1. singing really really good
2. having a personality where people say “hey! I like her/him!”

They sing their hearts out and try to impress watchers to vote for them. If no one likes them hopefully some hotshot producer gets a whiff and offers them a record deal.

Anyway, thinking about musicians got my thinking about an article I read. It said that to make a livable wage as a music artist you really only need 1000 true fans. These fans will drive 300 miles to hear you play, buy anything and everything you make because they just LOVE you. They’ll buy T-shirts with your quirky saying on them and facebook stalk you like no other.

Thank goodness optometrists are not musicians. Optometrist probably don’t need a 1000 raving fans but the point of this post is that you should have a nucleus of insanely loyal patients. These patients come on time, listen to your recommendations because they know you truly care for them, and recommend the heck of you.

In return you treat them like family, well, at least the good part of the family and not the crazy Uncle Steve who keeps asking for money. This is how you build a practice.

“Who you are is speaking so loudly that I can’t hear what you’re saying.”

I love this saying because it goes back to how to make meaningful change in your life, to create lasting relationships, and to communicate more effectively. As long as I have created consistent principles in myself, then the day to day interactions and word choices pale in comparison to the internal roadmap I follow.

A book I am reading is called “7 Habits of Highly Effective People.” I am only 30% done with it but one of the driving points is that you cannot change another person without first changing yourself. I can’t tell my staff to treat people fairly, kindly, and with legendary customer service that you see at the successful businesses like Nordstrom, Disney, and Zappos and expect them to just turn a switch and start doing it.

If I want to make my optometric staff change, I myself have to become a shining unwavering example day in and day out the model I want them to become. This can’t happen overnight, but with time it will become infectious.

Holy swollen optic nerves batman! Along with VF loss. Referred the patient right away to get emergent MRI. The neurologist did the MRI immediately, which luckily came out negative. Patient is scheduled for a lumbar puncture next Friday and I am waiting for news.

The patient stopped by my clinic after seeing the neurologist and gave me one of the biggest hugs I’ve ever gotten because she thinks I might have saved her life. Maybe I did, and it was a great feeling!

Update:

Patient came by the office. Lumbar puncture revealed elevated CSF pressure. I asked the patient if she was taking an oral med now like Diamox and she was floored: saying “Dr. Mai, are you a neurologist on the side, that’s exactly what the neurologist put me on!”

Neurologist told her that she could have went blind if I didn’t catch it and so he was impressed by her optometrist!

Personally, there have been certain summers of my life where I have hung out frequently with gym rats and nutrition nuts. Guess what happened to me during those summers? You guessed it, I worked out 3x more than I normally did and ate leaner. It was effortless. Everyone around me was doing it so it was infinitely easier to summon the willpower to go out and exercise. When my friends and I were hanging out, we talked about working out and nutrition. So it shifted my mindset towards those topics.

So if I want to make a change for the better. If I want my future self to be the person I can be proud of. I can grind away and work endless hours waging a psychological battle against my weak willpower. OR.  I can cheat. I can surround myself with people who my future self strives to be. My external environment can stimulate an internal change in mindset.

I want to become a better speaker. So I need to surround myself with polished speakers, join a club like toastmasters, and make it happen! I want to get better at fitting orthokeratology, so I am attending the orthokeratology academy meeting in Chicago next year. Seems like an obvious thing to do but sometimes common sense isn’t commonly thought of.

On Thanksgiving day, I went to west Los Angeles and donated my time and gave free eye exams to the underprivileged and homeless from Los Angeles. Other medical professionals were there as well giving medical care. The patients were mostly Hispanic, and ever so grateful to be receiving much needed care.

It really strikes me hard when I see someone who is 14 years old, and I find that their prescription is -7.00 DS and they’ve never had glasses before.

In my cohort of young ODs, we tend to get geeked up about ocular pathology. Everyone loves it. But they say the leading cause of blindness worldwide is refractive error. It’s not even close. And it is easy to see that it is the case when you care for the underprivileged. And once you correct it, I believe it can alter the course of a life.

How different would the 14 year old’s life be if she had gotten glasses (or contacts to avoid potential social stigma) at an earlier age? How much would her performance in school change? How much of her academic struggles were her fault?

Makes me wonder how many other children are falling through the cracks at no fault of their own.

My goal is to offer full scope care and always do right by my patients. It is why I chose the profession of optometry from the very beginning and I have no plans to deviate. But not everyone is like me. Just recently over dinner with 3 classmates I had this conversation:

“Nancy* (not real name), I bet you would make a great owner of a private practice! You’re smart, you’re a great communicator, and gosh darn it, people like you.”

“Naw, I’d make a bad one. I don’t have the aggressiveness and ability to lie to people to make it in business. Unlike my ex-boyfriend Jim* (not real name) who has worked with businesses, who can schmooze and be aggressive in making deals.”

First off, if you ever met ex-boyfriend Jim you’d think he’s kind of a tool.

In my mind the best businesses are obsessed in doing what is best for their customers or patients in our case. And really, what is selling? In my opinion selling is delivering solutions for our patients problems. If you deviate from this and give them things that do not help them, then I believe in a matter of time your reputation will diminish and you will lose patients because you were focused on only short term gain.

• According to the American Optometric Association, approximately 5,000 O.D.s over the age of 65 are still practicing. Their practices are either actively for sale or the O.D. is thinking about selling. This statistic is causing an imbalance in the number of sellers compared to buyers.
• Only 30% of optometric graduates are seeking private practice opportunities, according to the Pennsylvania College of Optometry’s Irving Bennett Business and Practice Management Center. This fact also adds to the imbalance of more sellers and fewer buyers.
• Private practice is perceived as being more difficult due to the onslaught of fixed-fee vision programs. This notion has created an environment in which most graduates seek employment opportunities, again adding to the market imbalance.

I think the optometry climate is ideal for a young OD to find an opportunity in private practice.

This dinner was last February.  If you are a new OD and are reading this, what are your plans?

Visit ODsOnCall.com to learn more!

Contrary to the fellow who goes to a social networking event, makes it rain with business cards and then leaves. Networking is not about trying to take advantage of others or to “get an in.”

Networking is about giving. If you realize this you’re much ahead of the game. Put yourself in another person’s shoes and think of ways you can make their life easier.

I  got a call from my classmate an hour before his informal job interview with two OMDs looking to add an OD to their staff. He got the interview through a family friend who worked at the front desk of the office, and called to ask my opinion on what types of things to say during the interview.

My bottom line answer for him was to be genuine. Don’t say anything generic like “I’m a hard worker!” but come up with specific examples. Ask good questions that you really want to know. What are the patient demographics? What do you envision my role to be? Who is currently part of the team?

As a student, networking and interviewing definitely can be scary stuff. =)

“What are you doing after graduation Sarah*?” (not real name) -me

“I’m doing a residency in pediatrics/vision therapy in order to fulfill my goal of introducing this specialty as an associate or even in my own private practice when the opportunity arises.” – Sarah

“YES!!!! GREAT ANSWER!!!” – me

I loved it! Because she mentioned something that I personally love doing in order to figure out where I’m going and why I am going there. She set goals and decided to pursue an optometry residency because it would help her fulfill her goals. 

Another friend of mine Scott (not real name) gave me this answer to the same question.

“I’m going to do a residency in primary care and then figure out what I am going to do later during my residency.”  – Scott. “I’m just applying to the residencies in Los Angeles. The VA staff doc really liked me and so I figured I’d give it a shot.”

When I hear the latter I just shake my head. Scott doesn’t have a plan. Or maybe he does, but he hasn’t adequately linked his decision to do a residency to a more longterm goal. Right now, his focus is myopic. His goal is to get a residency, nothing more. If that doesn’t pan out, he’ll start his job search.

Before you do anything, it should fit in a longterm plan. Otherwise you are just performing random acts in order to achieve success. All success requires clear planning followed by defined actions.

Which is why every optometric practice, or any business for that matter, should have a mission statement. The statement should define the longterm goals of a practice and henceforth drive all decision making. Let me give you some examples:

Recently I stumbled across this article in review of optometric business by Dr. Kathleen Andersen. (you’ll have to create an account to read the article but I think it’s very worthwhile to read some of the other great articles on that website). Dr. Andersen has introduced vascular health screenings along with her comprehensive eye examinations and I think it’s fantastic. By evaluating the carotid intima media thickness, optometrists can get a good indication on an individual’s vascular health.

Myself, I’ve recently started working with HeartSmart’s EyeCare division. Basically our goal is to expand optometry’s role as a primary health care provider by offering patients vascular health screenings. Millions of eye exams are conducted each year. In fact many Americans go see their optometrist more often than even their primary care physician!

If you think optometrists should play a bigger role in keeping patients healthy, like us at http://www.facebook.com/HeartSmartEyeCare

During my time there I get to work with Dr. Monique Nguyen, a residency trained doctor who owns a private practice in Ladera Ranch. It’s refreshing to talk to her about vision therapy and how she runs her private practice.

Working at CHOC is an awesome reminder of why I joined this profession. You have these children who are struggling in school because of significant myopia but cannot afford glasses. And many children rarely complain, quietly struggling through academics for years just because they have poor vision and can’t see what the teacher is working on in front of the classroom.

So it’s rewarding to break ground and give them their first pair of glasses. One patient (not at CHOC) but who I am following at the Eye Care Center who has a +9.50 DS Rx in both eyes proudly yelled at my last amblyopia continuing evaluation.

“I LOVE MY GLASSES!!”

Awesome.

In case you did not realize, the AOSA and AOA both have blogs where leaders post their thoughts and experiences. Here is my first blog as an AOSA blogger. I think I am the only non-former AOSA trustee or cabinet member to be invited to blog so I feel very honored!

How to refract like an OD and not a student. I realize that many optometry students and optometrists are masters at refraction, but hopefully some of my insights can help!