Dr. Maria Sampalis
This week I sat down with Dr. Maria Sampalis to discuss corporate optometry.
Read the full transcript below:
[00:00:00] Dr. Christopher Wolfe: Do you find that's a barrier for doctors to really jump over that, especially once they've been in practice or one of those models for a long enough period of time where they're no longer comfortable managing diseases because they chronic diseases because they haven't done it for awhile. And how do they get over that?
Dr. Maria Sampalis: Yeah. So I think a lot of doctors within a corporate setting can monitor right, and treat a lot of supplies, doctors, LC, Walmart, whatever the case is, have OTTs have ladies' technology do that. Um, some of the other models, if they're to someone say they can't adopt the medical model because things are just too busy or the staff's not trained and things like that.
But as they kind of look to expand that practice, they, they. If there's some, I think I find more sublease docs because they're invested in their practice that want to do this and can do it because they can invest. Sometimes they can't make a decision, even a private practice. They can what they want to have and what they want to do because often decision-maker, um, but a lot of practices will see a lot of disease and it's their decision whether they want to [00:01:00] treat it or send it out.
Um, so every doctor is a little different. So even some private practitioners that I've seen here in Rhode Island, um, still practice 1970s.
Dr. Christopher Wolfe: No. That's exactly the point. Yeah. That's exactly the point.
Dr. Maria Sampalis: It's on the doctor. It's not the four walls that sets, and I've seen a lot of great practices. I've seen, uh, one doctor in, uh, New York.
Um, he does, you know, myopia management. He does ortho K days do, has been doing it for years. So it all depends on what the doctor wants to do, um, and what they're happy with. Um, so, you know, that's. That's one of the things, but I find that more sublease doctors and that independent thing take more of a role to kind of initiative to do the next step.
And that was one of the things with, with Coda that I really wanted to have doctors embrace to, to kind of, you know, be independent role, their practice, expand scope of practice as well for optometry because our, our profession is a legislative profession. It's [00:02:00] changing, it's continuing to change. And I think there's always opportunities where in optometry, whether it's corporate or private and doctors, um, just, you just gotta take it, you know, by themselves the initiative to do it.
Um, No, I'd never started in a busy practice. Uh, I was at a Sears optical and, um, you know, I found opportunities. I was able to do, uh, have a good income. Um, net price net sometimes was same as the LensCrafters that I found out when I did a business evaluation for them. Um, it's, it's really the doctor and what, and what you want to do.
Dr. Christopher Wolfe: Hello and welcome to the crystal podcast on I code media today is the very first episode of 2021. And hopefully this is going to be a different year in 2021 than 2020. Although I'm not entirely convinced that it will be, uh, it'll probably be a gradual change and a gradual adjustment back to some sort of normal or continuing on with some sort of normal.
But, um, in any case today, I had a really fun conversation with Maria. Some policy [00:03:00] is who owns a private practice as well as has a lease on a corporate location. And we talked about the nuances of corporate optometry, as well as the struggles that corporate optometrists go through in terms of negotiations and maintaining their own independence.
And so it was a fun conversation for me, especially to dig into areas and topics that I don't know a ton about. And so, um, please enjoy our conversation as always be sure to subscribe to the podcast, write a review, share. With your friends and support those who support us, riding myopia control treatments in our practice for years, if you've been listening to the podcast for awhile, Cooper vision has received FDA approval of its innovative myocyte.
One day contact lens. This will be the cornerstone of a comprehensive myopia management approach to be offered by CooperVision. This daily wear single use contact lens is the first and only FDA approved product clinically proven to slow the progression of myopia when initially prescribed [00:04:00] for children eight to 12 years old.
And when compared to children in the control group, wearing a single vision one day contact lens. Check out the show notes for all the specific prescribing details and to get more information about this lens, how you can begin to offer it in your prep.
So how do you divide your time between your private practice and your corporate practice? So I
have doctors that work, um, private, corporate Brexit, a new, so they're part-time per se. And then over here, it was like four days, like an opportunity at my schedule.
Dr. Christopher Wolfe: Do you, so how many, um, how many corporate practices do you have right now?
One. Okay. Is that, is that where you started or, or that's what you started and then you built your private practice or did you build your private practice and move the other way?
Dr. Maria Sampalis: Yeah, so no, I started in corporate at Sears and then I'm sorry, I just put drops in my eyes. Um, I, I started at Sears and, um, you know, serious clothes.
I've my own business. And then what happened was with her. And [00:05:00] COVID recently this doctor retired, so. What is practice and combined things together. Yeah.
Dr. Christopher Wolfe: Do you, um, so that was so serious left Sears closed. What did they go? Bankrupt? Probably
Dr. Maria Sampalis: five, six years close. Three years ago. Okay. So when Sears closed, I, um, they gave me like two to three weeks notice.
So I opened a new practice. Holy
Dr. Christopher Wolfe: cow. How'd you find this space?
Dr. Maria Sampalis: I got lucky. I got lucky.
Dr. Christopher Wolfe: Yeah. I'd say three, three weeks is crazy.
Dr. Maria Sampalis: I got lucky. Yeah. Yeah. Um, it's um, it was kind of nice in that aspect because, uh, you know, it was an insurance company before there and, um, I didn't have to really do a build-out.
I just put an exam line in and, and dispensary and, um, I went from there. So.
Dr. Christopher Wolfe: What percentage of your patients followed you from Cirrus two or they, your patients, or are they a serious [00:06:00] patient?
Dr. Maria Sampalis: The patients cause I was subleased. So it's a little different and patients do follow, right? So if the place closed, where are they going to go?
There's no competition. So most of them followed. Um, you know, some of them are just sometimes their routine yearly exams and sometimes they're just coming in because they have a problem specific or they need glasses. So I would say about 60, 70% really did follow. And um, even now. Um, I've had patients where, um, uh, they come in and I haven't seen him in five years, but they're still seeing me so that they're not going anywhere.
So, um, you know, and if they need value, um, I have value eyewear for them and I have different options for them.
Dr. Christopher Wolfe: I think that, um, so I think when I listened to that story of of three weeks in an insurance billed out, so. In full disclosure. I I've never started my own practice. I, I, I, I, I have a partner with my father, so I'm purchasing him out of the practice.
And, um, and so I've never [00:07:00] actually said I'm going to sit down and start a practice from nothing. Um, and he did it in about, uh, early two thousands. I mean, he did multiple times, but early two thousands, he did almost the exact same thing. He saw a need in a small town, kind of. Which was a bedroom community at the time of, of Omaha.
Um, and it, uh, still is, and it, um, but he did the same thing. I think it was an insurance, uh, place that had closed down. And I remember going in there with him and my mom and, um, and, you know, had old carpet old, you know, like a, basically a bench that, or a table that was sort of could have been an optician desk.
And so we, we had that, it was already built in and there was one room, a closet, a bathroom. And, um, anyway, my point is, is that like, you didn't need a lot to do it. That community just didn't have eyecare. And, and so I just wonder, like now you see, um, people [00:08:00] coming out of school and you think, and I'm the same way.
Like I would want to have, you know, in practice almost 12 and a half years. And. It would be really hard. I think coming out of school and not having, let's say an Optus, a auto phoropter a, you know, OCT, typography. I mean, like all the things that we get used to using, um, You're not going to, you don't have to have it, but do you think that's a barrier for people actually opening a practice?
Dr. Maria Sampalis: Cause I opened a practice when I opened, when the circles I opened a practice with under $30,000. So, um, you know, I opened it, but I was able to save money, work in a corporate practice, make a little more money than being employed per se. You have also those admin headaches, but you'll learn kind of like on the way.
Um, and you know, you build a patient base, you know, patients. Will come because they're coming for eyeglass specials, but they stay because of the doctor. Right. And, and because I build that patient base, um, and I had the medical model, I had the autorefractor [00:09:00] I had, um, I had the retinal camera from before, um, and things like that.
And as, and as my practice was growing, I was looking for, um, discounts because they provided some things like FDT and things like that, but no visual field. Um, I am, I've expanded my practice now where I am looking to incorporate an OCT, but, um, you know, you kind of build this slowly and because of. The additional income in these practices because of the overheads lower.
Um, and there's no investment you're making good income to, um, start your own business if that's what you want. And, um, for me, I was able to, you know, move in quickly, um, because that's what needed to be done in order to not lose those patients. Um, and I got lucky with no build-out, but, um, I was also, I had the equipment to get rolled in too.
So I had an EMR and things like that. So I would tell doctors, look, there are bigger ticket items that you could probably hold off on and you can practice. You can still do a good [00:10:00] job. Um, but no, most of the thing is data and you gotta be able to keep that data. And EMR is one way to really get familiar with that and building your social network and your personal brand.
Dr. Christopher Wolfe: Yeah, I think that, um, I think that, you know, I guess my, my, my entire point about that is exactly what you said is that you have the ability. You don't have to do it all at once, and you have the ability to kind of grow over time into your patient population to offer different services. And I'm just wondering if you have a pulse on corporate practice.
I I've, I've practiced one day a week, um, in a, in a commercial location as an independent contractor for. A year and a half when I first got out of school. So my perspective is certainly, um, well, I, well, I think I have some perspective. I clearly have no perspective of what it's like right now to be in corporate practice, but I think you have that.
So what I'm trying to kind of garner is when you look at like surveys, Um, about where students want to [00:11:00] practice and then where they wind up practicing. There seems to be a disconnect between when they're in school and then when they're out of school. And so I'm just wondering if part of that disconnect between what they want and then the reality of what they they choose.
Um, if some of that is just a perception that they have to have. Uh, a, just this amazing space and all the technology that they want in order to practice optometry, what are your thoughts on that?
Dr. Maria Sampalis: Yeah, so I've done a survey in the corporate optometry group. Um, so, um, the students, um, and, you know, they do, some of them will say, I just want to go private practice.
And then when they looking for a job and what they want. Um, sometimes it depends on the demographics and where they are, um, and the job positions. Um, but some of them will go into the corporate practice. A lot of the corporate practices will have the latest technology. Um, they have retinal cameras, the hub Octos, um, they'll have tech support, um, things like that.
So they're [00:12:00] able to practice the way they want. No, each brand's a little different. Um, some brands are, are, are more medical model based than, than others. And, and, um, you know, the group has been very good to kind of help doctors make that decision and ask colleagues about that. And that's why the group has grown tremendously over the last five years.
Um, because of that, because there was a, there was a need for, for, in the industry for doctors to collaborate and get ideas. From each other and, and opinions, besides just whatever was marketed to them at the optometry schools. And one of the things that. I've been working with is, you know, trying to work with the optometry schools cause they still have that closed mindedness about, you know, what a Palmer tree should be.
And it's kind of practicing the old model per se. Um,
Dr. Christopher Wolfe: sorry, sorry. Can you amplify what you mean by that? What, what would it be? I mean, there's
Dr. Maria Sampalis: still some negativity about corporate optometry and the optometry schools, um, you know, and, um,
Dr. Christopher Wolfe: Well, let's [00:13:00] be honest, there's negativity, um, about corporate optometry in the general pop in, in not the general public, but in a general optometric community, I would say yes,
Dr. Maria Sampalis: of course there is so, so in the group, this negative there's pros and cons.
Um, but you know, at the end of the day, if we're able to practice. The way that we want. And the major goal is to keep up commentary independent. So we don't go pharmacy. So if sublease model is the preferred, now, if, if doctors go into, you know, thinking that they should be employed and because they're making a good salary per se, but they're seeing 40, 50 patients a day, how much longer can that work?
I mean, I've been out of school for about 13 years. You know, I can't, I can't do that anymore. I'm tired. Just, I get just to get two kids out the door I'm exhausted in the morning, you know? Um, so I think that's important perspective too. And they're saying that, you know, if you're 70% coming out are female, um, they're saying that, you know, employed models the best way to go because of this scenario.
And, you know, I worked three days a week. [00:14:00] I used to work sublease three days a week. Make more income work, less per se, um, and built a patient base for now where my kids are older and it makes sense. Cause there is more, um, financial stress per se because as they get older, there's more things. Um, and I was able to do that at that point.
And um, so I think it's kind of also the model to, if you want to go private. I think the way that it's going to change now is that they will go sublease, build a patient base. And then move out or stay in and take on additional practice if that's what they want.
Dr. Christopher Wolfe: Is that actually a strategy that, that you guys that are, there are people that are working toward
Dr. Maria Sampalis: that's right.
So I'll talk to a lot of doctors, conversations are private. Um, but a lot of doctors are like, I'm looking to do this, pay off my loans. Um, and then, you know, build a patient base. And if things work out, start my own practice. So I think how it's been used in the industry, the data was showing at 10 years out now [00:15:00] until about 12, 13, um, and
Dr. Christopher Wolfe: 10 years out.
Why, why 10 years is the magic number? Is it because your, your student loans are paid for, or you have more confidence or I think
Dr. Maria Sampalis: it's both. I think it's student loans in confidence. Um, and that was the data that I had gotten from the group. Um, and I think that was, um, Something where, you know, doctors are kind of like settled per se and they know what they want to do.
Dr. Christopher Wolfe: Are you guys including like, um, practice, like employees of, of a, like a private equity group where you're reaching out to those employees to kind of join your, your corporate model? Because what I've seen is that a lot of these, um, Uh, practices that sell to private equity, um, when they were what we would consider a private practice, but employing, uh, multiple doctors, those employed doctors [00:16:00] felt like they were in a private practice.
They, they, they felt like they had ownership. They may have had bonus structures that, that were basically, uh, ownership of, you know, all of their income in some form or fashion. But then, um, The things that they worry about changing tend to change. And I've seen multiple times where this happens and, uh, you know, the, the, the employed docs leave.
Um, but they weren't really thinking, they were thinking private equity is still private practice, but it seems to me, a lot of them are, are run like employed corporate practices. Yeah.
Dr. Maria Sampalis: Yeah. So I wrote an article on that, um, you know, private equity being a form of corporate optometry and did a survey in the group.
And a lot of doctors feel it's that way. Um, and you know, I think that's a big shift in the industry too, where doctors want to, you know, buy a practice. They feel like they have to kind of compete against that. Um, but yeah, I mean the private equity companies that I've, I've looked at contracts at from, uh, doctors that were.
The [00:17:00] salaries are much higher than their longer-term contracts, but, um, you know, the terms are different. Um, so I'll tell them, I'll say, you know, your contract is not renewed for three years. This is this I can't, you know, negotiate terms within, you know, after three years, the restricted covenants are higher.
Right. Um, and if you're, if you're a young grad and new grad and you don't know if you're doing film work and you're miles seven, uh, or, or you're a floater. So mile radius is basically the whole state. If you do one, two, three offices, right. And then there's non-disclosures and things like that. Um, I've written articles about that as well, with red flags and contracts.
Um, so me, I, you know, there's been debates in the group, they're saying it's private practice. Uh, but you know, if, if there's, that's not doctor owned and a corporation owns it, it's a corporate
Dr. Christopher Wolfe: That's why I think it's interesting. Oh, sorry, sorry, Marie, go ahead. These zoom, the zoom things are, there's a little lag, so
Dr. Maria Sampalis: it's fine.
I, you know, there was discussion in the group about that, whether it's, you know, private practice or corporate and, [00:18:00] um, there, there are private equity docs, employees or owners. Um, and I think they're part of that, that group, that sector of corporate optometry.
Dr. Christopher Wolfe: The, um, yeah, I mean, the more I think about it, it isn't intuitive because it comes from a, it comes from a, you know, A it's kind of founded historically in, in private practice, uh, where it's sort of, you know, eking in, on private practices and buying them up.
So we think about them like private practices, but once, you know, it, it tends to typically is it's not always the case, but the stories I've heard are that, you know, a year maybe that's that stable two years, that starts to feel less like the private practice to the, to the employed ODI. Um, So, what I thought you said was interesting that I wanna, I wanna kind of dig into a little bit more is the goal is, um, is you said a, um, I'm drawing a blank, a subcon sublease, right?
The goal is [00:19:00] leasing. Explain why that's the goal over, um, over being an employed ODI in a, in a commercial location and how that's different.
Dr. Maria Sampalis: Yeah. So for me, that was the goal of the group to kind of do that. Because if, if, if a poetry goes pose that employed model, we turn into pharmacy. Okay. And you know, that could be some pros for some doctors or not.
But I think for the industry as a whole, I think doctors being independent, whether it's private practice or within a corporate setting, um, is the best. Thanks doctor makes a decision on the patient, what they want to fit, uh, how they want the model they want to do. Um, and then certain laws and, and scope of practice, right?
So, um, doctors have investment in their, in their, in their industry, in their practice to kind of, you know, pull the industry together, um, and move for different scope. So I thought that was important. So when I developed the corporate deal Alliance group, the, uh, Coda is I call it. That was one of the major focuses.
To do that and to help employed Odis show [00:20:00] them that, you know, sublease model is if you're nervous, the easier way to go and then add your brand confidence to take on another one or do what you want after the fact, um, So that is one of the big things. And that's why I write a lot of articles on practice management that I have on my website and how to get started and vendor discounts, things that doctors have right there.
That's easy to go. Um, instead of saying, this might be too hard to say, look, download these two documents, contact these people and you can get started. Um, it's, it's that easy. Um, and I think it's good for the industry, um, and our profession. If we continue to. You know, keep that independent models that have, you know, the employed model per se, um, for the long term, uh, you know, as we can monitor our own patients and make the decisions how we want to do it,
Dr. Christopher Wolfe: I would say that that's, that's absolutely ideal.
What do corporations. How do they respond to that? Do they, do they have just one model where they [00:21:00] say, look, we're just going to employ you and that's all we're going to do. Or are there ways to say, look, you've got an open slot, but I don't want to be employed. I want to, I want to have control of my patient base of my patient decisions.
Uh, and so I'm not going to do that. Like I want, you mentioned the company, but I, I get, I get letters all the time from this company that say, well, you know, we'll pay you $10,000 to relocate and all this kind of stuff. And it's like, but you know, it's not, it's not how I want to practice. So are those negotiable or what, what have you found?
Dr. Maria Sampalis: Yeah, so there's different models, right? So the sublease, so you can rent, um, there's independent contractor positions, um, and then there's employment positions. Um, each brand is a little different on what their strategy is. Um, but I've known that Walmart will have an employed position. If a doctor wants to be subleased, they could do that.
Um, I think America's best models are, um, you know, mostly employed. Um, and then Luxotica has, they're mostly subleased, but they employ in certain States. I think there's 12 States that they can employ and they do. So, [00:22:00] um, everything is negotiable. They think that a lot of doctors I talked to, we do a lot of contract negotiations.
Um, and they'll say, well, this is a big company I can negotiate. Of course you can. Um, they have quotas to make, um, they have to fill these spots. Each spot. My understanding on certain companies is a hundred thousand dollars to recruit for one spot that cost money to the company, right. So they need to fill those spots.
Um, and they're offered big lucrative, um, uh, bonus structures because they need to fill those spots. Right. So if they had those spots full, they wouldn't be doing that. So, um, I think doctors need to understand what they negotiate and what they can, and I've helped a lot of doctors increase salary. Um, You know, $25,000 a year and sign on bonuses ranging.
So sometimes they say they don't give it and they do, and you can negotiate a lot of things. I think that, you know, going in with that mentality, if you're going to make a lot of money per se, you know, that you're going to see a lot of patients, they need to make back their, their income. [00:23:00] Um, So you need to produce, um, but you know, sign-on bonuses are good.
Um, but there are also tax, you know, there's 50% tax usually on that. Um, so some things that doctors just need to understand and know, but I always say, you know, you can try it out. Causes usually are between 30 to 90 days, depending on the company. Um, and, and, um, everything is negotiable. I've negotiated my contracts and continue to negotiate my contracts.
Um, as I, right now, I'm in non contract negotiation, one company to take on a sublease. Um, I've asked for 12 edits and it's it's, it's gotten done. So
Dr. Christopher Wolfe: do you think, so I think the, the crux of the, the concern, perhaps if we're going to kind of dig into, you know, the, the perception that corporate practice is somehow different than private practice, and you're, you have a good perspective of this.
You know, when you talk about like the medical model, what does that mean to [00:24:00] you?
Dr. Maria Sampalis: Yeah. The medical model for me is, um, to build my patients, uh, have them trust me, um, to see whatever they need to see me for. Um, and I think because of the industry changes online competitors, vision plans, we need to adapt. We need to change, um, to.
The our perspective, our image in the industry or in the community is, is the doctor they need to see for their eyes instead of 1-800-CONTACTS or, you know, going to the emergency room for a pink guy. Um, so that as well has been a big thing, um, where I've written a lot of articles on how to get started and did a lot of webinars on that as well.
Um, it's very easy to get started. It's not a big investment. You can start baby steps. Learn how to do billing and coding, um, and, and, and keep that patient retention too. So I've had something simple as a retinal camera image, um, where patients they're just routine. And they said, I come back every year because you have my image.
[00:25:00] So more of a patient retention thing, uh, as well, besides just a revenue boost, um, with all this noise out there, and that patients get all this information. Let them know that you're the one. And I think that's one of the ways to kind of combat, um, you know, all this, uh, misinformation out there, free eye exams and, um, you know, online refractions.
Dr. Christopher Wolfe: Well, I think it's pretty clear when you, um, when you are providing for patients who, who need a plethora of services that. Patients will perceive that naturally to be different than when they go someplace. And they have a free eye exam. If they buy two pairs of glasses. And if all I'm doing, I guess my, my question would be if all I'm doing is doing the same thing, but now I'm charging them for their high exam and charging them for their, or charging them appropriately for their glasses.
I'm not using any loss leaders or anything like that. Then. If that's all I'm doing, then I'm [00:26:00] just, I'm just practicing optometry in a, in a private practice, but I'm practicing the same way as I would if I were employed. So how do you, I guess my point is is that if all, if that's all I'm doing, then all I'm doing is shifting, you know, a, a corporate employed, uh, model into a private practice.
But if I've embraced the idea that. The most important thing is the doctor patient relationship. And we have to, we have to maintain that. And I'm actually following through on that by, uh, screening screening and managing, uh, both simple acute diseases as well as complex chronic diseases in my practice.
Then there's no. There's no confusion by the patient about what they're getting in my practice versus what they can get on online or in a, a location that is just basically has the doctor in there to generate a prescription so that they can sell glasses. So I guess my question is. [00:27:00] Do you find that's a barrier for doctors to, to really jump over that, especially once they've been in practice or one of those models for a long enough period of time where they're no longer comfortable managing diseases because they chronic diseases because they haven't done it for awhile.
And how do they get over that?
Dr. Maria Sampalis: Yeah. So I think a lot of doctors within a corporate setting can monitor right, and treat a lot of subleased doctors, LC, Walmart, whatever the case is, have OTTs have the latest technology do that. Um, some of the other models, if they're to say they can adopt the medical model because things are just too busy or the staff's not trained and things like that.
But as they kind of look to expand that practice, they, they. If there's some, I think I find more sublease doctor because they're invested in their practice that want to do this and can do it because they can invest. Sometimes they can't make a decision with even a private practice. They can what they want to have and what they want to do, because they, that often decision-maker.
Um, but a lot of practices will see a lot of disease and it's their decision whether they want to [00:28:00] treat it or send it out. Um, so every doctor is a little different. So even some private practitioners that I've seen here in Rhode Island, Um, still practice 1970s, optometry. No,
Dr. Christopher Wolfe: that's exactly the point. Yeah, that's exactly the point.
Dr. Maria Sampalis: Depends on the doctor. It's not the four walls that sets and I've seen a lot of great practices. I've seen, uh, one doctor in, uh, New York. Um, he does, you know, myopia management. He does ortho K days has been doing it for years. So it all depends on what the doctor wants to do. Um, and what they're happy with.
Um, so, you know, that's. That's one of the things, but I find that more sublease doctors and that independent thing take more of a role to kind of initiative to do the next step. And that was one of the things with Coda that I really wanted to have doctors embrace to, to kind of, you know, be independent role, their practice, expand scope of practice as well for optometry because our, our profession is a legislative profession.
It's changing, [00:29:00] it's continuing to change. And I think there's always opportunities where in optometry, whether it's corporate or private and doctors, um, just, you just got to take it, you know? By themselves, the initiative to do it. Um, you know, I'd never started in a busy practice. Uh, it was at a Sears optical and, um, you know, I found opportunities.
I was able to, to do a, have a good income, um, net price net sometimes was the same as the LensCrafters that I found out when I did a business evaluation for them. Um, it's, it's really the doctor and what, and what you want to do.
Dr. Christopher Wolfe: Yeah. And I, and I think to your point, I think we're probably simpatico on a lot of these issues in terms of having independence as the, as the doctor.
I guess my perception is it doesn't matter whether or not your like, like I agree with you that that physical location doesn't matter, but it does, I think matter. In general. I, I think it doesn't matter, but I do think that, um, that the opportunity that you have when you have control, you have nobody [00:30:00] that there's a barrier between the doctor patient relationship that allows you to integrate the tools and technologies that you need, that you feel is best going to serve your patient population.
Right. I guess if I w if I were going to see, think about the stumbling blocks that I see in, in other models would be that, um, For the long-term ability, uh, with our profession to continue to advance scope and, um, and advance advance that accelerate that doctor, doctor, patient relationship, where it's enhanced would be that.
My observation is when, and maybe I'm wrong about this, but when students get out of school and they have all these tech, you know, they have all this training, that's, that's wonderful. They can, they can manage all these diseases, but they get into any location, whether it's private, whether it's corporate, whether it's independently owned or they're employed.
If, if their mentors [00:31:00] are in a model of basically. Uh, refraction glasses, refraction contacts, refraction. Like if that's the model you, you made the point, they don't feel like they have time. If that goes on for too long. My concern is that you almost have to relearn how to manage those diseases, not just the one you're relearning, how to manage the diseases again, or refreshing your memory and two it's it's.
How do I, if I understand that the model. The the way I generate revenue is refraction glasses, refraction context. Right. If that's how I understand it, then it's really hard to figure out how do I generate revenue? What's my value in this other model. And then what I think happens when I, when I talk to doctors and when I work with them, what I see is that they, they don't understand the value of those other services.
So they don't. They don't take the time to delve into them. So the easy response is I'm going to put a bandaid on it, and if it's really serious, the patient will come back and then [00:32:00] we'll figure it out. Or I'm not going to deal with this. Once it gets to that second level of treatment where it's not getting better or it's not responding to what you want.
Well, I'm going to just let somebody else do this. It does this all the time. And I actually believe what's best is, is that, that you're describing that doctor is basically that main point of, of most things for that patient. So do you see that same thing I'm seeing? And if that's true, how do we get beyond that?
Dr. Maria Sampalis: Yeah, so you are very true. You hit the nail right on the head, um, on talk to a lot of doctors and that's the case. And even if you just take the example of dry eye, they'll just give some artificial tears. So, I mean, I took over this practice here and that's what the doctor was doing. And I've, I've incorporated simple things into the practice, like college and plugs, um, you know, other options like pads, nutraceuticals, um, to, to grow my business and even something small, like an anterior camera, um, just to show them and illustrate a patient education, why it's [00:33:00] important and why I'm prescribing certain things and even just.
It's the whole bluff riotous and, and, and, and, uh, besides just lit scrubs, you have things in your practice that you can give. Um, and follow-up visits. Those are ways to kind of increase, but the doctors don't do it. And we all, we're all trained. It's easy to do. There's no investment, it's anterior sex stuff.
It's easy stuff. Right. Um, so that has been something where some doctors have been a little nervous about, but there, I think it just comfort zone. Right. And I'm doing all right. I'm doing fine. I don't need to do, I don't need to worry about it. Most of my, you know, 50% of revenue in the industry comes from optical.
Dr. Christopher Wolfe: Well, actually, actually, if you look at, if you look at the MBA metrics, so this is, I, I don't know how far this extends into, um, into corporate practices that are, that are, uh, subleased. But if you look at independent practices across the country, 82% of every dollar that's generated in a practice is generated from the, the, the [00:34:00] sales of glasses and contact lenses and routine examinations.
So 82%. Yeah. Uh, so yeah, it's it's um, and so I think, and 7% is generated from, uh, from medical care.
Dr. Maria Sampalis: Yeah, so the doctors don't have revenue with it from the optical. So some of the ones that can sell contact lenses, the average is about 20%, uh, of their revenue comes from contact lenses. Um, each office is different and what they, and what they have, but, um, you know, that's why they have expanded to medical where instead of getting paid $40 for a routine exam, they're, you know, they're doing that to having the follow-up visits, they're trying to grow their business and trying to change the perception.
Uh, of their practice to patients to retain them as well. And, and, and to your point of how doctors can change, you know, I have tried to partner with AOA AOA and posted things in the group about legislative changes and what AOA is doing and why people need to join the AOA, [00:35:00] but also with changes within corporate optometry.
The group has done a lot of great things to kind of, you know, um, change things in the industry where corporate would just be like, well, this is how we do it. Now. They pay attention because 30,000 plus group, um, in a lot of information's out there, um, they've had to change the way they approach things and how they approach doctors.
So it's been really the, the voice of a corporate ODI, um, to change things, um, and, and how, how they want to do things in the practice. And there's a lot of communication. There's doctors, we're connecting doctors from California to Massachusetts, um, and saying, look, I worked for the same brand. What are you, what are you doing?
Oh, we're not doing this and that. And then knowing, you know, how to work together. Um, so there's a lot of work that I've done to kind of. No, have more of a say, uh, within corporate optometry from the doctor's perspective,
Dr. Christopher Wolfe: what do you think? So if we get to scope for it for a second, um, because I, I [00:36:00] agree, you said there's 30,000 corporate ODS
Dr. Maria Sampalis: in my group.
So there's doc 30,000 members in my, in my group. Um, some of them are corporate would be some over the years have swapped, will doubt. Um, so it's hard to kind of monitor that, but there's a lot of corporate optometrists in the country. I think 30% right now is corporate ODS and that number is going to grow right.
Especially as private equity purchases. Um, as doctors go into this setting, as they open new practices, there's a big growth, um, with, uh, offices, opening, uh, locations companies, opening locations.
Dr. Christopher Wolfe: So, I guess, um, you know, the, the thoughts I have are, are a couple, when we talk about scope of practice, one of the challenges that I do think is inherent is when, when we talk to legislators specifically, and also when we talk to, uh, when we, when we testify, uh, it is a challenge when, when our opponents want to characterize [00:37:00] procedures that we do.
Um, where you wouldn't want to have those done in a, like, attached to a big store, like you brought up Walmart. So I think there's this sort of idea that, that ha that makes it more challenging for people to say, Oh, I dunno if I want to get. There's a, there's a bias inherently against like, ah, do I want a medical procedure in Walmart?
Like in, in the legislator's mind now I think some of that's changing as you see some of the Walmart, like, uh, clinics kind of pop up for other medical services. I think that could change. But right now, it's, it seems to be an effective tool at least to some degree. So how do you think that, um, that, that barrier, if we're all working toward that same goal, how do you think that barrier can become, uh, overcome and how quickly can it be overcome where there's a perception of, of a legislator or, um, or a public regulator that, uh, it is.
You know, if I go to Sears or [00:38:00] Walmart or like, I'm okay. Having a procedure done in there because I think it's going to be safe. And I think it's going to be, you know, the doctor's going to be well-trained.
Dr. Maria Sampalis: Sure. Sure. One, one thing, one big barrier is in September trust versus optometrist, right? So there's been some private practitioners that look down on ODSP and, and, and things like that.
And corporate ODS. And that's been one thing within the group that I've tried to show that doctors practice same way. It doesn't matter all from the same school, but, um, you know, with legislation, I think. I think we need to partner with the AOA to get more ODI, corporate ODS and the setting to work together with them, um, to show them what they have and what they're doing.