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NEWLY LAUNCHED PROFITABLE -PRACTICE .COM Visit us online for up to date news, resources and articles on running a profitable practice. Learn more about our authors, gain insight and professional advice. None Of Your Business… Or Is It? Maximizing The Benefits Of Incorporation Tips For Setting Financial Goals Preventing Diabetic Retinopathy Interview With Dr. Graham Trope What Is A Brand… And Why Should I Care? Practice Appraisal – A Smart Move AND MUCH MORE! PROFITABLE PRACTICE EYE CARE PROFESSIONAL EDITION SPRING 2013 A HELPFUL RESOURCE FOR YOU AND YOUR PRACTICE PUBLICATION MANAGEMENT AGREEMENT #41073506
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Page 1: NEWLY LAUNCHED PROFITABLE EYE CARE PROFESSIONAL …profitable-practice.com/wp-content/uploads/2014/08/... · PROFITABLE-PRACTICE.COM Visit us online for up to date news, resources

NEWLY LAUNCHED

PROFITABLE-PRACTICE.COM

Visit us online for up to date news, resources and articles on running a profitable practice. Learn more about our

authors, gain insight and professional advice.

None Of Your Business… Or Is It?

Maximizing The Benefits Of Incorporation

Tips For Setting Financial Goals

Preventing Diabetic Retinopathy

Interview With Dr. Graham Trope

What Is A Brand… And Why Should I Care?

Practice Appraisal – A Smart Move

AND MUCH MORE!

PROFITABLE PRACTICEEYE CARE PROFESSIONAL EDITION SPRING 2013

A HELPFUL RESOURCE FOR YOU AND YOUR PRACTICE

PUBLICATION MANAGEMENT AGREEMENT #41073506

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1

1 | EDITOR’S PAGE Content and Contributors KAREN HENDERSON

2 | EMPLOYMENT LAW

None Of Your Business MARIANA BRACIC

4 | ACCOUNTING

Maximizing The Benefits Of Incorporation LLOYD WRIGHT AND CHRISTINE TAYLOR

6 | REAL ESTATE

A Life Changing Goal... For Generations TODD C. SLATER

8 | MARKETING

Your Brand Is An Asset DANIEL PISEK

10 | FEATURE INTERVIEW

Dr. Graham E. Trope EDITOR INTERVIEW

13 | RESEARCH

The Glaucoma Society Of Canada KAREN HENDERSON

14 | PRACTCIE MANAGEMENT

Thinking About Purchasing A Practice? TIMOTHY A. BROWN AND JON J. WALTON

16 | EYE CARE

Importance Of An Eye Exam For Diabetics DR. WESDON MCCANN

18 | PATIENT EDUCATION

13 Secrets Your Eye Doctor Won’t Tell You

19 | PATIENT ADVICE

Safety and Compliance Of Prescription Spectacles ORDERED BY THE PUBLIC VIA THE INTERNET

20 | PRACTICE MANAGEMENT

Smart Eye Care Professionals Have Their Practices Appraised DAVID ROURKE AND TIMOTHY A. BROWN

22 | FUND RAISING

The Foundation Fighting Blindness – Supporting Breakthroughs In Vision Research

24 | THE PRACTICE OF OPTHAMOLOGY

By The Numbers

25 | OPTICAL ODDS AND ENDS

Interesting Facts For Eye Care Professionals

PROFITABLE PRACTICES P R I N G 2 0 1 3

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profitablepracticemagazine.com

EDITOR’S PAGE

Notes on Content, Research/Fund Raising and An aging PopulationThis second issue of Profitable Practice goes behind the scenes and looks at two individuals who have decided to augment the way funds are raised for eye disease research. Our feature interview, Dr. Graham Trope was hit by the research bug very early in his stellar career and went on to found the Glaucoma Research Society of Canada Glaucoma Research Society of Canada in addition to all the clinical and teaching work he does. He admits that the bulk of the support for the Society comes from its members – those who have been touched by glaucoma.

Erin George found a way to take action against the eye disease that was stealing her sight; she co-founded one of the Foundation Fighting Blindness’ now signature fundraising events, Cycle for Sight, as a way for people affected by retinal eye disease to raise funds for research.

We are very pleased to provide articles on both Glaucoma Research Society of Canada and the Foundation Fighting Blindness so our readers can pass this valuable information onto their patients.

The need for more researchThe CNIB reports in The Cost of Vision Loss in Canada: Summary Report 2008:

epidemic of age-related eye disease. The number of blind and visually impaired Canadians has increased 37% in the last ten years and is projected to double between 2006 and 2031

develops vision loss

it can be prevented or treated

loss doubles approximately every decade. At 75, it triples

care costs (direct costs) of any disease category in Canada – costing Canadians much more than diabetes, all cancers or cardiovascular disease

More content notesTo round out this issue, we present the following authors who consistently provide the best guidance and business solutions for our subscribers.

Todd C. Slater, The $imple Investor and a regular contributor to the magazine presents a New Year’s resolution goal that could have a generational impact on your financial portfolio. Dan Pisek outlines and explains the importance and management of your business brand. David Rourke and Timothy A. Brown argue for the regular appraisal of professional practices.

Mariana Bracic recommends that employers have a workplace office manual in place and an employee agreement that clearly outlines what can and cannot be done by employees when using an employer’s office technology. Lloyd Wright and Christine Taylor make a very clear financial argument for incorporating your business, not the least of which is maximizing your net worth.

Whether or not to purchase a practice is a critical decision some practitioners face; Timothy A. Brown and Jon J. Walton present the top ten issues to consider. Dr. Wesdon McCann is a young optometrist based in London, ON who clearly articulates the effects of diabetes on the eyes and body and provides some pointers to help patients prevent diabetic retinopathy.

Finally we are always pleased to provide information to help protect your patients; this issue presents a brief study abstract discussing the risks of purchasing prescription glasses over the Internet.

Things to rememberReaders are reminded that for subscriber information, please go to the inside back cov-er of this magazine. Don’t forget to check out our 13 Secrets article on page 18. As always we welcome your comments and suggestions; if you would like to write for the magazine and have a story to tell that would interest our eye care professional reading audience,

-ablepracticemagazine.com.

by James Ruddy

ROI Corporation Brokerage

PUBLISHER ROICORP.COM

James Ruddy

EDITOR-IN-CHIEF

Karen Henderson MANAGING ASSOCIATE EDITOR

Natalia Decius Full Contact Marketing

DESIGN BY FULLCONTACTMARKETING.CA

HOW TO REACH US

LETTERS TO THE EDITOR

1155 Indian Road,

Mississauga, ON L5H 1R8

SUBSCRIBER SERVICES

PERMISSIONS

Profitable Practice: Optometry Edition is printed and distributed 2 times a year by Premier Impressions and is published by ROI Corporation Brokerage. The contents of this publication are protected by copyright and may not be reproduced without the written permission of ROI Corporation Brokerage.

The information provided through this publication is for educational purposes only. The publisher, by and through ROI Corporation Brokerage, shall not be liable to any person or entity with respect to any loss or damage alleged to have been caused, directly or indirectly, by the use or misuse of information, facts, ideas, or for deficiencies, defects, errors, omissions or inaccuracies in the contents of these materials.

This publication complies with the Canadian Advertising-Editorial Guidelines and is published by ROI Corporation Brokerage for educational, marketing and informa-tional purposes only. Our contributors are seasoned professionals who have agreed to share their advice in Profitable Practice and some of them partially fund this publication designed to provide our readers with timely information about industry news, analysis and stories in support of the dental profes-sion across Canada.

profitablepracticemagazine.com

Karen Henderson Karen Henderson is the Managing Associate Editor of Profitable Practice Magazines and can be reached at [email protected]

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None of Your BusinessBy Mariana Bracic

Imagine that one of your employees has downloaded pornographic images of a paediatric patient of your practice onto your office computer. Let’s say that it was done on the employee’s personal time. Is it “none of your business”? Do you have the right to search the computer? Do you have the right to hand the files over

recent, much anticipated decision of the Supreme Court of Canada: R v. Cole [2012 SCC 53]. The case high-lights the overwhelming importance to us as employers of having in place workplace policies that reserve our right to treat everything that happens on our computers as “our business”.In R. v. Cole, the accused, Cole, was a high school teacher whose job included policing student use of their networked laptops. Accordingly, the school board provided him with one of its laptops and domain-administration rights on the school-board network. Using this access, he logged into a female student’s email which contained naked photographs of her, and he saved them into a hidden file on his laptop. The file was discovered during routine maintenance by a computer technician. The school turned over the file to the police. While the issue in the case involved the exclusion of the evidence that the police had obtained without a warrant, what is relevant for employers across Canada to note is what the highest Court in the land has to say about privacy rights in the workplace.

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The Supreme Court said:Computers that are reasonably used for personal purposes—whether found in the workplace or the home—contain information that is meaningful, intimate, and touching on the user’s biographical core. Canadians may therefore reasonably expect privacy in the information contained on these computers, at least where personal use is permitted or reasonably expected.

The Court concluded that the police had infringed the teacher’s rights under section 8 of the Charter of Rights and Freedoms (which guarantees to everyone the right to be secure against unreasonable search or seizure) by seizing and searching his employer-issued laptop without a warrant. However, the Court felt that the breach of the Charter was not so significant as to justify excluding the evidence during the accused’s trial. This was particularly so as the police had reasonable and probable grounds to obtain a warrant and would undoubtedly have discovered the evidence in any case.

From an employer rights’ perspective, it should be noted that the Court held that the employer had the lawful authority to seize and search the laptop (although this authority did not extend to the police). The school board, in the Court’s view, was legally entitled to report its contraband findings to the police, who would presumably have then been able to obtain a search warrant.

For those of us seeking to protect employer rights, it should be noted that the Supreme Court was influenced in its decision by the following factors:

The fact that the laptop belonged to the employer;

The fact that the policies and practices of the employerpermitted only incidental personal use;

The fact that the technology in place at the school involved routine maintenance of computers which would thereby uncover information on the computers of whatever nature;

The school’s statutory duty to maintain a safe school environment.

The decision is generating controversy in legal circles and the Court has given out somewhat conflicting guidance.One thing is clear, however: if as an employer you have any hope of maintaining the comprehensive right to search or examine what is being done on your computers (as, in our opinion is

now, as never before, imperative that your Workplace Policy Manual contain an expertly drafted policy on the issue.

When we prepare policies for our clients as part of their Practice Protection Package™ we generally recommend that we include language making it clear that the employees have no expectation of privacy on any office-owned technology. As a destination employer myself, I find that very lamentable. I have said to MBC’s own, highly valued staff, that I wish that we could allow them to make whatever personal use they wished to do of any technology we give them (and we give them a lot as our work is highly technology dependent—laptops, BlackBerry® smartphones, VOIP phones, etc). I

possible. However, we cannot do so as the Courts have tied our hands. In order to preserve what I consider indispensable, namely, the right to search and examine any technology belonging to MBC at any time, in my opinion, we are forced to preclude any personal use by staff. Unfortunately, this is yet another of the many ways that Canadian employment law, by overreaching in its attempts to protect employees, creates the opposite result by forcing the hand of employers and leaving employees less protected.

A similar result happened, for example, a few years ago with a case involving disability insurance. An employee became disabled after he was fired during what would have been his “reasonable notice period”. Disability insurers do not like to continue coverage for disability insurance once the employee ceases to be actively working (for example, if they receive pay in lieu of working notice, or they are terminated summarily). The Courts have held that, in such cases, the employer steps into the shoes of the insurer, and is therefore liable for any disability the employee may develop, a potentially devastating financial result for a small business, if say the employee is incapable of working for many years. For example, in one such case, the employee received two years of compensation for lost wages, plus almost $260,000 (!) for lost disability benefits. As a result, we always advise our employer doctors not to provide disability insurance. (If you want to do something nice for your staff, take the money you would have spent on disability premiums and just give it to your staff, or give them some other benefit.) Again, this highlights how when Courts are overzealous in “protecting” employees while ignoring business realities they end up actually leaving employees in a worse position. No small business which has access to the best employment law advice would, in my view, choose to risk the viability of their business by offering disability insurance to its employees.

Similarly, in the context of our legitimate business need as employers to examine what is being done on our office technology, the Courts have effectively told us that we had better have a proper policy in place, unless we expect to be told that it’s “none of your business”.

Bottom Line: This article recommends employers have a Workplace Office Manual in place and an agreement with their employees delineating what can and cannot be done by employees when using an employer’s office technology.

Mariana Bracic

Mariana Bracic, BA (Hon.) JD, is the founder of MBCLegal.ca. Mariana is proud of the dramatic benefits of her completely unique, niche specialization (employment law + doctors) that enhances her clients’ wealth and happiness. She can be reached at 905-825-2268 or [email protected].

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Maximizing the Benefits of Incorporation by Lloyd Wright and Christine Taylor

ACCOUNTING

You may have been told to repay your personal mortgage first, save for RRSP’s, set up a tax-free savings account, etc. but if you have a corporation does this make sense?

Repaying your mortgageWhen deciding how to pay off your mortgage, let’s use the following example. Let’s assume you have a $100,000 variable rate mortgage and your current interest rate is 3 per cent. That means you pay interest of approximately $3,000 a year on this mortgage. If you had $100,000 remaining in your corporation and wanted to use these funds to repay your mortgage, you would withdraw the $100,000 as dividends, and would pay approximately $31,000 of tax. There would only be $69,000 of cash remaining to repay your mortgage. This amount of tax paid ($31,000) to withdraw the funds is more than ten years of interest. This does not make sense to do. In addition, the money that would have been saved in your corporation, if it were invested reasonably well, should earn at least 3 per cent. By taking money out of your corporation and repaying your loan instead of just investing in your corporation, you have $30,000 less. Obviously, you need to repay your mortgage over time, but there is no economic reason to pay it off sooner.

Tax free savings accounts (TFSAs)The same concept works for tax free savings accounts. There are many articles that recommend you put away $5,000 a year, but it costs you $1,500 in personal tax to take the money out of your corporation to invest in the same products that could be invested in your corporation. The growth that is not taxable in the tax free savings account would probably be much less than the personal tax incurred to take the money out of your corporation. The same strategy should be applied to other savings as well.

Other sources of fundsMany professionals have significant non-registered funds saved outside of their corporations. For example, an owner may sell a portion of their practice or company, pay the resulting personal tax on those proceeds and continue to take the same salary from their corporation. Does this make sense from a cash flow perspective? If he/she were to take the money from the sale, pay the applicable personal tax and live off the remaining balance, all profits could be retained in the company. Many owners who have other significant investments choose to take small dividends or salary from their companies and live off their personal investments. They can still reinvest the corporate money in the same investment products as personal investments, but pay a lot less tax.

To create wealth the goals are to minimize taxes and maximize growth of investments. The steps to start to create your wealth are:

Determine what you need as a family for living expenses – be realistic and challenge yourself on what you spend. You need to be much more careful today than in the past since we feel returns and growth for investments, our homes and businesses will be lower than they have been.

Review the family expenses and see if any can be paid by the corporation. Some examples may include corporate owned life insurance, certain health plans or golf mem-berships, which can be corporately owned in some cases, but there are other examples as well. We know that each expense may be small but they add up and could cost less after tax if they can be paid by the corporation. Your accountant can provide advice on this.

Determine any sources of income that are not from the practice – your spouse’s salary, your non - RRSP investment income, rental income, etc. and deduct these sources of income from what you need.

Determine how to pay the balance you need out of your company, either in the form of dividends or salary. The overall tax effect is usually about the same between the two options, but other considerations need to be examined. One of the main differences is the effect on CPP and RRSP contributions.

Meet with money managers to invest the excess in sound, long term growth investments and make the contributions regularly. Professionals must have a disciplined savings approach and monitor the performance, fees and returns on investments regularly.

Your accountant should be reviewing both your personal and business finances as a whole to help you maximize your wealth. It is your net worth (the sum of your assets, both business and personal, less your debts) that needs to grow, and by using your corporation to its full potential, you can help accelerate your savings.

Bottom Line: This article makes a very clear financial argument for incorporating your business, not the least of which is maximizing your net worth.

In the past we have talked about incorporation and the four situations that make incorporation beneficial. We want to continue to build on this concept and discuss how best to get money out of your corporation, pay the least amount of tax and hopefully give you some further insights to creating wealth.One of the reasons you incorporate is to have professional income taxed at corporate tax rates, which for most professionals is the small business rate for corporations. This rate is different from province to province but in

Ontario the corporate tax rate is currently 15.5 per cent on business income up to $500,000. Your personal

Ontario. Let’s expand on this concept with an example.

You can see that the difference in tax paid by leaving the money in the corporation instead of taking it out is approximately $31,000 or approximately 31 per cent. This is a significant amount which accumulates from year to year if you leave the money in your corporation. If you are not incorporated you pay personal tax rates as stated above. Our calculations assume you are at the highest personal income tax bracket in Ontario.

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Corporation No CorporationPROFIT EARNED IN A CORPORATION (AFTER WAGES TO THE DOCTOR) $100,000 $100,000

CORPORATE TAXES PAID – 15.5% $15,500 $0

BALANCE LEFT IN THE CORPORATION $100,000

IF YOU PAY THE BALANCE AS DIVIDENDS, PERSONAL TAX WOULD BE $31,000

BALANCE AVAILABLE TO SPEND $53,500 $53,600

Lloyd WrightLloyd Wright is a Partner and the National Leader for BDO’s Professional Services practice.

Christine Taylor

Christine Taylor is a Senior Manager and an integral member of BDO’s health care team.

Lloyd and Christine can be reached at 519-576-5220 or email [email protected] or [email protected]

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A Life Changing Goal… For Generationsby Todd C. Slater

The New Year is in full swing and its time to review some of our goals and resolutions. By Valentine’s Day, as in years past, we have betrayed and abandoned many of the resolutions we made. Remember those ads by fad diet companies and fitness clubs that bombarded you to finally lose those extra few pounds and provided you with an easy and fast plan to do so. “The NEW you in 90 days or your money back!” Of course, the fine print says you need to run ten miles a day and provide dated video footage!Goals are personal; some you will share with those around you while others you will keep to yourself. Typically, goals fall within one or other of the following categories: personal, relationships, work, health (physical, mental or spiritual) and of course, financial. I am sure there are a few more, but you get the idea.

As a former national athlete, one of the most important things I learned about goals was setting realistic ones and learning to focus on step-by-step programs that allow you to see success. If you decide for instance that this time you were going to lose 20 pounds (not that you

need to!), how would you set up your goal? Do you expect to lose five pounds a week over four weeks and call it a success? If you do that, chances are the 20 pounds may come back, and even bring a few extra friends! The true way to success is to go slow and steady. If you

weeks to reach your goal. The most important thing here is that it will change your lifestyle and show you that you CAN achieve something. You also stand a much better chance of keeping your 20 pounds and all their friends from joining you again!

So how does this apply to financial goals? This is the area

stand to lose a few pounds! A financial goal is normally the easiest goal to achieve. Providing that you set it up properly, you can monitor your success. Naturally, you have to select the best path for success. The average professional rents their office space, primarily due to location considerations. For most, this is the sticking point; however, purchasing a new location (in close proximity to your existing location) with a well-advertised and marketed move might marginally increase your revenue, but it will definitely build your assets. Let me break down some numbers for you to show you how.

If we look at renting vs. owning we see the following: PRO

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** For illustrative purposes, calculated simply with no compounding

As you can see, the numbers simply don’t lie. As an owner, at the end of a 25-year period, you will have a building worth more than $1.3 million, fully paid for and generating income if you so decide. As a tenant, you will have a happy landlord who may thank you and send you a gift basket for paying off his/her mortgage.

So, let’s go back to financial goal setting and strategy. Owning your practice location is one financial step you can take that is achievable and allows you to monitor its progress. The same formula is applicable to all rental properties as well. You can grow a portfolio of investment properties separately from your work that will do exactly same thing.

I wish you good luck in setting and achieving your financial goals for the rest of this year and years that follow. In con-clusion, we are here to help make reaching some of those goals….$imple.

Bottom Line: This article deals with financial goal setting and the rent-ing/buying issue of office space with a numbers analysis chart to consider.

Rent Own

VALUE $0 $800,000

DOWN PAYMENT/DEPOSIT $10,000 (FIRST/LAST) ALLOW LESS)

MONTHLY EXPENSE $5000.00/MTH MORTGAGE - $3000/MTHPROPERTY TAX -$1000/MTHMAINTENANCE - $1000/MTHTOTAL = $5000/MTH

UTILITIES SAME AS OWNING SAME AS RENTING

(NOT INVESTED IN PROPERTY)

PER YEAR = $9600/YR

USED AS DOWN PAYMENT$560,000 MORTGAGEPAY DOWN = $19,600/YEAR

EQUITY INCREASE $0

$800,000 X 2% = $16,000/YR(ASSUMING CONSERVATIVE 2% ANNUAL MARKET IN-CREASE)

END OF YEAR 1 $9600 GAIN$19,600 + $16,000 = $35,600 TOTAL EQUITY GAIN

5 YEAR GAINS** $178,000

Todd C. Slater

Todd C. Slater is the President of The Simple Investor Real Estate Group Inc. Todd has been one of Canada’s top realtors as well as host of Realty TV for four seasons. With his innovative approach to managed real estate investment properties, Todd educates and provides investors with solutions and opportunities for investment real estate. He can be reached at [email protected] or visit www.thesimpleinvestor.com

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Your Brand is an Asset. Manage It WellBy Daniel Pisek

MARKETING

Ignite your practice brand Just like you want a strong foundation to build for your home, you want a strong foundation upon which to build your marketing. After all, everything you do to market your practice is an extension of your brand. There are three key areas to consider to effectively brand your practice:

1. Your nameJust using your name to identify your practice does very little to tell people anything about what you are as a practice. It also says nothing about where you are located, the type of services you provide or anything about the patient experience custom-ers can expect. Cobblestone Family Optometry immediately speaks to the young families living in the Cobblestone Plaza neighborhood. Also, today communities comprise a mixed cul-tural diversity and keeping last names out of the practice name also keeps the practice culturally neutral.

2. Your logo It’s important to have the right look for how your practice name is presented. Just like the Apple or the Nike swoosh, you want a logo that your customers will associate immediately with your practice and thus be able to share the emotional reaction to the brand.

3. Your website Nowadays, many buying decisions including healthcare choices are made on the Internet. Your brand must translate well on your website. Image is everything here. Even if you start off with a very simple splash page, be sure that it is in tune with your brand positioning. You can always add to the website as the practice grows.

Your brand is an important asset When you buy a new optometrist chair, the day after this hard asset is installed in your office it begins to depreciate. When you invest in a professional approach to branding and nurture the brand with good marketing, you have an asset that will appreciate and play a very significant part in the overall success of your practice during its lifetime.

Getting your practice started With many doctors I meet have infinite ideas about how they want to launch their new practice. While it’s great to have ideas, investing in your brand should always be the first order of business. Focusing on a brand will allow you to make a good first impression, connect with potential new customers and create an immediate emotional response.

Your brand needs to flow throughout the practice. The colours on the walls and style of uniforms must reflect that personality. The look needs to be consistent from the sign out front to the furniture in the waiting room and treatment rooms.

Growing your practice With a strong brand in place, you have a head start with your

marketing. Your marketing will be more effective if people can immediately associate your brand with something. If we placed the Apple logo on a coffee cup, people would automatically

brand to move your practice forward. Be bold. Along with di-rect marketing, look for opportunities to team your brand with other like-minded brands in the community.

Branding is also a great motivator for your staff. When a team is on board with a common goal, they will represent and rein-force the values of your brand from the greeting on the phone to their interaction with patients in the office.

Customer loyalty comes from consistently delivering on the promise of your brand as well as keeping current. Styles change, but with an established brand you don’t have to reinvent your-self all the time. Starbucks recently freshened up their logo, but it was just a tweak. The logo is still instantly recognizable. Over time you can choose to update your logo or refresh the office interior while still keeping your brand association intact.

Realizing your optimal practice sale price When the time comes to sell Cobblestone Family Optometry, having that brand is like staging a home for sale. It makes it easier for potential buyers to see themselves owning the prac-tice because they see the practice’s personality, not yours. It’s not only an easier transition for the new optometrist, but for the patients and staff as well. It will still be the familiar Cobble-stone Family Optometry.

Brand recognition doesn’t happen overnight. If you are plan-ning to sell your practice, you should plan this well in advance. For the best sale price, one needs an investment of $10,000.00 for a complete professional branding package, as well as some solid marketing programs. This branding and marketing should be executed for at least three years before listing the practice to get the strongest return. I’ve discussed this approach with some of Canada’s leading practice brokers and they agree that well branded practices are better positioned to sell more easily and for more money than a poorly branded or unbranded practice.

Your brand is your lifeblood Your practice is a business with a life and your brand is the blood that pumps through it, keeping it strong. In order to keep that business healthy, you have to manage your marketing well - and that starts with your brand.

Bottom Line: This article outlines the importance of developing and maintaining a brand to help ensure the success of your practice.

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across the street, all lined up in a row, are Tim Hor-tons, Starbucks and McDonald’s. Which do you choose - and why?I have presented many seminars and workshops where I start with this “coffee choice” scenario. The Tim Hortons devotees choose to go there because they associate the brand with convenience and serving a good cup of coffee at a fair price. For the Starbucks crowd, they are fine with paying a little more for a premium cup of coffee. They get an experience which helps them boost their own image simply by carrying that iconic white and green cup around town.

McDonald’s is usually the loser in my audience opinion poll. People comment on how it is a very good cup of coffee, convenient to get and you can’t beat the price - es-pecially when it’s free. But even with the McCafe experi-ence, people still associate McDonald’s with “Would you like fries with that?” It’s a prime example of the power of branding - and how “brand perception” can really make or break business goals.

While the coffee business these days is very competitive,

so is the world of eye care. Let’s face it: In most cities, you don’t have to look too hard to find the office of an optometrist or optician. Dr. John Eye Doc Doe, Main Street Family Optometrist and My Optical on Main, like the coffee shops, are situated there in a row, competing for your attention.

Now more and more eye care professionals are realizing that an effectively branded practice is a key component to their success. Branding is a crucial tool when launching a new office, growing your existing practice or getting your practice ready to deliver a larger sale price when it comes time to retire.

What is a brand? It’s the personality your practice would have if it were a human being. It’s what people think of when they hear your practice name or see your logo. In the consumer’s eye, the expectation is for you to provide great care on the clinical side of things. Do you project the image of a progressive-minded practice and what is your patient experience? Effectively branding your practice is about effectively communicating who you are as a practice to set yourself apart from the competition.

Daniel Pisek Dan Pisek is the owner of Full Contact Market-ing, which specializes in health care practice marketing. He can be reached at 1-800-728-6651 ext. 24 or [email protected]

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1110

Feature Interviewwith Dr. Dr. Graham E. Trope M.B., B.Ch., Ph.D., FRCS(C), FRCOphth., FRCSEd. Dip.Ophthal.

Dr. Graham Trope is Professor of Ophthalmology at the University of Toronto. He has directed the Glaucoma Service at University Health Network

Ophthalmology at the University of Toronto and past Ophthalmologist in Chief at University Health Network. He has published 180 scientific articles and two books on glaucoma. He has been involved in glaucoma research and treatment for nearly 30 years and is the Founder and Scientific Director of the Glaucoma Research Society of Canada. Dr. Trope is a man on a mission: To eradicate glaucoma in this country…

Dr. Trope, can you give us a brief summary of your educational and scientific backgrounds?I graduated from medical school in South Africa and continued my studies in the UK where I did my training in ophthalmology. I also obtained a PhD from Glasgow

in Toronto by the then chairman Dr. Clive Mortimer.

Ever since then I have run the glaucoma service at the University Health Network.

How did you become so interested in glaucoma?In the late 70s while I was an ophthalmologist in training I attended an exciting lecture. The speaker (the late Tom Zimmerman) was a well-known glaucoma specialist who had just introduced beta blockers for the treatment of glaucoma. I asked him how the drops actually worked and when he answered that ‘we have no idea’ I was hooked!

I became very interested in glaucoma and its

drops work by binding to certain structures in the eye called beta receptors.

Why did you found the Glaucoma Research Society of Canada?When I arrived in Canada I was very keen to do research into glaucoma but I soon found vision science to be poorly funded; in particular glaucoma research was very poorly funded. On the one hand I had a group of patients who were asking me when a cure would be found for this terrible disease and on the other hand PR

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we had governments minimally supporting vision research. So I decided to form an organization with one specific aim: To support research and through this to try find a cure for glaucoma. I initially established the Glaucoma Research Society of Ontario and then with the help of Mr. Michael Cleaner and many other wonderful volunteers we went on to develop the Glaucoma Research Society of Canada. Our head office is in the Canadian National Institute for the Blind (CNIB) building here in Toronto. From here we raise funds and distribute them to researchers across the country to try and find a cure. That’s all we do.

With the money raised we give out research grants. We usually get anywhere from 9 to 15 applications for grants each year and we support the best ones. We have raised over $3 million so far and have supported a significant number of research grants. We are very proud that about 66 per cent of the recipients go on to publish their results.

Our organization is very lean; we have only one part-time administrator so the funds we receive are well used. We are most reliant on patients themselves for funding but the pharmaceutical industry have stepped up over the years to support us, particularly Pharmacia, Allergan and Merck. They have been terrific. But it’s mainly the patients who support us.

Canadians have glaucoma, so we desperately need more members. Anyone can join; all they need to do is contact the

will gladly send out the information. We are happy to take any donation, from $1 to whatever level supporters can afford.

What is the latest research you are working on?We have recently completed a major study on a new surgical

American Glaucoma Society meeting; we have recently completed another study on high risk patients for glaucoma. We also are continuing research on imaging and molecular biology in conjunction with Drs. Yvonne Buys and John Flanagan at the Toronto Western Hospital. Finally we have a big grant application pending with the CIHR (Canadian Institute of Health Research).

How does your volunteer program work?One of our board members (Richard Gallop) runs the program. The volunteers take the Society pamphlets and distribute them to the various doctors offices, hospitals etc. to increase aware-ness of our organization and thus increase membership.

You have something called a glaucoma simulator on your site. How does it work?This was provided by one of the drug companies. Anyone can go on the site and use it. It clearly shows the way that people lose vision with glaucoma. Unfortunately a lot of people are misinformed about glaucoma. The disease does not cause loss of central vision; side or peripheral vision is lost first and the simulator shows this very nicely. The loss of side vision worsens to the point where a patient is left with only tunnel vision and

then finally complete loss of vision occurs.

How does your organization differ from the Canadian Glaucoma Society?It’s very different. The Canadian Glaucoma Society is made up of eye surgeons with an interest in glaucoma. They meet on an

etc. It is an educational organization; the Glaucoma Research Society of Canada is a charity which raises the money to fund the work of these doctors and scientists who are working to find a cure for this disease.

What future direction and developments do you envision for glaucoma treatment in Canada?We are in a new world of stem cells and molecular biology. Although there are no new big breakthroughs expected within the next year or two, I do think that molecular biology will provide some amazing new therapies in the next decade. I am sure it’s going to happen. Scientists are looking at growth factors and other proteins/chemicals that will strengthen the optic nerve and enable sick nerves to regenerate. Hopefully one day we will be able to regenerate dead nerves but that’s probably decades from now. From the treatment point of view there are

developed, so in the next few years I think we will see some

What is your general impression about how the public regards glaucoma? Is Canada doing enough education about the disease?The majority of Canadians do not understand what the risk

or being black. All eye care professionals need to do a better job of educating the public, especially regarding risk factors and also how glaucoma presents. The public generally seems to know that glaucoma causes blindness but they don’t know it causes the loss of peripheral vision. Everyone at risk needs to be encouraged to visit an optometrist or ophthalmologist for regular eye checks, pressure checks and optic nerve checks.

times more likely to suffer from glaucoma than the average person. We can’t cure the disease; the best we can do is control it. Early diagnosis is the key to blindness prevention.

What role would you like Canadian eye care professionals to play to help forward your cause?I think all health care professionals including family doctors a have an important role to play, particularly in the area of education and disease detection. It’s not cost effective to go out and do mass eye pressure screenings. It’s been shown time and time again not to be useful. The screening of at risk people however is cost effective. We need our colleagues to educate the at risk public to visit eye care practitioners for regular glaucoma checks.

What is so worrying is that some provinces like Ontario have

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The Glaucoma Research Society of Canadaby Karen Henderson

RESEARCH

Dr. Graham Trope (see Feature Interview) formed the Glaucoma Research Society of Ontario in 1988 to raise funds to find a cause and a cure for glaucoma. In 1997, the Society became the Glaucoma Research Society of Canada, a national registered charity committed to funding research into the causes, diagnosis, prevention and treatment of glaucoma. The Glaucoma Research Society of Canada is the only Canadian charity solely dedicated to funding both clinical and basic science glaucoma research. Since 1989, it has raised more three million dollars in support of 150 research projects.

The Society’s mission is to support new ideas at their inception with seed money. Research proposals are peer-reviewed, and a highly regarded Scientific Advisory Committee, chaired by Dr. Trope, reviews the recommendations for the Society which awards research grants annually. The Society funds 10 to 15 per cent of all independent glaucoma research in Canada.

The Society has funded research projects by most of Canada’s top glaucoma researchers – doctors and scientists interested in finding new treatments and preventing blindness from glaucoma. These highly respected researchers are recognized across Canada and internationally.

Their research includes:

Seeking to protect healthy nerve cells in the eye and repair damaged ones

Searching for genes related to glaucoma

Studying blood flow to the eye

Making glaucoma surgery easier for the patient

the Society has only 1000 members, mostly glaucoma patients who truly understand how important research is to their disease and so support the Society’s work. More members and supporters are desperately needed.

There are many ways to support the Society:

You can donate publicly traded securities without

incurring the Capital gains tax and will receive a donation receipt for the fair market value of the securities

You can create a charitable gift annuity

You can create an Endowment Fund

You can gift a life insurance policy

You can make a gift in your will

The role of eye care professionalsIt is easy to spread the word about the Society; pamphlets are available for all eye care professionals to display in their offices.

Glaucoma is a devastating disease with no cure. Research is the key to discovering new diagnostic methods and treatments. Seniors are primarily afflicted so glaucoma will become even more prevalent as our society ages. Dr. Trope feels that all eye care professionals—opticians, optometrists and ophthalmologists—should play their part in recruiting new members to the Society to help find a cure for the disease through research.

Barbara Ullmann

Write: Glaucoma Research Society of Canada

1929 Bayview Avenue, Suite 215E

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delisted eye care exams for those under 65. So if you have a family history of glaucoma and you’re under 65 you have to pay for the first visit. If you cannot afford it it’s a disincentive to get checked. Once glaucoma is diagnosed the care is covered, but we know that the poor are suffering from this change in health care policy.

Let’s switch gears for a moment. What do you do for relaxation?I have a number of hobbies. I am a horologist, a watch - maker…I fix vintage watches. But it’s getting harder to do because of the Internet. The days of picking up

selling them on eBay are slowly disappearing. I am also interested in classic cars; I happen to have one and spend time in the summer working on it and driving it to car shows. Photography is a huge hobby, particularly animal photography. I am an ex African and still go back on safari.

I have read that World Glaucoma Awareness Week is March 10-16 this year; how will Canada contribute to this worldwide education effort? (See Sidebar)The Society is always involved; we send out notification to our members to get them involved. Dr. Neeru Gupta on our board is also very involved. She ensures that eye care professionals across the country are aware of this week; she is often in the media talking about it. We usually get the hospital involved by setting up a screening area in the foyer - so there’s a lot we do.

What still excites you about your work?There is still a huge amount that needs to be investigated; there is a lot we don’t understand about glaucoma. Not a week goes by when I don’t think of another project we could potentially do. I love developing new ideas but what primarily brings me joy and happiness is helping patients.

Do you think a cure will eventually be found?Yes I have no doubt about it. A cure will likely come from molecular biology or perhaps genetics. However we need to better understand the disease before this will happen.

Any final words?Glaucoma is a bit of an orphan disease. It mainly affects older people…it’s not sexy and so it’s difficult to get media coverage. When we do it’s usually late at night and no one sees or hears it. We need many more people especially eye care professionals to help us raise money by displaying the Society’s pamphlets and helping to raise funds for research.

glaucomaresearch.ca. Further information regarding

president Mr. Martin Chasson at the same address.

Dr. Graham E. Trope M.B., B.Ch., Ph.D., FRCS(C), FRCOphth., FRCSEd. Dip.Ophthal.Dr. Trope is the past Editor-in-Chief of the Canadian Journal of Ophthalmology. He is a winner of The Ontario College of Physicians and Surgeons Council Award for his contributions to patient care. He was recently awarded the Queen Elizabeth 11 Diamond Jubilee Medal for his contributions to Ophthalmology in Canada. He has trained 30 glaucoma fellows from all over the world and is a past examiner for the Royal College of Physicians and Surgeons of Canada. He is a member of a number of learned societies and has published two books: Glaucoma, A patient’s guide to the disease is in its 4th edition, and Glaucoma Surgery which is considered a major text on the Surgery of the Glaucomas. You can reach Dr. Trope at [email protected].

World Glaucoma Week March 10-16, 2013This event is a joint initiative of the World Glaucoma Association (WGA) and the World Glaucoma Patient Association (WGPA).

2013 theme: The world is a wonder to see every day – so don’t let glaucoma get in the way.According to the World Health Organization glaucoma is the second most common cause of blindness worldwide.

due to glaucoma and that this number will rise to 11.2 million by 2020. It is noteworthy that due to the silent progression of the disease - at least in its early stages - up to 50 per cent of affected persons in the developed countries are not even aware of having glaucoma. This number may rise to 90 per cent in underdeveloped parts of the world.

So World Glaucoma Week is critical in places like India, South America and North Africa. During this week edu-cational activities take place around the world—lectures, documentaries, flyer distribution along with free eye screenings and care.

There are media kits available to help organize events; the web site (http://wgweek.net) provides instruction and support.

Resources

World Glaucoma Patient Association www.worldgpa.org

World Glaucoma Association-Global Glaucoma Network www.worldglaucoma.org

Karen Henderson Karen Henderson is the Managing Associate Editor of Profitable Practice Magazines and can be reached at [email protected]

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Thinking About Purchasing a Practice?The top ten issues to considerby Timothy A. Brown/Jon J. Walton

Buying an eye care practice is a time-consuming and demanding process for a young professional.

difficult decisions be made. First, determine your geographic limits. For example, in order to be close to family and friends, you may decide to be within a 30-minute or less drive from home. This limitation prevents many practitioners from considering and relocating to thriving practices for sale outside of Greater Toronto.

The sooner you commit to an area, the more precise your search will become. Set your sights on one or two areas.

How much debt are you prepared to incur … $250,000, $750,000 or more? Many young professionals have student loans, car loans, new families, mortgages etc. to consider and do not want to borrow a large sum of money for a practice at this stage in their careers.

How many days/hours per week do you want to work? Some practices offer part-time hours that may

be more suitable if a buyer has outside obligations and commitments. Others may demand that you work 50 – 60 hours per week plus some evenings and weekends. Think about these issues carefully.

What is the scope of treatment you can offer and what must you refer to another practitioner or a specialist? Do not overestimate your skills too early — problems arise when inexperienced practitioner take on patients they should have referred out.

How long do you spend in an average appointment? How proficient is your dexterity and speed in the procedures you do? How much full-time experience do you have?

Will you be expanding your practice in the future to include other services and/or professionals? If your long-term goal is to own a large practice, plan well ahead. Relocating is very expensive and can be a serious disruption to practice income.

Once you have addressed the above, you can begin your search.

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Here are ten key issues to consider:

1. Start by phoning several brokers and informing them of the location where you wish to purchase a practice. Remember that brokers may have more buyers than practices for sale.

2. Each practice you consider should have a Professional Appraisal ready for your viewing. Most brokers ask that you sign a confidentiality agreement stating that your personal information and the data supplied to you about the other optometrist will be protected. This is usually done just prior to viewing the appraisal report, which should include all operational and financial data about the practice. If a proper appraisal is not available (complete appraisals are usually 50 – 100 pages in length)

informed decision.

3. A professional appraiser will allow you take the report to another appraiser for a second opinion — as long as he or she is informed. You will likely pay a fee for this service, as the other party will not be involved in the sale.

4. Visit your accountant. This is the most important step and will determine your ability to manage the practice. Your accountant will prepare a budget for your personal living expenses and income taxes over and above the office expenses.

5. You are now ready to view a practice. Usually, this is done after business hours. Most eye care professionals do not tell their staff the practice is for sale for fear of damaging their goodwill. Sometimes staff and clients will leave a practice when rumours about an owner are started, since some will think the owner has personal, health or financial problems.

6. Verify the information in any appraisal or report given to you. For example, counting active patients in a practice is something you should do. This indicates how busy you may be in the future. However, an active patient count is a very unreliable way to value the goodwill of a practice. The revenue earned from patients is a far superior indication of value of the practice.

7. Usually, brokers work for and are paid by the seller. Accordingly their duty, under agency law, is to represent only the vendor. This does not mean buyers participate without representation, so be sure to include your accountant, lawyer and banker. It is uncommon for two different brokers to be involved in the sale of eye care practices.

8. Once you have viewed the practice and performed your verification of charts, active patients, appointment books, financial records and confirmed that all is in order … it is

time to draft an offer. At this point it is essential to obtain legal advice. Remember that the Agreement of Purchase and Sale document is designed to be fair to both parties. Since most brokers want your business in the future, they will treat you fairly. Under agency law, buyers are entitled to full disclosure of all meaningful business facts about the practice they are purchasing.

9. The broker will perform most of the negotiations between both buyer and seller. He or she acts as the intermediary between the lawyers, accountants and the financial institutions if necessary.

10. Be certain you have investigated the entire process before signing the final offer. If you are not sure, walk away.

who threatens that you may lose this opportunity. There will be other practices for sale in the future. Do not compromise your career because of a rash decision.

Bottom Line: A concise and invaluable advice column on the central issues of buying an eye care practice.

Timothy A. BrownTimothy A. Brown is the President & C.E.O. of ROI Corporation Brokerage & ROI Capital, a company that specializes in practice appraisals, brokerage, consulting, locum placements, associateships and practice financing across Canada. Timothy can be reached at 905- 820-4145 or [email protected]

Jon J. Walton

Jon J. Walton is a national associate at ROI Corporation Brokerage and director of the eye care professional division. Jon can be reached at 519-829-5953 or [email protected]

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Importance of an Eye Exam for Diabetics by Dr. Wesdon McCann

EYE CARE

How does diabetes affect the body and eyes?With diabetes, high blood sugar levels can damage blood vessels throughout the entire body. Damage to blood vessels in the kidneys can cause kidney failure; damage to blood vessels in nerves can cause neuropathy; damage to the blood vessels in the eyes can cause blindness.

Focusing particularly on the eye, high blood glucose levels cause damage to the blood vessels in the retina. The retina lines the back of the eye like wallpaper and acts like the film in a camera — it detects the light that enters the eye and turns it into pictures for the brain to see. When diabetes damages the retina’s blood vessels, the retina stops working properly and one’s sight can be lost.

After one’s blood vessels are exposed to high sugar levels for a long time, they begin to develop weak spots. These weak spots often bulge out like bubbles along the blood vessels - called microaneurysms. Sometimes the microaneurysms can rupture and the blood bleeds into the retina to form small dot hemorrhages. As the body tries to heal itself, it will eventually clear the blood away, but some small byproducts of the blood are often left behind—these clumps of debris are called hard exudates. Altogether, these changes (microaneurysms, dot hemorrhages, and hard exudates) collectively form something called background diabetic eye disease.2

The greatest risk factor for background diabetic eye disease is the length of time one has had diabetes. Most people with diabetes get these small changes in their eyes after having diabetes for five years or more. Background diabetic eye disease does not usually cause significant vision loss unless the swelling occurs in the very center part of the retina, called the macula; swelling in this area is a common cause of vision loss amongst diabetic patients.2

Background diabetic retinopathy is a sign that the retina’s blood vessels are sick. If enough of the blood vessels rupture, the retina will not receive and deliver enough blood to keep itself healthy. Once this happens, the retina will try to grow new blood vessels to replace the sick ones. Unfortunately, when these new blood vessels grow, they cause more damage than good. They are fragile and break easily, sometimes spilling enough blood to fill up pockets of blood in the eye. When new blood vessels begin to grow we term this stage proliferative diabetic eye disease.2

Proliferative diabetic eye disease is less common than background diabetic eye disease, but is much more likely to take away some if not all of one’s vision. If it is caught early, before the retina is damaged, proliferative diabetic eye disease can be treated with laser therapy to save one’s vision. Once the vision is lost however, it is very tough to get it back. Furthermore, people with diabetes are at an increased risk of developing cataracts at a younger age and they are twice as likely to develop glaucoma.

Background and early proliferative diabetic retinopathy have no symptoms. The only way to know if someone has these

doctor regularly. People with diabetes should have their eyes

examined at least once a year to make sure they do not have early damage that threatens their sight. Because a person has been diagnosed with diabetes, these exams are covered by OHIP and will be at no cost. We do, however, highly recommend having retinal photography taken each year to monitor any changes in the retina due to the diabetes and other potential conditions. This has a small fee but is very important to manage the condition.

How can my patients prevent diabetic retinopathy?Retinopathy affects 23 per cent of people with type 1

news is that there are steps your patients can take to catch complications of diabetes early and prevent the progression of this disease1:

Visit an optometrist yearly. He/she may recommend

Maintain optimal blood glucose levels, blood pressure and blood cholesterol. Blood pressure and cholesterol can often compound the side effects of diabetes

Know their A1C (a test of your average blood glucose level over three months). Most people with diabetes should aim for a target of 7.0 or less. They should talk to their healthcare team about what their target should be.

Sight is an important part of life. Please do not take it for granted. Encourage your patients to get their eyes examined yearly.

1. The Canadian Diabetic Association www.diabetes.ca

2. The National Eye Institute www.nei.nih.gov

Bottom Line: This article outlines how subtle diabetic eye disease can be and how critically important regular eye exams and other tests are for those with diabetes.

What is diabetes?

Diabetes is a chronic life-long condition that results from an increased level of sugar in the blood. It is becoming a global issue as this disease affects nearly 285 million people worldwide. With seven million new individuals being diagnosed each

by 2030.1

Insulin, a hormone creased by the pancreas, is utilized in the body to regulate the levels of sugar in the blood. Diabetes results when there is too little insulin in the body (type 1 diabetes), or the body becomes resistant to insulin (type 2 diabetes).

More than nine million Canadians are living with diabetes or pre-

medical care and attention. Appointments with one’s family doctor or endocrinologist are important to monitor blood sugar levels, while

Many people are unaware of the effects that diabetes has on the eye: Diabetes is, in fact, the leading cause of blindness among Americans and Canadians today.PR

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Dr. Wesdon McCannDr. McCann earned his Bachelor of Vision Science and Doctor of Optometry at the NSU College of Optometry (2012) in Fort Lauderdale, Florida. He practices at Central Optometry in London, ON. He can be reached at [email protected]

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13 Secrets Your Eye Doctor Won’t Tell You

Safety and Compliance of Prescription Spectacles

1. “Never use tissues or toilet paper to clean your eyeglasses. Paper is made of wood, and it will scratch your lenses. I like to use my tie because it’s silk and really smooth.” -- Robert Noecker, MD

2. “Polarized sunglasses are great at reducing glare, but they can make it difficult to see the LCD on your cell phone or navigation system. It’s harder to see an ATM screen when you’ve got polarized sunglasses on too.” -- Janice Jurkus, OD

3. “Many of you seem to think you can go on with life as normal immediately after I dilate your eyes, but it’ll be two or three hours before you can do

Sometimes people get irritated that they can’t read a 12-page document.” -- Paul Harris, OD, associate professor at the Southern College of Optometry, Memphis

4. “Most people know that UV radiation can damage skin, but they don’t realize it’s also bad for eyes. You wear your sunglasses only when it’s sunny? That’s like saying ‘I only smoke sometimes.’ Wear sunglasses big enough to block the light from above

and below — they should have thick sides or wrap around. If you wear contacts, ask for UV coating.” -- Stephen Cohen, OD, past president of the Arizona Optometric Association

5. “Despite what generations of parents have told their kids, carrots aren’t the best food for your eyes. That honor goes to spinach, kale, and other dark, leafy veggies.” -- Andrea Thau, OD, associate clinical professor at the SUNY College of Optometry

6. “Eye drops (any kind) sting less if you keep them in the refrigerator.” Janice Jurkus, OD

7. “Some doctors pressure patients to have cataract surgery right away, but if it creates financial problems for you, there’s usually no harm in waiting. Cataracts rarely hurt you — they just make it hard to see, like looking out of a dirty window.” -- Robert Noecker, MD

8. “Reading in dim light won’t hurt your eyes. The worst that might happen is that you get a headache.” -- Eric Donnenfeld, MD

9. Take extended-wear contacts out before bed. Your chance of infection is 10 to 15 times greater if you sleep in them.” -- Brian Bonanni, MDPR

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10. “Don’t just grab any old bottle of eye drops out of your medicine cabinet when a new problem comes up. If you have an infection, steroid drops might make the redness look better, but the infection could get worse. I’ve had to remove people’s eyes because of that.” -- Brian Bonanni, MD, an ophthalmologist at Gotham LASIK, New York City

11. “Pinkeye isn’t always benign — a number of patients end up with light sensitivity and even vision loss. But many physicians treat it with antibiotics that won’t help if the cause is a virus. We do a rapid test for adenovirus — if that’s what you have, we treat it very differently than if your pinkeye is bacterial.” -- Robert Sambursky, MD, an ophthalmologist in Sarasota, Florida

12. “No, it’s not okay to wait for symptoms to appear. Some blinding eye diseases have few warning signs before they’ve taken away your vision. A yearly exam is the only way to catch things early.” -- Paul Harris, OD

13. “If you’re over 60 and considering LASIK, wait until you develop a cataract. Then we can fix your vision as part of the cataract surgery, and your insurance will be more likely to pay for it.” -- Robert Noecker, MD

Source: www.rd.com/slideshows/13-secrets-your-eye-doc-tor-wont-tell-you/

Editor’s NoteThere are many reputable on-line providers of glasses but buyers have to be wary.

Abstract

BackgroundThis study investigated prescription spectacles ordered from online vendors and delivered directly to the public for compliance with the optical tolerance and impact resistance

MethodsTen individuals ordered two pairs of spectacles from each of ten of the most visited Internet vendors, totaling 200 eyewear orders. Spectacles ordered consisted of ranges of lens and frame materials, lens styles, and refractive corrections reflecting current distributions in the United States. Evaluations included measurement of sphere power, cylinder power and axis, add power (if indicated), horizontal prism imbalance, and impact testing.

Results

308 lenses. Several spectacles were provided incorrectly, such as single vision instead of multifocal and lens treatments added or omitted. In 28.6 per cent of spectacles, at least one lens failed tolerance standards for at least one optical parameter, and in 22.7 per cent of spectacles, at least one

failed at least one parameter of optical or impact testing.

ConclusionNearly half of prescription spectacles delivered directly by

the patient’s safety.

*Source

Optometry - Journal of the American Optometric Association September 2011

PATIENT ADVICE

Ordered by the Public via the Internet*

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Smart Eye Care Professionals Have Their Practices Appraised by David Rourke and Timothy A. Brown

PRACTICE MANAGEMENT

What is an appraisal going to tell me? The most important thing you want to know… what is

my business worth?

Both the positives and negatives of your practice as deemed by the market.

Help you to identify where you are in your ownership cycle.

Provide you with the necessary information to maximize both your earning potential as an owner and then sale price as a vendor.

To be clear, we often perform appraisals and then advise our clients to continue to own their practices. As long as they are happy owning their business and providing eye care, it is in their best interests to continue drawing income from their business. As brokers, this doesn’t help us in the short term, but often leads to more valuable business and higher sales prices down the road.

The key here is, owners don’t know where their practices fit as an income producer or as a saleable asset until they take the first step and have their businesses appraised. Until then, we are all guessing and speculating and hoping the odds fall in our favour. As gamblers know, when things are left to chance, the house always wins. In the end, what eye care professionals don’t know about their practices hurts them financially.

Consider this – ROI Corporation Brokerage has been

years and has performed thousands of appraisals. Every two years, ROI Corporation Brokerage is professionally appraised

appraise our own business except for one issue; we are completely biased, making the appraisal irrelevant, invalid and inaccurate. We practice what we preach.

Bottom Line: Two industry experts present arguments why eye care professionals should have their businesses/practices appraised regularly at every stage of the their career.

Like most independent business owners in Canada today, eye care professionals are presented with both the challenge and great fortune to own a valuable business that generates very good cash flow. Sounds like a great proposition – so why would this be a challenge? The challenge is that very few of these professionals actually know how much their asset is worth and how it should factor into their financial planning. We all know that the market today is vibrant and practices are often selling for higher than ever values, but with a sale comes the loss of income. Selling too early can actually cost you money. At the same time, selling too late can lead to a declining business and a fall in income – ultimately costing you money and causing you to work longer. An appraisal is a snapshot of both your business as an asset and an income stream.

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Timothy A. BrownTimothy A. Brown is the President & CEO of ROI Corporation Brokerage, a company that specializes in professional practice apprais-als, brokerage, consulting, locum placements, associate-ships and practice financing across Canada. He can be reached at 905-278-4145 or by email at [email protected].

David Rourke

David Rourke is a sales associate with ROI Corporation Brokerage, operating in the province of Ontario. He can be reached at [email protected] or 647-519-5775.

FUN FACTS

by Dr. Hands OD

FUN FACTS About Animal Eyes

The largest eyeball on the planet is 18 inches wide, about the

An ant has only two eyes. But each eye contains lots of smaller eyes. This is called a “compound eye”.

Dogs can’t see the difference between the colours red and green.

A chameleon’s eyes can look in different directions - at the same time!

The shark cornea has been used in eye surgery, since its cornea is similar to a human cornea.

An ostrich’s eye is bigger than its brain.

Dolphins sleep with one eye open.

Your cat’s eyes offer her almost 285 degrees of sight in three dimensions.

The night vision of the cat is legendary. In order to see, they need only one-sixth as much light as a human. They cannot, however, see in total darkness. When enough light is not available, they use their whiskers to feel their way around.

Cats do see in color, and can distinguish yellow, blue, and green hues. Their eyes are best, however, at detecting move-ment and shades of gray.

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The Foundation Fighting Blindness –Supporting Breakthroughs in Vision Research

Sight: It’s precious, irreplaceable and usually taken for granted until something happens to it. Erin George first noticed changes to her vision when she moved to a new city for university. The then nine-teen-year-old noticed she couldn’t see the professors’ chalkboard notes in the large university lecture halls. Then she realized she couldn’t see at night – while

frightening experience.

“My little sister and I were returning home from a Dave Matthew’s concert in Detroit,” shared Erin. “I had driven there in daylight, but driving home after the concert I couldn’t see the moment we left the city limits. It was terrifying. I followed the tail lights in front of me and barely made the turn-off for home. In hindsight I should have pulled off the road, but I didn’t know what was happening,” she said.

Erin spent the next six years seeing optometrists and ophthalmologists. She thought she needed the right prescription glasses to correct her night vision and improve her contrast sensitivity.

“I had no idea it was something serious,” said Erin.

Finally, when she was 25, an astute optometrist suspected retinitis pigmentosa (RP). Several diagnostic tests and a referral to a retinal specialist

later, the diagnosis was confirmed. Erin had a genetic, degenerative, retinal eye disease for which there was no treatment or cure. RP soon left her legally blind.

“I have a recessive form of RP, so there’s no family history,” said Erin. “My parents unknowingly have one genetic mutation each and when their DNA combined to make me I got both mutations.”

Erin had never heard of the rare eye disease that affects one in every 3,500 Canadians and she had no idea where to turn for information and support.

“When I was first diagnosed with RP I was very angry,” shared Erin. “There was no reason for it and I was told repeatedly there was nothing I could do.”

“I’m not someone who enjoys feeling powerless. I needed information, I needed support but most of all, I needed to do something,” she said.

Erin found what she needed in the Foundation Fighting Blindness, Canada’s largest charity funding sight-saving research.

“Through the Foundation Fighting Blindness, I learned more about my eye disease and the research into possible treatments and cures, I met other young people living with vision loss and – most importantly – I found a way to take action against the eye disease stealing my sight: Fundraising for research,” said Erin.PR

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The Foundation Fighting Blindness funds Canadian researchers as they work to understand, preserve and restore vision for over one million Canadians affect by retinal eye diseases. Most of these retinal eye diseases are rare, such as Usher syndrome, Stargardt disease, Choroideremia, cone-rod dystrophy, the RP affecting Erin. A more common retinal disease is age-related macular degeneration. It’s the leading cause of vision loss for Canadians over the age of 50.

were losing their sight to RP, the Foundation Fighting Blindness has contributed more than $23 million to ground-breaking vision research at universities and hospitals across the country. “Vision loss can be an incredibly isolating expe-rience, but through the Foundation and Vision Quest, I was able to meet peers who were go-ing through many of the same things I was,”said Erin.“It makes such a di!erence for those of us losing our sight to know we are not alone.”Source: technologyreview.com

Vision QuestIn addition to funding research itself, the Foundation Fight-ing Blindness also provides information on retinal eye diseases and the latest research discoveries in easy to understand, accessible formats. The highlight of this work is the Foun-dation’s annual Vision Quest educational series held in cities across the country. Vision Quest 2013 will be held in Toronto (September 17), London (September 28), Vancouver (Novem-ber 2) and Ottawa (November 9).

Vision Quest includes sessions on research discoveries, clinical trials, and daily living skills, as well as low vision products and services. It’s an opportunity for individuals and families living with vision loss to hear directly from Canada’s top vision

Attendees report one of the best parts of Vision Quest is the opportunity to meet others affected by retinal eye disease.

“Vision loss can be an incredibly isolating experience, but through the Foundation and Vision Quest, I was able to meet peers who were going through many of the same things I was,” said Erin. “It makes such a difference for those of us losing our sight to know we are not alone.”

After attending a Vision Quest conference, Erin co-founded one of the Foundation Fighting Blindness’ now signature fundraising events, Cycle for Sight, as a way for people affected by retinal eye disease to raise funds for research.

“Cycle for Sight makes me feel like I’m doing something to stop RP – the dollars I raise from my family, friends, neighbours and co-workers, and the dollars raised by hundreds of other cyclists funds research will one day find treatments and cures,” she said.

Thanks to its generous donors, sponsors, volunteers and event participants, the Foundation Fighting Blindness is Canada’s leading charitable funder of sight-saving research. Join one of the Foundation’s signature fundraising events or start your own!

Cycle for SightIn June, cyclists – including visually impaired cyclists – will

Road Biking Event/Race in the Get Out There Magazine Readers’ Choice Awards, join Cycle for Sight in Ottawa (June 2) or Toronto/Collingwood (June 22). Register today at cycleforsight.ca.

Comic VisionShare the laughter and see the hope at Comic Vision, a com-edy tour featuring a line-up of hilarious Canadian comics. Get your tickets today for Comic Vision in London (April

1), and Calgary (May 2) at comicvision.ca.

Ride for SightIt’s the longest running motorcycle charity fundraiser in Canada! Ride for Sight events are held across the country

-tainment, motorcycle parades and free camping. This year, the Central Ontario Ride for Sight returns to Orillia for its 35th anniversary – a Father’s day long weekend bash headlined by Big Sugar. Learn more at rideforsight.com.

To learn more about the Foundation Fighting Blindness and connect your patients with educational resources on retinal eye disease call 1.800.461.3331, email [email protected], visit ffb.ca or find the Foundation Fighting Blindness on Facebook, Twitter and YouTube.

Erin George and her husband Andrew Hodge – on their tandem bike – cross the finish line of Cycle for Sight 2012 in support of the Foundation Fighting Blindness (photography by Andrew Elsdon – cllik.com).

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maintain vision. This number will double by 2030.

The number of ophthalmologists in Ontario has not kept pace with the growing population of the province. In 1992

same period the population of the province grew about 30 per cent.

In 2010 the average ophthalmologist provided 20 per cent more patient services than in 2006, meaning the average

as ophthalmologists struggle to meet the growing demands of Ontario eye patients.

Quality-of-life research shows that a typical elderly patient

per cent of his or her remaining life to regain vision lost to the disease.

Graduating doctors may be less inclined to continue or begin their practices in Ontario, and opt to move to a jurisdiction that will not expect them to provide vital tests at a net loss to their clinic.

The U.S. is currently predicting a doctor shortage of 90,000 by 2015 and has already implemented an aggressive recruitment campaign that targets Canadian doctors.

A light-sensitive polymer could offer a new way to develop artificial retinasResearchers are hopeful that a bendable organic polymer strip implanted in damaged and diseased human retinas will restore light sensitivity.

Source: technologyreview.com

Did You Know?*By the Numbers

*Source: Optometrystudents.com

Source: Healthzone.ca

OPTICAL ODDS AND ENDS

Air force pilots are chosen to be a least mildly hyperopic because the blue field of the sky activates their tonic accommodation. This would blur an emmetropic patient, yet would make a hyperope perfectly emmetropic!

Before they had UV protection sunglasses were extremely harmful to the eye. The darker conditions increased the dilation of the pupil allowing more harmful UV rays to reach the crystalline lens and fundus.

The blood vessels within the iris are extremely tough so that when the iris dilates and constricts the blood vessels remain intact and do not burst. This is necessary because these non-fenestrated vessels also maintain the blood eye barrier in the iris.

The visual acuity of a one month old is 20/638.

has 20/20 vision.

It is possible for a patient to be allergic to water. The allergy can be to cold or hot water. If this is the case you must seek an alternate form of therapy instead of cold/warm compresses on the eyes of patients.PR

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Photovoltaic Polymer Lets Damaged Retinas See the Light

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