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Tips and How-To

Keep the Clutter to a Minimum and Tell Your Own Stories Instead

Less is more when it comes to display.

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Less is more when it comes to display. No clutter, no overwhelming signs, just our licensed opticians telling stories about frames, lenses and our unique design. With our setting in a farming community, we like to hear good stories and that is what we offer patients. Grab a coffee and graze in our optical. We’ll tell you the stories of which lenses or A/R we use, while getting to know you and how you use your eyewear. Jillynn F., Bruner, OD, Professional Family Eyecare, Coldwater and St. Marys, OH

Since launching in 2014, INVISION has won 21 international journalism awards for its publication and website. Contact INVISION's editors at editor@invisionmag.com.

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Do You Or Don't You

Cross-Training Staff is the Way Most of You Go, But Some of You Still Say ‘No Thanks’

Most eyecare business owners see value in having staff handle multiple duties.

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Yes: 86%

  • All of my opticians do it all. Kevin Bushouse, RxOptical, Kalamazoo MI
  • Techs can do front desk scheduling when front desk needs vacation time or is out sick. Richard Kemerling, Margolis Vision, Lone Tree, CO
  • I am fortunate to have same team for 12 years and everyone can complete entire process, including cutting lenses. This allows for smooth vacation time or if our lab manager is sick, we can still order and cut the jobs without feeling the impact. Of course, I prefer everyone to keep in their lane so they can be as effective as they can be. Monika Marczak, Eye Candy Optical Center, Pittsburgh, PA
  • I’ve crossed trained my staff and recently took them to Texas for training but because of the Trump economy, I’ve received two week notices from two of my staff taking higher paying jobs with benefits. Two other local practices are having the same issues keeping staff. Marc Ullman, Academy Vision, Pine Beach, NJ
  • Staff expects and takes more and more absences. That combined with increasing wages to keep good employees require offices to function with fewer staff but still have coverage, so cross training is a must. Zach Dirks, OD, St. Peter Eyecare Center and Belle Plaine Eyecare Center, St. Peter and Belle Plaine, MN
  • We are a small office. All the staff can do everything, but focus on one main task. The front desk reception only stays up front. She is the doctor’s wife and doesn’t want to learn frame dispensing. We just roll our eyes when she says, “she is too old to learn selecting/dispensing.” Allen D. Hoek, OD, Ripon, CA
  • Cross training just worksEdna Shelby, Macomb Vision Associates, Shelby Township, MI
  • We have a team of 12, and inevitably someone is sick or more than one person wants the same day off. Cross training is time-consuming, but it gives us greater flexibility and can also improve service by avoiding long waits for an OCT/photos/dispense/scheduling if someone else can jump in and help on the fly. Sarah Jerome, OD, Look + See Eye Care, Minneapolis, MN
  • Everything is everything. Everybody does all. Steve Whitaker, Whitaker Eye Works, Philadelphia PA
  • In our office, no one person has one job. Every person has the full capacity to do at least two (mostly three jobs). Opticians can file insurance or cut lenses and do repairs/adjustments. Technicians can book appointments, order contacts, scribe and special tests. This ingraftsour family to ensure everyone is and can be helped. If someone is overloaded or absent, the machine still runs. Blake Hutto, OD, Family Vision Care, Alma, GA
  • During busy times in a small office, having an available staff member help a patient is paramount in offering the customer service we strive for. Karen Santos McCloud, OD, Hamburg Vision Center, Lexington, KY
  • We cross-train in numerous ways, but the big one is this: Everyone on our staff is able to fit, measure, dispense, and sell glasses. Jen Heller, Pend Oreille Vision Care, Sandpoint, ID
  • Just being able to jump in to help another department when overwhelmed. Pam Peters, Midwest Eye, Downers Grove, IL
  • It works well when a staff member calls in sick, we are each able to cover for the other. Amy Pelak, Proview Eyecare Optometry, Corona, CA
  • We are a small office. We all do a little bit of everything. I actually want to strengthen our cross training even more. There are a lot of things I do that no one else knows how to do, and if I got hit by a bus it could get tough! Jenna Gilbertson, McCulley Optix Gallery, Fargo, ND
  • I have a small staff so a certain amount of cross training is necessary. Expertise is still required in your given title and I like to be able to train a specific person on their specific position so we can grow and take care of our patients the best way possible. Shimul Shah, OD, Marysville Family Vision, Marysville, OH
  • With cross-trained staff, we can stay open during lunch time for pick-ups and new orders. Our opticians can run the front desk and our administrative staff can handle small repairs and orders. It isn’t always seamless, but hopefully our patients can appreciate our service. Angie Patteson, OD, Sunset Eye Care, PC, Johnson City, TN
  • What I tell our staff is that no one person is better than anyone else. We train all our staff to have the ability to do every day to day task needed to keep the patients and our practice happy. No one person is too good to take out trash or clean, or pre-test or educate a patient on what frame looks and fits the prescription best. All members of the team can advise a patient the reason behind the need for a particular product. It makes it so our patients have less of a wait time and a better overall experience! William Chancellor, Eye Can See Eyewear, McDonough, GA
  • We do personality and skill testing first to determine if they are a good fit to cross train in that specific department (scribe, stylist optician, claim processor, lab tech, etc.) We use tests like Myer-Briggs Type Indicator (MBTI), DISC, The Birkman Method, Wealth Dynamics and Sally Hoghead’s Fascinate (we learned about this one at the Transitions Academy in 2016. She was the guest speaker.) We do invest in these tests but some are free. We find this helps train them more efficiently and we know ahead of time if the task or skill they need to learn is congruent with their zone of genius. Diana Sims, Buena Vista Optical, Chicago, IL
  • Because we are an independent practice with seven staff members, cross training is vital when we are missing staff due to vacation, illness, staff leaving, etc. Angel Miller, Cynthiana Vision Center, Cynthiana, KY
  • All of our staff are cross-trained. We’re a new and very small office. So, all of our staff are trained in every department (optical, contact lens, welcome area, etc.) This way if one of the two employees need a day off, the other can pitch in and not a lose a beat. Shane Clark, Infinity EyeCare, Rapid City, SD
  • We have a small office with three employees. Everyone knows how to pre-test and check-out patients. That’s usually where our bottlenecks occur. Danielle Jackson, OD, Jackson Eye, Fairburn, GA
  • Front desk with insurance, OD tech with optical department. John LaShorne, Brown County Eye Care, Nashville, IN
  • We are a small three-person office so if anyone wants to go on vacation everyone has to be cross trained. We Have an employee follow one of us around for a couple weeks until they can do ok with the new job and then have them fill in every once in a while to keep up the skills. Tammy Hazelett, Wylie Vision Care, Garland, TX
  • We try and teach most employees several parts of the business. For example, our opticians can be our techs as well. Stacey Korte, Rockford Family Eyecare, Rockford, MI
  • It has worked well in all aspects; we are a small office and it is vital that everyone can help in all areas. Stephanie Crowley, Sie Eyecare, Charlotte, NC
  • Smaller practice’s need to be flexible so everyone jumps in when needed. Heather Nagucki, Brodie optometry, Perrysburg, OH
  • We currently have one front desk/receptionist that is cross trained for the tech position, another front desk/receptionist that is also trained as an optician, and a tech who is trained as an optician. Jason Stamper, Eye Care Pavilion, Davenport, IA
  • It really helps cover all aspects of the business during vacation time; anyone can rotate where needed. Kathy Maren, Comb EyeCare & Eyewear, Western Springs, IL
  • At any given point, someone in our office could be busy. This shouldn’t mean that a patient can’t be helped. As a result, we believe in everyone knowing a decent amount of each part of everyone’s job. That way, even if there are some things that can’t be addressed immediately, at least the patient feels as though they are a priority and being attended to. Christine Howard, Attleboro Vision Care, Attleboro, MA
  • Everyone needs to know how to work the front, cut lenses, do lab duties (clean, check, call work, neutralize lenses.) Dorothy Reynolds, Optical Alternatives, Milford, CT
  • Helps. Needful at times. Appreciation of others. T.S. Stephens, OD, Dr. Stephens and Associates, Vienna, WV
  • We try because in this day and age people are gone more and call in more. Likewise it is less affordable to have extra staff so having staff who can cover vital areas at times or on days that the office is short is imperative. Zachary Dirks, St. Peter and Belle Plaine Eyecare Centers, Saint Peter, MN
  • I have five employees: All five can dispense, sell, answer phones, schedule appointments, calculate and bill insurance. One is office manager also. Two of those are CL technicians. One is clerical, although two more are able when she’s out. All trained from the beginning, then then shifted to where their strength lies for the majority of the day. Dave Schultz, OD, Urban Optics, San Luis Obispo, CA
  • We’re a small practice so I personally pre-test patients, order glasses and CLs, adjust and repair frames, bill insurances, sell product, edge lenses in house, answer phones making appointments and I’m all worn out just talking about it. Jeff Grosekemper, Casa De Oro Eyecare, Spring Valley, CA
  • Telephone conversations, problem patients, training new staff, problem solving. BJ Chambers, Carrera Optical, McQueeney, TX
  • While we do believe in having expertise in specific disciplines for each person, it is important to provide basic training so each person knows a little about each other’s responsibilities. This helps in that: (1) In the event that a person is away another can provide some assistance in a person absence. (2) Team begins to respect the expertise each team member has by knowing “hands on” what another person does. Steve Nelson, Eye Candy Optical, Westlake, OH
  • All employees are trained on the phones to schedule appointments and take contact lens orders. This works well because if someone calls, they’re not put on hold. We’ve tried to train the front desk staff to do basic repairs but hasn’t worked well because opportunities are few and far between so they forget how or run into a situation they haven’t been trained on and still need to wait on an optician. Caitlin Bruno, Binyon Vision Center, Bellingham, WA
  • While most of our paperwork (recalls, insurance and patient registration) is electronic, pre-testing, OCT, Fundus, Fields and eyewear selection are performed by whoever is available. Eyewear measurements still require an optician. Dave Goodrich, Goodrich Optical, Lansing, MI
  • Front desk can do dispensing and price with insurances. Tech can do dispensing and show frames optician does all. Betty Aretz, The Eyecare Boutique, Wexford, PA
  • I wouldn’t ask you to do anything that I wouldn’t do. Jill Sweig, OD, Oyster Bay Optics, Oyster Bay, NY
  • Too small of an office to just have people special in one area. Jeff Hayden, Vision Care Center, Brighton, MI
  • Opticians answer phones and do check out. Jill Schnurer, Village Eyecare Co., Clarkston, MI
  • I only have two staff members. They have to be able to do each other’s jobs if necessary. Kimberly Riggs OD, Ligonier, PA
  • Cross-training our optometric technician in the matters of insurance eligibility, types of lenses, frame adjustments, etc. It allows her to fill in where necessary if a co-worker is ill or if our office is very busy. Cassandra Nash, HD Optical Express, Lansing, MI
  • Just in case someone’s on vacation or sick. Larry Wiggins, UseeMe, Rockville, MD
  • I am a one-person operation so I have to know how to do everything! Julie Uram, Optical Oasis, Jupiter, FL
  • We’re a small office so it’s a necessity. Rick Rickgauer, Vision Associates, Girard, PA
  • In a small office (six staff) we have to cross train because when staff go on vacation or sick, they have to be able to fill in different job titles. Scott Keating, OD, Vision Trends, Dover, OH
  • My scribe can tech and my tech’s can scribe. Everyone in the office can answer the phone, schedule appointments and answer general questions. We are a small office so cross-training is essential. Selina McGee, OD, Precision Vision, Edmond, OK
  • Opticians can pre-test our patients as well as answer phones and make appointments if needed. Theodore Sees, OD, Rockford Family Eyecare, Rockford, MI
  • Two licensed opticians do everything. Front desk can also prescreen patients and occasionally will deliver an Rx if needed. Texas L. Smith, OD, Dr. Texas L. Smith & Associates, Citrus Heights, CA
  • Our staff can run the front desk, work up patients frame style and adjust frames. Our intern also learns these important procedures. Robert M Easton, Jr., OD, Oakland Park, FL
  • Sales should know data entry and select staff is chosen for duties like ordering frames/lenses and insurance submission. We will see who’s able to be cross trained to do particular side work. Kaleena Ma, MK Vision Center, Forest Hills, NY
  • I have my office manager work on occasion in the vision therapy arena. There are times where my vision therapist has taken over some office clerical duties. Everyone works the optical area. Pauline Buck, OD, Behavioral and Developmental Optometrists, Miami, FL
  • We are a small five-person staff (plus 1 doctor) office and so being able to be out front, do auxiliary testing, and work with issues on glasses is essential to our success. Bridgett Fredrickson, Whelan Eye Care, Bemidji, MN
  • We train our clinical staff to help patient select eyewear. They establish a rapport during the exam process and we feel it translates nicely for when the patient is picking out eyewear. Vlad Cordero, Focus Eye Care PC, Hackensack, NJ
  • All of my employees are cross-trained. I can’t imagine it working any other way. As a small business owner knowing that I am covered if there is a call-off or vacation time puts my mind at ease. Each employee still has the thing that they are MOST responsible for, but each can pre-test, schedule, sell, and edge lenses. And I, as the doc, can also do ANY job at my office. Cynthia Sayers, OD, EyeShop Optical Center, Lewis Center, OH

 

N0: 14%

  • I’m a one-man shop. Kevin Count, Prentice Lab, Glenview, IL
  • It’s me (owner/optician) and a part time secretary. I’m a control freak so I have slowly let her do insurance billing, a little selling, and paperwork but I do the bookkeeping, edging, repairs, selling, adjustments. Jennifer Leuzzi, Mill Creek Optical, Dansville, NY
  • I think this would be a good idea but the size of our company makes it hard for a person to learn and retain that much. Smaller locations of ours we have started to try this and it has been helpful. Jocelyn Mylott, D’Ambrosio Eye Care, Lancaster, MA
  • We are understaffed and there is no time to cross-train. I help out when needed, but can only do so much. Frances Ann Layton, Eye Associates of South Georgia, Valdosta, GA
  • New staff needs to be trained first before we cross train. Pablo E Mercado, Mount Vernon Eyecare, Dunwoody, GA

What’s the Brain Squad?

If you’re the owner or top manager of a U.S. eyecare business serving the public, you’re invited to join the INVISION Brain Squad. By taking one five-minute quiz a month, you can get a free t-shirt, be featured prominently in this magazine, and make your voice heard on key issues affecting eyecare professionals. Good deal, right? Sign up here.

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Danielle Richardson

Daily Habits that Kill Productivity

These four things will obliterate your focus.

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DISTRACTIONS. DISTRACTIONS. DISTRACTIONS. In a perfect world, there would be none. We’d wake up, have our coffee, and head to work for a productive day crossing everything off our to-do lists. I’d love to visit this dream optometry land but realistically, on any given workday, there seems to be 100 things vying for our attention. It’s super easy to get off course and lose focus.

We can’t control everything that pops up to disrupt our flow, but we can control our actions. Many of us have pesky habits that kill productivity and make it hard to focus. Identifying and making modifications in our habits can help the day run more smoothly. Do you suffer from these productivity killers?

Social Media Breaks. Raise your hand if you’re guilty of checking social media during the workday. We all are! Punctuating the day with social media is the easiest way to kill productivity. You don’t need to post a status ranting about your complicated contact lens fit. It’s estimated the average person will spend about five years, or 116 minutes per day, on social media in their lifetime. Reclaim those minutes spent mindlessly scrolling and focus on the task at hand.

Multitasking. By far this is the worst habit we all have. Being a clinician requires us to do multiple things at once, but multitasking can have the opposite effect of the one we seek. The more we try to juggle, the more we stretch ourselves thin; in fact, studies have shown multitasking can reduce productivity as much as 40 percent. As a yoga teacher, I often invoke the principle of “be here now.” Be present to what you are doing at the moment.

Not Sleeping Enough. It’s counterintuitive, but you cannot be your best self without those 8 hours of rest. Arianna Huffington is trying to create a sleep revolution for good reason. We live in a society that praises entrepreneurs who run on three hours of sleep, but have we asked ourselves why? Sleep deprived people are more at risk for high blood pressure, obesity, and other adverse health conditions. Instead of picking up an extra cup of coffee to improve your focus, try heading to bed earlier.

Stressing About Things You Can’t Control. Stress is an emotional drain that depletes us of the energy necessary for focus and productivity. You don’t have to be a Zen monk to understand the philosophy of letting go of what is outside of your control. Anxiety and worry are the background chatter running through most of our heads and, when left unchecked, they can affect our behavior, making it hard to focus on the present. Nix this negative habit by picking up a mindfulness practice to help de-stress and refocus on your internal locus of control.

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Real Deal

A Difficult Teenager, Absent Parents and Unacceptable Behavior … Kick the Kid Out or No?

This office wants to show a pre-teen the door – should mitigating circumstances change their minds?

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IT WAS LATE MORNING and patient care was in full swing at a large optometry practice in Detroit. Doctors and technicians hustled patients between rooms, and the phone rang incessantly.

ABOUT REAL DEAL
  • Real Deal scenarios are inspired by true stories, but are changed to sharpen the dilemmas involved. The names of the characters and stores have been changed and should not be confused with real people or places.

 

ABOUT THE AUTHOR
  • NATALIE TAYLOR is owner of Artisan Eyewear in Meredith, NH. She offers regional private practice consulting and ABO/COPE approved presentations. Email her at info@meredithoptical.com

Technician Carol headed to reception to call in the next patient, 15-year-old Jennie. “Do you have a parent with you?” asked Carol, scanning the room. “My dad dropped me off,” she replied flatly. “It’s fine.” Carol shrugged and led Jennie to pretest. She began reciting her script of instructions, but Jennie threw her off quickly. “Is this the puff of air?” she asked dramatically. “No,” said Carol, “like I just said, it’s an auto refractor, it’s just a picture. Nothing is going to touch you.” Jennie was clearly skeptical, and kept pulling her head away from the forehead rest. Carol worked hard to convince Jennie to keep her head still, but only captured one good reading in each eye. She didn’t bother asking Jennie to use the non-contact tonometer, and escorted her straight to an exam room. That’s when Carol’s challenges really began.

Jennie refused to disclose her health history or medications, left the room twice to use the restroom, and repeatedly challenged Carol’s competency. Twenty-five minutes later Carol still hadn’t completed Jennie’s work-up. Saying she needed something from another room, Carol found a quiet place down the hall and took a minute to collect herself. When she returned, she immediately noticed the 90D and 20D lenses were missing from their regular places. She wrapped up the exam and found office manager Ed. “I think my patient is trying to steal from the exam room,” she whispered. Ed frowned and followed her into the exam room. “Hi Jennie, I’m Ed the manager,” he said, standing in the doorway. “Can you please check your pockets and backpack for anything that might belong to our doctors?” Jennie scoffed, her neck and arms erupting in hives. Time seemed to stand still. “Screw you!” she eventually yelled at Carol, who threw her arms up in exasperation. The exchange drew Dr. Cox out of her exam room. “What’s going on?” she asked Ed. As she neared, something hard struck the back of her hand. She yelped in pain as a 90D lens hit the floor then rolled fast along the baseboard. Dr. Cox looked up to see Jennie palming the 20D, a look of shock on her face. “I didn’t mean to hit you!” she said, clearly scowling at Carol. Panicking, she dropped the lens and grabbed her coat. “Move,” she said, and Ed finally cleared the doorway. Jennie flew around the corner and out the front door.

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Dr. Cox motioned Ed and Carol into the empty room and closed the door. First Carol, then Ed recounted the last half hour’s events, concluding with the same thought: “We have to fire her from the practice!”  Dr. Cox, gingerly massaging her hand, raised her eyes to the ceiling. “Jennie’s mom is my husbands’ boss,” she said slowly. “I am going to make a call after I get back on schedule, and we will figure this out.”

Hours later, Dr. Cox’s cell phone received a voicemail from Jennie’s mother. She explained how Jennie’s behavior over the last few months had been worrisome, and they were receiving assistance from a psychologist in addition to the pediatrician. She begged Dr. Cox to let Jennie return the next day to complete her exam, and promised to attend with her daughter.

The Big Questions

  • What considerations should a practice have when dismissing someone under 18 years old?
  • If Dr. Cox decides to allow Jennie back, the staff won’t be pleased. Is there a way to mitigate this?
  • At what point did Jennie cross the line, based on your office’s culture? Would you allow her to return?

Expanded Real Deal Responses

Judy C. Virginia Beach, VA

The first problem was allowing an underage child to be seen without a parent or guardian in attendance. That’s should never be allowed. Additionally, I don’t see dismissing an underage patient without a consultation with the responsible adults. The staff may not be pleased, but that should not affect their professional performance. If it does, there is a bigger problem to be addressed. Jennie crossed the line when she refused to participate in the pre-test workup and she should only be allowed to return with a parent or guardian.

Stewart G. San Francisco, CA

Why was this patient seen without a legal aged family member? The patient should have been kept in the waiting room until the adult relation arrived and could be present during testing. This child is a thief. She could have also declared that the staff touched her inappropriately causing a lawsuit and a ruined career.

Dennis I. Monroe, CT

Our office is very specific towards seeing unaccompanied minors. NO! If it is a new patient; definitely not! If a new patient’s parent insists, then we discuss the nature of liability in these situations. That usually ends with the parent making the appointment when they are available. If it’s a patient that the office is familiar with, there may be exceptions, but the answer is most often if not always: NO. There is too much that we as physicians are responsible for and parents need to be… Parents. There is too much at stake to see an unaccompanied minor.

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Donna R. Mission, BC, Canada

I once had a patient threaten to punch me when I did the NCT on her. She yelled at me loud enough for the doctor to come out. She quickly tried apologizing and said I scared her. He opened the door to the office and said he would happily send her file to any other doctor she wanted. If you know your child is having issues then you make arrangements to accompany them to appointments. There is no excuse for theft. As for the husband’s boss connection, that’s an employee standards issues if they take it out on you.

Kinga B. St.Catharines, ON, Canada

Really the issue here is that she has behavioral issues, and I don’t think they would magically go away at 18, only the legal issues change. There should be a policy that minors of any age can be seen alone provided they can BEHAVE like an adult. The conversation should be had with the person booking the appointment at the time of the appointment and if not, then at the time of the reminder call. Perhaps an email of expected behavior could be sent to the parent or student, or simply stated that any behavior not allowed at school is also not allowed at the optometrist’s office. And it should outline the concentration they are expected to have so the exam can proceed. There should be an open door or 3rd party policy to prevent the allegations of sexual abuse also. The first time any child or teen shows up there could be a behavior agreement they have to sign. Most kids are fine but with the high rates of autism/Asperger’s and general behavioral issues, and the large number of frazzled parents who can’t take the time to accompany their kids, there has to be a line in the sand and the office needs to set expectations.

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Erin J. (From Facebook)

Bye, Jennie! The lip I could look past, and would let her come back with a parent at our earliest opening (usually about two weeks out). However… the thieving and assault on my staff? No. That behavior would get you banned from any business, and possibly charged. My business is no exception.

Rick R. Girard, PA

1. Why would the parents let her come alone knowing she had problems? There is a parental issue to deal with. 2. It’s Dr. Cox’s office so I don’t think the staff should be upset. If they are that’s another issue. It’s not like Jennie threatened violence. 3. She crossed the line by stealing. Whether she can return should be based on all available info and Dr. Cox’s decision. Because I sometimes stupidly believe the best in people, I would allow her to return.

Dr. Texas S. Citrus Heights, California

No minor should be examined without another adult present—ever! I would do the pre-screen myself on the next visit. During the exam I’d show her what bio lenses are for. I’d dilate her mom, put the bio on Jennie and have her look into her mom’s eye. I’d ask Jennie if she had questions and be sure she leaves with pens, a makeup mirror, and eyeball keychain, but not my bio lenses or lens clock (I’ve lost three in 50 years). If Jennie needs an Rx, have your most tech-savvy optician take pictures during frame selection. If she balks at these, drop it.

What’s the Brain Squad?

  • If you’re the owner or top manager of a U.S. eyecare business serving the public, you’re invited to join the INVISION Brain Squad. By taking one five-minute quiz a month, you can get a free t-shirt, be featured prominently in this magazine, and make your voice heard on key issues affecting eyecare professionals. Good deal, right? Sign up here.

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