Dr. Mai's Optometry Blog

It seems like yesterday I was grilling up meat at a bbq for the class of 2013, and really it seemed like yesterday (2 years ago) when I was being served BBQ for my class of 2012. But today, there was another annual orientation BBQ. The SCCO class of 2014 was out with their bright eyes and youthful enthusiasm,

It’s fun to watch orientation 3 months after May when the seniors graduated.

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.

On campus today at noon, the professional eye care resource co-operative invited students to join them for lunch. This was the second time I joined the group for lunch, and they’ve always been an incredibly friendly group of people. PERC is an optometric co-opt comprised of individual practitioners who all gross over 1 million dollars annually.

Right now there are over 100 optometrists in the group, with the majority of them in Southern California.

A classmate of mine made this video. It highlights some of the more lighthearted aspects of being an optometry student at SCCO. This was also shown at our spring open house for interested SCCO students.

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.

One short anecdote I forgot to mention at the RAM.  My friend Denh was talking to Dr. Gordon, a staff doctor over at OCLA about ocular disease. It went something like this:

“Dr. Gordon! How much disease do you see at OCLA?!”

“Oh we see quite a bit, I guarantee you’ll learn a lot if you come here”

“Awesome! The more disease the better. We just learned about Trachoma in class yesterday, about ARLT’s line it was fun!”

:Chuckling: “A little knowledge can be a dangerous thing.”

I thought it was interesting what Dr. Gordon said, but he is right on the money. How many times do I expect to see Trachoma in the United States in my lifetime? Possibly ZERO times ever. It should very rarely be on my list of differentials. Inclusion bodies from Chlamydia, possible, but not Trachoma. So why do we learn it?

Some will fault optometry school, saying what’s the point of teaching all this “junk” information. Or mention that in a private practices someone shadowed, they never do phorometry on every single patient – so they’re mad that opt schools make us waste our time.

My opinion is that the point of optometry school is to learn as much as possible so that if I ever run across it, I can make the appropriate call. Definitely, it would be financial suicide to do 2 hour exams on all our patients when we graduate, but for now it is academic suicide to not practice all the skills we’ve been taught and to do a thorough (this is the emphasis, not speed) exam.

It’s much more common to hear about myopia at my age and less so with hyperopia. But the prevalence of hyperopia really struck me when I volunteered for Remote Area Medical last week. What is RAM? Basically it is an event where free healthcare is given to those who cannot afford it on their own.

I volunteered in the lab making glasses as well as dispensing them. With no stretch of the imagination, it seemed at least 75% of the glasses I made were for hyperopes. Some had it bad like +4.00 with a +2.00 add. It makes me wonder how long these people, who could not afford to update their glasses, have been functioning especially at close. With that much uncorrected hyperopia at near, I can’t imagine they could have been reading all that well.

Could the inability to read presently, and the accommodative demand manifesting as eye strain in their pre-presbyopic days have been a significant impact on their current financial plight? This is debatable but I would think it could have certainly impacted their performance in school and ability to learn due to a visual problem.

To me it just highlights the need to see an optometrist regularly. Undetected vision problems can certainly impact one’s ability to learn and just function. How many of these underprivileged people that RAM served could have avoided their situation altogether if they had proper eyecare at a young age?

http://www.aoa.org/documents/HCR-Outline.pdf

http://www.aoa.org/documents/faqs.pdf

If you’re confused as I am about healthcare reform and how it may affect optometry, the AOA provides some very useful information. Click on both of the links above to learn more!

Here is the AOA president’s blog as well. http://newsfromaoa.org/

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.