Growing an Independent optometry pPractice Toronto

Jaclyn Chang graduated from UW School of Optometry in 2018. In 2019, less than two years after graduating, she took the plunge and purchased an existing independent practice in an urban setting with plans to grow. She shares her story below.

 

By Jaclyn Chang, OD

I bought the practice in the middle of November, 2019. It was not a decision I made lightly.

The owner of one of the clinics that I was working at as an associate, in mid-town Toronto, was ready to retire and offered me the opportunity to buy the practice from him.

He had been working as an optometrist for over 38 years and had been in the office’s current location for the last 18 of them.

The equipment was original to the practice’s current location and was in need of an update; this meant that I would essentially be taking over an existing patient base, paying one lump sum for the patient records.

The office sold contact lenses but there was no dispensary or any auxiliary testing available.

Considerations
With a deadline, I had to consider my options and get back to the owner with my decision.

Because I had been working in the practice a few days per week over the previous year, I knew the patient demographic, staff, schedule, and location very well – a huge advantage as I was making my decision.

I liked the idea of building on a smaller existing practice as opposed to starting from scratch or paying a higher price for a larger practice.

There would be patients walking through the door on day one but I would still be able to put my stamp on the practice and really make it my own.

Ideally, I wanted to provide patients with more technology, including a retinal camera, OCT, and visual field. With this equipment, I would be able to continue to grow my skills as a practitioner in treating and managing disease.

Difficulties
Eventually, I would also want to give patients the convenience of having access to a dispensary in my own clinic – something which would not be possible at the current location.

As a newer practitioner, I was also limited financially and by the amount of business knowledge and experience I had.

I would have to figure out what equipment to purchase, how to finance it, and decide on the new fee structure for patients.

I would have to go through the process of creating a dispensary and hiring and training staff.

By adding new revenue streams that previously did not exist for this practice, there was no reference as to how the patient base would respond.

I worried about how long it would take to get to the stage I wanted and whether or not I would be able to afford it.

An Opportunity
Then, another opportunity came up for me to move the practice into a nearby clinic with the technology and dispensary that I was looking for.

As with any practice purchase, patients would experience a doctor change, but if we moved, we would also be putting patients through a physical location change and switching to a very different way of practicing suddenly.

However, it would also mean that I would be able to practice the way that I wanted to, with the equipment I wanted, immediately.

My Decision
I knew there was extensive work to be done on the practice and a steep learning curve to becoming a practice owner, but this was an opportunity that I could not turn down.

By December 2nd, 2019, I had moved the practice into the new office and had officially seen my first patients as a new independent practice owner.

This process did not happen the way I would have ever imagined, but now that one year has passed, I look back on it proud of the progress we have made and am excited to continue sharing my story with you!

JACLYN CHANG, OD

Editor NewOptometrist.ca

Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with NewOptometrist.ca.


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Quality patient care starts with the people providing it.

Perry Steigner, Optician-Owner

During an ownership transitions, maintaining standards of care among new staff is particularly important for practices that have thrived due to exceptional patient care.

Perry Steigner’s practice was one such case; tucked away in a medical building, Perry leveraged strong people skills to build a robust practice that stood out from the crowd.

His personalized, high-end service drew in repeat patients during its 27 years in operation, even without a street-level storefront. That lack of visibility might make it seem like an unlikely candidate for an acquisition, but Perry successfully sold the practice to IRIS in 2019.

With IRIS, Steigner was able to grow his legacy of patient care at a new location, while at the same time adopting a more fully integrated practice that enhanced competitiveness.

Below are the details of Steigner’s story: the sale, transition, and outcome.

A Second Look
When Perry started his independent practice in 1993, he wanted to stand out amongst the superstore and 1-hour optical outlets popping up in eyecare: “I wanted to get back to the basics: customer service, personal relationships and build a practice that way.” His friendly, conversational approach to service and commitment to quality care was what set his business apart in an increasingly competitive retail landscape.

Dr. Daryan Angle, VP of Business Development at IRIS, approached Perry in 2012 about partnering with IRIS, but the timing was not right for Perry. He was very interested in IRIS’s collaborative model of patient care but was not ready to make a move with a large lease term remaining on his office space.

His practice, Medical Arts Optical, depended on a strong relationship with nearby ophthalmologists and optometrists, giving Perry lots of referrals to work with.

While his store continued its robust growth year after year, Perry realized, that after 40 years in the industry, he still needed the perfect exit strategy.

When Daryan approached him again in 2018, his lease was coming up, and he made the decision pursue a partnership with IRIS.

Evolution of the Deal
IRIS provided Perry different options. He could choose to bring in a partner, keep a small percentage, or sell his practice outright. Perry decided to sell 100% of his practice to IRIS and work with them as an employee.

There were other offers on the table, but they all offered an earn-out over a specified period of time, whereas IRIS offered him the option to sell the entire practice immediately. Selling his practice gave him a chance to continue working and provided an easy exit option at the same time.

Although he did not plan to retire right away, he wanted a strategy that made the most of the business he had cultivated over the years: “All the people that I know, and I’ve been in it 40 years, don’t sell their business. They shut them down and get rid of the phone line, and that’s it.”

His passion for the work left him wanting to keep going without worrying about how he would make his exit and entrust his legacy of exemplary patient care to a responsible partner.

New Location, Same Great Service, Flawless Transition
Usually, IRIS will partner with an existing location, but this time Perry’s Medical Arts practice relocated to an existing corporate IRIS location half a kilometer down the street. IRIS made sure to bring the features of Perry’s practice with him, to keep his regular patients coming back.

Rose Chiarot, Optician

Rose Chariot, an optician with whom Perry had been working along for 20 years, was also transferred to the new IRIS location maintaining her schedule of two afternoon shifts per week.

Although IRIS does not typically have in-store edging equipment, Perry brought over his own so he could continue to provide assembly services.

Eight thousand flyers were sent to Perry’s existing patients, explaining the merger.  The Medical Arts Optical phone number was rerouted to the new location and the new welcome message was provided in Perry’s familiar voice. Steigner characterized the transition as flawless.

Perry also passed on his formula for friendly patient care to the staff at IRIS: “This is our stage, we are performers, let’s get to know our customers. It’s the personal touch that will set us above our competitors. They are very receptive to that.” Perry was rewarded by seeing the transformation among the staff, who learned from his approach by watching him work.

IRIS provided Perry with a three-year employment contract but told him he could stay on as long as he wanted. The three years will help IRIS integrate Perry’s practice successfully, and Perry was eager to help in any way he can.

A COVID-19 Lesson
On March 24th, IRIS decided to shut down the location after COVID-19 hit. After the Ontario regulatory allowed limited open hours for urgent care, the office switched to appointment-based services. Perry initially thought it would be a problem for the optical dispensing side but was impressed with the sophistication of IRIS’ digital appointment system.

His patients also commented on the shorter wait times as a result of appointment-based retailing.

The End Result
Perry has no regrets about his decision and keeps working out of love for the business. He was happy to make the switch to a great location, and to keep seeing his patients without the administrative hassle of running a business: “What I was glad to get rid of was writing the cheques, worrying about the suppliers, reconciling statements, all that stuff. All my energy now is 100% focused on getting these patients to IRIS.

“Even my accountant would say, ‘Perry, if you are looking at an exit strategy, this is textbook: here you go, you sold your practice, you like the guys you are selling to, you are two blocks away from where you were, the location is fantastic.’ It was a great opportunity.”

Update
Perry is  working Tuesday to Saturday, an arrangement that works best for this location. The stores sales volume has been exceeding projected goals.

Due to COVID the store continues to see patient’s by appointment only with very positive feedback from patients. Perry has suggested that even when the COVID situation settles down, IRIS should continue to offer appointments for eyeglass selection or repairs and adjustments, and pursue a balance of appointments and walk ins.

 

IRIS provided Eye Care Business Canada full unconditional access to ECPs that have recently completed a partnership agreement with the group.  Each partner story provides and insider’s view to the the acquisition;  challenges faced, obstacles overcome and the final results.

This is the fourth of a four part series:  The Power of Partnership: Overcoming Challenges Together.

Related Articles:  

Previous articles in the Series:

Power in Partnership:  An Early Adopter Parnership:  Lessons Learned and Shared 
Power in Partnership: Overcoming Challenges Together (Dr. Christa Beverley, Barrie)
Power in Partnership: Enhancing Value Through Transformation to a Full Service Practice 
Eyes Wide Open Podcast:  How IRIS Challenged the Ontario OD Regs and Won
Eyes Wide Open Podcast:  IRIS sees Sliver Linings Behind the Covid Clouds
Insight Profile:  Dr. Daryan Angle, IRIS VP Business Development


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Dr. Christian Nanini was aware of IRIS from their home province of Quebec. IRIS clinics had developed a forward-thinking, profitable business model that Dr. Nanini and his partners attempted to emulate at a smaller scale within their own practice – but without the benefit of the IRIS brand name. Ontario regulations stood in the way.

Profession’s Politics at Play

For many years, the Ontario College of Optometrists (COO) had very restrictive regulations that forced an antiquated pricing mechanism and forbade association among Optometrists, Opticians and corporate entities.

In 2006, the same year that Dr. Nanini consolidated three practices in the Niagara region into one location, IRIS led the charge to challenge the status quo which drew the ire of optometry’s regulators in Ontario.

Nanini and his partners wanted to move quickly but were advised to wait until IRIS’s challenge to Ontario’s antiquated regulations were settled.

Ultimately, by marshalling the support of the Ontario Ministry of Health and the Competition Bureau of Canada and citing the Canadian Charter of Rights freedom of association provisions, the COO publicly acknowledged resistance to IRIS’s business practices would cease.

Listen to Dr. Daryan Angle recount the story of IRIS’s challenge to the Ontario College of Optometrists in the Eyes Wide Open Podcast, hosted by Dr. Glen Chiasson

Gaining a Better Work-Life Balance
As a young family man, Dr. Nanini began to feel overwhelmed having to do everything in his business early on. Work-life balance was not in his vocabulary.

He faced the challenge of juggling all the balls that come with running a small business. Aside from patient care, his time was spent doing joyless grunt work: managing and training staff, marketing, payroll, strategizing how to grow the business and the list goes on.

Like many optometrists he simply wanted to do what he studied and trained for—examining, diagnosing and treating their patients. He did not want to feel weighed down by the tedium and stress of an endless to-do list, but still wanted a sense of control over the business.

A Shared Vision
Knowing of the success of IRIS in his home province, Dr. Nanini believed that his clinic would do better to partner with IRIS rather than compete with them for patients. He also saw the value in relinquishing essential business responsibilities that would free up his time.

“I was 100% okay with that because, for me, it’s freedom from all the workload, all the training, all of the advertisement, all the negotiations with suppliers. Everything was out of my hands now …freeing up my time a lot. After work, I could come home and enjoy quality family time instead of having to do paperwork,” Nanini remarks.

In 2009, two years after his initial meeting with Dr. Francis Jean (the now-deceased founder of IRIS), his clinic was officially a 50% shareholder with IRIS owning 50%. He chose this option over alternative percentage splits or a franchise model.

“Right from the beginning I didn’t want to sell the whole thing. I still wanted to have some power into some decisions.”

Transition Lessons Learned
Dr. Daryan Angle, IRIS VP of business development, worked with Dr. Nanini to transition the Welland Ontario practice. Discussion and negotiation about the partnership was smooth, however they did encounter challenges immediately following the merger.

During IRIS’s initial expansion into Ontario, Dr. Angle frankly admits that there was a steep learning curve with many missteps made around on-boarding, especially for the first handful of clinics that opened in the province. Part of the issue was that IRIS’s onsite on-boarding and training for the new system was compacted into a few short days before the actual launch.

IRIS Welland Reception Desk

Dr. Nanini recalls that he should have briefed his staff more rigorously about why the transition would make life easier, and what to expect when it happened. As a result, he lost two employees who could not adapt to the changes fast enough. Subsequently, he had to scramble to hire and train two new employees on top of everything else.

Today, IRIS’ on-boarding process is far more comprehensive. Training days are held months in advance to give owners and staff time to integrate the information. By the end, staff are well-versed in navigating the software system and have good knowledge about new products.

Navigating Pricing Changes
Even though the legal battle between IRIS and the College of Optometrists had been settled in 2008, it was not until 2014 that regulatory changes were made. While regulators moved slowly, the new IRIS in Welland Ontario was forging ahead with retail pricing while many private practice ODs cautiously remained on the sidelines.

None of Dr. Nanini’s staff, now part of IRIS, were ready for the retail-model pricing which created significantly higher price points than the previously regulated cost-plus dispensing model that IRIS worked to change. Dr. Nanini’s staff suddenly found themselves needing to explain and sell products to sticker-shocked patients.

Nanini recalls “We used to sell our high-end products at a really low price compared to what they were selling for everywhere else in Canada…people wanted the high-end products, but they were suddenly $200 more. That’s what the patients and the staff found difficult.”

Another stumbling block was that IRIS, at the time, only offered premium-priced eyewear therefore losing potential sales from patients with lower budgets. They now adopt a “good, better, best” approach that can accommodate most budgets while maintaining the highest quality of products possible.

Sharing the Experience with Others
Since its inception, IRIS has displayed a willingness to adjust to the needs of its customers, franchisees and partners. Customers get the best care and products, and independent eye care professionals thrive under a time-tested, profitable business model.

Today, Dr. Nanini helps on-board other optometrists who have embraced more profits and more freedom with IRIS. As well, he sits on internal IRIS committees to guide the integration process, sharing his experience.

When asked if he would do it again if he had the chance, Dr. Nanini had no qualms.

“Yes, definitely I would still join IRIS in my mind, knowing I lose some control but there is a lot of stuff that is off my shoulders now…I can enjoy a better quality of life. So, to me, I would do it in a blink.”

Dr. Nanini still works 5 days a week, and sometimes 6!  

He enjoys walking 6-7 km every day, jogging and biking.

 

 

 

 

IRIS provided Eye Care Business Canada full unconditional access to ECPs that have recently completed a partnership agreement with the group.  Each partner story provides and insider’s view to the the acquisition;  challenges faced, obstacles overcome and the final results.

This is the third of a four part series:  The Power of Partnership: Overcoming Challenges Together.

Related Articles:  

Previous articles in the Series:
Power in Partnership: Overcoming Challenges Together (Dr. Christa Beverley, Barrie)
Power in Partnership: Enhancing Value Through Transformation to a Full Service Practice 
Eyes Wide Open Podcast:  How IRIS Challenged the Ontario OD Regs and Won
Eyes Wide Open Podcast:  IRIS sees Sliver Linings Behind the Covid Clouds
Insight Profile:  Dr. Daryan Angle, IRIS VP Business Development


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