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John Marvin

This Simple Addition to Your Daily Routine Can Make You a Better Manager

Keeping a journal is easier today than ever before.




EVERY DAY of your practice you create a health record of the patients you examine and prescribe for. You meticulously make note of not only refraction results but also pathology or potential pathology that might be indicated by the patient’s family history.

Can you imagine if you did not keep these records? Besides not being eligible for third-party payments, each time you examined the patient, you’d be starting over. What quality of care would you be providing if your attitude was, “I really don’t need to write anything down. I can keep it in my head.” Sounds ridiculous, right?

The reality is: This is an important part of building a practice that provides quality care — keeping meticulous records of each patient visit. Here is my question: Then how do we think we can manage our practice without the same attention to note-taking or using the same approach to building our practice?

As an owner/operator optometrist, you wear two hats, one as a qualified health care practitioner and the other as the business owner and manager. Currently you are probably keeping very good records and taking excellent notes as the OD but my guess is that you are trying to perform the other responsibility by just keeping everything memorized. I don’t know about you, but I learned long ago that you can’t trust your success to your memory. We learned that in high school. Then why do we not think this is a bad idea for ensuring our success as owners and managers of our business?

Keeping a journal is easier today than ever before. There are countless smartphone applications that enable you to dictate your thoughts and interactions with employees and vendors. I use an application called Evernote. I find it easy to use and keep an ongoing record of daily notes related to my professional responsibilities. I have also set up a separate personal journal, which I use to record thoughts, ideas, notes from books I read, etc. I consider this my personal health record.

There are a number of different approaches: Some like pen and paper, others prefer a combination of digital and analog. The method matters less than the consistency of writing down the notes and building the record. If you commit to doing this for 90 days, you’ll see how it can help you be more productive and provide you with a base of information on which to make good decisions. In my case, it’s helped me be a better professional, husband and father.


This is a perfect time of year to start creating your personal health record. To start, simply decide before you go home each evening (or better, throughout the day whenever you have a few minutes), to jot down your thoughts as the business owner and manager. Plan time each week to reflect back on your notes, and plan the upcoming week building on the record you’ve created. You will be amazed at what you’ve learned and recorded in one year’s time.

John D. Marvin has more than 25 years of experience in the ophthalmic and optometric practice industry. He is the president of Texas State Optical and writes about marketing, management and education at the blog. You can email him at




Profitability with Managed Care: It’s Real

In the first of this three-part series, Dr. Eric White, Complete Family Vision Care, talks about managed care, and how to put your practice on the path to profitability.

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John Marvin

Sometimes Pulling the Goalie is the Best Decision to Make

Three examples of when and how you should go on the offensive.




MALCOLM GLADWELL IS ONE of my favorite authors. You may be familiar with his best-selling books David and Goliath, The Outliers, Blink and The Tipping Point.

In a recent episode of his podcast Revisionist History, Gladwell discusses his only rule for living: Pull the Goalie.

Hockey fans will know the meaning of this term. In some instances, a hockey coach may “pull the goalie” during a game to provide a sixth attacker and create an offensive advantage. However, when a coach chooses to do this, and under what circumstances, is controversial since it can make them defensively vulnerable.

It’s an allegory for the science of decision making. Deciding when to act or not act is something ECPs do all the time. And, as in hockey, those decisions can be second guessed and criticized by others.

I want to highlight three examples of when a business owner should decide to “pull the goalie” to create an advantage.

Hiring staff. If you are like most, you are constantly trying to determine if you have enough staff, should hire more, or let someone go. There are countless opinions about this. Most owners, like hockey coaches, are conservative in their decisions. If we think five staff members is the right number, we may try to operate with four. It is, after all, less expensive. We tell ourselves, “I would rather have four excellent people and pay them well than five who are mediocre.” But then one of our four all-stars leaves. Now we have three all-stars having a difficult time delivering the quality of service and care we expect. Everyone is frustrated, so we decide to hire someone. The first person with any optical or optometry background is hired whether or not they are the best fit. Now if we had pulled the goalie early and hired a fifth person, we could still have delivered the high level of service and taken the time to interview and hire an additional person. It is a dangerous cycle. The staff is shorthanded, which frustrates everyone and the result is a greater risk of additional turnover.

Correcting a problem. Reluctance to do so is the result of three stages:

1) Denial, where we attempt to convince ourselves we don’t have a problem. We rationalize, justify and procrastinate. Like in hockey, we tell ourselves, “We are only down one goal, we can still win.” The longer we stay in this state the worse our problems become.

2) Attempting to minimize the effect of the problem, since it is less disruptive than doing what is necessary to solve it. We move a difficult person into another position, we attempt to work out the delivery issues with the supplier to avoid changing vendors. We spend a lot of energy trying to avoid making a decision.

3) Accepting reality and recognizing we should have pulled the goalie early and avoided the problem all together.

Embracing innovation. Too many ECPs are waiting out the clock and hoping for the best. They believe that somehow, someway, all of the competition, innovation, changes in reimbursement, and demanding consumers will just go away. It will go back to the way “it used to be.” This is a dangerous place to find yourself. The competition just gets stronger. What used to be a secure and predictable practice begins to lose ground. Other services and providers are offering more and charging less. The industry itself is fighting to stay relevant. The best advice when you find yourself in this situation is to pull the goalie early and go on the offensive. Attend meetings, conferences, visit innovators, learn about the consumer. Fight to grow, build and win.

The good news is that many won’t and that gives you the advantage.

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John Marvin

Too Many Eyecare Practices Skip This Crucial Step — and It Hurts Them in the Long Run

Instead, most just hope for the best.




This article originally appeared in the March/April 2014 issue of INVISION.

DID YOU KNOW that in growing your business, you can decide what type of practice you want and the kinds of customers you want to serve? It really is up to you. So ask yourself: What kind of optometry do you want to practice? What sort of eyewear do you want to sell? Who is your “ideal customer”?

Most practices never really set these goals. They just open their doors and hope for the best. But this means your practice is left to circumstances and the ups and downs of economic, demographic and regulatory changes. By deciding not to decide, you choose to let others decide what kind of practice you own.

If you do not have a clear picture of the practice you want and the patients that you desire to serve, here’s what you need to do: Take one hour. Shut off the computer and phone. Close the door. Focus on deciding what you want.

Using paper and pen, with words or pictures, create a detailed description of the characteristics of your ideal patient. How old are they? Are they male, female, low income, middle income, high income, do they have families? Are they urban or suburban, millennials or baby boomers? Do they pay for their care with cash or with third-party payments?

The bottom line is this: Who are your high-value customers? Who are the customers or patients that will bring you the most business and cause you the least grief, year after year? You won’t necessarily exclude patients who do not fit your ideal. But this exercise will begin to guide decisions on how you will run and grow your practice. You’ll get insight into your practice’s physical design, its policies and — most importantly — the types of products and services that appeal most to those whom you desire to serve.

There is not a single best “type” of practice. Your business is yours; you get to decide. Some very successful practices focus on high-end frames, with professional optometry services offered as a convenience. Other optometrists feel a call to serve Medicaid or low-income patients and help them see the best they can. Our field includes practices that cater to children, or to athletes. Each model has its advantages and disadvantages. The important point is that you must decide on what type of practice and patient that you most want to serve. Once you’ve made this decision, your next steps will become logical. You’ll see a clear path of actions to create the type of practice that will appeal most to your target group of customers.

You will look at your business anew, asking, “Is this the kind of place my desired customers will want to visit? Do our customer service policies and conveniences appeal to my high-value customer? What type of inventory will they find most appealing? What type of services best suit their needs?”

You’ll also have new insight on how to best communicate to this group of customers. What are the issues that are most important to them? What community activities will provide you with the greatest exposure to them? What are their favorite social media platforms, radio stations and TV networks? How can I best go about building a relationship with them?

It is a fundamental truth that people associate with those most like themselves. So use this truth, and focus on getting referrals among friends and family of your best customers. The more you appeal to the customers and patients you have decided you value the most, the more referrals you will build from this group.

Building a successful practice is not about finding a magic gimmick or chasing after the latest trendy idea. Building a successful practice comes from making yourself appealing to those you wish to serve. And it beats simply hoping for the best.


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John Marvin

Measure Success Against Yourself, Don’t Compare Yourself to Others

It’s better to compare yourself to who you were yesterday.




RULE #4 IN JORDAN B. PETERSON’s best-selling book 12 Rules For Life, An Antidote To Chaos is “Compare yourself to who you were yesterday, not to who someone else is today.”

I have just returned from a conference at which there were many lectures on how to be a successful optometrist. I have attended many such lectures and while I have found them interesting, I have questioned their effectiveness.

The most popular are offered by other optometrists. They all seem to be saying, if you operate your practice like I do mine, you will be successful. Now I think there are several problems with this approach.

The first is that you are not them — practices are more likely to be personality-driven than process-driven. They each have their own culture which is largely defined by the personality of the doctor/owner. There’s nothing wrong with this, in fact it is why many successful doctors have devout staff members. You’ll often hear people talk about how they love working for the doctor versus talking about how they enjoy the job or position they hold. Patients are loyal to a doctor, not a practice. When they refer friends and family members, they refer them to a doctor. We recognize that a successful practice is about building relationships. And frankly, some are better at this than others.

The second problem with this approach is that it is more likely than not based on a series of what I call “novelty tactics” versus an understanding of a strategic approach. The truth is that patients are retail consumers and consumers have expectations. We are in a profession that depends heavily on the success of our dispensaries. The expectations that consumers have of our retail business are based on their retail experiences, not on experiences with other optometry practices. As the retail industry responds to a series of significant disruptions in delivery, consumers’ experiences are being shaped by these same disruptions.

It is important to understand these changed expectations and adjust our delivery. If we don’t, someone else will. It doesn’t even need to be another eye doctor or optical. Amazon is fully engaged along with Berkshire Hathaway and JP Morgan Chase in creating a new healthcare delivery system. This past summer they named their new CEO, Dr. Atul Gawande, a renowned surgeon. Telemedicine and tele-optometry are here.

The most critical problem with a traditional approach to building success is that it is based on comparing you to someone else. That is why Rule #4 is so important.

Success is not an upward escalator. It is more a meandering path, along which progress is made as you learn from mistakes. It is about the team you build and the relationships you establish. Not in comparing yourself or your practice to someone else who lectures at a conference.

But I will leave you with some great advice from another doctor. “Today you are You, that is truer than true. There is no one alive who is Youer than You.” — Dr. Seuss.

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