Podcast: Drs. Michele Andrews, Melissa Tada, and Jim Beckwith

I recently sat down with Drs. Michele Andrews, Melissa Tada and Jim Beckwith to discuss their perspectives on reapproaching contact lenses during COVID and beyond.

You can check out our full conversation here, or by searching "EyeCode Media" in your favorite podcast app.

Read the transcript here:

[00:00:00] Michele: [00:00:00] part of the world, what are they experiencing? And so this doctors from the UK, and so we were talking all things, pandemic, contact lenses, and just practice in general. And, you're probably familiar that, in the UK, the NHS provides funding for everyone for eyecare. And he made the conscious decision to not accept NHS funding for services.

[00:00:29] Now, when you think about that, that was I, and it's, this is directionally correct, but it's something like he was effectively eliminating all children under the age of 18 potentially and all adults over the age of 60. If, if his patient based literally said, well, if you're not taking it, I'm going to leave.

[00:00:47]and the reason they made that decision and Chris, it really ties into what you said about build the machine and then every, everything that comes up, you just have to fit into the machine. So he and his partner decided that they weren't able to practice optometry the way they wanted to practice optometry and accept that fee structure.

[00:01:06] And so they said, we want to practice how we want to practice. And so when the staff and everyone got nervous and said, what if everybody leaves. He actually got bold and said, I'm okay with it because I value the way I want to practice. I value my expertise. This is what I want to be about. And this is the value I'm going to put on it.

[00:01:28] So it kind of ties back to what you're saying about, yes, I know what the competition's doing, but I'm not going to let it drive my decision. And so they, they completely eliminate it. And he said to me, he says, I, I, I'm not the least, or excuse me. I'm yeah. I'm not the least expensive person in town. And he said, and this is how we do it.

[00:01:49] We have not turned back. And he said, not only have we not turned back, he said, we, people who have left our practice, they have a annual subscription plan for exam fees, everything. So if you are a contact lens patient with them, you pay a certain amount per month. 12 months out of the year. And you come in any time for anything.

[00:02:12] If he can see you via tele-health, we'll see you via telehealth. If you need to come in, you come in, but your price never changes. But if you only come in once a year, you're still paying. He said, I want to be your eye doctor. And this is my model. And I was, I was blown away. I was like, wow, this is just getting more and more intriguing.

[00:02:32] And then he like pushed all the chips across the table. And he said, yeah. And when somebody leaves, they can't come back for three years,

[00:02:42] Chris: [00:02:42] said, wait a

[00:02:42] Michele: [00:02:42] minute, wait a minute. Are you serious? He said, yeah. He said, because what people were doing,

[00:02:50] Chris: [00:02:50] I know exactly what you're going to say.

[00:02:52] Michele: [00:02:52] You could do pre the writing's on the wall.

[00:02:54] He said, they leave. And they'd come back and they'd want to start to gain my, my plan. He's a, so when they said to me, you know, I I'm, it's time to leave. He said, I perfectly understand. You're welcome to leave. If you change your mind and you want to come back, you have to wait

[00:03:13] Chris: [00:03:13] through. Cause he explained to them why that is.

[00:03:18] Michele: [00:03:18] Yeah,

[00:03:19] Chris: [00:03:19] I think it's, I can't tell you how many times we've seen that, where we're, we'll see patients even, you know, we, we aren't that bold yet, but I've seen patients where, you know, they come and they come every three years or so three or four years, once they have a problem, that's bad enough. They went someplace else where they, where they thought they were getting the same.

[00:03:36] W I know they didn't think that they didn't think they were getting the same thing, but they thought effectively they were getting what they needed. And then they wound up with a big enough problem. It's like now I got to fix it. Then I fix it. And then they go for three years, four years. And so, yeah. Wow.

[00:03:51] So that's cool that he's, I've got a, I know somebody that, that has done that in, kind of around us and, I think she's so far doing really well and she's, she's the same thing. She's like, this is what I want to do. This is how I want to practice. And so she's going to do great because she's a great doc and she's got, she believes in her model.

[00:04:09] That's

[00:04:09] Michele: [00:04:09] what he said. He said, exactly those words, Chris. He said, we got the entire staff together. We got all of our team together and we said, how do we want to do it? What are we worth? And how do we want to see our patients? He said, and this is just the decision we made. The staff loves it because the people that come there and stay there are the people who agree with the ones in agreement.

[00:04:33] And he said, so there aren't any arguments or discussions. About that because we were very open and forward thinking and we get to give our best hair. So they're satisfied. So they don't want their money back. They don't want to leave because they're getting. Exactly what they need.

[00:04:50] Chris: [00:04:50] Hello and welcome.

[00:04:51] Chris will podcast on Eicher media. On today's episode, I have a conversation with Dr. Michelle Andrews, who is the senior director of North American professional and academic affairs with CooperVision to give us some industry perspective on reframing and rethinking contact lens. And we're also joined by Jim Beckwith, who practices in Las Vegas, Nevada.

[00:05:13] And he's got a great practice. He was really kind enough to let me come out and visit his practice a couple months ago, so I could pick his brain and see how he and Dr. Mark Lee are running the show there and how they have integrated new technologies during this pandemic and, and, moving forward. So.

[00:05:30]he's really got a good frame of mind in terms of continuing to grow and build your practice at a really fun time meeting with him, and also fun time with him on this podcast conversation. And then, most of the Dr. Milton, Melissa Tata, who has a practice in Colorado Springs, and she really provides a great perspective of how to continue to move forward with using new technologies and integrating new technologies into the machine.

[00:05:55] That is your practice specifically with contact lenses. And, really gave us some great perspective. So I had it. I had a really fun conversation with the three of them. Please enjoy our conversation and as always be sure to subscribe to the podcast, write a review, share it with your friends and support those.

[00:06:11] Mr. Porter.

[00:06:19] Providing my opiate controlled treatments in our practice for years. If you've been listening to the podcast for awhile, CooperVision has received FDA approval of its innovative myocyte one day contact lenses. 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 for children eight to 12 years old.

[00:06:47] 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 and how you can begin to offer it in your practice, Jim, I was, so I. I think Missy, the last time I traveled was, we went out to Las Vegas, my wife and I, and my, my nine-year-old.

[00:07:09] She wanted to, she likes the Eiffel tower. So we, so we took her to Las Vegas because that's the closest place you can get. And so it was for her golden birthday, she turned nine on may nine. And so we had tried to get there, you know, all summer long, all summer long. And I think Jim, we made it out, October early October.

[00:07:28] And, and I would say for the most part I had been to, I've been to Georgia. That was, that was really odd because, the airport was just happening. At least half shut down. and then, and then I'd been through Denver up through rapid city and both of those seemed relatively normal besides the face masks.

[00:07:46] The stuff that was open was normal stuff that was open, but Las Vegas is the same way. It's like, I felt like Las Vegas international was a McCarran was open like normal, except for masks. I would say that, yeah, I would say Las Vegas. I don't know how to describe it, but, felt, I don't know, it felt, it felt relatively normal.

[00:08:06]but, but I bring all of that up because Jim actually, let me, I called him maybe the day or two before, and he let me kind of swing by his office and see how he's doing things. So he was re renovating a lot of things and it was cool to see, you know, your, you guys were certainly busy. I mean, I don't know if that's normal for you, Jim, but you know, in, in this time, when I think about.

[00:08:27] Kind of busy-ness and being productive are two, not necessarily linked things. So I got the sense that you guys are very productive during this time, and you guys have sort of a good analytical approach to things just from a, a general standpoint within your optical, within your practice. But one of the reasons I wanted to have you all on is just kind of talk about some of those approaches to being productive and kind of redefining our, our views within contact lenses.

[00:08:57] So, you know, we've, we've been through a lot. Certainly what we're going through now is different than what we're, that we were going through six months ago, which is probably going to be different than what we're going to be doing six months from now. So I sorta wanted to frame those ideas about, how you guys are approaching the changes that have occurred, and then the changes you're anticipating over the next six months.

[00:09:18] So, Jim, I'll start with you because. One of the things that I was really kind of taken aback by, and that I shouldn't have been, but Mark you and Mark really have, have a good analytical approach to your optical. do you look at the same sort of things when you think about your, your contact lens practice?

[00:09:37] We do,

[00:09:38] Jim: [00:09:38] but it's not as complicated as you know, the obstacle with frames and. The way the prices are different with managed care plans and you you're looking at fashion as well as function and how many products to keep in each brand? How many in each line it's, it's a totally different thing. So context, we are looking at it analytically, but it's, it's a lot

[00:10:05] Chris: [00:10:05] easier.

[00:10:06] Yeah. So when you take that approach, you know, Mark had those spreadsheets that he was wowing me with. Do you still have kind of the same approach to saying, okay, we have this many patients in a contact lens, this many patients in this type of contact lens. And how do you think that has changed if you, if you know that specific numbers that's great.

[00:10:24] Do you think that's changed over the last six months?

[00:10:29] Jim: [00:10:29] They, they

[00:10:31] Chris: [00:10:31] graphics of who's wearing the type of lenses that they're wearing. I don't know

[00:10:35] Jim: [00:10:35] if that's changed the last six months, we are tracking that and we are able to go on that spreadsheet, plug it in and say, Oh, if we switch, we know how many patients are in each product.

[00:10:45] And we know our costs and what we get paid. If we make a switch here, you know, how does it impact the practice? But I don't know if that's changed in the last six. Maybe the numbers are, are

[00:10:57] Chris: [00:10:57] a little

[00:10:58] Jim: [00:10:58] skewed because you had. We had seven weeks where we really weren't seeing exams, but we were selling context as I think most of you guys were extending prescriptions.

[00:11:07] Chris: [00:11:07] So it was kind of an odd,

[00:11:09]Jim: [00:11:09] you know, To look at that, those numbers and understand them on a, on a global basis to CEO, or are we really moving patients one way or there is tough. I mean, we could still understand on an individual basis how much we profit on different products. And we can look at new lenses that come out.

[00:11:30] And if we, if we can move patients into, how does it impact the practice?

[00:11:35] Chris: [00:11:35] Do you think, Missy, one of the things that we've known to piggyback on Jim's point there, and I'd love to pick your brain about this is that, you know, when we go back and analyze our data to Jim's point about, you know, we, we were extending prescriptions and, and so there's two things that, that I've recently become aware of probably over the last couple months.

[00:11:55] One is that. we're down year over year in terms of comprehensive exams, whether it's just a comprehensive, when I say comprehensive, I mean, we have done a refraction with that exam, whether it's from a managed vision care payer or a private payer, or, you know, cash pay patient, but we did a refraction on that exam.

[00:12:13] We're down basically a hundred, exams year over year to, even to this date. and so when, but when we look at where we are down, we also down about a hundred contact lens exams. So it's almost exclusively when we look at that, the number that we're down, because we have this re real ramp back up after we were kind of a hold back over, March and April.

[00:12:37] But I'm wondering how many of those patients, and we're really trying to go back after them now to make sure that they're getting the care that they need. But how many of those patients, it just, it's a, it's a correlation where that's the amount of people that we extended, right. Or I'm suspicious that we extended these prescriptions.

[00:12:53] And now we thought we're going to extend them for three months, but here we are. It's what, seven months later, six months later that they still haven't returned. Have you seen that same sort of thing?

[00:13:05] Missy: [00:13:05] I don't know if we've exactly seen that exact correlation on that, but we've seen this funny dichotomy that happens

[00:13:11] Michele: [00:13:11] with our contact lens

[00:13:12] Missy: [00:13:12] patients of theirs.

[00:13:14]So many people are working from home and I've heard a lot of my patients say, well, you know what, I'm wearing my glasses way more than I'm wearing my contact lenses. Cause they just don't feel like putting them on unless I'm on a zoom meeting. And so, and then the other half of it, because we have such a military area, we also have a lot of people who are going back to the office because they're for security purposes and things like that.

[00:13:37] And then they're coming back and saying, well, I never wear contact lenses. But I want to wear them now. So we

[00:13:43] Michele: [00:13:43] have this like

[00:13:44] Missy: [00:13:44] dip and raise in this funny change that's happening there. So, you know, I think that to your point, there are probably patients who are, who have extended. And we'll probably be two years before, you know, we see them and we get caught back up, but you know, our numbers aren't catching up because we've reduced the number of patients that we're seeing.

[00:14:04] We're not are, our numbers are good because we're capturing way more because of that time that we can spend with people. It's kind of that like when you first opened your practice and you could spend more time with folks, so we've been capturing. More than we used to. and you know, I don't know that I want to work any harder.

[00:14:23] Right. But, so are there spaces to put all those patients in there too, but I think we've been capturing more, but then there's the dip on the other side,

[00:14:32] Chris: [00:14:32] when you think about contact lenses, you know, you made the point of patients, of patients that now are all of a sudden considering them. is it mostly masking that that's forcing them where they're getting fogging or is it that when they are.

[00:14:45]in a mask, they want to have the option to have people see their eyes, because that might be the only thing they get to see. Right. If, if we're, if we're covering all of this, I mean, is it a cosmetic reason? Is it a fogging issue? What do you think fogging

[00:14:59] Missy: [00:14:59] is

[00:14:59] Chris: [00:14:59] huge.

[00:15:00] Missy: [00:15:00] Fogging is a great big thing. Cause you see everybody walking out of my exam lane with a giant piece of tape

[00:15:05] Chris: [00:15:05] sitting right across.

[00:15:07]Missy: [00:15:07] so that has been kind of the biggest issue with working on the computer and doing all of those things that they just want freed up from that. And also it's the, it's the physical, I don't know if you've had this in your optical, but we get it all the time.

[00:15:19] Michele: [00:15:19] Patients are going to put on a

[00:15:20] Missy: [00:15:20] frame, but they already have their glasses on, but because the mask is there, they try to put the

[00:15:25] Michele: [00:15:25] other glasses on

[00:15:26] Missy: [00:15:26] over.

[00:15:27] Their current glasses, because there's this weird synesthesia thing happening that, and I think they just wanted to get freed up a little bit from having that mass on their

[00:15:37] Chris: [00:15:37] face. Do you think that there's, that there is a, like a. A a type of person, or is there a way that, that you bring this, new technologies up to people who have never worn contacts before that seems to be really effective?

[00:15:53] Like, is there sort of this, this sort of high level conversation that you're having with patients where you're like, yeah, I don't know. This is how that, that is kind of very simple for you to approach. And then that opens the conversation that's been effective for you.

[00:16:09]Michele: [00:16:09] so

[00:16:10] Missy: [00:16:10] in regards to like bringing up that contact lens wear issue, you know, they're complaining about fogging.

[00:16:14] We talked a little bit about what solutions we've had in the office for us. And then if I'm sending them out to optical to look at their glasses, I just have a tech put on contacts for them so that they don't have a mirror. They're not trying to double up. You know, they, and,

[00:16:30] Michele: [00:16:30] and so then it's not, it's not my time.

[00:16:33] Missy: [00:16:33] It's not my skill. I'm my skill is grabbing, you know, telling them like lenses, but really I'm not looking at fit or anything. And, and at the end they either just take them off or they go, Hey, that was kind of

[00:16:44] Michele: [00:16:44] cool. So it's little, it's

[00:16:47] Missy: [00:16:47] minimal because again, we're trying to limit the amount of time people are spending in the office, you know, and that's.

[00:16:53] Michele: [00:16:53] We've gotten the

[00:16:53] Missy: [00:16:53] Creek where we're, you know, letting people hang out and have a party again, but we're trying to get it back, you know, with the surge and whatnot. So just really being mindful

[00:17:02] Michele: [00:17:02] of that.

[00:17:03] Chris: [00:17:03] So when you're going to do that, you say, so you say, Oh, Hey, let me have Justine put these contact lenses on for you.

[00:17:10] So you can have an easier time looking at your new glasses. And then you're not even bringing it up from a standpoint of saying this is going to be something you're going to be doing. Long-term you're bringing it up on the standpoint of this. Makes it super easy for you to look at your glasses. Yep.

[00:17:25] Missy: [00:17:25] It's that. And just to get a sense of what it's

[00:17:27] Michele: [00:17:27] like to put on glasses,

[00:17:28] Missy: [00:17:28] you know, or, or excuse me to, just not have that fog issue, like I just saw clearly, and I don't have that. So it was kind of talking about it without talking about it. Cause you know, we have so many long conversations in the

[00:17:39] Michele: [00:17:39] office.

[00:17:40] Well, so

[00:17:40] Chris: [00:17:40] then how do you, how do you justify the idea of, okay, now you have delivered, I know you, because you made these sort of nuanced comments about, it's not really your expertise that you're using. It's not your time now. Let's say that patient decides, Oh, okay. I've got my new glasses. This was pretty nice.

[00:17:58] Like, and they say, Oh, I'd like to have a prescription for that. How did, how does your staff handle that in terms of transitioning that back into. You or how does that all work?

[00:18:07] Michele: [00:18:07] So then it's like, okay, well then

[00:18:09] Missy: [00:18:09] go on back into the exam lane, we're going to have her take a look at those. And then we start the process of the insertion removal training, that kind of thing.


[00:18:17] Michele: [00:18:17] so now,

[00:18:18] Missy: [00:18:18] now you're on

[00:18:19] Michele: [00:18:19] the clock.

[00:18:20] Missy: [00:18:20] If I come back and I take a look at those lenses,

[00:18:22]Michele: [00:18:22] Oh yeah, we can move forward with a fitting,

[00:18:24] Missy: [00:18:24] explain what the fitting is. You know, how is that different than me? Just Chuck in lenses, on you and you getting out of there, right? That this isn't the same thing we're not done today.

[00:18:33] Michele: [00:18:33] Right.

[00:18:34] Missy: [00:18:34] and, and then we start the process, then we can charge them appropriately, and not give away.

[00:18:42] Michele: [00:18:42] Give away the services

[00:18:44] Chris: [00:18:44] there. Well, I mean, I think that's sort of the touchy thing is that, you know, I think making that clear distinction between here, I'm putting something on your eye. That's not going to cause you harm in 15 minutes, but if it's not fit appropriately and it doesn't have like, long-term, it could have a problem.

[00:19:00] So now let's, this is a great lens, but now it's evaluate the rest of it. And then we show you all those other things. And if we needed to have a follow-up via tele-health or in physically an office, then it all works. Right. Jim, are you guys doing anything like that?

[00:19:13] Jim: [00:19:13] Absolutely. And we've done that. And, you know, I think what Missy's doing really is, is making people feel special at the end of the day

[00:19:20] Chris: [00:19:20] when we do that,

[00:19:22] Jim: [00:19:22] we really differentiate ourselves in our practices.

[00:19:24] And so there are there even before mass there's people that are plus threes plus fours, they want to go out and see themselves in glasses. And we put those on and. Basically, what I'll say is because we do topographies on every contact lens patient, but on every other patient, we still have auto Ks. So I will tell them I have.

[00:19:46] Chris: [00:19:46] Your

[00:19:47] Jim: [00:19:47] corneal measurements. I'm going to go ahead and so-and-so and put some context on you. So you could see yourself in glasses. You don't, there's no commitment at all and we haven't put it on. And then like Missy says, sometimes they wind up going down the road of getting them, or what typically happens is the next year they come and they go, Hey, you know, last year you gave me and I'm really interested in them now.

[00:20:07] So, so I don't think it's, I really don't think we're. Giving away service where we're treating someone special and, and to do that, sometimes it means being creative, treating everyone, everyone in a different way, not, not a cookie cutter, so, so kudos to you. Great job.

[00:20:26] Chris: [00:20:26] Yeah, I liked that. And I think one of the things that, may be, I mean, we have so many other options, but how would you approach a patient with significant astigmatism or presbyope are you putting them in single vision distance when you do that?

[00:20:39] Are you putting them in some sort of multi-focal lens that gives them some abilities to see up close? I mean, have you guys have any approaches to that, that, that has, that is seemed helpful? Would it be, would it be the same type of lens that you would think, Oh, if you're going to be a full-time where.

[00:20:55] This is the lens I would have you in, or it's like, I just want you to see really well within a distance of 10 feet, you guys put any thought to that.

[00:21:04] Jim: [00:21:04] I definitely do. And, and I, you know, so I guess we're talking about, let's say that, that worst case scenario in that situation, you've got your, your, for SBO, who's got a buck and three quarters sale, and I'm going to tell him, Hey, I'm going to, which is in contact lenses.

[00:21:21] And what I will do is, is do kind of a modified monovision and, and I don't have to get into discussing it with them, just that they'll be able to see themselves. With that. And so, you know, maybe you're, you're under correcting one, I a box or something like that. And getting 'em where we're in a, in a social setting or certainly in a setting to see themselves in glasses, it works.

[00:21:43] And again, it kind of primes that, for them to go. Wow. I didn't, I didn't know. I can see like

[00:21:47] Chris: [00:21:47] this what's your threshold. Sorry. Sorry, go ahead. Go ahead and answer that too. Cause I was just going to wonder, you know, when you're thinking about those things, cause you nodded as well when Jim was talking about.

[00:21:56] You know, do do he puts them in kind of different types of fits in. I'd love for you to expand upon that. But when you think about the threshold, when just even in general with contact lenses, what is your threshold for saying I'm going to correct for this astigmatism? Do you have a, in your mind where, where it seems to make sense?

[00:22:13] I find that a lot of people won't won't do it until it's like a minus one minus one and a quarter sill and the

[00:22:20] Missy: [00:22:20] lenses are so good now, but you know, getting that three quarter diopters. Clarity, you know, would you work, would you ever wear glasses without? It is my question. Right. And so it's so repeatable now and it's, you know, it's not like

[00:22:35] Michele: [00:22:35] back in the day when

[00:22:36] Missy: [00:22:36] you hoped it was 10 degrees, you know, 10 degrees rotation was fantastic.

[00:22:42] Right. You know, versus versus what it is now, it's going to be very, very consistent. So, I mean, for that, I, I have no worries about putting three quarters of a diopter on somebody with. Cause their, their vision is going to be that much better, especially if I'm doing something like a modified monovision where I'm really relying on.

[00:22:57] On one eye to see really quite well. and, and they'll notice that blur even more. So, I would say, as far as like throwing lenses on, I don't think I go down the rabbit hole quite of doing a multifocal. just because I just want that immediate clarity. I don't want it to feel, I don't want a funny feeling.

[00:23:16] Now that being said, if they're interested, we're going to have a conversation. When I look at that fit. You know what now we're going to spend some time it's worth my time to have more of that conversation of, well, I did that for you for glasses, but what I really think is going to work for you because you're on the computer all day long, is this, or, you know, however, however that happens.

[00:23:35] So, just for expedience purposes, I tend not to be quite so mindful of, Best correction,

[00:23:42] Chris: [00:23:42] right? Yeah. The idea of, especially if you've got a patient with low sill and you're going to throw a toric lens on, maybe you're gonna throw a, a Biofinity toric on them and they ha they might be a presbyope.

[00:23:53] Well, you already know, even if you're going to have to fit them. You, you want a multifocal for them, but now you're, you're saying, look, if you decide you like this vision at distance, we can give you some more for near, and I can also, I've already got this lens settling on your eye for 15 minutes, even though we know we don't need that, but Hey, let's come back in and check it out.

[00:24:11] Now, all I got to do is figure out, okay, do I need two D lenses? You know, just follow your fit guide. And then it becomes like way easier in terms of thinking through like, what was the. Your technical time. And then all they've got to do is like, you know how that lens is gonna sit on their eyes, you know, it's going to rotate and then you just, you've got your other lens.

[00:24:29] They can pick up and then experience and have some time to where once it comes in and then you can do your follow-up via telehealth or via, you know, via physical in our office. Speaking of that, you guys doing a lot of these tele-health or are you doing a lot of them physically in office? What's your threshold for when you will?

[00:24:45] You'll say I want to see this patient back in my office. For follow up and contact lenses right now,

[00:24:55] Jim: [00:24:55] we're not doing as much. Tele-health now, as we were back in, in March, April, may, and our contact lens followups on new patients, we're seeing them all back. If they're their previous patient, we're not, not probably not seeing them back at all, unless there's a problem,

[00:25:11] Chris: [00:25:11] right.

[00:25:12] Jim: [00:25:12] Trying to finagle something with a.

[00:25:14] And the multifocal or monovision and playing with, with some numbers.

[00:25:18] Chris: [00:25:18] Yeah. What about you, Missy? I think we're probably in

[00:25:21] Missy: [00:25:21] the same boat. I I'm still kind of pick your battles, right? So is this the change I'm going to do to my staff right now for me to do this and just kind of picking one thing at a time to do that?

[00:25:35] I think it's smart, but I'm not entirely, I don't know. Chris, are you doing a lot of contact lens checks where you're looking at movement rotation or anything like that with tiles?

[00:25:43] Michele: [00:25:43] No.

[00:25:44] Chris: [00:25:44] I mean, you know, we were, we were doing some of that and I think you can, with decent images, I think you can get a sense, like, you can get a sense, but I think if I've got a patient, like if I've got a patient that's in a multifocal toric, right.

[00:25:56] And, and I want to see, you know, and even if I know that lens is rotating, it's really challenging for me to know what change I want to make. That's going to be most effective for them just by talking to them. Now I can have a sense of that, but so I'm with you, I'm seeing those patients back for sure. in my, in my practice, it's hard to do via telehealth unless they really just don't want to be there.

[00:26:16] And most of, most of them in our community, don't they, they don't mind coming in. Yeah,

[00:26:21] Missy: [00:26:21] we're doing okay with follow-ups and not getting that pushback.

[00:26:25] Chris: [00:26:25] Yeah. Yeah. Michelle, what do you think when you think about, kind of the general topics that, you know, about mask wearing and you kind of have a sense, I think of the general trends of what may be going on, maybe better than what we do based in our specific practices, but.

[00:26:40] Is the stuff that we're talking about. Does this seem to be what most people are, are, dealing with across the country? Is it, does it vary from, from different places? What's, what's been your experience when you've talked to

[00:26:52] Michele: [00:26:52] people? Yeah. In fact, there's quite a few similarities that we're seeing across the industry that, that both Jim and Missy and you, Chris are talking about today, you know, in Italy, when we talked about the practices closing.

[00:27:09] You know, you're talking about Jim, you talked about how the contact lens revenue kept coming in. what shifted of course is sending lenses directly to the patient's home. So we immediately saw a big increase in request to get patient product right to the patient's home. Certainly you weren't open to be able to have that take place at the office for in many cases.

[00:27:36]but being able to ship that product right to the patient's house was, was a really important trend that we saw.

[00:27:44] Chris: [00:27:44] And that's has that stayed? Is that stayed? that's stayed consistent. It

[00:27:48] Michele: [00:27:48] has it, it has, it is something that, first of all, consumers love, they're so focused on what are the most important things I need to do.

[00:28:00] And, you know, Missy, you, you made the comment, is this the thing I need to take on right now? And you, our patients are thinking the same way that I care professionals are thinking about. Do I need to go back? and so what we're seeing is patients are happy to buy that in the supply. They're happy to have it sent to the house because of then they have confidence that no matter what happens next, in terms of their community or their environment, they have the product they need.

[00:28:25] They had it shipped right to their home. And certainly if they, if they need you, they know where to find you. but assuming that everything goes well, they have everything that they need, until that next year. So, so that is definitely a trend that's consistent. The other thing that we're seeing is something that Missy described, just so well.

[00:28:48] She said, you know, I've got some people. dropping out saying, well, I'm not wearing them as much because I, I'm not doing these social things and I'm working from home. And then we have other people coming into the market. And the way, we're looking at that is what is the need of the patient now? And how has their life changed such that their need to wear contact lenses has changed.

[00:29:14] So for example, patients still think contact lenses. Are essential for them. They still value them. It's just that, because their lifestyle changed a little bit that they're saying, well, that occasion doesn't exist anymore. And so maybe I don't need to wear them as frequently, but there are other occasions or other things that drive contact lens wear.

[00:29:39] So for example, you may have someone that was on their laptop, a few hours a day. Now they're on their laptop. Eight hours a day, 10 hours a day. You know, you're getting that notification from your phone, how much increased screen time you had this time, you know, this week versus last week. And so the vision needs change.

[00:29:59] And so the eye care professional has the opportunity to say based on what you're going through right now, I have a solution for them. So that may be a change in contact lens prescription. It might be a patient who is really sensitive to just help them safety. And they're saying, I want the best ocular health and safety.

[00:30:20] And so what is that? So we may take a contact lens patient from a reusable lens and they might go into a one day lens. Because they're just paying attention to those things now, or, or they remember, you know, Jim, you said you had that conversation with me before and now they're coming back in and saying, gosh, I'm hearing this everywhere about, about safety.

[00:30:42] What is the best way I can take care of? And then of course, masking and fogging. So we're hearing a lot that patients who didn't wear contact lenses, their new normal involves a mask. And so now they have become contact lens patients. And so I think, I think you're describing exactly what we're seeing in terms of, of those trends.

[00:31:03] That contact lenses still matter to people. They still matter to the practice, but we're providing the care in a way that is helpful to them. You've all talked about how you've adjusted the, a exam, right. And who better to make that decision than the eyecare professional that has been seeing them year after year after year, you had great confidence and probably gave them great confidence.

[00:31:26] That you could extend that prescription. And if you needed to see them, you're all calling out examples of where you want to see that patient back. I think that builds it's great service. It's great loyalty and, and it's the eyecare professional. That's the best person to make that decision. And so, I think that, that we've always thought and always acted with our patient's best interests in mind.

[00:31:51] If we just continue to do that and listen and ask the right questions to find out how have their lives changed. We'll find the care delivery model that makes sense for them. We'll find the product delivery model that makes sense for them. And we'll find the modality and best contact lens option for them.

[00:32:12] And we'll stay flexible because it's probably going to change.

[00:32:16] Chris: [00:32:16] You know, it strikes me, Michelle that, you know, all the things that you're describing. There's a lot of work in that. And there's a lot of nuance in that. And a lot of expertise that comes from just having a conversation with a patient that we can't really obtain through quick questionnaires or, you know, online screening tools.

[00:32:34] And the reason I bring that up is that, you know, on the one hand, it, it does, Your irritates, probably the best word. It irritates me. When I see, you know, it's basically, whack-a-mole, you know, you see all these different online prescription refill technologies and I'll quote unquote, call them technologies.

[00:32:51] Because honestly, if, if, and I always encourage people to do them and I've done reviews on them on the podcast multiple times over the last couple of years. And, and is laughable. It's not, it's not advanced technology. It's not forward-thinking technology is not new technology. What it is is basically a picture.

[00:33:09] Not even a good picture, a visual acuity chart and plug your old prescription in. And if that's what we're competing with, if that's what we think we're competing with as professionals, then we must be out of the game. Like we might as well just let them do it. Right. But, but it's very striking to me that in this time with all of these things, I mean, I've taken a couple of these recently.

[00:33:29] It's like, there's no, there's no question about. You know, are you having fogging with your mask? Have you ever worn contact lenses before you have you changed your habits with contact lens wear? It's essentially like check off all the boxes to make sure that I can say that you had no problems or you denied all the problems that you may be having.

[00:33:44] So I can just see why, and then tell me what your old prescription was. And as long as you can see 20, 25 or 2030 with him, we're just going to have a, a guy just stamp, approve that. That's what you get and, and, and we're fine. So, So, I guess my point is, is all this stuff. Should help one. I mean, the stuff we do in our office should be blatantly clear to patients, even if they choose to go down one of those roads that it's like, yeah.

[00:34:11] Okay. Yeah, it is all right, I'll do this. But if we're doing that same stuff in our practice and we're not offering them any new options or rethinking the way that we're delivering contact lenses to them, then we aren't doing any better than they're doing and we are at risk. So I think I, you know, I think that.

[00:34:27] Having those deep conversations. I mean, in summer, I think what you're saying, Michelle is having those deep conversations about how their lives have been impacted and then figuring out solutions on how to adjust so that they can still have flexibility with glasses and with contact lenses, I think makes a ton of sense.

[00:34:44]when you think about, like utilizing other technologies so that you can provide those other avenues. for more of an omni-channel experience, are you guys using any technologies, your practice so that you can deliver, products to patients when they want them, how they want them? What are those, what are those technologies?

[00:35:08] I was asking. I was asking you, Jim, you can't tell which on the screen. Okay.

[00:35:15] Jim: [00:35:15] We're using

[00:35:17] Chris: [00:35:17] contact

[00:35:18] Jim: [00:35:18] lens, refill. companies to, to help us deliver the product to the patient.