DEDICATED TO THE INTERESTS OF WOMEN ODs...Sara Laschever, Women Don’t Ask: The High Cost of...

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That’s discouraging, but it’s not irreversible. Employment experts tell prospective employees to avoid providing a potential employer your previous salary. Instead, focus on what you want to be paid by redirecting the question. “I’m looking for a position in the $___ range.” Flexing your negotiating muscles comes into play far more often than in compensation conversations. (On page 5, WO Professional Co-editors April Jasper, OD, FAAO, and Katie Gilbert-Spear, OD, MPH, share their experiences.) While individuals can take some control over their personal situation, there’s also an effort to address the pay gap more broadly. Lipman cites a new British plan to have companies with more than 250 employees publicly report wages by gender. The government hopes that this move could elim-

inate the gender gap in a generation. In April 2014, President Barack Obama signed a mem-orandum instructing federal contractors and subcontractors to report worker compensation by gender and race. The Equal Pay Act of 1963 has been impeded, he wrote, “by a lack of suf-fi ciently robust and reliable data on employee compensation, including data by sex and race.” The drumbeat from organizations that track pay disparity among women and minorities is help-

ing to create this kind of institutional change. It’s an intriguing and frustrating subject, and there’s no easy answer. It’s also one that Women In Optometry will explore in greater depth at its live networking sessions held at Vision Expo West and the American Academy of Optometry meetings this year. When we make conversations about salary and negotiating taboo, we’re not doing any women any favors. WO

Marjolijn Bijlefeld, Director of Custom PublicationsPractice Advancement Associates

Publisher: Al Greco

Executive Editor: Roger Mummert

Professional Co-editors: Katie Gilbert-Spear, OD, MPH, and April Jasper, OD, FAAO

Director of Custom Publications,Practice Advancement Associates: Marjolijn Bijlefeld

Associate Editor: Maggie Biunno

Creative Director: Stephanie Kloos Donoghue

Graphic Designer: Barbara W. Gallois

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An August 13 opinion piece appeared in the New York Times, “Let’s Expose the Gender Gap,” in which journalist Joanne Lipman called the pay gap “one of the most intractable problems of our time.”

She wrote, “More than a half-century after President John F. Kennedy signed the Equal Pay Act of 1963, the gap between what men and women earn has defi ed every effort to close it.” Data shows that the gap exists in all professions,

including optometry. The 2015 ECP Compensation Study by Jobson Optical Research in conjunction with Local Eye Site reported that employed female ODs earned an average compensation of $99,914, compared to employed male ODs, who earned an average compensation of $115,550. Female owners/partners earned an average compensation of $137,091, about $10,000 less than their male colleagues in those positions, where the average compensa-tion was $147,322, according to the report. Economists and researchers have worked to analyze the issue, accounting for hours worked, time off for having and raising babies, age and race. What these studies show is that even controlling for these factors, women earn less—across the board. It also appears that they ask for less. Lipman cites a book by Linda Babcock and Sara Laschever, Women Don’t Ask: The High Cost of Avoiding Negotiation—and Positive Strategies for Change. The authors say that men are four times as likely as women to negotiate a fi rst salary. Women, they say, are often so grateful to have been offered a job that they accept the offer without question. Many people don’t like to talk about their salary and income. But by opting not to negotiate salary or compensation, people leave a lot of money on the table. Since many ODs, even those who eventually own their own practice, start out by working for someone else, the implication may be that women undervalue their worth from day one.

Marjolijn Bijlefeld

Women In Optometry® is published quarterly by the Professional Publications Group of Jobson Medical Information,

publisher of Review of Optometry, Review of Cornea & Contact Lenses and Review of Ophthalmology.

Address advertising inquiries to Scott Tobin, advertising production manager, Jobson Professional Publications Group, 11 Campus Blvd., Suite 100, Newtown Square, PA 19073,

at [email protected] or call 610-492-1011.

Comments on Women In Optometry can be sent to [email protected] or fax 540-242-3438

SEPTEMBER 2015

The Editorial Pages p 3

Supporting Sponsors:Lead Sponsor:

Mind the Gap

Women In Optometry September 2015

Optometrist Compensation by Gender

■ Male ■ Female

OD—EmployeeAverage Compensation

OD—Owner/PartnerAverage Compensation

$115,550 $99,914$147,322 $137,091

Source: 2015 ECP Compensation Study

on OutcomesBy JeanMarie Davis, OD, FAAO

PRA15006AE

JeanMarie Davis, OD, FAAO, is Global Performance Development, Vision Care Technical Head at Alcon.

Sponsored by Alcon

Ocular Wellness Starts With PreventionDon’t rely on trouble-shooting problems; become a wellness-promoter instead

1 Collier SA, Gronostaj MP, MacGurn AK, et al. Estimated burden of keratitis—United States, 2010. MMWR Morb Mortal Wkly Rep. 2014;63(45):1027-1030. 2 Clavet CR, Chaput MP, Silverman MD, et al. Impact of contact lens materials on multipurpose contact lens solution disinfection activity against Fusarium solani. Eye Contact Lens. 2012;38(6):379-384. 3 Shoff ME, Lucas AD, Brown JN, et al. The effects of contact lens materials on a multipurpose contact lens solution disinfection activity against Staphylococcus aureus. Eye Contact Lens. 2012;38(6):368-373. 4 Shoff ME, Lucas, AD, Phillips KS, et al. The effect of contact lens materials on disinfection activity of polyquaternium-1 and myristamidopropyl dimethyl-amine multipurpose solution against Staphylococcus aureus. Eye Contact Lens. 2012;38(6):374-378. 5 CLEAR CARE PLUS [package insert]. Ft. Worth, TX: Alcon; 2015. 6 Rumpakis J. New data on contact lens dropouts: an international perspective. Review of Optometry. 2010;147:37-42. 7 Based on a survey of 316 CLEAR CARE buyers, Alcon data on file, 2013.

Afundamental tenet of health and wellness as well as of business management is that preventing a problem is more productive in the long term than fixing a problem

after it occurs. In daily management of an optometric office, that might mean devising the processes and protocols that keep things moving smoothly. In the exam room, that concept extends to discussions about compliance with any prescribed medications, a healthy ocular surface and the importance of comprehensive annual eye exams. However, it’s also important to spend a few moments reviewing overall com-pliance with contact lens instructions, including the use of a recommended contact lens cleaning and disinfecting solution. Think of the potential problems that can occur when patients are not compliant with their contact lens instructions. According to the Centers for Disease Control and Prevention, there are nearly 1 million doctor’s office, clinic and ER visits for keratitis annually related to improper use of a multi-purpose solution and/or poor lens care hygiene.1

While ocular health is obviously critical to long-term successful contact lens wear, there’s a more immediate benefit for patients. Good compliance with contact lens recommendations can contribute to a comfortable daily contact lens wearing experience. Review con-tact lens replacement and care. Remind patients not to top off solu-tions and to replace their contact lens cases frequently, for example.

In light of recent FDA studies that show that disinfection could be compromised by preservative uptake in some lens materials2-4, it’s a good time to assess your recommendations. Look for products that are highly biocompatible and can contribute to a patient’s overall comfort and wettability. For example, Alcon launched CLEAR CARE® PLUS with HydraGlyde® Moisture Matrix, an innovative, proprietary reconditioning agent that surrounds the contact lens with long-lasting moisture.5 In addition, CLEAR CARE® PLUS neu-tralizes to a gentle, preservative-free saline solution, which makes it highly biocompatible. For patients who are not candidates for daily disposables6, recommend a solution such as CLEAR CARE® PLUS to optimize

the lens wearing experience. Making a firm recom-mendation for a cleaning and disinfecting solution doesn’t take much more than 15 seconds, but those moments can create a positive cycle for your patients. It’s as easy as saying, “I’m prescribing these contact lenses for you because of these spe-cific reasons. And here’s the contact lens solution that I want you to use because not all contact lens solutions are the same. This is the one that works well and will keep your contact lenses feeling comfortable. I want you to have the best outcome with your new prescrip-tion, so stay with this solu-tion.” Write down your recommended brand near the patient’s contact lens prescription. Alcon has

also created an instructional card and cou-pon for CLEAR CARE® PLUS. Staff mem-bers can reinforce compliance and specific care recommendations during the history and application and removal training. Sixteen percent of patients drop out of contact lenses annually, and the #1 cause of dropout is discomfort.6 Contact lens wearers using CLEAR CARE® Solution are 57 percent more likely than users of other brands to continue wearing their contact lenses rather than switching to eyeglasses due to irritation.7 The payoff could be huge in terms of patient satisfac-tion as well as impact to a practice. Imagine being able to impact a patients’ overall wearing expe-rience—for the short term and the long term—just by making a strong recommendation for a contact lens solution that enhances your contact lens prescription, too. It’s a proactive recommendation focused on prevention.

Are PatientsCompliant?Consider these statistics1:

n 85 percent of patients say that they are compliant with lens care

n 2 percent actually demonstrate good compliance*

n 42 percent topped off their used contact solution occasionally or every night

*A patient was considered to have good compli-ance when receiving a score of 90% or better.

1 Robertson DM, Cavanagh HE. Non-compliance with contact lens wear and care practices: a compara-tive analysis. Optom Vis Sci. 2011;88(12):1402-1408.

Negotiate From a Position of Strength

Men are four times more likely to ask for higher pay than are women who have the same qualifications for the role, according to Women Don’t Ask: The High Cost of Avoiding Negotiation—and Positive Strategies for Change. Their reluctance to negotiate

impacts them not just financially but in other ways, too. The authors say, “From career promotions to help with child care, studies show time and again that women don’t ask–and frequently don’t even realize that they can.” Earlier this year, Women In Optometry conducted a survey on negotiating salary and compensation. Of the employed women ODs who responded, 48 percent said that they feel uncomfortable or very uncomfortable negotiating for salary and/or benefits. In contrast, 19 percent said they feel or felt very or somewhat comfort-able negotiating these items. While 52 percent of all women OD respondents said that they did try to negotiate their starting salary, 40 percent said they did not. WO asked Professional Co-editors April Jasper, OD, FAAO, and Katie Gilbert-Spear, OD, MPH, to share some of their negotiating experiences.

Dr. Jasper: ”The purchase of my practice was certainly the most chal-lenging and rewarding negotiating experience. The challenge was that it was the most expensive and uncertain purchase I had ever made. There were many unknowns attached, and I was negotiating with a family whom I consid-ered very good friends. “I purchased the practice that my family had gone to for our eye care most of our lives. I cared a great deal for the family selling the practice, and yet this doctor was not going to give the practice away, as it was providing for his retirement. “It was very emotional for both of us, and knowing when to give and when to hold strong was tricky. In the end, the doctor I purchased the practice from commented to many of our friends on several occasions that I was a tough negotiator. I took that as a compliment. What made me most happy about this negotiation was that it was done with respect for both parties, and both of us walked away happy with the concessions we had given and earned. The practice purchase has obviously been one of the highlights of my life.”

Dr. Gilbert-Spear: “While I cannot pinpoint a specific negotiation that stands out, I do admire the negotiating skills of my 4-year-old daughter, Zara. She is a fierce negotiator. One of her tactics is to ask for more than she actually wants. I counteroffer—and land exactly on the place where she wanted to be.

“For example, we have lollipops at my office. Instead of asking for one and risking that I would say ‘no’ and she would get none, she asks, ‘Can I have two or one lollipops?’ Faced with a straight yes or no answer to the request for a

lollipop, I would normally say no. But when she presents this option to me, I typically choose the middle ground: one lollipop. “I realize that as ODs, we negotiate far more difficult challenges. But I still admire her strategy to determine what she wants and present it in a way that invites negotiation. “I encourage my employees to come to me with well-thought-out reasons and rationales for their requests, just as I prepare my own points when it’s time for me to negotiate. As I get older, I get better at negotiating. At some point, you get

past the fear that others think of you as selfish or greedy because you speak your mind and ask for what you want.”

Dr. Jasper: ”My comfort and skills with negotiating have improved with practice. Knowing when to walk away has made it easier, as well. If you are happy with where you are, then you are never negotiating out of desperation.”

Dr. Gilbert-Spear: “If you have trouble negotiating for yourself, recast the issue in your mind so that you are advocating for someone else. For example, if I were negotiating for a job that is going to take extra time away from my family, I’d feel I owe it to my children to make the job worth my extra time away. Thinking of it from this perspective lessens feelings of selfishness or greediness.”

Experts will point out negotiating on behalf of someone else or a group can be very effective. After all, you rarely negotiate just for yourself. Your negotiations impact those around you—your family and even your profes-sional colleagues and staff. When you successfully negotiate a deal that makes you happier and more content, those around you benefit, too. When you negotiate a reasonable purchase price for a practice or a partnership, you open the door to new opportunities for many people. WO

The Editorial Pages p 5

Dr. Jasper Dr. Gilbert-Spear

Find Us on the Web

Women In Optometry (WO) maintains an active website that features exclusive stories, columns and photos, as well as the current issue of WO

and archives. Visit womeninoptometry.com frequently. Also make sure that you are subscribed to the WO eblasts, such as Makeover Monday, which features a story about an office redesign or remodel; and WO Wednesdays, featuring new content or newly placed content on the web. Sign up for the eblasts by going to womeninoptometry.com/subscribe/wo-emails. Also visit us on other social media.

Ffacebook.com/WOmagazineFtwitter.com/WomenODsFlinkedin.com—and search “Women In

Optometry” to join the group

WO Advisory Panel

Naheed Ahmad, ODRoswell, Ga.

Louise Sclafani, OD, FAAOChicago, Ill.

Charlotte Tlachac, OD, FAAOAlameda, Calif.

Ann M. Hoscheit, ODGastonia, N.C.

Elise Brisco, OD, FAAOLos Angeles, Calif.

Kimberly K. Friedman, OD, FAAOMoorestown, N.J.

Forty-eight percent of WO survey respondents said that they feel uncomfortable or very uncomfortable negotiating for salary and/or benefits.


JeanMarie Davis, OD, FAAO, is Global Performance Development, Vision Care Technical Head at Alcon.

WO0915_Paragon.indd 1WO0915_Paragon.indd 1 8/17/15 2:14 PM8/17/15 2:14 PM

p 7


We made a decision to hire a fourth doctor for our office. What pushed me to it was that one of our associates had to cut her

hours by one day per week, and we were getting overwhelmed by the number of patients we were seeing. One day when I walked in, I saw my optician’s desk look like a bomb went off. Orders were piled up, and I real-ized I was stressing everyone out. We needed a little more breathing room. We also determined that we would not merely cover the hours formerly worked by our

associate. Instead of hiring an OD for just one day per week, we decided to hire someone

to work three or four days a week. That has allowed us to expand our office hours and make the time that we spend here feel less jam-packed. We hired a receptionist and one more technician to accommodate the additional patients being seen, but it’s been worth it. Too often, independent ODs—and I include myself—wait too long to

bring in help in the form of extra doctors or staff. Taking on that salary expense can seem

daunting when you just look at the big number, but time and time again I’ve discovered that when we hire more staff we get more efficient and reduce the burden on our other staff. That makes for a more pleasant environment for patients, doctors and employees and ultimately improves the bottom line of the practice.

I now have a little more time to concen-trate on practice management. I used to feel rushed just trying to squeeze in management tasks here and there in between patients. Although it is always scary to add another OD salary to pay, it has allowed me to feel a little more balanced at work and in life. WO

Sharing

Hire Another Doctor By Kimberly K. Friedman, OD, FAAO

Special little touches that show patients you care don’t need to cost a lot. They just need to be genuine ways to encour-age patients to connect with you.

For example, we recently added an unusual business card holder. It’s really a photo holder, with wires coming out of a small metal cube. It allows us to put business cards within easy reach, and because the display is almost sculpture-like, it encourages patients to grab a card on the way out. We have noticed

that we are replacing business cards much faster in this manner than when they were simply stacked by the front desk.

Business cards can help create a personal connection with patients—if you take just the simple extra step of circling or adding your email or cell phone number. If the patient walks out knowing exactly whom to call with questions on eyeglasses or contact lenses or eye care, that patient feels much more connected to the office.

We have other little touches throughout

As we approached our 10th anniversary, we wanted to incorporate our philanthropic efforts into our marketing and strategic plan as a practice that

cares about the community and the people. We had already determined that we would give a $10,000 donation to an organization for our 10th anni-versary. Then we realized that getting patients involved would be much better. For 10 days, we used social media to celebrate our anniversary, calling it “The Big Give Back.” We held daily contests for special prizes, such as a year’s

supply of contact lenses, eyeglasses or gift cards. We also encouraged nominations for 10

nonprofit organizations, each of which would receive $1,000. If you’ve ever wondered about the power of social media, a campaign like this can really show its reach. Patients and people in the community began commenting and sharing the details of the campaign. The level of engagement on our Facebook page was amazing. A local newspaper picked up the story, too.

The goal of the campaign was, of course, about giving back. We were delighted to be

able to provide donations to orga-nizations in the community that were so important to our patients. But we also gained. The interest that was generated from this social media cam-paign became a marketing bonanza that we did not expect or imagine. We gave—and we received. Both were wonderful. WO

Dr. Hoscheit

Modest Ideas Can Contribute to Connections By Charlotte Tlachac, OD, FAAO

Get Patients Involved in Philanthropy By Ann M. Hoscheit, OD

Great Ideas

Dr. Friedman

the office that pamper patients. We keep a candy machine on the front counter, and patients love to turn the handle to get a handful of M&Ms. Patients love the mini fridge with bottled water, as well as the puzzles, games and even a rocking horse for active children and the aquarium for young and old alike. WO

Views from our Advisory Panel

Dr. Tlachac

The WO advisory panel members were asked to share some of the most recent great ideas they’ve implemented in their prac-tices. We encourage our readers to do the same, and these great ideas will be shared in future pages of WO and on the

website, womeninoptometry.com. What’s wonderful about these ideas, too, is the wide range. There are simple, low-cost ideas and ones that involve significant planning and budgeting.

Have a Great Idea? Send an email to WO editors at [email protected] and one of our editors will follow up with you.

The practice invited patients to participate through social media.

866.853.8432 | www.carecredit.com | [email protected]

*Subject to credit approval. Minimum monthly payments apply. See carecredit.com for details. ^Subject to change. WO0915OA

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has a corner in the dispensary devoted to its young patients. A low, glass-top table with drawers displays the kids’ frames. “It’s kid-height and accessible. Children walk over and love to pull the drawers out to start looking,”

Dr. Sortor says. She doesn’t mind that at all because she believes that eyewear is meant to be experi-enced. “Sometimes adults are hes-itant to take frames off the board to try them on. This table display encourages exploration.” In fact, a number of children have already picked out their favorite frames even before they see Dr. Sortor or Christina

Curcione, OD. “They’ll carry the frame into the exam room and say, ‘I don’t know if I’m going to need eyeglasses, but if I do, I want these.” Or they’ll shyly tell her they found a pair they liked. “I’ll make a big deal and ask if I can see them, and they’ll be so proud and happy to put them on for me.” All the opti-cians also enjoy working with the children and go out of their way to stop by and compliment a child who is trying on frames.

The practice carries a number of Marchon frames for children and adults, too. The practice does particularly well with Nike, X-Games and Flexon frames for

young patients. The Flexon line for kids is terrific, durable and fashionable. “Our Marchon represen-tatives always guide us as to what’s new in fashion,” Dr. Sortor says. Don’t overlook the oppor-tunity to prescribe multiple pairs of eyewear for children, too, she says. She always recommends to parents of children with very high prescriptions that their child should have a backup pair. “These kids should never be without corrective eyewear,” she says. Teens and tweens who are moving into contact lenses should also have back-up eyewear. Children who are active in sports or particularly rough on their eyewear also benefit from multiple pairs.

Jennifer Sortor, OD, MS, FAAO, FCOVD, of Ann Arbor, Michigan, says that about one-third of her patient base is youngsters under 18. “I’ve been doing vision therapy

for a long time, so we draw a lot of families and a lot of kids,” she says. The practice, Ann Arbor Optometry, is located in a six-unit condo, and her vision therapy practice, Ann Arbor Vision Therapy, is just two doors away from her optometric practice. With this setup, she only needs to manage one optical dispensary. Vision therapy patients can walk to the optometric practice easily to select their eyewear. Because so many of her vision therapy patients are younger, it’s very important that she keeps a selection of frames that is attractive for this group. “Teens and tweens are also drawn to some of the smaller adult frames, but we are paying more attention to the fashion of kids’ eyewear, even for the younger kids, because they demand it. They want to see well, and they want to look great,” she says. Even for these young patients, eyewear is a fashion accessory. “It’s one of the most fun parts of our work when we can see that we’ve made a child feel confident in his or her new eyeglasses,” Dr. Sortor says. The practice

Parents can maximize the overall effec-tiveness of their children’s eyewear by adding photochromic lenses and antiglare treatments, too. “We used to reserve those special features for adult eyewear, but as parents have learned more about protecting their children’s eyes from UV exposure, more of our children’s eyewear carries those features, too.” Dr. Sortor also keeps a number of Nike sun frames for kids in the sunwear displays. “Kids get excited about eyeglasses when they’re here, and sometimes, when a child needs no refractive correction, they can still be excited about picking out a pair of sun-glasses that look great,” she says. “All the kids know the Nike name, so they’re excited about that.” WO

Dr. Sortor

p 9

Five Ways to Host a Successful Fashion Event for Kids

Hosting a trunk show for kids? Keep these ideas in mind.

1) Make it fun: Parents will appreciate a style show that’s short and sweet. Hire a face painter or other kids’ entertainment. 2) Open your schedule: Allow time for screenings or refractions so that families can complete the purchase while they’re there. 3) Involve your patients: Ask parents whether their child would be interested in modeling for the event. Encourage families to take photos and post them on social media for maximum impact. 4) Coordinate with a children’s boutique: You can tap into another business’ clientele—and vice versa. 5) Save treats until the end: Lemonade on the lawn, for example, gets the sticky food and active children out of your dispensary but lets the fun continue. WO

Educate Parents About Children’s Eye Health

Ann Arbor is home to the University of Michigan, which means that the patient demographics for Ann

Arbor Optometry are generally well-educated, informed families. “We have an outstanding patient base,” says Dr. Jennifer Sortor. “We stress the importance of vision and learning and seeing well in the classroom. We also tell parents that children’s eyes can change very quickly. One year, their vision may be perfect, and the next year, they’ll need eyeglasses.” That emphasis on preventive care and an overall focus on health care keeps her patients coming back year after year. “We do see most of our pediatric patients every year reliably,” she says. That’s a direct result of spending the time educating parents and the community. WO

Millennials voted Nike as their # 1 favorite brand, ahead of Apple, in a recent report. Marchon provides point-of-sale material highlighting the brand for young wearers.

Kid-friendly Practices Need Kid-friendly Dispensaries

SYSTEMS“The TRS-5100 has been a strong factor in increasing per-patient revenue because the technology allows me to show people the changes in their Rx with a push of a button. The practice has seen an increase in patients buying new eyewear, even with the subtle prescription changes.”

Dori M. Carlson, OD | Park River, ND

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exam. “Rave reviews come from busy moms, college professors and even our savvy geriatric crowd, who have complimented us on the ease of con-

fi rmation. It has lightened the load here so that we can focus on the demands and immediate needs of patients who are here in the offi ce.” Solutionreach, which offers a robust menu of services as part of a standard pack-age, has teamed with

Eyemaginations. So now the practice can send quick videos through text or posted on the website. “Early in the spring, we had a lot of sunglass-es in inventory. We did an eblast on the importance of sunwear and UV protection, and by the end of the month, we

had very few pairs of those sunglasses left,” Dr. Munson says. “It’s a great way to promote an event or a new service.” The practice is introducing the por-tal system to send patients secure billing reminders. Most fees and co-pays are collected at the time of service, but those patients who have a balance after the insurance has been processed can get friendly billing remind-ers at 30, 60 or 90 days. Patients can

also pay their bills on the offi ce app. “It’s very effective. It’s a way to keep us above and past the technology curve. Patients appreciate it,” she says. The surveys that are sent to patients two days after their exam or after new prescription eyewear has been picked up have helped the practice build on its reputation for excellence. “We have a lot of happy patients, thankfully, and they’re willing to share their experiences so that others can read about it on our website,”

Jaclyn Munson, OD, joined the Weatherford Eyecare Center, a Vision Source® practice in Weatherford, Oklahoma, two years ago. One of her

fi rst initiatives was to increase the amount of communication between the practice, its patients and the community. “We’re in rural America, and rural America wants this kind of connection,” she says. The practice connected with Solutionreach and has had an excellent experience, she says. “I did not get a degree in web design or social marketing. The company’s support team has helped me with all kinds of issues, from how to post survey responses on our website to how to create newsletters,” she says. It has also proved to be handy for instant communications. “One day we announced a change to the offi ce hours and sent an email to our family of patients. We had fi ve people show up within 10 minutes of that email going out to pick up their eye-glasses and contact lenses. Being able to communicate like that with our patients extends an arm of care outside of the structure of the building. Inside, we know we provide an intimate approach. Now we can extend that beyond our walls,” she says. Patients have mul-tiple interactions with the service. At the time that patients schedule their appointment, they receive a confi rmation text or email or both. Patients can customize which delivery method they want. And if they prefer to get a phone call from the staff, that’s fi ne. But the number of reminder phone calls that the staff now has to make has dropped dramatically. Patients can synch these reminders with their Google calendar, if they choose. They’re also sent a confi rmation notice two days before the exam, and they receive a reminder on the day of the

Patients Want to Feel Connected

p 11

Dr. Munson

Rural practice increases its outreach beyond the patient visit


Match your offi ce communications to patients’ lifestyles.

she says. Dr. Munson makes sure that she responds to any patient who voices a com-plaint on one of these surveys. She’ll add the comment and/or apology for a lapse of service just below the posted complaint. That way, others can see that the offi ce is responsive to these patients. The comments from these reviews help the practice address these situations and improve patients’ experiences. “It has increased our overall accountability,” she says. “Hearing from patients on a regular basis helps us keep our service real, relevant and exceeding patient expectations.” This fall, the practice will add iPads for registration for patients in the reception area and instant eyewear notifi cations. Patient forms can be downloaded to the two iPads, and patients can review and sign them. “It will streamline the process, and patients will be impressed that HIPAA information is even more protected,” she adds. “We anticipate that patients will also appreciate the more frequent communication about their orders for eyeglasses and contact lenses, for example. Our practice works with higher-quality labs, and that sometimes adds a day or two onto the process. We’re not competing with the 60-minute, one-stop bargain eyeglasses, so being able to tell patients that their eyeglasses order has been received or is leaving the lab or has arrived in our offi ce is a nice courtesy that helps emphasize the value.” WO

Patient reviews are posted on the practice website. Any complaints are addressed in that space, too.

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In Minnesota, a new effort designed to bring more women into leadership positions in the state professional association is underway.Marlane (Laney) Brown, OD, a past pres-

ident of the Minnesota Optometric Association (MOA), is leading a new group of women ODs

to encourage cama-raderie, sharing experiences and their involvement in the MOA. For the MOA, the need to increase the involvement of women ODs started with a discussion at a recent strategic

planning session of the group’s board. Beth Coleman, the group’s executive director, asked Dr. Brown if she would lead the effort. Getting more women involved in profes-sional group activities “has been a passion of mine for a lot of years, but I was never sure how or when to get started,” Dr. Brown says. A women-oriented group “either didn’t exist or nobody knew how important it was to start a group like this.” Dr. Brown has been in practice for more than 35 years in Minnesota, and through those years and her involvement in the MOA, she has come to know many people in the field. She pulled together a group of about 10 women from a variety of practice modalities, including corporate, group and private practice settings, combining younger ODs and those

with a longer career experience. At her invitation, and with some effort deter-mining a date on which they all were available, they gathered on a Monday evening at the asso-ciation’s Minneapolis headquarters for dinner. Dr. Brown asked them to describe their feeling of involvement with other OD professionals

and with the MOA. “Many said, ‘We do feel isolated,’” she says. Of the group she assembled, only half were MOA members. Group members decided to meet every other month. To grow the group, Dr. Brown gave them one require-ment—if you come to the next meeting, bring a colleague. So far they’ve had three meetings. The first was mostly to assess interest, which was very

high, she says. The second meeting was social; the group met at a bistro called Pinstripes, which

has bowling and bocce games for entertainment. The third meeting was a community service effort with a local chapter of Feed My Starving Children, a non-profit that uses volunteers to prepare hand-packed meals designed for undernourished children. “We all stood and packed meals, and that was a lot of fun,” she says. “We did good.”

These early meetings have been aimed to help these ODs get to know each other and form a network. One of the members, Georgiann Jensen, OD, came with a name, the Networking Optometric Women, or NOW. The group has a Facebook page (search Networking Optometric Women) and is continuing to work on attracting

more members. Dr. Brown thinks younger ODs, both men and women, tend to drift away from the net-working opportunities in the profession soon after they start practicing. “In school, you have all these classmates—comrades—with classes and labs and clinics and exams and boards, and you’re all in it together,” she says. “And then you graduate and you’re alone, and nobody holds your hand after that.” For older and more involved ODs, there are good reasons to make connections with their younger colleagues. First, every group needs the energy that new members bring. And sec-ondly, if you don’t get them, somebody else will. “They’ll get involved with something else, using their minimal free time for their church, community or kids’ soccer league. Then they fill up their plate, and they don’t have room or time to get involved,” she says. The MOA has also launched a second group, for young ODs, which is being lead by two MOA members, Lauren Haverly, OD, and Molly McDonald, OD. This group is also in the early stages and has been hosting networking events that bring together MOA members and nonmembers, along with ODs in leadership roles in the MOA. Young ODs, both male and female, benefit from some outreach from professional organiza-tions, Dr. Brown says. She thinks young women entering the profession can sometimes have differ-ent obstacles to making those kinds of connections. Some choose career paths that mean changing their focus from career to family and back again. “The women need to feel like they have worth, even if they’re working part time,” she says. This new group has the immediate benefit of connecting women ODs now, and there are future benefits, too. “I think we may get some leaders out of this,” says Dr. Brown. WO

The group had another meeting at a bistro that offers bowling and bocce.

p 13

Group Gives Women ODs in Minnesota a Chance to Connect

Dr. Brown

Networking Optometric Women plan their meetings around networking events. Here, they helped prepare meals for children.

“In school, you have all these classmates—comrades—with classes and labs and clinics and exams and boards, and you’re all in it together. And then you graduate and you’re alone.”—Dr. Brown

WO0615_Solutions.indd 1WO0615_Solutions.indd 1 5/28/15 11:21 AM5/28/15 11:21 AM


delaying the purchase or settling for less.By being able to extend eligible patients

special financing options with monthly payments (subject to credit approval), it makes it possible for many patients to purchase what would have

been out of reach. “We provide quality products and services,” says Dr. Allison, noting that the practice carries a range of eyewear. “But not everyone has $500, $600 or $1,000 sitting in his or her account at the time of the visit. Still, patients are here to purchase eyewear that they’ll need and want for the next year. Our staff says, ‘It’s not some-thing you should sell yourself short on.’”

Right from the start, patients understand that there is financing available to help patients fit their purchase into their household budget. There is point-of-purchase information from CareCredit at the front desk, and the staff weaves the financing options in throughout conversations about payments. “The optical staff does it in a way that flows well with the regular conversation,” says Dr. Allison. “For example,

if the patient is looking at a Varilux® S lens and a high-end frame, the optician might say, ‘This is the total cost, but with your insurance, and the remainder in 12 monthly payments with CareCredit, it’s $___ per month. Would you like more information about that? Or we also accept cash, check and credit cards.” As long as patients pay their minimum monthly payments on time and pay the balance in full by the end of the promotional period, they will not be charged interest. There’s no cost for providers to enroll, and there are no monthly fees for providers. Credit decisions are nearly

Monica Allison, OD, of Stone Oak Vision Source® in San Antonio, Texas, has built a significant practice through orthokeratology. As the success stories

mount, more families are interested in this option for their children, she says. “Ortho-k is a great option for bat-tling myopia progression. It is also good for kids who are very active in sports, as it allows them visual freedom without the restrictions that frames have or the fear that contacts could fall out.” However, it’s not inexpensive. That’s where accepting CareCredit health care credit cards has been very helpful. She’s been making that option available to patients since she opened the practice because it allows patients the option of selecting the most appropriate eyewear or eye care services without having to make that decision based on their available balance in their checkbook. Many patients do not want to add an extra purchase to their consumer credit cards. So they’re faced with the frustrating option of

instantaneous, and the practice receives pay-ment in two business days. Patients can use the health care credit card for any member of the family*, and the practice is protected from responsibility if patients delay or default on their payment with CareCredit**.

Dr. Allison says that she sees the process-ing fees that the practice pays as an invest-ment, not an expense. “Accepting CareCredit helps patients enhance their lives with a second pair of eyeglasses or higher-end brands that they might not have purchased without financ-ing,” she says. The percentage of patients in Varilux and other higher-end progressive oph-thalmic lenses has increased, as have contact lens annual supplies. She says she believes that CareCredit helped make that happen. WO

*Subject to credit approval. Minimum monthly payments required. See carecredit.com for details.

**Subject to terms, representations and warran-ties of the Participating Provider Agreement.

Learn More

There are about 9 million CareCredit cardhold-ers, who can use their credit card* with any

health care provider who accepts CareCredit. These cardholders receive periodic marketing messages and can access an online Provider Locator that they can use to find participating providers. WO

Dr. Allison

Easy Explanations, Easy Process

It’s not difficult for staff to explain that the practice accepts CareCredit. “We ask patients if they already

have a CareCredit health care credit card. If they don’t, we explain that if they apply here, they can use it for pro-fessional services and products and that their dentist and veterinarian may be participating providers, too,” says Dr. Monica Allison. The staff can submit the application or patients can apply on their own and receive an immediate qualifying value, if they are approved. “Once we have that number, we can tell patients what the orthokeratology payment schedule can be, or that they can get that second pair of eyewear, an annual supply of contact lenses or the nice frames using 12-month special financing.” Staff also explains that CareCredit statements make it easier to track medical expenses and reminds patients to provide these statements to their accountants. Payments from CareCredit are posted to the practice account within two days of the transaction. WO

“Not everyone has $500, $600 or $1,000 sitting in his or her account at the time of the visit. Still, patients are here to purchase eyewear that they’ll need and want for the next year.”—Dr. Allison

OD Helps Put Options Within Reach

Patient financing can remove the obstacles to the most appropriate care

p 15


practice’s financial data, filtering by frames or contact lens sales. “This information iden-tifies what we can work on and what we’re

doing well,” she says. The practice continues to increase its number of annual supplies sold, and the team is targeting opportunities to prescribe progressive lenses. Dr. Crooker says that she’s finding balance by creating some separation between her clinical and administrative responsibilities. “I’m here every day seeing patients, and then I like to have some time

to myself to focus when everybody leaves.” The time at the end of the day allows her to “slow down for the day and reel everything back in.” She also adds that it helped to find a lawyer who knew the ins and outs of optom-etry and the right strategy to take.

She’s already brainstorming ways she can expand the business to serve its patient base better. “We’re rolling out a whole line

A series of transitions are underway at Scituate Harbor Vision Source® in Scituate Harbor, Massachusetts. As one of the associate doctors

leaves the practice and a new OD joins the team, Jessica Crooker, OD, is in the process of purchasing 50 percent of the business with the expectation to buy the remaining half in three years. Dr. Crooker says that she didn’t think the opportunity to become a partner would present itself so quickly. She joined the practice three years ago as an associate OD, having previously worked in the practice during optometry school. She had discussed the pos-sibility with practice owner Gordon Price, OD,

but she says that she had imagined a longer timeline. As she and Dr. Price proceed through this change in ownership, Dr. Crooker says that she wants to learn as much as she can from his expertise. “I am confident with the clinical side, but I don’t know everything about the administrative side of running a practice,” she says. “While Dr. Price is still here, he can lead the way.” Dr. Crooker has already taken on some administrative responsibilities, such as payroll, running weekly staff meetings and monitoring prac-tice benchmarks with the office’s LIMBS software. Dr. Crooker can see trends among each doctor and staff member and look at the

OD appreciates the years-long guidance she has received as she enters partnership

of products to target the areas that we have heard patients talking about,” Dr. Crooker says. “They can come to the office and get a pair of eyeglasses but also talk about their wrinkles or eyelashes. I like to listen to what my patients say beyond their vision issues.” In June, she developed a sunglasses aware-ness campaign with practice manager Denise Price. “Sunglasses can be fun and functional, and we had a different theme each day for women, men, kids and the elderly.”

From her first experience in the practice as a patient to working in the office during optometry school, Dr. Crooker says that she developed high expectations and standards for a practice where she would work. “Dr. Price invests in the latest and greatest technology for everything in the office, and patients com-ment that they have never been in an office that is so progressive,” Dr. Crooker says. “My goal was always to work here.” Her new leadership position will allow her to impact the community even further. WO

From Family OD to Mentor to Partner

p 16

Dr. Crooker

A Change in Direction

Dr. Jessica Crooker had envisioned working at Scituate Harbor Vision Source® for many years before she became an associate OD in 2012. When she was

in high school and had worn eyeglasses only for several years, Dr. Gordon Price introduced Dr. Crooker to contact lenses. “They changed my whole life, and I became more social and felt better about myself,” Dr. Crooker says. While she initially considered a career in optometry, she chose sports medicine. Nearly done earning her master’s in exercise physiology, Dr. Crooker had her annual exam with Dr. Price. She shared that she thought this career path wasn’t for her and what she had expected. “He said, ‘Remember you wanted to be an optome-trist?’” she recalls. Dr. Crooker spent time observing in his office, and she says that she enjoyed the opportunity to work with a wide range of patients and cases. The rest is history, Dr. Crooker says, and she applied to the New England College of Optometry and worked in the practice one day a week as she earned her degree. While she had hoped to join the office as an associate OD at graduation, there weren’t any open-ings at the time. Dr. Crooker accepted a position and moved to Connecticut for one year, until Dr. Price called with the news that there was an opening with her name on it. “I feel so lucky to be here,” Dr. Crooker says of the small community where she grew up and where she regularly meets patients who know her parents, who teach in the towns nearby. “I really love that about this place.” WO

“[Patients] can come to the office and get a pair ofeyeglasses but also talk about their wrinkles oreyelashes. I like to listen to what my patients say beyond their vision issues.”—Dr. Crooker


areas where she doesn’t have as much expe-rience, such as oculoplastics, cornea and neuro-ophthalmology.

Her training and experience will be a benefit to the practice she’s joining, she says. “One of my colleagues who was also residency trained asked me how I would ‘continue to be’ challenged. I think that’s an easy answer. In the

medical practice, I was seeing a lot of end-stage glaucoma patients. But I’d much rather be involved earlier in the disease process to help diagnose sooner and prevent vision loss for patients. I have a strong interest in meibomian gland dysfunction and developing a successful dry eye practice,” she says. It’s a great oppor-tunity. “There are a lot of patients suffering from dry eye conditions who don’t even know that’s the problem,” she says. “Now is the time to be more proactive in our patients’ care—looking for

Leslie O’Dell, OD, wanted to have a stronger voice. She had enjoyed working in a medical/surgical practice for the past 11 years, and the fit seemed ideal

after a residency in ocular disease. But as the years went on, “I developed more of a desire

to be a leader. I wanted to have a say in the technology and staffing,” she says. So she needed to make a decision: go out on her own or join a group that was a good fit for her. “I don’t have the full range of business

skills,” she says. “Even though there are a lot of resources for optometrists starting out, I thought I’d have too much stress.” The better option for her was to take her medical practice experience in ocular surface disease and dry eyes and bring it to an optometric practice. She also has a strong interest in glaucoma, diabetes and age-related macular degeneration. Dr. O’Dell had a chance in the past decade to meet many ODs. In fact, she had the challenge of going to them to ask for referrals. As the first OD in her region to offer new technologies for dry eye management, she needed to convince ODs that their patients would be seen for this medical condition and then sent back to them for primary care. “They started to feel more comfortable with me because of the different skill set. I did a lot of reaching out and building friendships,” she recalls. Those networks eventually led to a job offer with Wheatlyn Eye Care, an optometry group practice in Manchester, Pennsylvania. She started this month, after taking much of the summer to catch her breath in the career transition and spend the summer break with her daughter, age 7, and her son, age 4. The new practice is about 20 miles from the medical practice—where she still has a strong connection with the surgeons. “They’re cutting-edge cataract surgeons,” she says. “It’s important to keep your connections strong. Don’t ever burn your bridges.” In fact, she also took time this summer to visit with other MDs in the area to learn more about

dry eye before symptoms present.”She’s eager to build a dry eye practice

that is not only accessible to patients but convenient, too. “I will be starting The Dry Eye Center of Pennsylvania within this new group. It’s a very exciting time for me, as this is something I have been planning since 2007, but I just hadn’t found the right setting until now.” One of her ideas is to offer dry eyes products in the practice. She particularly likes many of the dry eye products from OCuSOFT, such as Retaine® MGD® Lubricant Eye Drops, OcuSOFT® Lid Scrub Foaming Eyelid Cleanser and Tears Again® Advanced Eyelid Spray. “The spray is great for my older patients or anyone who struggles to use eye drops for dry eyes,” she says. She has also been introduced to OCuSOFT Oust™ Demodex® Cleanser, an in-office, tea tree oil treatment. “I’m excited to introduce this in my management for patients with Demodex blepharitis.” By having these products available for sale in the office, the focus moves to “one-stop shopping. When patients can leave with the product in hand, they will be more compliant. Compliance—whether we’re talking about glaucoma, dry eyes or contact lenses—is so important to successful treatment and, ulti-mately, patient satisfaction,” she says. To be successful with a dry eye practice, a practitioner has to be willing to build it into a practice. That means educating patients and even educating colleagues who might refer patients to you. Dr. O’Dell has also been invited to be part of the Tear Film and Ocular Surface Society’s Dry Eye Workshop initiative, known as DEWS II, a global dry eye research effort, where she serves on the public awareness committee. (See related story on page 28.) WO

p 17

Allows Doctors to Develop Primary Care-based Dry Eye Practice

Career Transition

Dr. O’Dell

Read More From Dr. O’Dell

Dr. Leslie O’Dell is the faculty/author of a one-hour online CE available course through Review of Optometry. Her course, Glaucoma and Dry Eye: Principles and

Parallels, jointly sponsored by Pennsylvania College of Optometry at Salus University, is available through Jan. 1, 2018. Visit reviewofoptometry.com and search under her name to find the link. She has also written on dry eye and ocular surface conditions for Optometry Times and other national and international publications. WO

“There are a lot of patients suffering from dry eye conditions who don’t even know that’s the problem. Now is the time to be more proactive in our patients’ care—looking for dry eye before symptoms present.”—Dr. O’Dell

COVER STORYp 18


arents of patients at Little Eyes in Carmel, Indiana, often ask Katherine Schuetz,

OD, what to look for and how to know if their child is having any vision problems. “A comprehen-sive eye exam is the only way to get it done, and it doesn’t mean you are a good or bad parent,” she explains. She educates all parents about how regular eye exams let her monitor vision and also ocular health. It’s been two years since Little Eyes, a pediatric-only practice, branched out from RevolutionEYES, located just two miles away. Dr. Schuetz spends half of her week working with practice owner Jeremy Ciano, OD, in the main offi ce. Little Eyes was inspired by Dr. Ciano’s son, Alex (read the full story at littleyes.com) and has

become well-received by the patient population and community. “In the beginning, some estab-lished patients wanted to have parents and kids examined all in one place,” Dr. Schuetz says. “We were fi rm and let patients know that Little Eyes is here to serve

the pediatric community in a special way. Once patients come here, they get it, and anything negative turns to positive.” There’s a differ-ent look to the offi ce space, and the exam experience is completely tailored for children from the video games in the reception area to the chance for patients to see themselves on the big screen TV after they pick up their new eyeglasses. Each piece of instrumentation chosen for Little Eyes was carefully analyzed, and while none of the technology is designed specifi cally for chil-dren, the features of each are kid-friendly. “We use a retinal camera that can get a good image quickly,” Dr. Schuetz says, adding that they also chose an autorefrac-tor that is well-suited for wiggly children in the chair. Expanding the pediatric segment of any practice can be benefi cial for business, Dr. Schuetz says, so choosing technology with these characteristics can help practice

owners who want to achieve that goal even without opening a separate offi ce. And while it wasn’t easy, Dr. Schuetz says that having a second location has paid off for the practice mission. “We were worried that we could cannibalize our own practice, but it’s been

the opposite,” Dr. Schuetz says. The concept has helped them grow both practices, and Little Eyes and RevolutionEYES regularly refer patients to each other. Personal visits to local pediatri-cians’ offi ces have also helped Dr. Schuetz build Little Eyes. In addition, the practice makes a donation to Indiana Blind Children’s Foundation for every purchase of eyeglasses and has partic-ipated in Indiana Colts Kids Club events around the state. Consistent education in both offi ces drives

Building a

Dr. Schuetz enjoys seeing the littlest patients.

The reception area includes lots of diversions to keep children entertained.

Pediatric Practice t’s back-to-school season, which means that many practices throughout the country have seen or are see-ing large numbers of children. However, these ODs have made their business plan out of catering to kids throughout the year.

Awareness for Children’s Preventive Eye Care

Colorful and fun displays (shown above and at middle left) attract the attention of young patients.

Dr. Schuetz

athy Doty, OD, can pinpoint her deter-mination to open a practice for pediatric and special-needs patients to a little boy she saw in October 2014. The family had a long wait

to get onto her schedule—she’s one of the only InfantSEE® and Medicaid providers for pediatric patients in the area. But when she saw him, she recalls feeling heartbroken. At 18 months old, he was developmentally delayed and she could sense the family’s stress. It turns out that the child was severely hyperopic, at about +10.00D in each eye. But that started her thinking that she wanted to dedicate herself to these patients. “Families and primary care doctors need someone whom they can turn to quickly,” she says. She spoke to her partners at Family Eye Care, a two-location Vision Source® practice in

New Bern and Pamlico, North Carolina. New Bern Family Eye Care already rented a building two parking lots away, which serves as its insurance, telephone and administrative center. The practice


leased additional space there, and the work started to create Special Eyes, which opened in May 2015. “We updated the building, with new

electrical and plumbing fi xtures. We painted with bright colors throughout.” She sees children and special- needs adults; several of those patients she saw in the fi rst few months that the practice was open had never had an eye exam. Having a separate children’s facility helps the offi ce fl ow in the New Bern practice, as well. “The pre-liminary workup area at the primary

care practice was very crowded. A lot of times when children come to an offi ce, they come with mom, dad and a few siblings. That takes up a lot of the reception area, too.” Now, the other doctors at the primary practice have taken over her former two exam rooms, providing them and the technicians with

needed breathing room. “I encourage any OD who has gotten to the point where he or she is having growing pains in the main offi ce to look at a niche practice in a separate location,” she says. She took her two highly trained technicians with her and hired a receptionist. The administrative staff who work in that building has stepped in to help with some duties in Special Eyes, too. Because the offi ces are so close to each other, Dr. Doty maintains

only a selection of Medicaid-covered frames in Special Eyes, so she can measure and fi t those patients right away. Others, however, are escorted by a staff member across the parking

lot. A staff member from Special Eyes calls the New Bern offi ce to let staff know a patient is coming, and Dr. Doty’s prescription, entered into RevolutionEHR, is printed out at the main offi ce so that an optician is ready to assist the family. “Our dream is to have a golf cart to use to escort these patients. We plan on painting it with eyeballs and eyeglasses,” she says. WO

Dr. Doty at the ribbon cutting for Special Eyes

Dr. Doty says a pediatric practice is naturally a pleasant place.

Pediatric Practice

Bright colors contribute to the fun atmosphere.

home the message about the importance of pediatric vision care. “We frequently have moms who are worried because their fi rst grader can’t read in school,” Dr. Schuetz says. “They bring along their 9-year-old, too, and that child with no symptoms is sometimes the one who needs correction. You can be a hero to a child and his or her family when you deliver +8.00D eye-glasses to a child who could never see.” These families become advocates for the practice. “It’s extremely rewarding working with kids, and our presence has changed the mindset of lots of parents and pediatricians, bringing a level of awareness,” she says, as her littlest patients begin a routine of having regular, preventive checkups. WO

Dr. Doty

Dr. Ciano and Dr. Schuetz opened Little Eyes two years ago as a pediatric offshoot of RevolutionEYES, located two miles away. Little Eyes is totally dedicated to pediatric patients.

p 19

A Pediatric and Special-needs Niche Practice Helps Community and Patient Flow in Primary Offi ce

COVER STORYp 20


Vision Therapy Focus Has Big Impact in Community

practice as a “gym” and not a more medically oriented therapy location. In fact, it mimics an exercise gym. Patients are given membership cards that they show when they check in at the front desk. Their fi rst stop is the “locker room” and from there, they’re taken to one of six therapy rooms, some designed to look like a gym, complete with the rubber padded fl ooring. “So many of these young patients already go to several different therapists. We wanted this to feel like a place that they want to go to, not just have to go to.” Dr. Collier has been intrigued by vision therapy as she learned the impact it could have on issues such as learning, mental fog-giness, balance, headaches and more. “I had always been a good student, but when I hit college, everything became more diffi cult. I thought maybe I wasn’t seeing properly, and my eye doctor gave me reading glasses—that made my convergence insuffi ciency worse.” In optometry school, when she realized the impact of vision therapy, she was hooked. She has eight vision therapists or assistants working for her, and she’s trained them all. The practice also accepts many medical insurances because she wants to make sure people who need vision therapy can access it. WO

uanita Collier, MS, OD, FCOVD, of Cromwell, Connecticut, opened 4D Vision Gym two years ago, after seeing the demand for vision therapy services

in her region. In fact, even as a relatively new practice, she says she’s been very busy. New

patients are booked two months out. “I’ll do some primary care for family members of patients. However, due to my waiting list, most of my patients are here for the spe-cialty care I provide, not necessarily pri-mary care.”

She also does not have an optical dis-pensary because she wants other ODs in town to know that her practice is focused on vision therapy, sports vision and an increasing amount of post-concussion therapy. While she works with adult patients as

well, most of her practice popula-tion is children and teens. She sees a lot of middle school and high school athletes who have suffered concussions, referred to her by an increas-ing number of concussion centers that have opened. Most of these patients spend about two or three months, with several weekly visits, in vision therapy, where she works to remediate any underlying binocular vision problem. “So many of these athletes have been able to com-pensate for an underlying vision problem, but it’s really important that these are addressed,” she says. Because these young athletes may

have been good at their schoolwork and good at sports, previous doctors may not have looked too carefully at these binocular issues. “But in that split-second decision where an athlete has to decide how to move when there’s a potential impact with another player or a ball, binocular vision can be extremely important,” she says. Patients who have vision therapy for learning issues, many of whom are on the autism spectrum, can come in weekly for six months to a year. That’s one reason that Dr. Collier envisioned her

Concussion awareness in youth sports raises interest in binocular vision

Kids who comes into the 4D Vision Gym stop in at the locker room.

Dr. Collier

Learn More

Visit covd.org for more information about vision therapy.

Lake Worth Eye School recently celebrated its fi rst anniversary.


p 21

Valamides, OD, see patients at the primary care Vision City location. For this fi rst year, she didn’t advertise. She didn’t want to be overwhelmed with a demand she couldn’t accept. Even so, patients kept fi nding her through dyslexia support meetings and occupational therapists who have seen the impact on previous patients.

As she enters her second year, she anticipates that she will start advertising. She’s also hop-ing she can begin to bill medical insurances successfully. So far, most families have paid for vision therapy as an out-of-pocket expense. “But the value to families is that their chil-dren can get homework done in 30 minutes instead of an agonizing two hours. Their visual perceptions improve, so these teenagers can drive safely. That’s tremendous value,” she says. She’s particularly interested in working with autistic children, those with learning problems and more severe strabismus. “I was able to use prisms on a 15-year-old autistic boy that changed his spatial awareness. That’s my vision of power, to be able to change spatial awareness for someone,” she says. WO

ake Worth Eye School has just cel-ebrated its one-year anniversary. “Students” at this vision therapy practice have their binders and their

homework, and when they achieve their goals, they earn an Odee. When they accumulate

enough Odees, they can turn them in for prizes. Odees and the make-school-fun approach of Lake Worth Eye School are the brainchild of Trina Lieske, OD. The eye school is now a part of her practice that

she initially opened in January 2006, Vision City of Lake Worth, in Lake Worth, Texas. Here’s how the expansion developed. When the issue of board certifi cation arose, Dr. Lieske decided that “I didn’t want to be last to be certifi ed. In fact, I wanted to be among the fi rst.” So she began studying in 2012. During that time, she came across sam-ple questions on vision therapy. “I remember thinking, ‘Why do I know nothing about vision therapy?’ I was looking up all the answers,”

she says. The subject hadn’t been part of her coursework when she graduated optometry school in 1998. At SECO in March 2013, she really hit her stride. She began taking CE courses on vision therapy and connecting with other vision therapy providers. “The more I learned, the more I real-ized what I could be doing for kids around here. There are children with strabismus and conver-

gence issues, and there’s no one around here to help them.” It quickly became her passion. As a parent of a special-needs child, she knows the stress that parents undergo. “The frustration for a parent who knows that there’s something not quite right with the child is so high. What’s the right answer? Drugs? Surgery? These parents

are looking for anyone who can help them,” she says. When vision therapy does help, the impact is tremendous, she says. “It can be the dif-ference between a kid who drops out of high school or one who goes on to college. So often, children are labeled as dyslexic or ADHD, and that becomes almost an excuse. When we can work on these issues, we end up with high-functioning students,” she says. That doesn’t mean it’s easy, though. In fact, so far it hasn’t even been tremendously profi table. Dr. Lieske trained her own tech-nician, taking her along to courses. The two spend about 90 minutes preparing for every hour of vision therapy delivered. Dr. Lieske has about an eight-patient load at Lake Worth Eye School, and she and her practice partner Jon

OD Schools Herself in Vision Therapy Then she opens a vision therapy school

The Spending Power of Odees

Whether a child is an impulse buyer or a saver, there’s an Odee incentive that works. Odee is a giant cartoon eyeball with tennis shoes. It’s also the coin of the realm at

Lake Worth Eye School. There’s a little store, where the most expensive item costs 12 Odees, says Dr. Trina Lieske. “We have chocolate eyeballs for one Odee. There are lots of little puzzles, toys, gift cards to a yogurt shop and vision therapy games, like ball-catching games. When kids show up for the appointment, they earn an Odee. If they remember to bring their binder to show that they’ve done their homework, they earn an Odee,” she says. One boy recently proudly turned in the 10 Odees he had saved to buy his mom a necklace. Even the impulse buyers who immediately swap their Odees for the day for little treats start to see the value of saving for a higher-Odee item. “Odees teach life skills, too. And it’s something that the parents can use to help give them structure. If a child needs to sit for 16 hours of structured homework time, the child and the parent have this as an additional incentive,” she says. “It’s vision therapy as a kind of life lesson.” WO

Dr. Lieske

Odee is the mascot and the currency at Lake Worth Eye School.


COVER STORYp 22

rlene Espiritu, OD, says that get-ting children involved in their exam experience is an important part of easing their worries. “If there

is any apprehension, I quickly get the chief

complaint from the parent, and right away address the child,” Dr. Espiritu says. Map out a plan for the exam. “I am constantly talking to the patients throughout the exam,” whether she’s asking them ques-tions about what they do for fun or about school or giving them a short description of what’s going to happen next. “I think engaging the child is key in a pediatric practice.” She explains to young patients at Eyes of East Sacramento, California, that she will show them pictures and letters and that the exam will be easy. “If it’s a long, drawn-out descrip-tion, the child gets too anxious,” Dr. Espiritu says. “The bottom line is getting the accurate results while being swift

about gathering the data you need. Children get bored too easily.” Keep your

descriptions simple and straightfor-ward, partic-ularly when discussing dilation and intraocular pressure (IOP) mea-surement. Dr. Espiritu says that children tend to be most apprehensive about those parts of the exam. “I make it a point not to overdescribe what’s going to happen,” she says. Dr. Espiritu uses an Icare Tonometer instead of traditional IOP testing, which she has found to be less intimidating for young patients.

“When children realize they won’t feel anything, they are put at ease and I

can complete the test.” Dr. Espiritu and practice partner Susana Belmonte, OD, can use a variety of different toys and gadgets to help throughout the exam, including fi nger puppets, light-up toys to check for dilation and video-on-demand within

the acuity chart. Popsicle sticks with detailed stickers are great to use for fi xation targets. They can select the most appropriate tools for

Help Kids Feel Comfortable

the child’s age and temperament. Eyes of East Sacramento has also dedi-cated a special “romper” room so children can relax before their exam or wait during dilation or while their parents are having eye exams. The room is in view from the exam rooms. Dr. Espiritu explains, “They are generally super-vised by their parent, or if they are playing comfortably and quietly, they are allowed by themselves since we are literally next door.” Kids can choose from an assortment of DVDs, as well as play on the train rug or pick from the box of toys and puzzles. WO

Visit womeninoptometry.com to read more about Eyes of East Sacramento, the collabo-rative vision of Dr. Espiritu and Dr. Belmonte after previously working together. Find their story under Models of Practice in The Physical Space channel.

The doctors use a variety of toys and

tools to engage young patients in

their exams.

Dr. Belmonte, left, and Dr. Espiritu have integrated children’s eye care into their primary care practice.

“I make it a point not to overdescribe what’s going to happen.”—Dr. Espiritu

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in the community, she says, but more than half of the patients who came to the center in the first year referred themselves. It’s important to educate patients that dry eye is a complex condition, she says. In fact, one of the first

steps is for patients themselves to recognize that dry eye is more than a nuisance. “Dry eye sounds so benign. But patients are frustrated by it and also skeptical that there’s anything to do about it,” she says. Part of that skepticism stems from them having tried over-the-counter artificial tears, often with very lim-ited or short-term success. Every member of the clinic staff

begins to educate patients that dry eye has dif-ferent forms and causes as soon as they come in. “We’re constantly explaining the tests that we do and what we’re trying to find out about their dry eye causes so that we can find the best treatment for that patient,” she says.

While the TearWell center does have the latest equipment—a LipiFlow® Thermal Pulsation System and a Lumenis M22 Intense Pulse Light unit—that kind of investment isn’t necessary for community-based optometrists who want to help their patients. “Fantastic diag-nostic equipment does help, but the greatest

The TearWell Advanced Dry Eye Treatment Center just celebrated its first anniversary at Southern College of Optometry (SCO). Whitney Hauser, OD, an assistant

professor at SCO and clinical development consultant for the TearWell center, says the timing was right for the college to add a dry eye center for treatment and research of dry eye issues. “The dry eye population is expanding exponentially as baby boomers age. It’s an underserved area, and some estimates show that as many as 60 million people suffer from dry eye symptoms.” Additionally, it’s not typically a priority for many practitioners. “But it’s a high priority for the patients. Our patients appreciate that we are uniquely dedicated to one focus,” she says. Between research being done on the ocular surface at SCO and at other places, dry eye is gaining interest. “For so long, dry eye disease just wasn’t glamorous from a clinical perspective. The patients can be hard to satisfy, and dry eye can stem from many different causes. But between research and drugs in the pipelines, we’re going to be able to do so much more for patients,” she says. Referrals to the center come from colleagues

key to success is listening to the patient. You have to be willing to be a partner with patients in their care. That’s what they’re looking for.” Dr. Hauser says she knows that isn’t always easy. “I was in private practice for 10 years, and I know that in order to keep the lights on and pay the staff, you have to move between patients quickly. But in dry eye cases, much of the magic can happen with the staff. If you have a well-educated staff, you can do so much for these patients.” She encourages doctors to drill down in their electronic medical records software to gain a better understanding of their patient population. “When you see who is walking through your door and whom you can serve, it’s easier to make the investment in passion, dedication, education and even capital,” she says. A dry eye component can be profitable to a practice, too. “It’s elective for many patients, and for others, exams and ancillary tests, such as external photography and tear osmolarity, can be billed to medical insurance. I see some of my dry eye patients every six or eight weeks.” But even beyond the potential profitability, it’s important to recognize that this is an issue that optometry should own, Dr. Hauser says. “This starts and ends in optometry’s wheel-house. Even when a cataract surgeon knows that osmolarity affects the outcome of surgery, that doctor recognizes that he or she would rather be in the OR than working on dry eye disease. So if ODs have great relationships with these MDs, it can benefit the surgeon, the optometrist and, most of all, the patient.” WO

Dr. Hauser

Finds Half of Its Patients Are Self-referral

p 24

Don’t Overlook Lid Hygiene

Dr. Whitney Hauser says that when students or visiting practitioners are examin-ing a dry eye patient at TearWell Advanced Dry Eye Treatment Center, they are

eager to “dive into the eye. They want to look at the tear film and the corneal sur-face, but often the origin of the problem is the lid or lid margin.” Dr. Hauser takes anterior segment photos first and tells patients that she’s look-ing at the lids. “Hyperkeratinization of cells along the lid margin can limit or entirely stop the secretion of meibum, which can influence dry eye symptoms and breed ocular surface discomfort,” she says. Multiple products with different objectives are available to treat these conditions. Surfactants are good for more aggressive, short-term cleansing; tea tree oil products are ideal for Demodex mites; and hypochlorous acid products reduce the bacterial load at the lid margin. There are also newer products containing hyaluronic acid that are still designed to clean cellular debris but have the added benefit of delivering moisture to the lids. “Sometimes I’ll use a scaled approach and start a patient on one and then move onto another,” Dr. Hauser says. WO


Center Dedicated to Dry Eye Treatment and Research

Paragon BioTeck, Inc., has introduced ilast® for Lid Hygiene, which contains hyaluronic acid, to hydrate and soothe dry, irritated skin around the eyes.


p 25

helped in educating the patients. “I love that you can show patients pathologies and irregu-lar tear film. It’s a very useful education tool for patients who don’t understand why they can’t see better,” she says. That holds true for those with higher-order aberration and even for patients with astig-matism. “There are a lot of ways to explain astigmatism, but when patients see it on a scan, that really clicks into place,” she says. It can help patients understand why they need specialty prescriptions, too. Several months ago, she brought the OPD-Scan III into her practice, and it has resulted in a higher level of accuracy and efficiency, she says. Marco’s support team and easily digest-ible online training videos helped everyone on the team feel comfortable with the technology, she says. “Now, I look at patients from a more global standpoint. Even before I see the patient, I look at the OPD scan and determine in my mind, based on those values, whether or not that patient can achieve 20/20 vision. Then I can take it to the next level with the TRS sys-tem, narrowing down the axis for astigmatic

Even knowing that there will be an adjust-ment and learning curve with bringing in new technology, Lorie Lippiatt, OD, says it’s worth it. She has been in practice for

26 years in Salem, Ohio, and has spent much of that time working with companies consulting and beta testing new technol-ogies. She’s worked on electronic medical records for several companies, integrat-ing medical equip-ment and improving office flow. In fact,

she says, her office has such a reputation for a well-planned office flow that other doctors have come to observe it. Dr. Lippiatt first added two TRS-5100 dig-ital refraction systems from Marco about eight years ago and then brought one of those units into each of her four exam lanes. “Once we understood the efficiencies it brought into the workflow, it became nearly impossible to use a manual system from the standpoint of time and accuracy,” she says. Integrating the TRS-5100 into the Eyefinity ExamWriter® electronic health records software doubled the practice’s capa-bilities in terms of workflow, she estimates. So she felt like the practice was operating at close to maximum efficiency. But she heard from other doctors that adding the OPD-Scan III would make her even more efficient. “I wasn’t sure of the value that the OPD-Scan III would bring to my practice. I thought I was doing a good job to begin with,” she says. She changed her mind after a dinner meeting with G. Timothy Petito, OD, FAAO, of St. Petersburg, Florida. “He said I wouldn’t believe the whole new level of sophistication the OPD would bring, and I said I’d have to see it to believe it.” So she flew to Florida to spend a day in his practice. He, too, had a lot of elderly patients with ocular surface disease, and she could see how the OPD information

Technology Brings Even

correction to within one degree. I didn’t bother with that before because it could have meant 15 minutes chasing down an axis measure-ment that may or may not have benefitted the patient. Now I know before I walk in if it could help,” she says. A high root-mean-square (RMS) value means that the patient is unlikely to achieve 20/20 vision, but a low RMS value generally makes it worth the effort to narrow the astigmatism axis to within one degree, she says. “In the first six months of having the OPD-Scan III, we’ve been able to correct patients’ vision to 20/15 in a way they haven’t ever seen before,” she says. “My evaluation process of the patient’s visual system has literally been cut in half. I no longer have to wonder about why I can’t get them to 20/20.” She says that it makes

her a better diagnostic clinician, as she is able to customize the visual correction faster and more precisely. The Marco technology also eliminates transcription errors. The result is tremendously happy patients who recognize that the new technology is providing them with a prescription for the best vision they’ve ever had, and that they’ve been able to achieve this quickly. “The OPD-Scan III is as fast as a traditional autorefractor,” Dr. Lippiatt says. The OPD viewing stations are set up on all monitors in the exam room and also in the doctors’ rooms so that they can take a look at the scan even before they go in to see the patient, she says. “I think that I’ve become a better diagnostic clinician in a shorter amount of time.” WO

Dr. Lippiatt

Higher Levels of EfficiencyOD was convinced technology could benefit her practice after visiting

another and seeing OPD-Scan III in action

Wow Your Patients

“We’re going to customize your vision correc-tion,” Dr. Lorie Lippiatt and her associate,

Carmela Abraham, OD, tell their patients. With the OPD-Scan III, they know even before they walk in to see the patient whether they’re going to be able to achieve 20/20 or better vision for the patient. The prescription and notes about lens treat-ments are in the practice management software, available to the optician, even before the patient steps into the optical. “It has increased our ability to provide the patient with the best optical correc-tion in the least amount of time.” WO

Dr. Lippiatt says that the OPD-Scan III brought a whole new level of efficiency to her practice.

Go To VisionSourcePlan.com and We’ll Give You Ours

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Amir Khoshnevis, OD, the Vision Source® administrator in North Carolina, and Michael Clark, OD, were having lunch one day in Charlotte when they walked past the display windows in the private practice that Michelle Mumford, OD, had opened in December 2011. Dr. Khoshnevis decided to go into the practice and ask Dr. Mumford to join him for dinner, so he could tell her about Vision Source®.

Dr. Mumford became a Vision Source® member in the summer of 2012. While that wasn’t soon enough to take advantage of Vision Source® pricing when equipping her office initially, it has helped to spur her growth. After having been a part of Vision Source® for about six months, she brought in an Optos Daytona unit. At The Exchange® in Boston in 2014, the first of those meetings she was able to attend, she purchased the Marco TRS-5100 refraction system for a second exam lane. “The benefits from my Vision Source® membership have allowed me to bring newer technology into my practice earlier than I might have otherwise,” she says.

When Dr. Mumford graduated from optometry school in 2008, she had a vision for her future practice. She planned to have a medical practice in a medical office complex. She laughs about that now because while she was searching for the right property, her vision completely changed. “There was definitely an evolution in my thinking,” she says. “The more I talked through what I wanted, the more I knew it wasn’t the sterile, medically focused practice I first imagined. I grew up wearing contact lenses and eyeglasses, which the cool kids didn’t do. So I wanted a place where people could have a good time, enjoy the experience and ultimately really enjoy their eyewear.”

As she expanded her location search beyond medical complexes, Dr. Mumford ended up finding a retail space in a high-traffic, high-end neighborhood. The glass front (the same one that had the displays that attracted Dr. Khoshnevis’ attention) grabbed her imagination, too. She hired designer Barbara Wright to turn the 1,500-square-foot location into an eyewear boutique in a family-friendly practice. “I had always pictured myself in a medical building, but the truth is that we are in retail.”

Her husband, Jeff Mumford, whose background is in business and finance, has been tremendously helpful in the process, she says. Her Vision Source® colleagues have been, too. “Going out on my own was an intimidating idea. But it’s so nice to know that I have many doctors I can call on who are willing to share their expertise with me,” Dr. Mumford says. “I always look forward to our Vision Source® monthly meetings.” That was important because she faced a learning curve on dispensary management. “I knew the medical side, but I had never made these kinds of purchasing decisions before.”

That’s where she picks up strategies about lab arrangements or products that could benefit her office. For example, she added Macro’s TRS 5100 to her new, second exam lane. Between that and the three team members that she has added since opening, she is so much more efficient. “I’ve been able to delegate a lot of duties to my technician, so that allows me to enjoy the fun part of the job—talking with patients—while still being able to increase the number of patients I see each day,” she says.

“We’ve been very busy, and we continue to increase our patient volume and awareness of the practice,” she says. It’s nearly time to add an additional team member, too. While the look of the practice has undergone an evolution, the focus on customer service has not changed. “Our original concept was that I wanted to keep a lower volume, with higher revenue per patient. That would also allow me to take on more challenging cases. The concept has been very successful,” she says. Yet she’s been able to build the medical practice, as well.

In the exam lane with the Marco TRS system, Dr. Mumford performs the autorefractions herself. “Every day, every exam, I hear comments on that. Patients will say how much easier it is,” she says. “We have so much more flexibility, and we’re keeping the patient flow going more smoothly.”

And patients in the dispensary are enjoying perusing the designer and higher-end frame lines, such as Barton Perreira, Lindberg, Chanel, Tory Burch, Gucci, Face a Face and Tom Ford, among others. They’re having fun in there … just as Dr. Mumford envisioned they would.

Michelle Mumford, OD [email protected]

Doctor discovers new dimensions for her practiceRe-envisioning Her Dream

027_WO0915_VisionSource.indd 1 8/26/15 10:37 AM

How to Become the

CEO of Youp 28


do it for. One of the best examples of this is The Ritz-Carlton mission statement: Provide genuine care and exceptional products and services resulting in profit leadership. In fact, I highly recommend reading all of The Ritz-Carlton Gold Standards, which include the company’s credo, motto, three steps of service, service values and more. When you define your mission, you’ll create a unique place for you and your services in any market.

Your vision is your where.

According to Psychology Today, a vision defines the optimal desired future state—it provides guidance and inspiration as to what an organization is focused on achieving in fi ve, 10 or more years. If there were no limits to what you could do, what would that look like? The image you get in your head when you think of that ques-tion is your vision. Capture it and put it into plain words that anyone can understand and implement.

By Lauretta Justin, OD, Orlando, Fla.

There are three essentials that all CEOs must have to ensure

the success of their organization: an MVP, a strategy and a team. In an earlier

issue, I provided an overview of the three, and now we’ll look more closely at the MVP—your mission, vision and purpose. Your MVP should be the foundation for everything you do. Once you defi ne it, you will have focus, clarity and direction.

Your mission is your what.

A clear mission will give you focus. It will inspire team members and patient engagement and boost overall company performance. Your mission should define what you do, how you do it and whom you

Your purpose is your why.

“People don’t buy what you do; they buy why you do it. And what you do simply proves what you believe.”—Simon Sinek Why do you do what you do? That’s a very important question you need to answer. Knowing your why will give you passion and fulfillment in your work. It doesn’t matter how successful you become; if you’re not true to yourself, you’ll feel empty in the end. Be true to you and deter-mine your why.

It is imperative that you define and write down your MVP and review it often, at least quarterly. Your MVP will give you a strong foundation to build on. In future publica-tions, I will review steps two and three. But for now, you have enough to start on your journey. So don’t waste another minute; go for it! Dream big, take risks and become the CEO of YOU. I’d love to hear your thoughts. Email me your comments at [email protected]. WO

Dr. Justin

Develop your mission, vision and purpose for a solid foundation

The Tear Film and Ocular Surface Society (TFOS) has launched an update to the original Dry Eye Workshop (DEWS) called DEWS II. DEWS II will update the

defi nition, classifi cation and diagnosis of dry eye disease, critically assess the etiology, mechanism, distribution and global impact of this disorder and address its management and therapy. Potential topics in the updated report could include:

FDefi nition and classifi cationFPathophysiologyFSex differencesFPain/sensationFIatrogenic dry eye (i.e., drug- and

surgery-induced)FEpidemiologyFTear fi lmFDiagnosis

FManagement & therapyFClinical trial designFConsumer (i.e., com-

munication of the conclusions and recommendations for the lay person) This report will be pub-lished in a peer-reviewed journal, and the TFOS DEWS II members will be authors. The TFOS DEWS II will be an international effort that will lead to a global consensus on dry eye disease. Preliminary subcommittee summaries may be presented at the next TFOS Conference in September 2016. Title sponsor for the study is Alcon, with Shire as a platinum sponsor. Additional sponsorship

comes from gold sponsor Allergan; silver spon-sor Bausch + Lomb; bronze sponsors Akorn, Dompé, Horus, Oculeve, TearLab and THEA; and sponsor Senju. To read more, visit tfosdewsreport.org. WO

DEWS II on Track

Visit tfosdewsreport.org to keep up with developments in DEWS II.


Women ODs largely seem to consider themselves fairly even-tempered. (A much smaller sample of men ODs responded to this survey, and their responses were gen-erally similar.) A majority of women ODs, 52 percent, said that they have to be extremely sad, frustrated or angry to cry at work, and 64 percent said that they have to be similarly sad, frustrated or angry to lose their temper. One-third of the women ODs who responded said that they almost never cry, and 21 percent of them said that they almost never get angry. In addition, 87 percent of women ODs said they were tolerant and sympathetic to their colleagues’ and staff members’ emotional ups and downs, with 44 percent of them saying that they were either extremely or very tolerant and sympathetic when others in the offi ce are dealing with an emotional moment. Work-related stress (not staff-related) topped the list of triggers, with staff-related issues following closely. (See chart on the next page.) Respondents who cited other causes

Mix together all the elements of a busy optometric practice—clinical decisions, staffi ng issues, patients’ emotions and personalities, fi nancial targets, retail

sales and pressures from outside the offi ce—and it’s no wonder that emotions can run high. Overall, the majority of women ODs who responded to a short Women In Optometry (WO) survey on managing emotions in the workplace said that they consider their workplace a happy place (66 percent). Twenty-seven percent said their work environment is neutral, neither happy nor unhappy and 7 percent said that they’d call their workplace an unhappy place. Most of the ODs reported that there are moments of tension—often—with 27 per-cent of the respondents reporting that they experience their own negative emotions at least every day and 23 percent saying they experience the negative emotions of others who work with them at least daily. More than half of the ODs who responded said they expe-rience their own or their colleagues’ negative emotions at least once a week.

ODs share strategies for taming the drama in the workplace

WO Survey Results

I experience my own negative emotions (frustration, anxiety, anger, crying) in the workplace

At least once a week—33%At least once a day—27%Rarely—24%At least once a month—16%

p 29

Continued on page 30

I experience negative emotions (frustration, anxiety, anger, crying) from staff/associates in the workplace

At least once a week—36%At least once a month—29%At least once a day—23%Rarely—12%

Emotional Energyin Optometric Offi cesSwirls

Employee and Patient Emotions Are a Part of Doing BusinessWomen ODs shared their views

No Place for Raised Voices “I am more tolerant of others who cry or become emotion-ally upset in the workplace more than I am with those express-ing anger or outbursts based in anger. I view reactive anger as unprofessional in the workplace.”

Role Model for Stress “Holly Hunter’s character in Broadcast News is my role model. She begins her day with a good, hard cry at her desk, after which she stands up and gets on with her day.”

Keep an Open-door Policy “I ask my staff not to bring their personal problems to work. We are in a customer service industry, and the patients aren’t there to learn about your problem. However, every staff member knows I have an open-door policy and I’m there to listen at any time and will help in any way I can.”

Treat the Whole Person “I fi nd that patients often become emotional during eye examinations, often about issues in their lives that have nothing to do with their eyes. I think that it is important as a health care professional to make the exam room a safe place to vent and express emotions, and to treat the patient as a whole person.”

Patient Emotions Are More Challenging “I think it is more diffi cult to deal with patients’ emotions than staff emotions. An angry patient can affect not only other staff but other patients, as well.”

Patients Want to Be Heard “I listen to patients as they vent or accept bad news by allowing them to cry (I’ll hand them tissues) or get matters off their chest. Once they are done talking, I ask them how I can help them. There may not be a ready solution, but at least they feel that they were listened to.” WO

WO Survey Results


p 30

frequently listed computers, electronic health records, third-party payers, billing, irrational patients and retirement planning. One heart-broken OD wrote in response to the survey, “Ironic. I’m sitting here at work crying right now. My dog is in his fi nal days, and I’m very distracted thinking about him.”

Discussions about emotions are infrequent Despite the prevalence of emotional energy in the workplace, only 14 percent of women ODs who responded said that emotional reac-tions are discussed routinely (at least once a week) in the workplace. Forty-four percent said that they are rarely discussed (maybe once or twice a year), and 42 percent said that they are never discussed.

Amber Mayes, OD, of Oklahoma City, Oklahoma, says that she tried to address some of the negativity among the staff of more than a dozen that reached a crescendo this past Thanksgiving. “I passed out old boxes to each staff member and let them wrap their box in paper and decorate it with their name on it. During the weeks leading up to

Christmas, everyone wrote notes to one another and put them in the boxes. The notes were fi lled with kind words, praise of a job well done in the offi ce or encouragements. Right before our Christmas party each staff member read her notes. It did seem to lighten the mood for a few months around the offi ce,” she wrote. Several other ODs reported that they feel it’s best to address emotional issues quickly.

“We allow time for ‘venting’ either imme-diately after a particular incident or during our weekly meetings or fi ve-minute hud-dles,” wrote one OD. Another wrote, “In the mornings, we have 15 minutes when employees can talk freely about personal lives. No work is discussed in this time. Once our fi rst patient arrives, the employ-ees know it’s time to work. By allowing this time in the mornings it cuts chatter about personal lives throughout the day.” Janelle Davison,

OD, of Marietta, Georgia, takes a proactive approach to known highly emotional patients. “In morning huddle we identify any return patients who may take the offi ce emotion to a neg-ative place. Everyone can be ready and prepared to ‘kill that person with kind-ness.’ In most cases, that preparation gives the staff the confi dence to handle potentially unrea-sonable patients, and a lot of times, staff comes to me to say, ‘Oh, they weren’t so bad.’ We also harness emotions with out-of-offi ce team building that doesn’t necessarily require seminars and education, such as going to family entertainment places like Dave and Buster’s or Main Event.” Many ODs wrote in saying that as long as the emotional reactions stay behind the curtain and don’t leak into the patient experi-ence, they’re not necessarily bad. Continued,

escalated responses by an employee might be grounds for dismissal. One OD said staff members who have repeated negative emo-tions are “highly toxic” to the offi ce. But many see the frustrating moments of the workfl ow as a learning opportunity. One OD wrote, “What did this event teach us that we need to do or change? I am beginning to see that a good culture at work allows for free exchange of ideas, concerns, difference of opinions and ultimately growth.” Indeed, said another, dis-cussing these kinds of issues more often can help everyone in the offi ce understand that criticism isn’t necessarily personal. “I do think in the workplace we (or employees) can be a little too emotionally sensitive and need to take criticism better because criticism can help to improve patient care.” Take it all in stride, advises one OD, who wrote, “You have to remember to breathe and act, not react.” WO

Continued from page 29

Emotional Energy Swirls In Optometric Offi ces

Harvard Business Review Explores the Myths of Great Workplaces

On March 5, 2015, Harvard Business Review ran an article, “5 Myths of Great Workplaces.” The article states that many assumptions about the imagined great

place to work don’t necessarily hold true.

Myth 1: Everyone is incessantly happy. The article notes that euphoria leads to being less careful and more tolerant of risks. Negative emotions, like anger, embarrass-ment and shame encourage greater employee engagement.

Where Women ODs Work

Primary work setting for women ODs who responded

Independent optometry practice

61%

Ophthalmology or medical practice

11%

Academia

4%

Government-related setting—1%

Other—1%

Corporate-affi liated practice

22%

Myth 2: Confl ict is rare. The article cites research that disagreements over tasks fuel better performance. Relationship-based con-fl icts, however, have a negative impact.

Myth 3: Mistakes are few. The article cites more research, specifi cally a study that showed that when employees were willing to acknowledge errors, honest dialogue lead to greater improvements.

Myth 4: They hire for cultural fi t. The article says that some sharing of similar attitudes is great,

Dr. Davison

Stressful emotional encounters have many triggers.

Work-related stress (not related to staff)—49%

Staff-related issues—44%

Family/personal situations outside of work—33%

Telling patients diffi cult diagnoses—11%

Other—9%

Dr. Mayes

but too much similarity leads to complacency.

Myth 5: Their offi ces are full of fun things. The article says that employees don’t need luxuries. “What they need are experiences that fulfi ll their basic, human needs….It’s the extent to which they satisfy their employees’ emotional needs and develop working condi-tions that help people produce their best work.”

Read the whole story at hbr.org/2015/03/5-myths-of-great-workplaces. WO

The space is bright and airy with a calming view of the courtyard, located centrally in the office. The inside has the feel of a spa with beautiful chandeliers, white displays and piped music in every room.

Combining the overhead of office and home allowed Dr. Blick to almost triple her square footage at the office and upgrade to the latest instrumentation and computers with-out increasing her overhead. “High-tech, high-touch is a huge wow factor for the patients,” Dr. Blick says.

When Dr. Blick wants to leave the play-ground, as she describes it, and “go home,” she locks the office and takes the elevator upstairs. Dr. Blick can access her home and car without entering the office. It’s an ideal situation for a business owner, Dr. Blick says. There is

Most business owners have a hard time leaving work

behind at the end of the day. For Christine Blick, OD, the line blurs even more. Her Celebration, Florida, office covers the entire first floor of the

Mediterranean-style building she had constructed, and her personal residence is on the second floor. She designed her office, which opened in 2007, to be an extension of the environment that she likes to live and work in. “Since the office is such a unique situation, there really is no need to decompress or disconnect at the end of a work day,” Dr. Blick says. “Being able to care for patients with state-of-the-art equip-ment in a picture-perfect environment means that going to work is really going to play.”

no travel time or expense to get to the office, and the rent that the office would normally pay for commercial space goes directly to the build-ing mortgage and increases the doctor’s per-sonal financial portfolio. Interest rates are lower, and the office overhead is under the doctor’s total control, she says. There are no surprise rent increases, maintenance costs or shopping center fees to be paid. WO

Dr. Blick

The 30-secondp 31

Courtney Dryer, OD, set out on her own to open her practice in Charlotte, North Carolina, just a year after her 2011 graduation from Southern College of

Optometry. She had earned her undergraduate degree in business, and even completed a small business project on opening an optome-try office, but there were still many lessons left to learn about running a practice. Dr. Dryer’s been gaining on-the-job experience since day one, and she says that she’s appreciative of the great advice she’s received from her family members, many of whom work in banking. Her plan from the start was to keep costs down. “When you have student loans, it’s more difficult to open a practice, so the more you can do yourself, the better,” she says. Dr. Dryer mocked up an office design on her iPad before consulting with an architect who created the blueprint. The creation of 4 Eyes Optometry was a

and a personalized experience from exam to optical dispensary. “I don’t want to see 20 to 30 patients a day,” Dr. Dryer says. “I try to capture those patients with multiple-pair sales and high-end eyewear. I can reinforce messages about antireflective treatment while we talk about frame selection.” Dr. Dryer says that a large percentage of her income comes from the optical. Dr. Dryer recently left behind fill-in work with a corporate location nearby to dedicate full-time effort to 4 Eyes Optometry. The prac-tice is turning a profit after just two years. Dr. Dryer shares insights and passion for style and office design as an author on newgradoptometry.com. She hopes to empower new grads to take on projects on their own and to tap into their networks for help. “Be resourceful and creative—and if you aren’t, you probably know someone who is.” WO

family affair. For example, her brother created the practice logo, and her family helped repaint, reupholster and repurpose furniture and décor found at antique centers or other resale outlets. These expenses were minimal compared to hiring someone to design

and decorate. “You can hire design help, but it doesn’t always express your individuality and what your practice is about,” Dr. Dryer says. Dr. Dryer’s vision was a boutique style shop—different and unique from the compe-tition in town—inspired by her favorite stores such as Anthropologie and Nordstrom. With the whimsical, artsy design, “we wanted to create an environment where patients want to shop,” she says. Dr. Dryer admits that she was a bit anxious to see how it would all coor-dinate, as she and her family worked on proj-ects piece by piece. However, she says that she’s pleased with the result, and the quirky elements tie together in the final design. Her target demographic includes women making health care decisions for themselves and their families. Dr. Dryer and her one staff member focus on a high-impact, low-volume approach by providing thorough education

Dr. Blick lives and works in a dream

setting—all in one building.

OD finds work balance and more financial control with residence above office

Commute

DIY Design Cut Costs


Dr. Dryer wanted a whimsical and artsy design to her office.

Other—1%

OFFICE DESIGN


how the office space was progressing. “We had to be flexible all throughout the process as our workspaces continually changed as the project progressed,” Dr. St. Jean explains. “As optical was finishing, we moved into that space, so construction could begin on the workup areas.”

Dr. St. Jean says that while the process was chaotic, she wouldn’t have done it any other way, and she credits her project manager and construction crew for their work ethic and professionalism. “Our project manager did everything he could to minimize disruption to our practice,” she says. “The crew came in on weekends, early mornings and evenings and kept the work area as clean as they could as they were working. The crew was also mindful that patients were within earshot at all times, and they were very

Advanced Eyecare, the Charleston, West Virginia,

practice of Rebecca St. Jean, OD, was open for business during five months of renovations in 2013, only closing for two weeks for demolition

and trenching for plumbing. “We needed to add 1,500 square feet, so we remodeled the entire space,” Dr. St. Jean says. “My goal was for a traditional, timeless look so that I would not have to remodel anytime soon.” Dr. St. Jean adjusted the schedule during the construction period, and she says that patients were understanding and eager to see

friendly to our patients.”

Dr. St. Jean incorporated fabrics and finishes that looked beautiful and are also durable to last for years to come. Patients saw the pieces come together when they visited the office or through updates posted on the practice Facebook page. The practice held an open house when the project was complete. “Our patients were very excited to be a part of the transformation of the practice,” she says. WO

Dr. St. Jean

Tory J. Goode, OD, opened Mountain View Family Eyecare

in Heber City, Utah, about five years ago. As her lease was reaching its term, she wanted to see whether expanding was a possibility. It’s

a tricky proposition for a solo doctor who does her own pretesting, she says. She needed to balance the desire for convenience and com-fort with the assurance that she’d be able to do more in a larger location. What she and her husband, Danny Goode, found was an office that was just a little larger (900 square foot compared to the 700-square-foot space that she had been in). But sometimes a few hundred square feet can make all the difference. The first office previously had been an

“Our town is only eight miles end to end, and we moved about a mile and a half away. Now we’re more in the center of town, on a main street in a larger building with other medical practices nearby,” she says. The square footage may be only a little larger, but the impact of the move will be a good one for years to come, she says. WO

insurance office, and Dr. Goode worked with the layout. “At the front of the office, there was a space for an optical and reception area, and then there was one room for exams and pretests,” she says. The space she moved to had been a dance studio with a wide-open floor plan. So she was able to design an office with better workflow. The business duties are now contained in an office space, so the front desk is truly a reception area. “We split the pretest and exam lanes,” she says. This was one of her most difficult decisions: should she put in two exam lanes or one testing room and an exam lane? She ultimately chose the latter because she felt that it gave her the most opportunity for growth. She can bring on a technician and have both rooms occupied at once.

The optical is larger, which is allowing her to bring in more frame lines and increase the inventory. Other than that, she didn’t have to add much. She even liked the color scheme in the dance studio and thought it was a nice break to get away from the blue walls of the old office.

Patients become engaged in the renovation process, unveiling of new space

Five-month Remodeling

Dr. Goode had help from the family

when she moved her office into a

new space earlier this year.

p 32

Working in a Construction Zone During

Position Practice for the FutureMove Enables Doctor to

Dr. Goode

The expansion resulted in a gor-geous blending of old and new spaces.

OFFICE DESIGN

WO sends out Makeover Mondays via email. Visit womeninoptometry.com to see these and other great ideas. If you have a makeover idea to share, email [email protected].



p 33

FAleta Gong, OD, FAAO, FCOVD, of Phoenix, was named 2015 Op- tometrist of the Year by the Arizona Optometric Association (AzOA). Lilien Vogl, OD, of Goodyear, became president of the AzOA, and Cheryl Schmitt, OD, of Tucson, became immediate past president. Beth Pyle-Smith, OD, of Avondale, is now secretary-treasurer. Lindsey Clyde, OD, of Phoenix, joined the AzOA Board of Directors.

FBelinda Starkey, OD, of Springdale, became secretary/treasurer of the Arkansas Optometric Association. Susan DeBlack, OD, of Conway, became immediate past president.

DeAnne Witherspoon, OD, of Rogers, received the 2015 Lifetime of Excellence Award.

FRebecca Wincek Bateson, OD, of Indiana, has been awarded the Southwestern Pennsylvania Optometrist of the Year Award by the Pennsylvania Optometric Association.

FThe American Academy of Optometry announced its 2015 Award recipients. Wendy Marsh-Tootle, OD, MS, will be receiving the William Feinbloom Award at the annual meeting in New

Orleans in October.

FSarah Lewis, OD, of Louisville, was named the Young Optometrist of the Year by the Colorado Optometric Association.

Womenin the

NEWSThese ODs have

recently been awarded, acknowledged orrecognized in theircommunities or by

organizations of the World Council of Optometry; Sally M. Dillehay, OD, EdD, vice president, clinical and regulatory affairs, Visioneering Technologies, Inc.; Jennifer L. Geertz, OD, owner of Bird’s Eye Optometry Ltd. in Batavia and Hodgkins, Illinois; Tonya Reynoldson, OD, chairman of the board, Tennessee Association of Optometric Physicians; and Lorraine Voorhees, OD, MS, vice presi-dent for student affairs at Marshall B. Ketchum University. Courtney Dryer, OD, of Charlotte, North Carolina, and Jennifer Smith Zolman, OD, FCOVD, of Charleston, South Carolina, were named Rising Stars. Rachel “Stacey” Coulter, OD, associate professor, Nova Southeastern University, and Jill M. Saxon, OD, director, professional strategy, Bausch + Lomb, were rec-ognized as Mentors. Innovators included Weslie M. Hamada, OD, FAAO, principal research optometrist, Johnson & Johnson Vision Care, Inc.; Jennifer Lyerly, OD, author and editor of Eyedolatry Blog in Cary, North Carolina; and Diane B. Whitaker, OD, chief, vision rehabilita-tion services, and assistant professor of ophthal-mology at Duke Eye Center.

FThe Association of Schools and Colleges announced several awards recently. Denise Goodwin, OD, FAAO, of Pacific University College of Optometry was one of the authors honored with the Dr. Lester Janoff Award for Writing Excellence. Molly Spatcher, OD, a 2015 graduate of New England College of Optometry, was honored with the Student Award in Clinical Ethics, sponsored by International Vision Expo. WO

FAndrea P. Thau, OD, of New York, New York, became president-elect of the American Optometric Association.

FThree women were among the five ODs honored

as Young OD of the Year by the California Optometric Association: Isabell Choi, OD,

of Orange County; Sarah Wolff, OD, of Bellflower; and Jennifer Hsieh, OD, FAAO, of San Jose.

FJanet Summers, OD, MHP, is now vice president clin-ical standards at HVHC, Inc.

FVision Monday named several women optometrists in its annual Most Influential Women In Optical report. Honorees in the Executive Suite included Susan Cooper, OD, FAAO, past president

Dr. Clyde

Dr. Lewis

Dr. Summers

Dr. Marsh-Tootle

Dr. Thau

Dr. Schmitt

Dr. Gong Dr. Vogl

Dr. Bateson

Dr. Choi Dr. Wolff Dr. Hsieh

Dr. Starkey Dr. DeBlack Dr. Witherspoon

Dr. Cooper Dr. Dillehay Dr. Geertz

Dr. Reynoldson Dr. Voorhees Dr. Dryer

Dr. Smith Zolman Dr. Coulter Dr. Saxon

Dr. Hamada Dr. Lyerly Dr. Whitaker

Dr. Goodwin Dr. Spatcher

Dr. Pyle-Smith

By Laura Armstrong, OD, Alberta Eye Care, Portland, Oregon

In Portland, green living is part of the culture. When I opened my practice in 2012, creating a business with a low environmental impact was important to me and my husband, James Armstrong, MBA, my business manager. Here’s how we do it.

Go paperless. Having an electronic medical records system is one important step. We go further. We use laminated rout-ing slips and forms for patients that can be wiped clean and reused. We offer patients coffee in mugs and, after their exams, patients are invited to have a glass of wine. That’s served in a real glass. We have an energy-effi cient dishwasher in the offi ce. Buy recycled paper. Avoiding all paper is nearly impossible, but we only purchase 100 percent recycled. This way we can print order forms or instructions to patients responsibly. Set up recycling stations. Next to nearly every wastebasket in the offi ce there’s also a recycling container. We also have recycling con-tainers in the reception area so that patients who come in with a drink

By Amanda K. Lee, OD, Myrtle Beach, South Carolina

The evolution of eye care in the U.S. has shown us one thing for certain: change is constant. In the early 1900s, we were refractionists. In the 1920-1930s, we were slow to adopt the designation of “doctor.” In 1971, Rhode

Island became the fi rst state to extend diagnostic medication privileges to optometrists. In 1976, West Virginia became the fi rst state to extend therapeutic medications privileges to optom-etrists. By the early to mid-1990s, only half of U.S. ODs were able to prescribe therapeutics. By the early 2010s, we became the provider of primary eye health care services. That seems like great news, right? But the irony is that by the 2020s, we face eradication of our profession by industry dynamics and economical effi ciencies driven by new technology. Look at the demise of the independent pharmacy since the 1980s or the infl ux of nurse practitioners and physician assistants that has altered the traditional medical practice. Fifteen years ago, primary care physicians were mainly independent. Now, only about 30 per-cent are, and that number continues to decline. It is becoming increasingly more diffi cult for them maintain their independent private practices. On top of that, optometry is fertile for disruptive technologies and

bottle or paper cup can recycle it.Recycle more than paper, glass and

cans. We let patients know that the blister packs for daily disposable contact lenses are recyclable. They’re too small for curbside recycling, but I encourage patients to return their blister packs

to our offi ce, and I’ll bring them to the recycling station. We also post signs about what can be recycled and where it goes: the recycling center or curbside pickup. I’ll bring packing pea-nuts to the UPS store and compact fl uorescent bulbs and batteries to IKEA or Best Buy. The city provides a website with an easy-to-use search function for recyclables. Use energy-effi cient lighting. Our large

front windows let in a lot of natural light, but we use energy-saving light-ing throughout the space and LED lighting in the optical displays.

Use reclaimed wood. All of the wood used in the displays, recep-tion desk and optical furnishings are reclaimed wood. Each piece has a story and character, which makes the space warm and inviting. WO

The green offi ce looks inviting with reclaimed wood and energy-effi cient lighting.

VoicesVoices

VoicesVoices Voices Voices

Why I Think Proactive Integration Is a Good Thing for Optometryservices. Warby Parker was introduced in 2010, and very recently, we’ve been rattled by the disruptive technologies of Opternative, Blink and Walgreens, to name just a few. What we need is for all of optometry to stand collectively and decide what optometry’s future is going to look like. If you choose to take a leadership role, we can accomplish whatever we want to as a profession. While there may not be an all-encompassing answer that satisfi es every one of us in private practice optometry, there is one entity that exists and has always existed to help private practice optometrists thrive: Vision Source®. Full disclosure, I am a private

practitioner in a Vision Source offi ce and help co- administrate the state of South Carolina with my practice partner Tammy Tully, OD. I’d rather stand among those who are proactive than reactive. That perspective helps me see why the acquisition of Vision Source by Essilor was not only inevitable, but takes the long view. Essilor was a natural partner in our industry. Would you consider Apple and Google health care companies? I would! Integration in health care is going to continue. So will the debates on whether that’s good or bad. In a book by Dan Millman, a character named Socrates said, “The secret of change is to focus all of your energy not into fi ghting the old but on building the new.” Let’s work together to build a strong future. WO

Dr. Lee

Are you interested in sharing your views or experience in this space? Women In Optometry invites submissions to Voices for each issue. Contact Editor Marjolijn Bijlefeld at [email protected] for more information.

Let Your Voice Be Heard

Dr. Armstrong

It’s Pretty Easy Being Green

p 34


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DEDICATED TO THE INTERESTS OF WOMEN ODs...Sara Laschever, Women Don’t Ask: The High Cost of...

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