Why Myopia Management Needs a Federal Framework Now

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Welcome to another episode of Optometry Profits Revealed.
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I'm your host, Peter Precht.
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Today I'm with Tony Summer.
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Tony Summer has had a 22-year career in eye care.
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He started off as an Air Force Academy veteran, and there's several different things that you've gone through.
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Rather than me got diving through them, I think I'm just going to introduce you.
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Thank you so much for being here, Tony.
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Thanks for being here.
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You bet, Peter, and thank you for having me.
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I know, you know, we'll start off with where you are now, and congratulations to that you're the CEO and the CCO, uh recently promoted of Treehouse Eyes.
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Talk about the culmination of your journey getting there, but talk heavily about them right now, what your responsibilities are there, and how you guys function in the eye care environment.
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Well, Treehouse Eyes is very mission-focused on helping give children better vision for life.
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We are focused on, and no pun intended, on pediatric myopia management.
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And that covers a number of different products and therapies.
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We're agnostic on those.
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But we own three clinics where we see patients regularly.
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And we also have a large network of partners where we help them do their own myopia management programs, and we provide uh expertise, guiding, coaching, mentoring, accountability, and services to help them on their own myopia management journey.
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Our entire focus is on helping more children be seen.
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That's what we do.
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We know that that at least we're able to see something impact the you know the development of myopia.
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But at the younger ages, you know, talk about that.
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How how how are we you just mentioned the beginnings of this started in all in Audi, in audio, which I found kind of interesting.
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Um so what yeah, I what I found interesting, um, if you think through myopia management, it started as kind of I'll call it frontier science, right?
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Because we kind of don't know why we get myopic.
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Right, we know axial links involved.
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So as you start thinking about how quickly we can spot this, you've got that dynamic.
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So you've got kind of indications, and then you've got products to treat it, but nobody's starting at the beginning, right?
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So, what what I came across is something called House Resolution 2527, and um and I came across it because of advocacy by the Myopia Collective and the American Optimetric Association getting behind it.
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Now, what is House Resolution 2527?
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It provides a federal framework for vision screening and testing at a very early age.
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And why is that interesting?
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Because it is fashioned after a similar law that was passed in Congress and very importantly had some budget around it and a regulatory framework for auditory.
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So if you do some more digging on this House resolution 2527, you can find that auditory maybe 3% of the children at the beginning of this century were were screened for hearing.
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Um, and 97% weren't.
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Well now, 25, yeah, 25 years later, they had a similar piece of legislation and a framework that was set up, and now it's 97% of children are screened for auditory at a very early age, babies, and that way they can be treated if they have a problem.
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And it's not a bunch of money, because most people think, well, federal government brings money.
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It's not that, it is a framework and an environment that allows state and local governments to go ahead and build programs and have an anchor point, right?
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I'm not very much into government affairs, I'm I'm not skilled at that.
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I'm a sales and marketing guy.
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Um, but you know, myopia enthusiast, you know, but very exciting about that because it allows other people who do this thing to have that framework.
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Think about what will happen if we can do vision screening that early.
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Well, the implication is unbelievable.
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To me, like you talked about axial length, I bet you we can find other reasons.
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I bet there's other, you know, obviously the more you look at something, the the other data you're gonna find.
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I mean, there's tons of research.
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Yeah, so the opportunity is there to expand out in in eye care in directions that we may not even be aware of at this point.
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And that I think that that's to me that's fascinating.
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Now, most of your career has been contact lens, and obviously we talk a lot about frames and lenses in this environment.
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But I want to talk about something specific because I'm fascinated with it, but I want to talk about monofit.
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We we touched on it very briefly before we started recording.
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Talk about those experiences and then talk about the SEMA lenses and then your your bisticons, you know, just like what did you see?
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You mentioned a lens a few minutes ago that ended up being being ideal for another treatment, and it was a multifocal lens, and I don't remember the name of it.
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But right.
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Yeah, so um my own personal uh journey through vision care has been through manufacturing, right?
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The manufacturing side industry.
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I don't um I'm not a clinician myself, never worked in an optometrist's office.
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Um and and I learned about contact lenses and and you know just from being a user when I was very young, coming out of school.
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So when I started working in in vision care, I had products for presbyopia, multifocals.
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I had no idea what they're for because I was not a presbyopia at the time.
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It was uh I was much younger then.
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But I learned that ways to treat um presbyopia were to do mono monovision, right?
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One near, one far.
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My father, that's how he was treated.
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Most a lot of patients that I knew were treated that way.
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That was kind of how you were taught to do it in soft contact lenses at that time.
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Fast forward, we had multifocals that we were trying to market, and the magic of multifocals was that you didn't have to do monovision, right?
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Right.
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Um and and the interesting thing, even with that, is that for contact lenses in presbyopia, for the most part, it is time consuming.
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Um, it does not give the benefits that patients want because they're used to seeing perfectly, or with their single vision contact lenses, and they have crisp effective vision.
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Well, you have a lot of trade-offs with the multifocal, and even with monovision, you have an adjustment period.
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So a lot of uh optometrists shy away from doing contact lens fits, and they'd rather do progressive spectacle lenses.
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It you know, it was more impactful.
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You had an entire infrastructure to help train and for the patient to adapt.
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They had potentially uh a better effect.
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I've never worn them, I've always worn contact lenses.
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So it it was just that was what I learned, right, with monovision and monofits to your point.
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Right, right.
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And you know, it there's no question that there's a heck of a lot more flexibility, there's a lot of adjustability uh with a set of glasses, there's a lot we bring them in and out and up and down.
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You know, you don't have those kind of you know uh abilities with contact lenses, it's it's very finite.
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So you've talked about this multiple visits, you know, those scenarios that aren't a good fit for whatever may be going on, you know.
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I think of eons ago, when my when my oldest was born, I remember fitting a guy who was came in seeking a progressive lens.
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And the problem was that as I talked with a guy, he had had neck surgery, he was wearing an executive.
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I mean, I was telling a nightmare back problem back to myself.
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That you know, you know he ended up listening.
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Uh and and thankfully that it ended up going away that that you know that was seamless and easy.
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But that's not fun.
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It's not fun to take somebody and curve them away from what they want, which is exactly what people are probably dealing with at optometry.
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You know, if an OD is dealing with a monofit, that's it's challenging.
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We're back and forth, or they may not know distances that they live in, work in, whatever may be the case, you know.
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Tony, I'm gonna stop this crazy beeping for the cat feeder behind me, so this will get edited out.
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Hang on one second.
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No worries.
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Um so uh, you know, as you as as we as we talk about um that contact lens journey and and how you've been through different places and how that how that's plugged into.
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What did you bring with you from that that helped you get involved with the situation like Treehouse Eyes?
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Because that's I don't know, that seems like such a dream situation to me.
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But probably it it it probably you probably see uncomfortable things, but at the end of the day, you know there's answers coming.
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And and you and it's not has nothing to do with insurance.
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So talk about what you guys are, how does that work?
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Okay, so for um treehouse eyes, we are uh a global fee environment, and we don't accept insurance.
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So um uh a parent brings their child in, um, and they've been they've had education about the entire myopia management category, what to expect, uh, what the visits are going to look like.
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They come in, it's an hour-long workout, and it is a comprehensive exam.
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And uh at the end of the journey, they enter generally a um a two-year commitment with us because we set up follow-on and follow-up appointments.
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Um, the doctors, the clinicians um pick an initial therapeutic direction and they go from there.
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Now, why do we do global fee?
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Um, global fee is simpler for our patients and it is allows clinical freedom for our clinicians.
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So because the other thing is if the treatment, if the child isn't responsive and we're seeing them on their three month, their third month follow-up, right?
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The clinician can say, well, this isn't going where I want to go, or I need to do a combination therapy, and they just do it.
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So that's why we charge a global fee because it allows for um the clinician total freedom, and it is easier for the parents to understand.
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That makes sense.
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The well, the flexibility that you kind of need to be there.
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Um I know we're uh ping-ponging around a little bit here.
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Um back to myopia management.
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Uh, you had a post a week ago or something like that where you were kicking around, oh, so we should we make it billable?
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Should we not make it billable?
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Um I'm gonna let you kick that one around.
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I don't know.
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I really don't know.
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Uh I don't, I just don't know.
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So um I'm not an insurance guy, don't know much about it, right?
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But what really piqued my interest in June was the um American Medical Association in their General Assembly, they had a resolution called um 411 or 411, which I thought was interesting, right?
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Yeah.
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For information.
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And they they declared that myopia is a disease and should be treated as such.
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Yep.
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Right?
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So you've got the you've got the physicians saying it.
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Now, why was that interesting?
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So optometry pretty much has been the leader of myopia management, and and probably will continue to be that place.
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There are more optometrists practicing myopia management, and a lot of the products are focused on optometrists.
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And ophthalmologists they don't do that, pediatricians don't treat it, etc.
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etc.
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But what this does is it sets up a chain of events that could eventually lead to reimbursement through medical insurance companies.
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Now that's not gonna happen next month, it's not gonna happen next week, it's not even gonna happen next year.
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There are a number of wickets that you have to go through in order to have CMS take it on, um, get codes set up, um, have um funding by the federal government, adjudication on that, lots of commentary, the insurance companies have to take a look at it.
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There are tons of stakeholders and tons of moving parts in some of the world's largest bureaucracies, right?
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So this is not a this is gonna happen next year.
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Um but what I find fascinating is that though this is this is what I've always considered an optometry owned thing, it's taking the physicians are now interested in it, right?
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Which opens tons of doors for screening of children and referral at that point.
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Because a pediatrician, if they're um up to speed, motivated, educated about this latest uh idea of what's going on, might start talking about uh myopia with mom and dad, right, when they're bringing in their child, no matter what the age.
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And you've all seen this, you've seen this in practice, you see this in clinic, you see this in the dispensary.
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Children holding on to a phone.
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Everybody's glued to a screen, right?
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So that's gonna have that's happening at a very young age now.
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Um and so pediatricians will now start remarking on it, not just the optometrists or the opticians being the bad guy if you think about it, right?
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Because how many times have you been in practice been asked, well, can you give them the talk about it?
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You're right.
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You're all right, yeah.
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You get to get a bad guy.
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Yeah, share some of that, you know, schmutz.
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You you get you deliver the bambies too.
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I kind of that's actually a good thing.
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Um yeah, and then referral comes from that, right?
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Well, you should go to so-and-so, um, you know, uh another medical professional, and you should get this treated or looked at or what have you, and then it can enter the the uh referral matrix and co-management.
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So, yeah, I mean it's a good thing.
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Uh what category education is a good thing.
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And if category education is done by more people with authority, whether they're within um the dispensary, the lane, or now in your pediatrician's office, um, that's a good thing, right?
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Because most parents don't know about myopia.
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They don't.
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Well, that's exactly what my next question was like, you know, what percentage of parents have a clue?
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And you're right, it's probably pretty low.
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That's yeah.
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Some stats I've seen is 30% of our children have myopia, and less than 5% of them are in formalized treatment for it.
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Hmm.
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That's crazy.
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Or it's what's even more disturbing is to think that they could go and get it treated in a generic way and make it worse.
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I mean that single vision.
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Um, you know, and and there's so many factors that go into it.
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You got screen use, you got lack of outdoor time, you got a number of different things.
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You got genetics, which in the old days we thought it was just genetics, right?
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And then you can see the research from some of the earlier researchers talking about, well, no, it's visual demand, lots of visual demand.
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Which it's again, you know, what percentage of that is going to the pull, to the to the jump, you know, why, you know, like like we were saying, we know how to connect a few dots, we still don't understand what the beginning of it is.
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And that seems bizarre to me that we've been uh doing this as long as we have, not you and I, but the industry.
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And there's some pretty there's some pretty big holes there that that that maybe ought to make a little bit better uh sense than they do.
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You know, to me regarding the billing and the and the non-billing aspect of it, you know, the the fundamental non-component is that at the federal billable level, optician doesn't exist.
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So there becomes some problems there uh when it comes to implementation of products like any myopia management lens.
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Um you know we here's up here's ugly softball that neither of us have an answer to at all that we mentioned before we were recording.
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Okay, somebody comes in and they're they're they're it's blatantly clear you're gonna enter a myopia management uh uh program and uh they want to order their glasses online.
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I wouldn't Yeah, right right now they wouldn't be able to.
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Right.
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Uh but if enough of them want to.
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Yeah, it's I I don't I don't have an answer for this.
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And and hopefully, hopefully, right now that's easily remedied and built through, and I don't and I don't know the full ramifications of it.
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I I really don't.
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Uh I know that there are places where uh you know things can get built and things cannot get built.
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And the fact that 411 took place to me may open the door as we're putting legislation together to become certified here to actually acknowledge and put on paper that an optician exists, considering there's hundreds of millions of people that refer to their optician or themselves as one.
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So, you know, it it's a strange and mighty thing to think how uh political and insurance can can weigh in on the terminology, which ultimately creates a billing code, which kind of answers the question for us.
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You know, uh it obviously the optometrist has some vested interest in billing with this, but you hit on it earlier.
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If all the errors keep pointing back to some practices that maybe they knew or not, it didn't help people down the road, you know.
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Took little Bobby from a minus four to a minus twelve by the time he was ten, you know.
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Okay, whoops, sorry.
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Well, what again?
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How did this end up happening?
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If it's gonna be billable, is the insurance gonna be any better get to the bottom of that?
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Uh nice long pause.
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I think we kind of know the answer to that one, or at least what we tend to think.
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Yeah.
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Um well, yeah, insurance helps with access, right?
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But insurance in and of itself is not care.
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And we know that right, right, you've got what I have in my pocket or the the group number that I give when I set up the appointment does not guarantee care.
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It just helps you with access to the care.
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So I think you answered the question of whether it'll be any better.
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But uh for me, it really comes down to clinicians who are trained in this.
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Um, other countries it's done by opticians, right?
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Um particularly in the United Kingdom and Italy.
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Right.
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You know, so um yep.
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So trained personnel um who are committed to the craft, because this is a specialty.
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Um right now it's considered a niche, but it's not.
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I mean, it's all around us.
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And you know, you just need to educate the public so they know the questions to ask and the fact that they need to seek professional help and then enter the program and get it done.
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There's lots of ways to do this.
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Which is probably the best part about it.
00:21:59.599 --> 00:22:11.680
Um Um the uh how there are a lot of ways to implement care, to take it into action, and a lot of different tools, you know, that are at the fingertips.
00:22:11.920 --> 00:22:23.279
Um that literally Yeah, uh that that have been in use for a lot of years, and uh uh so it's not it's it's not as if some all techniques are bad, you know.
00:22:23.359 --> 00:22:34.480
It's uh thing things have been productive in helping curve, you know, some of the some of the problems with with my opia getting so bad from someone so quickly.
00:22:34.880 --> 00:22:37.119
So let's let's talk a little bit.
00:22:37.200 --> 00:22:51.279
I asked you to kind of kick this around in your head before we started going about a a tech experience uh uh over your time that was good and then maybe not so good, and then I'm gonna kick off a new segment with you after that.
00:22:51.440 --> 00:22:52.480
So give us a thought.
00:22:52.559 --> 00:22:56.799
Give us a thought of a of a contact lens or a dispensary experience, whatever.
00:22:56.960 --> 00:23:02.880
Give us a tech that that you think was a game changer and you loved it, and then maybe one that wasn't.
00:23:03.839 --> 00:23:11.039
So we could go really old school and talk about what is usually a taboo topic, which is 1800 contact lenses, right?
00:23:11.200 --> 00:23:22.559
Okay, so that's a huge, huge technological game changer because it first used the phone, but it went online pretty rapidly when online became the thing.
00:23:23.200 --> 00:23:26.480
And tech experience, it's really good.
00:23:26.720 --> 00:23:34.079
It's got a great user interface, it's easy to use, it is seamless for you as a patient.
00:23:34.400 --> 00:23:36.799
Um, I've had family members who've used it.
00:23:36.880 --> 00:23:39.440
I personally haven't because I was in the industry.
00:23:39.759 --> 00:23:44.720
And um and it's wonderful if you're direct to consumer.
00:23:45.680 --> 00:23:50.799
The biggest issue, of course, is it's not the what, it's the how.
00:23:51.519 --> 00:23:58.319
And the how is what it really falls down on because it becomes um not as inclusive.
00:23:58.480 --> 00:24:05.200
You have other stakeholders like the optometrist who needs to verify the prescription.
00:24:06.079 --> 00:24:14.559
And the way it was set up is that you know it's automatically verified unless you, you know, proactively deny it.
00:24:15.519 --> 00:24:17.200
And that's the biggest rub, right?
00:24:17.359 --> 00:24:24.799
That was the biggest rub because then you have you have revenue share and you have all sorts of issues and complications.
00:24:25.200 --> 00:24:41.200
So great technology that helps potentially a patient, but it may not help the patient because the patient has an old and expired prescription, so it's not the right prescription, and they haven't been evaluated by a trained professional.
00:24:41.359 --> 00:24:44.400
And then you've got you've got channel shift as well, right?
00:24:44.559 --> 00:24:50.640
Business-wise, um, both as an optometrist or the um or the manufacturer.
00:24:50.720 --> 00:24:54.240
So it's it's one of those double-edged swords.
00:24:54.559 --> 00:25:02.000
Um patient convenience pushed it, but there's those there were those stupid holes.
00:25:02.079 --> 00:25:12.480
Like the things I remember being super annoyed about as an optician would be somebody who s seasonally knew to order their year supply at 11 months.
00:25:12.799 --> 00:25:18.880
And would only ever have a contact lens exam every two years after they people blew a fit, you know.
00:25:19.359 --> 00:25:22.559
And you know, they had it staggered just perfectly.
00:25:22.640 --> 00:25:26.240
I mean, they knew they were never gonna be.
00:25:26.480 --> 00:25:42.240
They were professionally uh professionally lens exam and avoiders avoiders or whatever the call, but they're non-compliant, and you know, getting an eye exam is easy and efficient and effective, right?
00:25:42.400 --> 00:25:44.559
We just know we're we're all fans of that.
00:25:44.799 --> 00:25:53.359
So I you know, people who who who are dodging it as a as a lifestyle, I I don't I don't get that because you can't especially in the contact lens world.
00:25:53.440 --> 00:25:56.160
I just never could understand that at all.
00:25:56.400 --> 00:25:58.079
You're you're not gonna see as well, right?
00:25:58.160 --> 00:26:00.960
You you've got an old expired prescription.
00:26:01.200 --> 00:26:03.039
So yeah, so that was a bad one.
00:26:03.200 --> 00:26:04.720
Um good and bad.
00:26:04.880 --> 00:26:07.200
But convenience drew it, not pricing, right?
00:26:07.359 --> 00:26:08.319
It is convenience.
00:26:08.559 --> 00:26:09.119
Absolutely.
00:26:09.359 --> 00:26:14.880
And you know, and and that's where we're at now, and there's other ways of of doing that that are more compliant.
00:26:15.119 --> 00:26:20.960
Um so then the the other technology story that I thought was interesting from this is Warby Parker.
00:26:21.119 --> 00:26:21.839
So think about it.
00:26:22.079 --> 00:26:27.119
Warby Parker started as a direct-to-consumer play.
00:26:27.599 --> 00:26:30.079
Um, and people loved it.
00:26:30.240 --> 00:26:36.559
They loved the style, they loved the lifestyle, it was really, really well marketed and produced good results, right?
00:26:36.880 --> 00:26:44.559
So I had several family members who who got their who got their uh Warby Parker lenses, and they they they called them Warby Parker glasses, right?
00:26:44.640 --> 00:26:45.519
So that was the thing.
00:26:46.160 --> 00:26:46.400
Right.
00:26:46.799 --> 00:27:02.720
But yeah, but you could tell that there was something missing from the business model, because we talked about, you know, someone someone adjusts my Warby Parker glasses if I walk in in a at at any shop, and some might and some might not, on a matter of principle.
00:27:02.799 --> 00:27:06.000
You know, I didn't dispense them to you, so I have no obligation.
00:27:06.319 --> 00:27:09.759
But right, you could which was an unintended pain.
00:27:10.160 --> 00:27:12.400
Yeah, it's an unintended pain, right?
00:27:12.640 --> 00:27:18.880
But then but then Warby Parker saw the benefits of having a physical presence.
00:27:19.119 --> 00:27:19.839
There you go.
00:27:20.079 --> 00:27:21.839
And it they did a little zigzag.
00:27:21.920 --> 00:27:31.680
They started off then heavy online and came back and tried to like change their leases because they did cut all those leases for a small window of time.
00:27:31.839 --> 00:27:35.039
I don't really understand what the philosophy of that was.
00:27:35.119 --> 00:27:38.720
Maybe they were thinking they could shift completely to online, but you are so right.
00:27:38.880 --> 00:27:42.559
They came back with a presence.
00:27:42.960 --> 00:28:00.720
And if you go to a mall, you can watch and the the watch, particularly young girls, well, they'll look at all these frames online, they'll have three or four, they'll go in and try them all on and look in the mirror with them on, put them back and go to the bench out of the mall in order.
00:28:01.119 --> 00:28:04.720
And that's it's it's yeah, exactly.
00:28:04.960 --> 00:28:09.200
It's well, it's but it but it's also right.
00:28:10.559 --> 00:28:12.799
Mod pizza that way.
00:28:14.079 --> 00:28:32.400
Yeah, well, you know, that fits their lane, it's relatable, it it's important to them, and let's go forward to where where Warby Parker is involved in education in Indiana at the high school level.
00:28:32.720 --> 00:28:39.839
Um, okay, any other optical, you want to be critical, be critical, but talk tell me you're doing that.
00:28:40.079 --> 00:28:43.039
Tell me that you're educating high schoolers in Indiana.
00:28:43.200 --> 00:28:45.440
Warby Parker is, they're part of it.
00:28:45.599 --> 00:28:49.839
Of course, do they have a vested interest of stopping remakes early in the process?
00:28:50.400 --> 00:28:51.359
Absolutely.
00:28:51.599 --> 00:28:55.839
And cultivating it within your own business structure, it's smart business.
00:28:56.079 --> 00:29:00.160
So split if it ends up with a smarter optician, I don't care.
00:29:00.640 --> 00:29:03.440
That works for me and it will work for me every day.
00:29:03.599 --> 00:29:13.119
So I think that's really cool that you mentioned them because they fit in to some very unique places where they are destructive and they don't care if they are.
00:29:13.279 --> 00:29:18.480
Um and that's just that's just you know business.
00:29:18.720 --> 00:29:22.319
And I'm in I'm in the business of patient care.
00:29:22.640 --> 00:29:28.160
So for me, I mean, I get convenience, I get fashion, I get good marketing.
00:29:28.400 --> 00:29:29.519
I totally get it.
00:29:29.759 --> 00:29:31.680
For me, it's about patient care, right?
00:29:31.759 --> 00:29:38.880
So that's why I wasn't a fan of the the 1-800 practices, you know, in when they started.
00:29:39.200 --> 00:29:50.880
And watching Warby Parker create a physical model with optometrists doing exams, right, in beautiful, beautiful retail settings.
00:29:51.039 --> 00:29:56.000
Um, because I saw them in New York for the first time and I was just amazed, and they were lovely.
00:29:56.160 --> 00:29:59.359
Um, I'm like, oh, okay, we've gone full circle.
00:29:59.440 --> 00:30:09.440
We've gone from uh a direct-to-consumer internet grab to a more sustainable, I thought a more sustainable patient care model, right?
00:30:10.160 --> 00:30:12.240
So that's where I came down on.
00:30:12.640 --> 00:30:21.440
I think it inevitably ends up reintroducing some elements that may not have been in that first segment of their retail journey.
00:30:21.599 --> 00:30:32.000
Um and again, the all these are all opportunities for education and existing optician groups to get involved.
00:30:32.240 --> 00:30:39.039
Um turn the page, meet patients where they want to meet.
00:30:39.440 --> 00:30:44.160
Um this is a great time to start off that the the new segment.
00:30:44.240 --> 00:30:58.720
I'm kicking off a new segment, and you kind of segue to it, so you may actually repeat yourself, but um the basically the new segment is for to tell an online uh eyewear ordering uh experience or story that you've heard of.
00:30:58.880 --> 00:31:00.720
You mentioned uh family.
00:31:00.799 --> 00:31:04.559
Uh if you have any others, uh go ahead and lob one up there.
00:31:04.720 --> 00:31:06.319
Good, bad, great, it doesn't matter.
00:31:06.400 --> 00:31:14.799
I I want there to be stories that are told because quite frankly, they are talked about within the industry in an open forum format, like we're going to do here.
00:31:15.519 --> 00:31:23.519
Yeah, well, I mean, the the the one that uh so there was the convenience of 1-800 contacts, and that was a good experience.
00:31:23.599 --> 00:31:30.960
And they my my family's not non-compliant, they just needed more contact lenses and you know, they ordered them.
00:31:31.039 --> 00:31:35.920
They were wearing daily disposables and they just worn too many, which is which is a great problem to have, right?
00:31:36.000 --> 00:31:37.599
That means they were very compliant.
00:31:37.839 --> 00:31:49.359
Um for for Warby, it was a lot of I get to try on all these frames virtually, I get to showroom this entire thing, and they got what they wanted, right?
00:31:49.680 --> 00:32:07.839
Um when it comes to and and it comes down to um consumer satisfaction at that point, because that's you know, if if you haven't been seen for an exam and you're not sure what your prescription is, and you're not having an actual person line everything up, right?
00:32:08.000 --> 00:32:11.200
Um then it's not really patient care.
00:32:11.359 --> 00:32:13.359
It's you're buying a thing, right?
00:32:13.519 --> 00:32:21.839
And then your your thing, if you don't have the people that are trained to have it work properly, well, yeah, you're taking that risk.
00:32:22.079 --> 00:32:24.640
Um, didn't have that problem with with my family.
00:32:24.720 --> 00:32:27.039
So they they loved it, they loved the ordering experience.
00:32:27.119 --> 00:32:34.960
Everything was built around the pay uh around the the consumer experience, just like any online business.
00:32:36.400 --> 00:32:41.839
That to me, that is so telling, you know, it built around the consumer experience.
00:32:42.079 --> 00:32:50.079
It you know, that I think is a part of the journey of getting glasses if you've never gotten them before.
00:32:50.240 --> 00:33:03.759
You know, if you're 19 and you get a new prescription in your hand, you know, and and and you and you don't have a vision plan or or you're not on your parents, or for whatever reason, you know, but that that's a what do you do?
00:33:04.000 --> 00:33:05.839
You know, how is that handled?
00:33:05.920 --> 00:33:06.960
Who does what?
00:33:07.440 --> 00:33:17.200
How is how how do I go about that in my life, you know, and how things traditionally change, like you talked about?
00:33:17.680 --> 00:33:34.960
An ordering experience, you know, the the 1-800 experience changed that in a clunky, aggressive, ugly way because they were pre-internet, but the whole thrust of it didn't go away for the patients.
00:33:35.119 --> 00:33:53.039
And I like how you sort of connected the convenient aspect of it with a succeed and a win on both ends, you know, and and and and you know, regarding Orby Parker, it was a win to give life back to certain people that maybe have a little too much invested, you know.
00:33:53.200 --> 00:34:04.079
We while before we were recording, you know the the young family with a kid, you know, two eye exams on a Saturday.
00:34:04.160 --> 00:34:04.960
Uh no.
00:34:05.440 --> 00:34:09.599
Of course they're gonna want to do that in any other way that they can really do it.
00:34:09.679 --> 00:34:11.840
Get in, get out, get your script and go.
00:34:12.159 --> 00:34:14.159
You know, they want their Saturday back.
00:34:14.400 --> 00:34:18.960
It's not that they want to spy so much less, it's that they want some of their life back.
00:34:19.199 --> 00:34:30.159
And, you know, you're working 45 hours, you're raising a family, you're trying to make sure you're not gonna, you know, run out of everything.
00:34:30.559 --> 00:34:31.920
It's it's a challenge.
00:34:32.079 --> 00:34:43.519
So the convenient aspect of it, and like you talked about, how gorgeous that the retail experience was that you went into with Warby Parker, that was pretty right.
00:34:43.920 --> 00:34:55.840
What a good combination, you know, what a what an interesting way to meet the people's ability and want to shop this way, but still do this, you know.
00:34:56.000 --> 00:35:03.440
When when I was interviewing um the optical Jedi, Rick Peralta, he talked about how his daughter does that.
00:35:03.679 --> 00:35:06.639
She'll look here, do all her homework here.
00:35:06.800 --> 00:35:13.039
I don't know if you're if you're seeing that, or you know, my my children are in their 20s, and I do see that.
00:35:13.280 --> 00:35:21.119
It they analytically analyze what they're going to do with their money, and then they'll they're tangible with when they spend it.
00:35:23.199 --> 00:35:24.639
I think it's a good thing.
00:35:24.880 --> 00:35:30.000
Um but I but we just it goes to retail 101, though, right?
00:35:30.159 --> 00:35:43.760
I mean, which is which which is I think the key to to the commercial aspect of opticianry, which is I remember the first time I bought frames that I bought, to your point, right?
00:35:44.239 --> 00:35:52.079
So I have had to wear glasses for a long time, and I got most of my glasses in the military.
00:35:52.159 --> 00:35:58.639
They're literally handed to me in a bag, and it's like I had four pairs and they all look the same.
00:35:58.800 --> 00:36:03.199
And luckily I was an aviator, so they weren't black frames, they were the silver frames.
00:36:03.280 --> 00:36:15.760
And to this day I wear them, I wear those frames, and I just have the spectacle lenses uh redone because where I live, there aren't very many people who are Air Force veterans, so I don't look like a dork, right?
00:36:16.079 --> 00:36:18.239
So so I wear them.
00:36:18.559 --> 00:36:51.760
But when I when I got to choose my own frames, what I loved was I got my eye exam and the optician I was given to her, and she looked at my face because I'm Hawaiian Chinese, I've got a round face, and she's like, We're gonna go over here, didn't ask me how much I was gonna spend, we're gonna go over here because these will look better on you, right?
00:36:52.639 --> 00:36:54.239
And yeah, it was.
00:36:54.320 --> 00:36:56.000
It was she took me over there.
00:36:56.159 --> 00:37:08.000
I have no idea whether I overspent, but what I knew was this person took me and explained and showed me what she was looking at when she put them on me, right?
00:37:08.480 --> 00:37:16.719
Yeah, you know, and it wasn't the bag of frames that I was handed, um, you know, that I would get every two years, right?
00:37:16.960 --> 00:37:17.760
Right, right.
00:37:18.639 --> 00:37:20.000
As an aviator.
00:37:20.159 --> 00:37:24.000
So yeah, and that that has stuck with me for all my life.
00:37:24.159 --> 00:37:30.559
And I choose frames based upon her recommendation 35 years ago.
00:37:31.599 --> 00:37:40.559
Again, uh, it's fascinating that that you can have a single experience that wows you at any service level.
00:37:40.880 --> 00:37:54.079
Um you you spend a fair amount of time on the road, so you understand the service components, and it I used to say this all the time, you know, there are places that I'll go where the service is outstanding and the food is bad.
00:37:54.400 --> 00:37:54.880
Yeah.
00:37:55.599 --> 00:38:04.800
But I'm there for the conversation, I'm there for the way to watch seamless beauty in action, you know, for lack of a better term.
00:38:05.599 --> 00:38:07.840
I mean, the food is as average as could be.
00:38:08.159 --> 00:38:31.599
But the people really flow in a in a in a way that is, you know, when you see something run really smoothly like that, the operations that are run like that, practices that are run like that, um that's a really good example, actually, because they they are crazy, crazy busy, and they do get the they're designed to get people in and out very, very quickly, and they do a good job of it.
00:38:31.760 --> 00:38:33.039
It's not sloppy either.
00:38:33.119 --> 00:38:37.199
They're you know, they they do they do it in a very, very direct way.
00:38:37.519 --> 00:38:53.119
But but the production line part is encouraged in our industry, and and you and I tend to want to slow this down at some level to make sure that care gets introduced to the right people at the right times.
00:38:53.519 --> 00:38:53.840
Exactly.
00:38:53.920 --> 00:38:56.000
It's all the earlier that we can.
00:38:56.239 --> 00:39:05.280
Well, you know, it are the are there that you're aware of, are there are there parts of legislation that that are introducing?
00:39:05.519 --> 00:39:11.760
I know Pennsylvania is is they just had something passed recently where that care goes very early into place.
00:39:11.840 --> 00:39:15.440
I don't think it had anything to do with 411, but maybe it did.
00:39:15.760 --> 00:39:27.440
But you know, is there anything well uh I tell you what, uh how about myopia being recognized at a federal level that you just mentioned earlier in this interview?
00:39:27.840 --> 00:39:33.360
I mean the impacts of that have got to hit policy, I would think.
00:39:34.079 --> 00:39:40.960
So yeah, so that that'll start that chain, right, with 411, and that's with the the AMA making a stand.
00:39:41.119 --> 00:39:56.239
What's interesting to me though, because you know my life for the last 12 years, uh 11 years, has been focused on category education about myopia with optometrists primarily and opticians overseas.
00:39:56.400 --> 00:40:02.719
And the key issue for it is that I always get I always get this.
00:40:03.119 --> 00:40:12.239
Well, wouldn't it be great if my schools gave everybody a vision screening and referred them to optometrists automatically?
00:40:12.960 --> 00:40:14.400
Well, sure, that's great.
00:40:14.960 --> 00:40:24.480
So do you talk to the school nurses in your area and you know offer vision screenings for all the children?
00:40:24.639 --> 00:40:25.599
Well, no.
00:40:26.239 --> 00:40:29.440
Okay, you know, what are you going to do?
00:40:29.679 --> 00:40:33.199
Locus of control, because yes, that'd be great if they did that.
00:40:33.360 --> 00:40:40.960
And I've talked to, you know, I was on the board of uh Global Myopia Awareness Um Council GMAC, right?
00:40:41.199 --> 00:40:50.719
And we would talk to um the National School Nurse uh Foundation and everything, and it's just it's hard to get anything done on a broad scale.
00:40:50.960 --> 00:41:15.360
But this is where something like House Resolution 2527 can start that because it gives the infrastructure, and then states and municipalities kind of know where to go if they want to get involved in that, and there's a little money, but not much, but they can tap and they can organize around that, and and that's the big thing because there's so many demands.
00:41:15.440 --> 00:41:19.760
But people always say, wouldn't it be great if this category education began?
00:41:19.920 --> 00:41:24.239
And that's where things like HR 2527 can do that.
00:41:24.880 --> 00:41:33.119
But every time um I talk to my own clinicians, it's like, well, how do we get more referrals?
00:41:33.280 --> 00:41:35.199
Have we talked to the local pediatricians?
00:41:35.519 --> 00:41:35.760
Right?
00:41:36.800 --> 00:41:39.039
And sometimes people push back a lot, you know.
00:41:39.119 --> 00:41:39.360
I don't know.
00:41:39.440 --> 00:41:45.199
I said you're you're it's lunch with friends, it's coffee with friends, I'm in sales, right?
00:41:45.440 --> 00:41:53.679
So to me, it's like, oh, I'm just gonna go visit you and we're gonna talk and just educate because to get a referral from a pediatrician is a gold standard, right?
00:41:54.800 --> 00:41:58.880
Um because normally they just say, Oh, go see the ophthalmologist.
00:41:59.119 --> 00:42:01.760
Here's you know, here's their information.
00:42:02.400 --> 00:42:10.400
But with this 411, it might become optometry, and that would be great, but start now.
00:42:10.960 --> 00:42:17.519
Start talking to other uh providers in your area about myopia's disease.
00:42:17.679 --> 00:42:18.800
Here's the thing.
00:42:19.119 --> 00:42:20.960
Let's have some coffee and talk about it.
00:42:21.119 --> 00:42:23.280
By the way, this is what I do, right?
00:42:24.159 --> 00:42:35.760
So there are oodles of uh regularly meeting networking groups that are connected with forums like alignable and whatnot, um, as well as others.
00:42:35.920 --> 00:42:43.119
But they're constantly meeting multiple times a week at at places, events, you know, and anything.
00:42:43.280 --> 00:42:45.440
You know, sometimes it's just a regular lunch.
00:42:45.519 --> 00:42:49.760
You know, I know there's one that's in York, I'm in Philly, so I never get to it.
00:42:50.000 --> 00:42:56.400
But it it's good to know that they're meeting and the diversity of people attending is kind of kind of out there.
00:42:56.639 --> 00:43:02.000
I mean, it the the networking capabilities are quite genuine.
00:43:02.239 --> 00:43:11.280
You know, the sooner that you can connect in with the next generation, that we we know we have a myopia problem.
00:43:12.639 --> 00:43:14.159
We haven't eliminated it.
00:43:14.320 --> 00:43:17.440
Like we've talked about here, we don't even know where it comes from.
00:43:17.679 --> 00:43:25.679
Um but there's a management that's in place and we're moving towards that, and we also know that it starts young.
00:43:26.000 --> 00:43:27.679
So it starts young, lots of shit.
00:43:28.000 --> 00:43:30.559
Getting out there makes all the sense in the world.
00:43:30.719 --> 00:43:33.840
Being in their face so they know the signs.
00:43:34.079 --> 00:43:41.039
Um you know, and yet it's one of those topics that's so gray for new parents.
00:43:41.360 --> 00:43:59.840
I don't, you know, uh, you know, you you don't want to be scaring, but by the same token, nobody wants to watch somebody go down that that that that journey of of you know being a mild myope to, you know, someone who, you know, couldn't get behind a wheel without uh glasses at all.
00:44:00.239 --> 00:44:10.480
you know so it's a it's a it's a it's a topic that is continuously changing and moving in in in in in the direction I think is is huge.
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That you know thank you for hitting on both aspects the contact lens and the classes aspect of the online ordering story because they were both a direct impact to your world and your family and I think that that's that's kind of cool.
00:44:24.079 --> 00:44:26.079
That's a good way to start off that segment.
00:44:26.400 --> 00:44:47.440
Is there is there anything that we did not hit on that you specifically want to talk about I I am amazed at the fact that that Treehouse Eyes is able to be a self-standing on its own entity um which you know when I say on its own I mean not attached to uh policies and procedures that are going to be dictated by an insurance group.
00:44:48.239 --> 00:44:57.039
Yeah I think yeah the the whole thing about what I love about Treehouse Eyes is it's focused on category education in our local markets.
00:44:57.519 --> 00:45:08.239
And there's a lot of ways of doing that right but what I think is interesting for us is we don't think of new patient sourcing as one thing.
00:45:09.360 --> 00:45:14.000
We have an entire group of activities referrals.
00:45:15.039 --> 00:45:20.480
Referrals is a big one we do do some local advertising but not much.
00:45:21.199 --> 00:45:35.519
We do have SEO marketing on our website and we've also bled over into AI right so if you type in myopia management wherever we are we show up right into your AI bot.
00:45:36.800 --> 00:46:28.639
We also do category education so that because we charge a global fee so the parents aren't surprised right when a parent hears gets a message from school like they're getting in the next couple weeks depending where we are Georgia they started where I live they started school last week so in a couple weeks you'll start getting notes from school saying your child I had to move them closer to the whiteboard right you might want to get their eyes checked that's usually how people find out right so you'll find that out and you'll be like oh I have to go to the eye doctor well I've gone to the eye doctor I've got enter your vision plan here so I'm expecting a$40 copay some cute frames and we're gonna walk out you know um but that's not the case for myopia management it's a disease it's a it's a big deal we do a global fee.
00:46:28.880 --> 00:47:33.039
So when they encounter us as a place they're gonna go get treated we have um they call it telehealth but it's we literally educate people on a Zoom call about this is what it is here's the experience you're gonna have in our practice and here's what you can expect to pay right so they're completely informed and then they come in and they go through the consultation they get the therapeutic recommendation and then they start the follow-up but they know that it's a program much like braces right right we know what to expect with braces I started saving for braces for my children the day they were born right right as we know chiropractic yeah there's a lot of like times where you're education on a program education is it was the next one I was going to hit on that and that's which makes the most sense obviously as you're stepping along and progressing towards stuff and physical therapy chiropractic all of those you know there's there's a regimen moving you towards from A to B.
00:47:33.119 --> 00:48:17.840
You're heading towards a goal you know of hopefully better health healing range of motion whatever your goal that's what that's what we do right we educate um our our prospective patient base on what to expect and this is not this is not unique to us you just talked about chiropractic I know about PT same kind of thing physical therapy you have these expectations you get educated about this that is the biggest thing missing from myopia management in this country people don't know about it and sometimes if all you did was read the stats they'd get scared of it because you're you're gonna be blind at age 50 if you don't do something about it and then they shut down.
00:48:18.079 --> 00:48:23.039
Well exactly and how much of us get data about things that we don't know that way.
00:48:23.280 --> 00:48:25.599
You know we can get scary internet stuff.
00:48:25.840 --> 00:48:45.119
Exactly and you know whatever the algorithm is going to scare you some more woo you know yeah so let's get on X and get really scared on X, you know but yeah it's yeah and I it's yeah so I'm proud of us doing the category education and the intake and for me it's all about patient experience.
00:48:45.280 --> 00:48:56.320
You could tell from the way my family responded to the two examples I talked about I really follow how people encounter our services and go through our treatment.
00:48:56.400 --> 00:49:01.280
It's very important to me because I want them to get what they want so they can get their Saturday back.
00:49:01.679 --> 00:51:48.960
Well you ask difficult questions and that's one of the things that really attracted me to you on LinkedIn is that you don't shy away from some topics that aren't really fuzzy and warm and and you know how are things going to move past the gray areas past the the the closed doors you know how are we going to do that um in an effective way to connect and bridge those gaps uh those the build the bridges that that that are missing you know we always come back to no no well even with even in Pennsylvania when we submit this legislation uh 26 we don't expect anything to be implemented on the ground until well into 27 if it even passes um if it even passes if there's restrictions and pushback and and there that could well be something that we face then you know we s we we seek who we can we tell the stories that we can and I think that you know we have a few heavy hitters thankfully in our our lineup so I think we're gonna be fine but you know building a legislative roadmap you know that that can uh be implemented in other places is is is is what we're trying to do and and connecting that care to uh delivery rooms you know as you and I have have hit on is you know it's the natural extension of what we do so moving in that in that direction gathering data finding things out we probably don't understand right now and then changing our policies as we go um I think that's about everything that that that that we're supposed to do in that care environment and again you know um at least myopia care has shifted and moved towards it which I think is is wonderful compared to when you uh you know certainly when I started and and certainly 25 some years ago when you when you began was there anything else that you wanted to uh add into this mix uh I will add that that I vicariously follow you uh live through your uh AT trail experiences that I think it's completely awesome I love uh that you document when you do it I also like um your follow-ups you know um when there's regular posts and then there aren't any where there's those of us that are like oh crap is Tony okay that you pull a hammy an easy on a rock somewhere well I got I I got a really good one from um so I ran into a bear um last Friday and posted Oh you did yes you did you did that was that was fun um so yeah it's it's uh I love the Appalachian Trail.
00:51:49.039 --> 00:52:09.760
I love it because you can recharge you know a walk in the woods as they say um my friend Tom Arnold actually gave me that book um so yeah it's it's a great place to go so you can think we talked about that and I love the social aspect of the trail because I you know I I hike alone but you're never alone on the Appalachian Trail.
00:52:09.840 --> 00:52:13.519
You run into people that you're in their life for five minutes or five years.
00:52:13.840 --> 00:52:15.519
And um so cool.
00:52:15.679 --> 00:52:16.719
I I think it's amazing.
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I think it's amazing well well there's definitely uh the the trail stories the the human connections uh with the AT trail and the same with the I forget the name of the one the the outwest which is even longer but that you know yeah PCT yeah I mean those stories are tremendous and they're about people connecting reconnecting recharging um I have a friend that literally calls that whenever he organizes a guy's trip it's recharging the batteries and uh and you the great thing about it to your point is you have no you're you're not a you're not a role when you're out there you're not a title you're not your place in society you are a nickname and how you show up at that at that moment right so if you show up with a lot of negative energy people are going to avoid you and be like goodbye right and now you you're the jerk with the nickname they don't they don't know what you do whether you're you're you could you're you're not the plumber that owns this very successful company you're just you're just a dude that's out there who happens to be really good at filtering water right so well and and the people there the people there tend to know that too and uh not all but most most of them have a pretty good grip that that that's part that's a lot of why you're there uh it's with it it's certainly about the overlooks and the beauty but uh the the reconnecting uh with the the planet and the people uh in that way you know when there are these woohoo you know we we're we're doing something right at you know at least in my mind um yeah so I love it absolutely thank you so much for this interview I I've been waiting a while to do this uh this is very very exciting and you know to to talk about uh how how we can impact at an early age how it can go through uh the journey that will take place before us that you and I are a part of is is completely awesome.
00:54:21.440 --> 00:54:38.079
Any links uh links to Treehouse Eyes to you Tony will be in the show notes by all means participate in the profit prescription quiz it helps to talk about online experiences ordering and tools to remedy any leakage in the practice.
00:54:38.320 --> 00:54:42.559
Thank you so much everybody for another episode of Optometry Profits Revealed.
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Take care