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The 19 Contrarian Rules of Business

Don’t promise excellent service? Run annoying ads? Business leaders insist these counterintuitive principles work.

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To make a point about how our brains operate, the American neuroscientist Gregory Berns likes to encourage people to close their eyes and imagine the sun setting on a beach. If you just tried it, odds are the image that arose was the clichéd one — a warm tropical island scene, most likely framed by the fronds of a palm tree, awash in orange, as opposed to, say, a dark, wind-whipped pebble beach off the coast of northern Scotland.

The brain “is fundamentally a lazy piece of meat,” Berns writes in his book Iconoclast. It needs energy to operate and has evolved to use it as efficiently as possible. As a result, it defaults to using as many shortcuts as it can — past experience, other people’s opinions, common practice — to avoid the taxing effort of perceiving or imagining afresh.

There are, of course, people who make it a habit to buck convention, who have a knack for seeing something no one else does. Berns refers to these disruptive original thinkers as “iconoclasts.” Generally, they are probably better known as contrarians. These are the brave and often odd souls whose questioning of the conventions of society or their professional field have repeatedly caused history to change course or leap forward.

In business, entrepreneurs are often contrarian by definition — they see value and opportunity where others do not. The contrarian investor Bill Gurley notes that “you can only make money by being right about something that most people think is wrong.”

The idea of being an independent spirit appeals to many. Of course, by definition, it’s not possible for the majority to be contrarian, even more so in a tradition-bound industry like eyecare. But as a magazine geared specifically toward independent ECPs, we suspect many of our readers consider themselves liberated operators charting their own destinies in a world where most of their peers opt for the security of more regular employment.

However, it’s not easy being a true contrarian. There is the risk of ridicule, having to live with constant uncertainty. Being contrarian for the sake of contrarianism is pointless.

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There is, unromantically, much to be said for doing the things the timeworn “best practice” way. We thus begin our exploration of contrarianism with a caveat — doing something differently is exciting, possibly liberating, often far more lucrative than the conventional way … and often dangerous. Go charging away from the herd with care. Ultimately, you want to choose from the following ideas — new or old, intuitive or rational, bizarre or conventional — the ones that serve you, and your business, best.

The customer is not always right

1It’s actually irrelevant if a customer is right or wrong. This is, after all, a commercial transaction, not a debate. Just because a customer wants, needs, or expects something does not mean that delivering it is the best thing for your business. Indeed, “keeping certain customers happy can be a horribly inefficient and downright distracting way to run a business,” note Brent Adamson, Matthew Dixon, and Nicholas Toman in an article in the Harvard Business Review. It’s also not much fun.

As a business owner, you need to make decisions that best apply your company’s capital, intellectual energy, and product capabilities. Rather than customer satisfaction, the ultimate goal should be running a sustainable business. Have a written, legally defensible terms of service statement, warranties, guarantees, and a simple process to determine which clients or customers deliver the strongest ROI and which are actually costing you money. In some cases, it’s better for long-term growth (not to mention staff morale) to jettison a high-maintenance client and focus on improving the quality of your customer base.

Don’t give your
staff the resources they need to fix a problem

2Constraints breed resourcefulness. This is an idea that has been gaining influence in business circles for the last few years. “Is there something in the nature of constraints that brings out the best creativity?” writes Scott Berkun, the author of Mindfire: Big Ideas For Curious Minds. Consider a good haiku or sonnet, and the answer is obviously yes: it’s precisely the limits of the form that inspire new ways of working inside them. In the workplace, that means no more “blue sky” brainstorming: if you want the best answers to a question, focus it narrowly; consider a time limit, too. Google sometimes puts fewer engineers on a problem than it needs; it inspires ingenuity. Behind all this is the counterintuitive insight that discipline and structure are often the path to freedom, not its enemy. See constraints as a game. Not only are games about fun, but they are distinguished by the rules that govern them.

Ignore terriFfic opportunities

3One of the dangers of business success is that it leads to more opportunities. Pursue them at your peril. In business, there is always a trade-off. Doing one thing well invariably means you can’t do another at a high level as you spread yourself too thin.

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The result is a damaging mediocrity.

In his book, Essentialism: The Disciplined Pursuit Of Less, Greg McKeown cites studies that show the loss of focus is a key reason companies fail. The antidote? Spurning good opportunities. “Not just haphazardly saying no, but purposefully, deliberately, and strategically eliminating the nonessentials. Not just getting rid of the obvious time wasters, but being willing to cut out really terrific opportunities as well,” he says. “Few appear to have the courage to live this principle, which may be why it differentiates successful people and organizations from the very successful ones.”

Don’t believe in ‘long work’

4Few things are as American as the belief in the merit of hard work. The problem is too many small business people confuse work and progress. A day when lots of things get done, when you arrive home exhausted after holding six meetings with staff and vendors, clearing 300 emails from your inbox, and finally straightening those old files in the backroom, sort of feels like a productive day, but it’s unlikely to have helped your business take the next step forward. Marketer Seth Godin calls this bias for efficiency over effectiveness “the trap of long work.”

“Long work is what the lawyer who bills 14 hours a day filling in forms does. Hard work is what the insightful litigator does when she synthesizes four disparate ideas and comes up with an argument that wins the case—in less than five minutes.
“Hard work is frightening because you might fail. You can’t fail at long work, you merely show up.”

The management guru Peter Drucker suggested the best way to address this issue was by constantly asking yourself the question, “What’s the most important thing for me to be doing right now?”

Think Small

5In his 1994 book Built To Last, Jim Collins introduced the world to Big Hairy Audacious Goals, or BHAGs, his term for the ambitious long-term goals that he argued galvanized successful companies. And it seems the term is rolled out in every discussion of good business practice. But the problem is that the excitement, energy, and envelope-pushing boldness stirred up by such endeavors often dissipates quickly in the face of the day-to-day running of business. Worse, such big-picture thinking, telling yourself something is epic and of crucial importance, often leads to fear, resistance and ultimately inertia and disappointment. As the psychologist John Eliot writes in his book Overachievement, “Nothing discourages the concentration necessary to perform well … more than worrying about the outcome.” The marathon runner who’s reached a state of “flow” isn’t visualizing the finish line, but looking through a narrower lens, focusing on one stride, then another, then another. Like the formula for contentment (happiness = reality – expectations), it’s often better to forget the end goal, aim low and just focus on the process if you really want to get things done. This can apply to everything from setting lower targets for salespeople (spurred on by achieving the goal, they will often break through and hit a higher number) to big projects. The young Jerry Seinfeld’s scriptwriting technique involved marking an X on a calendar for every day he sat and typed. His goal was an unbroken chain of Xs. If he’d aimed instead to write masterful jokes, he’d have been distracted and intimidated.

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Forget audacious. Just go do it.

Get Rid of the rules

6Too often, managers assume the key to improvement must be clearer procedures, more exactingly enforced. But the result is organizational structures that permit zero autonomy — and extremely annoying customer service (“Sorry, sir, our policy doesn’t allow you to …”). Perhaps even worse is that such management fails to capitalize on the talents of those lower down the hierarchy. Zappos’ contrarian founder Tony Hsieh made headlines a few years back when he said he was rolling out “Management by Holacracy,” which eliminates the traditional oversight role of the manager and instead relies on the employees themselves to decide how to get their day-to-day responsibilities completed on the basis that they probably know best. That may be too much for most business owners, but according to Harvard Business School research, “loose monitoring” of employees makes for higher profits as well as happier workplaces. Striking the right balance between autonomy and control is very likely the essence of being a good manager.

Don’t ask for the sale

7The traditional approach to selling says tout the benefits, close throughout, finish with an assumption and then push for the add-on followed by another. You’re just efficiently taking the customer in a direction she wanted to go anyway. In contrast, the “slow sales” movement, which has been gaining ground for a few years, argues that there are intelligent, deliberate customers who prefer an almost “do-it-your self” zero-pressure environment. Granted, getting them to the cash register may take longer. But according to Inc. magazine, this technique alleviates the extra costs of post-purchase dissonance from returns, customer service time, negative feedback, and customer churn.

Stop asking, “Where do you want to be in 5 years?”

8Hiring employees who will challenge management is another staple of business advice, but everyone has probably worked with “yes, but” employees who basically oppose every new idea and approach. To find true contrarians, Peter Thiel in his book Zero To One recommends asking the following question when interviewing employees: “Tell me something that’s true that nobody believes in.” (God, global warming and aliens don’t cut it.)

Forget trying to fix your weaknesses

9In a series of bestselling books, the Gallup consultant Marcus Buckingham has made a persuasive case for a strengths-based approach to life and business: it’s both more effective and more enjoyable, he argues, than struggling to fix your weak spots. According to Buckingham, most people try to “plug” their weaknesses, while the really successful focus on exploiting strengths. The weakness-plugger is the employee who goes on courses to become less awful at public speaking, when she’d be better off in a job that calls on her written skills. You’ll rarely improve a weakness beyond mediocrity, argues Buckingham, not least because it’s hard to invest sustained energy in something you don’t enjoy. If you truly know what you’re bad at, you’re already ahead of the pack. Don’t throw that away by wasting your time getting slightly less bad.

Give away your time

10Overwhelmed by work? Feel you are in a constant race against the clock to get things done? Try making some time for others. “While it might seem counterintuitive to sacrifice some of the very thing you think you don’t have enough of, our research shows that giving a bit of time away may, in fact, make people feel less pressed for time and better able to tick things off their to-do,” Cassie Mogilner Holmes, an associate professor at UCLA and Michael Norton, a professor at Harvard told the Wall Street Journal. Another hack to deal with time scarcity — erase a day from your schedule. Busy? Don’t schedule anything for Fridays. The work you didn’t get done will flow over … and you’ll finally knock off those to-do list items.

Look for mentors and staff who do it the “wrong way”

11Tim Ferriss has an interesting approach to considering contrarians: Be on the lookout for the anomalies, like the wispy girl who can deadlift 405 pounds. They’re performing with techniques rather than genes. “These iconoclasts show the differences in techniques and attributes,” he says. “If someone has become really good at doing something in a very nonstandard way, you can infer that the standard path isn’t necessarily the best methodology for learning a skill.”

Be last to market

12Among business gurus, few things are as unquestioned as the notion that innovation is the path to success. “Innovate or die!” goes one mantra. Yet if innovation was a surefire way for companies to achieve dominance, the world might look very different. White Castle, RC Cola, and Diners Club were all innovators, but think of fast-food, soft drinks and credit cards, and those are unlikely to be the first names that come to mind. The upsides of unoriginality are clear: imitators let others make the costly mistakes, and if they’re clever enough, can incorporate the lessons learned into a far better product. (Exhibit A: the iPhone) In his book Copycats, the management theorist Oded Shenkar argues we need “to change the mindset that imitation is an embarrassing nuisance.” Rather, it’s a “rare and complex” capability, one we could all do with cultivating, he says. In his book Zero To One, Thiel argues that “it’s much better to be the last mover — that is, to make the last great development in a specific market and enjoy years or even decades of monopoly profits.”

Drop some F-bombs

13The eyecare world is one of patient care, education and professionalism, not the place for profanity. Yet swearing, when done judiciously, according to various psychologists, boosts endorphins, promotes social bonding and makes people more persuasive. Periodically, let your staff and customers know you’re human.

Stop holding meetings

14Jim Buckmaster, chief executive of the hugely successful website Craigslist, has a simple policy — “No meetings, ever.” There are several reasons why meetings don’t work. They move, in the words of the career coach Dale Dauten, “at the pace of the slowest mind in the room,” so that “all but one participant will be bored, all but one mind underused.” A key purpose of meetings is information transfer, but they’re based on the assumption that people absorb information best by hearing it, rather than reading it or discussing it over email, whereas in fact, only a minority of us are “auditory learners.” The key question for distinguishing a worthwhile meeting from a worthless one seems to be this: is it a “status-report” meeting, designed for employees to tell each other things? If so, it’s probably better handled on email or paper. That leaves a minority of “good” meetings, whose value lies in the meeting of minds itself — for example, a well-run brainstorming session.

Run annoying ads … often

15There’s a reason that grating TV ads work: the more they grate, the more you’ll notice them, and noticing — thanks to what psychologists call the “mere exposure effect” — leads to liking.

Depressingly, whatever we’re repeatedly exposed to, and regardless of any other reason to like or dislike it, we’ll end up growing fond of. According to Roy H. Williams, author of The Wizard Of Ads, there’s actually no way for successful advertising to avoid being irritating to some degree. “Ads that twist our attention away from what we’d been doing are always a bit annoying,” he says. But if you fail to get your audience’s attention, your ad has failed at the first hurdle. “Consequently, most ads aren’t written to persuade; they’re written not to offend. But the kinds of ads that produce results make us answer “yes” to these three questions: Did it get my attention? Was it relevant? Did I believe it?” Williams claims 98.9 percent of all the customers who hate your ads will still come to your store and buy from you when they need what you sell. “These customers don’t cost you money; they just complain to the cashier as they’re handing over their cash.”

Don’t promise excellent customer service

16Ask independent ECPs what is their point of competitive advantage and they’ll overwhelmingly say excellent customer service. But, something big corporations know (but never publicly say) is that delivering excellent customer service ultimately results in unhappy customers. Thus the field of “expectations management.” “If you want satisfied customers, it’s certainly wise to act in ways that will satisfy them. But it’s also wise to pay attention to (and, if possible, influence) their criteria for feeling satisfied,” writes Oliver Burkeman in the Guardian. Training customers, employees, and partners not to expect a “yes” in response to every single request might be crucial for preserving sanity. Far better to have a reputation as an ECP who, for example, turns around a repair within three days than one who does it overnight — because in the latter case, as soon as you fail to deliver on that tight deadline, you’ll be seen as underperforming.

Don’t be so professional

17We live in an era with more opportunity than ever to burnish the image we’re projecting, and more pressure than ever to do so. But in her new book, Cringeworthy: A Theory Of Awkwardness, Melissa Dahl makes a persuasive case for celebrating those times when “someone’s presentation of themselves … is shown to be incompatible with reality in a way that can’t be smoothed over.” Awkwardness pierces that facade, exposing the imperfect life behind it. Quoting the words of the philosopher Adam Kotsko, she says it creates “a weird kind of social bond” — a solidarity arising from seeing that behind the fakery, we’re all just trying our best to seem competent. The awkward you, then, is the real you, the one without the defensive performance. And people will like you for it.

Ask customers for favors

18The “Ben Franklin effect” states that if you want to get someone to like you, you should ask him or her to do you a favor. The strategy, named for the founding father’s habit of borrowing books from opposing politicians to win them over, works because humans hate cognitive dissonance: we can’t stand a mismatch between our actions and thoughts. So if we find ourselves helping someone out, we’ll unconsciously adjust our feelings for them. The implications are striking. Don’t suck up to your customers — ask for favors or even just their opinions (“Where do you think the economy is headed?”).

Hire more introverts

19On the surface, introverts don’t seem to have the makings of great salespeople or even managers. Social interaction tires them, they have trouble with insincere flattery, they don’t like to push people, and they don’t tend to contribute vocally to meetings or brainstorming sessions. But there are positive flipsides to all this: introverts tend to demonstrate a higher degree of sensitivity in emotional interactions, they are more likely to be experts in their field, they are less likely to be yes-men or women, and as for managing people, they do better than extroverts when the staff itself is full of self-directed go-getters. “Although extroverted leadership enhances group performance when employees are passive, this effect reverses when employees are proactive, because extroverted leaders are less receptive to proactivity,” says Susan Cain, author of Quiet: The Power Of Introverts In A World That Can’t Stop Talking.

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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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New Owners Weigh In On the Hardest Part of Their Business — Starting It

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They say that starting is the hardest part. If that is true, then these ECPs—whom we asked to share their businesses’ origin stories while they are basically still happening—should have it pretty easy from here on out, right?

Kidding aside, if you’re curious about what happens in that space between idea and execution, we’ve got the perspectives of four new business owners who implemented different models and priorities as they got off the ground. From business plans to securing financing, from what they’d do differently to advice for others looking to branch out on their own, read on for all the fascinating details.

A FAMILY AFFAIR

Julia Laval and Anissa Laval
Cutting Edge Optics, Berkeley, CA
Opened: November 2018

We are a mother/daughter optician duo and opened Cutting Edge Optics in November 2018 located in the charming Elmwood community on one of Berkeley’s busiest streets, College Ave.

Julia also owns Montclair Optical in Oakland. Montclair Optical boasts a long history; it has been in business for 42 years and passed down through several generations of opticians in our family for the last 35. Montclair Village has its own lab and Julia has been the technician in charge of cutting all lenses for the last few years.

I have been an optician for the last nine years. I learned my skills from my mother; observing the techniques needed to succeed in the business. If not for having seen first-hand how to correctly understand lenses, prescriptions and frames, my climb into the business would have been much steeper. I’ve worked under enough doctors to understand how not to run a business, enough that I knew I was ready for this adventure.

We opened Cutting Edge Optics because of our passion for opticianry. We are bringing true optical knowledge, new techniques, and unique, fresh brands to Berkeley. As two opticians with genuine love for this profession, excellent service comes naturally to us. We take our time, offering personal attention to every customer, and supplying a broad yet original selection of glasses to guarantee the perfect fit, customized in every way: from color and lens shape, to the glasses-buying experience itself.  

The shop was previously owned by an optician who was ready to move on. The decor was entirely white. Our aesthetic is based on a New York studio loft. When we took over, we painted and put up a gorgeous plant wall as the focal point. It pulls in the green, sustainable and eco-friendly aspect of the neighborhood, fitting these values into our urban aesthetic. The large windows create an airy, inviting feeling. We play music from all over the world, including Africa and Central and South America. We even mix in a little French rap.

This store has an extensive business plan. After more than 30 years of success in Montclair, it was natural to apply those guidelines to Cutting Edge. We are very serious about the buying process and making sure we don’t overspend on frames. Optical businesses fail in one category: how big their eyes get when a rep walks in verses how much they have in their bank account. It should never be a race to rush patients in the door just to cover your costs month to month.

Julia knew from experience what was needed to financially support the business and get it off the ground, and Anissa knew how to deploy social media and advertising to generate a buzz before the doors even opened. Before Day 1 our Instagram had over 700 followers and we gave hour to hour updates and sneak peeks. Business has been busy from the first day.

We constantly push ourselves to keep our patients informed about what we’re doing next. Social media gives us a platform to align brands with specific people. Every brand introduction and major event is published online. Photographer Dione Green (@Dione.Green), who took our photos, is key. We also advertise a lot with the Elmwood community newsletters.

Business, especially starting cold, can be a waiting game. When you revamp an established business, you’re going to deal with customers who are accustomed to the old way, the old prices, and the old frame selection; these loyal customers can take a while to warm up to changes. One of the most important lessons we’ve learned is not swaying to please everyone.

Annisa (l) and Julia Laval have brought true optical knowledge, new techniques and unique, fresh brands to Berkeley, CA, with Cutting Edge.

In terms of advice, make a detailed guideline to how you want to financially run your business and stick to it. Our way is to make a frame board. Our frame board details how many frames can fit into a section and how much money we are willing to spend on that section. You may think more is better but picking the right frames for customers is smarter than having as many as possible. Listen to your gut, not the rep! For example, if I’m buying 60 pieces of Garrett Leight, I need to ask myself how much I’m spending and how far they will get me before I have to repurchase. Then I need to consider what happens if 35 percent of those frames don’t move. I cannot purchase Caroline Abram just for its beauty, I have to consider who is going to buy these frames and is it worth having the same frame in three colors.

Also, have a social media advisor. Social media is the new Yelp. Without a visual aid to generate intrigue for customers, you’re doing your business a disservice and damaging its ability to grow and make profit. Social media is a digital lasso for new customers.

QUICK Q & A

What was the first major milestone you celebrated?
We wanted to open as dramatically as we could. Our doors and windows were covered then we did a large reveal online and on the Elmwood community site. We were met with overwhelming support.
Have you already had to break up with a patient/customer or vendor?
We have had to break up with many vendors and bring in new brands.
Has the business made you cry?
Of course! If a business doesn’t make you cry, you’re not working hard enough.
Would you have done anything differently?
No.
What’s been your most empowering moment?
A customer who had been looking for frames for over three years left with six. She later came back with three friends who all purchased.
How long did it take until you felt like were gonna make it?
Instantly. Business grows if you control money flow. Everything else comes easy.
Do you ever feel like you’ve made a terrible mistake?
Never. You have to be confident in your ability to succeed.
What do you do to help overcome doubt?
We sit in the office every time we feel overwhelmed and say: “There’s no way we are going to fail.”

 

GOING HOME AGAIN

Erika E. Mabus, OD 
Muncy and Laporte, PA
Opened: September 2018

I established my corporation on July 26, 2018 and officially signed closing documents on Sept. 6, 2018. I purchased it from an optometrist who had been practicing in the same location for the last 20 odd years. It’s 12 miles north of where I grew up and 25 miles south of where I live now. It was well-established, privately-owned, and one of very few independent offices in my area. I believe in private practice optometry and I am excited to officially be practicing in that capacity. 

I’d been contemplating my own practice since graduating from optometry school in 2013, and the timing just felt right. The optometrist had plans to retire soon, so it’s been a nice way for us to transition patients and give me time to pick his brain on the business aspects. 

I spent months going over the financials with an accountant and business advisor, as well as a lawyer with expertise in accounting and business acquisitions. I was surprised at how long it took for lawyers to go back and forth to on the contract’s terms. The retiring doctor and I began the process in April 2018 and finalized it September.

I secured financing through PNC Healthcare Business Banking and have been extremely happy with the help I received before, during, and after the purchase. I contacted a few smaller local banks, but they asked for high down payments or collateral; PNC made it simple and easy. 

I made a business plan, but just as everything in the world evolves, so has my idea of how my practice should run. I am happy with what I have accomplished in the last seven months of ownership, but I am always striving to do better. Currently, I am considering a consultant for more accountability and to keep myself on track, but also to help me achieve my future goal: comfort with the cost of new technology to set my office apart. 

Part of the appeal of private practice in a rural area is that patients feel at home. My team greets every patient by name and in the exam room I always try to make at least one personal connection. I recently saw an older patient I thought may have patronized my grandfather’s business years ago. We reminisced about the time he and his father spent in my grandfather’s hardware store. 

Taking over from an established OD where she grew up was Dr. Mabus’ way to ownership.

The retiring doctor and I put up a photo in the waiting area with a note welcoming me to the practice. I advertised with local high school sports teams and drama club programs and T-shirts. I also contacted the local newspaper for a “spotlight on business” article which brought a lot of business to my new location without any cost to me. 

The day we signed the agreement there was a full book of patients and it’s been that way ever since. Keeping the same staff with the retiring doctor still seeing patients has been a huge help. Patients are getting used to the idea of another doctor and they get one final visit with their previous optometrist. I opened a second location cold in January and I am just now starting to have a full day of patients there after a few weeks of one to five patients a day. 

I am happy with the quality of medical eyecare I provide, but I’d love to incorporate more advanced dry eye treatments. It is one of my personal passions, since I experience it myself. I also hope to become more skilled at specialty contact lens fittings to differentiate myself and complement my dry eye treatments. I thought I would be ready to jump in and purchase more equipment the first year, but now I hope to do so in year two. 

If anyone else is thinking of purchasing or starting their own practice, I would recommend getting an excellent set of advisors: a good lawyer, a competent accountant, and a business advisor. Having people to help is huge. My other advice is to integrate yourself into your community. Patients love to make connections with you, and that’s easier if you go to the same restaurants, know the schools, join the same gym, or shop in the same places.  

QUICK Q & A

What was the first major milestone you celebrated?
I brought in two new independent frame lines that focus on sustainability — TOC lunettes Monkey Glasses and David Green Eyewear
Have you had to break up with a patient/customer or vendor?
Not yet, thankfully. Has the business made you cry? e Not yet! But I have had a few sleepless nights since September
Would you have done anything differently?
I would have set up my website sooner, which is still not complete.
What’s been your most empowering moment?
I still see patients at two other retail locations on evenings and weekends. When I tell them I have two private practices, they tell me that they are excited to see me there next year.   
 
How long did it take until you felt like you had it under control?
About three months, although there are still times when I feel like I’m lost with the business aspects. 
Do you ever feel like you’ve made a terrible mistake?
Not yet. Even when I am working seven days a week because I know in the end all the hard work will directly benefit me, not someone else.
What do you do to overcome doubt?
I breathe. I meditate. I trust that I am enough. I work hard, so I know that I’ve done everything I can. 

 

FROM BIG BOX TO BOUTIQUE

Mitch Peterson and Kelsey Keltgen, OD
SEEK Eyecare / Victoria, MN
Opened: February 2017 (Soft), April 2017 (Grand)

My wife, Dr. Kelsey Keltgen, and I cold-opened our practice in early 2017. We chose a new building in downtown Victoria, MN. We were the first and are still the only practice in Victoria.  

My wife, and high school sweetheart, had been practicing for about six years prior to opening SEEK. She worked as a paid hourly doctor right out of school and filled in at other practices on the side. After that she was a lease-holding doctor at a big box optical. I have a diverse background, from working on my family farm to starting a few successful businesses. I was even a bouncer and drove semi-trucks in college. Our unique backgrounds make us a great team. She is one of the most passionate ODs out there.

We both worked six to seven days a week to pay off our personal debt. So, when we were ready to open our dream store we were financially able to do so. We wanted to open our own practice because no one was doing what we wanted to do: offer a state-of-the-art practice that provided comprehensive exams with an approachable retail space. My wife wanted to be able to take a preventative approach that would be more beneficial to patients.

We did a ton of research. We used our experience to develop a patient experience that picked up where a lot of practices fall short. We had to figure everything out from scratch. None of us knew how or where to purchase frames … What lenses or lab to use.

We developed a very in-depth business plan with multiple options to pivot with if things didn’t pan out. We have adhered to the majority of it. The only major change is that we had to adapt due to how fast we are growing. We are hitting our goals for years four and five in year two.

We secured a build-out loan fairly easily due to our favorable debt-to-income ratio and self-financed the operating side. The most surprising challenge we encountered was that construction was always four months behind schedule due to more than 35 inches of rain the day we broke ground. We had to meet frame reps at a coffee shop.

Insurance credentialing was a huge project that my rock star wife handled. Start working on that the second you can. We are involved in the community, volunteering and sponsoring events. I’ve used unique marketing avenues to get our brand out. Constant logo use and branding is important to my marketing plan. Since we previously leased at a corporate big box practice, the patient base was ours. We posted on social media each step of the build-out.

Business was crazy when we opened. We had so much local support and we both have large families; they were some of our first patients. The support from our friends and family has been amazing.

Over time, we have gotten very precise in how we operate. We have brought in more high-end eyewear than we initially planned. The biggest learning curves have been on the optical side: we’re more particular with our frame purchases; we make sure the product is great and the rep is even better; if they aren’t, we get rid of them.

Our advice is don’t over-extend yourself. If you aren’t financially and mentally prepared to do everything yourself, wait a few years. Write up your dream business model and find the patient base that fits it. Don’t let anyone or anything push you to start cold. You have to be all-in. We have zero regrets and love working as a wife and husband duo.

QUICK Q & A

What was the first major milestone you celebrated?
The night before we turned the OPEN sign on, we sat and had a beer in the front office after a month of 100 hour work weeks.
Have you already had to break up with a patient/customer or vendor?
We are break-up free on the patient side. We have had to let a vendor or two go.
Has the business made you cry?
It has been an emotional rollercoaster but I think the only tears have been tears of joy.
Would you have done anything differently?
e Nope.
What’s been your most empowering moment?
When publications like INVISION contact us to share our story. It reassures us that we must be doing something right.
 
 
How long did it take until you felt like you were gonna make it?
Once the first patient came in the door I knew we had created something special.
Do you ever feel like you’ve made a terrible mistake?
e No success comes without mistakes. It is how you move forward and learn from them.
What do you do to help overcome doubt?
We work through everything as a team. If there is any doubt we talk it through between the doctor, Rachel and myself. Keeping each other in check keeps confidence high.

 

CROWDSOURCING SUCCESS

Jason M. Klepfisz, OD
Urban Eyecare, Phoenix, AZ
Opened: August 2017

We opened Urban Eyecare in August of 2017 to bring comprehensive care and independent eyewear and specialty contacts to an underserved area, and also hoping that bringing these services would springboard future growth.

I spent the better part of three years jotting down notes on all the little aspects of private practice and optical that resonated with myself. I wish I could say it was all fun and games, but there was a lot of monotony: Which slit lamp has the best optics? Manual vs. automated phoropter? White-gray flooring or gray-white? Pricing out the optical. The best advice came from those that have gone down this road before, those that are currently practicing, and those looking to hang up their own shingle.

I come from an Indian Health Services background, having completed residency in a rural community. This continued in a geriatric setting for years when I returned to Phoenix before deciding to open my own office. The biggest challenge we faced when opening, and one that changed our overall goal, was getting credentialed on medical insurance panels. We pivoted to focus on our retail experience, seeking harmony between a medically and optically oriented office. What I didn’t expect was to fall in love with the materials and craftsmanship as much as I have.

To make ourselves stand out, we push brand-awareness social media campaigns and provide adjustments and free cleaner to anybody who walks in. We exhibit local artists in our office.

We got the word out through trial and error. We started with our online presence. I also hand delivered letters to about 250 local businesses on a 100-degree spring day. We called local businesses and found ones who allowed us to deliver gift bags to their employees. We took every health fair opportunity available. Every bulletin board, coffee shop and college building we could leave flyers, we did, even handed them out on the street.

Business was great when we opened. The problem was we lost our optician just a few days before opening. I had no previous experience with optical and my staff were untrained in the area. In our first week, we slowly built up a pile of lab orders ready to be placed but nobody to place them. Fortunately, by the end of that week we found a wonderful replacement who has been our rock star ever since!

The main lessons we’ve learned are, firstly, to check out eyewear in person before buying. With our limited window to purchase frames while opening, we carried some brands we were less than thrilled with over the course of the year. We shed about half of the brands we started with and are much more careful in our choices now.

Lastly, my advice is to follow your dream! Don’t feel the need to take over somebody else’s problem office because starting cold is too difficult. Create something unique, a place that patients want to go, rather than a place they reluctantly need to go. Create an experience that makes people want to come back.

QUICK Q & A

What was the first major milestone you celebrated?
Adding a fourth doctor day per week. It was wonderful to spend another day in my practice rather than working for somebody else. 
Have you already had to break up with a patient/customer or vendor?
We have unfortunately had to drop a few vendors. The beauty of ownership is we can choose to work with brands that complement us and our mission, to grow together.
Would you have done anything differently?
I would make design changes for our next office. A doctor who owns a large chain once told me that you always like your first office the least, but each one after gets a little better.
How long did it take until you felt like you were gonna make it?
It’s still day by day, even though we are turning a profit. The days with 16 patients make me feel like the king of the world, while slow days make me feel like tomorrow is never going to come. I don’t think I’ll feel like it’s completely under control for a couple more years.
Do you ever feel like you’ve made a terrible mistake?
Never!
What do you do to help overcome doubt?
Wake up happy every day and excited to go do my dream job at my dream office!

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Cover Stories

How to Keep Your Inventory Ultra-Fresh With an Aggressive Dog-Dumping Strategy

Noteworthy ways some ECPs have found to move their moldiest inventory.

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Woof … You may have loved a particular frame or collection but that was no guarantee your customers would. So, how do you offload the bad picks, the misfires, the ones that silver-tongued sales rep talked you into ordering? … Return to sender? Massive discount? Strip them for parts? Here are some of the more interesting ways your ECP peers dispose of their dogs.

BLOWOUTS, BUNDLES and BOGOS

When it comes to clearing out unsold frames, returning them is probably the most common option, but many ECPs fail to factor in the expense. As Annette Prevaux at The Visionary in Allen Park, MI, points out, “There is an expense to return frames and it is passed on to the practice… I am surprised at how little is really taught about frame buying and the cost of returns.”

Most ECPs will be familiar with options such as standing discounts (a “junk drawer”), periodic clearances, value packages and the tried-and-true BOGO (buy one, get one free), or offering a special price without warranty. Remember that offering stock as freebies or incentives tends to work best with lower-cost frames. Jocelyn Mylott at D’Ambrosio Eye Care in Lancaster, MA packages stock lenses with discounted frames to sell them off. “We use these frames to fill the board space for all the vendor back orders as we board manage,” she says. Smart move, as it fills in unsightly holes in your board and gets eyes back on this malingering product.

Accepting insurance creates additional possibilities. MK Vision Center in Forest Hills, NY, uses unsold stock as insurance-covered frames. Explains Kaleena Ma: “We usually try to sell through our unsold inventory by using them as insurance frames for the plans that give allowances for the frame.”

When it comes to using sales and discounts to clear inventory, the Vend retailing blog suggests keeping the following in mind: Try to turn sales into periodic events with a few “bells and whistles” so you’re creating new customers or building loyalty. Always use sales as a way to gather customer information, and remember to mix in a few good sellers as loss leaders.

REVERSE PSYCHOLOGY

Where some see dogs, others see gold. Dr. Selina McGee of Precision Vision in Edmond, OK, dares you to “Mark it up — way up. That way everything else looks less expensive and it’s very exclusive. If you sell one, then you cover more of your investment.” (Our hunch is this would work best with luxury frames that aren’t moving.) Doreen Erbe at Snyder Eye Group in Ship Bottom, NJ, urges you to “Make that collection into a really cool display. Everyone will think the frames are new.” This is good advice; re-merchandising can breathe surprising new life into old stock.

STAFF CHALLENGE

Nikki Griffin, owner of EyeStyles Optical and Boutique in Oakdale, MN, offers this memorable advice: “Dogs become the ‘steak-dinner frame.’ If you sell that puppy I will buy you a steak dinner.” Interestingly, food also seems to be the prime motivator for hungry sales staff at EyeShop Optical Center in Lewis Center, OH, where, explains owner Dr. Cynthia Sayers, “If a staff member sells that dud I buy them lunch.”

DONATE TO CHARITY

Your unsold merchandise can be a force for good. Lions Club is renowned for its eyeglass-recycling programs Charitable donations entitle you to a tax write-off. For a detailed “how-to” of donating stock to charity, of “Gifts in Kind,” check out the column Gary C. Smith, president and CEO of the National Association for the Exchange of Industrial Resources, wrote for INVISION in December 2017: invisionmag.com/041903.

SWAP IT OR SELL IT ON

Their proximity to the Mexican border gives Carrera Optical in McQueeney, TX an interesting option: selling unsold frames to opticals in south Texas that see large numbers of patients from Mexico. These customers are looking for a level of quality they believe can only be found in the U.S. Says BJ Chambers, “We sell multiple frames to several shops; sometimes these opticals are on credit hold to the frame manufacturer and cannot purchase directly.”
Some vendors will buy back any competitors’ frames that aren’t selling. Europa will pay you to take back another vendors’ frames, provided you have or set up an account with them. Dr. Zachary Dirks at St. Peter and Belle Plaine Eyecare Centers, Saint Peter, MN, reports: “We have some reps we have good relationships with that will exchange product for theirs.”

And here’s a channel right under your nose you might not have thought about. Julie Uram at Optical Oasis in Jupiter, FL on occasion gives unsold frames to a friend who puts them on eBay. Remember that using online marketplaces can be time consuming, as you’ll likely have to set up pages and jump through some other hoops.

THERAPEUTIC RENTALS

Those in the therapy niche take note: Dr. Pauline Buck at Behavioral and Developmental Optometrists in Miami, FL turns non-sellers into loaners that therapy patients can take home temporarily. “Concussion patients may often benefit from yoked prism base lenses. By … creating glasses in bases up, down, left or right — as well as a few base-in for individuals with convergence insufficiency — I can rent or loan them out.” Patients sign an agreement; if the glasses are not returned, Buck bills them the full price.

a gram OF PREVENTION…

Of course, you should always be monitoring inventory, but it’s important not to let your reps slack: “Keeping the frame rep responsible for shipping the top sellers in each frame line is one way to make sure the dogs never get dumped in the office,” counsels Leisa Lauer at Dr. H Michael Shack in Newport Beach, FL.

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