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Handling Tough Talks

Your employees keep coming in late. Your sales rep can't seem to get orders right. Your managed care provider keeps screwing up your reimbursments.

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With additional reporting by DEIRDRE CARROLL | Illustrations by MAR JEFFERSON GO

These days it’s hard to escape Donald Trump. Open a paper, turn on the TV and there the presidential hopeful is. But let’s not forget how he became a household name:

“You’re fired!”

THERE IS SOMETHING “succinct and very beautiful about the words … they’re so definite and final,” he once told Newsweek of the signature line of his former reality TV show, The Apprentice.

He may find those words beautiful, but there are very few others who do. For most of us, those words are almost unutterable, no matter how badly they need to be said.

Much more likely is a rambling speech that starts off something like: “Listen John, I’m not quite sure how to put this to you, but I’m afraid we’re probably going to have to let you go. I hope you can understand. Sales are down, and it, um, doesn’t look good. And then there’s my wife. She said we need our employees to show up on time, be polite to customers, make sales, you know, that sort of thing. As for me, I’d love to give you another chance, but you understand, right? My hands are tied …”

So how’d you do there? Well, you blame-shifted, told about three lies, all whoppers, and were barely coherent to boot. And this is probably after spending weeks or even months, dwelling on the issue and thinking of ways to approach it.

Let’s face it: As a species, most humans are not very good at managing difficult situations. No matter what the situation — dealing with an irate customer, a partner we don’t believe is fairly sharing the load, a longtime supplier who is no longer price-competitive, a repair man who always charges more than his quotation, or even an employee with a body-odor or chronic tardiness problem — most of us will do nearly anything to avoid these little conflicts.

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But in business, such avoidance comes at great cost. It leads to what consultant and author Susan Scott calls a “culture of terminal niceness.” Everybody evades or works around difficult employees, problems don’t get tackled, and mediocrity is tolerated.

There are also personal and psychological costs for managers and staff when issues aren’t addressed effectively or honestly. Trust diminishes and misunderstandings multiply. Festering problems consume huge amounts of emotional energy and sap creativity.

In some cases, when the situation finally becomes unbearable, we do take action. But we invariably go about it the wrong way. We vent, point fingers and lay blame, leaving hurt feelings and the seeds of a new misunderstanding in our wake.

In contrast, when conflicts or difficult conversations are managed well, better decisions are made because goals are clear, teamwork and productivity increases and workplace morale surges. Conflict resolution, done effectively, also helps foster a climate of learning that allows people to learn from their mistakes and encourages managers to provide critical feedback.

But how to do it?

Dr. Tim Ursiny, author of The Coward’s Guide to Conflict, says there are seven ways of dealing with a difficult situation:

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1. AVOID IT.

(Bad, for the reasons stated above.)

2. GIVE IN.

(Bad, because we don’t permit our- selves a chance to properly remedy the problem. We let someone else win the argument and then we feel bitter about it. Sometimes the other per- son knows we’ve surrendered, but most of the time they don’t have a clue and go about their business as always. Grrrr…)

4. BE PASSIVE-AGGRESSIVE.

(Like when you huff and puff and scowl when someone uses a mobile phone in a movie theater. This is about as effective as giving in, even if we do make an effort to ensure the person knows our feelings.)

5. COMPROMISE.

(Now we’re getting warmer! But still, compromise suggests that neither party got what they really wanted. After all, the focus of compromise negotiations is what you are pre- pared to give up.)

6. HONOR THE OTHER PERSON.

(Sound sappy? You’re right, and this is a solution best saved for situations involving family and significant others. This is where you make a choice to give up something and enjoy the sacrifice — say, you decide to forego a disputed bit of parking space to help out a neighboring businessman.)

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7. PROBLEM-SOLVE TOGETHER.

(You’ve probably guessed; this is the best way to go.)
Now, suggesting that you “solve the problem” might seem excruciatingly obvious — but what Ursiny, who is an executive coach and psychologist by training, is really advocating is the use of a technique that invites mutual analysis of an issue, takes into account the emotions on both sides, and results in a win-win situation.
Easy to say, but surprisingly hard to achieve. And that’s because most of us are thoroughly inept at doing the basic things required to achieve such a goal, oh like listening properly, understanding the other person’s point of view, and refraining from making critical judgments.

We’re here to help you better navigate your way through difficult conversations, but first we need to address the 800-pound gorilla in the room. And its name is … fear.

Our behavior in times of looming confrontation is invariably driven by fear. Fear of physical harm, fear of rejection, fear of losing a relationship, fear of anger, fear of being seen as selfish, fear of saying the wrong thing, fear of failing, fear of hurting someone, fear of getting what you want, fear of intimacy, fear that people will think less of us.

Sometimes these fears are rational or based on experience. You may have tried confronting someone before and it went badly. Or maybe you worry that talking will only make the situation worse.

And sometimes our fears are irrational. She’ll be crushed and kill herself if I tell her our clients hate her coffee. He will hire a Cessna and drag a 200-foot sky banner over my neighborhood telling everyone what a cheapskate I am if I don’t give him the pay rise.

Or maybe the anxiety wells up because of something that happened way back in your formative past — something at the very core of your identity. You’re afraid what the looming conflict will reveal about you as a person.

One of the things about the problems life throws at us on a daily basis is that we know deep down inside that the best way to deal with them is to put aside our worries and tackle the situation head-on. Don’t believe us? Think about your reaction the first time you saw Nike’s old “Just Do It!” ad campaign. You probably went out and did something … didn’t you? With that campaign, Nike proved that they knew the shadows that lurk deep in our hearts. Everybody wants to act forcefully, without restraint. Few do.

And “just doing it” is still one of the best ways to summon the courage. No, that doesn’t mean that you should simply jump right into your difficult conversation without preparation. But you should commit to doing it as soon as possible, and then start taking the necessary steps to make it happen. Weigh up the pros and cons and focus on the long-term benefits. Recall a case where you confronted a problem and it worked out well. Except for those cases where there is the genuine possibility of a physical harm, tell yourself that the conversation won’t destroy you, that you
can handle it, and most important, that it is the right thing to do. The relief you stand to gain will be permanent — as opposed to the temporary respite avoidance provides.

To give you that extra edge for your upcoming difficult conversation, we’ve compiled some expert advice from masters of the art of conflict resolution. Using it, you’ll find that disagreement is not only nothing to fear, it can be healthy. You’ll grow from it. Trust us.

But first, let’s examine the nuts and bolts of the conversation you are about to have.

 

PREPARING FOR THE MOMENT OF TRUTH

The first thing to do when preparing for a difficult conversation is to pick the right time and place. It’s pointless to start such a conversation if you don’t have the time to do it properly or are going to be constantly interrupted.

Then, ask yourself some questions:

Why are you having the conversation? What do you hope to accomplish? If you think, “I just want to get something out in the open,” or “We just need to talk,” that’s not good enough. Your purpose is too vague, and vague goals almost always mean disappointing results. Your purpose needs to be forward-looking.

You also need to question your objective. You may think your motives are honorable, like educating an employee. But as soon as you start talking, you notice yourself lapsing into language that is highly critical or condescending. (And believe us, the employee does as well.) This is also a good time to think about how you contributed to the problem.

Work on yourself so that you approach the conversation with a constructive aim and see it as an opportunity to learn about the other person’s point of view. Think “I wonder why he keeps doing that?” instead of “That’s it. I’ve had it with the way he keeps doing that and I’m really going to let him know it!”

Second, investigate what assumptions you are making about this person’s intentions. You may feel intimidated, disrespected, or ignored. But you shouldn’t automatically assume that this was the other person’s intended aim.

Third, start thinking about the other person’s viewpoint. What might they be thinking about this situation? Are they even aware of the problem? If so, how do you think they perceive it? What fears and needs could they have? What solution do you think they would suggest? Stop looking at the other person as an adversary — instead, see them as your partner in solving the problem at hand.

Finally, ask yourself what reaction the other person might have that is most likely to throw you off balance. What if they accuse you of picking on them or acting unprofessionally? Identify which reactions would be the toughest for you to deal with and plan how you might respond if the other person breaks down in tears, gets angry, or withdraws. Don’t just “wing it.” If that’s your approach, you won’t be very effective.

 

GRABBING THE BULL

The best way to start is much the same way you would for a meeting: Set out an agenda. This outlines the problem to be discussed, establishes that you want to hear the other person’s perspective, that you want them to hear yours and that you would like to do some joint problem-solving. Use the opening part of a conversation to be upfront about why you’d like to talk and what your main point is. You’ll engage the interest of the other person and help them understand what follows.
When describing the issue at hand, state it neutrally, the way a mediator might. For example, instead of saying, “I want to know why you insist on making the staff wear these silly Santa hats,” you can begin with, “It’s obvious we both care about the business. And we both want to do what we think is best. But you and I have different approaches to marketing. Let’s see if we can talk about that and find some middle ground.” This approach includes bits and pieces from both sides and seeks to close the gaps between your two perspectives. No one will feel attacked and you’ll be off to a smooth start.

Then, invite the other person to share their side of the story first. Don’t feel compelled to dive in with your perspective. You’ll actually be more persuasive if you let your counterpart get their side out first.

This way, you get to learn what they care about, how they see the problem, and you can respond accordingly. Also, until the other person feels heard, they don’t have the mind-space to hear you. It’s infinitely harder to persuade someone who hasn’t felt heard than someone who has.

Remember too, as Stephen Covey, author of The Seven Habits of Highly Effective People, says, “to listen to understand and not to reply.”

Often one of the things blocking our pursuit of the truth is that we think we not only understand our own point of view, but we also believe we know for sure what the other person did, said, and thought on the subject. He always does that because he knows it irritates me. She intentionally came in late to make me mad. She knows exactly what is expected of her, but doesn’t want to do it.

The problem is, such tough discussions are not about things that can be shown to be right or wrong, say Douglas Stone, Bruce Patton and Sheila Heen, authors of Difficult Conversations: How to Discuss What Matters Most. They involve facts, but they are not at heart about facts. They are about conflicting perceptions, feelings and values. They’re not about what a contract says, they’re about what a contract means. They’re not about which sales technique is most popular; they’re about which sales technique the store should employ. Finally, they’re not about what’s true, they’re about what is important.

If you automatically think you’re right, the conversation becomes one of trying to get the other person to admit he’s wrong. As strategies go, this is a poor one — the other person immediately becomes defensive and closes down.

The mistake of assuming we’re right leads to a second common error: We don’t ask enough questions. Studies have shown that about 90 percent of what is said during a failed conversation is advocacy, and only 10 percent inquiry. That means, the two parties find a lot of different ways to state their own views over and over again. Understanding is never reached. And too often, poor decisions result.

One of the first things you’ve got to do to get through a tough talk is to understand how the two of you see things differently. And doing that requires questions, questions and more questions.

 

YOUR TURN

When you sense that the other person has been able to unlock some of their energy and express the essence of what they want to say on the topic, it’s your turn.

From what they’ve told you it should be clear what they don’t understand about your position. Start by trying to clarify your view without minimizing theirs.

Be quick to identify the problem areas that remain. Be authentic too. There is something in us that responds to people who level with us, who speak from the heart.

Regularly summing up what you’ve said can boost the quality and accuracy of the dialogue — and eliminate many of the problems caused by misunderstandings.

Use words that reflect the other person’s meaning as well — “What you’re saying is that you feel that when I’m busy, I’m prone to treating people like they don’t exist. Am I understanding you right?” This way you demonstrate empathy and also get the chance to confirm that you’ve got it right.

If the conversation becomes heated or adversarial, go back to asking questions. Asking for the other person’s point of view usually neutralizes emotions. The challenge is to reframe the conversation from “whose fault is this” to “where did the misunderstandings occur, and how can we correct them so we can move forward?”

If the other person keeps saying everything is your fault, you can say, “I know I’ve contributed to this problem. Let’s talk about that, and we should also make sure to discuss ways that you’ve contributed to the problem as well.”

Be persistent in your efforts to keep the talk constructive.

 

FIX THE PROBLEM

Once you know what the other person wants and they know clearly what you want, then it’s time to find a solution. There is no guarantee this will be easy but at least both sides now are aware of all the factors in play.

Remember to keep asking questions. Ask your colleague what they think would work. Whatever they say, find something that you agree with and build on that.

Often such discussions get caught on the question of what’s fair. But, remember, fair is a subjective matter. What is a fair salary when the economy is doing badly? What is a reasonable vacation policy when the company is under-staffed? Your opinion and that of your counterpart are almost certain to differ. Of course, this scenario is specific to employee conflict, but the underlying principles remain the same.

The best, most straightforward way to approach any issue is to put on the table what both sides want and then brainstorm to see what is doable. In this instance, maybe a higher rate of commission based on achieving a new sales target would better reflect the economic conditions and the employee’s performance.

BREAKING BAD HABITS

Start by knowing why your brain acts the way it does.

They often don’t seem it, but almost all conversations are incredibly complex.

“Lovely day outside,” the cashier says as she rings up your toothpaste.

Was that sarcasm, you wonder. Why was she smiling at the cereal I was holding? Maybe she was flirting?

And that’s an easy conver- sation. difficult ones are so much more complex.

In their book Difficult Conversations: How to Discuss What Matters Most, Douglas Stone, Bruce Patton and Sheila Heen theorize that each difficult conversation is really three simultaneous communica- tions.

There’s the standard “what happened” conversation, with the two sides’ competing ver-sions of the “facts” and their significance.

Second, there’s the “feelings” conversation, with unacknowledged emotions running amok.

And there’s the “identity” conversation, which affects our sense of self in the world.

The question of how to deal with feelings in the workplace is complicated. Some conversations are at heart about feelings, and the only way to communicate efficiently is to acknowledge them. If you don’t raise feelings of fair treatment, for example, morale drops, and more “positive” feelings, like passion and respect, fade away. This is significant. Studies suggest that almost 50 percent of people who leave jobs quit because they feel underappreciated.

The other thing about feelings is that no matter how hard you try to suppress them they will be heard, either in your tone or body language or some other way.

Obviously, you can’t spend time processing everyone’s feelings. But be aware the “check your feelings at the door” ethos can be harmful.

“Identity” conversations are hard because they pose a threat to how we see ourselves. One mistake many make when they feel their identity is being impugned is to take the criticism as absolute. But criticism is not all or nothing. A manager who makes a mistake is not a bad manager. The store owner who says “no” to a day off is not an evil slave driver. Becoming familiar with the identity issues that are important to you allows you to look out for defensive reactions.

The psychology of tough talks is that they tend to expose us for what we are: complex beings riddled with competing emotions and conflicting needs.

It is because we lead our lives according to “Big Assumptions,” say Robert Kegan and Lisa Lahey, psychologists and the authors of How the Way We Talk Can Change the Way We Work: Seven Languages for Transformation.

“Big Assumptions” are ideas we accept as truths. They once may have been true, but now it is no longer necessarily the case. Nevertheless, these assumptions are difficult to change because they’ve been reinforced so many times.

The authors suggest the answer lies in reflection and experimentation. Once you become aware of these patterns, try to transform using a three-step approach.

First, be on the lookout for when a Big Assumption is guiding your actions. Secondly, explore its validity, and finally, test it. Refuse a small request and see what happens. Then try a bigger one.

 

PRACTICE, PRACTICE, PRACTICE

A successful outcome will depend on two things: how you act — centered, curious, persistent — and what you say. Don’t expect to handle every difficult conversation with ease and poise. At the beginning, you may be tongue-tied, scared and inarticulate. That’s OK. Your goal is not eloquence. It is openness and honesty. As with any other skill, you will get better with practice. Keep in mind that failure is the best teacher.

It is also worth noting that there are times you should walk away from a difficult conversation. There isn’t enough time to confront your partner, boss, staff or clients every time they annoy you.

But if walking away ends up being your response most of the time, you’re on the wrong track. Your feelings will fester. And in the long run, if you don’t raise important issues and have those difficult conversations, you will damage the relationship you were hoping to protect.

 

TOUGH TALK TIPS

Here are some more tips and a few conversation starters to help you:

Don’t aim for perfection. Difficult conversations are tough for a reason. Aim for gradual improvement each time.

You don’t win a difficult conversation. Your goal is not to get the other person to capitu- late and admit that you were right all along. It’s to express your feelings, allow the other person to express theirs and hopefully reach an understanding you both can live with.

Need to deliver bad news or fire someone? There are no magic words that will somehow make it less upsetting. The best you can do is be honest, to the point, and sympathetic. You can’t take responsibility for the other person’s feelings. If your accountant is inept and messed up your books, you need to let him go. His feelings are immaterial to the outcome. It is only the facts relating to his poor performance that matter. The success of a conversation should not be judged by whether someone gets upset or not. (And don’t try to trick the person into accepting blame first.)

Don’t waste time and energy defending the weak parts of your argument. In any tough conversation, no one is 100 percent right or wrong. Each side has weaknesses, and it is wise to acknowledge the problems. Take responsibility for your share and focus on a solution.

Controlling your emotions is crucial to avoiding a destructive argument. You need to look forward — not try to defend a position or win an argument. If a conversation is getting heated, use silence to slow it down, says Scott.

Stay with the issue; straying will always sabotage your mission. You’ve had a great year and you would like to discuss bonus levels with your sales manager. But he notes how two years ago, he didn’t get a bonus when (he believes) one was promised and doesn’t feel he can trust you in this discussion. Suddenly you find yourself debating your role in the conversation. In such situations, refocus on the future.

Use “I” statements rather than “you” statements when discussing your thoughts and feelings. “I” clarifies for the other person what you think and feel while “you” can make them feel criticized. “I” reduces defensiveness and fosters communication. Good “I” statement: “I feel uncomfortable when you interrupt me during meetings. I feel it shows a lack of respect.” Bad “you” statement: “You always interrupt me during meetings. You have no respect for me!”

Say “and,” not “but.” The word “but” has the power to erase everything good said before it. For example, “Joe, I really liked the way you closed that sale, but next time don’t spend so much time talking about how bad insurance reimbursements are.” Far better to say, “Joe, I really liked the way you closed that sale and I think it would be better if you didn’t mention our issues with the patient’s insurance provider.” This is something improvisational actors are taught. The basic premise is not to reject what is proposed and focus instead on elaboration, to create new ideas and move forward.

Similarly, avoid negatives and absolutes as they shut down communication. Example: Negative: “Why can’t you …” Positive: “What if we …” Absolute: “We must do it this way.” Non-absolute: “Here’s a good idea to consider…”

Avoid judgmental words like “bad,” “ugly,” “wrong,” and any that imply fault like “unprofessional” and “inappropriate,” Ursiny recommends.

The same goes for you. Many misunderstandings arise from faulty assumptions. So when in doubt, say what you mean. Hinting isn’t good enough. Don’t rely on subtext.

Remember that acknowledging the other person’s feelings is not the same thing as agreeing with them. Saying “I can understand this is really important to you” indicates an effort to support the other person, but doesn’t mean you’re going to go along with the decision.

In cases where you find yourself poles apart, use the “100+1 approach.” Find the one percent of the other person’s position you can agree on and endorse it 100 percent. That suggests that you are committed to finding middle ground.

Research shows that we spend a lot less time talking to people close to us than we imagine. These same studies also show that many of our more challenging dialogues could be avoided by staying in more regular contact.

Blaming the other person for not understanding you — or for you not understanding them — is pointless. Be willing to recognize when you don’t understand or need to know more. If you don’t have a clear understanding of what the other person is saying, keep trying until you do. It could be that their thoughts are unclear. Encourage them to be specific.

What if it’s someone you’re going to have to work with again — for instance, a high-performing sales associate who is suddenly suffering a five-alarm case of body odor? Same deal. Take him aside and let him know his new antiperspirant isn’t quite up to the task. Of course, he’ll be embarrassed but eventually he will thank you. Knowing that you can’t control the reaction of the other person in a conversation can be liberating, say Stone, Patton and Heen.

The best decisions are the ones that people reach themselves. So be lean on the advice, but generous with help and support.

Don’t just listen to the words, listen to the “music” as well, including body language and voice quality. Also, look for clues in what is not being said. Ask yourself and the other person, “What is it they really want, really mean?”

Being genuine is at the heart of all worthwhile communication. Don’t be afraid to share your feelings. Author Scott recalls a conversation with a friend who said: “I notice I’m becoming defensive, and I think it’s because your voice got louder and sounded angry. I just want to talk about this. I’m not trying to persuade you in either direction.” The acknowledgment helped the two to re-center, she says.

Not sure how to open the conversation? Consider some of these lines:

  • “I need your help with something. Can we talk about it?”
  • “I think we have different views about [insert topic]. I’d like to hear your thinking on this.” “I have something I’d like to discuss with you that I think will help us work together more effectively.”
  • “I’d like to talk about the recent changes to our compensation structure with you, but first I’d like to get your point of view.”
  • “I’d like to see if we might reach a better understanding about our store’s dress code. I really want to hear your feelings about this and share my perspective as well.”

Final tip. Realize difficult conversations are part of life. They aren’t going away, but they can become easier, less anxiety-causing and more constructive if you work on it.

STORIES FROM THE OPTICAL FRONT LINES

DAVID W., DALLAS, TX:
One of the tough discussions we had with an employee was about getting involved with our patients in personal matters — selling/buying cars, planning play dates, making social plans, etc. She did not understand why it was inappropriate and was indignant at first, but we explained that if anything “went wrong” in her personal relationship/dealings with the patient, then it might negatively affect the doctor/patient relationship and possibly our bottom line. She eventually understood, and we now have a “WWDD” (What Would Doctor Do) policy.

STEVE N., WESTLAKE, OH:
Our tough talks are most often with a ven- dor. We took on a lot when we opened, including frame lines, labs, etc. Sometimes you nd a line or company simply doesn’t t your vision and you have
to say goodbye. The toughest part of all is that you truly build great personal relationships with people. So business decisions are made but in the end you can feel like you hurt someone’s feel- ings. Nonetheless… we must do what is right for our shop.

KEVIN B., KALAMAZOO, MI:
I called a doctor out on his chronic tardiness starting the day. He asked if I always saw my doctor on time. I told him this wasn’t my doctor’s of ce, it is our patient’s doctor’s of ce, and we see our patients on time. He was never late again. People are unreasonable only because no one has ever told them they are being unreasonable.

RICK R., GIRARD, PA:
When I was the manager of a large retail chain store, a married-with-children associate and a lab tech had an affair. None of our business until it started to affect work. It was interrupting our customer flow as well as causing other associates to complain. The lab tech was an exemplary, invaluable associate. We carefully explained the facts that were affecting his performance, careful not to mention the relationship, although he had to know that was part of his problem. I didn’t think it went very well. I honestly thought
we would lose him. We were lucky. The retail associate had been making the rounds and the problem corrected itself.

SELINA M., EDMOND, OK:
I fired an employee. I sugarcoated why and said that she would be a better off elsewhere. I needed to be more honest that she couldn’t do the job and show her all the times that we tried to train her to, because she sued me for age discrimination. Being honest and direct could have avoided this. I now follow this guideline, “To be kind is to be clear, and to be clear is to be kind.

SIOBHAN B., NEW LONDON, CT:
Telling a potential vendor you aren’t interested in their product is always tough. I recently had someone come in and while showing me trays asked me if I wanted to start writing up my order. I was so shocked that I said what I always want and never do: that I was allowing them to show me their product but I never said I would be taking it on.

KRISTY S., REYNOLDSBURG, OH:
Had several talks with a new optician. She was sloppy and kept dropping the ball. She was a hard worker, but made mistakes that added up. We decided that she would work closer with me. We worked like that for five weeks. Now, she is a great optician with a huge following!

ANGIE P., JOHNSON CITY, TN:
I had a frame rep that was very disrespectful to my optician. I called and spoke to her personally. She was not remorseful, so I dropped the line. I was professional and gave her the opportunity to make things right. Since I felt that I handled myself well, I did not regret phasing out the line.

BRENDA S., BUCHANAN, MI:
We had a patient that was very rude to the staff every time he came in and no one wanted to assist him. I addressed his attitude, asking if we had done anything to anger him or if there was a way we could serve him better because we wanted his experience to be great with us. He apologized to all of the staff, has remained a patient, and has developed a great relationship with all of them.

TED M., TIFTON, GA:
I’ve had so many difficult conversations with our team over the years. I’ve not always been good at it. I came to the realization after listening to an episode of the Dave Ramsey Entreleadership podcast, that by not confronting the issue there would still be tension. By acknowledging the issue (and the tension) at least everyone knows where everyone stands. So, I have been embracing the 800-pound gorilla. The main issue is communication. I know that gets a lot of lip service, but if you are committed to truly communicating it means having those difficult conversations.

RICHARD E., ENGLEWOOD, FL:
I once kept a lab tech around for a long time thinking I had to have him due to our high volume. My instincts kept telling me he was a problem. He was very confrontational. One day in my absence, an associate asked him how long a single vision job would be, and it set him off. He threw trays and yelled while customers and staff watched. I had to terminate him. My lesson was to follow my instincts and document any issues with staff no matter how uncomfortable you feel.

 

 

 

 

 

Chris Burslem is the Group Managing Editor of SmartWork Media.

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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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Cover Stories

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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