Article Date: 11/1/2010

Hindsight Truly Is 20/20
If I Had to Do It Over

Hindsight Truly Is 20/20

What experienced ODs would have done differently

By Bob Levoy, OD

NO DOUBT ABOUT IT. Experience is the best teacher. As a result, one of the questions I've asked countless optometrists as part of the research I do for my books and articles is: “Looking back on your career, what would you have done differently — if you knew then what you know now?' The result has been a veritable treasure trove of insights and practical advice learned the hard way. Here are a few of them:

I would have stopped working for a commercial chain sooner and started my own practice. This life-changing insight was shared by numerous ODs including a Midwest practitioner who was caught up in what he called the “Golden Handcuff Syndrome.” On the plus side, he had a good salary (plus benefits) for what was essentially a 9-to-5 job with no management responsibilities. It enabled him and his family to live a good life. The downside? He hated what he was doing. Reality check — life is too short to wake up on a Monday and wish it were Friday.

Action step: After ranking his priorities, he decided to take a leap of faith and make a fresh start in a less hectic, more satisfying type of practice. It took a while for his income to match his previous earnings, but eventually it did. Looking back, he says, “It was the best gift I ever gave myself.”

I would have used a different marketing strategy to grow my practice. This decision was reached by many ODs who later realized their efforts to promote their practice took them in an entirely different direction than the one they had intended.

The image of a practice, which is greatly impacted by marketing strategies, has two components: visibility and credibility. “Visibility” refers to how well known you are in your community. “Credibility” refers to how well regarded and respected you are. There are essentially four permutations:

1 High visibility/high credibility: This results in being both well known and well regarded. It's obviously the most desirable image — the one with the highest potential for attracting new patients and physician referrals.
2 Low Visibility/low credibility: If you're new in practice or have recently moved to a new community, you're most likely unknown. You may be tempted to jumpstart your practice with discounted fees or other forms of self-promotion to get your name out there. This will also put you in competition with highvolume offices that have more purchasing power and deeper pockets.
3 Low visibility/high credibility: In this scenario, you're well regarded and respected but not well known. The challenge is to increase your visibility in ways that don't undermine your credibility (see below).
4 High visibility/low credibility. This is the worst of the four possibilities. You're well known but not well regarded. Recovery is possible, but as the saying, goes you seldom get a second chance to make a first impression.

Action step: Take an objective look at what you're doing to promote your practice. How well do these efforts meet the visibility/credibility test? It's an analysis that will help you make the right decision for your new practice.

At one time, the mass market was every optometrist's target population. Niche marketing involves an entirely different strategy. It means targeting a specific population of patients, identifying their needs, then addressing those needs more competently than anyone else does.

“If you're the only practice in the community,” says Ken Gibson, OD, Appleton, Wis., “you can be all things to all people. But if you're in an urban area or in a town with more than two or three other optometrists, you need to set yourself apart — with a specialty practice.”

Today, there are more specialty opportunities than ever. Among them are dry eye, orthokeratology, specialized contact lenses, low vision, co-management, vision therapy, geriatrics, pediatrics, sports vision, computers and vision.Another consideration: when seeing specialists, patients tend to be less concerned with fees.

I would have have increased my networking efforts. Another of the many effective ways to achieve visibility and credibility is networking with physicians and allied health care professionals. This strategy can pay huge dividends – the most obvious of which is referrals to your practice. Such referrals are especially valuable because patient acceptance (and in turn, loyalty) is almost guaranteed when someone has been highly recommended by a trusted physician. In addition, unlike patient referrals that are self-limiting, physician referrals can be an endless source of new patients.

Among the prospects for optometric networking: primary care physicians, ophthalmologists, other optometrists, neurologists, pediatricians, pharmacists, psychologists, athletic coaches, occupational therapists, hospital emergency room personnel, school nurses and teachers.

Oculoplastic comanagement may prove to be lucrative for optometry as more types of surgeons are branching out into eyelid surgery, says Eric Schmidt, OD, Elizabeth-town, N.C. “You'll get involved not only with oculoplastic surgeons but regular plastic surgeons, some oral surgeons and maxillofacial surgeons. Most of them don't have visual field instruments, so patients will end up paying full-fee for the surgery.

“Tell those doctors that the patient may be able to get insurance to cover a portion of the surgery by having a visual field test done to prove that the blepharoplasty will improve their field of vision and hence, improve their lifestyle,” says Dr. Schmidt, “This is an avenue to increase referrals to the optometrist's practice.”

Action step: One of the simplest ways to begin networking is to write selected physicians in your community. Explain that you're in the process of establishing a network of primary care physicians and specialists to whom you can refer patients who are new to the area or are without a physician. Request information about their practices.

Keep the letter low-key. Don't include a brochure about your practice, article reprints or business cards. It's not about you. It's about your patients. And it's a safe bet that some physicians will reply.

I would have done more public speaking. Many optometrists learn to appreciate the power of public speaking to achieve visibility and credibility, and in the process, attract new patients. It's one of the most effective ways to market yourself and carries the lowest cost. Best of all, the demand is out there.

“There are many community groups from service clubs, chambers of commerce and civic organizations, PTAs, church based sub-groups, youth sports organizations, to senior citizen organizations,” says Jerome A. Legerton, OD, MS, FAAO, San Diego, Calif., “who are eager to have a polished and pleasant speaker inform them about the wonderful gift of sight and the technologically advanced services and products that are available today.”

“In our office, the Alderwood Vision Therapy Center in Lynwood, Washington,” says Nancy Torgerson, OD, FCOVD, “we have monthly workshops for parents, grandparents, spouses, teachers, occupational therapists, speech therapists, physical therapists, and so on to help them learn about vision. I have found that it's a very effective way to communicate to other professionals and parents.”

Action step: If you lack public speaking skills or experience, consider joining Toast-masters. Seek out situations where you can get some practice in front of groups: volunteer for a committee, speak at your church, participate in school board meetings, join a study club or teach a class.

I would have spent more time with my family. I'm sad to say that this a frequently heard regret.

Many optometrists, especially those starting out, put in long hours, often 6 days a week including outside activities (such as networking). In most cases, these efforts pay off, but often result in borrowing against the future. The assumption is that there will always be a future. However, time quickly slips by … one day, they realize that by focusing exclusively on their practices, they've missed their children's youth and their partner's companionship.

Another regret I hear from women doctors is that they didn't set aside time to have children. “My husband and I put off having children because of our commitment to the profession,” says Dr. Margaret Rucker, a veterinarian in Lebanon, Va. “At the time, balancing work and life didn't seem important. As I've gotten older, I've begun to see what I'm missing.”

Action step: To avoid later regrets, think about what's truly important in your life and your practice and make all decisions with that in mind. nOD

Dr. Levoy is a columnist and editorial board member of Optometric Management and author of seven books on practice management. His newest book is “222 Secrets of Hiring, Managing and Retaining Great Employees in Healthcare Practices.” He can be reached at

Optometric Management, Issue: November 2010