Dating before a Partnership

By Ashley Blasi, OD, guest columnist

My husband and I dated for six years before we bit the bullet and got married. Those six years provided us an opportunity to know the good, the bad and the ugly about each other. No secrets were left untold before we became hitched. Ten years later we are still running strong. Entering an optometric partnership works much the same way. Here are a few tips to consider before taking the plunge:

Learn to communicate– Just like any strong relationship, communication is key. Express your desires and concerns to your potential partner. Ask what is expected of you if you do enter into a partnership. Talk about the finances. Compliment each other when compliments are in order, or let your potential partner know when you are frustrated about something. A relationship works best when all cards are on the table. Communication builds trust.

Join a practice where your weakness is another doctors strength– I enjoy cooking, and my husband is happy that we have a meal to eat every night. My husband is great with finances and I appreciate that he pays our bills. We complement each other. The same scenario holds true in a business partnership. I like using technology and all the benefits it has to offer. However, I am not the go-to person when something breaks or is not working properly. Thankfully, a doctor at our office loves all the ins and outs of technology and heads up this area of the practice. The stress level of a partnership can be reduced if each partner picks an area or areas of the practice that he or she would enjoy managing. Divide up who manages the HR, technology, accounting, optical, marketing, etc. then come together when decisions need to be made. Partnerships survive when everyone works as a team.

Get to know their family and hobbies- As cliche as it sounds, partnerships are like marriages. Go to dinner with your potential partners and their spouses. Ask questions about their kids and what they like to do on weekends. You want to be in business with people who have the same morals, values and beliefs as you. It also gives you a chance for your potential partner’s spouse and family to become familiar with you as a person.

Entering into an optometry business partnership is a huge decision. Many partnerships fail to thrive due to conflicting interests and broken communication. It is important to build a trusting relationship before committing long term. Taking the above steps will position you to enter a partnership that will succeed.

Blasi headshotAshley Blasi, OD a 2008 graduate from Southern College of Optometry in Memphis, Tennessee, and practices at Wichita Optometry, P.A. in Wichita, KS.

4 ways to ensure a successful first year of practice.

The first year of practice is both exhilarating and frustrating. New doctors must be mindful of many things, but concentrating on the following four areas can pave their way to a successful career:

1. Never stop learning –  After graduating, most new optometrists are relieved to finally be finished with four years of studying and testing. However, we must not forget that the field of optometry is always growing and advancing. In school we had access to the latest technology, treatments, and research, but now as doctors we must follow new developments on our own. It is important to continue reading optometric magazines, optometry journals, blogs and websites (some are even dedicated to new optometry grads). Research the areas where you feel you may need more knowledge. Continuing education courses are also good, but new graduates need to keep in mind that for the first few years some classes may simply be a review of recent education. The important thing is don’t relax in your office chair for too long, if you get behind the learning curve it is hard to catch up.

2. Take time to listen  –  Listening to your patients is crucial to success. As a new optometrist your schedule may not be as busy as a seasoned veteran. This allows you more time to spend with each individual patient. Listen closely to the patient’s symptoms and complaints. All of your patients are “new patients” so there’s a lot of history of which you are not aware. Get to know not only their ocular history, but also their career, family, hobbies, etc. This will build a rapport with them for future visits. Make notes in your chart about the things you talked about. At the next year’s exam you will be able to strike up a conversation, picking up where you left off. Listening to patients helps build relationships, which makes them feel as if they are an important part of your practice–and they are. Marketing to the patient sitting in your office is easier than trying to reach the masses in the community. Patients who are satisfied with their care are more likely to return, and they are also more likely to refer family and friends.

3. Don’t be afraid to ask questions  –  In school our attending doctors held our hands. They were always there for us to ask questions and for them to question us. When we walked across the graduation stage, they let go of our hands. Now our questions must be directed to different people. You will encounter many different situations with patient care, insurance reimbursements, billing, frame representatives, staff, etc. Do not be afraid to ask other doctors in your practice or at continuing education meetings. Especially consider the doctors you know and respect. No question is a dumb question when it comes to any of the previously mentioned concerns, and remember every optometrist was in your shoes at one time. Take the time to pick the brain of your colleagues and don’t have so much pride you can’t ask their opinion or advice on a particular patient or potential treatment plan. Some of the more thought-provoking conversations I have had came from discussing patient cases and treatment plans with my colleagues.

4.  Find a niche  –  Consider Low Vision, Specialty Contact Lenses, Vision Therapy, Dry Eye treatment, or other specialty and less commonly performed aspects of optometry. Look at the needs in your practice, among your patients, and even among your colleagues in your community. You may work in a practice with another doctor who does not have experience or interest in fitting SynergEyes or Scleral contact lenses. Consider discussing with this doctor options for the patients in your office who would benefit from these specialty contact lens fits. Or you may find the majority of your patients are on computers for more than eight hours a day and have concerns with eye strain, fatigue, and dry eye symptoms. Dry eye treatment is multi-factoral and requires several examinations to evaluate and treat. Also consider prescribing computer Progressive glasses with a blue-blocking filter technology. Not every private practice or corporate setting provides all areas of eye care or specialty eye care. Finding a niche in your group practice or community can ensure a successful first year and many years to follow.

Consider one or all of these areas and run with them. They may not only jump start your success for the first year but for many years to come. If your first year has not been as successful as you hoped or planned, don’t let it dictate your future. It’s never to late to plan for your success.

 

Heide headshot    Drew Heide, a 2014 graduate from Northeastern State University Oklahoma College of Optometry practices at Wichita Optometry, P.A. in Wichita, KS.

Playing the Vision Benefit games for better profits.

Putting the health of his eyes firstStaying on top of the optometric game’s changing rules can be daunting. The optical department especially has its own regulations. Vision benefit companies like VSP and Eyemed have cut reimbursements down to a dispensing fee, so it’s difficult to find the money to pay staff and keep patient care high. Most owners know that VSP and Eyemed “reward” practices financially for using their lenses and lab systems whether the practices order finished product or uncut product that they will edge themselves in office. We have decided to maintain profitability our optical department needs to edge our lenses.  We also have created a system for patients depending on their vision benefits.

Consider these three rubrics:

  1. VSP Package – Patients with VSP have a benefit that aligns them with certain services and products for their package as a VSP member. Even though the office may prefer a HOYA lens, the product that fits into the VSP package is the Unity lens. Is it the better of the two lenses? Maybe, maybe not. Is it the lens that VSP feels is best for their members? Yes, and they reimburse providers accordingly.
  2. Eyemed Package – Patients who present with Eyemed have product and incentives laid out as best for their members. When you purchase Eyemed lenses and edge them in-house, the opportunity for profits is greater. Eyemed seems to operate with the attitude “use our product and way of doing business” and we will reward you.
  3. Everyone else – For patients who do not have one of the above, office staff have the freedom to choose the lenses that they believe are best for the patients. Without a loaded advantage of using one product over another, staff can present patients with options for best technology and performance.

Business owners have the privilege of using whichever products they would like in the dispensary, however, prices will be higher if they don’t follow the vision benefit companies’ way. Imagine if the pharmaceutical companies were allowed to give doctors an incentive for using their product. If Aetna owned shares in a pharmaceutical company and a doctor was reimbursed more for prescribing a medication that Aetna indirectly owned, wouldn’t that be a conflict of interest?  So optometrists are put in a position where it seems as though there is a conflict of interest that allows vision benefit companies to reward optometric businesses for using their products. Many of us would like to go counter current, but find that doing so erodes profits to the point of “playing the vision benefit game” or dropping the vision benefit company altogether.

What do your patients think about eye care?

The advertising industry understands product education and uses it to win people over to their respective products. Through Facebook ads and ESPN commercials, we are constantly being educated about what we need and why we need it.

When patients receive education from their eye doctors about the proper care of their eyes, they often communicate this information to all their friends and family. For example, how many times have you heard something like, “My friend told me she can sleep in her contact lenses for months and the doctor says she is doing great. I want contact lenses like that.”

Whether you want to successfully pass your patients to the next generation of optometrists or you want to gain unlimited referrals, learning to educate patients about their eyes benefits everyone.

Be a great eye educator for your patients. Make sure they understand the importance of:

  1. Regular eye exams – Many patients do not understand why it is important to regularly (once a year) get their eyes examined. Use every interaction with patients to remind them of what you do when you care for their eyes. For example, when doing a slit lamp exam talk to the patient about what you are looking at and why. For the optometrist, the slit lamp is routine and monotonous, but for the patient it is a chance to learn something new or be reminded of something they think about only annually. Patients may not know that an eye doctor looks at the movement their contact lenses to make sure they don’t get an infection that could cause them to lose their sight.
  2. Not ignoring medical eye problems – During the course of a work day, an optometrist will likely see a patient who has early signs of macular degeneration and has ignored this medical eye problem for a long time. For example, the patient smokes but still hasn’t had an eye exam for five years, and is unaware that smoking increases the risk of blindness. The patient is also unaware that the macular degeneration started four years ago. How could this happen? Perhaps the patient’s last optometrist told her to return to the office in a year or two, but didn’t set an appointment. If the optometrist doesn’t educate the patient on her condition and insist on setting an annual appointment, the patient is left to assume that as long as her vision isn’t decreasing she doesn’t have a problem, and preventative care is optional.
  3. Comprehensive exams even if the result is refraction only – Optometrists will do a comprehensive eye exam and end the exam by telling the patient he needs to update his glasses. The optometrist did not discuss anything but the change in refraction because the optometrist did not find any problems. If the optometrist doesn’t mention the health of the eye, the patient logically assumes the eye exam was for glasses only. This not only hurts optometry but it is a disservice to the patient. Discuss healthy eyes also and what you are ruling out in an eye exam.

When whitewater rafting it is a break to ride the current through smooth waters. You get to rest, recuperate and prepare for the next whitewater. In optometry, riding the current can become a way of life and new ODs and experienced ODs alike can become comfortable with doing the minimum. You will get reimbursed the same for a comprehensive exam whether you barely talk to the patient or educate them extensively about their eyes. Everyone wins when all optometrists work together to educate our nation about the importance of regular eye care.

Is optometry less profitable than one year ago?

Everyone wants a piece of the pie. Decreasing margins and healthcare initiatives that focus solely on cost savings cause many of us to wonder if the good days will ever return. Making a decent profit in today’s environment is a difficult task for even the most astute business CEOs in optometry.

To find profits, increase the font so you can read between the lines in these three areas:

  • Vision Benefit and Medical Insurance – Many medical insurances need a vision rider to meet requirements to provide vision services to various demographics. Consequently, we have seen a huge influx of low-paying vision benefit providers with thousands of patients.  Most optometrists are on, have been on, or are thinking of joining these low-paying vision benefit panels. Without a profitability plan in place, you will be on the road to working harder for less money. There are ways to attack this animal:
    • See more patients.
    • Decrease cost of goods.
    • Increase “spiffs” (Special Payment Incentive For Fast Sales) from vision benefit providers in using their product.
    • Loss leader for the benefit of having access to the patients medical needs.
  • Optical – As mentioned above, decreasing cost of goods or increasing spiffs can be an answer to greater profits with low-paying vision plans. The market is rewarding opticals that commit to the vision benefits products. This does not seem fair in a free world but the vision benefit plans incentivize you (pay you more) for using their product. This was the mainstay in pharmaceuticals until the pharmaceutical companies were mandated to not incentivize doctors for prescribing their product.
  • Increase office efficiency – Numerous groups specialize in business efficiency. Many of us continue to do things the same way we did 10 years ago, although with the evolution of technology and patient care the business has completely changed. Many don’t even know where to start. It starts with breaking down the systems in the office and asking our colleagues how their systems work. For instance, how does our office spend significantly less time managing the frame board? Or how have we decreased the time spent on the phone scheduling an appointment?

 

 

All these ideas and thoughts take time and energy to think about and effectively execute. That is the difference between practices that are keeping large slices of the pie and those who only get a sliver. In today’s business world it requires adapting to change at a much faster rate then ever before. I’ve found that taking more time for administrative work and less time in patient care has allowed us to keep up with change and remain profitable.

Avoidable Mistakes of the Seasoned Optometrist

The farther I get in my career the harder it is to face mistakes that I have made. All optometrists make mistakes, the important thing it to learn from those mistakes.

“The hardest thing about being a doctor,” Dr. Karen Delgado said, “is that you learn best from your mistakes, mistakes made on living people.”

All new practicing optometrists face the dilemma of having a head full of knowledge while holding only an empty cup of experience. During the first couple of years we realize practicing optometry is exactly that, practice.

So when you have patients who need contact lenses for the first time, it is second nature to fit them with the latest technology in single use contact lenses. As the years go by the “go to” contact lens becomes the “old” lens as new and improved ones come on the market. This is what begins to separate the quality of care received by patients from different optometry practices, and I would venture to say the dilemma that ophthalmology faces when viewing our profession.

Avoidable Mistakes that optometrists make as time passes.

  1. Not keeping up with research – “If it ain’t broke, don’t fix it.”  This mantra does not work in optometry because too many patients are breaking down later in life because their optometrist never took the time to actively prevent future problems. Is it OK to not dilate a patient with diabetes because the Optos technology allows for a 200 degree field of view?
  2. Only fitting patients in contact lenses that the office keeps in stock – This is an easy one to overlook but I have had to humbly order multi-focal contact lenses because the two different companies that I prefer did not have a product that worked for the patient. In the last month, I have had two patients who have been happy because I ordered trials from a company we seldom use because they have a mainstream multi-focal contact lens that other ODs say works.
  3. Stop asking questions – New ODs are fun to practice with because they have questions and get excited about pathology that we seasoned doctors have seen multiple times. They come and ask us about what we would do in cases and they read about what they experienced in clinic. Too many of us seasoned doctors think that we are supposed to know most everything we encounter in practice by now. Let’s get honest, we need to regularly ask each other dumb questions. When we don’t ask questions patients suffer the most.

Some mistakes are avoidable. Don’t let these keep you from practicing at the highest level. It takes humility and a desire to give great patient care to embrace the above mistakes and not let them define your career.

When busy people need to meet, use this

Scheduling a meeting can be time-consuming. Finding a suitable time and date for multiple doctors and all staff members sometimes requires numerous emails over the course of several days. Instead of spending your valuable time, let technology assist you. Doodle.com* has saved me lots of time and stress by finding the best meeting time for everyone. Here’s a glimpse of how it can save you time.

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The beauty of this technology is that the basics are free, and the basic scheduling capabilities it offers has the potential to make your job easier. As optometrists we can become overwhelmed with all of the duties associated with running an office and managing people. If we are not constantly working on being more efficient at these fringe responsibilities, we will be limited on what we can accomplish. Spend more time doing what you want when you want to do it.

*OptometryCEO and its constituents receive NO funding or support from Doodle.com, we just love the technology.

Is wearable technology distracting your optometry staff?

Go anywhere these days and you’ll see people checking their phones and accessing social media. That’s why as an optometry business owner, you most likely have a office policy detailing proper use of smart phones during work hours.

But what about wearable technology? With the advent of the Apple Watch and others, your staff members have the capability to stay posted to their most recent notifications throughout the day and others may not even realize they are doing it. Before you have to reprimand a staff member for monitoring social media while working up a patient, it’s a good idea to become familiar with the popular wearable technology options and have a policy in place. It’s always easier to address the issue before it becomes an issue.

Three common wearable technologies that communicate to the user from his or her smartphone.

  1. Apple or Samsung Watch – These watches are the easiest to spot because they are rather large. This technology allows the user to view incoming text messages and notifications while also allowing for short responses. From an owner’s viewpoint, if you don’t allow your staff members to use their cell phones during patient care, then you will most likely need to ask them to not wear their smart watches during patient care. Adding this to your policy now will keep it from being a major issue later.
  2. Pebble Watch – This is similar to the above mentioned watches with fewer features. The Pebble does allow for communication but is more discreet than the above two watches. One of your staff members may be wearing one now and you might be completely unaware of the technology. I would recommend that you list this one along with the Apple or Samsung watches in your policy. I’ve used a Pebble dress watch for the past couple of years to screen calls and watch for important messages throughout the day while seeing patients. When I see a doctor-to-doctor call, I can politely excuse myself from the room and take the call.
  3. Garmin Vivosmart – This looks like a Fit Bit (another wearable technology) that monitors steps and physical activity throughout the day. The reason that I own one of these instead of a simple activity monitor is that I am able to get all notifications through this little guy. I love it because it is the ultimate in being discreet. Because these have notification capabilities it would be wise to ask staff to also refrain from wearing these during work so they will not be distracted by all of the text messages, Starbucks notifications, calendar updates, etc. that are sent to this wrist device.

When did the job of an optometrist become a policy maker and enforcer? The moment you became the owner. Unfortunately, these are the issues that we all deal with in small optometry business. The wise owner takes action prior to the issue becoming a problem, rather than letting the damage accumulate as issues remain unaddressed. Decide now what your policy will be on wearable technology and add it to your employment/policy manual.

Profitable technology for the optometry business owner

Technology encompasses most areas of the optometry office. There is technology in clinical equipment, practice management software, electronic health records (EHR), information transfer, and hardware. Keeping current with all this technology is expensive and possibly daunting for a less-than-enthusiastic technological owner. So which technologies are necessary and which are not?

The technology to invest in needs to do at least one of three things:  improve financials, increase new patient growth, and/or give you a competitive advantage.

  1. The right EHR – Not all EHRs are created equal. A quick reference to ehrcompare, an online rating system for optometry software, reveals that there are varying degrees of software, both good and bad. This is not an area to cut corners.
  2. The right web involvement – Word-of-mouth is still the best way to get new patients through the loyalty of current patients. When your patients can easily navigate your website and e-communications, they view your practice as convenient and user-friendly. I recently was reminded how important this is when I received an email from my dentist’s office for an upcoming appointment. I realized I had a conflict and needed to reschedule, but the email did not link the phone number to their office, plus the only option was to call during their business hours. IMatrix is a partner of optometryceo and is used by my office. After partnering with them our new patient numbers have increased and weekly we have patients who comment about how nice it is to schedule and confirm appointments online anytime without having to call our office.
  3. Hardware that costs less – Have you looked at the costs of keeping your PCs, printers, scanners, and wired/wireless network up to date? These costs may be eroding your profits. Maintaining an in-office server requires a knowledgeable IT service and adding a printer or scanner can take a well-paid technician hours to set up. To cut hardware costs moving forward look for two things:  cloud printing and a cloud-based EHR.

Many optometry business owners feel stuck in their current systems, but this does not have to be the case. Deciding to change is painful, but we tell patients all the time that if they do not change their contacts regularly or use a hydrogen peroxide solution they are going to have regrettable problems. You may not believe you have a technology problem now, but will your current technology allow your practice to be healthy and thrive for years to come?

Managing millennials in an optometry practice

Successfully managing staff may be the most difficult aspect of running an optometry practice today. Keeping up with new technology and yearly updates to insurance plans is challenging, but nothing is as unpredictable as managing people. The small optometry business owner and the OD were not trained for this in optometry school.

Generally owners and ODs are older than the staff they manage, so generational issues often compound the problem. Millennials, who comprise the 19-35 year-old age group, look at life from a unique perspective. Employers who hope to successfully employ and retain a team of millennials should be aware of their mindset.

Millennials in the work place

  1. Millennials want more freedom in their work, so they are resistant to the 9-5 job. In fact, Millennial Branding polled over 2,000 millennials and found that over half of them would rather travel while working than take vacation time. They also found that 87 percent would rather work whenever they would like.
  2. This same poll revealed that over 50 percent would rather work from home.
  3. Millennials prefer to work late at night.
  4. Over 60 percent stated they would most likely quit their jobs within the next two years.

Managing the Millennials

  1. Give them projects that allow them to explore their entrepreneurial spirit. They like work that expresses their creativity. Include them in decisions.
  2. They like to move ahead.  Give them plenty of feedback and let them know areas in the office they can improve and also tie this to life success.
  3. They resist corporate. Remind them you are a small business which will allow them to learn new things and allow them to be cross-trained.  They don’t want to be limited to a cubicle and a rigid job description.
  4. Of those polled, over 50 percent of them classified themselves as entrepreneurs. Take advantage of this and give them projects (i.e. – website function and design) or leadership within the optometry practice that allows them to run on their own. This can be difficult in small businesses but can pay dividends when staff are not constantly turning over.

Staff turnover is one of the most expensive overhead charges that isn’t discussed in practice management dialogues. Optometrists want to discuss cost of goods and buying groups, but I have not found a buying group that helps me keep staff members longer and increases their job satisfaction. Working to understand your staff members and tailoring their positions as much as possible to their preferences will help you, your practice, and your patients benefit from consistently dedicated staff.

Reference: Small Biz Trends (http://smallbiztrends.com/2013/05/millennials-work-and-entrepreneurship.html)

http://www.pewresearch.org/fact-tank/2015/01/16/this-year-millennials-will-overtake-baby-boomers/