Pursuing a specialisation is a cost-effective way to differentiate your independent practice in a competitive environment. It can also turn a great career into a brilliant one.
How many practices are within a 10km radius of you? It’s a good question to ask yourself. My practice at Ramsgate Beach in Sydney’s South has approximately 80.
That’s a lot of competition. A patient on the edge of that 10km circle is driving past 80 other practices to come see me. Why would they do that? Relationship, customer service, trust, quality of products are all important reasons, but on many occasions, it’s because you offer that patient something extra that the competition doesn’t: you have a practice specialisation.
You may have heard of the old saying ‘jack-of-all-trades, master of none’. This implies that someone who does a lot of different things cannot master one thing. I beg to differ and I’ve reworked that saying to ‘jack-of-all-trades master of some’.
Throughout my 22-year career I’ve wanted to offer my patients every service possible. I’ve studied behavioural optometry as part of my Masters degree, I’ve lectured on dry eye at Alcon’s Dry Eye Academy, uveitis at Australian Vision Convention, orthokeratology at Super Sunday, miniscleral contact lenses for the Cornea and Contact Lens Society of NSW and recently I gave a lecture on optical coherence tomography analysis at the Singaporean Optometry Association Meeting.
Orthokeratology
I’ve never wanted to be pigeonholed, but if I had one specialty that stands above the rest it would be orthokeratology (ortho-K). For me, orthokeratology is the most rewarding part of optometry. Ortho-K has two great selling points; the first is to eliminate the need for glasses. Seeing a child who has been glasses dependent walk into the practice without them gives me a great sense of excitement, much like a laser surgeon would get when their patients come in for their post-op appointment seeing 6/6.
The second, and most important selling point, is ortho-K’s role in slowing the progression of myopia and decreasing the patient’s risk of myopia-related eye diseases. It’s one of those intangibles that you can never measure – who can predict how myopic a child will become? But that contented smile that a –13D parent gives me when their child’s Rx hasn’t changed is thanks enough. We share a special moment knowing their child has a lower risk of sharing the same fate, a blinding macula off retinal detachment.
Satisfying My Career Needs
Ortho-K means the world to me – it gave me professional satisfaction in a career I had almost left. In 1998, only three years after graduation, I started a commerce degree with the intention of leaving optometry for good. I was bored and under-stimulated, I wasn’t going to spend another 40 years spinning the dials of a refractor head, but I don’t know why I thought commerce would make the difference!
In 1999 I joined Ray Fortescue, now Executive Chairman of EyeQ Optometrists, at his practice at Ramsgate Beach and my journey with ortho-K began. Ray had been one of its early adopters in Australia and he taught me the ropes. Being in a practice with an optometrist with a large, loyal following also built my professional self-esteem.
Despite the advantages of learning about ortho-K from Ray, I still had gaps in my knowledge and I knew that the only way to fill those gaps was further education. I attended the Orthokeratology Society of Oceania (OSO) meeting in 2000 on the Gold Coast and I returned with a mission statement. Yes, like Jerry Maguire, I created a mission statement. I formalised, in a powerpoint document, what I wanted to achieve and how I needed to go about it. I realised just how important it is to write down your goals and formalise them, rather than allowing them to sit in the back of your mind for another day. Your goals need to be given life.
Above all, ortho-K delivered an unmet need in the community. At the time, I felt that myopia progression was a serious health issue and children weren’t getting access to this important treatment. I began recommending lenses to nearly every myopic child, from ages as young as six and prescriptions as low as –0.50D. For me the evidence was irrefutable: it slowed down the progression of myopia. Kids would come back year after year with unchanged prescriptions; I just had to wait for the science to catch up.
write down your goals and formalise them, rather than allowing them to sit in the back of your mind for another day. Your goals need to be given life
Expanding Markets
Orthokeratology was also an opportunity for me to attract a new demographic of patient, Asian Australians. In the early 2000’s there were only a small number of prescribers in Sydney, people like Oliver Woo and Gavin Boneham. Word quickly spread through the Chinese community and every few weeks I was receiving a new referral, friends of friends, brothers, sisters and cousins. Concerned parents who were myopic themselves were bringing their children in for fitting.
In those early years, ortho-K was hard and very time intensive. There was plenty of chair time spent refining fits and because I was diligent in my aftercares, I would review every child every six months. My Saturday mornings would be full of ortho-K aftercares, which restricted the business I could write. At one stage I thought I had created a monster as my patient list grew and grew. However, the trust and relationships I created is now my greatest treasure – and watching those children grow to become adults and parents is incredibly rewarding. I know every aspect of their lives, I know every member of their family, the sports or instruments they play, the schools they attend and what they want to be when they grow up. Relationships are the foundation of a practice; those tiny little social connections bind everyone together into a complex web. For me, my practice life has never been more enjoyable. I did a study a couple years ago and analysed the spending habits of long-standing patients versus new patients: on average a long-standing patient will spend double what a new patient will, simply because they trust you.
It’s How We Survive
Practice specialisation is how many independents survive, particularly when we don’t have massive marketing machines driving patients through our doors. When we created EyeQ in 2007 we wanted to create a company of independent optometrists, who could have the buying and marketing support of a large company, while still providing full scope optometric services. Our tag line is Experts in Eyecare.
EyeQ has given me the opportunity to surround myself with likeminded people, who understand that a good business is dependent on strong relationships and excellent clinical care. I couldn’t ever be a paycheck optometrist; the craft of optometry is my true passion.
Your working life is long, it’s also important that it’s enjoyable. Extend yourself and exceed the goals you set for yourself way back when.
Mark Koszek, B.Optom(Hons) (UNSW), M.Optom, is a therapeutically endorsed optometrist who practices at EyeQ Optometrists Ramsgate. Mark is also a renowned lecturer on contact lenses and dry eye and sits on the board of the Contact Lens Society of NSW and the Optometry Association of Australia (NSW Division). He is an orthokeratology lecturer for the UNSW’s Optometry Masters Program.
