July 22, 2020

Myopia Management Journey - E1

Myopia Management Journey - E1

Myopia Management Journey

This is going to be fun. So in order for you to know where I am going, you have to know where I have been, thus we must hop into our proverbial delorian’s, go back in time, and let me take you down memory lane.


In 2011 I graduated from ICO and was all set to take a job at Lenscrafters. I had busted my tail the past four years and honestly was a little burned out. So, to the chagrin of my professors and surprise of my colleagues, I decided to forgo a residency and just try to make some money before starting an office. Well, life happened and I backed out on Lenscrafters and started an office cold in my hometown of Allendale, MI.


Now for all you brave souls who have started cold, you understand the undertaking this was/is. Thankfully, I was too naive to realize what I had done and had no other experience to compare it to. Let me tell you some key things to remember when you are starting cold: 1. You have NO patients, no protocols, nothing to lean on as a safety net. 2. The patients that do wander into your office did not fall from the sky and just decided to get their first exam ever at your office. No, those magical souls usually are usually unhappy at the last 3-4 places they went and want to “try” you out. This will test your customer service skills and business acumen to its limits, but if you survive, you may have a patient for life, or just be that much better when you get a little time and experience under your belt. 3. As a result of points 1-2 you are willing to try anything: punctal plugs, dry eye, vision therapy...heck I considered renting a lane to one of my staff members who was also a hairdresser on the side! You just want patients in the chair and one more day of being in business! 


I could go on and on with stories of a startup office, and I am sure if you stick around long enough you will get your share of those stories (they are plentiful...like when I had a full day of training for my staff and within the first hour, I thought it was a good idea to dilate them all to show them how to drop each other/relate to the patient….genius!). 


That being said, I tell you all this to illustrate my desire to define a culture and find a specialized niche in the optometric world. Believe it or not, I graduated as the valedictorian of my class, so I had thought residency, fellowship, and publishing were in my future. Knowing what I know now, I picked the right path for my personality and passions but I still have a desire to be an “expert” in something beyond primary care of the eye. I also want my so-called expertise to be financially beneficial as well.


You name it and I tried it. I was basically the online dating guru of optometry's subspecialties. I started with vision therapy to realize I didn't have the patience to work with kids in that manner, did not want to train staff how to train patients and have them leave 2 weeks later, and did not feel parents found value in “paying” for treatment. I played football in undergrad (Saginaw Valley State University) so I tried to persuade myself into thinking sports vision was the answer. Whelp, see above and add die hard parents that think Johnny is going to the NFL or Major leagues and you swipe left real quick!


I casually flirted with the other major players, dry eye, ocular disease, scleral lenses and basically fell flat on my face. The average age of my patient base is probably around 35, so I do not have a huge demand for dry eye care or an abundance of ocular disease. Do not get me wrong, I do a lot of red eyes and foreign body removal, but I am a few years from being able to justify an OCT and going head first into the medical model. With sclerals, they are just stinking hard to get on and take a ton of chair time, I have not given up completely, but let just say I am ghosting them for now.


That has led me to my diamond in the rough, the gem of all gems: myopia management! It fits my patient population, has the ability to just be ortho-k for my older patients, and is what I believe to be optometry’s “braces” moment. Screw those blasted dentists with their voodoo marketing that gets people in the office twice a year for “cleanings” and then has the ability to hold parents hostage to braces for the next decade of their lives! This is our time to shine! Throw in the fact that my wife is a -6.50 and I have 3 girls 4 years old and under and this hits home personally.


Now that you know where I have been, over the next few weeks, months, years, I hope to bring you along my journey as I try to carve out my niche in this amazing profession we call Optometry. Get ready for a rollercoaster of a ride!