Resources to Remember
All the recent updates on myopia summarized in one article.
The International Myopia Institute has been publishing excellent consensus papers on myopia for about a decade. These White Papers are jam-packed with research and clinical insights. For those of you who'd rather not read all those papers but would read a summary of those summaries, check out Review of Optometry's Take-home Messages from the Latest IMI White Papers.
3 books from which every optometrist would benefit.
I ramped up my reading this summer. It was wonderful. Here were my favorite reads, moving from ground-level practice to the bigger questions underneath it:
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Protecting your practice starts with understanding your biggest risks.
PPP Practice Risk Assessment helps identify potential compliance, billing, HR, and operational gaps that could be impacting your growth and profitability — before they become bigger problems.
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Articles to Apply
Age of onset of ocular allergy predicts complications more than severity.
Allergy patients who've had it since childhood may be a different clinical population than adults who develop it new. In this 5,030-patient retrospective, childhood-onset ocular allergies carried dramatically higher odds of keratoconus, limbal stem cell deficiency, and steroid-induced glaucoma compared to adult-onset disease. The practical takeaway: age of onset, not just current severity, should shape how aggressively you screen for and monitor these complications. Cornea
Quotes to Consider
"Choosing responsibilities is not about seeking public credit for good deeds or doing penance to atone for bad deeds. It's not about fitting into societal expectations. It's not about acting out of guilt. It's not about giving money to good causes (though you might well do so), and it's certainly not about applause for one's philanthropy. It's about responsibility, not recognition. It's about choosing to give of your encodings, fire, and resources toward something you believe must be done and holding yourself to personal account for it." -- Jim Collins, What to Make of a Life
My Observations
If you pulled off a Julie Helmus, OD–style summer sabbatical, what 2-3 metrics would tell you whether your practice was thriving, surviving, or in trouble?
Call it the desert island test: stripped of daily access to your practice, what numbers would let you rest easy and keep you adequately informed?
For years, I've promoted Revenue per OD Hour as the single best metric for a practice that's both robustly medical and optical (i.e., comprehensive). I won't rehash the full case, except to say there's still no better holistic, all-encompassing number for tracking how productive you are with the time you have in clinic.
Second number: total encounters. Nearly seven years into building my practices, I rest easier knowing how many patients we saw last week and how many are on the schedule for next week than I do watching any single revenue line. We count every encounter, revenue-generating or not. If a patient sits in the chair because they had a reason to be there, it counts. Each one is an opportunity to help someone, so I track it.
My third and final metric is one that I recently learned from Eugene Shatsman and Jamie Rosin in their new book, The Eyecare B.O.S.S.
As I’ve admitted here in the past, I have an allergy, a Type I hypersensitivity to hype. And I admit, when I heard about this book and the hype surrounding it, I was skeptical.
But knowing my skepticism radar has been proven wrong before, I bought a copy and read it.
It's excellent. If you’ve read Traction but never quite implemented it, this book will make that implementation so much easier.
My one real critique: it leans optical-dominant in places, treating medical management, dry eye, and myopia as subspecialties (aka optional) rather than as the core of comprehensive care. That's a gap Comprehensive Optometry Simplified was built to close and probably a reason Chris and I should be collaborating with these guys.
The number I keep coming back to from their work is Exam Only %.
Exam Only % should be calculated at the end of each day or first thing the next morning. It asks: of the patients who received a refraction or comprehensive exam, how many left without a same-day optical order or a medical eval scheduled within a year?
Shatsman and Rosin's data puts most practices at 30-50%. The target is under 30%. I don't know a better single number for telling you whether you're actually capturing your patients for both optical and medical care. In other words, this could be the essential comprehensive optometry metric we've needed.
So there's your answer. You're six weeks into a Yosemite sabbatical, and your office manager texts you three numbers from last month: Rev/OD Hour, # Encounters, and Exam Only %. That's all you need to know to tell you if you’ll have a practice to come back to.