For the 6th and final installment of The Future of Canadian Optometry Series presented by Aequus Pharma, Dr. Harbir Sian interviews Dr. Kerry Salsberg to get the perspective of a successful independent optometrist.
Dr. Salsberg is the owner of modern and advanced practice named Eyes on Sheppard in Toronto. In this episode, Kerry shares his thoughts on the direction the profession is heading. He explains how optometrists across the country can embrace the coming changes.
Tune into all six episodes of The Future of Optometry Series on The 20/20 Podcast to hear the perspectives of leaders from various organizations in the Canadian eye care industry.
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Dr. Kerry Salsberg - The Future Of Canadian Optometry
Welcome back to the Future of Canadian Optometry Series presented by Aequus Pharma. I’m very excited to bring you the sixth and final episode of this series. To do a quick recap in case you missed it, there have been 5 previous episodes with 5 leaders from various organizations that have a footprint in the Canadian optometric industry. We kicked off the series with an interview with Dr. Alan Ulsifer, CEO of FYidoctors.
Next was with Dr. Daryan Angle, VP at the Iris Visual Group. The third interview was with Mr. Bill Moir, GM of Specsavers Canada. The fourth interview was with Mr. Rick Gadd, President of Essilor Canada. The fifth was with Mr. Alfonso Cerullo, President of LensCrafters. As I’ve mentioned before, if you're reading, you've read that the sixth and final episode is with Dr. Kerry Salsberg. I wanted to wrap up this entire series and make sure that I got the perspective of independent optometry.
I don't want this to look like a big advertisement for all the various corporations that we could potentially work at. I want to make sure that we hear from a successful independent optometrist to hear what it takes to become successful in the Canadian market, what it's going to be and what it's going to take for us to remain successful moving forward into the future. Kerry definitely is the perfect person to talk about that. In this interview, one thing I asked every guest is for them to be candid. As I’ve mentioned already, some guests were candid and some were not. Kerry is about as candid as it gets and does not hold any punches.
That's exactly what I would love to hear from him because it's time for a bit of a wake-up call for us as ODs to understand what it's going to take for us to make sure that we are able to elevate our profession and what it's going to take for us to maintain a high perception for the value of the service that we provide in the public eye.
As always, I’m going to ask before I get into the episode the same thing I ask with every episode, which is that I hope you share this with our friends and our colleagues, whether you post it on Instagram, LinkedIn, Facebook, or send a text message with the link so everybody can tune in and learn Kerry's perspective as well as all the previous perspectives from our past guests on The Future of Canadian Optometry Series here presented by Aequus Pharma. Here is the episode with Dr. Kerry Salsberg.
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Dr. Kerry Salsberg, thank you so much for taking the time to join me here for this special conversation about The Future of Canadian Optometry here on the show. I appreciate you joining me.
Thanks for having me. I know this is a long time coming, and I’m glad that we could work this out.
It was well worth the wait. Definitely, you're top of the list for this particular, very specific conversation that we're going to have because you are the sixth and final installment in this series, The Future of Canadian Optometry Series. I deliberately wanted to keep you for the end because, in the end, I wanted to have the conversation rounded out by speaking with an independent optometrist. Someone who's been successful in that realm, specifically as an independent, and can showcase how ODs can do as independent and what it takes to succeed. You're the perfect guest for this, and I was more than happy to wait to make sure all the stars aligned. Thanks again.
I’m looking forward to this. It should be interesting.
Kerry, as you probably know and anybody who's tuning in for the sixth episode now, I’m sure, is familiar that I put a call out to the industry and the profession through the show. I did deliberately name some organizations by name to have them come forward to invite them on the show to talk about what is the future of Canadian optometry. What are these organizations doing to support the profession of optometry to make sure it continues to grow and thrive?
I’ve been fortunate to have some great guests and leaders from these different organizations who can give their opinions and perspectives than the average optometrists will get to see normally. I also feel like, again, you're in that position, a slightly different position, than many optometrists with the type of practice you have and the way you practice. I know that you're going to do this already, but I’m inviting you to be as candid, open, and share as much as you possibly can. I’m not afraid that you're going to be too secretive about anything. The first question that I’ve asked every single guest is, in your opinion, what is the current state of optometry in Canada?
The current state is, one, uncertainty. In Ontario, we're going through this OHIP process or negotiation process. We have staff and associate shortages. We have all these new players coming in. It's a big free for all right now. With that, comes concern, uncertainty, and anxiety. The pie may be getting a little bit bigger, but the slices are getting much smaller. We've heard about Specsavers coming in and all these online players. I think that the dust will settle. I don't think the market is big enough to accommodate all these new players. You see this in the stock market with marijuana stocks and pizza parlors. If it's too good to be true, the strong will survive.
That's for us to decide who's going to survive. Right now, gathering from talking to a lot of colleagues, there are concerns. That's good to have those concerns. You can't be myopic and have the blinders on. You have to know who your enemies are and your allies are. The state with Covid going on and we're starting to get the patients coming back into the practice, there's a little bit of apprehension in anxiety.
You touched on a lot of different aspects. There are topics there, which we're going to try to unpack a few as we go through. Obviously, there's a feeling or a sense of some negative feeling. Anxiety is the word you use. I can't quite put my finger on what it is, but some disarray is happening in the profession. Are there positive things that we can look at right now? What's something that you would look at and say, “That's a good thing in our profession?”
The future is bright. There are so many niches when you think of optometry. When my dad was practicing, he was doing refractions and dispensing glasses out of a drawer. He couldn't even showcase that. We've come a long way, whether it's myopia control, macular degeneration, aesthetics, low vision, and dry eye. We have so many specialties, so we can create our own destiny.
The future is ours in terms of figuring out what you enjoy and how you create a niche because it’s what's going to happen. The generalists are dying. You can't switch dials all day long. You have to have a specialty in order to differentiate yourself, like the products that are coming out, the technology, and the contact lenses. I have ADD and I’m constantly being bombarded by all this stuff.
When I graduated, it was a stale profession. You had some new daily disposable contact lenses and that was exciting, but now, it's coming at you at a million miles an hour. I’m excited about all the opportunities and the technology that will be born out of a lot of these new niches that we're seeing right now.
The future is bright. We're not running for the hills, but you have to be very careful in terms of how you plan the next 5, 10, or 15 years. You have to have a plan and direction. If you're going to be a one-person operation, spinning dials, and trying to compete in terms of the optical and contact lens market, you're going to have a tough go for the next five years.
If you can create a service that not many people in your area are doing, then you're going to be fine. It's planning and not practicing in a 10x10 room and in the dark. You have to know what's out there and the competition that's coming in. Get online and figure out what some of the new services are being offered. I’m excited. The next 10 or 15 years in optometry are going to be transformative and it's going to be completely different than what's going on nowadays.
That's definitely good to hear that somebody like yourself feels that the future is bright, there's a lot of positivity to take away and things to look forward to as long as we're proactively building that for ourselves. To go back to what you said earlier, enemies and allies. I’m curious to tap into that a little bit, and again, if you're comfortable sharing. Who would you slate as those people in the profession right now? Who should we be looking at with a bit of caution and as potential supporters of the profession?
Somebody told me once that the shoe market was X millions of dollars before Zappos came around. The shoe market now is twenty times that. Zappos to the old cobbler would've been competition. I don't look at all these new players as being competition. I think it's going to expand the market and there's going to be greater awareness and education.
Certainly, there's going to be some pain as new players come in and it may be erased to the bottom in terms of pricing points, but by creating awareness of the harms of blue light, UV, and the importance of getting an eye exam, it only can help us. There is going to be some turbulence over the next couple of years. No doubt. The fear is that Specsavers has very aggressive growth plans.
There are going to be 200-plus locations in a span of two years. That's tremendous growth. We have to be aware of the competition, but you have to up your game. The greater awareness will strengthen the profession. That's why the pie will get bigger. It's just a matter of how much independent optometry will have a slice. Do I think that online businesses are good for the profession? Probably not. I do look at it as every person that comes into the market. There's an opportunity for us to get better, stronger, and be better business people. It's a kick in the pants to get your game on. Maybe I’m insulated.
Optometrists must be aware of their competition and level up their game. The pie will only get bigger, and it's just a matter of how much slice the independent optometry will have.
I’m not concerned about any of these players. I practice at a different level, not in terms of my skillset, but I have a very focused and laser-focused direction in terms of where I see my practice. Although we were successful when we grew from one doctor in a room about this size of the whole practice to now over 10,000 square feet with 40 staff and 8 doctors.
I’m not resting on my laurels. It's always what's next. What do I have to do to better myself to provide a better patient experience? Having this competition fuels that and makes you think about how am I going to survive and compete. I’m not worried about the competition. I’m aware of the competition, but definitely not worried.
I feel like we've had a few kicks in the pants over the last decade or so. You're right. I agree. Sometimes, if you could take it that way, you take it as a little bit of a wake-up call. Let's start thinking about new ways to practice and serve our patients. On that note, I did an unofficial poll. I don't remember if I mentioned this to you. When Specsavers announced that they were coming into BC before they'd officially opened any stores, I started texting colleagues across the country asking if I saw them in person, “In your opinion, what is your initial sentiment of Specsavers coming to Canada? Positive, negative, or indifferent?”
It’s about 40 votes and the result was 1 positive, low 20s like 23 negatives, and 17 or 16 indifferent. Obviously, it skewed pretty heavily to one side. I would probe each person and ask them, “Why are you negative? Why are you indifferent?” The way that it all seemed to flush out was the people who were indifferent were, generally speaking, practitioners and business owners like yourself who were doing well or comfortable.
They're forward-thinking and growing their business and they're saying, “I’m not worried about my business from a business perspective.” The people who were negative were somewhere worried about their business, but the big chunk of it was worried about the profession as a whole being devalued. What do you think about that? Do you feel that there is a reason to be concerned about that side of things, like the whole profession being devalued by a large player that perhaps brings down what the perceived value of optometry is?
That speaks to what I was mentioning before, which is the generalist doing refractions in a slit lamp and an OCT. There's going to be pricing pressure. In order to get a chunk of that pie, there will be a race to the bottom. I know that some retailers are offering $80 to $90 exams. You have Specsavers that are offering OCT and power to them. They figure out that a lot of doctors are charging for this for $95 or whatever it is and includes an OCT. In that respect, in terms of the optical, the contact lens, and the general eye exam, you will have to do something and make sure that we don't commoditize the eye exam.
We've already done it with contact lenses to an extent that we've done it with glasses. It's the Zara or H&M factor, which is disposable goods, but there's also a little bit of backlash. Now people are going, “I want to buy quality as opposed to quantity.” It's important that you establish relationships with your patients that something that may not come as easy to some of these chains and online players. Lifelong relationships are super important. Listening to your patients, being curious about your patients, and establishing. The biggest thing is listening. If we could do a better job listening to our patients as opposed to dictating recommendations and treatment plans, we can regain some of the lost market shares.
Competitive Pressures: Lifelong relationships are important. If optometrists can better listen to their patients than dictating recommendations and treatment plans, they can regain lost market shares.
These chains are basically commoditizing the exam, which I don't think is in anybody's best interest. We have to be concerned about that, but our fees have gone up. It’s the right thing to do. It sounds counterintuitive. When patients say it's too expensive, what they're saying is it's too expensive for the service or product that you're offering. If you can show value, even though it may be more expensive, it's not always about the lowest cost dollars. If we up our game plan and provide something that nobody else is doing, we're safe. Everybody has to do that to survive.
When someone is in your office, they've had an eye exam and they're at the end of the process, and they say, “Wow, that was worth $200.” I’m deliberately trying to pick a little bit of a higher number. I know that's not as high as some people charge, but it's more than what I charge. Let's say $200 for an eye exam, but they felt good because they went through the process, got all the tests, you listen, and serve that patient well. That was $200 well spent. What about before they even walk in the door? They're seeing that one of the chains does a $90 eye exam or $95. Let's say Specsavers include OCT, but somebody else charges $150 to $200. How are we going to show that patient at that point that there's a difference?
It's tough. I don't think a website cuts it or listing your service. I don’t think that resonates. People don't know what a visual field exam is or a cover test. It's word of mouth and you have to start. If you're starting fresh, you have a little bit of a problem. You have to do something. You cannot be a refractionist or do standard eye exams. Whether that's vision therapy or pediatric, you have to differentiate if you're starting. If you have a full contingency of patients and you have thousands of patients, then it's your job to make sure that those patients don't migrate to these chains. You're going to lose some. I know that I’ve lost some where they go once or twice to a chain and then they come back.
That's a good lesson. I can afford to lose those patients as part of a fact-finding mission, but you have to. It's all about service. As much as the patients don't like paying more, it's easier when I’m charging the fees. Some of my colleagues are charging 1/3 higher than what I’m charging with the expectation that it's good quality because they have no other way of comparing it.
If they know that somebody is $250 versus $95, there's an expectation that there's a differential. If they hear it from other patients that you have to go to Eyes on Shepherd or to your practice, they've already been pre-sold. The worst thing that doctors can do is bring down their pricing. If anything, you have to go the other way around but create service and value that the patient is able to feel and to pick up on.
Competitive Pressures: The worst thing doctors can do is bring down their pricing. Create service and value that patients can feel and pick up on
What do you think are some of the forces? We hear about consolidation. There are companies like Specsavers coming from overseas and there are online. What do you have to be, as an independent or as an associate doctor, working at somebody else's practice? What do you think may be the biggest threat right now to the profession or is there one, generally speaking?
You mentioned before the word indifferent. If you're indifferent, resting on your laurels and you have this annuity, you make X number of dollars every year and you don't have to worry, you're going to ride out the storm and retire in 10 or 15 years, the profession is in trouble. If you see this as a stimulus to get better, learn more, market more, and merchandise better, it's great. It's a wake-up call for the industry that has historically been complaining about a lot of things but making a lot of money and a good living. The ability to generate X number of dollars a year without working hard, that's over. You're going to see a practice erosion.
Patients are going to migrate because you haven't provided them with something that they can value. As an independent practice, I’m able to pivot and be so nimble. If I see a new device or new product, I can literally have that in a day. Our practice has been known to carry all the latest technology. One of our advantages or value added is that every time a patient comes in, they're going to be exposed to new technology and new product offerings. It's important because we only have touchpoints with these patients every year. Some practices, every two years. You better have something different so that they can judge that you're a progressive practice. Again, complacency and indifference will be the deathbed of optometry.
I love that answer because the direction I’ve been taking this whole thing is that there's something else out there that's going to be the death of optometry. What you're telling me is that we need to look inside or within and fight for that. Thanks. I needed that. On a similar note, a big part of this is the call-out. This series of episodes I have is asking these corporations and organizations what are they doing to support the profession. Do you think they have any responsibility to actually support the profession of optometry?
No. I don't think it's their mandate or any responsibility. It ultimately comes down to the almighty dollar. At the end of the day, they have to appease shareholders and their investors. It can be ruthless and cutthroat, but I don't think they need support. Frankly, if these companies are saying that they're supporting optometry, I’d be scratching my head and thinking, “I don't know about that.” I don't believe that. These players are here to make money and to seize market share, and that's it.
What Specsavers’ model is that you own the practice in some respect. What should they be looking at, in your opinion, when they make a decision to go work at this corporation or that organization or own a share in that practice? Do you have any thoughts on how they should make that decision, whether they should go independent or become an associate at an independent practice if we're looking at that ODs career path, but an overall profession for the benefit of the profession as well?
It comes down to freedom of practice and how you see yourself if you're being dictated by the corporation to pump out prescriptions. What kind of luxury do you have to bring in new technology and niche services that may not translate to greater net revenue for the corporation but provide fulfillment for the doctor practicing? Before we started, I said there's no free lunch in life.
At the end of the day, all these incentives and bonus offers will erode over time. We've seen it historically with managed care and Specsavers. No knocks against Specsavers. In fact, we should be applauding them. They've done a great job. What a great business plan and they've known how to tap into the consumer psyche, so kudos to them.
There is no free lunch in life. At the end of the day, incentives and bonus offers will erode over time.
I also know that if you're an optometrist there, there's probably going to be erosion and remuneration for yourself over time, just as there has been with managed care. As an independent practitioner, I can dictate how hard I want to work, what I want to do, how much time I can take off, how much time I can spend with patients, what technology I want to bring in, and what products I’m going to align with.
For me, being nimble, able to pivot, and able to decide my own destiny is a big thing. I get it. If you come out of school and you have $250,000 in debt, you're in panic mode and survival mode. You have to pay that back. I can see the lure of going into some of these chains and new players, but at the end of the day, these companies are there to make money.
They're not there to satiate your demands for what you want to make per year and they will cut costs. One of the best ways to do it is to take your percentage of whatever you take in, and that becomes eroded over time, so I’d be cautious. If it's too good to be true, it usually is. I’d also do research. I’d contact, other players that have been working for chains and see what the pluses and the negatives are. I don't want to criticize any of these players because they do have a business model. Independent optometry is not for everybody, nor is working for a chain. That's what makes the world interesting.
Competitive Pressures: Medical companies are here to make money, not to satiate demands you want to make yearly. They will cut costs, so be sure to take your percentage of whatever you take in.
That was one of the questions that I posed to each of the prior guests. For our conversation here, I like the fact that we're flowing through this a bit more freely, but with the previous guests, I had a much more structured interview process. One of the guests gave me the question, “Was companies are handing up these incentives?” For example, when I spoke with Dr. Ulsifer from FYi, I said, “You're giving these new grads forgivable loans.”
When I spoke to Bill Moore from Specsavers, I said, “You have these big salaries for some of your locations.” Do you think that the new grads have the leverage and the power or is that being clouded? Are their career paths and decisions being blinded a little bit by the money or the dollar signs? It’s interesting to hear the mixed response depending on if a corporation did have one of those incentives or if it didn't. Coming from an independence perspective, your perspective here sounds like it's not the OD who has the power in that decision or has the leverage, really.
You have to decide on the destiny that you want, whether you're with Iris, FYi, in a buying group, or working with these chains. The fact is there's a cost for that. They're not being nice and helping you grow your practice. Often, there's an issue. You don't want to deal with the administrative duties of a practice you've been practicing for a couple of years. You want to sail it into the sunset and see patients. There's a cost for that. Now, you can leverage some of their vertical integration and their cost savings on stuff. The salaries commiserate with maybe what you made before. As an independent, I feel that I can dictate what I want to make and how I want to practice.
I love the administration. I love being able to meet with my doctors and management and decide where our practice is going to go. I don't want to be governed by a corporation that says, “We have to improve our revenue or decrease costs.” I don't want to be part of that equation. I look at it more from how much money I can make to what life I want to live. It’s very important. Again, that dollar and loan forgiveness is a big lure, but that's fleeting. That 2 or 3 years where you've removed some of that pain, there's a cost for that. You either pay now or pay later, but you always pay. It's a difficult decision to make.
We were saying earlier offline the demand for ODs. I was saying one of my pain points these days as a business owner is I can't find associates. It's hard to find people to come and work. In general, it seems there's a shortage or a high demand, however it is. Pendulum seems to have swung one way. Usually, when that happens, it swings back. Is that what you see? At some point, it's got to reach a peak, and then it's going to somehow come back. If you put on your future goggles here, what do you see in that regard?
I liken it to the real estate market. Not too long ago, it was a seller's market buyers could not afford. Now, it transitioned. That pendulum analogy is very fitting. I don't know where these associates have gone. I know there was a cry that there were too many optometrists in the marketplace and too many schools graduating optometrists. As a practice owner, you have to be very careful in terms of who you bring on. Right now, if you have a pulse, we'll take you. That has long-term consequences. You have to take a breath. First of all, a lot of doctors that are bringing on associates do not need associates.
They haven't filled up their day. You have to do an analysis on your practice and figure it out. Are you better off not bringing in associates, condensing your hours, and maybe working a four-day work week instead of a five-day one and having gaps in your schedule? Most practices that feel that they need to bring on an associate typically don't. Sometimes, it is a lifestyle issue. Everything reaches an equilibrium. There's homeostasis and there will be. I just don't think it's right now. This is a very turbulent time for bringing in associates, finding qualified staff, and staff that lasts more than 2 or 3 weeks, and the pricing pressures to bring on those staff.
You can have somebody that should be paid $20 an hour, and they're asking for $28, but they're not worth that extra $8 premium. You have to be on the sidelines right now. There's so much uncertainty. Marketplace doesn't know what's going on. The stock market is in a quandary right now. Are we going to be in a recession? How bad is inflation? Are the rates going to go up? There are so many things that are uncertain right now. You have to take a breather and tread water. There will be some equilibrium that happens, but it's tough for independent businesses for sure.
For sure, it is, but it will be interesting to see how it all plays out. I can't imagine the way it keeps going this way for more than another year. We'll see how it all plays out or what kinds of changes will come about. You mentioned this earlier. You feel like the future of optometry is bright. What do you think the job and optometrist's job will look like 10 or 20 years in the future?
A lot of the stuff that we do will be online. Technology is improving. I can see where companies are going with the delegation and having your staff. A teleoptometry thing is going to be huge. If you're in a rural setting, you're going to have a reach of probably twice or three times your current population pool because of teleoptometry. The whole profession is going to be different. We are going to be using drops to treat myopia and molding new corneas. We're going to be using light therapy to treat all sorts of diseases that people can do at home. People are going to be able to do self-refractions, and these things shouldn't be scary. They're opportunities. We have to be current.
We have to make sure that we understand what some of these potential threats are. What we're doing with the equipment that you see behind me is going to be antiquated. I don't know, but I can tell you that going to conferences and seeing in terms of the future of lens design and imaging technologies, I’ve had the privilege of seeing the latest in OCT scans. We're talking about going from 100,000 megahertz to 400 megahertz and taking pan-retinal scans in 10 seconds. The traditional fundus BIO exam will be a thing of the past, thank God, because, with a click of a button, it takes a 360-degree scan, anterior and posterior, and everything in between.
Competitive Pressures: The optometry practice must be current. Everyone must ensure they understand that some of the equipment being used today will soon be antiquated.
That's 4 or 5 years away, a lot of change. Think about optometry from 1920 to 1980 was basically the same profession. You then had soft contact lenses, disposable contact lenses, great designs in multifocal imaging technologies, and myopia control. All sorts of things. I can't imagine what this profession but this is parabolic. We're on that hockey stick upturn. That's why we have to be excited, but we have to be knowledgeable. We have to go on the internet, go to conferences, talk to colleagues, find out what's the latest and greatest, and grasp onto something. Don't wait for everybody else to be doing it. Nobody remembers the second person on the moon.
They remember the first person on the moon. We also have to be able to part with our money. I see so many doctors complain about how much money they make, yet they're driving fantastic cars, going on luxury vacations, and having cottage properties. For every dollar you put into your practice, the return on investment of that can be $2, $3, or $4. People are very apprehensive to invest in their practice. You have to invest in your staff and your practice. It's exponential in terms of growth. When new technologies and new products come out, embrace them. The worst thing you can do is have a paperweight, but the best thing is you can offer new services and get clientele that way. Embrace the future.
There are some potentially very expensive paperweights out there carrying if you don't put them to use.
It's funny because we have pretty much every piece of technology. Probably duplication. I won't get into the company that we did business with. There was one device that didn't live up to its expectations. It pales in comparison to all the equipment that has brought not only value to the doctors but to the patients and has increased revenues. I don't think there's anything in our practice that I could live without now. We're one of the first ones to bring in Whitefield imaging, and I’d be lost if we didn't have that. The same thing with OCT and digital auto phoropter. I can move my shoulder now. It's amazing.
I’m starting to get a little pinch going here. It's taken a few years. Count has come up in almost every interview, interestingly enough, and I’ve never expanded on it, but the word delegation. That word has come up a lot when I ask that question about the future of our profession or the future of what an optometrist job is going to look like. What does that mean? Is that something we should be afraid of?
No. Patients judged the exam based on the one-on-one interactions that they have, whether it was 5 or 10 minutes. The perceived value can often be 20 or 30 minutes. As the patient goes through the gate of tests, they're spending upwards of 15 to 20 minutes doing pre-testing. Think about you have your visual fields, wide-field imaging, refraction, and tonometry. If you're doing VA, some doctors are delegating refraction, which I don't think is a bad idea, but it's getting all that data, understanding it, and then communicating it with the patient as opposed to typing in stuff. One of my big pet peeves is not facing the patient and my screen. Not too long ago, I was still writing on paper charts because I could do this and still face the patient.
Scribes are very expensive. As much as they're great, in the next year to two years, you're going to have digital scribes. You're going to have offsite scribes. Delegation is the way to go. Your time is valuable. Whether that means seeing more patients per day or less patients per day and having a lifestyle bonus, delegation is important. You got to train your staff. Gone are the days when patients expect you to do every procedure. That's how businesses run efficiently.
As part of that, the tele-optometry, as you mentioned, the upside is expanding the reach that we will have and the number of patients and geographically how far we can reach. On the flip side of that, should we be afraid of corporations being able to do the same thing, first of all? Secondly, AI and other things interfaces like that potentially replace the role of the doctor and settings like that. Again, with the digital refraction, I saw something about alternatives coming through the FDA. It’s getting some FDA approval in the states. That's obviously coming. Should we be afraid that we're going to be kicked out of this picture entirely?
No, embrace it. The good old days of putting up a sign in front of your office and be guaranteed annuity, whether you're a good doctor or a bad doctor, those days are over. You have to be at the cutting edge, or at least aware of it. We own those patients right now. It's for us to lose those patients. Unless you are progressing your practice and maybe doing things that are uncomfortable to you, getting uncomfortable to be comfortable later on, you're doing yourself a disservice by not being aware of these things. There's nothing that is coming out that is scaring me. As long as we can figure out that opportunity, that new service or new technology provides. Corporations are going to do it because they're going to chase those dollars too.
If you are not doing uncomfortable things to progress your practice, you are only doing yourself a disservice. You must figure out the opportunity that technology can provide.
The benefit of being independent and running your own business is that you have a lot of skin in the game. You care and you have great relationships with patients. I’m not saying that you can't be an optometrist at Costco and have great relationships, but the one main advantage that we have is that we have trust, we listen, and we're curious. I’m sure you're the same. How much time of an exam is spent talking about their vacation in the restaurants that they've been to and their family?
How's Billy doing with softball versus doing the exam? What the patient perceives is that you're turning all these dials and you've done an exam and spent the majority of your time getting to know a patient. What a wonderful opportunity. If I was a dentist, I’d go crazy. We could talk, but we couldn't get any feedback. The twenty conversations that I have a day with my patients, they value that.
They're willing to spend a little bit more to have that one-on-one, especially with Covid and being secluded and outside of many social circles. It's a great opportunity to bring them back for public life, having those conversations, checking in with them, and seeing how they're doing. An answer to your question, embrace technology and change. It's the only way that you're going to survive.
You've already hit this throughout the interview here, but if you were speaking to a pre-optometry student or looking for a profession to go into yet, what advice would you give that student?
Make sure you understand the profession of optometry. Work and volunteer or go into a variety of settings to understand where you see yourself. Not everybody is a business person and some people want to check in and check out them, and that's fine. Understand what the future of optometry is going to look like. Some are competitive pressures. Make sure that this is the right thing for you. Knowing what I know now, I would absolutely go into optometry. It's so exciting. For somebody that is like, “There's something shiny,” I love it. I went to Mito in the spring and talk about a trade show. I was wired.
The amount of money that these companies are spending on introducing new products is mind-blowing. There's no better profession. If you're in the healthcare profession, I think of optometry. I’m not saying this because we're having this conversation, and I don't want to sound like I’m 100% upbeat because there are days when I go home and go, “What the hell am I doing?” This profession is incredible and I’d love my kids to go into it. My son wants to be a baseball player/optometrist. We'll see what happens there. For my kids that want to go into it, I’d welcome it. It'd be great. I had the fortunate pleasure of working with my dad for 25 years and it was a great opportunity. I love that. It's been a wonderful ride and I have a few more years to go.
Hopefully, many more.
I hope so.
I appreciate that answer. It’s interesting to hear that you would encourage your children to go into it because that always is the tell-all at the end. When I’m talking to patients and they're asking, what would you do if this was your kid. I said that I’m always giving you the answer without you asking me. I’m always giving you the answer based on like, “If this was my child, what would I do?” In a situation setting like this on a podcast, I’m asking you this question.
Guests often feel compelled to sugarcoat the answer a little bit and make it sound nice to the optometry community. That's generally not the answer I want and definitely not during this series of conversations, not the answer I want. I’d like to hear genuinely if there's something negative that you want to tell that kid. How old are you before you go to optometry? 22? When you want to tell, “It's actually harsh right now. I’m not sure,” or you want to tell them, “No. Stick with it because ten years from now, this is going to be an incredible profession to be in.”
If you look at the aging population, you look at all the opportunities. You can be a salesperson or medical optometrist. There are so many different niches that you have. The one big challenge that we all face, and we talked about it before, is managing people. You have to be a leader. You can't be a manager or a boss anymore. You have to elevate your team. To be honest with you, I actually love it when my staff decides that they want to venture into something else. They want to go into real estate. They've learned how to talk to people now. They see a bigger, better future. You got to let these people go. Nothing is forever.
One of the biggest challenges all medical practitioners face is managing people. You have to be a leader instead of a manager or a boss. You have to elevate your team.
That means there's a constant churn of staff, and you have to manage that. When you have a staff of 40 people, there's going to be 3 people that are out sick. There's going to be somebody that has to move to the city. As we practice in Toronto, the city is getting prohibitively expensive. To make that commute an hour and a half away isn't feasible. It's a challenge, but it's also such a pleasure to see the ability to hire 40 people and for them to provide food for their families and grow personally and professionally.
It's wonderful. For other people, it's a headache. To see people grow and create this business family is great. To each his own, everybody has a pain point. My pain point is making sure everything flows properly. I am a little bit of a perfectionist when it comes to that. I get very nervous when I’m late for an appointment. It makes me crazy more than it makes my patient. These are some of the stresses that I have, but as long as you're working towards a goal to minimize those, you're good.
Dr. Salsberg, any final words of wisdom you'd like to share on this topic of The Future of Canadian Optometry?
To my colleagues, don't bury your head in the sand. Get out of your 10x10 room. See what's going on at the retail chains. See what's happening in terms of merchandising if you have an optical gallery in terms of marketing. Embrace administrative technology and be aware of the environment. It's not so scary. When you practice in the dark and think in the dark, it can be quite challenging.
Competitive Pressures: Optometrists must not bury their heads in the sand. They should get out of their room and see what is happening at retail chains and merchandising.
We are so fortunate to have a stable of patients that we have. We have to culture and nurture that patient pace. It's fun. We're doing this 8 or 9 hours a day. I want to have new technology and talk to patients. Granted, this has been a long day for me and you get a little bit parched, but it's great leaving the office. When you have a great day, your staff are happy, and your patients are happy, what more could you ask for?
That's a great way to end the episode. I appreciate you sticking around these late hours after work after a long day to share your insights. Dr. Salsberg, thank you for joining me and thank you to everybody who's been reading. This is the sixth and final installment in The Future of Canadian Optometry Series on the 2020 Show, presented by Aequus Pharma on Canada's number one optometry show.
Make sure you send me your messages and leave reviews. If you got something for Kerry that you want him to know, shoot those messages over. Let's keep this conversation going. Maybe we'll have even more of these episodes in the future if we feel like we want to ask more questions. Thanks again for joining me on this journey, guys. I appreciate it. We'll see you again soon.
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There it was, the sixth and final episode, the interview with Dr. Kerry Salsberg, owner of Eyes on Shepherd. I hope you enjoyed it. I hope you found some great insight like I did. Even some of the words that came out of my mouth that was like, “I guess I got to get my act together too.” Kerry didn't hold any punches. He tells it straight. That's exactly what we all need to hear. As ODs, how do we, as colleagues, come together to make sure that our profession continues to grow and thrive in the future? I hope you found a lot of insight.
If you haven't read any of the previous interviews, please go back and check them out. Once again, there are five other interviews with Dr. Alan Ulsifer, Dr. Daryan Angle, Mr. Bill Moir, Mr. Rick Gadd, and Mr. Alfonso Cerullo all prior to this interview with Dr. Kerry Salsberg. All right here on The Future of Optometry Series presented by Aqueous Pharma on the 2020 Podcast, Canada's number one optometry podcast.
I hope you've loved this series, guys. I hope you give me as much feedback as you can, and I’m very open to as much constructive criticism as you can provide because I want to continue to make this better. As I’ve said before, there's a chance that I’ll have some of these guests back on. If you think there's something I missed, I’d love to get back into it with them with any of the questions that you'd like me to ask in the future. Thanks again for joining me on this ride. It's been a great journey. I’ve learned a lot. I hope that there's been value in this for all of you that has helped and will help us as colleagues and professionals to continue to grow. Thanks again for joining me, guys. I’ll see you in the next regular episode right here. Take care.
Important Links
Dr. Alan Ulsifer – Previous Episode
Dr. Daryan Angle – Previous Episode
Bill Moir – Previous Episode
Rick Gadd – Previous Episode