During his interview process prior to being selected as the current President of the New England College of Optometry, Dr. Howard Purcell was referred to as a round peg trying to fit into a square hole.
And since being selected for this position, Dr. Purcell has lived up to this description. Bringing his immense wealth of knowledge from his experience working within two of the largest corporations in the eye care industry, Dr. Purcell is working to prepare optometry students for the disruption and evolution our industry will be navigating in the coming years.
During our discussion, I had the opportunity to ask Dr. Purcell a variety of questions including thoughts about some of Essilor's previous mergers and acquisitions, recent regulatory changes in the industry, and where he sees the eye care industry going in the future. I hope you learn from and enjoy this episode as much as I did!
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Presidential Insights From Dr. Howard Purcell
This episode is an interview with Dr. Howard Purcell, who is the President of the New England College of Optometry. My alma mater and his alma mater. In fact, he graduated from NECO in 1984, and his father also graduated from NECO 30 years earlier. A pretty strong history for the New England College of Optometry within Dr. Purcell here. He has quite the background experience himself having worked within the industry with a couple of big companies that I'm sure you have heard of, as well as working in academia. Now being at the head of one of the main optometric institutions in the country.
I'm very excited to have this conversation with Dr. Purcell to ask him a lot of different questions. We are hopefully diving deep into a couple of topics that are near and dear to me but also, he's such a fun, energetic guy. I'm sure it's going to be an entertaining conversation overall. Without hesitation, let's jump right in.
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Thank you, Dr. Purcell, for taking the time to join me here. I know you are a busy guy. You are very much in demand. I appreciate you spending the time with me here.
It's my pleasure.
We will start with some housekeeping or easier questions, things that personally I'm interested to know. I'm assuming if I'm asking the question, there are other people out there who are probably interested as well. Can you define your role as the President and maybe compare that to other roles within the school, the dean or other positions like that?
We have different ways we set up optometry schools around the country. Let’s start with the basics because not everybody is familiar with them. If you are part of a larger university, then the dean of the optometry school runs the school. They have all the decision-making capabilities but they do report to a university president typically or a provost. That's the majority.
There are only, to the best of my knowledge, three remaining independent private institutions. At those institutions, which mine happens to be one of those, the head of the optometry school is the president. I'm President and CEO because I have chief responsibilities for our clinical environments as well. In any case, at our institution, we are the end of the road. There are no other presidents and provosts, etc.
I liked that because if you look at an example where it can backfire on you. Nova, wonderful institution, I spent five years of my career there and I love those guys. They are great. They had a little situation in which perhaps things were misunderstood about a contribution that was intended to be made to them. There is where you get into a situation where the optometry school could think one way, the administration of the university thinks another. When you look at the big picture, I like the idea personally, I prefer to live and die by my own decisions. I will take the heat when it goes wrong and we will celebrate when we have good things happen. For me, I like that environment.
In our institution, we also have a dean but in a private institution. The dean is the head academic first. They have leadership and decision-making capabilities for the academic program. I'm not an academic. I don't come from that world. Our Dean, Erik Weissberg, has been at the institution since he graduated. He had brought so much knowledge. He has been in many different roles at the institution. I personally think for a dean, that is the perfect profile. They understand it and have been in the trenches. He and I can have great discussions because I come from such a different perspective than he does. At our institution, we also have associate deans. Our associate Dean could be up to the clinical side of the house as an example. Our clinical faculty have someone who represents them.
In a university setting, you could have your one dean that runs the institution. The deans and private institutions are at the end of the road. Other than perhaps the Board of Trustees, the people are interested. I report to the Board of Trustees. They have issues, do my review and look after fiduciary responsibilities, etc. It happens to be I was a member of the Board of Trustees at ASCO that has worked in my favor in knowing the board and understanding what drives them. It has been helpful. I hope that, to some extent, answers your question.
I had a little concept of where the lines were drawn on that, and I'm familiar with Dr. Weissberg. He was there when I was at school at NECO. That's cool to know that he's the Dean. I don't think I knew that already.
He has been the dean for about a year. He has done an outstanding job. The dean should bring that real experience of being in the trenches, etc. Eric does that in such an incredibly positive way and he's a great leader, too. At least for us, it works in our institution.
You have already alluded to this but your background is not so much in the academia you mentioned. You have done quite a bit of work in the industry, if I'm not mistaken, with J&J and with Essilor. I was curious to see how that experience has informed or shaped your approach as the President of an academic institute.
I will answer it by telling you a quick story. At the last step of my interview, I had been called much throughout the whole process, the square peg in a round hole. I'm not an academic. I don't come from that world. I spent five years of my career in academia and I appreciated it, and we laughed and joked about it at the end of the interview is my last interview with them.
Their final question to me was, “Dr. Purcell, you have been called the square peg in a round hole. How are you going to round off the edges of the square peg fit into the hole?” I already know the answer. I can tell already the answer I gave but let me admit first that I felt little pressure. I was happy in my job. I would have been happy to retire at Essilor and continue there but to be the President of my institution, which is something I couldn't pass up on the opportunity.
Anyway, my answer was, “If that's what you are looking for, I'm not your guy.” When I looked around the room, I remember calling my wife and saying, “Don't worry. We are not going to be moving at all.” We are pretty much sealed the deal but nevertheless that I think helps to answer the question. I come at it from a different perspective but at this point, it's not a bad thing. As I sit around the table with my colleagues at ASCO and they are amazing people, most of them have spent their entire career in academia. I hope what I can bring is a different perspective. My time in the industry allowed me to visit thousands of practices and talk to thousands of practitioners. I tried to understand as best as I could the challenges and issues they were facing.
It enabled me to be better at leadership, management and holding different positions at different levels but maybe most importantly, I would have to say and it started at J&J. They have something called the Credo, if your readers are not familiar with the Credo, you should take a look at it. It was written by General Johnson a couple of hundred years ago. It says that when you have difficult decisions to make, here's how you prioritize. For J&J it's, “The users of our product and our patients that use us are number one. Our employees, our environment and our shareholders.”
I find that interesting in a big company, the shareholders at the bottom. What they will tell you is to take care of those first three and your shareholders will be fine. That left an impression on me because we all have difficult decisions to make. I'm sitting in my office and what comes into my office now and levelize it is the ones that people can't out. There are good arguments on both sides.
All of a sudden, I'm supposed to be the smartest guy in the room and I'm going to be able to know what the right decision is here, and both people are making great points. I have learned a lot from the industry but this is probably the biggest thing. If you can share with people ahead of time, this is how we prioritize. We are going to make a tough decision. This is the number 1, 2, and 3 things we are going to look at.
What I found happens and it's interesting, you have two people that made their great points and both sound legit. What you don't say is, “Here's what I think that's what we are going to do.” I haven't found that to be quite as successful. If I say, “You remember this. Our priority number one is the student first. That is how we make decisions. It's how we are going to make all this.” If we agree on that, then clearly, you two have both made great arguments but your argument seems to me to be much more focused on students first. That's how we are going to go. Even though that other person who didn't get their way is still okay with it because it wasn't some person who thought they could make a decision. It was based on something we have all agreed on. I saw the same thing at Essilor.
You work for Fortune 500 companies. You learn why they are Fortune 500 companies. If you prioritize and know what guidelines you are going to use, call it a Credo, prioritization or whatever it is but if you all agree on it, it does make those difficult decisions easier. They are still not easy but they become a little easier and you get more support because people understand how you are making decisions.
It's not because you think that's what it should be. Now you get to sit in the big office, therefore, you make the decision. I could probably list ten more things but that was the first one that came to mind. I think about it almost daily. That's why it comes to my mind when you ask and that is a great question but I learned a ton.
I hope that the experience I have will help guide the college to the future because we are looking towards the future. We are trying to prepare our students for not only what we see nowadays but as best possible, what we see upfront. One of my functions in Essilor was to look at everybody's new widget and the newest thing that was going to change the industry. I’ve got to see so much of that that I hope I can bring some of that, not only to the college but to academic optometry in general.
In that answer, what I love is that you have given me a segue to the next question. I appreciate that. Some decisions are always going to be hard but at least the person who doesn't get their way sees why that decision was made. I think that's powerful in keeping a team or an organization institute working on the same path and the same direction. It reminds me of something I learned about Jeff Bezos, speaking of large companies, which when he was having a meeting, he's always got a chair for the customer. It's an empty chair but he says, “This is the customer is sitting here.”
It’s amazing how he does things. I also learned something that I have implemented. When you have a tough project that you are looking at, it’s way on front and it's a long project. The way he approaches it, write the press release first and sit down. You are just starting the project. Write then what do you want it to say? What do you want the differentiator to be? It's an incredibly powerful tool because now, once you agree on that, and it takes a while to agree on writing what the press release is going to say, you can plan the path to get there.
There's a reason why the success that he has been. I may get argued all different kinds of things but overall, the guy has been incredibly successful. He has some unique ways. One with the chair, I have heard two. That one I liked, too. Write the press first, and then you know what the targeting is and where are you going?
We talk about having a clear vision. That's about as clear as your vision's ever going to get is what are you telling the world when the product is ready. The segue that you had made for me was talking about the future, and I have heard you say you are preparing students for tomorrow’s optometry if I'm hearing that correctly. I’m sorry if I'm misquoting that. I was curious then in your mind, what tomorrow's optometry looks like however, many years in advance in the future you would like to go. What are you telling students that are in NECO now? What would you like them to learn that would prepare them for that future?
Here's how we approach it and I have taken some heat for this but I'm happy to tell you that I believe it's the right thing to do. Our students should not graduate after four years of being in an optometry school and not see some of the things out there that are disruptive, that is changing the way we practice. Even if I like them or I don't like them, personally, I shouldn't be the judge of that.
The first step to it for me is I want to expose our students to everything that's possibly going on out there. I want them to be able to ask questions, to challenge people, to talk about it, and I will tell you we have done it. We have started doing it several years ago. Our students ask amazing questions. They don't have biases and preexisting thought processes, and they ask great questions. Telehealth is a great example of that.
Several years ago, we decided we were going to heavily learn more about Telehealth. We were going to look at how we validate. Dr. Gary Chu and his team have been doing a wonderful job, along with many. It came in handy and I had to step away. Another example, Warby Parker. We know our friends at Warby Parker and we have been friends for a while. Neil Blumenthal is the Head of Warby. I have known him for a long time.
He was going to be at Harvard speaking and he said, “I will come over to NECO if you would like and I will talk over there. I thought, “That would be fantastic. I want a student council. Would you guys be interested?” “We love it.” We had a packed house, people sitting in the stairway and we listened to Neil tell us about this incredible vision and tell us what an amazing entrepreneur and philanthropist he is. We also listened to him explain optometry.
It was clear. He didn't understand that optometry well. He recognized it and he asked a lot of questions, and it made for great dialogue. I think our students got a lot out of it and Warby got a lot out of it. I’ve got a lot of nasty ramps from people saying, “How dare we let such a person even walk in the door?” My philosophy is, I owe to you, the students, to expose you to as much as I possibly can.
Artificial intelligence, virtual reality, 3D printing of lenses and frames, and what we talked about. All these different applications and it's not about, do we think they are good? They are not. The students should have a chance to play with it, utilize it, involve themselves in it, and then ultimately make their decision as to, whether they think this is something good or not but I believe we owe it to them.
I am always searching with Gary to find out what is new and innovative going on out there. We want those people to come and visit us. The unique thing and you know this because you are an alum. There's a huge advantage to being in Boston. There’s going on when it comes to healthcare, IT, and technology across the river.
You know this from MIT. We've got Tufts, BC, BU, Harvard, Northeastern and it goes on. We are in a wonderful position to be able to take full advantage. I would say over these past several years, I'm proud of how things have accelerated. I recognize that some will love this idea but I think it's hard to argue that we should not present this to the student.
They shouldn't see it after they graduate and say, “What is this? I never heard of it. I didn't even know what was going on.” That's how I look at it. We say, “Prepare today’s optometrist for tomorrow's optometry.” We haven't fully assessed what we think is going to truly be tomorrow's optometry but we work on that every day. When we see something, we think it influences it positively, negatively or we don't know. We feel it's important that our students have a chance to see it, touch it, feel it, play with it, and ask questions about it. To me, that's education. That's what you have to do in addition to the poor principal.
There is a lot more to it but that's the root of the thinking and I will tell you, the students have responded incredibly positively. They want it, they want more of it and ask incredibly good questions. I continue to reinforce to do it but I do occasionally take a little heat. The other thing that's come up and I will throw out there is, what should the relationship between industry and academia look like? This has been a little bit of a church and state relationship in many ways. We draw that wall, create that wall, we don't want either. I look at that a little differently and probably because of where I came from but we cannot achieve the goals that we have set for ourselves at NECO. I suspect this is true at every institution, without the supportive industry. We have to find the right balance.
The industry doesn't want to come in and dictate our programming. That's not what they do. They want to expose themselves to students early. Students know who's supporting them that they are out there. Ultimately their products have to stand on their own but I believe we have to perhaps change the dynamic a little bit of the relationship between industry and academia. It's why we started the industry collaborative. We have now over 60 companies that are part of it.
I'm proud of the work Gary Chu and his team have done to bring us closer, to talk to each other, to understand the importance of that relationship. What's okay and what's not okay? To lift up the hood and show people what's going on in optometric education because I have said this before and you have probably heard me say it. If I had these two years of experience in academia and went back to my old job, I would be ten times better because now I have a better appreciation for what the issues and the needs are.
Our industry collaborative part of the emphasis behind that or the purpose of it is to help each other understand the key issues as well as have something at stake. If we graduate better optometry, for example, as a better business thinker because that's something we do poorly nowadays, in my opinion, and not just my opinion. I think in a lot of people's opinion in optometry schools.
One example, if the industry could help us save with a post-graduate course is difficult, as you know to incorporate it into the four years. We do it but it's hard for lots of reasons but if we could create some type of accelerated two-week program after graduation, where people could come in or even if you are out 1 or 2 years and you want to brush up on some of the business of optometry, that it didn't matter where you practice. You would be prepared for a better understanding of the business.
One example, I believe we have to reframe our relationship with industry because I have sat in both seats, I think it's doable without inappropriate influence but together we can do so much more. If you think of this new entity, EssilorLuxottica says whatever you will about them, you love it, you don't love it. The resources they have now are immense.
If we can ask the right way, do the right things to get their support, we will be able to do things that we have only dreamed of. Sorry, I'm a little bit on my soapbox on that one. I feel strongly about that for a lot of reasons, I have been to both places and the intentions are good. We have our colleagues and top optometrist at every major company that supports us. These are our own colleagues. We need to be talking to them.
In my opinion, we need to be freer in sharing the real issues. What I learned when I was in the industry were superficial issues. I didn't hear about the deeper ones that you learn when you come to academia. Some of the challenges exist in any situation but without industry support and they want to support it. We have a meeting in Boston, which is incredibly enthusiastic. We had a panel of students and a panel of faculty talk to the industry, and those could have gone on for 2 or 3 more hours.
Eye Care Industry: If you all agree on something, it does make those difficult decisions easier. You get more support from people who understand how you're making decisions.
It was one of the first times that industry was able to ask students, “What is it like? What are your challenges? What are you thinking about as faculty? Are you the people that couldn't practice? That's why you taught it was a candid conversation and I believe our colleagues left there impressed. I don't know what they expected our students to be but they were blown away at the quality and caliber, and that's not just NECO. That's across the board.
We have the best and I know you are going to agree with that but there are great students throughout the country, and they have never been exposed to that. I don't see any downside to that. In fact, an incredible upside to that, when you are trying to form a partnership, the better you can understand each other, the better that partnership is going to be. You can think about marriage, business relationships, whatever it is, the better you understand each other. I didn't understand academic issues as well as I could have and I have ultimate responsibility for supporting that.
That's a lot of amazing insight there and there are a lot of comments I would probably want to make about some of the different things you mentioned but to go back to the earlier stages of what you are trying to instill in the current students. It's hard to know exactly where optometry is going but the fact that you are giving them this exposure is extremely important.
The word that was coming to my mind as you are describing that was agility. A lot of times in business these days with the way everything is changing quickly when you have this information, you are more agile. You can jump on something a little more quickly. For example, eCommerce. I know you have spoken extensively about eCommerce and I feel that generally, our profession was not slow to move but almost deliberately opposing it for a long time.
COVID gave everybody a shot in the arm like, “We’ve got to go online if you are not on already.” I think that's cool that you are doing that. Since we are talking about the industry, I did have some questions regarding that anyway. I had some order of questions but it's not that important and particular Essilor. You were there for a long time and it sounds like you had a great experience working there and have a lot of positive feelings for the company.
You mentioned the merger, which I know left people feeling anywhere from ambivalent like mixed feelings to like, “What the heck is going on? My career is going to end. Essilor is going to own the world.” Part of my question was, are you hearing a lot of that now? Are students expressing any of this concern to you as well? I already have a feeling but your personal thoughts on an entity like EssilorLuxottica having such a presence in our industry, is it good or bad? What are we looking at?
I have to caveat this by saying, “I know the people at Essilor. I don't know intimately all the people at Luxottica, although I have worked closely with them.” What I can tell you about the people with Essilor is that they have all the right intentions. They allowed an optometrist to sit at the highest level at what's called the leadership team, not only the executive committee but on the leadership team of only seven people have the honor of being able to have a seat at that table. Essilor and J&J want the input of optometry. Let me start that first and it makes sense. If you are running a business, you better understand and be supportive of your customer.
I also appreciate that when anyone gets big, there's nervousness about that. To me, it ultimately comes down to the people. All Essilor is a bunch of people trying to run a business and be successful running that business. The intentions of this combination of EssilorLuxottica had so much potential to change things. Think about the resources they bring to the table. Think about it if they went out there and continued to support things like telling people the importance of annual eye exams.
Getting out there and speaking about what optometry does more, the resources are incredible. Even look at simple things like lens and frame. There are rarely ever lens and frame are designed together. You have lens companies, you have frame companies, and now you have a company that can come together and does amazing things by having control over the frame and lens component. That's a unique opportunity
In education, there’s so much good that can be done. The way that is dictated is feedback from colleagues. This was an important piece. I wanted to make sure to answer your question here. What you may think is, “I'm a practitioner, I'm here, I call up Essilor and student group thing. They are going to care what I say.” Few people take the time to give that feedback and I will tell you this, every president I worked for at J&J and Essilor has been a few of them.
When I go to a meeting, the first thing, when I get back there picking my brain, what did they say? What are people talking about? What are they interested in because few people give that feedback? If I had any words of advice and that might be more important than my experience at these companies is if you have something to say, pick up the phone and say it. You may think that it isn't going to be heard but few people do it that a good industry partner is hungry for that information.
I would encourage people to give feedback and make sure that you take the time to give the feedback. I read everything that came through to Essilor and people are saying either great or not so great because I thought it was important we do that. A good company is going to listen. You should speak up as much as you can. Here's the bottom line answer to that for me, and that is this could go a lot of different ways.
Set aside the frustration and try to participate. Offer your suggestions on what this entity could do that could be positive, that you would love to see you do. Lastly, and I can save this now. I couldn't say it when I was part of the company. It does frustrate me that the two companies can't seem to figure out a way to get along and that is disappointing to me.
At the level of some of those people are getting over it. Get over yourself and let's move forward and do things that are good for this industry. EssilorLuxottica has such an incredible opportunity. All have been in between Essilor and Luxottica or whatever you want to call them and VSP, needs to work it out. A battle between those two companies is not a positive thing for this industry. I can say it now or I could say this stuff before.
There are great people at VSP and there are great people in Essilor. Figure out a way to have the conversation and think about your customers. That's the key. You are making this hard on your customers now, both as Luxottica and having challenges to getting along. Essilor and VSP, get over it, keep in mind what's in the best interest of your accounts and your customers and we will get things done.
I see this still has huge potential but I would like our colleagues to speak up more. To understand you have a voice, they have to care about what you think. Speak up, send them a note, call them. Those things are important. For me, that's the key message I could anticipate about what I think is going to happen. I don't know but I know there is huge potential there. Think about you as a clinician, where you see that potential, shoot them a note and say, “Here's something you guys could do as an entity that would be hugely powerful for this industry.” They have that opportunity.
I have to admit my experiences in that regard. Sharing feedback and chatting with people within the company has always been a good experience. They always tend to be open but I'm going to speak for myself about that nagging feeling of this omnipresent entity. it’s always a little bit concerning for the independent optometrist to feel that at any point in time, your whole career could have gobbled up. I might be misguided.
Essilor cannot survive without the independent, at least in its current business format. Keep that in mind when you are thinking about, “I'm a little antsy. I have nothing to say.” They cannot thrive they have. Essilor was built on the independent. A lot of people think otherwise. Let me tell you, I have seen the numbers, I have been inside of it, and I know what's going on there.
Essilor relies on the independent to survive. It’s critically important. They know that we need to know that, and I would strongly encourage us to continue to provide that feedback. Rick Gadd is a great guy. I worked side-by-side with him for almost ten years. He understands that he wants to do the right thing and talk to him. Millie Nye, she's amazing. She does a fantastic job. Talk to Millie, let her hear from you.
When you move over to an industry where they listen to your opinion before now that you are one of them, now they want to hear from others. I have talked to six of my colleagues and let me tell you what they think. That is powerful. I think we underestimate how powerful it is when we speak up and make a comment about things. It gets to the right people.
When you have people like Millie in place and Rick, and some of the others who were there, it gets to the right people. I'm speaking for it now. You’ve got Thomas and Swami over at J&J. I'm not sure there are two better people there either. Again, I’m speaking for the companies that I have been a part of. They listen and I'm not suggesting others don't. I think you know who the ones who listen are.
I want to comment on something that is going to lead me into the next thing. One of the concerns that I have had and I have spoken to colleagues about it is the fact that they gobble up other companies and own multiple labs in our area. There were used to be independent labs and now they are owned by Essilor. Those types of things make people a little bit uneasy but in particular, personal and close to home for me. In 2010, days before I graduated, the government here in BC decided to deregulate all glasses and contact lens sales. I'm not sure I'm familiar with this.
I’m very familiar with it. It was right around then Essilor required clearly and greatly. That's the one much involved. Imagine how it feels when you buy a company and they are in a lawsuit with your customer. That's never a good position.
I was already on the fence, to begin with colleagues who had changed their perspective significantly because, for the most part, optometrists and opticians around here don't like clearly. The fact that Essilor bought them meant while Essilor is not looking in the optometrist's best interests but that's not the road I want to go down here. The question that I want to post here was more about the FTC regulatory changes in the US.
Some of the statements that were made by Kelly Slaughter, were eerily similar to the statements that our health minister made hereafter our deregulation. It's in the patient's best interest to be able to go buy whatever lens they want. The doctor maybe shouldn't mention the manufacturer anymore. I know that's not in the law now but that was a suggestion that was made. I don't know what the chatter has been for you, with students and things like that.
The students and faculty feel much like you do. There’s certainly a concern with the new FTC ruling or the update to the rules. The biggest concern there is, it seems overly complex. You have already told us that we are going to give them their prescription. Now you are allowing us to do it electronically, which makes sense and should have been the case from the beginning but to now mandate that there's a signature and this type of thing.
To me, it shows this lack of respect and confidence in a practitioner to be able to do what they are supposed to be doing. I never had an issue with giving the patient the prescription but to now make them go jumping through six more hoops to make sure they get it and they are signing. It seems excessive. In a world where virtual paperwork has overwhelmed us, it seems so inappropriate and untimely. It's something 15 to 20 years ago I could see it but not now. We give the patient their prescription, etc.
The other thing I will say is we still have that first shot at all of these patients right there in your office. You've got your optical. You've got the offer of contact lenses. You still have that opportunity to do whatever you want to do or do not want to do to make the sale to the patient. I don't have any issue with giving the patient their prescription. They deserve, own, and should have that but to make us then continue to jump through five other hoops to make sure it has been done, given to them, and all this certainly, I don't think any optometrist is going to agree.
I don't write a brand or base term but you could fill it with anything. Anybody who spent five minutes as either a contact lens wears a prescriber knows that's ridiculous. You do scratch your head once in a while at some of the ways this is going. All that said, though, I think we do have some colleagues and unfortunately, we tend to pay the price for those who wouldn't get the prescription, you have to pay me or something else.
This is not ethical, in my opinion. You are getting an eye exam and you pay for an eye exam. That information is yours and we should provide it. Perhaps we are paying the price for a real minority who didn't play by the rules. It still seems to me to be excessive. I think what you were addressing was the FTC rule.
What I wanted to ask you was, do you see, based on some of those other separate comments, the potential for further deregulation, anywhere similar to what we are experiencing here in BC, and what should we do or ODs do to help or hopefully prevent something like that from happening?
Patient education is at the heart of this. If I don't believe there is any risk of one contact lenses for twenty years, the worst thing I have ever had is a little redness in my eyes that I took my contact lens out and I was fine. When I don't think as a patient is what great care I'm getting from my practitioner who continues to look at me, evaluate, make sure, and preempt anything that's going on. I think the risk here is almost zero. I have never had any problems that were disposables. I would throw them out. This is great. If I believe in my opinion that the risk is low, then all this other stuff sounds ridiculous. I don't want to go so far as to now start to show horrible pictures about all zoonotic eyes and things like that.
That’s the other end of the spectrum. I think educating people when they come in for their follow-up visits and we have gotten a little less aggressive with follow-up visits because candidly, disposable lenses, people generally do well. When we used to bring people in more regularly and you could argue it was inappropriate.
We didn't need to do it because most of those visits were fine and at least allowed us to say to the patient, “I'm seeing this. How long are you wearing them? I'm seeing some blood vessel growth. That's not a good sign. Your cornea is a little oxygen. Let's be careful.” That they know what we are doing brings value. We felt we had gotten much better and the risks were low. We don't want to take a spot in our schedule for a follow-up because we don't ever see anything. That's the upside but the downside is we have lost the education.
What I have seen a couple of our colleagues do and I loved, all their contact lens patients get some regular education. Even if they have done great, they have never had anything. It's a good education to continue to provide them that what you are doing does carry with it a risk. That risk could potentially be vision loss. That's serious.
Let's make sure we are keeping up. I'm now an educator. This makes sense. Education to me is at the heart of it because if I don't understand there are risks, then what's the big deal? Why are you guys making a big deal? I could go buy those lenses anywhere. If you switch it in cheaper, sure because I don't understand. To me, that's where it has to start before.
We started fighting what all these people were doing. We would have a supportive consumer if they understood a little bit more. Your most supportive consumer in this issue is someone who's had a bad eye problem and had a bad consequence. Those are the best patients because they appreciate how fragile and sensitive the eye-individual system is. I believe a lot of it honestly has to do with education.
To directly answer your question, when I say, “Do I think something like that could happen in the US?” Absolutely, it could. You have big lobbiers that have a lot of money to spend and I think it could happen. We have to prepare for both. The way you prepare for the potential of it happening is through education. I'm sure you guys are counted on doing the best you can but the decision has already been made.
We have been playing catch up for ten years but patient education was the key that was missing in the beginning. We also had a bit of disarray in the ranks in general, with ODs and not seeing eye to eye but luckily, that's improved significantly. I had a conversation with Dr. Jennifer Lyerly at Defocus about this specific topic because she was interested to hear what it has been like in BC for the last several years. My take was the two things that we needed to do years ago were patient education, making sure everybody is on the same page, and fighting in the same direction. I think the AOA does a good job in a lot of ODs are on the same page but the patient education is exactly what's missing as you said.
I would put pressure on the people like clearly and others to say, “Play your part in that education.” This is obvious and I don't think my friends at Essilor would be too upset with me because I do still have what I think are a lot of friends. Essilor relies on optometry. You have a little leveraging there, not so much to say, “I don't like what you are doing with clarity,” but more to say, “Have you thought of this? Would you consider doing this?” These were things I was talking to them and too clearly about when I had a louder voice over there but we have a loud voice. I hope that message that has come through during this enjoyable conversation with you is that we have a voice.
Don't underestimate that voice that you have. You are such a critical that you, individually, and you, as an aggregate but one person writing a letter. I found it surprising when I joined the industry. You would be very surprised at how far that letter gets and the impact that it has because few people take the time to do it. It's a powerful tool we have that we probably don't use often enough.
If anybody takes anything away from this conversation, it is that you have a voice and you should share it. Write, call or email the companies to let them know.
I encourage you to do that and if you don't have connectivity with someone, call your colleague at the company. That's always a good place to start. We have many great ones that are working hard and they take a beating. I respect that I have been in that seat. I was the spokesperson for Essilor. You can only imagine when we acquired clearly when the merger and the combination took place, and I was out there talking about it.
These people take a lot of heat and give them the respect that they deserve. They are trying to do their best to represent you but talk to them. Every day that we are out of practice and in the industry, we can become less connected to what's going on. I mean that with all the respect in the world for my colleagues and industry but I was in the same boat.
Eye Care Industry: If anybody did a true assessment of one's unintended bias, you would find opportunities to improve, especially if you're creating an environment where there is a sense of being and belonging.
We rely more on you guys. Tell us what's going on. We think we know but now it has been several years since we have seen a whole day's worth of patients. We need that perspective. I'm hitting on the same things but it's important. Do it, speak up, talk to your colleagues, particularly in the industry but anyone will talk to you. The president of any of those companies will talk to you. I promise they will. Don't think they won't and if they don't, shame on them and you should tell people they don’t. The good ones will.
I want to shift gears here quickly. With a lot of the big things that have happened, there have been a lot of social change in unrest and a lot of discussions, particularly around diversity, race, Black Lives Matter and all these other things. You had a conversation with Black EyeCare Perspective. Adam and Darryl are great guys, and they are amazing. They have a clear goal and are vocal about it. I had a conversation as well on the show with them and they are clear about, “Here's what we recommend, and here's what our suggestions are.” The 13% thing was great and I know that that's caught on.
What I was impressed with was, in that conversation, your comfort level with it but the initiative that you already had taken and then I was doing a bit more research. The diversity and inclusion stuff is something that you have been talking about from well before, what's become in social media and popular to discuss now, so thank you for that. I'm curious to know what compelled you to take that initiative enough. I know we have also received an email about the steps that NECO is taking to pursue the DNI more and I would like you to share a little bit about that if you could.
I appreciate the opportunity to do that. It is something we are all pretty passionate about and it's clearly an important issue in our society. Where optometry can play its role, we want to do that. Several years ago, when I arrived at the college, after about three months of meeting with everyone who had blood pressure at the college, everyone got an hour with me, it became clear to me that we had three key strategic objectives and not to take time to go through all of them but one of them was to boil it all down, creating an environment where all are welcome. I was proud when I arrived at NECO to honestly see much of the diversity that I saw in many ways. However, as you know, we, like others, have gaps. For us, the gap was people of color, in particular, Latinx and Black students.
We didn't do well there and I felt it was critical. There are other areas I think we do extremely well. If you walk around our campus, you will see it. It is blatantly obvious and it's not unique to NECO, that our profession continues to struggle to recruit people of color. Mr. Floyd's murder and all of these things that have been happening certainly have brought this more to the forefront.
I have a great deal of respect for what Black EyeCare Perspective is doing. Let me also back up and say, “I have a great deal of respect for the NOA and the NOA says.” I have been participating in them since I started in the industry several years ago because I believed in what they did. I don't think it's a bad thing that Black EyeCare Perspective and these other groups have formed. This is not an indictment of NOA. It's saying, “We are going to help. We are jumping on board and we are all going to work towards this.”
Occasionally, I brought up Adam and Darryl. Some of the other things are going on and people will push back a little bit but be careful. This has been NOA’s domain. I love NOA. Sherrol Reynolds was a student of mine. I know her well. She's the current President of NOA great group. I think together, we can aggregate and create some change, and that's what needs to happen. We have a problem. That problem is that our patients tend to look like us and therefore, if we don't have Black doctors, then we have a big problem.
If we don't have Latinx doctors, then we have a big problem. We must be, in my humble opinion, representative of our community. We are in all the community health centers. It is one of the true differentiators of NECO that our students spend time in a community health center. They serve underserved communities. They see the importance and perhaps most importantly, they also see the value of giving back. We have such momentum behind that at the college.
We came up with the strategy that we felt would address that. That was several years ago. We have now accelerated that a bit. What we initially did was we brought in a group that was intended to be an assessment group. It's called The Impact Seat. They assessed where we were, how bad were we, where were our opportunities? It was enlightening, at times, horrifying to think that perhaps some unintended biases existed significantly at the college that we needed to deal with.
If anybody did a true assessment of that, you are always going to find opportunities where you can improve, especially if you are trying to create an environment where there is a sense of being and belonging but here's the bottom line. We are not going to meet any criteria that have been set. If we can't get students coming in, we are never going to have faculty and practicing Black optometrists if we can't start it at the schools and colleges. I don't want to put all the pressure on the schools and colleges but essentially, that's where it's got to happen. We've got to get better at recruiting, in this case, Black students. We are working in many areas. I can quickly give you a rundown and maybe it sparks some thoughts on people's minds.
One, we created a position that we had always had in mind. We are waiting for The Impact Seat to finish their work, which is a diversity inclusion officer. Dr. Angela Abraham is taking over that role. She's amazing and doing a fabulous job in it. I'm confident in that. We formed two groups and internal and external groups that are diversity and inclusion.
Alliance for the Advancement of Diversity Inclusion is one and then the Diversity Inclusion Council. Council is internal, that's made them students, faculty and staff. The external is people in our community who have contributed to this movement and can help us be smarter about it and that has been amazing.
To be honest with you, we have also created some vehicles and a hotline. We went to old school. We went to the suggestion box because we want people to be able to write something down and put it in, you can call the hotline or you can send an email to Voice@NECO.Edu, giving you three different ways to give us feedback. Part of the feedback from the team who came into assessing was people didn't always know where to go if they observed something or they felt something uncomfortable. We want to make sure there are lots of resources and vehicles to provide that feedback.
With training, we want to do training for everybody. That means mandatory training when you come in, incorporating within our cases that we present within our leadership courses and other types of courses that are amenable to this to include cases that involve these types of issues. We talk about how you deal with it. I'm excited about how that's going so far at the college. One of the other things we did, which is probably turned out and I wouldn't have expected this, to be honest, and be one of the more controversial things was, I have heard for several years and I'm sure my predecessor Scotty has started many years before me that people love our facility.
It's like Hogwarts about optometry. I have heard of that. Our building is older and it's a classic historic building. It's gorgeous. We all love working there. When you walk around, there are some beautiful portraits up on the wall. All of older White men, and the reality is these are the people who contributed to our institution but I heard over and over that, has every woman ever contributed to anything that happened in that NECO?
Has any person of color ever contributed? When we started soliciting, there were so many who had. They are incredible women who have contributed to NECO. They are incredible people of color who were the first to do things out there. We want to recognize them. We are going to rearrange some things and we are going to try to diversify. I will tell you the response to that.
I told you this earlier, 95% of the responses to what we did have been positive but there have been a few people. I think this one in particular. There has been this correlation that if we are moving some of these portraits must be bad people. These are not bad people. We love these people. They are our history but at the same time, we are going to show more of our diversity.
I mentioned it because not many that I heard upset them. Let me say if they are reading because I know a lot of people listened to the good stuff you put out there. These are not bad people. We are not suggesting these are bad people. We are suggesting we have a diverse contribution and we want to be proud of that as well.
It's not in place. It's in addition to, and the majority do. Think about the ones that have been critical and I have given you a hard time. You scratch your head, “Do they understand what we are trying to do?” I don't think they do because if those couple of people who did get the negative feedback did understand, they would be supportive. I respect our history, believe me. Our Founder, Dr. Klein, started this institution up the road from us many years ago. I love our history. I can't learn enough about it. It's critically important to me but we are at an interesting time in our world now and the sensitivities that exist. We believe it's the right thing to do. We are going to continue to do it.
In the last couple of things, we set goals and that's where Black EyeCare Perspective helped us. It's the 13% promise that you mentioned. I hope a lot of my other colleagues, schools in colleges and other entities will take them up on this. It's a lofty goal over several years to get to it. As one example, now we are 3% students. We need to get the 13%. That's a big hurdle but if you don't set lofty goals for yourself, you will never get there. I will say this and I don't mind saying it. If in five years, we are at 10%, I will celebrate that we went from 3% to 10%. We will have a party, celebrate, and continue to work towards getting ultimately to that magic 13%.
If you get to that 13%, Adam promised he will make a plaque.
I salute those guys for giving us something tangible because when you can have something, you can work toward it. It’s something you understand, “We all know it. That's what we are working towards.” I think it helps. You've got that target out there. You've got something you look forward to like writing the press release at the end. You know where you are trying to get to. Lastly is a buy-in report. Twice a year, we will report to the institution and publicly on our website how are we doing moving towards these goals? I thank you for letting me talk about it. It's something we are passionate about. I hope our alums understand what we are trying to do. As I said, 98% of them do but for those of you who don't, I want to make sure they know. They can call me anytime and they can talk to me. I want to hear their issues. I want to understand where they don't agree or where they do agree.
There will be some situations I won't be able to change people's minds, I appreciate it but at least that they have the facts, and then they still feel it's not good, then that's fine. If they don't feel that's good, then talk to the Board of Trustees and let them know you want a different president. That's your other course of action but, in any case, we are doing what we think is the right thing. The support from students, faculty, and staff have been outstanding. Honestly, that's my constituency.
I'm dealing with 21, 22 and 23-year-olds. They are passionate about their position and that is my constituency now. That's my customer. I know they don't like when I say it and I don't say it often but they are my customer and I have to serve the needs that they have to assure the college continues in this incredible trajectory that Scotty left it on. We are pleased with where we are, where we are going, and having a wonderful alongside to yourself.
We continue to demonstrate the quality of the student that comes out of our institution. We are proud of what you have done and how you continue to not only serve your patients but also support our industry because it's easy to let everyone else do that. I congratulate you on what you are doing and I'm honored to be a small part of it.
I'm truly grateful to you for taking the time. I think this is a good place to get close to wrapping up here. I always ask two questions at the end of every show. They are a little more personal, maybe make you reflect on yourself a little bit. The subtitle for the show is Bringing Clarity To Business, Entrepreneurship and Life. I think there has been a lot of that covered in this conversation. Tell me about this specialty within optometry. I'm trying to bring in outside perspectives, and I appreciate you doing a lot of that.
These last two questions are meant for you to share some thoughts that can help inspire ODs and ETPs who read this. The first question is if we could jump in a time machine and we could go back to a time in our life that was particularly difficult. You can share the specific moment if you would like but more importantly, I would like you to share, what advice you would give to yourself in that difficult time?
People ask me why am I passionate about this? I think we all have our life experiences and I have been influenced by listening to stories that Adam and Darryl have brought forward to us. People I know and care for, and hearing your stories that are horrifying to me. My friend, Terry Ingram, who unfortunately passed away too young, told me the story of being the first graduate at UAB Optometry and how difficult it was for him and how he wasn't treated well, and then he became an Executive at J&J.
Many of the people at UAB wouldn't even talk to him or help him with any exams or anything. All of a sudden, he became his buddy and said, “Terry, what's going on? Can you help us to support this and that?” As soon as they would walk by us, we kept on. He says, “That guy wouldn't even talk to me in optometry school.”
Hearing other people's stories are incredibly impactful. Mine pales in comparison to something like that. My story is a little bit of what I would learn from it and do differently in high school. I went to high school in Miami Beach, Florida. At the time I went to high school, we had bus seats. Miami Beach High had 50% Black students, 50% White students. It was a difficult time to go to high school. We had motorcycle cops riding through hallways. We had race fights almost on a weekly basis, Black students over here, White students over here. What I recognized that there was, I had no idea what was the cause? What was I even fighting for? What was it?
I learned and I wish, now I could have been more than I had. I wish I could have stepped up. I went along with everything that was going on. If I'm White, I should be standing over here. My Black friends had to be standing over there. I wish that I had a little bit, perhaps more sense of the importance of that type of situation. It left a lasting impression on me. There’s no question about it. However, I wished I could have done a little bit differently and maybe done more to influence that. I did have some friends who did, and I admire that they did but most we followed along. We didn't even know why we were following along and that's the saddest part of it.
If I had to do that once again, I would have stepped up and spoken up a little bit more. I would have tried my best to minimize it. Having said that, though, having had that relationship or that experience, I wouldn't change it because it has made me a lot of who I am and understanding a little bit better how that can feel, how you can feel and being separated because of something that is about you and who you are. I can't say that I have walked in the shoes but what I can say is that influenced me because we came off of the discussion about race and those things. That’s what’s in my head that that situation had made me a lot of who I am, how I handled and learned from it. I did ultimately learn from it but it took maybe longer.
Eye Care Industry: Students should not graduate after four years of being in an optometry school and not see some of the disruptive things out there.
That's a relevant situation and experience to share and I think an important one because a lot of times, with social media and things like that, maybe there has been a bit more encouragement for people to get involved now. Even a few years ago, there was plenty of people feeling the same way. They don't know if they should step up. They don't know if they should have a voice or be out there. It's good to hear that from somebody in a position like yourself to share that. Hopefully, that will encourage people to speak up more when they feel like they should be taking a step towards helping certain situations.
We are doing something with The Vision Council. They asked me to facilitate it. It will be interesting because I have already heard a few comments on this. It's going to be a group of White colleagues talking about this issue. Most of the people who know and care about me tell me that I'm nuts to even pride to do it but I think it's important and I hope some good dialogue can come of it that is helpful for people.
I respect you for allowing us to have platforms like this, to have some important discussions. Wherever we can continue to support what you are doing, we will do. I hope you will continue to tackle the difficult subjects because it's important that we have a respectful dialogue and we should be able to do that in this profession.
I said this before, “Optometry could lead the way here. To show what can a profession do to change, adapt, be more inclusive, diverse and equitable.” All these words are incredibly important. This allyship, which is what the show is going to be about. You even mentioned that. I had to look it up because I wanted to understand. I thought I had in my own mind what allyship meant but it wasn't. Building relationships based on trust, consistency and accountability. Taking on the struggle as if it's your own. I think we owe it to our colleagues of color, in particular, to take on this struggle as if it's our own because we are not perfect.
My colleague said to me, “NECO has never been racist. It isn't racist now, and it never has been. I respect that position but I do have to say we have a lot of room to improve.” Not perhaps direct racism. It depends on how you define it but we have a long way to improve. At the very least, if a Black student walks into NECO, I want them to see some people who look like them.
I want them to feel comfortable there. It's a chicken and egg story, we've got to get the students to get the faculty but we are working hard in ASCO, by the way, not just NECO is working hard at trying to come up with solutions to this. Part of it is going to come down to money, unfortunately, and scholarships. I hope that our industry, which already has been incredibly generous, will continue to look at opportunities for scholarships because we want the best Black students to come to optometry.
I don't want the ones who nobody else wants or we thought about medicine, and then they will fall back on optometry. I want the best students to look at optometry and say, “I'm going to change people's lives every single day. I'm going to make a good living. I'm going to be a professional and a doctor, and I'm going to have a good work-life balance.” We should be able to convince the top students to look at optometry because of that. I'm committed to making our best effort as I know others are to be able to do that.
I listened to the Dean of Harvard Business School, an incredibly smart guy as you can imagine. He said, “We had a huge opportunity, 400 years, this has been building. When we think back on the greatest generation, our forefathers who fought for our freedom, people could look back on our generation and I include myself and yours in the aggregate of this nation. We have a chance now to make a difference. To be one of the best generations who finally said, ‘Enough is enough, we are going to move forward in the best way we can to provide equity, diversity inclusion, at least in our profession, which is what we have control over.’” That has stuck with me. We have a huge opportunity here. Let's not miss that opportunity to make a big difference.
That's fantastic to look at it as an opportunity. I know that's difficult in the earlier stages of a change like this but it can be that. The last question that I wanted to ask you and this one could be a shorter one up to you. With everything that you have accomplished to this point, and now being at the head of an academic institution, how much of what you have accomplished to this point in your life would you say is due to luck and how much is due to hard work?
I have always been the person who had to work a little harder. My classmates who I lived with could read over the notes once. They get B's and A's. They could do a lab once and they would be great. That has never been my situation. I have always had to do extra work that when others can look at it once, I look at it three times to get the same grade.
In the clinic, I always did extremely well but in the classroom, I'm not a straight-A student. I had to work harder at it. As a result of that, I have had some luck. There's no question, I have had some luck but I would like to say, along with my career, I have always had to work a little harder to perhaps get the same as someone else did. I look at that now as a huge advantage. I know I’ve got to sit down a little bit longer when I think I'm done. After an hour of looking at I'm going to stay another 30 minutes and look at it again.
That probably is what has helped maybe. Honestly, I'm not any smarter than anybody else but I have had an incredible ride in optometry. I have been able to be in private practice with my dad. I have been able to be at a new school and helped start their contact lens program. I have been in J&J, an amazing American company, for thirteen years of my life. I move over to Essilor. A French company taught me so much.
Now, I get to come back to my optometry school and act like I know something. It's incredible. It's a little bit of both for everybody but my direct answer to you would be, I have always had to work a little bit harder. As a result of that, that's who I am now. I feel like I had to put in that little extra to non-par and where I saw it as a disadvantage. Honestly, when I was in college and even a little bit in optometry school, now I see it as an advantage.
Some people give me a percentage. If you want to give me, that’s okay.
If I had to give a percentage, it would weigh heavily on working harder but there is no question. I have had some luck. As you said, people are going to give you a percentage. We all feel like it's some balance between the two. I have heard some people say it has been all luck. I look at them and I know they have worked their butts off to get where they are. It’s always going to be a combo but it has been fun. I appreciate it.
The last thing is how can people connect with you?
You mentioned earlier @NECOPrez is always a way you can but my email is PurcellH@NECO.Edu. I love to hear from alums and anybody. If you have thoughts, comments like what we are doing or don't like what we are doing, we would love to hear from you. Thank you for allowing me to say that.
Thank you, Dr. Purcell. I appreciate you taking the time and I look forward to talking again.
You have to promise me one thing from here on out.
Thank you very much.
It has been a pleasure. Thank you.
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That was the interview with Dr. Howard Purcell, President of the New England College of Optometry. I hope you found that insightful and informative. As I mentioned in the intro, Dr. Purcell is an energetic, fun guy to have a conversation with. If you like this episode as always, please share it, take a screenshot, throw it up on your Instagram story. Tag me and tag Dr. Purcell, @NECOPrez. I'm sure he's going to be happy to hear from you as well. Tell us what you took away from this and if you have any further questions so we can keep chatting a little bit more. Thanks again.
Important Links
Black EyeCare Perspective - NECO Magazine article
Show - Past Episode
Jennifer Lyerly - Defocus Past Episode
@NECOPrez - Instagram
About Dr. Howard Purcell
Howard Purcell, OD ‘84, FAAO was named the College’s 13th president in July of 2018. Dr. Purcell brings to the position a wealth of experience in private practice, academia, and the optometric industry. He is well versed in evolving trends and technologies in healthcare and optometry in particular and brings this expertise to the presidency.
Prior to his appointment as President, Dr. Purcell served as the Senior Vice President, Customer Development for Essilor of America. He was part of the Essilor team for 10 years. Prior to joining Essilor he spent 13 years as Senior Director of Professional Affairs for Johnson & Johnson Vision Care.
Dr. Purcell is a graduate of New England College, Class of 1984, and has long been involved in the school through presenting continuing education, supporting student development, and serving on the Board of Trustees. Dr. Purcell began his optometric career by participating in a group optometric practice for eleven years with his father, NECO alumnus Saul Purcell, OD ’54, in Miami Beach, FL.
Beginning in June 1991, Dr. Purcell joined the faculty of Nova Southeastern University College of Optometry. During his career at the college, he was a principle in the development of the Department of Cornea and Contact Lenses. As Associate Professor, Dr. Purcell was responsible for both the didactic and clinical components of the program. He later reached the rank of Deputy Dean of the college.
Dr. Purcell is a Diplomate in the Cornea and Contact Lens Section of the American Academy of Optometry. His energetic and enthusiastic style has made Dr. Purcell a popular lecturer internationally. Purcell’s unique philosophies and practices have often attracted the media to focus attention on current optometric issues and research in the industry.