Episode 40 - The Vaccine

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Dr. Birinder Narang is a family physician and clinical instructor at the University of British Columbia who has spent the last 9 months working on the front lines during the pandemic.

He has been a great resource and an advocate for health and safety regulations that are in place to help us stop the spread of the virus.

He also just got his COVID vaccine today!

In this episode, we discuss what these past 9 months have been like and what to expect with the vaccine.

Connect with Dr. Narang on Twitter and Instagram: @drbirindersingh

You can also watch the full episode at YouTube.com/HarbirSianOD

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Episode 39 - What It Takes to Build A Brand From the Ground Up

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Suzanne Sendel is the founder of the Suzanne Sendel Agency, which is a distributor for multiple high end eye wear brands. She is also the creator of an intriguing new product called The Original FTG.

In this episode, Suzanne and I chat about what it has taken for her to build two successful businesses within the eye care industry and her fascinating journey into the eye wear world.

Connect with Suzanne:

LinkedIn: https://www.linkedin.com/in/suzanne-sendel-83151a2a/

Instagram: https://www.instagram.com/theoriginalftg/

You can also catch the full episode on YouTube: youtube.com/harbirsianod

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Episode 38 - Red Light Therapy: From Dry Eye to health and Wellness

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Red Light Therapy (RLT) has been shown to have a variety of health benefits from better mental health, to quicker healing, to even improved ocular health.

In this episode, I had the pleasure of chatting with co-founder of The Above Club, which is company that ultimately aims to help elevate the greater consciousness of humanity, starting by creating products that help those with high aspirations attain the success they wish to achieve.

Learn how red light can improve our ability to think, learn, heal, and see from a cellular level.

Connect with The Above Club:

instagram.com/theaboveclub

aboveclub.co

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Episode 37 - Specializing in Myopia Management with Dr. Sherman Tung, OD FAAO FIAOMC

TTTP 37 | Myopia Management

Dr. Sherman Tung is the former president of the BC Doctors of Optometry and 2019 BCDO Optometrist of the Year. He has completed a residency in ocular disease and a fellowship in myopia management and now runs a pediatric specialty optometry clinic where he specializes in myopia management.

So, it's safe to say he is a great source for information on how to get started in myopia management and what treatment options to recommend to your patients. 

I had the pleasure of picking Dr. Tung's brain about how he got started in myopia management and how we can all benefit from including this specialty in our practices.

You can also watch the full episode at YouTube.com/HarbirSianOD

Connect with Sherman:

helloeyelab.ca

instagram.com/helloeyelab

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Specializing In Myopia Management With Dr. Sherman Tung, OD FAAO FIAOMC

Thank you again, as always, for taking the time to join me here to learn and grow. I truly appreciate your presence and your support. If you haven't already, please do subscribe. You can subscribe on YouTube if you like to watch. Subscribe on Apple Podcasts and follow along on Spotify as well. Make sure you leave a review, leave a comment, and let me know what you think. Tell me which guests you love. Tell me which content you love so I know which guests to bring on.

I like to bring on people who can help inspire and motivate us to grow and to do more no matter what profession you happen to be in. Our guest is an excellent example of that within the optometry field. His name is Dr. Sherman Tung. He is an Optometrist here in Vancouver in the beautiful Kerrisdale neighborhood. He has completed a residency in ocular disease and also a fellowship in myopia management. His practice is called Eyelab and is a pediatric specialty practice. Sherman himself spends a lot of time in myopia management.

We're going to dig into myopia management, learn a lot about Sherman's different practices, and different techniques. Also, we will learn a little bit about the business side of things. What does it take to start a specialty practice? Is that a good decision to make? A lot of Sherman's insights go back to his experience within our association. Sherman is the former President of the BC Doctors of Optometry, another pretty amazing title and an amazing amount of experience that he has within the association and networking across North America. He's applying a lot of those lessons to his practice now. He’s an incredible person to learn from.

Before we go into the episode, I want to thank our sponsor, which is Hoya Vision Care Canada. Hoya has the MiyoSmart lens, which is an incredible new technology for us as optometrists to offer our young myopic patients. The MiyoSmart lens employs the new patented DIMS technology to help slow down the progression of myopia. In a two-year clinical study, it was shown the MiyoSmart lens decreased myopic progression by 59% and axial elongation by 60%. To learn more about the MiyoSmart lens, check out Hoya.ca or reach out to your local Hoya rep. Without further ado, here is the episode with Dr. Sherman Tung. Stay tuned for more exciting episodes coming soon. Thanks a lot.

Dr. Tung, thank you so much for taking the time to participate in this interview. Thank you so much.

No problem. My pleasure.

I gave a brief intro to you but I'd love for you to tell us a little bit about what you do, where you practice, and what your life is like day-to-day.

I’ll tell you a little bit more about myself. I graduated from UBC. I was born and raised in Vancouver. I did my schooling in Chicago. After Chicago ICO, I did another residency in ocular disease. That's why I was going towards ocular disease and then I got bored easily. I came back. I worked for corporate and then I got bored of that. I did my own private practice. I opened it with a partner and then I got bored. I then joined the association. What I like to do is pediatric optometry. I opened another clinic that specializes mostly in pediatric eye care. That's a little bit about me.

Some people get bored and they sit on the couch and watch reruns of shows and eat chips. You get bored and you're like, “Let me go even bigger,” every time. That's pretty cool. We're going to talk about the practice. We're going to talk about pediatric optometry, myopia control, and that type of stuff. I want to rewind. You’re the former President of the BC Doctors of Optometry. I'd love for you to share with me what your path was. How did you get involved? What led you to become the president of the association?

This is how it all started. One of the things that I was a little bit upset about at that time was I didn't know what my association did for me. It’s like, “Why am I paying all these dues?” I have no idea. Before I quit anything, I want to find out why I'm quitting and have a good reason before I quit. I joined the membership committee to learn more about what does BCO does for us.

You and I were on that committee together.

After that, I moved up to the next level. I learned about it and half of the stuff, I didn't know what they do for us. They advocate for us. They have so many resources, all the networking. Because I was a new grad and I never tapped into that, I didn't understand what they did. One of the reasons why during my time when I finished graduating is that there were more Canadians that graduated from Waterloo than American schools at that time.

Find something that you love, find your niche, and charge for your services.

At that time, when I came back, everyone knew each other. I didn't know anyone there. That's one of the reasons why I joined the association so I can meet new people. I was learning about it. It’s like, “They do a lot.” Each time we have a negotiation for a contract with MSP, they go and negotiate. As I was getting more involved in helping the association, I found out that they do a lot for us. “Sherman, you've been involved. We’d like you to be part of the board member.” I was like, “One-year term, that's fine.”

We had this year where there was no succession planning and they were like, “We need someone to step up.” They looked at me, “Sherman, what do you think?” I was like, “No. I'm not ready. No way.” Somehow, I was like, “If I get elected again, maybe I'll consider it.” The next day, I was like, “I'm the president.” That's my story of how I went through. I was about to quit, learn more about it, and then how much the association does for us. I'm still part of the association. I might not be the president anymore but I do feel part of the committee and all different committees.

You're still involved and it's always appreciated. I've been part of the association my entire career. I know that when you were president, things were going in the right direction and people appreciated the work you're doing. Thank you for that. There are a couple of interesting things there. You were about to quit. Rather than quitting flat out like, “This seems useless to me. Let me learn about what is happening here. Maybe I'm missing something. Maybe I'm not quite seeing the full value in it. Why does this thing even exist if it sucks that bad?” It turns out, it doesn't.

There's maybe a miscommunication or misunderstanding of the full capacity and what happens. That's important in a lot of ways. Before somebody quits their job, profession or whatever, see what else is out there. You mentioned MSP. For the people who are reading who don't know what MSP is, that's our provincial health care plan.

Everybody talks about Canada having this universal health care. That's part of the government that pays for certain parts of health care. Our association negotiates with them to increase the fees that the government pays us for certain services that we do, so we're on the same page about that. What did your job as the president entail? Let's narrow that down. What was the coolest thing you did as the president?

It's personal growth, to be honest. Even though I gave a lot of time to the association, I gained a lot back from the different meetings you have to go to, all the leadership responsibilities. You have to lead by example. You have to go to these different meetings. One cool thing that I learned a lot during those meetings is that you need different leaders or forefront thinkers. It’s like, “Where's the profession going to go?” You pick one and you listen to them.

At the time, you might think, “They're crazy. Why are you thinking about that?” All we're going to do is glasses and eyes and that's it. That's not going to be the future. I learned quickly years ago, “That's not the way we're going to go. You have to specialize. You have to find a niche.” Find something that you love, find your niche, and charge for your services.

If you're going to be doing regular exams, what makes you different from someone else? That's what engrained me as a president. I learned a lot. What's the future going to be like? How do you want the future to look like? These leaders are shaping it. We hear the industry leaders, what the industry is telling you, and what everyone's seeing. It gives you that different insight. That's one of the coolest things that I learned as a president.

From being part of the association, I see that other provincial presidents come to our meetings and everybody's networking and discussing things. It makes sense that you would be chatting with the foremost people and the people who are cutting edge and whatnot. You would be a good person to follow as far as what you're doing in business and in your optometry clinic.

Here you are specializing in pediatric optometry, which I don't know how many people I know who are specializing. I know some people do VT. I had some people who like to do myopia control. You do those things. You don't do the regular stuff anymore. Maybe something that the rest of us need to catch up on is to start to specialize and cut down into that niche that you're saying. When is it that you decided to do pediatric optometry? You renovated and rebranded and everything in your practice. What was it called before? When did you make the decision?

I used to be at another practice. Back in 2010, when we first opened that new practice, it was like, “We're going to be a family eye care.” That's how we started. We outgrew that space. It was great. I had a great clientele. The problem was it was like a family GP. You do the same thing over and over. It wasn't getting that same satisfaction. I did enjoy optometry. The great thing about optometry is that whatever you do, there are many different ways and things you can do. There’s low vision, VT, and lots of different things.

TTTP 37 | Myopia Management

Myopia Management: These leaders are shaping it. We hear the industry leaders, what the industry is telling you, and what everyone's seeing. It gives you that different insight. 

One of the things that I was always interested in was myopia management. As a business mind, if you want to open an office for myopia management, it might be a little bit hard. I found another doctor. I hired her as an associate. She does the VT stuff. I see a lot of kids and it’s like, “You need VT.” There's not a lot of VT doctors on the west side of Vancouver. I saw a solution to that. I was getting a lot more myopia management patients. I need to create this bigger space. I put two and two together and it’s like, “Let's make a pediatric office that does kids exams, VT, and myopia management.” Most of these are geared more towards kids. That's the reason why we opened up a pediatric office.

When did you officially open Eyelab?

We officially opened in February 2020. There's never perfect timing. You roll with it. It is what it is. We did close for two months. During those two months, I had time to study for my fellowship, which I got with myopia control. I’m also working out all the different protocols to give us that extra time to be like, “What are our protocols? What are our procedures?” It prepped us for when we do open full time, we have everything all set so things will be more organized.

What advice would you have for somebody who's getting bored as you did of the family practice setting and wants to specialize? What is it that they should look for psychologically and mentally for themselves to be prepared for it? Also, what should they see in their practice that they can use as landmarks to say, “This is a good time for me to make that leap into a specialty.”

It depends on what type or stage in your optometry life. If you're young, within the first ten years of your career, go for it. Whatever you love, whatever you find, go for it. The only way you're going to learn is by going for it. One of the characters of an optometrist is we don't like to take risks. Most optometrists don't like to take risks. I don't know why. If it's within your first ten years, go for it. What's the worst-case scenario? You can work with someone else later down the road.

If you're going where you have a big patient base and you're like, “What I'm going to start doing?” You got to start thinking about how to strategize. You can't go cold turkey and say, “I’m seeing these patients.” You don’t build up these patients expecting to see you. That's the part where you might hire an associate. Let's say your mission is called Eyes Vancouver. You might want to branch it out like Eyes Vancouver Family. You might want to do Eyes Vancouver Kids, Eyes Vancouver VT, or something along those lines. You can still have your name and you can branch it out. You might want to do that if it's more than ten years. That's what my advice is.

You have to look at your clientele. One thing that I learned as president is most offices don't have a strategic plan. I know it's hard. If you can, take maybe 2 or 3 days out the whole year, have your retreat, and have all your staff members. It’s like, “What's our vision for the next 2 or 3 years?” Plan it. If you think about it, you still need your whole team to buy into it. That's something that you might want to consider, strategic planning. It’s like, “Where do we want to see ourselves in five years? Are we happy doing the same thing that we're doing?” If you are, you might not want to do this stuff. If it's something like, “I want to incorporate this,” you might want to consider that.

That's a good idea, having a plan and vision of where you want your practice to go. If you're more established, you should probably slowly branch off and create that niche versus cold turkey. It would be hard to be like, “My practice is running smoothly. I'm bringing all this revenue.” All of a sudden, you stop that, “I'm going to try this other thing.” It's hard to get that revenue or get all those patients back in the door and back in the chair again. It makes sense to ease into it.

I wanted to focus a bit on your specific specialty. You see a lot of kids for myopia management. Myopia control is a hot topic. The prevalence of myopia is increasing. Can you give me your main treatment options for kids that you would be seeing in your practice? What are your go-to’s? If you don't mind, what would help you lean towards one or the other if there are certain criteria that you're following as well?

For your readers, if you’re an optometrist, the best example I can give you is glaucoma. There's no one silver bullet that will treat your glaucoma. It's not like, “Let's use prostaglandin,” and you're done. You have to see what type of glaucoma you have and what's your systemic. You'll then figure out what is the best thing to do, SLT is the best thing to do, or maybe surgery if it's end-stage. It’s the same thing with myopia. There are different stages. You want to be aware of what's the best option for that child.

Having said that, there are four things that are in the market. The one I like to go to is orthokeratology, OK lenses. That's the type of lenses where you wear nighttime. It reshapes your cornea. When you wake up in the morning, you can see clearly for the whole day. That’s my specialty. Sometimes not all children can put hard contact lenses. Parents are not comfortable with that. You have your specialty, multifocal design from CooperVision like MiSight and those types of contact lenses.

Each one has its pros and cons. Some have their limitations and what the parameters are. You got to keep that in mind. The third one is atropine drops. Lastly, the newest one is from Hoya, the MiyoSmart lenses. I’ve been eyeing that for a while. That one is a pretty good lens also. If someone can’t do contact lenses or drops, MiyoSmart will be a good option also.

Orthokeratology has come a long way, but it's not commercialized yet. 

We'll come back to the MiyoSmart in a minute because there are some cool things to chat about there. If you don't mind, as briefly as you can, what are the parameters or limitations of ortho-k? What patient are you fitting into ortho-k? Which one would you put into the MiSight lens? I have a couple of questions about atropine as well.

Orthokeratology depends on what type of lenses you're using. It's not one type of lens and that's it. Within the parameters of ortho-k, there are different treatment zones. There are different sizes you can manipulate. There are different curves you can manipulate. In the beginning, when I first started, if you use one of those that are commercialized brands that you can use, they have such a parameter. It's usually less than one doctor who still has some issues with the rule. It’s usually anything below -5. Those are your nice and ideal patients.

You always want to start with easy patients, the -1 or -2. As I learned through this fellowship process, you start to customize your lenses. When you can customize your lenses, you can go up to -8, -9, -10. Back then, that couldn't fit people with astigmatism. Now, we can do bitoric ortho-k lenses. Back then, you couldn’t. Now, I can do that because it's different bitoric base curves.

Orthokeratology has come a long way but it's not commercialized yet. I design most of my lenses on my own. I try to make them. That's why I could fit way higher different parameters. When you're starting out, talk to your lab. They'll tell you which lens they feel comfortable using. They'll tell you what the parameters are. It’s not easy first. There's one piece of equipment that you have to buy if you start ortho-k. It's bare minimum. You have to buy a topographer. If you don't, you won’t know how the lens fits on your eyes. Don't practice ortho-k if you don't have a topographer.

It's basic advice. I appreciate that. Have you had much experience using the MiSight lens from Cooper?

Yes. For my patients that are under -1, usually, I don't fit them with ortho-k yet. For -1, that's where I might fit them with a MiSight or MiyoSmart. MiSight is great for that. Sometimes kids don't feel comfortable sleeping at night or they don't like the comfort of it. Maybe I’ll have a sixteen-year-old, ortho-k might not slow down as much. Maybe I'll start with MiSight. Those are the patients where I start MiSight with. The drawback of MiSight is it's hard to mask. Let's say you’re -4, -1. You could get away with it. If you're -4, -3, then you can’t. Those are the pros and cons.

Do you prescribe atropine a fair amount or not as much since you do lenses more?

We can never promise that we could stop the progression. It’s impossible. You'll be lying to your patients. You can slow it down. I don't use atropine as my first line of treatment. I use it as my second line of treatment. If they're still progressing quickly, then I will start them on atropine. That's how I do it. Before, I do start on atropine. Now that I have more options, I usually use atropine as my second line.

When you say the second line, the first line didn't work, so you stop using it and then you start atropine. Do they overlap at some points?

I usually overlap.

You double them up.

Yes.

That's been a question that I've heard come up. If we know option A will decrease or potentially decrease progression X amount, option B will decrease at Y amount. What if you put them together? Would it increase it or improve the results significantly?

TTTP 37 | Myopia Management

Myopia Management: You always want to start with easy patients, the -1 or -2. As you learn, you start to customize your lenses. When you can customize your lenses, you can go up to -8, -9, -10. 

We're waiting for all those studies to come out. We’re doing a lot of those studies.

The fourth option that you had mentioned was the MiyoSmart lens from Hoya, which is an exciting new option. I want to dig into that a little bit. MiyoSmart is based on DIMS technology. Would you be able to elaborate a bit about what the DIMS technology is?

This lens didn't come out in 2019 or something. It's been out for a while. It's been out since 2013, 2014. They were designed by Polytech University in Hong Kong. The whole idea of myopia management is based on the hyperopic defocus and the peripheral myopic defocus. The idea is that if you wear regular glasses or wear regular contact lenses, on the peripheral, you’re going to get a hyperopic defocus, which means that the focal point is behind the retina.

Those send signals to the brain and the brain will send a signal to the retina and the eyeball will elongate. Every single time your perception goes up, you get new glasses or contacts, it sends those signals again, over focus, and your eyeballs get longer. The idea with ortho-k is that your central vision is still clear but your peripheral raise in front of the retina. Now it doesn’t send those signals. That's how it slows it down. DIMS technology mimics that. Instead of using the OK lens, you’re using the lens.

You can see these little prism peripheral blurs. In the center part, you can see clearly. On the outside part, it causes that myopic defocus. It loses that light in front of the eye. By doing that, it slows down the progression of myopia. The reason why I'm excited about it is when I went to a conference and I started learning more about this. There are patients that don't want to wear contacts. They're too young or they can't put them in. The only option is atropine at that time. I was waiting for this lens.

By 2016, 2017, they released it in Asia. They commercialized it by Hoya. All the colleagues in Asia were like, “Sherman, this lens is working well. It works.” I was like, “When is it going to come to Canada?” Almost every single month, I'll be calling my rep, “Is it here yet?” “It's coming in July.” “Is it here yet?” “There might be some delay.” “Is it here yet?” “There’s COVID.”

Finally, it was released sometime in August 2020. My rep was like, “Here you go, Sherman.” You have to do a course or a class to learn more about the lens. Once you get certified, you can sell the lens. I've been using it since. There are patients that have been using it for about six months. It’s a good alternative to slow down the progression. That's why I'm excited about it.

The lens came out a few years back in Asia. They did some proper studies as well as studies go. They did a two-year clinical study and it showed some pretty significant results.

I’ll tell you what I love about that study. It was a randomized, double mass study. That's one of the reasons why I liked it. There was no bias. The study shows that it can slow down myopia progression by 60% or 59%. They also did something cool. They also looked at the axial length. That's going to be the feature of myopia. You have to measure the axial length. They also showed that it could slow down by 60%.

Everything has pros and everything has cons. One of the things with this study was the subject group. It is between 8 to 13 years old for Asian patients. Some can argue, like, “Does it work for a different ethnicity? How about someone who’s 14 or 15? Does it work?” If it works between them, you have to extrapolate the data and use your best clinical judgment. I feel comfortable using someone that's under eight. For someone that's over fourteen, I still feel comfortable prescribing it.

By extrapolating and by using my personal clinical experience, that's the age group that tends to progress the fastest. It’s that preteen, early teen years. Of course, I've had plenty of kids who are -3 by the time they're five years old and trying to jump on that lately. My first line of treatment has been atropine, but it's going to be changing significantly. I'm doing that course to get certified in the MiyoSmart lens. What do you say to someone like me who's trying to get more into myopia management? Is the MiyoSmart lens a good, easy way to get into it? What are the benefits from a practitioner’s and the patient's perspective?

Each patient is a little bit different. You have to ask about their lifestyle. If the child doesn't play a lot of sport and stays at home, the lens might be a good option. If you start the lens off in six months or one year and you do get some progression rapidly, then you might want to think about changing to OK lenses or a different type of method. You might want to add atropine too. Is it a good starting point? Yes. For someone who doesn't want to go into OK lenses or doesn't want to go into MiSight or other options, it is a good option.

Whatever you love, whatever you find, go for it. The only way you're going to learn is by going for it.

Be aware. Don't think of it like, “This will solve all problems.” Sometimes that’s where doctors feel, “I feel comfortable.” It’s the same thing with the glaucoma analogy. It’s like, “This person has glaucoma. I'm going to give them a prostaglandin and it's going to solve everything.” Keep an eye on it and make sure you still follow them up every three months. How are you doing? If there's something not according to what you want, you might want to refer out to another colleague of yours that specializes in that or call them up or ask for a second opinion.

A lot of this question comes from personal experience. In conversations with other colleagues, one of the challenges I have when it comes to specializing in something and one of the things I've been working on specializing a bit more is in the dry eye. One of the biggest hurdles is when I bring in something that's a new technology, there's always a fee attached to it for the patient.

Talking about pricing and getting reimbursed adequately for the services that you're providing is important when you're trying to specialize. Can you give some advice? You don't have to talk about specific dollar amounts. Do you have pushback from people when you’re trying to recommend specialty options? How would you encourage someone like me who's trying to get into the area to overcome that mental barrier that I have talking about price?

Some patients might be put out by how expensive things are. How I approach it is a little bit different. The first thing is I'm providing a service that will solve your problem. If I can do that, give you a plan, and educate you on what I'm going to be doing and where your value is going to be, then most of my patients will be agreeing to my services.

My question is, why is it expensive? If you can take the time to educate them, why we're doing this, how will it benefit you, what I'm trying to achieve there, and you apply the process. Usually, they'll buy it. If you go, “This will help you do it. This is the cost.” No one's going to buy it. It's like an investment. You invest in getting your eyes better or investing to slow down the progression. What is your plan? What are you going to do?

Some things might help. For example, you can show your qualification. If you do a lot of the dry eye stuff, “I do dry eyes. I got certified here. We have the latest technology. We’ll show you each equipment, why we're doing it, and how we're solving it.” If you set down the time and discuss that with them, they'll appreciate it.

If price is the issue, they might go somewhere else. They’re like, “That doctor didn't address that.” Usually, you pay what you get. A lot of patients understand that. If you provide a great service, you believe in it, and you educate your patients, I don't think you should think the price. If I decide not to, I won't lower your prices because of that. You still have to believe in your services.

Stick to your guns. Believe in what you're doing. I find that there's a disconnect between me saying, “It’s $500 to get this treatment and it will make you better,” and the person feeling the results of that treatment. Once they feel the results of that treatment, if it worked the way you said, then they'll say, “That $500 was worth it.” How do you get them to understand that the treatment is going to benefit them? Education is the key there.

Believing in what you're doing is probably the biggest initial hurdle. Believing that what you're doing is helping the patient, you're going to be reimbursed adequately for it. I'm going to keep saying that because it's one of the biggest things that I've had to deal with, being comfortable telling a patient that they're going to pay this fee for this service. In the beginning, there were a lot of patients who are going, “Forget that.” As I've learned to explain it to them a lot better and educate them more appropriately, you see that their reactions are different on the whole.

I'm not sure if you do this. Do you have any brochures, stuff that's geared towards your branding?

No.

I'm going to use for example, “Here's a brochure. Here you go.” They're like, “This is dry eyes plan. This is not your plan.” If I list out all the different types of myopia management, it’s like, “This one is for you. This is why I'm not doing this one.” You can customize, “Your child's prescription, this is where it can go towards.” Maybe you can do a list of dry eyes, “Here's the whole dry eyes spectrum. This is where you are at. What we're trying to do is we’re trying to get you from here to here.” Sometimes that might help.

Do you have brochures or content like that printed out in the office that you had with your branding on it?

TTTP 37 | Myopia Management

Myopia Management: Some patients might be put off by how expensive things are. Approach it a little bit differently. Position yourself as providing a service that will solve their problem.

Yes. With every single consultation, I will give them something to take home that's customized for them. When they take it home, they understand that plan was geared towards them. If they do go price shopping, they'll go somewhere else. That’s what will differentiate you. They go somewhere else and they’re like, “You didn't talk about this. You didn't talk about that. Where's the brochure that’s customized for me?” One funny story is when I went to Kiehl’s. This is the first time I ever went to Kiehl’s. Have you have ever studied the Kiehl’s?

I've been to Kiehl’s.

They sell stuff. They’re like, “Let's do a skin test.” I was like, “What’s a skin test?” You go in there and they're like, “Let's do a customized skin test for you.” All they do is hand you this litmus paper and you put it on your forehead or whatever for five seconds and they're like, “Let's match it. This is your skin. These are the products you need.” Here I am. I was like, “Okay.”

The next thing you know, I stepped out and I spent $150 or $200 worth of products. My wife is like, “That's great for you.” I was like, “Okay.” I saw the value. I’m like, “This product is based for me.” Even if I go somewhere, I’m like, “Maybe I'll go buy from The Body Shop. Maybe it’s cheaper.” They might not have the same product or they might not be doing a skin test. Something that's personalized makes a big difference.

That is genius. That's excellent. That's an amazing thing that we could implement in our practices. You've already been doing it. Do a legitimate test. We're not making something up here. Show the patient where they fall on the scale and what treatment is specific to them. That's awesome. Good job, Kiehl's. I want to go back to something that you mentioned earlier super briefly about axial length. Do you have anything that measures axial length in your office?

Axial length is going to be the future. They're going to be into myopia management. The reason is axial length will precede your prescription change. Sometimes that will change how you treat the patient. Let's say I have a little kid or their parents have -7 each. You see this five-year-old kid and you're like, “What's the risk?” You measure their eyeball length. Let's say I measured it to be 25 or 26 millimeters. That's a high number. I might have to monitor this kid a little bit differently. Maybe I can't wait one year. Maybe I'll have to see you back in three months. If something happens, I will start treatment earlier.

What I'm using is my OCT that can measure the axial length. It was not accurate. I decided between two different products to see which one I'm going to buy. Axial length machines are not cheap. They're about $30,000 for each one. If it's something that I believe in and it follows my vision statement, then I'm most likely to get it.

I’m going to check back in with you on that too, because I'd love to hear about how useful that is in your practice. Maybe that's something I'll look at down the road for me as well. I love this whole conversation. We've covered a bunch of different topics, your experience in the BCDO and giving back to the profession and the importance of that, learning to specialize, how to specialize, and when to specialize. Within that, myopia management.

We're going to talk about two completely different things here. The last two questions that I like to ask everyone at the end of the show are a little bit existential, some people have said, to prep you for that. Before we get to that, I want to put out there if people want to get in touch with you, what's the easiest way? Where can people find you? Where can people find your clinic? What's the best place for everyone to go?

I'm located in Kerrisdale, Vancouver. The best thing to do is to look me up. You can follow me on Instagram, @HelloEyeLab. Go to our website, HelloEyeLab.com, to find more information.

The first of the two questions, if we could hop into a time machine and go back to a moment where younger Sherman was struggling, whether it's financially, mentally, school, or whatever it is, you're going through a tough time. You could share that moment if you want to share exactly what was happening but more importantly, I would like you to share what advice you would give yourself at that time.

That probably would be when I was in university. One of the things is that I didn't feel like I maximized my university, you pretty much go to school, try to get the best grades you can, and then you go to the next level, professional school. One thing I highly regret or never did was enjoy the university. All about the university is to learn oneself. There might be subliminally I learned about myself but there are no lessons that are like, “It's not about the test score. What can I take from this?” I read one of your blogs or something that resonated with me.

Each patient is a little bit different. You have to ask about their lifestyle.

The quote was, “In school, you learn the lesson and then take the test. In life, you get tested and then have to learn the lesson.”

Even though I was being tested outside, I didn't take it and learn my lesson until years later. That's how TOMS Shoes came in. That filled in that gap to learn more about me. Even though there was much growth for me, I didn't find it like that. I thought it was easier than undergrad, to be honest. That's where I learned more about myself, living in a different city. Going back, I wish I took a little bit more opportunity to be a little bit wiser.

Sherman, that's good advice. I'm not looking for any specific type of answer there. It’s what comes to mind. If that's what comes to mind, that's great. That's important. In undergrad, that is where you do learn a lot about yourself. High school may not be comfortable for everybody but it's a fairly comfortable environment in the sense that it’s super safe. When you go to university, things expand. It's a chance for you to meet new people and do different things.

You moved to Chicago. When I moved to Boston, the same thing happened. You realize that all these years you've lived in Vancouver or wherever you grew up, you've had a bubble of some sort. When you move away, all of a sudden, you're meeting completely different people from completely different places who do not think like you most of the time. You are forced to learn. It's beneficial if you can try to start that process in undergrad, like you're saying here.

To let you know, a lot of university students have volunteered for me. I'll share some of my wisdom with them. Sometimes I’ll be like, “Come on in. Do you want to learn something about life today?”

Listen to Uncle Sherman.

Little fun things I like to do.

Storytime with uncle Sherman. I love it. That's great advice. The last question, Sherman, everything that you've done up until this point, everything you built, president of the BCDO, your practice, how much of this would you say is due to luck, and how much is due to hard work?

It can be different. What I believe is that if you put your hard work into it, opportunities will arise and that's where you become lucky. If you don't put in the hard work, you can't be lucky. At the same time, some people work hard and they don’t get a break. In my case, it’s 50/50. I'm lucky to see the opportunity and then I know that's the time when I need to work hard to seize that opportunity. If I don't see that opportunity, I won't work hard. Does that make sense to you?

You have to be lucky to see those opportunities also. That's where I feel like some luck. It's the perfect timing where it gives you that luck to get into it and then I became president. Back then, it was competitive to get into optometry school. Guess what happened? There was 9/11. Enrollment was down. I was lucky to get into it. If you take my OAT scores or whatever, if I'm not prepared, I wouldn't be lucky to get in.

50/50 is great. Most people answer it's all hard work or it's 90%, 99%, or whatever. It's impossible to get there without hard work. It's humble of you to appreciate and acknowledge that there's that luck involved. That's cool.

TTTP 37 | Myopia Management

Myopia Management: Axial length is going to be the future. They're going to be into myopia management. The reason is axial length will precede your prescription change. Sometimes, that will change how you treat the patient. 

That's for me. I wouldn’t give my advice. It’s like, “50% luck, that’s what Sherman said.” I celebrated my birthday and I thought about it. I was like, “Huh?”

What did you do for your birthday, anything fun?

I decided to postpone it.

I'm sure everyone will be happy to still attend and celebrate with you. Sherman, any last words of wisdom, any last things you want to share with us before we wrap up?

You asked me about being president. I've been around all different types of optometry, corporate, industry, academia. At the end of the day, we won't be able to practice what we want to do without the association. They’re the one that's always fighting for our rights. It’s our union. If we don't support and invest in them, our whole degree is useless. Be involved in the association, join the association, and see what you can do. The more optometry association, the stronger we are and we’ll have a louder voice.

I cannot agree more. Sherman, I don't know what large percentage of all the opportunities have come to me through the profession because of my connection to the association, either directly or indirectly meeting people like yourself and many other amazing optometrists. On top of that, we don't have a profession unless we have someone advocating for our profession and that’s our association or whatever provincial, state, society, or association in the US as well. Make sure you get out there and be part of that. Make sure our voices are heard.

Thank you so much, Sherman. I appreciate you taking the time to share your wisdom, your expertise, and your insights. A big thank you to everybody who’s reading. Whether you're listening on Apple Podcasts, watching on YouTube or Spotify, whatever it is, make sure you subscribe. Make sure you leave a review. Let me know what you think. Give Sherman a shout if you have any questions about myopia control or pediatric optometry. I'm sure he’ll be happy to help as well. Thank you and we will see you again for another episode. Take care.

Important Links

About Dr. Sherman Tung

TTTP 37 | Myopia Management

Dr. Sherman Tung was born and raised in Vancouver. His passion and dedication for myopia management led him to pursue a fellowship in both the FAAO and FIAOMC. He was honoured to be named BC Optometrist of the Year in 2019, the highest award given to an optometrist who has not only contributed to the advancement of optometry, but has also demonstrated a fervent commitment to serving the community and improving the visual welfare of the public.

In his free time, Dr. Tung enjoys spending time with his beautiful twin daughters. He is also very passionate about Ultimate Frisbee and can be considered an amateur foodie.

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Episode 36 - What is Your Definition of Disruption?

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Listen to the podcast here

The incumbents within any given industry will most often view disruption of a negative thing. But is it?

In this episode of The 20/20 Podcast, I had the pleasure of chatting with Sanaz Bissonnette (founder of Lensbox - a new platform providing digital solutions to ECPs) and Dr. Pavan Avinashi about what disruption in eye care means to them and should mean to ECPs.

You can also watch the full episode at YouTube.com/HarbirSianOD.

If you are a customer/patient looking to learn more about how you can order your eye care products online, go to SHOPLENSBOX.COM

If you are an ECP looking to sign up/learn more, go to LENSBOXPRO.COM

Music: Rujay Music - Self Made

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Episode 35 - Sami Jo Small: Olympic Gold, Stoicism, and Optometry

Episode 35 - Sami Jo Small: Olympic Gold, Stoicism, and Optometry

As a goalie for the Canadian Women’s Hockey team, Sami Jo Small won 3 Olympic medals, 5 World Championships, and was twice named MVP of the Women’s World Hockey Championship.

She is also the author of a new book named, The Role I Played: Canada’s Greatest Olympic Hockey Team.

In this special first anniversary episode of The 20/20 Podcast, I had the incredible pleasure of chatting with Sami about her journey as an athlete, parallels between sports and medical professions (her grandfather, father, brother, and sister-in-law are all optometrists!), and what it means to play your role with the greater good in mind.

Connect with Sami:

instagram.com/samijosmall

linkedin.com/in/sami-jo-small-csp-oly-b387945/

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Episode 34 - Presenting Your Best Self with Asma Ahmed, Founder of Soapbox Presentations

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In this new normal world filled with webinars, virtual presentations, and Zoom calls, we have all had to learn the appropriate techniques and etiquette to make sure we are getting our message across loud and clear.

I had the pleasure of chatting with Asma Ahmed, found of Soapbox Presentations, who specializes in prepping people to present their best selves. Asma shares how she trains her clients to inform, influence, and impress with every presentation.

She also gives us her top 5 recommendations for success... you might be surprised by what is on her list!

Connect with Asma: https://www.linkedin.com/in/asma-ahmed-soapbox-presentations/

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Episode 33 - LIVE with Dr. Richard Maharaj and Dr. Trevor Miranda of the Canadian Dry Eye Summit

Episode 33 - LIVE with Dr. Richard Maharaj and Dr. Trevor Miranda of the Canadian Dry Eye Summit

I had the pleasure of chatting with two amazing docs about how they each created successful practices with strong dry eye specialties.

Dr. Richard Maharaj, owner of eyeLABS optometry in Ontario, went well against the grain almost a decade ago to create a medical optometric practice focusing on dry eye. Dr. Richard Miranda is co-owner of 4 optometric practices on Vancouver Island with all the latest tech in dry eye treatment. Both docs are also co-creators of the highly regarded Canadian Dry Eye Summit.

Listen to learn how you can win a free registration for full access to all the COPE approved talks at the Summit. You can also enter Dr. Maharaj's Instagram contest by following instagram.com/dryeyesummit and posting a picture using his "bald" filter and tagging #imajedi2.

Follow:

Dr. Richard Maharaj instagram.com/dry.eye.jedi

Dr. Trevor Miranda https://www.linkedin.com/in/trevor-miranda-463003aa/?originalSubdomain=ca

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Episode 32 - Amy Gallant Sullivan, Founder of Eyes Are The Story

Amy Gallant Sullivan is the co-creator of the Tear Film and Ocular Surface Society (TFOS) and founder of the new ocular health conscious beauty brand, Eyes Are The Story.

I had an absolute blast chatting with Amy about how she helped turn TFOS into the ultimate resource for ocular surface and dry eye across the world, how she approaches gender bias in the business world, and how she launched her new company during a global pandemic.

Connect with Amy:

EyesAreTheStory.com

Instagram.com/tamingamy

Linkedin.com/in/amygallantsullivan/

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Listen to the podcast here

Amy Gallant Sullivan, Founder Of Eyes Are The Story

Thank you for taking the time to join me here to learn and grow. I am very excited for our guest joining us all the way from London, England. I wish I was there. Anybody who knows me knows I grew up there. She spends a lot of time in various cities. She is the Co-creator of TFOS and the Founder of Eyes Are The Story, a wellness-meets-beauty brand creating different products tailored around eye health. I'm excited to welcome and introduce Amy Gallant Sullivan. Amy, thank you so much for being on the show.

Thank you, Harbir. It's so nice to be with you and thank you for accommodating the time zone.

It’s my pleasure. We'll get to the whole London and Europe thing. One of the things that I loved about when I first introduced myself to you to reach out and to connect, one of the first things you said back to me is, “I'm not a clinician or a doctor.” Inside, I was like, “Perfect,” because anybody who knows me knows that I'm deliberately trying to get out of the bubble of eyecare professionals or health professionals and talk to people in business and entrepreneurship. That was a great way to introduce yourself to me but I was curious, how do you introduce yourself to people in general? We often describe ourselves by what we do. I would say, “I'm an optometrist.” How do you describe yourself?

It's amusing because I spent the first half of my life trying to escape from the medical field because my entire family is in the medical profession. I said, “I won't have anything to do with it.” I'm not going to say I was dragging, kicking and screaming but it was funny because no matter how much I tried not to be a part of it, it's part of my DNA so I had to work with doctors. I said, “Fine, let's do this.”

How do I introduce myself? Maybe you could consider me a misfit. I don't fit into a mold with anything. That has also encouraged me to start the companies that I have. I did once try to work in the corporate space with the cubes, the carpets, and those rules but I always had so many different ideas. I didn't fit into a box. I always had a different vision and desire and I was so fast and furious. I'm a misfit entrepreneur.

That's a cool title, misfit entrepreneur/ninja.

That's my name. One of my friends said it's interesting and intriguing because we launched TFOS right after 9/11. When there was a global economic downturn, I launched another foundation for art preservation fundraising. When everybody else was losing money, I launched a sponsorship program. During the pandemic, I launched another company. It fits into the misfit category because I don't follow the typical patterns, rules or cultural norms. I like to create things and when there's an unmet need, I like to make it happen.

With those three things that you described, those specific times in history, going against the grain is a term that's coming to mind. That's pretty amazing that you have the guts to pull that stuff off during those periods. How would you describe your journey then into entrepreneurship? You said your family and your background has a lot of medical professionals or you're surrounded by and dragged into that. Was it a straight line like, “I'm going to be an entrepreneur,” or was there something or a few things that happened along the way that made you want to go out and do your own thing?

The interesting thing is, especially with TFOS, when 9/11 happened, I was working for a normal company in the tech space. I was working with tech startups. That whole industry pretty much bottomed out at that time. My father came to me and he said, “Would you be willing to help me create a company?” I said, “That sounds like fun.” At that point, I had to interview for a new job and I said, “I don't want to work in a cube. I can't do that again. I did not fit into that box.”

He said, “While you're looking for a job, could you help me create this thing called the Tear Film & Ocular Surface Society,” which he had incorporated a couple of years before the idea. He had organized conferences and said, “We need to do something. We need to build an organization or a society and engage doctors, scientists, and industry from around the world. Because of your business background, your languages, would you be willing to help?”

I said, “I can create something.” There isn't anyone that's going to tell me, “You have to do it this way or that way.” My only rule was if I failed, I would disappoint my father and I would look like an idiot. I said, “Don't fail.” That's what got me into the entrepreneurial track because I was so excited to be able to create something at that stage at the beginning of my career. I had to prove not only to my family but also to the entire world that I could do it.

It didn't matter what my age was and that I was female. I said, “Prove yourself. Prove it. Do it.” From that point, I said, “Let's build and create. We have a vision. Let's make it happen.” That ignited the passion for creating things and saying, “Let's go for it.” You say it, put it out there and just do it. There aren't obstacles.

If you can make it happen, you make it happen. It resonates with me but I didn't think of it that way. As an entrepreneur, you're a creator almost in the terms of like an artist. You get a blank canvas and get to make what you want to make of it. The autonomy for sure was one thing that I remember appreciating. Being a self-employed person or business owner, I can't imagine myself being in the box and having to answer to a greater power.

We're going to get back to TFOS because that's something that's very intriguing. You split your time between a few different cities, Boston, London, Paris, and a few places in Italy. You speak multiple different languages. When did this all happen? When did you start traveling between these different cities? What takes you there? When did you learn the languages?

What's interesting is I moved a lot growing up with my family because of my father's studies and his multiple degrees so we happened to move a lot. I always thrived on change, new things, and meeting new people so I always made it a part of my personal culture. We were always changing and when I would go into new schools, I would also meet the other children who had moved a lot, and typically, they were from other countries. I was fascinated by their languages and cultures. From a very young age, I started picking up other languages. I speak a few and I'm always learning more.

Beauty Brand: Believe in yourself and bring people together that support your passion or energy, can add to your vision, and help you see your path.

Also, even with the TFOS side because we work with doctors all over the world. It's incredible because when travel is a little bit easier than it is at the moment, I have the opportunity to go to a lot of different places and I do make a point of trying to learn as much of the language as I can before I have meetings even as an icebreaker. I've always loved it. I graduated from university early and moved to Paris because why not? I wanted to study for a little bit longer. I'm an overachieving geek. I graduated early, moved to Paris, and it started from there.

I'm watching you on social media and navigating all these different things that you're doing. You're truly an entrepreneur and a CEO. What would you say are some important qualities that make a successful entrepreneur in your eyes?

First of all, it's important to believe in yourself and have ideas that you believe in. You have to be very structured. I say structured because I said that I don't fit into a box and I don't like structure. At the same time, I've had a virtual office since 2000. I thrive on the virtual structure if that makes any sense. For being an entrepreneur or CEO, it's important to be able to direct yourself, maintain yourself, have a vision, and follow-through. Also, surround yourself with people who can help you because you can't be an expert at everything. Even if you try, you won't be.

When we started TFOS, I asked my father, “Would you like me to take some classes so I can learn more about the anatomy of the eye, eye disease or something?” He said, “You know so many of the world's experts in ocular surface diseases. I can introduce you to people. We know people who know people. Focus on what you know and do what you know.” For me, it's always about the team. It's important as an entrepreneur and a CEO to build teams that can support you and help you achieve your idea or at least get you going in the right direction.

As one person, you cannot do everything, even if you try. I am an overachieving perfectionist, which is not a good thing at all, but I have a box of Wonder Woman band-aid on my back pocket so I'm like, “I'm going to fall flat and scrape my knees,” I just get up and make it happen. It's important to believe in yourself and be able to bring people together that support your passion or energy, can add to your vision, and help you see your path.

In the sense that they don't have the funding or the funds to create or build a team to pay people, how do you start there?

You just do it. I have lots of examples of that. I'm doing that now but with TFOS, I didn't have a salary at the beginning. It's like, “If you can raise a salary, you can get a salary.” It's important to find people who believe in what you're doing and incentivize them in other ways because if it's your company, you work for free. It's not 24/7. It's 28/7. You can't expect others to work for free because it's not their dream and vision.

What can you do to engage them and make them as passionate or at least energized so you can bring them along the path with you and then say, “I will you give you this and help you do that?” It's a team effort. Bootstrapping is part of it. It's the grassroots effort I used to do like canvassing for politics once upon a time. You can't do these things anymore but knock on the door, “Would you like to learn more about this candidate? Let me give you some information.”

It's the same thing whether you're going out to investors, doing sales, or what have you because people don't know who you are and why they should support you. People don't trust anybody else. How do you bootstrap? Start from the beginning, build a foundation, and bring the team together. There isn't an exact recipe but positive energy helps.

People are drawn to energy whether it's positive or some other vibration that gets them feeling, “This is worth being part of.” What would you say regarding raising capital, fundraising or getting people to invest? Is that something that you've spent a lot of time doing? Are there any real quick tips for somebody who might want to start doing that?

I've been doing that my entire life and it's not easy. There was someone from the TFOS industry who called me a pit bull. This is from a big company. He told me, “You are a pit bull. You walk into a room and people whip out their checkbooks.” With my screen name, Ninja, I go in for the kill. I have backup information and I won't back down until I get what I'm asking for. That is a tip. If you believe in what you're doing and what you are creating, and you can back it up with evidence and as much of all your blood, sweat and tears, if you can get someone to believe in that, you can typically raise the funds.

TFOS is different because it is a nonprofit like the foundation I have with the Vatican Museums. Those are nonprofits. It's very different from asking for a donation for a nonprofit than it is raising capital for a new venture. With Eyes Are The Story, it's a whole other game and it's not easy. I don't like to put it into this context but being female is very challenging raising capital for the company.

I don't want to turn it into that type of conversation but I've had a lot of investors tell me, “That's a cute idea but where's your private life? How are you going to balance that? Are you dedicated to this new company? You can’t work a lot.” I look at that and say, “I'm not asking you to find me a date. I'm asking you to fund my company and the private life has nothing to do with it.” It's interesting in terms of fundraising.

It wasn't a planned part of our conversation but if you're okay with it, I'm interested to go a little bit further into that. When I see somebody who is successful or ambitious, gender, race, and stuff like that gets completely blurred to me. I get intimidated just as equally by men and women. I get motivated by men and women equally. I find it interesting and unfortunate that that still happens. What would you say to other women who are in that position? What have you done to overcome that serious hurdle?

Don't back down. I don't like to say you have to fight but you have to prove yourself because it isn't just a numbers game. It's who you are as a person and what you've achieved elsewhere. I started out working in the international banking space with very powerful international businessmen. I was groomed in that area and I knew how to maneuver that. It's interesting fundraising now because I'm faced with the same men that I worked with at the beginning of my career. They're looking at me now as though they were looking at me when I first started my career. They said, “Who do you think you are? You're a little kid. Why should we write you a check for $1 million?”

I look at them and say, “You spent $1 million on the golf course because you lost a bet. $1 million is nothing.” When I'm going for, let's say, a $10 million raise, I know what I will have to do for that but it's interesting because it's cultural as well. There are women's groups out there that do fund female-founded startups and small businesses but they typically don't either fall into my category.

What's interesting is that when you have a concept that's addressing an unmet need that has not been done before, you can't say, “They did it this way. I'm doing it better. They did it that way and this is how I would change it.” Instead, you say, “I have this new idea and I want you to be a part of the story, so please write me a check.” They will look at it and say, “I don't understand.” How do you ask a male to invest money into, let's say, a beauty and wellness play? It sounds like, “How sweet. Why don't you have a bake sale?”

It's interesting because if you have an ophthalmic diagnostic, it's evident because you're like, “Let's collect a tear sample kind of thing,” but if it's an eyeliner, “What?” The fact that you bring them together, it’s like, “You understand the pharmacy and diagnostic space,” but then it's a beauty thing. It's an interesting play because it's not a golf game. How do you prove yourself? It's different because it's not something that men or women get. Women and men think you're supposed to have a bake sale so you're sitting there going, “I do that too.”

Often when we look at gender bias, we look at it as men looking at women in a certain way but women look at women, and often it's just as bad and that's even more unfortunate to me. That reminds me of the story of the brand Spanx. Sara Blakely is the founder and it sounds like a lot of what you're describing is what she has described in her story of starting that brand. People were like, “That's cute. I'll see you later.”

Eventually, you got to stick with it to get that one person convinced and roll with that. Thank you for those insights because it's one thing to hear somebody give a polished answer that they have practiced in some other interviews. Somebody like Sara Blakely, for example, has done a million interviews specifically talking about that story. Most answers are not so clear-cut black and white. A lot of them are like, “It's this or this.”

Beauty Brand: There is no exact recipe for bootstrapping, but positive energy helps.

I'm still fundraising. When I get to that level, I will say, “Harbir, we're going to have another interview and I'm going to tell you how I did it.” Right now, there isn't a recipe other than believing in yourself and don't back down. Sometimes you have to be a pit bull.

Maybe you can teach me how to be a pit bull. I need those lessons. We have already mentioned it many times but the Tear Film & Ocular Surface Society was originally founded by your father and co-created by yourself. You joined in the early 2000s to bring it to fruition. Can you tell me what your dad does and how he started it?

Dr. David Sullivan, my father is at Schepens Eye Research Institute and a lot of people know him as the dry eye guy. He has a PhD specializing in Ophthalmology, Endocrinology and Immunology. Otherwise known as the ménage à trois. That's a different presentation. When he was a graduate student at Dartmouth Medical School, I'll make the long story short without giving the whole TFOS presentation, he decided one day he wanted to bring together his international peers and colleagues and replicate a meeting that his supervisor at that time was doing in Bermuda.

That was how he started it. In 1992, he organized a conference in Bermuda. About 120 doctors from around the world came and the meeting started around 6:00 in the morning and went until around 10:00 at night because once again, overachieving geek runs in the family. It was in Bermuda. They never saw the beach. They didn't know where they were. They just knew they had a lot of work to do.

He did another one in 1996 in his laboratory. He doesn't have a conference management company. This was his idea. He indexed everything. This was when fax machines still happened. Fax machines were invented then. He was doing everything literally handwritten. In 2000, he incorporated the name Tear Film & Ocular Surface Society because he realized that organizing conferences are extraordinarily expensive. He said, “My great-great-grandchildren could be paying for this conference if it doesn't go well. How am I going to do this?”

That was one of the reasons why he decided to at least incorporate the name Tear Film & Ocular Surface Society. November of 2000 was when he organized that meeting. He organized these international conferences but there wasn't an actual name at all until he incorporated it in 2000. In that conference, everybody that attended was surveyed and asked, “Would you like to participate in a more formal organization? It isn't just a conference every four years but we could get together on a more regular basis and at least do something more than every four years. Show up.”

That was in November of 2000 and then in 2001, 9/11 happened. In November of 2001, my father asked me if I would be willing to help him create the society because he said, “Everybody wants it. I don't have time. I have a laboratory. Your background is in business. Could you help me create this?” We kicked off TFOS as it is known now in January of 2002 but there were many years of pre-plotting by my father. We created it into a beast.

No kidding, it's a beast. Anybody, even like me who is just getting into the dry eye space, not so heavily in it like some other colleagues of mine, but pretty much anybody who is even trying to get into the dry eye space needs to know TFOS and DEWS II. It's like the Bible now. You can't talk about dry eye without referencing DEWS II. It's what people use to reference, diagnose and treat. Most of the recommendations are coming from there and that is incredible. In a nutshell, how do you put something like that crazy together? Who do you have to bring into a room?

Crazy is a good word. The first one was the TFOS DEWS report that was published in 2007. The European Medicines Agency in fact did call it the Bible for dry eye. The industry was sharing it with their employees saying, “If you're in ocular surface, you have to read this Bible.” In 2017, we published TFOS DEWS II. It's the sequel. I say crazy is the perfect word for it because the whole venture was a multi-year production. It took almost three years to put the whole thing together. It took more than $2 million to fund the whole thing.

There were more than 150 specialists from around the world that participated and so many different subcommittees. The sex, gender and hormones subcommittee that my father was part of had over 1,000 pages of their initial references for that. Let's say the 424-page report was less than half of a DNA sample of what it started out to be. It was an insane undertaking because we had experts from around the world. It was not only redefining dry eye disease and re-establishing the importance of the fact that it's a disease and it’s quite omnipresent but also realizing that there's so much more work to be done.

Between 2007 to 2017, the ten-year window, the number of publications and clinical trials that were created because of this new education that was created and disseminated was phenomenal. We realized, "There's so much more that we don't know and we need to do." It's exciting and daunting simultaneously because there are specialists that focus just on the dry eye now.

TFOS itself isn't just dry eye. It's also an ocular surface disease. For example, our next workshop will be on what I like to call the lifestyle epidemic because the ocular surface disease is something that we bring on ourselves in many cases. It isn't just the iatrogenic dry eye but there are so many of the lifestyle choices that we do that are inadvertent in some cases and can compromise our vision, and cause or exacerbate OSD. That's our next workshop.

What's the timeline on that if you're allowed to say?

There's fundraising first so I look at it and say, “TFOS DEWS II cost us over $2 million to produce, disseminate, and do all that fun stuff.” We will try to make this workshop a little bit of a smaller production instead of having 150 experts and bring it down a little bit because it's not easy to have that many people involved in something. Hopefully, we will start that soon. I will be starting fundraising for that soon and then we will have more information available very soon at TearFilm.org. Sign up.

With DEWS, the first workshop, and DEWS II, you've laid such a huge foundation that maybe you don't have to tackle so many things all at once and focus on a more specific lifestyle. One of the other things that I know is the more you learn, the more you realize you don't know so you start to dig into all this other stuff.

To that point, even with the iatrogenic section of TFOS DEWS II, everybody realized, "There's so much more that we need to address." We thought about having the next workshop be iatrogenic dry eye and then we said, "Stop. It's not just iatrogenic." In fact, there is doctor-induced eye disease but in so many cases it's patient-induced. It's what are we doing to ourselves that will cause or exacerbate the ocular surface disease. It's growing into another beast because we realized there's so much more to it. It isn't just 1, 2, 3, 4, 5. There are a lot of subcommittees at this point.

You had the TFOS 2020 Conference. From the sounds of it, it was a huge success even given all the circumstances. As a virtual presentation, it sounds like it went well. Can you tell us how it went down and what went down during that conference?

In the TFOS 2020, it was so heartbreaking not to be able to gather everyone together in Northern Italy, by Lake Como.

I would love to go to Lake Como.

I'm like, “Can I have a party there?” We could have something to give everybody an excuse to come because it was a very special location. I didn't want to give that up, everyone was so excited to come, and we had spent more than three years planning that meeting. What we had also done was plan a pre-meeting to the meeting. That session was going to be a half-day session about addressing the unmet needs of ocular surface disease around the world.

In 2019 in Rome, we brought together the European ambassadors who gave presentations about the unmet needs in their respective countries. We thought that it would be fantastic if we bring several experts from around the world to address the unmet needs globally. This will also be a good teaser for what we are doing with our global ambassador program. I said, “We can't have the conference and the party but we have to do something because we want the excitement and the passion to keep going.” We want people to realize that there is so much more that needs to be done.

That was how we ended up creating the five-hour presentation in Rome. It was heartbreaking because we couldn't have everyone together in Northern Italy but it was also tremendous to be able to have some of the KOLs come to Rome in fact, because there were several of them that we're able to fly there and be present. We were able to do a live stream as well. We had the TV crew on-site in Rome. The doctors that were in Rome were present, and not breathing on each other. We had a live stream all over the world. It was nerve-racking but it was exciting.

How many people attended virtually?

We had about 2,000 registrations but we have also made the presentations available online for viewing afterward. We have had over 4,500 hits. We're asking people to share it because the presentations are about the unmet needs of ocular surface disease around the world. People can watch the presentations one by one. They don't have to watch the whole session because it was about five hours in total.

It's fantastic because you can go on for free, sign up, watch all of it, and get a snapshot of all the different areas that are necessary to address. It's good for the industry because they can see potentially how to address their products, some new product ideas or what have you. It's great for your colleagues too because you can see what others need in other parts of the world. It may give you some ideas or new treatment or diagnostics suggestions.

There are a lot of opportunities that are generated from that. It's important to keep sharing because it engages everyone even though we can't be together in person. TFOS has always been virtual in fact because we had about 40 different countries involved when we first launched, but now we have doctors and scientists in over 100 countries. We can't get together on a regular basis so it's all virtual. When we can be in person, it definitely helps but we can still do a lot, just no talking.

The minor silver lining of COVID is it advanced this whole virtual experience a little bit. It has forced everyone to get into it a bit more, and that might help people who are in all these different countries to connect a little bit better. Where can people check out those videos and share them?

At TearFilm.org. On the homepage, the front smack center. You can click on it, register and access everything. It doesn't cost anything. It's all free and anybody can share. Everything is in English. Usually, when we do TFOS meetings, they're all in English. When we do reports, we translate them into different languages. Everything is free. If you can share, please share.

Beauty Brand: If you believe in what you're doing and create and back it up with evidence and as much as all of your blood, sweat, and tears, you can typically raise funds.

The big thing I wanted to focus on in this conversation is this amazing brand that you have launched. Eyes Are The Story is a wellness-meets-beauty brand blurring the lines between beauty and pharma. I have so many questions but give me your breakdown of Eyes Are The Story, what it is and who it is intended for.

Eyes Are The Story, even the name has a story behind it. What is the entire focus of this new brand? The eyes. That's why I created it. When I first started with the whole TFOS movement, I needed to educate myself about the ocular surface and eye health, and be able to process as much information into my brain and translate it into my human speak. I started asking a lot of questions and then I was thinking, “Maybe there is a larger prevalence of dry eye in women because of eye makeup. Is that possible?” I started researching the different chemicals in eye makeup and skincare, and realized there's a lot more to learn. That was how it started.

I've been fortunate to be involved in a few different little ventures and startup-related types of things. I look at this and I'm like, “There's so much to know. I wouldn't even know where to start.” For example, how do you know which labs and manufacturers to work with? What was the process of figuring that out?

That was not easy either. When I first thought about doing this, I said, “How do I do it?” I'm not going to knock on the door of a big beauty brand and say, “I have this idea. Do you want to work together?” They’ll steal it and run with it. It doesn't work like that. Because of all my years working with TFOS, I have a lot of relationships in the ophthalmic pharmaceutical space so I started asking around, “Do you know any laboratories?”

There was one laboratory that I wanted to work with that I said, “We could create this whole product line and everything.” They told me, “This sounds wonderful,” but then they said it would take at least two years to get authorization to start doing some dabbling in the laboratory because they have their protocols in the laboratory. You can't just whip up a new chocolate cake because if you've always been making vanilla, you can't do chocolate. It doesn't work like that and I don't want to go into science.

They couldn't do it without the authorization so they said, “We can but we need to file for the authorizations first.” I said, “Let me get back to you on that one.” I started cold calling private label companies and then I said, “How do I do this? If I can't go to a laboratory and ask them to make products for me, let's do private label.” I realized with private label, after calling so many companies that I lost count, I don't want to say there isn't quality control, but you can't control what's in the bottle.

You can call them up and say, “I love that.” You pay them, slap your new logo on it, and put it on a shelf. I said, “That's not what I want.” The whole point is I don't like the chemicals that I'm finding in the products. I need to be able to create my own. Once again, creating a monster. I went through my network and one of my contacts had a contact with a laboratory in Canada that only works with big-name cosmetic brands.

They said, "We do not look at startups so we don't care but your idea sounds interesting. It's the whole sensitive eyes dry disease. Do you mean that the chemicals can actually impact this?" Somebody in the business development department had a dry eye so they said, "We want to hear more information." I started with them in terms of the formulation and it was amazing because then they introduced me to another laboratory, and then I ended up working with another laboratory.

I am collaborating with one ophthalmic pharmaceutical company. Those products will be known later. They're helping me with some things. I have a laboratory in Canada that at this point they do the mascara and eyeliner. I have a laboratory that I'm collaborating with in the US and they're the ones that do the face wash, cleanser and serum.

There are different laboratories for different products.

It's not easy because unless you're a multi-billionaire that can set up shop and say, “I have my own laboratory,” you can't do it. You might want to be a specialist for everything but you can't. It's the same with laboratories because if one laboratory is authorized to do one thing, they can't do the other.

That's an amazing perfect example of perseverance. It's like what you touched on before. When you have a vision, you believe in it and stick with it. On a much grander scale, I would normally be talking to young optometrists or optometry students about that. I often will tell people, and it sounds old school and not technologically advanced enough, “You pick up the phone and start calling people.”

You might have to call ten people but somebody is going to be like, “I like where you're taking this initiative. Let me see if I can put you in touch with someone else.” From there, another door opens. Somebody might think, “Amy got lucky and she had somebody who knew somebody. ” You had to call how many people before you connected that?

I'm like, “Pound the door. There must be someone.” It took years. It wasn't something that I did overnight either. I started in 2015. I had been thinking about it for a long time. I started doing the research about all of this back in 2002 when I had the idea. It wasn't until 2015 that I said, “Maybe I should try to do it.” I had mentioned it to Leslie O'Dell. I said, “I need to try. I'm not sure what I'm getting myself into.”

I wanted to ask you, from inception to launch, what was that? Officially, you made the decision in 2015 that you're going to do it. Would you say that’s roughly five years from when you decided, “I'm going to do it?”

I incorporated the name at the beginning of 2016. In 2016, that was when I started speaking with all the different companies and laboratories, and just started. I didn't start doing formulations until maybe 2017. I did about two years of pre-work and self-funded everything. I didn't start asking anyone for money until 2020 because it goes back to the story of, “Aren't you cute? Are you baking cookies in your kitchen?” No. It was several years of pre-work before I even had any products or laboratory relationships that I could move forward with. There were lots of due diligence and legal works. I have so many attorneys for everything. It was a lot of due diligence.

That's incredible that you're able to manage and handle all of that. On top of all of that, you ended up launching amid a pandemic, another global crisis like in previous launches and endeavors. Did Eyes Are The Story launch in March 2020?

It was supposed to launch during Vision Expo at the end of March 2020 in New York. It launched in May.

What was the new approach? You took a month or so to recalibrate and then what did you do?

It was tricky because it took so long to have a product, even the company or anything like that. Even the final branding and everything, it was like, “Let's launch.” I had wanted to launch in 2019 but then I said, “I can't launch in 2019. I have to launch in 2020. It's the year of vision. This will help my investor story. I'm doing everything in a year of vision because Eyes Are The Story.”

It was interesting because we said, “We can't launch in New York. We can't launch at Vision Expo. When are we going to launch?” As we all remember, in March 2020, that was in North America, when the lockdown happened. All the clinics closed. We were supposed to launch through the clinics. I said, “How am I going to launch if the clinics aren't even open? We don't know anything.”

John Dell has suggested and said, “Why don't we come up with a way to excite the doctors about this brand and maybe we can find a way that they can get some sort of return on it. If they can't sell it at the clinic, maybe they can do something. Is there any way that we can?” I said, “Wait.” The doctors can sell in their clinics but in that case, the clinics weren't open. We created an affiliate program so doctors could continue the conversation with their patients. They could still have an online presence and learn about products. People could buy online and the doctors could get a cut. Why not? It's easy.

That was how we did it because so many of the doctors were at home and their clinics were closed. They were on the sofa doing so many Zoom calls and going, “Where are my patients? Where am I? What's going on? When is the world coming back to normal?” Also, even with the Zoom calls, which is fantastic, creepy and bizarre. Everybody was in front of a screen, everybody was thinking about eye makeup. What better excuse to say, “Let's talk about eye makeup and beauty.” It was so amazing at the beginning.

Even more now, we are all wearing masks. I asked my wife about this. I was like, “Do you think that women are doing the eye makeup a little bit more than they used to?” She was like, “Yes. I'm pretty sure.” I feel like it's even more relevant, thanks to the masks and Zoom.

Scott Schachter made up a word. It was before our TFOS briefing in DC for Dry Eye Awareness Month. He said, “Think about it. Mask Era. It's like mascara as in eyelash thing. Mask Era meaning overly makeup while wearing a mask.”

That's what we would go to him for. It's smart things like that. With all of that and the new approach, how are things going? Doctors are back in the office. Are they starting to carry this product in the office as well?

It's interesting because it's such a sensitive time. I don't want to push people and say, “Buy our products. Sell our products,” because there are still people getting sick. There's still a bizarre pandemic above our heads. People are opening their clinics but in many cases, they're not restocking supplies that they normally would and not ordering new supplies. They're trying to get back to some sort of normalcy.

It's different in that sense because I even lowered the minimums for wholesale. Before, every clinic will order 100 boxes. No big deal. That's easy. With Bridgitte Shen Lee, we went over all of the pricing because she has a lot of traffic in her clinic and stocks a lot. She was like, “These are the prices. This is good. This will be great.” The pandemic hits. Clinics are closed. How are we going to do that?

The clinics are reopening and people are starting to get back into the swing of things but it's slow. The doctors are signing up. We have at least 100 wholesale and 100 affiliate link accounts set up. It's great but everybody still is hesitant. They're like, “I'm so afraid,” but then they think, “My patients are all using extra eye makeup and this is a great conversation to have.” There are a couple of doctors that have already done about five orders. It's starting to get more of a normal rhythm.

It's great because there's the option to buy from the clinic or you can get online. What's also cool with the affiliate link is you can embed it into your clinic page. If you have your own clinic, you can have a page. There are several of your colleagues who have done that. They will have a section on beauty and wellness and they will do Eyes Are The Story. They put in their affiliate link so they can sell it at the clinic but also sell it online. If they sell it online, they don't have to ship it.

One of your Canadian colleagues has her online site so she has the products with her in Montreal. It's easier for people to buy from her sites and she will ship in Canada instead of having to buy in the US. There are duties and all that. It's interesting to see how people are integrating it onto their websites or their clinics. It's a rhythm but it's disruptive and different because it's not an area that people were doing before.

It's different. Going back to what you were saying about looking for funding and stuff, it's hard to bring that up. It's like, “I'm doing something that hasn't been done before. Please trust me. I can make this work,” and then there was the pandemic and everything. It sounds like things are finally starting to come together and that's great. Can you give me a quick breakdown of the lineup of products that you have? How can somebody bring them into their practice?

First of all, everything can be found out via EyesAreTheStory.com. It's easy. In order to access the wholesale prices, you have to set up a wholesale account and that can be done through Info@EyesAreTheStory.com. It's simple. What we have for the first generation is a small collection and we did that intentionally because we want to focus the story on eye health. We have the basics that you will use in the morning before you go to the office, the clinic, or what you do at night before you go to bed. We have a face wash. Without going into all the reasons why but everything was developed because everything you use on or around your eyes can impact your vision.

The face wash is relevant because the ingredients in the face wash do not hurt your eyes. We have a face wash. It's a month's supply of face wash. There's a bottle of serum, which can be used around the eyes or on the entire face. I've also had people say that if they have flaky lids, they love using that because the flakiness goes away. It's called an Eye Proof Serum or Eye Proof Facial Serum. You can use it on your face and around the eyes.

I would not recommend the serum. Only doctors can tell their patients, “You can use it on your lids,” but I did not tell people, “You can use it on flaky lids.” Somebody said, “This is so good. Can I use it to lubricate my eyes?” I said no. There's a face wash, serum, and then we have an eyelid wipe or eyelid towelette, which can be used to refresh or cleanse the lids because hygiene is so important. They're also good for removing Eyes Are The Story eye makeup, which we have. We have mascara and eyeliner. We have black eyeliner and black mascara but we are soon to be offering as well dark brown or espresso.

Before we move on, the branding is something that I love. I love talking about branding, personal branding, branding for companies, products and things. You look at it like, “I want to buy it because it looks so good.” How did you come to that? What was the process?

Beauty Brand: Work hard and work harder. Hopefully, you get to where you want to go but don't give up. Thrive on your challenges, obstacles, and drama.

I love that part of that as well. Think about going into Apple Store. Somebody goes into an Apple Store. They're so excited to get a box from Apple. They're like, “I'm going to go home and play with my new toy,” or La Perla with lingerie. There's such beautiful wrapping and you're like, “Wow.”

We wanted to do something so we made two doctor's sets. We made box sets for the clinics. Every individual item has its own box with the Snellen chart on the front facade. On the inside, you will have an iris. What's neat is in the box collection, if you open it up, the iris is cool. It's very obvious but for someone who's not a doctor, it's not icky.

It's also not feminine. It's for everyone because everybody has sensitive eyes. The idea is to have something that you want to get excited about and you can use it again. The collection box is neat because you could put pens in it, your contact lens, assortment or cuff links. You can put everything in there because it's this great little box.

The design was important. When you go to a doctor's office, you think, “My eyes are bothering me.” You leave your doctor's office and you feel old, ugly and sick. You don't want that. If you can buy something pretty, sexy, cool and like a Bond toy, everybody wants to be Bond or a ninja, it doesn't make you feel old and ugly.

You think, “If I listened to my eye doctor, my eyes might not be so bad and maybe I won't feel sick. Can I address the situation? I should trust my eye doctor because they sell me amazing things and make me feel better.” It's like putting hope in a bottle as well. You feel good about it and you want to try it. You don't want to leave the doctor's office feeling old, ugly and sick. That was the mentality as well. We didn't want it to look like a pharmaceutical product.

It looks beautiful. The packaging is very attractive. I get a little more excited about that stuff than the average person. Looking at the lines, the shape of the bottle and the branding of it all are fantastic. Good job. With every episode that I do, there are always two questions that I would like to ask every guest at the end. I would like to ask you those. The first one is, if you could hop in a time machine and go back to any specific point in your life where you were struggling, what advice would you give to yourself in that particular moment?

Once again, it goes back into the entrepreneur persona. You have to believe in yourself. It's not easy to deal with stress, change and obstacles. As I said at the beginning, if there's an obstacle in your way, move it and find a way. It's not easy. Launching a company during a pandemic is not easy and it takes all of you to believe that you can do it. Launching a company without investors is not easy but you say, “I created this company for a reason because there is an unmet need. I have to do it.” There are so many times that you can give up, curl up on your sofa, and put the eye patches on. You can't. You have to get up and say, “Go.”

As an entrepreneur, that's extremely relevant. I feel like that's also relevant in so many other areas of life, whether you're a student, a doctor, or in some other realm. Being able to struggle or battle through those tough times and persevere like you have so many times in your career already is pretty amazing.

It can be cheesy to some people but the expression, "I opened two gifts this morning. My eyes." That's a blessing in itself. I don't care if it's raining outside or cold. If it's raining, the flowers will be happy. Every day is a new day and we get to open our eyes and see something. It is a blessing. Back to your art comments, art is such a part of my life and everything that I do in all of my companies. Vision is like art because it's priceless. We have to focus on ourselves, believe in ourselves, and move forward. If there's an obstacle, just move it.

“Vision is like art because it’s priceless.” That’s very well said. I would like to end on that but I do have one more question so we're going to go through that. With everything that you have achieved and you have done amazing stuff, how much of what you have achieved up until now would you say is due to luck? How much is due to hard work?

I happened to be a little bit superstitious, I have my evil eye on me, but I don't think anything is luck. It's lucky when I run into someone I haven't seen for a while and that's special. In terms of the business, everything is hard work. Nothing has come easily. Even though I can make it seem easy sometimes and glamorous, nothing has come easy. That's another thing that my family instilled in me. Work hard and work harder. Hopefully, you get to where you want to go but don't give up. You can't give up. I thrive on challenges, obstacles and drama.

Trauma or drama?

Drama. Maybe trauma too but trauma can fall into the drama category.

You have a thing for the dramatic.

It makes a good story.

That's true and the eyes are the story. Thank you so much. What incredible insights and knowledge. This was such a fun conversation. Where can people find you online? Where would you like people to connect with you?

Let's keep it easy, EyesAreTheStory.com. Come visit, come by, and share the story.

Thank you, everybody. I know you enjoyed it because Amy is such an amazing guest with so many incredible stories and insights to share. If you did like it, please take a screenshot, throw it up on your Instagram story, tag us both, and let us know what you thought and what you took away from it. If you're listening on Apple Podcasts, please leave a rating. If you're watching on YouTube, subscribe, hit like, leave a comment, and let me know what you thought. Thanks, everybody, for joining. Thank you, Amy, for everything you shared.

Thank you.

Important Links

About Amy Gallant Sullivan

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Amy Gallant Sullivan is the co-creator of the Tear Film and Ocular Surface Society (TFOS) and founder of the new ocular health conscious beauty brand, Eyes Are The Story.

I had an absolute blast chatting with Amy about how she helped turn TFOS into the ultimate resource for ocular surface and dry eye across the world, how she approaches gender bias in the business world, and how she launched her new company during a global pandemic.

Connect with Amy:

EyesAreTheStory.com

Instagram.com/tamingamy

Linkedin.com/ /in/amygallantsullivan/

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Episode 31 - Dr. Eye Got This

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Listen to the podcast here

Dr. Rachael Wruble is an award-winning, multi-practice-owning, successful optometrist who also happens to be the President of the North Carolina Optometric Society.

Rachael shares incredible insights into financial security, practice management, and how she handles everything she has on her plate.

Connect with Rachael: instagram.com/dr.eyegotthis

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Episode 30 - Dr. Jackie Garlich, Creator of 20/20Glance

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Dr. Jackie Garlich is the creator of 20/20 Glance, weekly newsletter that helps keep optometrists up to date on what's happening in the industry.

In this episode, Jackie and I chat about her entrepreneurial streak, tips as a content creator, and her unlikely path to becoming a business owner.

Connect with Jackie: instagram.com/2020glance

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Episode 29 - Chris Turcotte on switching your mindset and Overcoming Your Past

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Listen to the podcast here

By just about anyone's standards, Chris Turcotte had a challenging upbringing. From having an abusive, alcoholic father who died ON Chris' 16th birthday to losing his mother in his early twenties.

Yet today, Chris is running two national brands in finance and property management and he has built huge momentum on social media with his personal brand and positive messaging.

I was humbled and grateful that Chris offered to share his story with me in this episode. I think its the type of conversation that will provide that shot in the arm for anyone who is looking for some motivation.

Connect with Chris: Instagram.com/christurcotte_

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