Dr. Mai's Optometry Blog

Not optometry related as much business related.

Last weekend I went to Las Vegas, and in particular ate at a Restaurant called Bouchon‘s in the Venetian hotel. It was awesome, except pricey, but price isn’t the biggest factor when picking a restaurant in Vegas.

My friend Elaine orders a dish, but she ends up not liking it too much. The waitress notices immediately that she doesn’t like it and without prompting suggests that Elaine pick something else. Elaine doesn’t mind it so much and says no thanks.

Without us even asking, they take the entire dish off the bill. And Elaine gets free dessert.

Also, besides the fact that they had people watching the table nonstop to refill our waters when the glasses were even half empty, get this.

I went up to use the restroom and throw my cloth napkin without even thinking about it on the table. When I come back the waitress apparently had stopped by, and folded it into a neat pretty fan-looking thing! Wow I was impressed.

They say you can only win two of these three categories of price, quality, and service when running a business. Most private optometric practices will never win the price war, so don’t fight it. But if you can “wow” someone in the other 2 categories, they’ll keep coming back.

My AOSA Trustee Dave sold me on going to optometry’s  meeting, so I went last week to the AOA optometry’s meeting in Orlando and boy was it an event. The Gaylord Hotel was enormous with multiple pools, bars, and a large convention center. There’s just something about a huge auditorium with two big screens showing the speaker and powerpoint presentation that is just cool in my opinion.

Highlights:

- Optometry super bowl (hosted by Essilor) . It was like a sporting event, people were chanting and screaming for 2 hours for their representative to show everyone who was the biggest nerd of all in a knowledge bowl optometry trivia match. Unfortunately, our guy Andy didn’t make it past the first round. Dr. Kevin Alexander, our president, was there and told us if we won the bowl he’d give the winner a full-ride scholarship – so I’m going to go for it next year!

- Went to a seminar by John Rumpakis, and A. Kabat about day to day dilemmas. It was similar to my case analysis classes and there were probably 500+ students in attendance.  Val and I were the only students to walk up to the presenter A. Kabat after the lecture to get his opinion on why he used Azasite for something in conjunction with oral doxycycline – though I forget what the condition was (ocular rosacea?).

- John Rumpakis and Ryan Parker had a presentation on private practice and the transition from student to doctor. They did something really ingenius to get participation by putting up their cell phone numbers for us to text questions and while the other person was talking they would read the text messages and answer the questions. They might have answered 20-30 in total and 2 of them were mine! I asked them who they thought would win, Lakers or Celtics, before the actual game and they were split. I also was confused at how Dr. Parker got his practice breaking even 2.5 months after starting cold without stealing patients from his former partner – he kind of shyly answered the question but Dr. Rumpakis called him on it and said he basically stole the patients lol. I guess in optometry, you gotta do what you gotta do.

- The receptions were a ton of fun. I met a bunch of other students from Berkeley to SUNY and thought everyone I met was super nice and easy to talk to. The future of the profession looks bright, I know this because nice people finish first in my opinion =).

- Practicing optometrists at the AOA convention love the profession and think it has a bright future. I kept hearing from the young and older docs “Congratulations! You joined a fantastic profession.” To be honest, it makes me feel great to hear such things.

- Some believe optometry  is oversaturated. “Get out of California, come to my neck of the woods.” Others (some of the hotshot consultants) think saturation is no big issue.

From optometric management

Clink on the link above to read an article about bringing a new grad into an established practice.

Just attended a quick presentation by a elite level vision therapist in the bay area who sees 40-50 VT patients a week. And I wanted to jot down some of the take home messages quickly. In general, most things are common sense but sometimes you don’t think of the common sense stuff.

Most of his points were generalities:

Why do patients leave a practice to go somewhere else? It’s never the doctor’s fault. Optometry school is a great equalizer where by and large every student that graduates is an exceptionally smart, talented, and skilled doctor. They leave because of the person they come into contact with first, the staff member who answers the phone, they feel is incompetent or doesn’t care.

Take home message: either answer phones yourself or have the next BEST trained staff member answer the phones. Don’t delegate to the newby. You want the patient to get the most accurate information possible so they know the staff and office are competent.

You think debt in optometry school is a big deal? Not really, the biggest mistakes are the ones you make AFTER you graduate. Spending an extra 50k partying during optometry school is peanuts versus signing a wrong lease, opening cold in a town that can’t support you, hiring a bad staff member or associate doctor, or paying too much to buy out a practice.

THM: Don’t sweat it in school. But don’t rush into hasty decision after schools. All optometrists will be successful as long as they just avoid the trainwrecks.

Don’t inundate your patients with massloads of information. Don’t have a slew of pamphlets and give them information overload. Assess them quickly, and tailor your patient education to their condition.

The presenter sees patients like an orthodontists does, spending 5-6 minutes of individualized time per patient. Spending a lot of time is not necessary. If you watch TV with your spouse for 4 hours, is that quality time? Or is having a 30 minute conversation in a car ride more time well spent in the relationship than the 4 hours spent watching TV?

THM:  Specialize in knowing your patient and address their needs specifically, do not inundate them with information.

I believe his practice is setup right next to another multi-doctor practice that does general practice optometry. The situation is ideal because he can get referrals from them for VT and they don’t mind because they know he isn’t going to steal any of their patients.

VT is mostly private pay because no insurance covers for his patient base. The pay is thus limitless because no 3rd party sets the fee, you do.

He also talked about the most important thing to success is how you manage your failures. One successful patient might tell 1 or 2 others if you are lucky. But one failure will tell a dozen or more for sure.

THM: Your reputation is priceless. Manage the failed patient cases by quickly refunding their money. Everyone on staff must realize this as well, and the policy should be in writing and displayed proudly for all the patients to see. A patient can’t be mad at you if the therapy didn’t work if you refunded them the entire amount quickly and honestly. A key is to do it quickly and not grudgingly. (example, if your spouse asks you if you like their new haircut, don’t pause and then say you love it. You must say you love it unequivocally and without hesitation).

From a presentation two nights ago.

Cheap stuff may be found at dotmed.com

For recall, patients don’t like emails or letters but postcards. Have them write the postcard if you want.

Hire a consultant if you are a inexperienced. The advice given will pay for itself.

Send postcards for Thanksgiving and Valentines day thanking a patient and showing them you care.

Why don’t future optometrists want to pursue private practice?

Because they realize they’re going to be broke the first few years out of optometry school if they start in private practice. That it’s a big risk, that working 9-5 and then going home sounds sweet after a grueling optometry school curriculum. And then they’re at Costco, or Walmart, or even a big HMO like Kaiser.

Why does this happen?

For the same reason I drove to Subway for lunch today. I’ve got sandwich supplies at home, but I still didn’t make my own sandwich because the thought of cutting up the tomato, getting the lettuce and turkey and mayonnaise to assemble my own sandwich was too great of a barrier to overcome. So instead I spent MORE time and energy driving around to spend more money on a sandwich that isn’t much better than what I could have made with the supplies at home.

I did it because of barriers.

Those that will have the most success in life recognize barriers quickly and ruthlessly tear them down.  Some barriers are obvious like needing a key to open a door, or opening a backpack to get a book. While others are invisible like the fact that not having a pen at my desk is an obstacle when someone calls and I need to jot something down real fast on a scratch piece of paper. Some barriers are helpful like when I want to stop surfing the internet mindlessly instead of studying, I drive to school and study there in the library or lounge.

But the number 1 obstructive barrier for anyone out there is simple. It’s not the local economy, over saturation of optometrists, OMDs, education,  or lack of money. Just look into a mirror.

It’s YOU.

Just as soon as you dream a dream, you start thinking of all the things that could go wrong.

“I can’t make it in Southern California because it’s so saturated.” When you should be saying “what are the things I need to do to overcome this barrier?”

“I can’t afford to go to optometry school.” instead of “how can I afford to go to optometry school?” (wait a minute, I think I read that somewhere in a Kiyosaki book…)

It’s why when I asked my friend about getting into private practice, she doesn’t ask me about where to find one, how to market and sustain it, or how feasible it is in certain locations. She asks “how the heck am I supposed to get a loan to buy one when I have no credit?”

Some people are afraid because they aren’t aggressive enough for private practice, that they have a hard time commanding people. But who says you need to have these traits? In the words of Dr. Paugh in lecture today, “it’s fine to be an introvert!”

How do you know you need to be aggressive to make a sale? Because you see salespeople on TV do it, or at a car dealership?

It’s more important to follow one rule. Really, just one rule.

Do what is best for the patient. If what is best for the patient happens to be more expensive, so be it, but always advocate for this and you will never go wrong when you advocate for what is best for them. If wearing polarized sunglasses while driving in the morning makes it easier to see, I’m recommending it. If wearing AR coating lets more light reach pass the lenses, I’m recommending it.

In the end, if you want to get from A to Z, don’t keep creating all these mental barriers that stop you from doing something even before you’ve started. If you want something, set a goal and go for it. I know I will, so good luck to the both of us.

I heard an inquiry about what state is best to practice optometry in on the Student Doctor Network. (http://forums.studentdoctor.net/showthread.php?t=630694)

While the responses are varied, in terms of purely salary one place to look is the Bureau of Labor Statistics. http://www.bls.gov/oes/current/oes291041.htm

I read articles on optometric management regularly and came across 2 good articles by Dr. Neil Gailmard.

http://www.optometric.com/mtotw/tip.asp?tip=412

Here is another one about finding job opportunities.

http://www.optometric.com/mtotw/tip.asp?tip=413

In this economic climate, and if you are an optometry student in California, it is never too early to start the wheels turning.

There’s a lot of hoopla over at ODWIRE.org about board certification. Seems like the majority of them hate the idea of it.They don’t want to spend the time and money to take the test, especially the older docs. Are they just the vocal minority, or are they representative of what many practicing doctors believe?

Then at SCCO, our president Dr. Alexander, is a huge proponent of BC and so are many of the faculty. Are they the academics who just don’t understand the “real world” from their ivory tower view?

Regardless of whether it’s necessary or not, if not being board certified leads to optometrists being discriminated by insurance companies, what would the ramifications be? Would some docs retire early? Or is this just putting another hoop for us to jump through needlessly?

By far the two most important topics that they wanted more information on were

1. Appraising a practice (finding diamonds in the rough)

2. Negotiating contracts.

SCCO students are weird in their prioritites. I’ll explain why.

There’s a practice management symposium coming up this Saturday at SCCO.  It features professional consultants who are generally paid thousands of dollars to speak. They are going to talk about real world stuff, not the ivory tower stuff you often hear at the schools. Like how to set up a practice, how to buyout a practice, negotiating contracts etc. All practical stuff, how to interview, how to communicate. Things they don’t teach at school but should like financial literacy.

The 5-hour event is free, plus, there’s free food.

You’d think out of the 300+ students on campus that most of them would show up. I mean, the vast majority of them show up to lectures about inanely esoteric subjects like how rabbits have a higher percentage of arginine in their aqueous humor than humans do. They furiously highlight and make note of such things. Quiz each other during lunch about it and burn the night cramming these facts into memory.

So far about 30 people want to come. Did I mention there’s free food?

It’s crazy. That students  spend 95% or more of their time learning about things that won’t matter when the real determinants of success – dealing with people, communicating effectively, and financial literacy are, in my humble opinion, incredibly more practically useful.