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Power Hour Optometry
The Myopia Management Mindset: How Top ODs Convert and Retain More Patients
01:04:38
In this Power Hour episode, host Eugene Shatsman brings together two of the most respected leaders in the field: Dr. Brianna Rhue and Dr. Thanh Mai. Collectively, their practices manage thousands of active myopia patients across multiple locations....
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- [00:00]
Dr. Brianna Roo
Foreign.
- [00:07]
Eugene Shotsman
Welcome to the Power Hour, Optometry's biggest and longest running show. We're more than halfway through our season. I'm your host, Eugene Shotsman, and today's episode is one that you really want to listen into. If myopia management is something that you care about in your practice, listen. If you ever thought about offering myopia management, if you're dabbling in it and it's just not quite clicking, or if you're doing well, but you just want to do better, These are the two people you want to listen to. I brought together two absolute powerhouse doctors, Dr. Brianna Roo and Dr. Tanmay. Together they're managing thousands or their practices are managing thousands of myopia cases, kids in treatment across multiple locations and they've helped guide countless other practices through it. But listen, when it comes to this particular episode, we're not just talking theory, we're talking about what actually works, what's actually happening in the practice, what's the mindset that you have to have in order to be really good at myopia management, what percentage of your patients could potentially qualify for cash based myopia treatment and how, what you should charge, how to make that number feel like a no brainer? How often should you see those patients? What are the treatment modalities and what is an acceptable close rate? Is it 5% like some practices, you know, for every time I talk about treatment, 5% of patients, or is it 98% like you might hear on the show? How does it work? We break it all down from pricing models that scale to scripts and silences that convert to processes, how to reframe the entire exam room, conversation outcomes instead of options. And look, Bri and Thanh do not necessarily agree on everything that this episode turns into this really complete list of wish I'd knowns that are like, wow, that is exactly how I do it or that might really work for my practice. So whether you're looking to grow your myopia program, struggling to get patients to say yes, or just looking to unlock a new level of clinical and financial impact for your practice, this episode is for you. Before we dive in, two quick things. Make sure you're subscribed on YouTube, Spotify, Apple Podcasts so you don't miss future episode drops. And by the way, if you've got episode ideas, questions, or if you want to continue this type of panel discussion on anything that you hear today, head to Eugene Shotsman.com drop me a note. I absolutely respond to every single note. Now let's get into it. Here's today's power hour. Okay. Dr. Brianna Roo, Dr. Tanmay, welcome to the Power Hour. Excited to have you both on this amazing panel.
- [02:38]
Dr. Brianna Roo
Excited to be here. Let's go.
- [02:40]
Dr. Tanmay
Hey, thanks for having me. This is my fourth time on the Power hour and I'm just super excited to be back.
- [02:45]
Eugene Shotsman
Let's do it. So here's the deal. I think the best place to start is to just give the listeners a little bit of context about each of your practices because they are a little bit different. And while we're going to zoom in on myopia, I think it gives everybody a chance to think a little bit about what kind of practice you're starting with and how you landed there. So, Brian, I'm going to have you go first. Just describe your practice. You know, roughly how many patients you guys see, how many pediatric patients you see, and then also how many kids you have in your myopia program at this exact moment in time.
- [03:20]
Dr. Brianna Roo
Yeah. So private practice, Fort Lauderdale. We've got three and a half lanes, so meaning that half lane, we can't really refract in there. So it's an overflow room. Two doctors running, but we have three. I have two associates and myself. So I see patients day and a half a week, Tuesday, half day, Wednesday morning, do Dr. Contact Lens the other 90 days a week. And then really primary care practice. We do obviously heavy in myopia management. We are part of two studies, one just finished, which was a signxis study. We're also enrolling in the CooperVision study, see about 30 to 35 patients a day. What I want that to be more, of course, we're just bottlenecked at our pretest area. So we're just busting at the seams at our practice. And honestly, it comes down to parking, which is why we can't see more patients then we do. And we'll get into this in the episode. But like my Tuesdays from 2 to 4 only allowed for myopia management practice. So we've got about 650 kids, 700 kids now in some form of a treatment. And we'll get later into just a case. I saw two cases I saw on Tuesday and why I do what I do.
- [04:34]
Eugene Shotsman
That's amazing. Okay, great. So 650 to 700 kids in some form of myopia management program. Yeah, got it. All right, Thanh, over to you. Talk a little bit about your locations.
- [04:48]
Dr. Tanmay
Yeah, great. Thanks for having me. First of all, Eugene, a little bit about me. I actually own four locations in Southern California in Orange County. One I opened Cole 10 years ago and three acquisitions. So I'm kind of just in merges and acquisition mode now. Besides owning the practices, I also work at Trios Eyes. Our job is to go around the country. We have got about 70 locations. And my job is to train the doctors how to install a myopia management program within their office. I also run the myopia protocol at Vision Source and teach at scco. And so a little bit about our practice. Well, I'll talk about mostly about the first one because that's my baby. That's my cold start. I don't do a lot of primary care there. Probably sell like one pair of glasses a day. We've got five doctors working, but I've got 12 doctors total, but five at that practice. And we've done easily over a thousand myopia cases. I don't know the exact number, but it's a big part of what we do besides special contact lenses like scleral lenses and vision therapy. And so I've kind of just like Brianna, heard every objection. Sales objection, every, you know, what is this? Why does it work? I've heard every thing from other optometrists as well. Because I speak and lecture and I went into, you know, Brianna, both want to say ODs that just some get it and are dialed in and some need to get it and need to get their butt kicked. And so a little bit of both. And so on the business side and also to the consumer side, I'm kind of dabbing in both.
- [06:23]
Eugene Shotsman
Yeah. So this is great. And I think this gives the audience a lot of context for where the two of you are coming from. Let me just ask, how is the field of myopia management really evolved in Europe? Like, you think about it from your perspectives. You know, you each eat, live, breathe this every single day. There are some providers who, you know, this is a pretty solid adjacency for them. Meaning, like they'll do it but maybe once a month or not at all type of thing. So that the field. But I think the awareness. And when I'm asking the question, I wonder if from your perspectives, the awareness on the provider side has increased substantially over the last five years. And then on the other side, has the awareness from the patient side increased substantially? Thanh. I'll go to you first.
- [07:12]
Dr. Tanmay
Yeah, we have but one problem with myopia. We don't have a treatment problem. We don't need to invent new science. We have a messaging problem, a process problem, and a reframing the story problem. And that's mostly in my opinion, it will be almost an impossible nut to crack to find that message and to get the public awareness out. So I think the main avenue in which I've been trying to raise my opiate across the country is to get the ECP to finally start doing it. I think 10 years ago, very few doctors were doing it. There's the niche, the small groups, the early innovators and early adopters were doing it. The 5 to 10% today, luckily in 2025, I'd say the vast majority, probably at least over 80% at least know about it, know it exists. Don't think it's voodoo science. Their problem is more of a process and implementation execution. Clinical confidence, staff training done with the prices set, the pro you know, the contracts written and how to do the messaging in the exam room problem. That's the biggest nut to crack in my opinion. We're trying to solve that, but it's a hurdle and I'd say it's gotten though exponentially better where now people know it exists. Where tenure you years ago the doctors did not but now the doctors know it exists. They just have a hard time implementing it. From the patient public awareness side. I still don't think it's. The needle is barely moved. I think that's probably only 3% actually get the message.
- [08:40]
Eugene Shotsman
Yeah. And you know what's interesting is tan I have some data about that patient awareness side. Bri, over to you first and then I'll try to add my thoughts.
- [08:50]
Dr. Brianna Roo
Yeah, can we just like clock that answer? Clock it ton. I just learned from one of my Gen Z employees. So he's standing on his business right there, Tom. Ten toes down. So what I see it as is parents are now like seeking this out and the case I just had on Tuesday. Guys, this doesn't ton. I think you're exactly right. You can't open a journal with without reading something on myopia. You can't go to a conference without doing something on myopia or see someone talking on it. It really is a belief system that we have to overcome and that the no objections. Right? So as ODs realize, yes, you are providing a solution. Call it sales, call it a solution. It really just comes down to presenting it some things now we have these amazing calculators like Ocumetra and all these other things now that really get your talk track straight and it comes to just a belief knowing what you're doing is right for that kid and understanding it's not up to you decide if it's right or not. For the kid. It's up to the parent to decide. It's up to you now to present the option. Meaning on Tuesday, where I'm fired up right now. Is this the case? 14 year old, minus 14, minus 3 sil in both eyes. Was seeing a pediatric ophthalmologist in my area and was told she was not a contact lens candidate. Like, are you kidding me? Of course she's a freaking contact lens candidate. Okay? And now had been in this pediatric ophthalmologist since she was three years old, was never told there was anything that he could do or that she could do. The mom could do. She went to another optimal, another optometrist who said, do not pass. Go, go see Dr. Rue. They're in my chair. The whole 20 minute consultation and exam was me dealing with a mom absolutely livid that no one had talked to her about this before. Livid, I mean, couldn't stop saying, like over there, just shaking her head, almost in tears. Like, it almost like just pulled at my headstrings. Like, I'm apologizing on behalf of my profession. I don't know number why, what no one told her that she could do contacts. I found, like, I just put what I could the highest that I had and her face just lit up and it was like, not even close to her prescription. You guys know what fit sets we have? So imagine what I put on her, right? And I'm never going to throw somebody under the bus, but I had to sit there and apologize. Yes, we just got treatments in 2020. In 2020, but she would have been 8 in 2020 or 9. She was probably a minus 6 at that time. That's again, guys, like, this isn't rocket science, man. It's just not rocket science at this point. So I think when you take away this, that's what Tan and I. You're gonna hear us over and over again with this passion in these cases. If you don't want to do it, don't. If your jam is dry eye, glaucoma, like, find someone to refer to, man. But you can't do this anymore. Like this. It's not fair. It's not fair to the parent, it's not fair to the patient, and it's not fair to your profession.
- [12:17]
Eugene Shotsman
Yeah. So I love the passion and both of you have it. And that's why I really wanted to put this panel together. I mean, let me just say this. This is really the consumer data that seems to be that seems to be evolving is that when you look at the total volume of searches, and this is, you know, an indicator of demand, Right. It's not the only point of demand, but it's an indicator of demand. But if you look at the total volume of searches for things like eye doctor, eye exam, and all of the related terms, myopia management is less than 0.002% of any of those searches. And that's in some of the busiest parts of the country.
- [13:01]
Dr. Brianna Roo
Hey, that's less than. That's less than the atropine dosage that we're talking about here, Eugene.
- [13:07]
Eugene Shotsman
Right. Yeah, I like it. The problem is, you know, and I. And I think this is where it gets kind of interesting, is that the patient doesn't. To your point, Bri, exactly. To your point, is that the patient does not know that this solution exists. Right? So it's. And there is. I think CooperVision is trying to do a little bit of this, but there is very little public awareness, education to say, hey, this treatment is available for your kid, and this is what it does. So in all reality, what keeps happening is that you rely on the patient, or, sorry, you rely on a doctor who has that patient in the chair to do all of the education. So now I kind of go back to the point that both of you just made, which is the messaging in the chair. Before we get to the messaging in the chair, let me ask you both. Is every pediatric patient that comes into a general practice, should they have a myopia, whatever we call it, a myopia eval, a myopia consult, a myopia talk with that patient. Bree, what about you first?
- [14:19]
Dr. Brianna Roo
Yeah, I look at everyone, right? So am IOPIA screen. So it's real quick, guys. It's just an equation that you're trying to figure out with the endpoint. So if you don't have an A scan or a biometer or whatever, right, You've got probably a topographer. If you don't. What are you doing? Please get a topographer. Like, this is so simple. Okay? This is not something that's a big investment. So if you have K readings and you have refraction, you can figure it out. Axial length, it's an algebra equation, right? So now you figure out how aggressive you need to be or not aggressive you need to be. I'm not telling you that every patient needs myopia management. That's not what I'm saying. But you got to find those 4, 5, 6 year olds that are going to be like that case. I just talked about or even end up as a minus five. Right. So I don't go into the scare tactic or anything like that, but just make this more simple.
- [15:19]
Eugene Shotsman
So let me ask you what percentage of. If you see 30 kids this week, I'm making this up, but let's say your practice saw 30 kids this week. Of those 30 kids, how many of those kids are candidates for myopia management program?
- [15:38]
Dr. Brianna Roo
Out of the 30, I would say a good chunk of them. Again, it's just dependent. You're looking at age, you're looking at parental myopia. They're all on devices. None of them are outside. So I'm always like, go touch grass, bro. Like, get out there. So the I would say probably 1 in 2, 50% or it allows me to see them back if I'm worried. Let's see where you are in six months. Like, there's just not enough. There's not enough of that. Plus in the system that we all are hoping for, it's not there anymore. I don't know what you're seeing.
- [16:18]
Eugene Shotsman
We're going to come back to you with the messaging in the chair momentarily, but I'm going to ask you the same question. Ton if a typical practice maybe, you know, again, we talked about how there's not enough patients calling and saying, I want your myopia management services. Right. So what you're typically saying is, hey, do I have a. Do you guys see kids for an eye exam? And the answer is, okay, yes, got it. So now you're gonna see a kid for an eye exam. If I see 30 kids for an eye exam, whether it's in a week, in a month, whatever, how many of those kids could be candidates for myopia management treatment?
- [16:55]
Dr. Tanmay
Good question. So in the general wild, you'll probably have 42. So 42% of people will probably develop myopia in the United States, It'll probably be 50, 50 by the time we're in 2050. But today we'll say it's 42% or so. Right. But that's the general population. In the general wild, that person unfortunately doesn't necessarily call my office and schedule an appointment. The ones that schedule an appointment and call my office over index with a problem. That's why they showed up. So in my office, it's probably over 60% because they came in with a problem. 6, 60, 70%. But it's almost like the survival bias of who finally picked up the phone and decided to call me because they failed a school screening. But ballpark in My heavy index Asian community in Irvine, it's, you know, the vast majority of those guys are going to be like 70, 80% of those guys are developing myopia. So we index heavy. We screen every patient with axial length measurements, anyone under the age of 18. Because myopia is such a big deal that to me it's important to screen it and to account for it. So we don't dabble. We're all in high percentage of malpractice.
- [18:08]
Eugene Shotsman
Do you think that most doctors screen every patient or do the calculations as Bri was saying?
- [18:14]
Dr. Tanmay
No, absolutely not. So they don't. And so that's, that's, that's the thing, you know, is it going to be your thing? It doesn't have to be your thing. The biggest, by far the most important sales conversation we have is with a man in the mirror. And the man in the mirror doesn't necessarily believe that he, he or she needs to treat myopia. And if you can sell that person, you will win. But the problem is that most doctors have not sold that person yet because if they did, then they would measure axial length measurement on anyone 18 years old or under. They would have a coin topographer, they would invest, they would dabble. If they don't, they do not dabble. If they are dabbling, they would actually be committed to referring out, but they're not sold on it yet. But when they do, that's when the game is won. We just haven't done a great job yet of doing it.
- [19:04]
Eugene Shotsman
So you're saying step one is mindset.
- [19:08]
Dr. Tanmay
Mindset, yeah.
- [19:09]
Eugene Shotsman
Tell yourself that you're going to do this and you're going to go all in.
- [19:12]
Dr. Tanmay
That's right. Once you, once you do that, it changes everything. It changes your trajectory a thousand percent. And that's the number one hurdle.
- [19:20]
Eugene Shotsman
Yeah. Which I think is such a key point. And it's exactly what Brandon was saying, which is that, you know, measure every patient so at least you've got the data and then you can, you know, you don't have to sell every patient, but you have to sell. But you at least know who needs it and who doesn't need it. So I'm just going to ask a numbers question.
- [19:38]
Dr. Brianna Roo
Eugene. On that. On that. Eugene. We're big numbers people, right. As scientists. So you know, if you don't measure it, you can't track it and you can't grow it. So it's anything, your contact lens business, your dry eye business, your marketing dollars. So it's about putting a focus. But I love What Thanh said there about the man in the mirror. Right. This is a shoulder back moment when you're presenting. So if you don't feel it, your patients are going to sniff you out. And that's where a lot of these no's are coming for. So a lot of this again is overcoming those belief systems. Patients can't afford it, they're not asking for it. I don't have the clinic for it. Guys full on all that.
- [20:27]
Eugene Shotsman
Yeah.
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Dr. Brianna Roo
Because 70% of the patients that you saw, 80% of the patients that you saw this week or seeing today, guess what, they're myopic. Guess what, A lot of them have kids. You already have a myopia clinic, you're just not building it.
- [20:41]
Dr. Tanmay
That's by the way, Brianna, that's such a common thing. So at triage eyes, I go around, I'm trying to, you know, sometimes I talk to prospective doctors to join our network and they say, hey, I don't have any kids.
- [20:52]
Eugene Shotsman
You have no.
- [20:53]
Dr. Tanmay
Do you see any patients aged 25 to 55 that are like mom and dads? Because some of them, some of them, not all of them, some of those people have kids, by the way. So yeah, you're sitting on top of it.
- [21:04]
Eugene Shotsman
Yeah. And I think you're, you're, so you're, you're both establishing a really interesting point and I think to hammer it home, I'm just going to ask you a number question, then I'm going to ask you how you do it. So we talked about what percentage of the patients could be myopia candidates. So now you speak to 30 myopia candidates. Brianna, for you first you speak to 30 myopia candidates. How many of those accept treatment in some form for your myopia management program and agree to pay cash money to your practice?
- [21:41]
Dr. Brianna Roo
Me, I'm probably at a 98% close rate. And to me it's really not an if they do say no, it's a not right now and I'll see you in three months.
- [21:50]
Eugene Shotsman
Okay, we're gonna come back to that. That's incredible. That is, that's incredible. And we're gonna know how you do it momentarily. Tan. What percent, what, what percent do you think is the right percent for you or your doctors?
- [22:03]
Dr. Tanmay
Yeah. So in our 70 locations at Trias, my target for them is 50%. If they do 50%, I'm happy. For me, it depends on why they came in. If they are referred by another doctor, referred by a friend, a hundred percent. If they are referred by me because I found a Problem initially, they've never heard about it before. I'm happy at 60%. So I'm not as good as Brianna because she would get 98% of those too. But for me it depends on, you know, if it's a Google campaign. They've never heard about it before. I'm early in the funnel. My closure is not going to be that high. I'm happy with batting 50. 50.
- [22:41]
Dr. Brianna Roo
Okay, so, but Eugene, one thing right there that I like to add. Okay, so we're trying to recruit for a study and We've done now two studies here. One is 75% of the kids get the drug, the other 25% don't. But it's a four year study. If they progress, you can't put them on drugs. We are having now the hardest time enrolling because they're like, no, I'll just pay for it.
- [23:13]
Eugene Shotsman
Okay, why not? So this is where before, before I ask you how you do it, let's talk about the modalities in each of your practices. So how are you treating and what specifically are, you know, what are your most popular modalities for, for helping kids with myopia? Tan.
- [23:34]
Dr. Tanmay
So I started initially as an orthok guy. So it's kind of been the genesis of my myopia journey. So we heavy index into it. There's a few reasons why. First, the doctors love it. Secondly, we just have a high Asian population. And if you guys understand the Asian population, some of them, especially if they're from China, Vietnam, they come in asking for it. And my spiel when it comes to when I'm training doctors across the country is there are certain protocols that say XYZ might be better for this scenario based on axial length, growth and demographics. But then day, if mom wants something, it's okay to give mom what she wants most of the time. Because if only 3% of kids only get, get anything at all, I'm happy if something, if the patient's on something. So I don't let perfect be the enemy of good. I usually go to what mom wants. And in my practices mom usually wants orthokay a little bit more. We have an interesting model is that at all locations all across the country we actually recommend kind of a flat fee model for all the three, all the modalities doesn't matter. Atropine, soft, multifocal or orthokeratology is we actually have good data to show that when we give the patients, and we have tens of thousands of patients when we give that case presentation that way and we say the price is the same because we're selling an outcome, not a not. We're not selling contact lenses or glasses or drops. We're selling an outcome which is myopia management similar to orthodontistry. Right. So I learned this from Jay Abrahams. Like some of the best ideas are in other industries but you drop it into ours, it's like an atomic bomb. So a lot of the consumer research we've done, we've done consumer research, we've also interviewed and worked with, networked with orthodontia and their groups and, and study their case presentation. So in orthodontia they don't study, they don't sell rubber bands and brackets. They're selling an outcome with straight teeth. Right. So tangential. But anyways, in our model where we say it's the same price, our goal is to sell myopia management, the patients, interestingly enough, when you remove the factor of price, if it's truly the same, most of them in our network actually offer orthogology when price is level and flat. When, when you remove that barrier, I think it's because of the coolness factor. It's you know, freedom. It's going to swim without lenses on. And some patients don't like the pharmaceutical eye drops. So that to me is an interesting finding that we've learned and especially it's true in my practice, even though I bend heavy orthok is that the flat feet model? People opt for it anyways, so that's where we started. We would do everything though we do a lot of my sight, we do lower attribute all day long and um, but that's just my, my practice because of my demographic. But sell what works, you know.
- [26:13]
Eugene Shotsman
Okay, that's by the way a really interesting insight about the. When patients are given the choice and the price is not a factor. That's interesting. Bri. What. What do you think?
- [26:23]
Dr. Brianna Roo
Yeah. So we do the full gamma, so low dos atropine which I think is really a gateway drug to get into a contact lens option. Uh, we do my site, we do orthokay but it's really looking at the family unit deciding what's best for the patient, the family and the case. So same thing. Our model is a little bit different for year one. My site orthokay are the same. Atropine is a little bit less to again because this is a really long term treatment. I'm not selling just one year of treatment. I'm selling the next 13, 14 years of treatment. And so I think It's. I don't want to do a disservice by overpricing it and getting them out of the thing. Right. Because I have a little kid in orthodontia as well. And I love that you're not selling, you know, brackets and. And rubber bands. You're selling an outcome. And so you have to paint that picture. That's where things like Ocumentra has really helped me come in and do that. So when you pick what's right for the patient, pick what's right for the. The parent and the unit, you're gonna. They're gonna buy into the treatment and they're gonna, they're gonna do it. So you've got some kids that go kicking and screaming in one way. I was just listening actually to a lecture by Maria Lu the other day. She was spicy on that one. It was amazing. So she was talking about the spectacle lenses coming, and I feel like a lot of people are like, oh, just throw spectacles on everybody. I mean, she was like laying into these on how kids aren't wearing them. They're actually developing head tilts because they can't see through them. They. It's like a minus one. They're really not going to wear them. It doesn't give them any freedom. So I think as these things start to get approved, realize you, you gotta do what's best for that patient. That's why I became an optometrist. My optometrist gave me contacts in third grade because one, like one of the girls was like, beating me up on the playground with wearing glasses. Right. So you don't still probably need to do some therapy on that one. But you have to advocate, man. So you got to advocate.
- [28:32]
Eugene Shotsman
So you. In your case, is the price different for each modality.
- [28:39]
Dr. Brianna Roo
So my atropine is a little bit lower because they go source it themselves. Right. Then my atropine and any soft lenses are. It's the same and it's all one program, Right. So they don't. You don't have to deal with like, okay, I can go to Costco and get these because they're cheaper because that's. You're going to come up against that, right. So we get. We get nip that in the butt. So we've kept it really simple for.
- [29:08]
Eugene Shotsman
Them to opt in and in in both of your cases. Again, I'm going to go into how you sell it momentarily. But in terms of implementation, one of the pieces of feedback I've heard from some optometrists is the reason I don't like to do my opiate management is because those patients are really needy. They come back a lot. They have problems. They do, you know, they're difficult to manage. They're, you know, they have a lot of, A lot of issues and they're always tying up my phone lines. I've heard this, you know, from some clients. And I'm just curious your thoughts on that how in your program. Because I imagine the program comes with visits, right. If you have any problems, come in, we'll help you. Blah, blah, blah. Right. Like that's. So the program comes with some number of visits. Bri, how do you deal with that and what's your perspective on it, dude?
- [30:00]
Dr. Brianna Roo
I mean, are you allergic to helping people and making money at this point? I don't. It's not computing for me. So the piece to this to remember, yeah, like they are paying you a lot of money. But what I've done ton. Maybe you. You've done this now because you, you've also seen a lot of kids. So I used to be like, really religious. I was like, okay, week, one month, 13 months, six months, nine months, 12 months. And then we see them every six months. Like, I'm starting to really push this out. I'm like, I don't need to see you this often because it's working. So I've gone now to like orthokay. We see them obviously back at one week. There's a call at one month just to make sure everything is okay. And then now I'm seeing them every four months for that first year. And then really I go to every six months. A couple of kids this week I was like, dude, I'll see you in a year, man. Like, you haven't progressed at all in three years. Why would I need even see you back in six months? So you'll start to get more confident as you get the right treatment.
- [31:04]
Dr. Tanmay
Yeah. To chime in, you know, another reason why we do a flat fee model is that one of my favorite sayings is simplicity, scales and complexity fails. I went to some doctors that have like, they've got like seven prices for their orthokay program. They're like minus one, minus three, minus four, minus two and a half. And if they wear a green shirt or red shirt, it's a different price. And I'm like, hey, man, like, it can work for you if you've got. If you've been there for 30 years and serve your staff. But what you don't remember is you've got the Curse of knowing because you know what's going on. But maybe your new associate doesn't know and your new staff member doesn't know. And you just introduce so much operational hurdles for you and the patient. So the messaging is confusing for someone picking up the phone. The message is confusing for a new doctor during the consultation and for the staff member taking the handoff. So for us, by having flat fee models, it's easier on phone call, it's easier to quote fees either or in the exam room. And it's also easy for staff to understand what it's going to be when they answer when they talk to the patient. So that's another reason why we decided to do the flat fee model, besides the fact that we're selling outcomes.
- [32:12]
Eugene Shotsman
What about the frequency of patient visits as far as.
- [32:15]
Dr. Tanmay
Yeah, it's because the revenue per patient is so high. The frequency of exam. The frequency of visits is not a problem because it's covered. So what I like to look at is this. Let's assume that one reason why you can fail is if your price structure is off. Because if something is not economical, you will not do it, right? So as an example is this, let's assume that you can see two patients an hour and sell glasses to them, right? And so like let's say you sell glasses 50% of the time you see two patients an hour. That's just ballpark. Let's just say you made $500, okay, on averaging primary care. But with myopia, let's say you make $1,000. So let's say that patient with myopia to ballpark, you sell it for $3,000 and you take three hours a year with the patient consultation plus all the follow ups, right? That'd be a thousand dollars an hour. In that scenario, you're making more revenue per hour than doing primary care. That is check. You'll probably succeed because you price it appropriately. Flip on the other end, you decide to sell myopia program for 1500 or 1000 and still takes you three or four hours. It might be a push or behind. During primary care, what inevitably happens is that if it's a push or behind primary care, you and your staff will unknowingly start to self sabotage. Because the economics don't fund the follow up visits. That's when they become a burden, like oh gosh, more follow up visits. I'm losing money here. You will feel it and so will your staff. Same thing with taking a bad client. Let's say Eugene, you have a bad client. The good Clients are great. The 20% of them are 80% of your business. Right. But some of the other 80%, they just suck up your time. They're constantly emailing you, and they are just hard to work with. And they're actually a loss. But they could be a win if you price it just crazy high, but. And then you filter them out. But it's the same thing happens with Myopia or any specialty. Pricing can destroy or build a program.
- [34:19]
Eugene Shotsman
Yeah, I mean, I think you make a really good point. Is that price it at a point where you can budget those extra. And you said four hours, so maybe that's what it is. Think about, if you divide it by 4, does that pay you well enough to where you can prioritize this particular program?
- [34:37]
Dr. Tanmay
Exactly. Otherwise, then you don't have a problem with them tying up your phones because they've paid for it.
- [34:41]
Eugene Shotsman
Yeah.
- [34:42]
Dr. Tanmay
You okay.
- [34:43]
Eugene Shotsman
At this point? They've paid for it. You feel good about it? Yeah. Back to your mindset, man in the mirror type of point.
- [34:48]
Dr. Tanmay
Exactly. What's that?
- [34:51]
Dr. Brianna Roo
This is like an Aaron Werner quote. He says anytime that you say it depends on the phone, he goes, depends are for, you know, other problems. It's not for a phone call. So when a myopia management patient calls. Yes. You got it on your website. And I live in a transient area. Okay. This comes back down to staff training. How people answer the phone, how they're finding you. Guys, our phones. Can you please just go back after you listen to this and listen to how people are answering the phone? I cold call a lot of you guys. So does Eugene. So does Tom. Guys, phone etiquette, man. 101. People are calling you to do business with you, and you're acting like you're doing them a service. Halal, Wes Broward. I care. What do you want? I'm like.
- [35:43]
Eugene Shotsman
That'S when we answer the phone, Bri. That's. That's the 75% of the time when we answer the phone. 25.
- [35:48]
Dr. Brianna Roo
Oh, my God. Don't get me started.
- [35:50]
Eugene Shotsman
Like, don't even get me on that. On that. On that podium, because I am.
- [35:54]
Dr. Brianna Roo
Yeah. So I'll call. I'll call an office if I have to transfer a case. And, guys, what we're doing, again, if you need to transfer a case to another doctor, give them all the parameters. If it's in ortho, K, give. Please don't. Don't make someone else look good. So I'll call up and I'll search because we're in, like, vision by design or whatever. I'll search that first, but I'll just randomly search a city. Myopia management. Right. I'll pick a place. Top three that come up. Hello. Hey, do you guys practice my OPA management there? I don't know. Hold on. Does that sound like you practice myopia management?
- [36:35]
Eugene Shotsman
Yeah.
- [36:37]
Dr. Tanmay
This is where, you know, we've looked into, in honesty, the average AI will answer phone calls and deliver a better service than the average person. So much better practice. We've looked into AI as well that multiple ones and we actually considered it, but our staff is actually quite good. Our all counter. Our call answer rate is really high. We've. We've made a call center that's, you know, it's outside the country though. But they are so good and on top of it. And so. But I'd say for the average practice, AI should be implemented and take all phone calls, like 95% of them because it would be absolutely better than the.
- [37:12]
Eugene Shotsman
Current staff that they're your music to my ears. That is on the Innovation podcast coming up in a couple weeks for everybody. Having said that, when we come back from break, I want to go to the juiciest part of the show, which is you all talking about what the heck it is that you do in the chair to get those incredible conversion rates. We'll be right back on the power hour. All right, we're back on the power Hour and this is, I think, the most exciting part of the show. We heard some incredible conversion rates both from Thanh and Bri, and I really just want to dig into what the heck. Once you've convinced the man in the mirror, Ton, as you've said, that you're all in, you're qualified, you're able to do this and that your patients need it. As Brianna said, the question becomes, what the heck do you say? And how do you overcome those price objections and what do you do? So, Ton, I'm going to go to you first and maybe just start with the. Okay, you've identified a candidate and let's not make this the easiest type of candidate. This is not a referral. This is someone who maybe came in for some pediatric exam and you're having this myopia conversation for the first time with the parent and you know, like, what do we got to. Let's. Let's talk about. Let's actually break that conversation down and think about all the different parts of it. Good.
- [38:31]
Dr. Tanmay
First of all, there's no magic script. There's no magic script. If you think there's a magic script. You're wrong.
- [38:39]
Eugene Shotsman
Okay, well, let's just shut down the show. Okay. I guess we.
- [38:44]
Dr. Tanmay
So there's no magic script, except for when Brianna does it. Then there is a magic script. But what I obsess about more if I'm trying to scale this to 100 locations across the country, let's say, is more about the process. So what are we trying to solve and how do we make a process that solves that issue? We're trying to solve one problem. Mom doesn't really know what's going on. If she's referred by a friend, she knows what's going on. But that's not what happens most of the time because I'm not trying to just treat my all goal is not to treat 20 patients a month. Our goal is to do 300amonth. Right. How do we get there? And so to get there, we need to basically create a process in which we educate the mom. So assume that we're at the top of the funnel. For those who don't understand funnels, basically, they're not that educated, they're not that interested in what you're trying to sell, and they don't know what you're going to talk about ahead of the time. They're not a referral or one lead like Eugene's mentioning. So this is, he's saying coldly, out in the wild, they just showed up because they just want a regular eye exam, right? What happens then? So that patient, you know, most likely will not sign up the minute they walk into the exam room. Why they've never heard about it before, and they need to think about it. And if it costs $4,000, they're going to need to definitely think about it, right? So for that, the solution is this. The goal is to make. If the. If the problem that you're trying to solve is the information is new, then the. Then the solution is you try to make the solution not new as much as possible. And how you do that is this. First of all, you're going to have better data and collect and have a better conversation at the front end. So to have that better conversation, you might measure axial length, you know, fraction. You take a nice uncorrected acuity to demonstrate a problem because sometimes the parents don't realize what 2060 means. And so you have to demonstrate the problem because if there's no problem, then no one seeks a solution. So the inconvenience of your solution, which is coming back for more visits and paying you, the problem must be bigger than that. So your goal is to create the problem and to solve the problem of not knowing. And so we do that by showing axial length measurements. We show that by showing where you are today and based on our studies, where you'll be in the future and how that can lead to future problems like myopic maculopathy and retinal detachments. That's something that you might say. The problem is that in the fast flowing exam pace that you have the first time you see the patient, you might not have time to talk about all that stuff because you're supposed to see patients every 20 to 30 minutes. Where it falls apart in a regular primary care practice, not in a Brianna Roux practice who just got knocked out of the park, but where Ferros falls apart in the regular practice is that they have either too long conversation at the primary care visit and then the patient's overwhelmed and then nothing happens because of analysis paralysis. And so the goal in my opinion is actually at the primary care exam, the goal is to give a little bit of information and then sell a consult. At the consult you give a ton of information. And then the goal is between the primary care eye exam and the consultation, you're going to drip market tons of information repeatedly over the course of the next week or two. You're going to send them repeated text messages of ideally videos of you or someone else explaining what myopia is, why it's a problem, possible solutions and what might work for their child. You might email them information, you might give them a brochure, pamphlet, something, right? So you're solving the problem of make it not new. And then when they come back for the follow up visit. The problem that most doctors have is they are scared of being a youth salesman. Patient walks in for a regular eye exam, you're selling $3,000 Myopia program. The chief complaint does not match your solution. Usually by setting up their myopia consultation and drip marketing them along the way. When they come back for the consult, usually now they say, oh, I'm here to talk about myopia control. Hey now, your solution matches problem. You're more likely to succeed when that's the case. This happens not just with myopia. It could be anything, saying glasses or contacts or whatever it is. Flower lenses, dry eye programs, same thing. The second thing that doctors get wrong in terms of ignoring the magic script is pricing. I'll give you an example. If you price your microbread console at $500, you better get 100% close rate because they sign up to pay 500 bucks, regardless if they do treatment or not. So you've choked your funnel by pricing, right? So that's the question you want to have. Do you want. Because we, we tend to focus clearly on the close rate in the exam room chair, but we've missed the close rate over the phone before they even saw you. And so your reception is not good at closing. Either their scripting needs to improve, their conviction needs to improve and or your pricing model in terms of how you price, a consultant needs to improve to widen the funnel. So again, these are different factors that we need to do to find out to improve your overall close rate, not just the artificial one you've made by sometimes having a really high priced console. I'm not saying that's what people do, they close it artificially high. I'm saying that because what happens when you look, you need to look holistically at your entire front to end from your pricing, your cadence, your follow ups to your, your scripting, to your education in between. So that's kind of a brief overview. I want to give Brianna time of things that you need to look into.
- [43:53]
Eugene Shotsman
Yeah, I love that. Great perspective. Ton, I want to dig into some details. But Bri, you go, you go next. Here.
- [44:00]
Dr. Brianna Roo
Gotta go and make things so complicated. Okay, number one patients, whether it's a contact lens sale, a glasses sale, myopia management, dry eye selling, someone to do their glaucoma drops, right, they're leaving because we are confusing them. Confused patients don't buy. They're not going to remember 10% of what you said. They're going to forget 90% of what you said. So like ton sells another visit. I ain't got time for that. Ain't nobody got time for that. Okay, so what I do again, I block my 2 to 4:30 is just for myopia management patients. You do not put a VSP eyemed visual field on my schedule. I turn into mama Fair ferocious. Okay. What I also do is I practice with my door open. Yes, some people will ask me to close it, but as other patients now guess what, it's a community. They see other kids in there between two and four. They realize that this is now not just their kid having a problem. They've heard me talk about it now to another patient and another patient as they're being worked up. So it's all about priming and taunts that are really bad. Word in most of our words is selling. Okay. Optometrists don't like to sell. That's okay. I'm providing a Solution over sales to a problem that I'm showing that they have. So how they walk in. Patient, mom, dad, whatever walks in. Typically, it's what we call a one legger. Okay? So if you've not heard me on any other podcast, I'll describe a one leg or two legger. Okay? You got to have both parents present and you learn out a lot about family dynamic. How I learned this, my dad was a furniture salesman his whole life. And you're never going to furniture shop the same way either. When a one person from a couple walks in, okay, we call that a one legger because they can get out of the sale. They got to go talk to their pet fish, their turtle, their significant other to get the okay, because mom came in thinking they were going to leave with $150 pair of glasses. And here you're talking about a $2,000 treatment. $3,000 treatment, okay? Very disconnected. If you have both parents present and I do this, I'm going to get some information. I'm going to put this all together in my myopia calculation. So I'm already priming. I hand them a pamphlet. Before I even start collecting data. Hey, I want you to just kind of zoom through this really quickly so I, you know, physically hand off. They take it. There's a connection there. Get your other significant other on the phone now. I know family dynamic. If they're in ortho, K, do I need two sets of lenses, one for moms and one for dads. Who's making the decision? So we call that as a two legger. Because now mom or dad, if they heard everything that you said, if they leave in that moment, how do you think they're going to describe that to the other person? They can't. So now I put them into the little calculator. Hey, I'm. You know what I'm seeing here in Dalton's eyes? There's some things here that concern me. His eye, just like you've seen him grow like a weed over these last couple of years. His feet are growing, his hands are growing. He's growing up 2 inches. Have you seen that? They start nodding. Okay, well, his eye is growing faster than it should. If the mom and dad is myopic, super easy to sell. If they're not right, I gotta show them why the problem. So the retina is like a fitted bed sheet that we all love to fold. Okay. That tissue back there is stretching. There's things we can do now to eliminate that from stretching. So later on in their 40s, and 50s. We're not worried about a retinal detachment or a glaucoma or cataract, but we have to do it now while they're growing. Hey, Dalton, how much time do you spend outside? And they're like, it's crickets. Okay, what I want you to understand here is you got to get comfortable with the silence. Don't overspeak. Let them answer. Most of us interrupt our patients 18 seconds into them describing a problem. So when you get used to the silence. Dalton, how much time are you outside? I don't know. Like, they look at mom, they look at dad, whatever. Like, 30 minutes a day. Okay, how much time are you on a device? And they get real quiet. How much time you're on a device? I don't know, like, three, four hours. So if I looked at your phone right now, it tell me three or four hours. Like, no. Does that sound like balance to you? Okay, so now they're already bought in. Now I have my axial length measurement. I put that into the calculator, and I show them that's what I'm using as ocky metra. We give them solutions again if they want to pay for it now or over time. Does insurance cover it? No. They don't believe in prophylactic treatment. So now this calculator, their plain old. It's projecting them to be a minus six. We know what you know. A picture's worth a thousand words, and they don't want that to happen. So if they do have to think about it. So now I'm like, okay, are we ready to get started? Number one mistake we all make is we talk. So if I said, okay, Eugene, we're going to get Dalton started here. Treatment starts at 1999. We can break that up over time. Are you ready to go? Count to eight. This is what counting to eight feels like. Eugene, are you ready to get going?
- [50:19]
Eugene Shotsman
That is a. That feels uncomfortable, but you're absolutely right. Like, let them process now. And you're doing that, by the way, while you've got the mom in front of you and the dad on the phone.
- [50:30]
Dr. Brianna Roo
Yep.
- [50:32]
Eugene Shotsman
And you're just playing the game to see who. Who speaks first.
- [50:38]
Dr. Tanmay
By the way. Same thing happens with Price. Sometimes a staff member or doctor would talk about, quote the price, and they'll be like, it's $3,000, by the way. You're gonna get all this stuff. And by the way, there's a. There's a money back guarantee, and you're starting to lose.
- [50:54]
Eugene Shotsman
Oh, yeah. The second that you make and it's not even in what you say. It's the tonality of apologizing for the price that automatically creates the, I guess we'll call it the cognitive dissonance between this is valuable and it's not valuable. Right. Like this is, this is, this is expensive. But maybe it's not that valuable if they have to apologize for it in their tonality. Not even the words that they say. Just the confidence with which you deliver the price. Going back to your kind of man in the mirror comment earlier. But okay, so Brianna, back to you. So then they just what, like say.
- [51:30]
Dr. Brianna Roo
Okay, yeah, what else are they gonna say? I mean, what they can say. They can say, let me, you know, let me take some more information and think about it. That's great. So, and I kind of. And I, I push on it a little bit. Okay. So they either will do it or they say, let me think about it and we'll put another appointment on the book if they need to think about it.
- [51:58]
Eugene Shotsman
How far out?
- [51:58]
Dr. Brianna Roo
So we don't actually also call follow up visits, follow up visits or evaluation visits because follow up means free. So call them evaluation visit.
- [52:08]
Eugene Shotsman
So do you charge for the evaluation visit?
- [52:12]
Dr. Brianna Roo
It depends on if I. Oh, shit, I just said it depends.
- [52:15]
Eugene Shotsman
Yeah, yeah, get the diaper.
- [52:20]
Dr. Brianna Roo
If they're really pushing back, I'll say, let's just see where they are in three months. And yes, I do charge for that visit. If it's something where I know that they're right there, then, hey, we're going to set you up for your contact lens fitting ortho K evaluation here in a week. Tamara will get you set up at the front. And what I want you guys to hear on this call, the confidence that Eugene has, the confidence that Thanh has, the confidence that I have. It comes because we are all readers. What Thanh was talking about. I know exactly what books he's reading, what Eugene's talking about. I can tell you what books he's reading. You can probably. Both of you guys know books I'm reading, right? So Ton was doing a little gap selling in there. Eugene was throwing a little to sell as human in there. Eugene also likes this book, story brand 2.0 in there. There's some Dan Martell stuff going on in here.
- [53:18]
Eugene Shotsman
Yep. I, I heard you doing Dan Martel very quickly. So I kept waiting for, I kept waiting for one of you guys to say when, when someone says I need to think about it, like, that's great and so good. So what are you going to think about?
- [53:39]
Dr. Tanmay
Or if they say, I need to talk to your husband, say, oh, well, what questions would your husband have? And then they say, what do you.
- [53:45]
Eugene Shotsman
Think your husband would want your kid to get more myopic? More myopic over the years? Like, is that what you're saying? They would want your kid to have worse vision and possibly horrible side effects? Yeah.
- [53:56]
Dr. Brianna Roo
Yeah.
- [53:57]
Eugene Shotsman
Is that what you're saying?
- [53:57]
Dr. Brianna Roo
What else you're hearing too, in this conversation, guys, is reps. We've done the reps. Yep. We've done the work. We can spit the data.
- [54:08]
Eugene Shotsman
Yeah, well, and it's the, the other part of it, of course, gets reinforced. And this is where the man in the mirror kind of conversation happens is when you have the happy patients, right. When you have the testimonials, when those kids are like, when the parents are thrilled for their kids, when the kid, when you're seeing the results and when you, when you know you've changed lives and your staff knows they've changed lives and you get the confidence to do it again because you feel good about it.
- [54:36]
Dr. Tanmay
That's right.
- [54:37]
Dr. Brianna Roo
And I know that this may sound like it's just myopia. Guys, I get it. Like it's not childhood cancer and it's not all these bad things. And Todd and I are not saying that you treat every kid, that they're going to be a minus 12. That's not what we're saying. What we're saying is you give the parents the option because if they don't hear it from you and then they come into toner, my chair, the conversations we have to have now are different that you could have easily had.
- [55:08]
Eugene Shotsman
So let me ask you this, your money, you both are pretty unapologetic about the out of pocket treatment costs, are you?
- [55:18]
Dr. Brianna Roo
I didn't go to optometry school for free.
- [55:22]
Eugene Shotsman
Fair enough. But are you seeing more resistance for high ticket purchases over the course of the last, let's call it six or eight months? We're seeing a bunch of consumer data that showcases that patients are a little bit more tight fisted than they were six or eight months ago. Are you seeing that in your chair?
- [55:46]
Dr. Brianna Roo
I'm not.
- [55:47]
Dr. Tanmay
Not, not yet. We have not. Our practices are up, you know, 20, 30, 40%. But that's because we're growing. Also on the page, you know how many patients we're getting. We have a good marketing engine and a referral network that we have. That's just crushing it. But I'd say the revenue per patient for the closing, for vision therapy, for instance, as a, as A side example is down this year than last year. And so there are some things where I have the. I feel like there has been some economics macro but for the most part in optometry, one thing that we're great about, and we actually studied this back in 2020 too when we're looking at when we were afraid about our so at Triass Eyes we've got clinics that only do myopia. That's it. So and Brianna, you mentioned Maria Liu. She's one of our offices. She only does myopia at our trial size clinic in Pleasanton, California. There's no other source of revenue. The good news that what we find with myopia is that it's fairly resistant, the price is inelastic to demand and even in recession, parents still will pay for their child's vision, care and other things that the kids need. They got to make it work for their kids. And so overall I feel like our industry is fairly resistant and it hasn't been too much of a problem over the last six months. I think if you're selling commodities though, like you're selling product glasses and Gucci frames, I think that probably has taken a hit, but not in our. What we do is we, we kind of don't do very much of that personally. So it hasn't been a big issue.
- [57:22]
Eugene Shotsman
Yeah. And brief for you as well, right?
- [57:25]
Dr. Brianna Roo
Yeah. And I think you just have to make sure that you're keeping everything convenient. So I'm going to do a selfish plug for like things like Dr. Contact lens and Optify and you, you give yourself the chance. So if your Capture rates at 70%. Did you graduate optometry school at a 70% maybe. Is that a good capture rate? No. Are you doing things to plug the leaky bucket? Are you investing in time with your staff? So again, patients are leaving because we are confusing them.
- [58:02]
Eugene Shotsman
So let me ask on that front, what are your top three tools? And I think you've said a few of them already, Brianna. But I think it would be helpful for people to hear what are the top three things that you use that help you and by the way, is financing one of them for either of you that help you close more patients and what does it look like? What have you found that's ultimately helped to reach that next level of success? And beyond the closing conversation, what is it? Brave first?
- [58:36]
Dr. Brianna Roo
Yeah, mine is definitely offering things like care care credit or sun bit so you can actually back out of the conversation if they need to and they need to break it out over time. My Favorite things. One is Acumetra. I full disclosure, I'm on their board. I been using it now for six months. I'm fast at this pitch. The elevator pitch, we like to call it. It's really. It's honestly caught up another minute or two and the examine when you're busy, that's big, right? Because they can actually print out the report. It shows them where they are, where they're headed. And then I even say, okay, you've been in this treatment now for three years. Let's do a look back, see where you were. My other favorite tool is my axial length. Hate it or love it, right? I have the DGH scanner and I also have the lens star. Why I love the DGH scanner is I put a magic drop so I numb the kids. And I can get this on most of my four year olds. But I do it myself because I know what kind of patient I have. So I'm not just looking at the patient data like eye growth or axial length. I'm looking how are they sitting? How is mom hovering? How is the patient meaning like the patient sitting in your chair? If I can get that scan, I'm talking contact lenses. I'm not even presenting atropine. So that's my other thing. And again, you just have to. You have to have the equipment. So we have. We do a topography on everybody and then your pamphlet. My other favorite thing is we take a Polaroid picture of every single kid. Yes. With their consent. But everybody walks by a wall of kids. Eugene, you guys see kids here? Why yes, we do. Number one referral source.
- [60:19]
Eugene Shotsman
Nice. That's awesome. That's great. What a good tip. That's awesome. Thanh.
- [60:24]
Dr. Tanmay
Yeah. For me, tools front to back is so mostly at triage eyes. Right. So for the. I'll give an example some marketing to get them into the chair first. And I'll talk about some sales stuff. So there's this great marketing company called Nashville Strategic Group that triassize.
- [60:41]
Eugene Shotsman
Oh, I've heard of it.
- [60:42]
Dr. Tanmay
They're fantastic. We use them at all 70 locations to help drive Google Ad campaigns, build SEO, get them in that snack pack on Google and so that. So that's where I'm writing my check right now. Ton that 002% ends up being like 20%, you know, so natural Strategic Group to organize our practice. Because if you show up and you're a nice optometrist to your patients, you will have a $1 million practice. But if you want to get the 3, 5, $10 million practice you needed Some systems and scale and operational support. And this other group we've used before is called the Power Practice. They've been pretty good with that too. And so the national Strategy group, Empower Practice Instrumental to Success at Trios Science in all of our practices, in fact, a lot of our clients are Power Practice clients. The next thing is the tools we use. Similar to Brianna, you know, at Trios, we've got, you know, axle length graphs and projections and we've got QR codes that people scan and drip markets them videos over time to market and educate the mom and dad about what's going on. And yeah, besides that, you gotta measure axial length, you know, don't just dabble.
- [61:49]
Eugene Shotsman
And then in terms of conversion rate, is there anything that you do as follow up or as anything that you know, especially you mentioned, I'm curious because Brianna doesn't do this, but you do. In between the patient leaving for the primary appointment and the patient walking in for their myopia consulting, is there anything that you mentioned you guys do some sort of follow up? Is it a structured tool or anything like that?
- [62:14]
Dr. Tanmay
Yeah. So Brianna is really good about the scripting, but I'm more of a process guy because I'm actually not in patient care very much. So I'm trying to fix a process at another practice, not even mine. One thing that we recommend highly is the follow up process post consult that doesn't close. So let's say you are batting 50%. The other 50%, you can improve it to 60, 70 if you have a structured follow up sequence. What we usually recommend is a series of phone calls, probably at least five touch points. It goes back to, you know, we've all heard the rule of seven and other things like that, but some parents just get busy and they actually mean to follow through, but they just need to be nudged and nudged and nudged. What we found is we're big data geeks at Treehouse is that if they say no though, eventually they say, you know what? No. What we find is very helpful is even in that situation of no, we've offered like hey, just come on back for like a freebie axial length check in three to six months, it's a freebie. So our close rate of that freebie is usually high. Cause it's a freebie. And the vast majority when they come back, I think the last Data point was 82%. The ones that show up to that freebie, unfortunately the patient gets worse and the close rate is actually quite high when they were initially unknown. And so that's been another tool that we've used on the follow up sequence to help kind of plug up the leaky bucket.
- [63:34]
Eugene Shotsman
Somewhat interesting. That's great, you guys. We probably could talk about this for another three hours. I think our listeners probably prefer if we end the show usually at the hour mark. But we may. I'm going to open it up to the group of listeners. We may continue this conversation. I may collect some questions for the two of you because you guys are just a powerhouse of knowledge and. And I had maybe six or seven more questions that I had prepared that I never got a chance to even ask you. So we may do this again. I'm going to turn it over to the audience and say if you want to get a panel, get the panel back together, get the band back together. I'm happy to do that and I'm so grateful for both of your participation. I know your time is super valuable. Thank you for everything that you do and thank you for sharing your insights, your knowledge and your genius with the listeners here.
- [64:26]
Dr. Tanmay
Appreciate the time.
- [64:31]
Eugene Shotsman
Sam.