSARY?
Dr. Maino: Not unless you are doing developmental vision/vision perception testing and in office VT.

Dr. Bonilla-Warford: Not necessary. It is common to have one exam room that does have a few extra items for kids, but it can be used for adults as well, so it doesn’t really require extra space.

ADDITIONAL MARKETING REQUIRED?
Dr. Maino: Definitely. You need to get the word out about your expertise in this area. Use social media.

Dr. Bonilla-Warford: Very smart [if you do]. Add children’s specialty services with info and descriptions on your webpage so patients can find and learn about them. Informative displays about children’s vision are an inexpensive and easy way to raise awareness. Networking with referral services is very effective.

HIGHER AVERAGE REIMBURSEMENT OR REVENUE PER PATIENT?
Dr. Maino: Yes. You often need to not only do a comprehensive examination but also a sensorimotor assessment and other testing as well. Frequent follow up appointments are often necessary.

Dr. Bonilla-Warford: For typical children’s primary care, the reimbursement is somewhat lower because they often do not need glasses or contacts. However, specialty services such as myopia control and vision therapy are significantly more because they are often higher-end self-pay services.

Dr. Dominick M. Maino

IN SHORT:
Dr. Maino: When I work with my optometry students, I always tell them that a smile is the best piece of equipment you could have. You must be genuine. You should keep up on the current research in this area and be ready to take that extra step. You are not just working with a pair of eyeballs, but also with the child and the whole family. It is fun, challenging and fiscally rewarding.

Dr. Bonilla-Warford: Working with children is so fun. It is very rewarding to see them grow and develop and to know that you are helping them reach their goals, whether it is in school, sports, or overcoming symptoms. However, it can be challenging. You have to be honest with them in a way that they can understand. Children will not hesitate to tell you “I don’t like you! I am never coming here again!” If staff sets the tone so the child can feel that you are on their side, you will be amazed how much clinical information you can get from them at very young ages. Knowing when to stop or change a particular test or activity is essential. Most importantly, have fun! And get good at retinoscopy.

Specialty
MYOPIA MANAGEMENT

EXPERT:
Matt Oerding, co-founder/CEO, Treehouse Eyes, Bethesda, MD and Tysons, VA

ASSOCIATIONS OR GROUPS AVAILABLE:
“The International Myopia Institute provides evidence-based treatment guidelines for this specialty; American Academy of Orthokeratology and Myopia Control (aaomc.site-ym.com)

TRAINING OR CERTIFICATION NEEDED:
No. Any optometrist can technically perform pediatric myopia management. However, specific CE/education is required to become proficient at the various treatments proven effective. These are currently orthokeratology lenses, multifocal soft contact lenses and atropine.

Dr. Charlene Henderson

SPECIALTY EQUIPMENT OR TOOLS REQUIRED:
Yes. A practice must have a good topographer as a highly accurate map of the cornea is critical to success. Additionally, a device to measure axial length is highly recommended.

ADDITIONAL EXAM LANE OR TESTING SPACE NECESSARY:
No. This can be done within an existing exam lane or space.

ADDITIONAL MARKETING REQUIRED:
Yes. Currently pediatric myopia management is not covered by vision plans, so it is a private pay procedure. Due to lack of parental awareness of the risks of progressive myopia and the availability of treatments, marketing is critical to generate interest. At a minimum marketing to existing primary care patients via email, newsletter and in-office marketing is required. To gain new patients for pediatric myopia management, social media, PPC and PR are all proven techniques.

HIGHER AVERAGE REIMBURSEMENT OR REVENUE PER PATIENT:
Yes. Because this is a private pay procedure and children are likely to be in treatment for several years, the revenue per patient is significantly higher than a typical optometry patient. Fees vary widely, but typical is $2,000-3,000 for the first year of treatment.

Dr. Pauline Buck

IN SHORT:
Pediatric myopia management can be an incredibly fulfilling specialty when done correctly, as you are helping a child see better today and reducing their long-term risk of serious eye diseases associated with progressive myopia. Offering these services can generate significant patient/family loyalty to the practice, as treatment typically lasts several years and successful patients are proven to be great referral sources to others in the community.”

Specialty
VISION THERAPY

EXPERT:
Dr. Pauline Buck, Behavioral and Developmental Optometrists, Miami, FL

ASSOCIATIONS OR GROUPS AVAILABLE:
The College of Optometrists in Vision Development (COVD); Neuro-optometric Rehabilitative Association (NORA); Optometric Extension Program (OEP); College of Syntonic Optometry (CSO).

TRAINING OR CERTIFICATION NEEDED:
Post-graduate training is very much needed. A new graduate from optometry school has the basics to begin a vision therapy program. Yet a successful vision therapy doctor will stand on the shoulders of their predecessors by learning what has already been learned. COVD and OEP provide training. OEP has regional seminars. COVD has state study groups and their annual meeting. Mentors are provided to assist when there are questions.

SPECIALTY EQUIPMENT OR TOOLS REQUIRED:
Yes and no. Bernell is a great resource of vision therapy equipment. There are many computer-based programs as well. However, I know many experienced doctors who have used something as simple as a stick and a straw to illicit a change in their patient’s visual system. This ability comes back to the training. When you really understand the system, you can make changes using just about anything.

Dr. Nathan Bonilla-Warford

ADDITIONAL EXAM LANE OR TESTING SPACE NECESSARY:
Again, yes and no. Yes — the functional vision evaluation is done in the exam room using the phoropter and equipment that is standard to the profession. No — I have an entire room, ‘the play room,’ dedicated to the testing of physical performance. How do the eyes affect a person’s ability to perform an everyday task? I also have another room for the testing of classroom skills, which contains a desk, slant board, and a lot of paperwork.

ADDITIONAL MARKETING REQUIRED:
Yes. ‘If you build it, they will come’ doesn’t work. I have gone out in the community and lectured about vision therapy. I have spoken to therapists, doctors, teachers, parents and other professionals about the visual system and how it can affect performance. Those individuals eventually become referral sources. I am constantly practicing my elevator [pitch] of what I do.

HIGHER AVERAGE REIMBURSEMENT OR REVENUE PER PATIENT:
Yes. Most optometrists will see a patient once a year for their annual or several times throughout the year for care of ocular disease. When a patient is doing vision therapy I see them for their annual, their progress evaluations every 10 weeks, and weekly for the therapy sessions.

IN SHORT:
Vision therapy is understanding the nuances of the development of the visual system, how it can change behavior, and how it can alter a person’s performance. It can benefit children and adults with brain injury, children with difficulties in the classroom, individuals with autism and down syndrome. When all other professionals have told a person that there is nothing else to do for their condition and they come to me for a glimmer of hope, I offer the potential for change. When their symptoms decrease and their performance improves, those are the moments of my greatest job satisfaction and I am thankful that I have a ‘tool box’ large enough to have made that possible.

Specialty
SPORTS VISION or VISUAL NEURO-COGNITIVE TRAINING

EXPERTS:
Dr. Don Teig, founder/CEO, “The A Team” High Performance Vision Associates, Hollywood, FL; and Dr. Charlene Henderson, Blink Eyecare and Eyewear, Charlotte, NC

ASSOCIATIONS OR GROUPS AVAILABLE:
Dr. Teig: This niche or specialty has always been referred to as “sports vision” but more recently as ‘visual neuro-cognitive training’ given the attention to the impact concussions and chronic traumatic encephalopathy (CTE) has had on sports. I also often refer to it as ‘high performance vision.’ I am the founder and executive director of ‘The A Team’, High Performance Vision Associates (highperformancevisionassociates.com), there is also ISVA (International Sports Vision Association, sportsvision.pro).

Dr. Henderson: High Performance Vision Associates and the AOA.

TRAINING OR CERTIFICATION NEEDED?
Dr. Teig: Yes. I provide a 16-hour course with certification (ultimateevents.com.) I also travel to provide this training. ISVA is working in conjunction with me to develop a certification program.

Dr. Henderson: It is necessary to understand the sports you are working with and how vision plays a role in success. Sports vision training by people who have pioneered the concept is invaluable. We went to Don Teig’s Sports Vision training weekend, and Fred Edmunds Xtreme Sight sports Vision training weekend. They are both excellent. We also did several Sports Vision AOA courses and read all the books out there.

SPECIALTY EQUIPMENT OR TOOLS REQUIRED?
Dr. Teig: Yes. The A.M.P. System (Achieving Maximum Potential), an immersive virtual reality technology; Senaptec, a digital testing and training instrument; NeuroTracker, a multi-object awareness trainer; FitLight motion and light sensors; and Quick Board, an eye to foot training tool.

Dr. Henderson: Yes. When we built our new building, we added lots of exciting equipment like Vision Coach, Fit Light, Senaptec, and the Bassin anticipation timer among others. We still use traditional VT equipment like Marsden balls and flippers and balance boards. The athletes like the bells and whistles of the digital devices.

ADDITIONAL EXAM LANE OR TESTING SPACE NECESSARY?
Dr. Teig: Yes. At the very least a room that is 10′ x 12′ is a must.

Dr. Henderson: Yes, for testing space. You need room to swing or jump or dribble a basketball, for example.

ADDITIONAL MARKETING REQUIRED?
Dr. Teig: Yes, by all means! Internal marketing with videos, pamphlets, etc., in your office and external marketing through social media, TV, radio and print.

Dr. Henderson: Yes. Internally tell all your sports-minded patients. All our patients walk by our sports vision room. You should reach out to teams and clubs and let them know what you do.

HIGHER AVERAGE REIMBURSEMENT OR REVENUE PER PATIENT?
Dr. Teig: Yes! A typical Sports Vision patient can generate revenues of up to $3,000 each if they complete an eye exam, a Sports Vision Workup, a Sports Vision Training program of 12 weeks minimum; specialty contact lenses or sports eyewear and goggles.

Dr. Henderson: Yes. Sports vision training is an additional service not covered by insurance. So, it is up to you to set the fees you think are fair for your time for the evaluation and then training sessions.

IN SHORT:
Dr. Teig: Having been a pioneer in this field for almost 40 years, I can confidently say that sports vision is both emotionally and financially rewarding beyond belief. However, it doesn’t happen overnight and requires continual hard work. That being said, if you love sports like I do, it’s well worth the ride.

Dr. Henderson: It can be really rewarding if you have a passion for sports and working with highly competitive people. The niche does require training, equipment, space and active marketing. So, it will not just fall in your lap. But it is a great way to help people achieve their goals and use our skills as vision experts.

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