Navigating Financial Challenges with Dr. Rhue

Adam: Welcome back to another episode of 2020 Money, Dr. Brianna Rue! Thank you for joining us today.

So, I find myself wondering which of your many roles to introduce first: co-founder of DrContactLens.com and TechifEYE, or Optometrist at West Broward Eye Care Associates. It seems your focus might shift depending on the project at hand, doesn’t it?

Dr. Rue: Well, I’ve recently transitioned from identifying primarily as an Optometrist to embracing my role as a tech entrepreneur. My work with DrContactLens and TechifEYE allows me to extend my reach and contribute positively to our community and colleagues, and, ultimately advance our profession.

Adam: That’s fascinating. Our conversation today gained traction due to our collaborative work on the ODs on Finance panel a month ago. I’m always eager to host guests who are dedicated to helping practice owners enhance the patient experience in every aspect. As the commoditization of various services, including optometry, continues, it’s crucial to not only offer excellent service but also create a memorable experience for patients. This approach is vital for attracting and retaining patients, considering the increasing awareness and expectations of today’s informed consumers.

Adam (Continued): Perhaps I’m getting ahead of myself, but I believe you share this perspective. Instead of making assumptions, let’s start from the beginning. You began your career providing primary patient care as an Optometrist. How did the journey evolve to entrepreneurship and the inception of DrContactLens.com?

Dr. Rue: It’s quite a story. Jen Tabiza and I attended optometry school together and purchased practices simultaneously. Engaging in weekly discussions about enhancing the patient experience, we brainstormed ideas while operating bicoastally—I’m based in South Florida while she’s in LA. This arrangement required late nights for me and early mornings for her, but we managed to build our company despite the time zone challenges.

The initial idea was simple: we wanted to facilitate a seamless process for our patients to order contact lenses from us. We recognized early on that contact lens patients are invaluable to our practices. However, every time we handed out a paper copy of a prescription, it felt like we were giving away $300 to another store.

Dr. Rue (Continued): The goal was to meet patients where they are and offer them a sense of control they desire. It was disheartening to hear patients compliment the quality of their eye exams but choose not to support our practices. We, as optometrists, need to rise above this challenge. I often say that we, the disrupted, can become the disruptors if we take the initiative to implement changes for the future.

The inception of Doctor Contact Lens was driven by our desire to allow patients to order their contacts from us with the ease of Amazon. We had the prescriptions and wanted to facilitate direct uploads to assist staff in making informed decisions and utilizing their time efficiently.

Adam: That’s a compelling start. As an entrepreneur myself, I understand that building tech from the ground up is a unique and often challenging experience. For our listeners who might be multitasking right now, could you briefly describe the experience of using Doctor Contact Lens from both the patient’s and office’s perspectives?

Dr. Rue: Certainly. The journey with Doctor Contact Lens begins when a patient comes in for their Contact Lens exam. The patient’s demographic information and contact lens prescription are uploaded directly from the EMR to Doctor Contact Lens. The staff can then easily place an order for the patient’s annual supply, which will be shipped to their home. This process not only saves time but also enhances the patient experience by providing convenience and efficiency.

Dr. Rue (Continued): From the patient’s perspective, the process is intuitive and straightforward. I realized we were onto something special when my father, who is not tech-savvy at all, successfully placed an order through Doctor Contact Lens. He received a text message link, followed the prompts, and had his contacts delivered in two days. This ease of use is crucial for ensuring all patients, regardless of their comfort level with technology, can benefit from our platform.

For instance, if a patient purchases a six-month supply, our system sends them an automated reorder reminder in six months. This proactive approach not only facilitates convenience for the patient but also ensures that the practice retains the sales instead of losing them to online competitors. It’s not just about price; it’s about convenience. If a patient insists on comparing prices, we provide a digital copy of their prescription along with their vision plan benefits and rebate information, allowing them to make an informed decision.

Dr. Rue (Continued): The patient can then choose to order through us or go through a lengthy process on a different website. The convenience we offer often wins sales 90% of the time. We also send text messages to patients, which is crucial as emails often get lost in crowded inboxes. Most of our orders are placed after 9:00 PM, showing that patients value the ability to order at their convenience, even outside of regular office hours.

Adam: That’s fascinating. Having access to data like when a patient clicked on the link, how many times they clicked, and how far they got in the buying process before potentially abandoning their cart provides invaluable insights. That info allows clinicians to understand and improve the patient’s journey, enhancing their overall experience and increasing the likelihood of successful transactions.

Adam (Continued): It’s amusing to consider the perception of price and convenience with platforms like Amazon and Costco. These companies have crafted unique buying experiences, yet not everything offered is the cheapest option available. However, the perception and experience often lead consumers to believe they’re getting the best deal. For instance, shopping at Costco might not save you money on every single item, but the overall experience and the bulk buying option create a perception of savings and value.

Dr. Rue: Absolutely, Adam. It’s essential for doctors to understand that it’s not always about price. While many patients claim price is their primary concern, often it’s more about convenience. That’s why platforms like Amazon are so successful; it’s not necessarily that they offer the lowest prices, but they provide unmatched convenience.

Dr. Rue (continued): We’ve also shown doctors that discounting isn’t necessary. When you discount, you’re not only affecting your bottom line but also inadvertently doing a disservice to your patients and staff. For instance, if you’re constantly discounting, you might find it challenging to adequately maintain your practice or give deserving employees a raise. It’s crucial to understand that we shouldn’t position ourselves at the bottom of the pricing barrel.

Here’s a funny story about Costco. Back in 2010, I created a price comparison chart showing the cost difference between getting contacts from our practice versus Costco. Surprisingly, getting contacts from Costco turned out to be double the price! 

So, in reality, getting contacts from Costco was not as cost-effective as patients might have believed. This example illustrates the importance of considering the overall value and convenience, not just the price of the product itself.

Adam: Absolutely, and the time factor is crucial as well. Time is a valuable resource, and if patients have to spend extra time going to a store to pick up their contacts, that’s an additional cost to consider. Your platform seems to address these issues effectively, providing convenience and value to both the practice and the patients.

Adam (continued): Now, let’s delve a bit deeper into the numbers. You mentioned saving 300 hours of staff time earlier. Can you elaborate on that and share how implementing Doctor Contact Lens has impacted practices in terms of top-line revenue, capture rate, sales, and net income?

Dr. Rue: So numbers are an interesting thing. Unfortunately, many ODs don’t really know their numbers; they’re somewhat in the dark. And to be honest, I don’t scrutinize all of my numbers either, so I don’t want to seem like I’m criticizing others unfairly.

We aim to shed light on a couple of crucial metrics: your annual supply rate and your capture rate. When I ask a doctor about their capture rate and they respond, “Oh, we capture 90% to 95% of our sales,” I find it optimistic considering the industry standard is 70%.

Let’s put a number on this for clarity. If you have 1,000 contact lens patients and your capture rate is 80% (giving you credit here), that still means 200 patients walked out of your door without making a purchase. You didn’t even give yourself a chance to capture those sales. Now, considering the 800 patients you did capture, what is your annual supply rate for them?

Dr. Rue (Continued):Understanding these numbers is vital. Many ODs are content with making $120,000 to $150,000, but there’s no reason why we all shouldn’t be making $250,000 to $300,000 by implementing small changes. We are willing to invest $45,000 to $50,000 in an OCT, yet we hesitate to spend $4,000 to pursue $200,000 of revenue. There seems to be a fear or reluctance to invest in areas that can significantly boost revenue.

It’s been a revelation transitioning from being an OD to selling to ODs. It’s surprising to learn how challenging it can be to convince my peers to adopt practices that could increase their earnings substantially. We’re literally, I think, a little scared. 

Adam: I think part of it is it’s a sacred cow, or not really a sacred cow, but it’s just become the norm. When practice owners think about ways to increase top-line revenue, one of the low-hanging fruits often mentioned is focusing on photo capture rates. There are various reasons why some don’t bill insurance for this, leading them to invest in equipment. This equipment is often prominently displayed at trade shows, marketed as essential for practices. For multiple reasons, these pieces of equipment have become go-to places to spend money.

Adam (Continued): You’re talking about reinventing the buying process from both the OD and the patient’s perspective, which is fantastic. From a disruption standpoint, there’s a famous quote by Henry Ford when he was building the Model T. When asked what people wanted, he said, “If I had asked people what they wanted, they would have said faster horses.” Steve Jobs referenced this quote when deciding to get rid of the keyboard on the iPhone, which was a significant point of contention between him and the product designer, Joni Ive.

Adam(Continued): This conversation reminds me of the historical battle between BlackBerry and iPhone. BlackBerry was hesitant to remove the keyboard, while iPhone was bold in their decision, leading to their eventual success in the market. Similarly, in the context of optometry practices, it’s essential to think outside the box and not just do things the way they’ve always been done. We’re trying to quote Wayne Gretzky here, right? Go where the puck is and go where people are wanting to be. By reinventing processes and being willing to adopt new strategies, practices can significantly enhance their revenue and improve the patient experience.

Dr. Rue: I believe they understood, Adam. If every OD signed up for Doctor Contact Lens tomorrow, we could significantly challenge these online platforms. This impact would primarily be based on the statistics of your annual supply and your capture rate. It’s crucial to understand that all of us have a very leaky bucket, and our contact lens patients are foundational to how we build and sustain our practices.

Dr. Rue (Continued): The reality is, many patients are slipping through the cracks, and we’re losing potential sales and revenue every day. By improving our capture rates and ensuring that more patients purchase their annual supply of contact lenses from us, we can retain more revenue within our practices. This approach not only supports the financial health of our practices but also enhances the patient experience by providing them with a convenient and efficient service.

It’s about understanding the dynamics of patient retention and sales capture. If we can tighten the leaks in our service delivery and sales process, we stand a better chance of not only retaining our existing patients but also attracting new ones. The convenience and efficiency offered by platforms like Doctor Contact Lens play a pivotal role in this process, helping us provide superior service while capturing the sales that would otherwise be lost.

Dr. Rue (Continued): Furthermore, it’s not just about retaining patients; it’s also about understanding the value each patient brings to the practice. When we talk about the leaky bucket analogy, it’s essential to recognize that not all leaks are equal. Some patients contribute significantly more to the practice’s revenue than others, so losing them to online platforms or competitors can be particularly damaging.

That’s why it’s crucial to have a system in place that not only helps retain patients but also maximizes the revenue generated from each patient. Doctor Contact Lens is designed to do precisely that. By making it easier for patients to purchase their annual supply of contact lenses directly from their OD, the platform helps practices capture sales that would otherwise be lost, while also providing a convenient and streamlined experience for patients.

Dr. Rue (Continued): And it’s not just about competing with online platforms on price. We have to offer something more – convenience. Patients are willing to pay for convenience. If they can reorder their contact lenses with just a few clicks and have them delivered directly to their door, they are more likely to order from us, even if the price is slightly higher than online competitors.

This convenience factor is a game-changer. In today’s fast-paced world, people are willing to pay a premium for services that make their lives easier and save them time. As optometrists, we need to leverage this trend to our advantage. By offering services that are not only high-quality but also convenient and user-friendly, we can retain more patients and capture a larger share of the market.

Dr. Rue (Continued): Think about it: if a patient can easily reorder their contact lenses through a platform that’s directly linked to their optometrist, they’re likely to choose this option over ordering from a third-party online retailer. This choice is especially true if the process is smooth, quick, and hassle-free. That’s what Doctor Contact Lens offers. It’s a win-win situation for both the practice and the patient.

We’re going direct to the manufacturers and saying, “Oh, they’re giving us a 2% rebate here, or whatever it is. Or free.” This direct approach allows us to pass on savings to the patients while maintaining healthy margins for the practice. It’s a strategic way to offer competitive pricing while ensuring that the practice remains financially healthy and sustainable.

The technology we’ve built is genuinely remarkable, and the excitement from both ends is palpable. The joy and satisfaction derived from seeing the technology function seamlessly are shared by us and the users alike. The immediate value and efficiency provided by our service can be realized with just a single click, making it perplexing when individuals hesitate to sign up.

Adam: Absolutely, it’s fascinating to observe the difference in patient behavior when it comes to annual and semiannual sales. We know that patients often try to extend the life of their contact lenses, sometimes beyond the recommended usage period. With this in mind, how frequently do you send reminder texts to patients? How do you manage the communication process to encourage timely and necessary purchases without being intrusive or pushy?

Dr. Rue: Communication with patients is indeed a delicate balance. We aim to be consistent and timely without being perceived as invasive or aggressive. The reminder texts are strategically timed to align with the typical usage patterns of contact lenses. For instance, for patients with a six-month supply, we don’t wait for the entire six months to elapse before sending a reminder. Instead, we initiate communication a bit earlier to account for those who might have used their lenses more quickly than expected.

The frequency and timing of reminders are also adjusted based on the feedback and response rates from patients. We closely monitor how patients interact with our reminders and use this data to optimize our communication strategy. The goal is to be helpful and prompt without causing annoyance or discomfort to the patients.

Dr. Rue (Continued):It’s crucial to understand that every patient is different, and their needs and behaviors vary. Hence, our system is designed to be flexible and adaptive, providing personalized communication that resonates with each patient while encouraging them to make necessary purchases in a timely manner.

Adam: Is there a practice that’s not a good fit for this? I mean, unless you’re not dispensing contact lenses.

Dr. Rue: Essentially, unless a practice is not dispensing contact lenses, this system is a fit for every single office. It doesn’t matter if you’re a startup location; in fact, we have special deals for startups. If you’re a new practice or have under a certain number of patients, you can get started with Doctor Contact Lens for a very low amount. This approach is particularly beneficial for new practices as it sets the tone for how you want patients to interact with you from the beginning, which pays off significantly in the future. So, for startup locations, it’s highly recommended to get on board with this immediately. It should be one of the first steps you take.

Adam: Dr. Rue, I’m curious about the inception of TechifEYE. Could you share with our listeners how this platform came to be and how it assists practice owners in integrating technology into their practices efficiently?

Dr. Rue: Certainly, Adam. TechifEYE was born out of necessity. As we were developing Doctor Contact Lens, we realized that there were many fantastic tech tools available for optometrists, but there was no straightforward way for doctors to discover and integrate these tools into their practices. We found ourselves wishing for a platform where we could easily find vetted tech tools designed for optometrists.

So, in July, Jen and I were heading to Vision Expo. It was going to be our first time having a booth on the floor. We were thinking about the optometrists attending the expo, entering this gigantic hall filled with myriad booths and not knowing exactly where to go or who to talk to. Often, ODs might shut off after the first sales pitch and then just wander around the exhibit hall, somewhat aimlessly.

Dr. Rue (Continued):We wanted to create something to engage and awaken ODs. When you take three days off from your practice, maybe even flying your team out with you, you’re there to do business. It’s crucial to understand that you’ve closed your practice for these days to be present at the expo. So, we talked to various technology companies, and many of us quickly came together. These discussions often turned into therapy sessions for us, pondering why the industry isn’t changing and where we are heading.

This collaboration led to the creation of a “therapy group” for startups in Optometry. We embarked on a patient experience journey, exploring everything an office needs on the technology front. From a great website, live chatbot, ordering system for contact lenses and glasses, to text communication with patients and specialty offerings like neurolens and Save the Sale frame line. We brought twelve companies together, all very vetted, joining forces to offer a comprehensive solution.

Dr. Rue (Continued):We organized a track through the expo for ODs to follow, helping them understand what each company is doing. This guided experience culminated in a high-level lunch where deeper discussions and connections happened. I was part of BNI (Business Networking International) for a long time, serving as president for multiple years, and the format of this expo experience was somewhat inspired by the structured yet collaborative environment of BNI.

That’s when the idea for TechifEYE struck. We envisioned a platform where ODs could discover the best tech tools for their practices, learn how to implement them, and understand how these tools could enhance the patient experience and improve practice efficiency. TechifEYE is designed to empower practice owners to make informed decisions about the tech tools they choose to implement, ensuring they select options that align with their practice goals and patient needs.

Dr. Rue (Continued): I was part of BNI, Business Networking International, for a significant portion of my life, serving as president for multiple years. During my tenure, I consistently won the sales pitch because I would sing and make my presentations memorable. This experience was foundational for creating TechifEYE.

TechifEYE was born out of a necessity for change and innovation in our field. One of the primary goals was to awaken our EMR (Electronic Medical Records) companies. These companies often inhibit innovation by not allowing new and beneficial technologies, like ours, to integrate with their systems. They sometimes make business decisions on behalf of the users without the users’ knowledge or consent, hindering the potential for progress and improvement in patient service and care.

Dr. Rue (Continued): These EMR companies need to understand that they are the ones holding us back. We need open APIs and communication tools to foster innovation and improve the services we offer to our patients. The industry needs to move forward, and for that to happen, we need to change our approach and adopt new, efficient technologies that benefit both practitioners and patients.

The second objective of TechifEYE is to assist optometrists in decision-making and implementation. Often, professionals attend conferences, get exposed to a myriad of ideas, and return to their practices overwhelmed, not knowing where to start with the implementation of these new concepts. TechifEYE guides them through the process of initiating and integrating these projects monthly. Another crucial aspect is staff involvement and alignment with future trends. When staff members seek a raise, it’s essential to discuss how this can be achieved—either by seeing more patients or increasing revenue per patient.

Adopting TechifEYE can only lead to positive outcomes for all parties involved.

Adam: That sounds like an invaluable resource for practice owners looking to stay ahead in the tech curve. With the rapid pace of technological advancement, having a platform that helps navigate through the myriad of available tools is crucial. How has the reception been among the OD community?

Dr. Rue: The reception has been overwhelmingly positive. Practice owners appreciate having a resource that simplifies the process of discovering and implementing new technology. Before TechifEYE, many ODs felt overwhelmed by the sheer volume of tech tools available, and they often didn’t know where to start. With TechifEYE, they have a curated list of vetted tools at their fingertips, along with guidance on how to integrate these tools seamlessly into their practices.

What we’ve noticed is that many practice owners are eager to embrace technology, but they need support and guidance to do so effectively. They want to ensure that the tools they adopt will genuinely benefit their practice and their patients. TechifEYE provides the clarity and confidence they need to move forward with technology adoption, helping them enhance the patient experience and improve practice efficiency.

Adam: You are obviously one that doesn’t necessarily wait for someone to fix something. You identify a need and you figure out, you know what, there’s a better way to build this. So, what advice would you give to an OD contemplating practice ownership, but they’re scared or nervous to take the leap into business ownership?

Dr. Rue: Taking the leap into business ownership is indeed a significant decision, and it’s natural to feel apprehensive. However, it’s crucial to understand that as ODs, we’ve already taken substantial risks to get where we are. We’ve invested time, money, and effort into our education and training. Taking the leap into business ownership is essentially doubling down on ourselves and our capabilities.

If you’re contemplating practice ownership, my advice is to not let fear hold you back. Reach out to mentors and individuals who have walked this path before. Learn from their experiences and gather insights that can guide you in your journey. The longer you wait, the longer it will take for you to realize your dreams and achieve your goals.

Dr. Rue (Continued):) I’ve always known that I wanted to be a practice owner. Growing up with a father who was a small business owner, business felt natural to me. I understand that I’ve been fortunate to have the tools and resources to invest in myself and move forward. As ODs, we need to be willing to take risks again, invest in ourselves, and push forward despite the fears and uncertainties that accompany entrepreneurship.

Adam: So, what’s the biggest financial lesson that you would go back and teach your younger self?

Dr. Rue: Growing up with my father, I was fortunate to learn early on about the rule of 72 and the concept of doubling down. However, the most significant financial lesson I would impart to my younger self is about handling student loan debt. It’s like a looming cloud over your head, causing undue stress and sleepless nights. I wish I had been more patient and gracious with myself, understanding that it would eventually get paid off as long as I followed a sound plan.

Student loan debt can feel like a ball and chain, especially when it’s all you can see. It’s crucial to cut that chain and compartmentalize the debt, allowing yourself to move forward. Once I mentally compartmentalized my student loan debt and truly understood it as an investment in my future, I was able to proceed with confidence and focus on building my career and practice.

Adam: That’s a valuable lesson indeed. We’ll conclude our conversation here. For our audience, we’ll provide links to everything we discussed today, including the website and TechifEYE demos. Brianna, if there’s anything else you’d like to share with our audience, please feel free to send it over.

Dr. Rue, thank you for sharing your insights and the valuable work you’re doing with Doctor Contact Lens and TechifEYE.

To our listeners, thank you for joining us on this episode of 2020 Money.