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THE ENTERTAINING SIDE OF OPTOMETRY

Q&A

Biologist Thomas Huxley once said, “Surely there is a time to submit to guidance and a time to take one’s own way at all hazards.” Although he wasn’t talking about optometric practice, this quote easily applies. Our profession is faced with several challenges, such as immense competition and decreased reimbursements, requiring the guidance of those who have come out on top.

This month kicks off a series of interviews with these individuals. Specifically, they are the heads of optometric alliances. These alliances provide the tools needed to grow and compete in today’s complex eyecare marketplace, while also affording immense savings and networking opportunities with like-minded doctors.

This month, I speak with David Golden, O.D., co-founder and CEO of PERC, and Jerry Sude, O.D., chairman of the board and co-founder of OD Excellence. Both offer tips for your practice, outline the benefits of their individual practices and more.

Once you’ve finished reading my interview with these gentleman, be sure and stop by the Travel, Food & Wine section, where Kirk Smick, O.D., tells you about his adventure in Hong Kong.

Jack Schaeffer, O.D., F.A.A.O.,
Editor-in-Chief
O.D. Scene

Key Optometry Alliance Leaders Weigh in…

Q CAN YOU DESCRIBE YOUR PREVIOUS OPTOMETRY PRACTICE?

DG: I started practice in 1987 with my father. I quickly realized that differentiating myself by working in his shadow was never going to be easy and to some extent, impossible. He was an exceptional O.D., a talented communicator and a very astute businessman. I wanted to create a patient experience and business model that was more sustainable and not centered around one superstar doctor. Today, I run five locations with 12 O.D.s, one O.M.D. and about 80+ team members.

JS: I am still the president of Novus Clinic in Northeast Ohio, which consists of three locations, an ambulatory surgery center, three ophthalmologists and seven optometrists. I still see patients seven and a half days a month, which gives me a pulse on what O.D.s are dealing with in their respective practices.

Q: WHAT IS THE IDEAL OPTOMETRIC PRACTICE OF THE FUTURE?

DG: An integrated, full-service, easily accessible eyecare facility. The office needs to be connected electronically to all payers, medical records and portals for the population they are managing. The office would have a nurse practitioner or physician’s assistant to extend primary care services to their patients. All the O.D.s would need to be fully qualified and comfortable to manage patients to the full extent of their license. Patients would have access to on-site general and specialty ophthalmology services. The ideal office would be open seven days per week, including all weekday evenings with an optical that is run like a retail business, differentiated to compete with any retail optical establishment on price, service, selection and quality.

JS: The typical independent optometric practice we know today will have to make changes to thrive or even survive going into the future, considering the changes in healthcare delivery systems, lower reimbursements and the overall increased costs in operating a practice.

I believe the key elements the future practice will have to implement going forward are: (1) a CEO rather than an optometric manager, who is knowledgeable in all operations, as well as in understanding the economics of our industry; (2) Closer attention to contact lens as well as frame and lens margins, as our reimbursements have been lowered; (3) Closer attention to monthly P&Ls, ensuring labor and COGS are in line; (4) Access is critical, as patients can no longer wait more than a few days to see their OD; (5) Customer service must be at an all-time new level in order to truly compete and retain patients; (6) Having the diagnostic equipment to practice full-scope medical optometry; (7) Optometry must become the vision component for coordinated care teams going into healthcare reform.

Q: DO YOU THINK THERE IS A FUTURE FOR THE PRIVATE/GROUP PRACTICE?

DG: Absolutely. I believe our future has never been brighter. Most of the changes in healthcare policy and care-delivery models center around primary care physicians and their ability to manage chronic diseases, such as diabetes, hypertension and hypercholesterolemia, within a given population. Optometry is perfectly positioned as a primary care profession for the eye and one that can extend its services to help primary care physicians manage chronic disease. Our scope of practice continues to expand, and technology is improving our ability to provide our patients with better outcomes. In addition, we have one of the best brick-and-mortar footprints of any doctoral level clinician that includes evening and weekend accessibility, and we have the capacity to see additional patients in our schedules.

1: Dr. Sude enjoys kayaking in his backyard. 2: Dr. Sude with Angela.

JS: I feel single practitioners will find it increasingly more difficult to deal with all the changes in our industry, and we will see more and more individual O.D.s bringing in partners or associates to help with increased access, operations and strategic planning. As a result, I think group practices will be the practice of the future, and some of these groups will be O.D./M.D. partnerships.

Q: WHAT ARE YOUR SUGGESTED MAJOR STEPS FOR SUCCESS?

DG: Increasing office hours, spending time, energy and money to make your retail presence attractive to your consumers/patients/customers; investing in technology by always having the best diagnostic and therapeutic equipment possible so patients know they are getting exceptional care leaving your facility; increase physician referrals by showing their offices how they can schedule patients online into your schedule-making care coordination easily and seamlessly; educating local primary care physicians on how you can extend their services, and deliver value.

JS: The following points are critical to ensure your practice thrives moving forward: (1) Train a CEO in your practice to oversee every aspect of your business; (2) Create an ongoing training program for the entire staff that includes insane customer service; (3) Make sure your dispensary mix is geared to maximize profitability in a managed care environment; (4) Watch your accounts receivable closely, and create guidelines for your billing people to follow; (5) Have ongoing staff meetings with agendas that allow staff participation and buy-ins; (6) Find a way to see more patients per hour; (7) Be sure to prepare your practice for healthcare reform, so you are not experiencing patient attrition.

Q: HOW WOULD YOU ADVISE A NEW GRADUATE TO PURSUE A CAREER IN OPTOMETRY?

DG: I would tell him or her that optometry is the single best healthcare profession that provides a great balance between patient care and retail, and that I find it to be exciting and unique from an entrepreneurial and care delivery prospective.

JS: I would recommend searching for an independent O.D. practice that has an owner willing to mentor you in all aspects of patient care, as well as the economics of running an optometric practice. I would also say to make sure after interviewing the potential employer, that he or she is well versed in the areas mentioned. At some point if purchasing or starting your own practice makes sense, make sure you have an experienced noncompetitive, successful O.D. or entity mentor you from the beginning.

Q: DO YOU FEEL A RESIDENCY IS IMPORTANT?

DG: Absolutely. In our practices, we specifically are looking for residency-trained O.D.s. Currently, five of our 12 O.D.s are residency trained. I encourage all the students I have helped get into optometry school to complete a residency before they come work with my group.

JS: I feel a residency is very important, and there is nothing that better prepares a new graduate to make good decisions, as well as choosing how to practice. The clinical and operational experience is invaluable. I have been involved in a residency program for years with The Ohio State University College of Optometry, and it has been a valuable experience for all.

Q: WHAT DO YOU THINK MAKES YOUR BUSINESS ALLIANCE UNIQUE?

DG: PERC (Professional Eyecare Resource Cooperative) and IVA (Infinity Vision Alliance) include optometrists, ophthalmologists and opticians, we are a free model in that we do not charge our members for aggregating their purchases, and we have created a business-to-business ecommerce enterprise where our 2200+ locations can purchase 17 different frame brands from a centralized warehouse leveraging more than $1M in frame inventory. This means independent doctors can purchase like a national chain by having PERC take an inventory position and efficiently distribute it to its members. In addition, we have frame brand consultants who partner with our member practices to improve their product brand selection, increasing their inventory turn rate and improving their patient capture rate. PERC and IVA have a strategic partnership with iCare Health Solutions, which works to build, connect and provide patient access for our member locations. The iCare Team work with all types of healthcare delivery models managing almost 2M patients with 19 different payers. This partnership allows us and our members to build a narrow network and have access to a risk-bearing organization that can pass a Medicare delegated audit, has comprehensive clinical protocols, a call center, TPA (third party administrative) services and all the other necessary functions that networks need to function and connect to payers.

1: Dr. Golden with wife, Sheila, in Cuba.
2: Dr. Golden and his girls.

JS: We are certified by the University of Houston College of Optometry. This online and live program takes a key individual in your practice and teaches him or her every aspect of running a practice, as well as understanding the economics of an optometric business. We provide a pre-employment assessment program, which helps our members screen and select the best candidate for each staff position within your office. We provide a healthcare reform platform program that outlines for you a personalized road map to success, and we include an ongoing orientation to key terminology needed to confidently speak the language of healthcare reform. You are guided through the process of implementing critical changes in your practice based on healthcare reform concepts and explaining your presence as the vision component in your community. We provide consulting services on all operational and practice management issues that are critical in running a business. We hold an international vision conference in San Diego, which includes 16 hours of COPE-approved education, 14 hours of office manager education leading to certification, 13 hours of staff training, coaching sessions by consultants, social events and networking with your peers. Finally, we have no contracts, we don’t take a percent of your practice, and you can leave at any time without penalty.

Q: WHY JOIN A BUSINESS ALLIANCE?

DG: There is strength in numbers. Individually: doctors do not have the leverage to significantly negotiate and lower their cost of goods; they don’t have the time or expertise to connect their practice to healthcare reform; they find it difficult to manage all aspects of their practice and still see patients full time, etc.

JS: The changes we are seeing in our industry are monumental and very difficult to navigate alone. With ICD-10 CM, reduced reimbursements, complex billing and coding protocols, wasteful marketing expenses, staffing issues and healthcare reform, it becomes necessary for a practice to align with an optometric business alliance.

Q: IF YOU COULD HAVE DINNER WITH ANYONE, LIVING OR DECEASED, WHO WOULD IT BE AND WHY?

DG: My Dad. I would like to share all the wonderful opportunities he gave me and let him see the fruits of his labor and love. He passed away almost two years ago. Not a day goes by that I do not ask myself, What would dad do in this situation? His prospective, insight and clear thinking was NOT always what I wanted to hear, but he ALWAYS had my best interest in mind.

JS: Warren Buffett. To be able to spend time with an individual who has created Berkshire Hathaway, which owns companies in many different segments of business, and having made them successful, is an amazing testimonial to an amazing individual. His demeanor is very relaxed, and when listening to interviews, he talks at your level. I feel listening to his investment strategies and strategies on how to run a company could be life changing.

Q: WHO ARE THE MEMBERS OF YOUR FAMILY, AND WHAT DO YOU LIKE TO DO FOR FUN?

DG: My wife, Sheila, and I have been married for 26 years. She has an M.B.A. from UCLA, and we are putting it to great use! We have two daughters: Cassidy (age 20), a junior at the University of Pennsylvania, and Erin (age 19), a sophomore at Davidson College. For fun, I like carpentry, fishing in Alaska and Mexico and traveling and tasting regional cuisines with my wife.

JS: I’ve been in a wonderful relationship with Angela Ellison for 15 years. For fun, I enjoy playing golf, spending time with Angela at our home, working out, I’m on several Boards of Directors, I help fund many animal welfare groups in Northeast Ohio, and I cofounded the Aladdin Foundation for children who have life-threatening illnesses at our local Children’s Hospital.

Q: WHAT IS YOUR FAVORITE MOVIE, BOOK, BAND AND ADULT BEVERAGE?

DG: Movie: The Bucket List; Book: “Kite Runner”; Band Harry Chapin; Adult beverage: Kettle One – Dirty with extra olives.

JS: Movie: Hard to pick one. The Graduate, A Bronx Tale, The Godfather; Book: “Unbroken”; Band: Green Day; Adult beverage: a great glass of wine.

TRAVEL, FOOD & WINE

Hong Kong: Culinary Capital of Asia

Kirk L. Smick, O.D., F.A.A.O.
Senior Editor, O.D. Scene

I recently had the opportunity to spend four days in Hong Kong. My visit came at the conclusion of a 13-day cruise from Singapore during which I visited much of Southeast Asia, including Vietnam and Cambodia.

OVERVIEW

Hong Kong is a shopper’s delight. It includes several outdoor markets where bargaining is the word of the day. (And English is well spoken.) We visited the flower market, the bird market, the jade market and the ladies’ market. Just about anything you can imagine is available.

Further, the city is home to several beautiful upscale malls, and each have as many as 50 wrist watch stores with prices between $10,000 and $50,000.

Personally, I took advantage of the requisite Hong Kong tailor shops, having several shirts and sport coats made.

One of the most interesting sights in Hong Kong is the Central Mid-Levels escalators and walkways. They stretch more than 2,600 ft. and almost 433 ft. through steep hillside streets connecting Hong Kong Island districts. Opened in 1993, the Central Mid-Levels are comprised of 20 individual escalators and three moving walkways.

WHERE WE STAYED

Our hotel room was on the 115th floor of the Ritz-Carlton Hong Kong. The hotel is a five-star property located on the 102nd thru 118th floors of the International Commerce Center (ICC). It includes a bar and swimming pool on the 118th floor, making both the highest in the world. Look down, and you’ll see a bustling harbor scene and the Star Ferry terminal.

CUISINE

Hong Kong is known as the “culinary capital of Asia.” We ate at Lung King Heen, the world’s only Michelin three-star Cantonese restaurant. Other evenings, we ate at Tin Lung Heen, a two-star restaurant at the Ritz-Carlton, Ye’ Shanghai, a one-star, and Tosca, a Michelin one-star Italian restaurant.

Peking Duck was the star of the show, and the mahogany color of the birds was elegant. Needless to say, following some wonderful dining on our cruise, we found it necessary to let our belts out a notch or two.

Hong Kong is a fascinating city and worth a special journey. Together with Singapore, these Asian superstar cities make a perfect 10-day vacation for anyone.