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Power Hour Optometry
A Candid Conversation with VSP’s Former CEO Jim McGrann: Innovation, AI, and Industry Challenges
00:49:47
In this must-watch episode of Power Hour, host Eugene Shatsman sits down with Jim McGrann, former CEO of VSP Vision and current CEO of Advancing Eyecare, to address the pressing concerns of eye care professionals (ECPs) and explore the future of...
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- [00:00]
Jim McGran
Foreign.
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Eugene Shotsman
Hi, everyone.
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Welcome to the Power Hour, Optometry's largest and longest running show. I'm your host, Eugene Shotsman. And today's show was recorded in the Advancing Eye Care booth at Vision Expo West. So it was recorded with Advancing Eye Care's new CEO, Jim McGran. And Jim has had a lot of influence on our industry, including his recent and, I guess, current work as the chair of the nonprofit that's called Prevent Blindness. But I think he may also be very well known as the former CEO of vsp. And whether you love VSP or you hate vsp, this turned out to be a very interesting conversation that touched quite a bit on what that role of CEO of VSP actually meant. Jim talked to me about how he sees the role of managed care, especially now that he's not at vsp. And I asked him pretty directly why it is that VSP has not raised their reimbursements in so long. So it's an interesting answer. And we talk about how to combat this phenomenon and strategies, for example, to increase revenue per patient, which then led us to talk about the role of technology in patient expectations and the role of technology in care. Today as a whole, we cover AI. We cover the future of optometry, the ability to leverage AI and stay and be competitive in your practice. And we also talk about some key challenges with technology and with AI today. So overall, this was a fascinating discussion. Again, recorded live at Expo west in Vegas. And I really felt like sitting down with Jim gave me a greater appreciation for our industry and provided me with just kind of a more global picture of this amazing space that we operate in. So watch it on YouTube or make sure you're subscribed on Apple, Spotify or wherever you get your podcast. And I'm really excited to hear your feedback. You can reach me on the Power Hour website or@eugene shotsman.com I look forward.
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To being a resource for you.
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And here we go with today's episode with Jim McGran.
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All right, Jim, thank you so much for joining me on this live Vegas Power Hour. We're here at Vision Expo West. There's a lot that's going on here. And just curious, when did you get in and what have you seen so far that might be relevant for us to share with the audience?
- [02:13]
Jim McGran
Well, thanks so much, Eugene. Thanks for having me. And yeah, it's great to be here in Vegas again for Vision Expo west. Probably my 26th Vision Expo West. I arrived Monday evening. Actually, I. On Tuesday I had a board meeting. I'm A board member of a software company called ocuco. It's an industry based practice management, electronic medical record, enterprise software. So spent Tuesday with that team in the board meeting and then on. On Wednesday. There were two main events that day. The Prevent Blindness Organization. I happen to be the chairman of the board of Prevent Blindness currently. And we always sponsor our annual Swing for Sight golf event here in Vegas.
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Eugene Shotsman
I've heard a lot about that, by the way.
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Jim McGran
Yeah, it's a lot of fun. And one of the things we're hoping for is that it used to be at a much higher level of participation. We had about 60 participants. We raised about $60,000 for Prevent Blindness. Before COVID we used to get probably 120 to 150. So we're hoping to bring that back. But we had just a beautiful day. Great support from all of our sponsors. And it's just such a wonderful organization raising awareness and explaining to folks that are suffering with, you know, sight loss. All the resources that are out there to help them and get them access to. So really great morning. And then that should.
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Eugene Shotsman
It's phenomenal, by the way, to see the industry come together for such a great cause.
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Jim McGran
Absolutely. It's one of the things I always say about. There's two things I always joke about with this. Not joke about, but say about the industry. One, I refer to it as the Hotel California of industries.
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Eugene Shotsman
You can never leave.
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Jim McGran
You can check out anytime you like, but you can never leave. But the other thing that I think is really special is that while there's a lot of competition and competitors in the industry, we all, when necessary, come together, whether it's to support Prevent Blindness or during COVID coming together to help support private practice and keep private practice thriving as we came out of it. And I just love it. There's nothing like it. And I think it all has to do with us being all part of the same purpose. That we come to work every day hoping to help people see. And I know it's the doctors that do the real work and the hands on work, but we all get to work for companies and businesses that are playing a role in helping people see.
- [04:30]
Eugene Shotsman
And you know what's fun? And this is where I really think that Expo is such an important time to pay attention, is that this is when everybody rolls out all the different innovations and the things that they basically bring to the table to help the. To help accomplish that goal even better. Even more so.
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Jim McGran
Right, Exactly. And I. And I. That's a perfect lead into. So after the Prevent Blindness event, Yesterday afternoon was a, was an event that Jobson put on around AI and it was building off. They had had a Vision Monday summit in New York at Vision Expo east that really gave a good high level view of what's AI, where is it going, what's the future. But then the feedback they received was from the, especially from the doctors and the practitioners was, that was great. But can you put together a program that really helps me drive into what should I be doing, what should I be focusing on in my practice?
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Eugene Shotsman
So what were some takeaways from your vantage point?
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Jim McGran
So to me there's a couple of great things. One, I've been to two AI summits in the lab. So I was at one that was put on by our founding company, Cornell Capital, our owners, and it was the focus there or what I would take. The one main takeaway I took there was the quote they opened the meeting with. And it's, and the quote was AI is not going to replace humans, but humans with AI are going to replace humans without AI.
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Eugene Shotsman
Yes.
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Jim McGran
So yesterday I saw the same theme in the conference, but really you took, you could take it to the doctor and the practice level. So it was basically, you know, AI is not going to replace doctors or practices, but practices with AI and doctors with AI are going to replace those without. So I think the key message was that, you know, we all need to get on the AI bus, understand and plan specifically for how we can implement it in our businesses or in, in the practices. And then the one speaker I found really, really fascinating, she, she focused very heavily on the data and it was interesting because, you know, everyone focuses a lot of times on the tools, like, oh, I'm going to implement tool ABC or XYZ. And as she presented, it was like that's about 20% of the effort, but the 80% effort is getting the data, getting it clean, getting it usable, trying to remove bias that's just naturally built into data that's there that you have to understand what are those biases? And she showed some great, you know, great examples of that where you, you assuming you have like a clean data set, but once you roll it out and you realize, well, no, that's, that's not the right right or that's not the right intention or what we're trying to do here.
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Eugene Shotsman
So well, and you know how passionate I am about data. And one of the things that we tried early on, and I think where this is a practice that's evolved, but we've actually taken the database of the practice, you know, all the patients. And we said, okay, let's scrub this, let's put it into a secure AI basically chamber and then let's let AI analyze this data so we can say, you know, things that other software wouldn't be able to tell you. You can kind of jump in and say, well, how is this practice, how is this location improved over time? What is my patient? What for example, is my most profitable location? What for example, is a location that, or what is my relationship with this particular managed career? And what happens with those patients that have that particular managed care plan? And you know, we found that data was really a product of the success of that data was really the product of successful prompt engineering. And I think we failed 10 times more than we actually succeeded when we were running those experiments because we found that, you know, just asking AI to provide us the answer wasn't enough. You had to really kind of think through the process of how is this computer, how is this machine that's learning, but how is this self learning machine actually able to process this information, almost learn to speak its language.
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Jim McGran
Exactly. Yeah, great point. And that's what I would say was the biggest takeaway. Because as we've been looking at how to implement AI in advancing eye care, let's say to help improve our customer service and our customer support, what we've learned is we have an enormous amount of data and information that from 60 years of being in business, all of our product knowledge that we have within our team members and it's how do we get that built into the tool and cleansed in a way that it's useful so that when a customer, whether it's an office manager or it's a doctor, sends its prompt in about a question about one of our devices, they get an answer that's useful and they.
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Eugene Shotsman
Can get it right away.
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Jim McGran
Exactly.
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Eugene Shotsman
Well, and I'm really curious to hear how you guys are going to think about doing this because, you know, I've seen this in practices and we actually, we've been experimenting with this in practices is, you know, the first line of patient questions could be answered by AI, but it's kind of dangerous to do it because AI tends to still hallucinate a little bit. And you know, when a patient asks a medical question, you gotta be super, super careful. Maybe that's not the case when you know, somebody is using technology and AI is the first line of defense. So it sounds like it's pretty exciting as an impact to your business.
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Jim McGran
Very exciting. And I think. But the same question, right, we have to Be careful about someone asking a question about, say, a reading that comes from a machine.
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Eugene Shotsman
Yeah.
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Jim McGran
You know, we have to make sure that. Because that's, you know, passing on medical information about, you know, how, how someone should handle or understand what they've learned from the device. But one of the real wins, we feel, is giving the power to the practices and to the doctors to be able to solve their own problems as opposed to having to call into a customer care office, speak to an agent. They'll be able to solve a lot of their own problems just because we put that knowledge into the tool and then have the proper structure of the data.
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Eugene Shotsman
Yeah, fantastic. Great point. And one of the things that I definitely wanted to ask you because you mentioned this is your 26th Vision Expo, so you've seen the industry evolve quite a bit.
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Jim McGran
Absolutely.
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Eugene Shotsman
And, you know, before we talk about where it's going next, let's talk about where it's been and what are some of the most transformative changes that you've seen over the last couple decades?
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Jim McGran
Yeah, so definitely from when I first joined, I joined Marshawn eyewear in 1999.
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Eugene Shotsman
Right.
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Jim McGran
Back then, that was the height of the Internet craze.
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Eugene Shotsman
And at that point, that was, you know, Y2K time. The planes were going to fall out of the sky, you know, everything was going to shut down if we didn't have the four digits.
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Jim McGran
We had our IT team members slept in our data center that night on New Year's Eve just to make sure the computers didn't blow up.
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Eugene Shotsman
Right. Okay.
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Jim McGran
So, but it was also the time of, you know, the heyday of the Internet. And we in our industry specifically, there was 15 business to business portals that came up that they would come and meet with us at the frame company, the Eyeglass frame company, and they would say to us, if you don't put your frames on our portal, you're going to go out of business. Because this is how the doctors are going to order from here on out. They're just going to order online. They're not going to call your customer care office. So we spent an enormous amount of time, and I'd say 99 through 2001, really assessing those portals and saying, is this really true understanding from our customers? Is this what they want to do? And what we learned is there was a certain portion of the market that shifted to using business to business portals, but a lot of folks and their offices and their processes, because they hadn't updated them, still enjoyed making a phone call at the end of the day to the Marshawn call center and say, give me the Calvin Klein1234 and the Nike 1234. And they actually enjoyed the interaction with our customer care teams. So it wasn't an all or nothing. And it was, it was the same thing technologically back then about laser surgery. At that point the view was, okay, laser surgery is going to put us out of business. No one needs glasses anymore. And, and then it, you know, leveled out and it's still, you know, a great surgery for the right people. But it didn't put the eyewear companies out of business. But those were, those were those technological advances that, but when you take a look at it, there were, there were 15 that we were meeting and we're trying to assess, you know, who do we do we play with one or we play with all 15. How's work? As it ended up in the end, there were only two left and both of those portals were owned by the large players in the industry. So VSP owned ifinity and Esslore. Now Essloral Exotica owned Vision Web. And also there were other, you know, there were other industry players that had invested in Vision Web. So to me, those survived because they had those major players behind them and the support of those major players and then them driving, you know, driving customers and business to that. So that was, that was the big shift in the beginning and where the focus was then as the industry moved forward, consolidation started to take over. Right. You started seeing the roll ups of, you know, my eye doctor, what's what, what my eye doctor now and eye care partners and Kepler and all of these consolidators feeling that, you know, they're going to be strong, they'll be stronger together by bringing the practices together and that the doctors will be able to go on and do what they want to do, practicing their medicine and taking care of eye health and eye health wellness and wellness and the, and the roll ups would take care of the back office processes.
- [14:17]
Eugene Shotsman
Sure.
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Jim McGran
That still to this day continues. Right. There's still that. And I think Covid, Covid did have a, you know, it was definitely a defining moment, I think for a lot of independent practitioners saying, you know, I don't want to have to take on all of this HR and legal and personnel matters related to a, you know, a global pandemic. It's just too much.
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Eugene Shotsman
Well, yeah, some doctors want to be entrepreneurs and they want to run every aspect of the business and then some doctors want to practice medicine and only practice medicine. And that was, you know, I think that's still a guiding driver for why somebody may or may not engage in a transaction.
- [14:55]
Jim McGran
Great, Great point. Yes. And. And then that's where you also saw, in this time period that I've. That I've been around the industry, you saw this shift of expanding scope of practice for optometry. Yes, optometry becoming focused on dry. You know, becoming more medically focused. And in. During. Again, during my time saw, it was where there became this real tension between the optometry profession and the managed vision care companies. Because, you know, there was a. There was a view, I believe, from optometry that the managed vision care companies were preventing them from moving down the medical route. And the managed vision care company's view was, no, no, no. We, you know, we help bring patients into your practice, and those patients will become your medical patient.
- [15:45]
Eugene Shotsman
Okay, so we got to slow down and talk about this particular point because, yeah, I mean, you've run vsp, and I think, you know, if I'm being really honest, I think that there are some companies that, you know, if you ask a typical optometrist, which companies do you love? You know, VSP probably wouldn't be on that list, but maybe they should be. And, you know, you're gonna bring an alternative viewpoint here. But, you know, I think that there are practices today who say, well, you know, the reimbursement has been the same, and I don't really feel like the managed care companies are truly supporting my practice. And, you know, if you're in that hot seat and you have to answer that question, what do you say to the optometrist listening to the show today?
- [16:24]
Jim McGran
Sure. You know, and I. I was in that hot seat, you know, for about eight years and got the question many times about, you know, Jim, have you gotten a raise in the last 10 years? You know, because we haven't. And that was how the discussion would always start. And what we talk about is, you know, in all transparency to the doctors who say, I remember presenting to a group of doctors once and said, I'd love to be able to pay you $200 for an eye exam. Right. I get it. You went to school for four years. All the cost and the training and everything you needed to do, and you're telling me, you know, that what they're. The pushback they were giving us was, you know, it's as much as we just had a little guest walk by.
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Eugene Shotsman
But, yeah, it's fun to do this.
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Jim McGran
The, you know, that, you know, the other comment they use is to say, you know, I pay more, I pay more to get my hair cut than you're paying me to perform an eye exam.
- [17:19]
Eugene Shotsman
Yeah.
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Jim McGran
And what the challenge was was what we explained to them. And I think for the most part it was understood. Not, not that anyone liked it, but it was really the market that drove those exam fees. It was not, it wasn't our, our have run and drive huge profits. You know, VSP was a community, is a community based benefit organization. You know, not for profit at the, at the top. And it's a, you know, it's a tax paying, not for profit with that. But our desire was always to try to pay as much as we could. The challenge was, is the way those way managed vision care contracts are written, the customers, the employers, they get a view into, you know, what we are reimbursing doctors. So there were a number of other players in the industry. I think for a long time VSP held pretty firm to fairly high levels of reimbursement before competition came in. That competition came in, started to drive those reimbursements down. Then VSP had to respond to that. It was either we would retain the contract or a competitor who's paying $40 for an eye examination is going to win the contract because the customer, the, you know, the employer is saying, well, I'm going to, this is the same doctors are on the VSP network as on company X's network and they're paying them 40. Why are you paying them 60 or 70? So it became a real market challenge. So what we got focused on was, you know, how were there other ways that we could help the practices improve their bottom line, whether it was through the frame company or through the lens company. And I know that, I know that also gets frustrating because for the doctors, it's like I want to make my own decisions around the frames I carry or the lenses I carry. But if we were able to drive business into those parts of the organizations, we were able to share those profits. And yeah, it didn't show up as an exam fee, but they were able to, you know, get better reimbursement and all. It's always, it's always been very hard to explain. And in the end, the way I look at it now, you know, outside, outside looking in for a typical practice, a managed vision care plan and the acceptance of it should really be looked like at like a marketing expense. Those patients are showing up in the, in the practice because they've looked up on the VSP website and says, okay, Dr. Jones is a participant in the VSP and I have VSP and I want to go in network, so I'm going to go there. So then they walk in the office and I get it. They have, you know, a frame allowance and a lens allowance. But some of the smarter practices, and I've heard them, the way they do it is they treat it almost like a coupon. They say, oh, by the way, you know, welcome to the practice. You have a $150 coupon towards your frame, and here's all the frames. And, you know, they. Again, it does put the burden on them to become salespeople and their opticians and their office staff. But coming in with that $150 coupon is a good thing if you can drive them up the board. Right up to.
- [20:23]
Eugene Shotsman
Right. And I think that's where you have to. Really, what it sounds like what you're advocating for is that you need to change. If you're talking to the average optometry practice, they should really change their perception of the relationship between them and the managed care company. As the managed care company is just bringing patients.
- [20:41]
Jim McGran
Correct.
- [20:42]
Eugene Shotsman
And what you have to do inside the practice is maximize the revenue per patient with. Because that's what the industry demands now. And I agree with your point. You know, there's a market force that's behind how VSP prices its products. And then obviously there's a market force behind how VSP pays its vendors. Right. Its suppliers, so to speak, if you're thinking about the doctor. So I get it. So, okay, change the mindset. Now we've got the patient, and now we have to turn that patient into the. Help that patient as much as possible and also make that relationship as profitable as possible.
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Jim McGran
Correct.
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Eugene Shotsman
And so when I think about that, that means retaining the patient, number one. So having all the things you need in the practice to make sure that patient has a great experience and then comes back and has. And you have the, the tools and the, and the software and the support and the marketing your practice to just bring that patient back again.
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Jim McGran
Exactly.
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Eugene Shotsman
And bring him back, you know, at 13 months or 12 months rather than a 24 months. And then also it's when they're in the practice, you need to have all the stuff. And let's talk about what that stuff is. But you need to have all the stuff to drive revenue per patient. So, you know, I'm, you know, we're here in Vegas and there's lots of stuff here. Right? There's lots of stuff that. And some of that stuff is specifically designed to help practices drive Revenue per patient. What's your take on that?
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Jim McGran
Yeah, I agree. And one of my, one of my theories always was that, you know, so you get a managed vision care patient in your practice. So a lot of the frustration comes from when they get a patient that comes in and says, I only want, I only want what's covered. Right? I only want what's covered. So that right away sort of puts the practice on their heels and they, they have to start thinking about how they can, how they can change that. Because I agree that it's, it's tough to, it's tough to make money on, on a vision care patient that is only taking what's covered. I get that complaint. The other, the other thing is we also ran into a lot of times where a patient would show up in the doctor's office because they love their relationship with the doctor. So they, because they knew they would get a great comprehensive exam, but then they'd leave and wouldn't buy their materials from the doctor. So for me, about the stuff question is, I would say if you're running a practice, you need to have on your board, let's just talk frames first and then we can go in other areas. But you need to have, you know, one, you need to have some of these lower price frames that are online. You need to have a pair of them to show quality and understand, say, look for this price that you're paying for this online frame for, you know, $10, this is what you're getting. And it's not going to last very long and you're not going to be able to bring it in here for me to fix it. But here's one that I have a very comparable level, better quality, and if you have any problems with it, you can bring it into my practice. My view was always keep that patient in there, get the hook in and get them to become a part of your practice. And then as time goes on, you'll end up moving them up the value chain. The challenge I remember facing is that a lot of times the doctors would just get angry. You know, when the person would bring up a website they were going to buy on or go buy here, instead of having an answer for it, they just get mad, say, okay, fine, you know, get out of my practice kind of thing. And that's not going to solve it. It's having understanding. The practice needs to understand the solutions that are being offered. The stuff. We'll stay on the stuff, using stuff outside of their practice. What, you know, why are they going to do it? Okay. I don't know, convenience, it's a cool thing to do, whatever and then figure out what your answer to it is because they can develop an answer. And for all of us that have been through this process, you'd much rather stay and deal with your doctor. You know, I've already had my exam. The frames or the contacts or everything's right here. It would be so much easier for me to do this than to walk out my prescription. Then I got to find something online. You know, it can be done, but the practice has to manage it very closely and have answers for the more value priced offerings that a lot of consumers look for on the Internet.
- [24:56]
Eugene Shotsman
Well, I think it's, you know, and as, as someone who spends a lot of time communicating value to patients and obviously our listeners know my backgrounds in marketing, but the reality is that, you know, like, it's all about how you communicate, how you explain it to the patient, you know, and it's. And then also it's a lot about, it has to do a lot with your capture rate and your exam only rate and how you're managing that in your practice. And what's the handoff? Like, how does the patient really understand that what the doctor has prescribed that you're gonna wear for 18 hours a day on your face, that really is a, both a medical device and a fashion accessory. And your practice is truly equipped to solve both problems better than their alternatives. And really I think that that's where communicating that value is so freaking important.
- [25:45]
Jim McGran
Absolutely. And you know, again, for me, you know, I've been here at advancing eye care for the. But it really was my, it's been my first entree into the medical equipment, the ophthalmic equipment, part of our industry. Right. Because our industry is so big and there's so many sections. But one of the things I've learned being in this space is that the other thing consumers are looking at when they go into doctor's offices now is what kind of technology they have. What technology do they have? What technology are they using? Because we're actually seeing customer reviews of practices actually mentioned, hey, I had this great experience in my eye doctor's office. Their technology was amazing. They came in, they, I signed in on an iPad, the doctor was looking at me the whole time. They never had to like look on a screen and type it in. Everything was integrated like consumers because technology has become such an important part of our everyday lives with our, our phones in our hands, they have an expectation and they're actually looking for it. So when they Walk into a practice that's still paper based or, you know, isn't integrated and the doctor has their back to the patient more than half the time keying information in, they notice it, they take notice and they won't be back.
- [27:01]
Eugene Shotsman
And I think it's a huge retention tool, but it's also a revenue opportunity. Right. Because I've, in some of the practices we work with, I mean, we talk about this all the time that, you know, yes, the managed care company could be giving you $60, but you could also get, you know, 40, $50 for diagnostic fees from the patient based off of the technology that you have in your practice.
- [27:26]
Jim McGran
Exactly.
- [27:27]
Eugene Shotsman
Talk about that.
- [27:28]
Jim McGran
Yeah, for sure. I mean there's certain, certain tests, certain and especially people that present with a, with a medical condition that it shifts from a normal comprehensive eye exam to, to an eye exam that's more medically focused that can be billed to the medical insurance. And what we're seeing now is, you know, a much, much higher incidence of eye disease. Right. Diabetic retinopathy, AMD glaucoma. And with the expansion of practice within, within the optometry field, more and more of them are using and leveraging medical plans. So I personally believe, like even though this argument's been going on for 10 or 15 years between the profession and the managed vision care, I do believe that those patients coming in, those managed vision care patients who come in and just think I'm getting a refraction and a pair of glasses, they become there, they become their medical patients and then, then the whole world of medical insurance opens up to them and those billings. So it's really, it's really important to not lose sight of that and to really practice to the folks full scope of your, of your licensure.
- [28:39]
Eugene Shotsman
Yeah. And I think that's one opportunity for sure. Medical. Right. I think your other opportunity is cash based services. And I talked about this really good point. I spoke at an event yesterday and we talked about demand. And you know, it's interesting. In 2024, demand for eye care services has stayed relatively flat. You know, we haven't increased like we had in previous years. So it stayed, you know, 2024 and at least the season that we're in now, which is fall of 2024, the reality is that the industry, you know, a little bit, little bit down, a little bit flat, you know, in certain cases. But you know, what's interesting is that the parts of the parts of the industry where I see demand consistently jump up is specialty based services, consumers, patients are becoming Much more solution, aware of things like myopia management, dry eye or dry eye. Right. Or even scleral lenses and, you know, things that ultimately require some additional services from practice that you can't get at, you know, Costco, Sam's Club, whatever. You also oftentimes have a patient who becomes more loyal because you've been able to serve them in a way that not all practices in your neighborhood can.
- [29:48]
Jim McGran
Right. And I. I know you're asking me the questions, but I'd love to hear your thought, you know, especially from a marketing marketer's perspective. You know, one of the things that's always frustrated me on the optometry side is I feel as though it's the only medical profession. Sometimes you walk into a practice and you're there for your exam, and then they say to you, do you want to get this scan? Do you want to get this scan? Do you want to get this? And I sit there and you think about, there's no other doctor that you go to that if the doctor needs that information to treat you or take care of you or assess you, it just ends up. You're, you know, you're billed for it. And, you know, some of it's covered by insurance and some of it's not. But we almost. We're almost, you know, so over the top, like, and putting it on them. And for the most part, they have no idea, like, whether I need that, that or not. Like, back in the old days when they were. When you go to a car salesman and they'd ask you, you know, like, do you want the undercoating for your car? Well, I don't know. It sounds like it's a good idea.
- [30:53]
Eugene Shotsman
How much is it? That's the only. At that point, it's really the only thing that I have to make a decision on is, well, you know, I don't know what undercoating is. It sounds like it might be useful, but how much is it? I don't know. Like, that's the only decision driver that I have because I don't understand the value. I think you're absolutely right from a marketing perspective, but really, from a patient education standpoint, it's all about positioning.
- [31:16]
Jim McGran
Yeah.
- [31:16]
Eugene Shotsman
It's not like, why give them the option to get the diagnosis, to get the oct, right. Just tell them they're getting the oct. Because the way we care for our patients here is we have testing, and that specific testing is what the doctor has. What the doctors determined as our protocol.
- [31:32]
Jim McGran
Exactly. I agree with you, and I think it's Almost done. And I get it. I also get the sense of the transparency and all, but it's almost done in an apologetic way as opposed to. No, this is just to help you. Help us perform better on your behalf and really assess not only your eye health, but your overall health and wellness. Which is another thing that is so missed about the value of optometrists and annual eye exams, the things that they're able to uncover in an eye exam that, you know, the statistic. I've heard from a number of doctors. Dr. Justin Manning, who I worked with a While back at Peka, he taught me this one about. In 2017 or 18, 500,000 cases of diabetic retinopathy were uncovered by independent optometrists in people who didn't know they had diabetes. And it had already gotten to the point where the diabetes was affecting their eyesight.
- [32:32]
Eugene Shotsman
Wow.
- [32:32]
Jim McGran
And they're just learning because they aren't going to their primary care doctor. The optometrists, I mean, I just think they're such an important part of the overall healthcare continuum and they play such an important role and we should be screaming it from the rooftops.
- [32:48]
Eugene Shotsman
Yeah.
- [32:49]
Jim McGran
And a lot of times we're just more apologetic for some.
- [32:52]
Eugene Shotsman
I think it's because somehow, somewhere along the way, we feel like in the industry, we feel like we are more financial advisors, we're managing the patient's pocketbook. And, you know, that's great, but the truth is that's not, that's not the profession. That's not why they came to us. They're not here to learn about how this is going to impact their pocketbook. It's like, you know, when you, when you need life, I don't know, life saving treatment, you're gonna find the money here. It's that, it's that I always think about glasses and vision correction. It's. It's the thing you use when you're not sleeping. So, you know, it's like, that's a lot of. That's a lot of my life.
- [33:31]
Jim McGran
Right.
- [33:31]
Eugene Shotsman
It's a lot of my life that I care about. And so the reality is that. Why is it that. Not that we're making that, that the argument, the value proposition to the patient, that we can support that time that you're awake, that you're using those eyeballs, you know, that we can, we can solve that problem for you in a way that others can't.
- [33:49]
Jim McGran
Absolutely. And, and because we're. It's a very non, invasive, non invasive medical process and procedure, we can also Help you take care of your overall health and wellness.
- [34:00]
Eugene Shotsman
Yeah.
- [34:01]
Jim McGran
By looking at the back of your eye and examining these images that we're taking. I just think it's something that we don't talk enough about. And we should, because the number of people. And I'm sure you do, too. Like with your friend, I always ask my friends, I say, did you get an eye exam this year? Nah, I'm seeing fine. Everything's good.
- [34:19]
Eugene Shotsman
I don't think my prescription change.
- [34:21]
Jim McGran
I'm not going. Or the flip side, they go, but usually they go when it's. Well, at night, I'm having a hard time. I'm driving, but I can't really see. Or you go to the movies. I can't see the screen. You know, it's like we got trained as kids to go to the dentist twice a year, and otherwise our teeth are going to fall out. We need to change that thinking with your eyes. I mean, I'd way rather have my teeth fall out than lose my eyesight and going in, getting that check. And then I also love that they help you manage your overall health and wellness. And a lot of the ODs that I've gone throughout the years, that's the focus and that's the best practices I visited. You know, you go in and you feel like you've had this amazing medical exam where they're touching on your eye health, but also your overall health and how you're doing and everything. And then they seamlessly move you into this really nice retail experience where you say, you know, why am I going to. I'm just going to take care of this. Yep, I need a new pair of glasses.
- [35:19]
Eugene Shotsman
But at that point, it's not just that it's convenient because you're there, but it's also because they've established themselves as true experts in what they're doing. They've positioned themselves as preeminent advisors for the patient rather than, oh, well, you could shop here. What do you want to do? Want to shop here? No, if you don't want to shop here, you could go other places. You know, like, if that's not. If the patient doesn't feel like your recommendation, not even your recommendation, your prescription is the thing that's driving their decision, then you failed as an advisor to the patient.
- [35:47]
Jim McGran
Right.
- [35:47]
Eugene Shotsman
You failed to be seen to position yourself as the person you should.
- [35:50]
Jim McGran
Great point. Yeah. And another, you know, I think another great technique is besides the, you know, the health and wellness focus is when they're. When they're asking you about, when do you use your glasses or what do you do, what are your activities? You know, do you fish, do you play golf, do you run, what's your lifestyle? What do you, do you really do then feel like, okay, they're building that into what they're learning in the exam. So. And then their recommendation for what lenses to use and how to best, how to best solve for how you're using the, using your eyewear, they just play such a critical role. And I just don't like when it's, like you said, when it's just sort of like, well, you can buy it here if you want or not. You know, do whatever you want. Get, you know, get excited with them about, you know, what they can do for you.
- [36:40]
Eugene Shotsman
So to that point, let's talk about where the industry is going, because we're here Expo, there's a lot of people exhibiting a lot of exciting things. And I think to your point, you know, how could we potentially care for patients better and get. What tools can we use to assist that level of care? And quite frankly, you know, what, what should we be looking at? If you're looking not at this Expo, but at this Expo a year from now, where do you think things are going?
- [37:06]
Jim McGran
Yeah, so I think we, you know, we had opened up with, you know, some of the things I had done here in the first few days of visiting Vegas in the show. And, you know, I do believe that looking at what's going on with AI and how to integrate AI into the practice and into the workflow is going to be really important. So you're going to want to work with partners who understand AI and how it can add value. Because like we said early on, and I think we said it while we were recording, but that quote about, you know, AI is, AI is not going to replace doctors, but doctors with AI are going to replace doctors without AI. That is absolutely going to happen. So working, working with knowledgeable partners and, and you know, whether it's your, whether it's your software vendors or your equipment vendors or who, you know, who are.
- [37:54]
Eugene Shotsman
Your marketing vendors or your marketing vendors.
- [37:56]
Jim McGran
Right. Whoever's helping you integrate your. Integrate your practice is going to be so, so important. And it's, I think it's, it's starting now. And like you said, as you're, as people are looking at the stuff, they should be looking for that kind of stuff. Examples of things like just in our, in our world of equipment.
- [38:15]
Eugene Shotsman
Yep.
- [38:15]
Jim McGran
Things like automated refraction, they should absolutely be doing it. I was with, I was with Dr. Scott Morris earlier Today, and we were talking, and I hadn't heard him use this. I hadn't heard him use this term before. But on autorefractor, where it shows you, you know, it shows you what your current prescription is, and then it says, here's what we found out. And you look when you go between the two, and you're like, oh, my God, I don't even know how I'm seeing today. And he calls it the money button, because you hit that button and it shows a person automatically, like, well, why wouldn't I want to get to this level of vision and clarity and seeing? And I just thought it was a funny term. But it's true. There's all of this technology. Don't be afraid of it. Don't steer clear of it. Go see it. Right. Test it. A lot of, you know, equipment vendors and distributors will allow you to test things, and if it just doesn't work out or fit in your flow, but you're going to be able to do so much more. You'll be able to see more patients with, you know, a technology integrated practice, and the patients are going to feel like they're having a much better experience. And like we were saying earlier, patients are becoming much more technologically savvy. And they're understand. They're expecting. There's cool technology when I go in there, and they're expecting my doctor to stay connected with me. And they expected all these things that in the past weren't as much of a focus. Right. The focus back in the day was probably like, what. What's the decorations in the office look like? Or was I comfortable sitting in the chair? That's all changed. And, you know, with all the, you know, the younger generations and even, you know, even older generations that, you know, the boomers have gotten more connected with technology and they expect it to.
- [39:58]
Eugene Shotsman
Yeah.
- [39:59]
Jim McGran
So, you know, that's. It's, It's. It's a really. It's a really exciting time. It's scary, you know, and I know it's. It's easy to sit back and everyone think, you know, all of this technology and everything's going to replace me. And it's not. It's really going to enhance your situation and allow you to focus on the things that you love to do.
- [40:17]
Eugene Shotsman
Yeah. And I think a lot of people are afraid of being early adopters. And I think the truth is that the early adopters, we're already past that point.
- [40:26]
Jim McGran
Yeah.
- [40:27]
Eugene Shotsman
Where some of this technology, you know, it's kind of interesting how quickly AI is evolving but yes, I agree that if you were using AI in December of 2022, you're an early adopter for sure. But, you know, if you're using AI in December of 2024, you're kind of, yes, you're, you're, you're on the, you're on, you're in the right place of the wave. You know, the wave hasn't passed you yet. You're not that person who the patient says, oh, yeah, you know, my doctor still has shag carpet and, you know, 1970s wallpaper and is documenting on a napkin. You know, the reality is that you're not quite, you're not quite there. But right now, more and more practices are integrating tools, and I see this with our clients all the time, is that you're integrating tools. Being technology focused does drive patient demand. It also drives patient experience, which makes your patient more likely to come back. But it also gives you a competitive advantage if you do this now and not three years from now when everybody else has done it and you're just doing it to catch up.
- [41:27]
Jim McGran
Correct. Because you will have, in those three years, the things you will have learned, the things you will have tuned, and all of the learning that would have continued into your AI systems would be there for three years as opposed to getting started three years from now. Couldn't agree, Couldn't agree more.
- [41:42]
Eugene Shotsman
You know, I think I want to ask you, when people are picking technology, what are the biggest mistakes they make? And, you know, what are the biggest, and what are the ways to avoid those mistakes?
- [41:52]
Jim McGran
Yeah, I think what one big mistake is always that, you know, this is going to be simple to implement, that I'm going to, you know, the change management is going to be really simple. So never, never, ever underestimate the need to have a very formal change management plan for your staff and your employees. I think also you can't, you have to get involved with the technology, whether it's, whether it's a trial or, you know, a really serious demo before just accepting it based on, you know, a brochure or, you know, recommendation from a colleague. Yeah, yeah. Now, I was going to say, though, recommendations from colleagues are important because especially, like, if they've been through it, right, they've implemented either a new piece of equipment or a new piece of software that, that they're using, that can, that can be really valuable because, like what you just said before, the people that adopted AI back in 22, they're going to be really helpful to their colleagues as they're moving on in 24. So I would, I would put that, I would put that high on the list. If I was looking at upgrading to a new software package in my, in my practice, the main thing I'd want to do is I'd want to talk to other doctors and I'd also, you know, but ask the hard questions.
- [43:08]
Eugene Shotsman
Not just, do you like this? Nah. Well, what do you not like? What do you like? How is it compared to what you had before? And sometimes if you ask the, the hard part is the implementation questions.
- [43:20]
Jim McGran
Right, exactly.
- [43:21]
Eugene Shotsman
And it's part of like, well, what did it take? And sometimes people don't really want to talk about that experience because that experience was painful and they'd rather forget it.
- [43:27]
Jim McGran
Yeah, exactly. So. And I would also don't try to find doctors who've implemented it that aren't just handed to you by the company selling you the product. Find someone that they're not, that isn't front and center, that isn't appearing in their brochures.
- [43:43]
Eugene Shotsman
Right.
- [43:43]
Jim McGran
Because, you know, you'll probably get a little bit more, you know, direct, you know, direct. And hopefully if it's a good product, you know, it should be fine across whoever they talk to. But I think that's really important. And one of the things I have, I've learned in being in the industry this long and it doesn't matter what segment of the industry, frames, lenses, contact lenses, equipment, even managed vision care, insurance, doctors want to hear from doctors, doctors want to hear from other doctors. They want to know that their peers, I think their peers won't look at them and go, why did you implement xyz? I could have told you that's going to be a disaster. And I get it. And I've been in the situation where I've been presenting with a doctor and you stand up there and I say, I say something and they look at you or they growl at you or something. Then the doctor standing next to me says the same exact thing and they're like, oh, that was great, that's brilliant. We gotta do that. And I get it. I absolutely get it. They trust their peers. They've all been through the same stuff, right? They've been through the same schooling, they've been through the same hard knocks, you know, opening a practice or building a practice. So, and I think that's great. And that's why I think it's so important that, that they listen to one another as they're doing it, because it's going to be that, that's how, that's how this momentum is going to go. Right. That's how the, this wave is going to go, is that they're going to start seeing their friends and their peers having success with these different tools. And that's great. You know, it's exciting.
- [45:13]
Eugene Shotsman
Yeah. And so I think that's kind of a big, big part of the whole thing is that if you are somebody who's implemented something, whether it's working or not working or whatever, share your experience. Because I think that's the other side of how the industry grows. We grow from the collective intelligence of each other. And, you know, if we're all just siloed in our own thing and doing our own thing and only see. And only seeing each other only at these expos, if we even go right. The reality is that, you know, we don't get to grow as quickly. And so my part of the mission of this podcast and part of the mission of the show is to really try to help grow the industry. And part of growing the industry, I think, is everybody sharing some of their collective experiences.
- [45:52]
Jim McGran
Absolutely. I've heard the phrase since 1999 when I joined the industry. I've heard the phrase grow the pie since the beginning. And there is a pie to grow, there's no question. Even if you just limit, even just limit it to people that have some form of vision coverage, whether it's a managed vision care plan or vision coverage in the, in their medical plan.
- [46:16]
Eugene Shotsman
Sure.
- [46:17]
Jim McGran
If you look at the statistics of the number of people that utilize that benefit, the amount of people that leave that benefit on the table each year, you know, they, I know it's. And they think of it as insurance. And okay, I have this insurance in case I need to use it, but there could be so much more done. And using. Just, if they all used it, the pie would be tremendous. And again, there's some challenges there. When you look at it from an insurance perspective, like a run on the bank kind of issue, if everyone uses.
- [46:49]
Eugene Shotsman
It, if everybody uses it, then the price goes up by the.
- [46:51]
Jim McGran
But, you know, we, we, we have. There is so much opportunity in this, in the space, as you said, to grow the pie. And we all have to collectively work together, as you said, to, to figure out the best ways to do that.
- [47:04]
Eugene Shotsman
And I think that the, the role of growing the pie isn't just for people who are, I would say, at the top of organizations like yourself. It's really. Everybody can play that role, including everyone who is in an optometric practice today.
- [47:17]
Jim McGran
For sure. For sure.
- [47:19]
Eugene Shotsman
So, Jim, it's been great having you on the show. It's so interesting to hear some of your insights. I'm sure we could probably talk for hours and hours and maybe we will continue with future episodes. But thank you so much for your insights and thanks so much for sharing some of the things that you've seen at Expo and where you think the industry is going.
- [47:36]
Jim McGran
Well, thank you for having me, Eugene. I really appreciate it. And congratulations to you on, you know, what you've been doing with the Power Practice and all the people you've been reaching because it's podcasts like this and the work you're doing that is helping to build that collective knowledge and driving people to ask questions or send in. So thank you for doing that too.
- [47:53]
Eugene Shotsman
Thank you, Jim. Always, always a pleasure.
- [47:55]
Jim McGran
Great. Thank you.
- [47:56]
Eugene Shotsman
Hey there, it's Eugene, and I've got a question for you. Do you do medical billing in your practice? What if we took 10 charts and looked at them pretty closely? Would they be good enough to pass an audit? Or would you owe the insurance company some money? Or would there be some found revenue that you could put back in your pocket? So looking at 10 charts is a new service that's now available from the Power Practice, and it's called the Power Audit. What happens during the Power Audit is that some of the most knowledgeable billing experts in the country are going to do a friendly audit on your charts and see if they can find opportunities. By the way, in auditing hundreds of charts, nine out of ten charts they look at, they find something, and typically that something fits into two categories. One, something that better protects your practice, or two, something that can make you more money. In fact, almost every single audit they do uncovers under billing areas where you can get paid more for what you already did.
- [48:47]
So let's just play it out.
- [48:49]
You send them your medical charts and a few weeks later they provide you with a detailed report and analysis or write up a coaching guide that helps you prevent any issues in the future and again, helps you get paid more for what you're already doing while protecting your practice. If so, if you're doing any amount of medical billing in your practice, this is a service that's well worth the $2,500 it costs. And as a limited time opportunity, 10 listeners from this episode can get a $700 savings certificate for the Power Audit. So the price is only 1799. But the opportunities that the Power Audit uncovers are worth many, many, many multiples of that. So go to the Power Practice website. Up near the top, you can click Request a Power Audit now you're not committing to pay anyone at that point, you're just locking in your $700 savings. But you will get a chance to schedule a 10 minute phone call to get your questions answered and to see if the power audit is a fit for your practice. Again, that's the power audit on the powerpractice.com.