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Power Hour Optometry
How I Built It: $4,000 Per Visit in a Specialty Practice, with Dr Stephanie Woo and Eugene Shatsman
00:58:20
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- [00:00]
A
I owned three private practices and then in 2020, I sold those three practices to open my now practice, which is only specialty lenses. That's all we do. We don't see primary care patients, we don't have an optical, and we don't take insurance.
- [00:17]
B
Talk about the process of opening that and how you built it.
- [00:22]
A
It took, I would say, about a year to really plan. The most important thing, I think, was the networking portion. Going out, introducing myself to the local op, ophthalmologists and optometrists and how we can help their patients, and then just kind of starting to gain referrals from there.
- [00:38]
B
How many referral relationships are you currently managing in your practice?
- [00:42]
A
At least 100, if not more.
- [00:44]
B
When somebody's trying to add a specialty, one of the most challenging things for an optometrist is to kind of get into that handshaking mode.
- [00:53]
A
You're right, it is hard. It is something that a lot of people don't want to do or feel like they don't have the time. But whenever I'm giving a lecture on this topic, I always tell.
- [01:05]
B
What do they pay for this? What are your fees?
- [01:07]
A
I want to say the average price per patient is like $4,000 or something very high compared to like, you know, when I was in traditional primary care.
- [01:17]
B
Let's say a practice is trying to bring in a specialty, even if they've tried and they probably haven't been as successful as they could have been, what advice would you give to someone and what did you learn along your journey?
- [01:30]
A
So here is what I would tell people. Have an interest in doing this. First.
- [01:43]
B
Welcome. Welcome to the Power Hour, Optometry's biggest and longest running show. I'm your host, Eugene Schottzman. And today's guest is someone whose career path completely redefines what's possible in optometry private practice. So Dr. Stephanie Wu joins us and she talks about how she started with three traditional offices, full scope optometry, optical, post ops, everything. Then after she sold them, she took a pause and started to build her dream. This is a specialty only practice in Las Vegas focused entirely on custom contact lenses. No optical, no insurance, just specialty lenses. She's got concierge service, she's got two hour appointments, and she's got real impact for patients. And so we talk a lot about what that transition took. How did she build over 100 doctor network that is referring to her daily. And what did that take? What can we learn from that? Why does her average patient Visit exceed over $4,000 and what can ODS do to successfully integrate specialty care inside of their practice. And she's got a lot to say on these topics. It's a massive amount of insight. But in the second half of the episode, we shift gears to something that's helping the entire profession. Wu University. This is her nonprofit. She founded it. It's already delivered more than 250,000 thousand CE certificates, most of those for free. And we talk about how it started during COVID what's behind its rapid growth, and just kind of the balance between in person CE and virtual learning for busy doctors. So this is a really cool story. Yeah, we talk about passion, precision, paying it forward. I think you're really going to enjoy this episode. So before we dive in, just make sure that you're subscribed on YouTube, Spotify, Apple Podcasts so that you never miss an episode. And if you've got feedback or ideas for future shows, want to reach out for help, just send a note to me directly at Eugene Schottzman.com or at the Power Hour website. I do respond and read to every single message. And now let's go to the show with Dr. Stephanie Wu. All right, Dr. Stephanie Wu, welcome to the Power Hour. Excited to have you on the show.
- [03:39]
A
Thank you so much, Eugene. It is a pleasure to be here.
- [03:42]
B
Okay, so we have so much to talk about and we're going to try to cram it all into one episode. So let's start with your practice. I think it's such a fascinating model and if people don't know about it, they should. So I maybe start there. Give people a little bit of context about yourself and the practice that you have.
- [04:04]
A
Perfect. I'd love to. So just kind of going back a little bit further. I owned three private practices in Arizona and California beforehand which had very traditional optometry type of clinics where we saw most everything. Glasses, contacts, regular exams, optical specialty lenses, post op cataracts, all that stuff. And then in 2020, I sold those three practices to open my now practice in Las Vegas, which is only specialty lenses. So that's all we do. We see patients start at 10am, which is very weird for me. I'm so used to starting at 8, start at 10am we see, you know, patients in one to two hour time slots, not my traditional 20 minute time slots that I had back in the day. And all we do are specialty contacts. We don't see primary care patients, we don't have an optical, and we don't take insurance. So it's a. I basically built the exact practice that I wanted to work at and, and the way I wanted to see patients.
- [05:15]
B
Okay, so how did you decide that? I guess going from the traditional model to the, I'm going to call your model the super specialty model. Right? Because people can add specialties and we'll talk about this is like what, what advice you'd have for people as they add specialties to their, to, to their current, we'll call a traditional practice. But going from a traditional practice to the super specialty model, talk a little bit about the frustrations that you were trying to solve and then talk about why it is that you decided to specialty lens, for example, versus other things maybe.
- [05:51]
A
Yeah, so I guess when I first started in, after my residency, so I was cornea contact lens residency trained, so obviously I had a big passion for that already. And so when I finished my residency, I moved back to my hometown, started working with my childhood optometrist as an associate. And he was doing all the, I guess we'll call it traditional optometric practice type of things. And then I asked him if I could maybe try to integrate some of the specialty lens stuff into the practice as well. And he was totally for that. It was a big need because really no other optometrist in the area have like a lot of experience or desire to fit a lot of these specialty patients. So we kind of built that into the practice. So over the course of about eight years or so, we went from seeing essentially zero specialty lens patients to about 20, 25% of our income ended up being from specialty lenses by the time we sold the practices. So year over year, we were able to expand that. And then kind of towards the end of that kind of eight year, ish period, I really kind of just sat down and thought about where I was in, in my career and what my favorite days were as an optometrist. And for me it was, well, whenever I see patients on the schedule that are specialty lens consults, fits, dispenses, follow ups, those are the days I am happiest and where I really feel like I am providing the most value to the patients. And so from there I started thinking like, is there a way that you can have a specialty only practice? I mean, I didn't really know anyone that had, that had this type of clinic. So I started doing some research and asking a lot of my friends that were in the specialty lens realm. And then they kind of directed me to like some people that had either like heavy specialty lens type practices. And so then I started talking to those people. So people Like Sue Resnick, Nick Despotitas, Elise Kramer, Ed Boshnik, Jeff Soncino. I mean, I talked to so many doctors that did lots of specialty lenses. And it wasn't until I really talked to a lot of people and visited practices and really got a feel for, you know what? This is something I can do, and I think that I would be really happy, but I can't do it here where I was living, because I'm from a small town. So to have a specialty lens practice, there's not that many patients that need that type of care there. Which is why we chose Vegas, because it's a bigger market, lots more people here, and a lot of people that would need our care.
- [08:53]
B
So talk about the process of opening. That sounds like cold, right? And how you built it over the last few years.
- [09:03]
A
Yeah. So it took, I would say, about a year to really plan of as far as visiting locations and figuring out where I wanted to be as far as what part of town and visiting just different commercial properties and figuring that part out. Once we had secured that, then we said, all right, we know where we're going to be. Now let's kind of outline how we want the practice to look. And our practice, about 1500 square feet. And I knew that I wanted to have, like, a really big, like, exam lane area for special equipment. I wanted to have, like, a really nice waiting area that was very, very concierge type feeling. Once we kind of outlined all of that, then we searched for the equipment portion. Okay, what are the things that we absolutely have to have for a specialty lens clinic? And then maybe make a list of like would be nice. And then I just got quotes from different equipment companies and then decided, like, okay, these are the things I have to have right off the bat. These are some things that I can add in later once I have more income. And then once we figured that all out, then we started, you know, getting all the licensing, all that, the business stuff. And then the most important thing, I think, was the networking portion. Going out, introducing myself to the local ophthalmologists and optometrists in the area, letting them know what we were doing, how we were different, how we could help their patients, and then just kind of starting to gain referrals from there.
- [10:41]
B
So when you get. When you have those types of conversations, because I hear this all the time, is that, like, when somebody's trying to add a specialty, one of the most challenging things for an optometrist is to kind of get into that handshaking mode of, you know, I guess you also call it gripping and grinning. Right? Like, you got to go find the people and have. Have a positive conversation with them. And also kind of describe a business relationship that might make sense. So how do you do that? And can you offer some tips as to first describe what your business relationship looks like with the referrals, with the referring practices that you have, and then maybe describe some tips that might make sense for people as they're thinking about doing something like that?
- [11:29]
A
Yes. So I'm glad you brought this up, Eugene, because you're right, it is hard. It is something that a lot of people don't want to do or feel like they don't have the time. But whenever I'm giving a lecture on this topic, I always tell the audience, like, 90% of the people in this room will not make the effort to go and knock on doors and introduce themselves and explain who they are, what they can do, how they can help their patients, and have this great relationship. So it's really the people that even just take action, those are the people that are going to get the referrals. And I know it seems so simple, but again, most people are just not going to put in the effort to actually do it. So if you are one of those people that are like, okay, I am going to do this, and you just show up and introduce yourself, those are the people that are going to get the referrals.
- [12:28]
B
So that's simply by just showing up, basically, as part of the, like, showing up sounds like it's more than half the effort.
- [12:35]
A
Exactly. I think that just even taking that step to just showing up and saying, hey, you know, I'm Dr. Wu. I would love to meet Dr. Smith. I'm new in town, and I would just like to introduce myself. I don't think I had any clinics say, no, I mean, maybe like, one or two out of, like, you know, 100 clinics I visited over the last few years. But, you know, just making the effort to show up and introduce yourself is you've already won, like, half of the battle just by showing up. And then secondly, from there, just getting to know the other doctor, I think, is also equally as important as telling them of what you're doing, but also getting to know that doctor. What types of patients do you see? How can I help your practice? What are the types of patients that you would want me to send to you? So for a lot of the optometrists, I would ask them, like, what kind of patients they saw, and a lot of them would say, oh, we have like high end luxury frames or something. And so it's like, oh, okay, so I can send patients to them that are really looking for, like these really high end luxury frame type of situations. Other people, you know, they saw a lot of Medicaid patients, so they're like, okay, so if you have patients that have Medicaid insurance, like, we would love to see them. Okay, perfect. So now I have a doctor that I could send those patients to. So I think it really needs to be more of like a back and forth relationship where it's like, it's not just you telling that doctor all the things that you can do, which is great, so they know what they can refer to you for, but also what can you do for them.
- [14:14]
B
So how many relationships are you currently. How many referral relationships are you currently managing in your practice?
- [14:21]
A
I mean, gosh, I mean, at least 100, if not more. You know, we, we really try to go out and say thanks to the doctors that are referring to us, go meet doctors when they first come into town. If we find out, we try to go to a lot of the networking events either through the Nevada Optometric association, you know, if they have, you know, educational events or dinners or things, you know. So we're just, we're always trying to get creative and trying to reach as many doctors as possible and just kind of keep our names out there and just kind of introducing ourselves or just keep maintaining those relationships as well and.
- [14:58]
B
Go back to the technique. So, like, do you literally just cold walk into somebody's office or somebody calling ahead and setting an appointment for you to show up and need Dr. Smith? Um, or are you like literally just driving by, you pop in and you're like, hey, I'm Dr. Wu. I'd like to meet Dr. Smith.
- [15:14]
A
Great question. So in the beginning, I would call and ask when it was a good time for me to come and stop by, but with that, I found that like 80 to 90% of people would never call me back. So I'm like, okay, well, that's not good. Which, understandable, right? The staff are probably doing a thousand other things. This is probably like low on their priority list to, like, get back to you. So then what I did is I got a list of eye doctors. I just kind of like googled it or, you know, just kind of looked at to see what eye doctors were in like a certain area of town so that I could make the most of my time. So let's say on Monday, like, my goal is to meet eight eye doctors in this specific zip code. So I would go look, see who the eye doctors were, and just kind of make like a little route on my map. And then I would go and just show up. I wouldn't even call. I would just show up and just say, hello, I'm Dr. Wu. I'm new to town. I would love to meet Dr. So. And so do they have some time for me to just introduce myself? And like I said, almost everyone would say yes. Even if I had to wait, you know, after they saw their patients and things just kind of in between, it was totally worth it. So then it would be like, okay, then Tuesday, I would go to another zip code part of town and then do the same thing and just kind of repeat. So I would say that the phone call situation, I really wanted it to work, and I thought that that was going to be the best way, but it's just no one really called me back. And so I was like, well, I better just start just randomly showing up.
- [16:47]
B
Yeah, I mean, I think. Were you a girl Scout by any chance, selling cookies door to door?
- [16:53]
A
Yes, I was.
- [16:54]
B
Okay, so, like, that, that's the, that's the training our kids need to be able to be comfortable with doing something like this. But I think a lot of people would be a little bit uncomfortable. But I also realize that that's. That's exactly why 90% of the people won't show up, as you, as you said. But also, I also, I think about it from the perspective of the doctor that's in the exam line. Like, it's one thing to keep, like a sales rep waiting in the lobby, but another doctor, like, that's a colleague, and I don't want to keep a colleague waiting in the lobby. So, like, there's a really good chance they're going to see you if you show up. Now, what about your positioning, though? Like, are you. Are you worried that if a doctor and I can just think of, like, what are reasons people say, well, I don't want to do that? Well, maybe one reason they don't want to do that is because they're worried that this doctor will perceive them as, like, not successful or not busy because they have time to just, like, show up to random offices and, you know, position themselves.
- [17:50]
A
I guess you could view that, you know, if you're trying to think of, like, all the. Yeah. Negative things or things that could be thought of or said. But I guess in my mind I was like, well, I think they'll be understanding because I'm new to town. I just moved here. I Just built my practice. I just opened the doors, and I think they would totally respect what I'm trying to do as far as meet people, introduce myself. And I tried to look at it from, like, your point of view, Eugene, is like, if I'm a doctor that had an established practice and. And when doctors would come into my clinic and introduce themselves, I was always more than happy to stop. You know, what I was doing. If I was just doing admin things or, like, in between patients, like you said, and I would go out into the waiting room and. And meet them and say hello. And I always, like, had a great deal of respect for doctors that would come by the practice and. And say hello. So I guess that never went through my mind of, like, well, they must not be busy.
- [18:45]
B
And I think what you're doing is you're. You automatically in your positioning, you gave a reason why. I'm new to town, but there could be any reason why as. And as a marketer, and I do a lot of analysis of why people make decisions the way that they make decisions, and kind of consumer psychology, and we're all consumers. I think the reality is that any reason why is good. Even if I was driving by your office and I thought, you know, I drive by your office often, and I thought it would be good to pop in and say hello or to introduce myself. Like, that's a fine reason to go in. So. But keep. Keep. Let's just keep the technique going. So, okay, so then the doctor comes out in between patients, and, like, how long do you keep them engaged? And how. How much effort do you have to put into that relationship in order for the referrals to start coming in? Tell me more about what you do.
- [19:37]
A
Yeah, I would try to keep it as short as I could because I knew I was stopping in unannounced. And I mean, as you know, when you're seeing patients and then you have some sort of interruption, it's like you kind of want to just get back to, like, all right, I have a patient. I have to right now. So I would just try to limit it to, like, five minutes, maybe 10 minutes if they showed that they had more interest or they had more questions for me. And I would basically bring a folder that had three things. It would have my biography, just a quick snapshot of, like, why I'm qualified to see these types of patients. It would have a referral form that was super easy to fill out that they could make copies of. And then it also just had, like, a very small snapshot of, like, why choose us? And just some very quick little facts and just something that, like, if you looked at it, it's like, oh, okay, like this. These are the types of patients that she wants to see or wants us to refer to. So I'd give them like this little folder with some those things and some business cards, just explain like what kind of patients we see, how we can help them. And then again, I would always get their business cards as well and find out what types of patients they like to see and what type of patients would be helpful for them for me to refer over to them. So kind of like a mutual exchange and try to keep it, you know, five minutes so they could get back to seeing their patients.
- [21:00]
B
Got it. And then what's the follow up? Like are you scheduling like a follow up meeting on the spot to check in or are you. Do you find that it takes a couple visits in order to get someone to start referring to you?
- [21:14]
A
Yeah, I would, I wouldn't schedule a follow up right then. And maybe I should have, but I'm sure you know more than me with all the marketing experience you have. But I never scheduled any follow ups. I would just, you know, give them my card, my personal cell phone information and just say, you know, call me or text me anytime if you have a question or even if you have a patient case where you don't know what to do. I'm always happy to just like help that person out if maybe they don't know. Like, hey, do you think this person has keratoconus? I'm happy to like help give my opinion on that patient, even if they're not sending them to me. So I think just kind of showing that you, you care about that doctor and their patients and you know, the community as a whole is, is really good. And then yeah, sometimes it would take a couple times of me visiting and saying like, oh, hello, like I don't know if you remember me, you know, just all this stuff. And then again, like, we're just continue the marketing efforts. So, okay, maybe the next time I'm not coming in, maybe it's like sending off a mailer that has like an interesting case report that of a patient that we saw, like with information on how to refer. I got that idea from there's a vision therapy doctor here in Vegas that she sends out these kind of quarterly, like really interesting case reports on patients that she helps with that you might not think need vision therapy. And so I was like, oh, this is such a cool idea. And so that might be the Next marketing effort. And then maybe the next one is like we would host, we hosted like a cocktail hour for like the referring doctors or even you know, just the doctors in town just to kind of learn more about us. Where we had some cute case reports, like a snapshot and we had them framed in like a poster board of like referred by Dr. So and so and it just had like pictures of like this patient. Quick synopsis, you know, 28 year old keratoconus fit with scleral lenses, 2020 vision, like just something really quick. But then people could kind of see their names and their patients that they, that they've referred to us. And so that was like really fun and successful. So I think just trying to keep it like interesting where it's not just you popping in all the time, but just inviting them to do things or sending them other pieces of marketing, you know, just to keep it interesting.
- [23:35]
B
So was it, has that been your biggest kind of key to success is building this massive referral network of 100 doctors?
- [23:43]
A
Yes, I totally think and I stand by it is like just taking action and, and going into that doctor's office. Again, 90% of people are not going to do it because yeah, they're uncomfortable or they just don't want to take the effort. And it's like the more I did that, the more respect I had for the, these drug reps that have to go to these doctor's offices every single day. And like, like you said, they might be staying in the waiting room for however long, but it's like I can't believe the amount of energy it takes to find, you know, go bring stuff, find parking, walk in Vegas. It's so hot here in the summertime, you're dead. It's like doing all of that effort just to like say hello to someone. It's like I just have a massive amount of respect now for all the drug reps that come to visit me. So when they, when I do have a drug rep I'm like, oh, I don't want them to wait for that long because I know how much effort it took for them to like get here and then they want to get up to their next place. But just making that effort is huge.
- [24:51]
B
Yeah. And I think you're, you make a really good point that if that's been the biggest practice building activity for you, partly it's probably because you're the only one doing it. Yeah. In your area. Yeah.
- [25:05]
A
Yeah.
- [25:06]
B
So talk a little bit about your practice. So you already mentioned it's kind of a Concierge feel and you spend an hour with every patient.
- [25:15]
A
One to two hours. Yes.
- [25:17]
B
Yeah. So, so what's your flow? So first of all, like describe what you do with a specialty lens patient and then also like maybe, maybe let's zoom out. How many patients do you see per month or how many patients does the practice see per month?
- [25:32]
A
So per month I'm have to do it, but I was just analyzing per week. So like every day, if I could see a patient for two hours, I could probably see four patients a day. So times four days and then multiply that out per month, whatever that math ends up being.
- [25:49]
B
Got it. Okay. And then the idea is, are these mostly new patient visits? Are you doing a lot of follow ups too?
- [25:57]
A
So the way that our practice works is I usually will see all of the initial consults and do the fittings and then my associate doctor will do all of the insertion removal training, dispenses, follow up care, all of that. So we kind of have a unique flow and how we kind of manage the patients and how their process goes. So how it basically if we're just going to go through a quick patient journey is they get referred or they find us on the Internet, whatever, they come in for their consult with me, it's a two hour appointment and we do a very thorough case history. Kind of find out who, what vision problems they're having, what types of contacts they've used before, what are the things that have worked, not worked, what are their frustrations really make them feel like they are being heard and that we totally understand all of the things that they have been through because a lot of them have had a lot of surgeries and seen a lot of other doctors for different things. From there, then we do a really extensive diagnostic workup where we're using lots of different instruments to evaluate their whole eyeball. From there, we select some lenses to put on their eye and actually do a diagnostic fitting so that we can demonstrate to the patient what their vision is going to be like if they decide to move forward with the fitting program. So once all of that is done, I show them on a big TV screen, I show them all of the pictures and videos we've taken and I just thoroughly explain like what type of condition they have, why they can't see well, why they cannot see with glasses or traditional soft lenses. Just really make them understand like, oh, this is, this is why. Because what I found is most patients, they really have had, they don't know they've never seen pictures of their eyes before. They have no clue really why they can't see and why they can't just get Lasik to solve their problem and then from there answer all their questions about their eye, the specialty lens fitting process. And then my staff come in and then they're going through all the like financing all of that stuff, answering all of those types of questions. And then if they decide to move forward, we order the lenses. Then they come back in for their dispense insertion removal training with my associate doctor and then all of the other follow ups depending on what's needed. So that's kind of like a 5 second snapshot of what happens in our practice.
- [28:21]
B
And so what do they pay for this?
- [28:24]
A
It ranges between like a thousand dollars per eye to $5,000 per eye. It just depends on what service they're getting, what type of lens is needed? Lots. Some of the lenses that are super custom cost a lot of money to us as the practice. So then obviously those ones are a little bit more then other ones. If they're just getting like a more simple, maybe custom soft lens that doesn't cost us a lot of money, then we'll go through with something a little bit less. So really just I would say that's always a good benchmark. When they're calling, we always tell them kind of a price range like you know, starts at $1,000 for your situation. It sounds like you might be in this, you know, middle tier of $2,500 or 4,000 or whatever. It ends up being that way they kind of know or kind of expect like some sort of a price range before they come in.
- [29:18]
B
So I mean what you just said, if it's 5,000 per eye on the upper end, your revenue per patient and probably per year is like $10,000 right. At the high end.
- [29:33]
A
Correct.
- [29:34]
B
And do you know your average, I.
- [29:37]
A
Want to say the average price per patient is like $4,000 or something to that effect. So very high. Compared to like, you know, when I was in traditional primary care, it's a lot less. But you're seeing, you know, a lot more volume.
- [29:52]
B
Well, yeah, and I can totally tell that. And by the way, when they come in for that two hour workup, so to speak, that that also costs money. Right, Right.
- [30:03]
A
So that's a consult fee that just gets applied if they decide to go through with a specialty program. So we charge, I think it's like 350 or $400 for the consult. So in case that they decide to not do anything, which is fine, but you know, at least we have something to pay for their, you know, the time for the staff and the equipment, whatever. But the capture rate, I believe is somewhere up to 80, 90%, which is very good, especially because the staff really explain things to them before they show up. So they kind of have a price range in mind. They're not like sticker shocked when they get here. And. Yeah. So that just.
- [30:42]
B
And that's kind of one of the big benefits of running a specialty referral business because, you know, they don't expect this to be like a, you know, it's, it's not like an upsell. It's. I'm coming in for a specialist, really. Right. And that's kind of the idea.
- [30:58]
A
Yeah. And I think it's, it's, it's tough because when patients call and they're like, well, why would I see you guys instead of going and seeing a doctor that just takes my insurance when I. And it's like, yeah, absolutely, here's all the things that we can offer that a traditional practice that's taking insurance maybe can't. So a traditional practice taking insurance guarantee you is not going to spend two hours at every patient appointment with you. That, that's just not possible with the rates that insurance pay. You know, you're the only patient in the office the entire time that you're with the doctor the whole time. You know, all of these things that you just can't do in an insurance type of setting. And that was when I was developing the practice, I was like, I know that there are patients out there that want this type of experience where they, they want to be with the doctor for an hour, two hours. They want to be the only patient in the office and not feel rushed. They want to be heard. They want their hand to be held through this whole process. You know, they, they want that like five star customer service experience. I was, that was just my, my hope and my vision that when I would, when, when I started the clinic.
- [32:14]
B
Yeah. And I mean, if you, if you think about kind of the amount of overhead in terms of, let's just put it this way, in order for you to run a practice that, you know, let's say is a $3 million practice is different than for a traditional practice to run a $3 million practice with the number of staff, with the amount of space you need, with the amount of equipment you need, I mean, realistically, even though you have probably a lot of specialty equipment, it doesn't sound like you have a lot of exam lanes. It doesn't sound like you have to deal with inventory. It doesn't sound like you have to deal with a large team in order to be able to do this. How big is your team, Stephanie?
- [32:55]
A
We have myself, so I see patients one or two days a week. I have my associate that sees patients one or two days a week. And then we've got one full time staff member and one part time staff member.
- [33:08]
B
Wow.
- [33:08]
A
So it's really a very small group. Like you said, Eugene, it's like cutting out like all the different things and being laser focused on something that you truly love and are passionate about, I think makes a huge difference. I don't know if you've ever read that book, the Pumpkin Plan, but I feel like that was. I'm like, oh my gosh. I feel like I'm doing this kind of thing that he's talking about where it's like I'm only focusing on these types of patients, the 20% of these types of patients that I really love and care to serve and getting rid of like all the insurance and the optical and the inventory and all the stuff that, like, I just did not have a passion for.
- [33:47]
B
Yeah. And so I guess, you know, now flip it for me because most of the audience is not going to be in the, in the position to be able to kind of exit their practice and start a new one and do all this cool stuff. Like, let's talk for a couple minutes about if you are. Let's say a practice is trying to bring in a specialty and let's even call it like, okay, let's. Let's say somebody is trying to get into doing more squirrels or more of this. And even if they've tried and they probably haven't been as successful as they could have been, what advice would you give to someone and what did you learn along your journey? Because you mentioned, you know, running that practice for eight years and then consistently growing the amount of specialty that you guys were doing. Talk a little bit more about what you learned along the way and what advice you would give to somebody who is trying to get good at specialty lenses.
- [34:44]
A
Yes. So I love this topic as well, because if we remember, earlier on in the conversation, I started off in a practice that did essentially zero specialty lens fits. So we're going from traditional practice. And because I had a desire and a passion that I wanted to add this in, we kind of had to figure out, like, okay, how do we do all that with like the type of patients and things that we're doing now? So here is what I would tell you people that have an interest in doing this first. You need to become knowledgeable somehow on specialty lenses, whether it's attending events, workshops, reading books, going on forums, whatever you need to do to get interested and enhance your skills. Great. Do that. Once you're like, all right, I'm for sure adding this in. You have to create time in your schedule, and that is committed specifically to whatever that is. So, for example, I worked Monday through Friday, 8 to 5. I had patients every 10 to 20 minutes slots. That's how my practice was. But then when I said, I'm for sure going to add in one specialty lens fit a week, I want to block out between, let's say, 11 and noon or 4 to 5pm or however long it's going to take you to do a specialty lens fit. Okay, so I would either do that, then that would only be on like Tuesdays. So the rest of the week I'm not affecting the income, I'm not affecting the staff, all that stuff. But I'm starting with one time slot in the day, and I would recommend doing it right before lunch or right before the end of the day in case the patient no shows. Then you're not just like, have this giant gap in the schedule. And if. And so then it would be up to me that I needed to fill that spot with a specialty lens patient. Otherwise the income is going to be down, which is going to affect my bottom line. Well, assuming you're getting paid off, you know, commission or production, whatever, so if I did not fill that spot with a specialty lens patient, let's pretend 11 to 12 on Tuesdays, then I would say, okay, if I'm not filling that in, I am using that time to figure out how I'm going to fill that spot. So I'm going to call a random doctor in town and talk to them about specialty lenses. I'm going to work on a blog that I'm going to put on the website about specialty lenses. I'm going to do a social media post on specialty lenses. I'm going to write a thing for the newspaper on scleral lenses or something. So it's like I would dedicate whatever that time slot was to either filling it with a specialty lens patient or doing something related to specialty lenses so that we could just build off of that.
- [37:40]
B
Right? And don't let, obviously the mundane nuance of like, oh, hey, I have, I have to catch up on some charts and, you know, I have to, I, I have to get some of these things approved. Like, don't let that fill that time slot. And I. I assume your next step is expand that time slot, Right? Like, now it's not just Tuesdays. It's Tuesdays and Thursdays. And now it's not just twice a week, it's four times a week. And that kind of thing, it just.
- [38:11]
A
It kind of naturally progresses where it's like, okay, it used to be Tuesdays, 11 to noon. That's where Dr. Wu sees all specialty lens patients. Oh, now that spot's getting filled up. She's backed up for a month. Oh, okay. Now we need to open up Thursdays from 11 to noon. And then just like you said, Eugene, it just naturally just. Okay, now it's going to be all Thursday afternoons is all specialty lens patients. And then it just becomes like, oh, my gosh, now it's like all day Tuesdays and all day Thursdays are specialty lens patients. So it's cool to see the progression of like, none to one to, you know, like, your entire week is now filled with them. So it's kind of cool to see the progression.
- [38:51]
B
Are there any tips that you would give to somebody when they're trying to convert a comprehensive exam into, we'll call, like, a specialty consult?
- [39:02]
A
Yes. So I did that all the time. So I would see patients for their regular exams. And then if I saw something that was, I guess, interesting, like, okay, something's going on with their topography or their astigmatism has changed dramatically from one year to the next, I would just explain to the patient, hey, you know, I'm seeing something interesting on your. On your exam. I'd like to have you come back in just for a few other tests just to make sure everything's okay with the front of the eye, just to help optimize your vision and just see if there's any room for improvement. Almost no patients are going to say, oh, no, thank you. Almost all of them are like, oh, I'm so glad that a doctor is like, actually taking note of, like, yeah, I feel like my prescription has been changing a lot. Or like, I'm. I'm kind of seeing double even with my glasses. Like, just some of these things that maybe, just maybe went. Overlooked, and they just thought that's what their vision is. I would just tell them I want to do a couple other tests just to see kind of where the status is of your eye to make sure you are seeing the best that you could possibly see. And they would always, for the most part, show back up for just a few weeks.
- [40:11]
B
But you wouldn't call it, like a Specialty lens consult or something like that to them.
- [40:16]
A
I, I would just have them come in and I guess I'm trying to think of what we called it. I guess we would just say like, it was like additional testing on like a different day where we would actually do a variety of whatever the specialty lens consult program was at that time, what the tests were. But it was usually because of something that we saw or a patient complaint, you know, that they felt like that their vision wasn't their best or they were seeing ghosting or halos. And where I am from, a lot of patients had rk so they, a lot of them could not see that well and had a lot of these complaints. So I would have them come back in and do some of these tests, put on a lens to show them what their vision could be and be like, hey, like, this is definitely something that can improve your vision. So yeah, it, most patients are happy to come back in if they could possibly see better.
- [41:09]
B
Yeah. And do you get a sense of are there during that consult? So it sounds like you have no problem converting a comp exam into a consult as long as you kind of call it additional testing and you're not like overselling it in the beginning, like, oh, well, there may be some specialty lenses that, that or whatever, and Those start from 1 to $5,000. I mean, like, you don't, you're not doing any of that during the comp exam. You basically say, I need you to come in for some additional testing. And then when you say, and then when they're there for the additional testing, you sit down with them and what was your treatment plan acceptance rate at that point?
- [41:46]
A
Yes. So in my other practice, I took insurance. So the conversion rate's very high, especially if the insurance is going to cover what they need. So they would come in for their specialty lens consult after, you know, their comprehensive exam, and then we would put some lenses on, show them what their vision could be. And, and then I would explain again, like why they cannot see their best with their glasses they're used to or the soft contacts they've been fit in all these years. So then we would have that conversation and then we, what would happen from there is we would work with the billing person and she would come in and kind of talk to them about their insurance, figuring out like, are there any co pays, do they need to sign, you know, abn all that stuff. Like, I don't know all of that particular nuances. But, but the, the conversion rate was pretty high because they, the insurance would, would Cover a lot of these. If the insurance didn't cover them, the. Then we would still go through the entire thing and say, this is totally up to you. And that's how I am in this practice now, is I never want the patient to feel pressured. I never want them to feel like it's like a sales type of environment. I'm doing this because I genuinely want to help you see your best. And that is the honest truth. And to do that, this is what it entails. These are the types of visits we can expect. This is the process. This is the cost. What questions do you have? So I think, like, just being very transparent with the patient and, you know, not making it like a very high sales type of environment, I think is very important.
- [43:27]
B
Yeah. Okay, got it. And you're saying that even when it was cash pay, what percentage of patients would typically say yes for cash pay? Yeah.
- [43:40]
A
I would say maybe 50%. I think that with specialty lenses in particular, the cost is pretty high compared to, you know, like a. Maybe a pair of glasses or like soft contacts that they're used to. And the. And, you know, if you have a payment program or something, maybe that will reduce the anxiety that the patient might have. But yeah, I would say like 50 or 60%, depending on what the issue was. How determined are they to see better? You know, what's their financial situation like? You know, all that stuff.
- [44:19]
B
All right, that's great. All right, we have to take a break. After the break, we're going to shift gears and we're going to talk about Woo you. All right, we're back in the Power Hour with Dr. Stephanie Wu. I am. I think you've given us a ton during the first half of the show on adding a specialty to your practice or running a specialty only practice. But you have this other really fascinating project that, while I have you here, I think it's, like, really important for us to talk about it because it really does help the industry. So why don't you talk a little bit about Wu University?
- [44:54]
A
Yes, it's my new baby. So the way Wu came about was actually because when I opened up my specialty lens practice, it was January of 2020 is when I opened my doors. Then two months later, I had to close. And I was just getting started, you know, going out there and letting everyone know that I have this new specialty clinic. And then, of course, no one was accepting any visitors. A lot of practice practices were not even open with COVID and everything. So I had a ton of time to think because I wasn't Seeing patients. I wasn't able to go out and meet doctors because of the pandemic. And interestingly, when I started my specialty lens clinic, I already knew that I did not want to go back to seeing patients five days a week. That was never going to be the goal. I already had done that for the first, you know, 10 years of my career. And I just was wanting to do something different. I didn't know exactly what that was going to be, but during COVID it gave me a lot of time to think and I just saw a lot of my friends having to take out, like, loans and defaulting on some of their equipment things, and it was just really sad and hard to see that type of stuff. So in my mind I was like, okay, is there anything that I can do to help my optometry friends? And the only thing I could think of is, well, I've given a lot of lectures, so maybe I could figure out some way to like, give some sort of free CE at least that would help people so they didn't have to pay for some CE credit hours because we all need some CE credit every year. And that's really where, like, Wu, you kind of got started is just this random thing of, like, what can I do to help some of my friends out? And the only thing that I could think of is, like, I could give a lecture, I guess. So we did that. And then it takes a while, you know, with the accreditation through COPE and everything. And then WUYU was founded and I was actually at the end of 2020, and we really kind of get started 2021. But then it really snowballed from there. So we gave Dr. Tom Arnold and I gave the first lecture and. And Visionary Optics supported that one and was on specialty lenses, and that was really well received. There was like 80 doctors that showed up. So I was like, oh, okay, this is cool. Because it was just from our social media postings of like, hey, join us for this free CE. And I was like, Hey, 80 doctors. Like, that's pretty cool. So then we partnered with other companies and entities on different things. And then I was like, you know, this is going to get really boring with just me talking about specialty lenses, so we need to find other people to talk about other stuff. And so then because I had been in like the lecturing circuit all these years, I had all these amazing connections with, like, the best of the best speakers. So then I kind of would let them know, hey, I'm trying to do this thing to offer CE to doctors for free. Would you have any interest. And that's kind of where things got started. And then it just ended up becoming like its own company in 2021 and, and to now where we just were hosting events almost every single week. We're offering free CE for like 95% of our events. And so, you know, our, our mission as a nonprofit is really to host an array of education for low cost or free for eye care professionals. And I think we have really done that over the last few years.
- [48:43]
B
What were your. Some of your best attended courses?
- [48:48]
A
Yes. So anything having to do with oral pharmaceuticals is always going to get a lot of doctors. We had one that was like 1900 doctors showed up last year and that was Dr. Vin Dang. He was talking about glaucoma and eyelid issues and ocular surface issues. That was super well attended. We just hosted a Retina series that one. You know, I was logged in the other day. There was like over 1600 doctors that were tuned in, I think to Dr. Julie Rodman's course. She was talking about Retina Pearls. So it's cool because we have all of these different topics, all of these incredible faculty and you know, most of it is free. So it just, it makes me feel really good because I just feel like we're providing such an incredible service to optometry, you know, my colleagues and friends and it's been super fun and incredibly rewarding.
- [49:43]
B
How many CE certificates have you distributed?
- [49:47]
A
Yes, to date we have delivered over 250,000 CE certificates with the help of Icare Pro actually. So they have been amazing as far as helping us distribute the CE certificates to all the doctors and they've been a great partner with us as well.
- [50:05]
B
Yeah, that's, I mean it's really, really cool. So you've been able to touch. I mean certainly a lot of it sounds like there's probably quite a few repeat, repeat docs. But so talk to me about and what do you hear? Because there's obviously a lot of in person CE events as well. So when is an in person CE event more appropriate? When is a online CE event more appropriate?
- [50:32]
A
Great question. And that was kind of when I was developing Wu U. I was trying to develop it as on one hand, if I was an attendee going to a ce, like what's important to me as a doctor, like that's going to one. So for me it was like it has to be really easy to register. It has to be easy to attend. Like I had been on so many virtual CE platforms that were like really not user friendly. Clunky couldn't figure it out. Like it. So I was like, it needs to be something very, very simple and easy to use. It's got to have very high quality education, like doctors that I really want to learn from. And you know, cost, you know, being free would be like a huge bonus. So that's kind of the thought process of where I was going with it. And you know, from someone that is from a rural area. It was really hard for me as a doctor that was seeing patients five days a week to go to some of these in person conferences. So I would have to drive three hours to an airport, fly to wherever the meeting was, get a hotel, food, pay for the registration of the conference, miss time away from my practice. I'm not getting paid. And you know, it's like all of those expenses really add up. And so in my mind I was like, gosh, you know, if you could just get a lot of your CE virtual, you know, depending on your state and stuff, that seems like a great thing because you're getting the same lecture that you would get at one of these major meetings, assuming you could get that faculty member to give that same lecture. But you're sitting in your home, you're not having to spend all of this money and time away from your practice and your family. So that's really where I just, I love the virtual component for those things and the in person component. I think that there's nothing that can really ever replace the face to face networking aspect of these meetings. Not even necessarily ce, but any sort of networking component is going to always be more effective. There's just something about that human interaction. So that's why we support some of these.
- [52:54]
B
You built a whole business on 5 Minute Human in person human interactions. So I totally agree with you. I think that there's value maybe sometimes in the lecture, but oftentimes in the other people who are sitting in the lecture when you're in person. But at the same time from both a convenience standpoint and from a fit into kind of your busy lifestyle standpoint, nothing beats virtual as long as you can get the same quality material.
- [53:27]
A
I that's why I think it's happened. It's just good to have both options, right? Sometimes you want to go and see your friends and your colleagues and or be able to talk to the lecturer face to face. You know, a lot of people go up to this, the faculty, after their CE and ask them questions like there's just something about like that human interaction like you said Eugene, that's like so Important, but then also having the virtual component of like, you know, you're not taking time away from your family or your practice or having to spend all this time and money going and traveling. You know, there's just, I think it's a balance. Yeah.
- [54:02]
B
And I think it's different too because I think you do some of each right. And you're absolutely right. Every time I give a lecture, I always end up, you know, in the room for another 30 minutes where somebody, where, you know, you get to answer questions and you get to make a big impact and a lot of things that happen in those little conversations afterwards where you can be like, oh, I can tailor this to this particular person, I can give them a really good tip to help them out. And at the same time, you know, again, if you're going to check a box, that's a completely different story. And I've been to a lot of those lectures too where, you know, I can see right at the, you know, at the 50 minute mark for a one hour lecture here, like people are getting antsy and they're looking for the QR codes that they, that they have to scan. Right. So, yeah, I think the, the truth is that it makes a lot of sense and the fact that it's free and the fact that it's, you know, you're doing it in collaboration with the industry, which means that oftentimes, I guess I was going to ask you kind of one of my last questions is what's the, what's the involvement of the industry in some of these things? And how much of a course on WIU is like a commercial for something in the industry?
- [55:15]
A
Yeah, so you know, we've got grantors and we also have sponsors. So those are two different types of funding. So the grantors, they don't have any sort of commercial interest. They are just happy to fund the education to meet the demands of their educational initiatives. So that's one source of funding and then the other are from the industry sponsors, which has been huge. So of course they're going to have an interest in whatever their service or product is. But they're really great because we partner together to figure out like a course or some sort of event that would make sense for them to like exhibit at or be a sponsor of because it like relates to their product or service somehow. And so the industry has been huge in supporting what our mission is, what our initiatives are and they know how many eye doctors we're helping. So it's, it's been just such an incredible amount of support in both the, the, the, the sponsors and the grantors. You know, the whole industry has been incredibly supportive of this initiative and there.
- [56:24]
B
Are obviously restrictions, but that cope places on how much, you know, as how much sponsorship based messaging there could potentially be in any course. So I don't think it, it's, I, I, it sounds like you found the balance there really well.
- [56:40]
A
Yes. Yeah. You have to follow all the rules to a T. And so we have everything that is, you know, separate. So if the messaging is taking place, it's always in a different room. Same thing if we were doing an in person meeting. All of the exhibitors and anything with logos and stuff has to be outside of the CE specific room. So you do have to follow all.
- [57:01]
B
Of the, how do you do that virtually? How do you, how do you get them in a different room?
- [57:05]
A
So the, basically the sponsor, if it's, if it's a sponsored series is, it is like waiting in a separate zoom room that is not taking place where the CE is. So once the CE is has concluded, then attendees click on a link and then they can go transfer over into the sponsor room if they want to hear from what the sponsor has to say.
- [57:28]
B
Interesting. Oh, that's great. That's, that's, you got technology working to your benefit for sure. So if people want to get more information about the courses, just go to wu.org right?
- [57:40]
A
That's it. Yep. Just, you could search Wu, you could search wu.org we, we always have stuff on our Instagram and Facebook feeds as well. As far as upcoming events, they're, they're all really easy to register and attend and be happy to see everyone there.
- [57:57]
B
Yeah. All right. Stephanie, such a pleasure having you on the show today. I think this has been an awesome episode. Thanks for sharing all your knowledge and thanks for everything that you do for the industry.
- [58:08]
A
Thank you so much. Bye.