San Diego County Optometric Society
The San Diego View
Inside this Issue:
Robert Grazian, O.D.
June beckons in the beginning of summer, and for many people here in San Diego County, it brings the promise of long, beautiful days at the beach, warm evenings at outdoor concerts, barbeques with family and friends, and thrilling times at the County Fair. The days seem lazier and longer. This time of year also marks important graduations of students of all ages and school levels. Almost everyone is touched by a graduation somewhere this month.
For graduating optometrists, June is a month to reflect on all their hard work, on all the endless nights of studying and cramming for tests (remember those board exams?). Having achieved their dream of being called “doctor” and practicing their chosen profession, they can celebrate the end of a long journey and the beginning of a new one. For many of us, these graduation memories are almost palpable; for others, it seems like the beginning of time since we last wore a cap and gown.
Once new OD graduates are formally inducted into our profession, they’re faced with choices: they can proceed to practice optometry right away, for example, or continue on with a residency program. Much nervous anticipation about how they’ll fit into the profession must now be placed into an action plan. These first few transition months can be difficult for new OD graduates—after completing multiple goals, passing so many examinations, and practicing with patients as an intern, the next steps may well be an assortment of unknowns.
If you’re a new OD, the California Optometric Association and San Diego County Optometric Society can help make your summer of planning for the future a little easier. The AOA, COA and SDCOS have a library of Resource Guides to help with obtaining state licensing and DEA and NPI numbers, as well as getting credentialed with the various insurance panels and vision plans in our state. Career resources are also available, such as job search tools and optometric business and career webinars.
COA membership was free of cost as a student, but new ODs may not realize that the free membership continues to the end of the year in which you graduate. This means you can take advantage of membership benefits while you transition to become a working professional. In addition, COA makes membership affordable for new ODs by steeply discounting dues over the first five years following graduation.
Locally, SDCOS offers new graduates a variety of useful resources. You can read the monthly newsletter and log onto our award-winning website at sdcos.org. You’re welcome to attend our membership meetings at the Handlery Hotel, and take advantage of the free continuing education (and included buffet dinner). Be sure to introduce yourself to practicing ODs sitting at your table—there exists real fellowship at our meetings that we hope you tap into.
As stated above, new graduates can join the COA for no cost during the remainder of the year, and after that, there are discounted fees and other opportunities such as Project Keep. Project Keep is a program built to encourage new California optometric licentiates to become involved in the leadership of their society. It’s a local service program that allows you to earn reduced COA membership dues for many years—if you’re a new OD, be sure to inquire about it!
Also at the local level is a classified and job connection list maintained by Dr. John Fitzpatrick. This is a great tool if you’re looking for a job, are looking to hire someone, or are interested in buying a practice. Please reach out to him at email@example.com with any inquiries. The society website and online newsletter also provides great information for new graduates or new ODs in San Diego. Always feel confident to ask a SDCOS Board member about what resources are available to you as a new OD. The AOA, COA, and SDCOS are here to help.
Stay tuned for your invitation to our annual New OD barbeque to take place on June 15th, hosted by Dr. Eric White and sponsored by the SDCOS Board and VSP. It will be a fun, food-filled event where you can find camaraderie and advice as you imagine what your next career moves will look like. We hope to see you there!
The Future of Wet AMD
By Nikolas J.S. London, MD FACS
Director of Clinical Research, Retina Consultants San Diego
Chief of Ophthalmology, Scripps Memorial Hospital La Jolla
The past few weeks have been interesting. Not for anything at all related to medicine, but we have had a family of red-shouldered hawks who clearly built a home right next to our driveway by my family’s home. Sounds wonderful, right? Well… this particular family has clearly decided that they don’t like me and dive-bomb me nearly every time I walk outside. I have been hit soundly in the head three times by a large hawk, and now have PTSD and flinch whenever a fly flies by. Not fun, but I digress. In between hawk attacks, I thought it would be interesting to write a quick update on what we have to look forward to in the management of wet AMD. I love to tell my patients about these upcoming advancements to keep them excited for the future and that they are not destined to see me every four to six weeks for the rest of their lives!
Several emerging therapies are making headway in addressing the unmet need of more durable suppression of disease activity.
Brolucizumab, also known as tiny humanized single-chain antibody fragment and a potent VEGF inhibitor. The small size allows higher dosing per volume, which may result in a longer-lasting effect. Two large phase 3 trials, HAWK and HARRIER, investigated the efficacy and safety of brolucizumab and demonstrated noninferiority of brolucizumab to aflibercept (Eylea, one of our current kings of wet AMD care). Moreover, over 50% of patients were maintained on an every 3 month dosing schedule, promising fewer injections for our patients.
Port Delivery System
Genentech is developing a surgically implanted drug delivery system, the Port Delivery System (PDS) for use with ranibizumab (Lucentis, Genentech). This surgically-implanted reservoir promises to slowly release drug over time, and in the phase 2 LADDER trial 80% of patients who received the highest dose did not require refills for at least 6 months.
Simultaneous with developing the PDS, Genentech is developing a novel drug, faricimab. This is a highly-engineered bispecific antibody that suppresses both VEGF similar to all current drugs as well as angiopoietin 2 (Ang-2), which is also important in vascular development and stabilization. It is hoped that dual blockade of VEGF and Ang-2 may bring synergistic effects in the treatment of neovascular AMD. The phase 3 study of this drug, TENAYA, is currently underway and enrolling patients.
In the more distant future, there may be even greater promise for patients with neovascular AMD through one or more of the gene therapies that are now being explored in phase 1 and 2 clinical trials.
One of the most intriguing therapies being developed, RGX-314 (RegenxBio) is a recombinant adeno-associated virus gene therapy vector carrying a coding sequence for a soluble monoclonal antibody fragment that binds to and neutralizes VEGF. Essentially, treatment with RGX-314 engineers a patient’s retina to produce Lucentis. The early results are promising, and next-phase clinical trials will be coming soon.
In all, some exciting developments are on the way, and every 4-6 week antiVEGF injections may be a thing of the past in just a few short years. I am very encouraged by early results with these treatment options, and am excited to share these advancements with our patients.
Thanks again for reading. Please don’t hesitate to contact me with any questions.
Best wishes, and until next time,
Nikolas London, MD
Retina Consultants San Diego, Poway, La Jolla, and Coronado
firstname.lastname@example.org (personal email)
email@example.com (RCSD email)
Positioning Your Practice for Sale
Rhuan Rogerio, Vice President, Wells Fargo Practice Finance
The owner of a successful practice often puts in years of building their business and watching it grow and for many there is a very tangible end-goal: the sale of the business. Proper planning can not only help to relieve the stress associated with a sale – but also potentially make it more profitable.
Here are some initial steps to consider in positioning your business for sale:
Assess your business’s condition
The sale of your practice is no time to have rose-colored glasses about its physical condition. Being honest about physical wear and tear to the location can help to identify concerns of a potential buyer and correct them. These corrections can be simple, like a fresh coat of paint or replacing some light fixtures, or be larger cosmetic or remodeling upgrades. Regardless, an honest assessment with an eye toward the needs of a potential buyer can create a positive first impression that may translate into a higher sale price.
Organize your finances
A potential buyer will pay close attention to the finances of the practice they are buying, so having accurate records and documentation is critical, including tax returns, expense records, client lists, and lease agreements going back several years. Also, shareholder agreements and employee records provide an accurate view of the business to prospective buyers. Beyond records, eliminating unnecessary expenses prior to putting the business up for sale can help maximize earnings to better demonstrate the value of your business.
Determine the value of your business and your sales options
Obtaining a business valuation from a reputable third party (such as a business broker or valuation service) prior to putting it on the market is important for a profitable transaction as well as proper assessment of any adjustments that need to be made.
It is also important to determine the best approach to the actual transaction of the sale, particularly deciding whether to hire a broker or work independently. Each approach has its advantages and disadvantages:
- Hiring a broker
- Pro: You have an experienced negotiator to guide you from start to finish. Brokers actively market your business and can identify qualified buyers.
- Con: You have to pay a sales commission – commonly 10%. However, if a broker helps you get a higher price, that can cover the commission and more.
- Working independently
- Pro: All earnings from the sale go directly into your pocket. You also have control over how and where you market your business, and negotiations with potential buyers.
- Con: Selling a business takes work and attention to detail. If you don’t have time to commit to the process, you may struggle to do everything by yourself. Start by considering how and where you’ll find buyers, be it a business-for-sale listing website or via word-of-mouth.
The sale of a practice contains many moving pieces, requiring diligence and professionalism. If approached in this way, you can not only extract value out of your business and build personal wealth for you and your family, but also continue to support your customers and employees for years to come.
Rhuan Rogerio is a Business Development Manager for Practice Finance at Wells Fargo.
Business Development Manager | Healthcare
Wells Fargo Practice Finance – San Diego/Inland Empire Region
Tel 855.405-2107 l Cell 858.357-7416 | Fax 855.741-2219
written by Dr. Byron Y. Newman
GENERATION Z IS UPON US
“Generation Z is poised to become the largest group of consumers in the world this year, supplanting millennials as a key target for brands,” according the an article in the April 29th issue of Bloomberg Business Week.
Companies, and even optometrists, can’t afford to get this one wrong,
Generation Z people, roughly age 7 to 22, account for about a quarter of the global population and already wield spending power as much as $143 Billion in the U.S. alone.
What do we know about this new and upcoming group? Gem Zers don’t know a world without the internet, and they live on social media. Companies that expect to prosper going forward must first learn how to reach this socially conscious, always-connected cohort.
The biggest surprise for marketers about this new cohort of youthful US consumers is that they love the shopping malls and use them more than earlier groups.
As Business Week put it, we have a “new Crop of Mall Rats.”
About 95% of them visited a shopping Center in a three month period in 2018, according to the article. Three quarters of them said going to a brick and mortar store is a better experience than online, according to the International Council of Shopping Centers.
Macys and other big stores are working to make shopping more entertaining, by adding more color and creating individualized clothing by adding things to their clothes after purchase to the request of the teens. Some offer inducements to those who have a photo taken of them wearing the items they purchased at clothing stores. Could ODs offer something for a photo wearing their new glasses, or contact lenses?
“More traditional retailers haven’t really thought about…what this group wants out of a shopping experience,” says GlobalData Retail’s Saunders. That’s starting to change.
Check out Dr. Newman’s website, www.thehumorfactory.com!!!
We are committed to helping you fulfill your CE requirements through our local meeting with the support of our sponsors!
Featured Annual Sponsors
June 9th, 2019, 5-HOUR CE – Annual Retina Symposium
- Dr. Arash Mozayan
- Dr. Anne Hanneken
- Dr. Atul Jain
- Dr. Ray Gariano
- Dr. Ehsan Mozayan
- Dr. Paul Tornambe
- Dr. Nik London
All 2019 CE meetings are located at the Handlery Hotel, 950 Hotel Circle North, San Diego, 92108.
2 Hour CE
- SDCOS Members: Free if reserved 4 days in advance*
- COA/AOA Members: $35
- Non-members: $130
- Registration 6:00 pm, lecture at 7 pm. Dinner included.
5 Hour CE
- SDCOS Members: $90 if reserved 4 days in advance*
- COA/AOA Members: $90*
- Non-members: $325
- Registration 7:00 am, lecture at 8 am. Breakfast included.
*Late registration and no-shows will result in an additional fee of $35 to cover the cost of food.*
Members need to make sure they sign out at the end of all CE meetings. Even though they receive a letter of Validation and COA is notified, if audited, the sign in and out sheet is the document that will be considered.
Optometry Practice for sale: in an upscale shopping center in Escondido, San Diego County. California. Solo Private Practice established since 1996. Please email firstname.lastname@example.org for details/questions. Has a large patient base. Equipment is in excellent condition. A full scope Optometry Practice. Complete Sale or buy out option. (06/19)
Practice for sale: North County Carlsbad “Upscale” Practice established in 1982. Great opportunity to buy a practice in a well-desired location with great visibility and walk-in traffic. Only two miles to the ocean! The owner is interested in an immediate sale or will consider a buy-in or possibly merge with another practice. I am looking to retire but will consider a part-time position to make the transition easier. Center is well established with Vons market and Movie theatres as anchors. Don’t miss this opportunity to own your dream practice! Email: email@example.com or call 760-310-8492 (06/19)
For Sale 140 optical job trays, misc. colors; 28 Sterilite 7 quart containers with lids for optical cases $150. Please email firstname.lastname@example.org (06/19)
Part-Time Associate Optometrist Position Available: Urban Optiks Optometry is seeking an awesome OD to join our beautiful high-end boutique practice 2-3 days per week. This is a great opportunity for an associate doctor to eventually acquire a full-time partnership in our practice. For a chance to join our exciting team, please send resume & cover letter, including why you think you’d be a great fit to email@example.com (06/19)
Administrative Assistant/Medical Billing Specialist wanted at The San Diego Center for the Blind and its Low Vision Clinic (LVC) The LVC administrative assistant and medical billing specialist will serve as the first impression for our low vision clinic. They will be responsible for patient care management including but not limited to the tasks of scheduling and medical billing. All interested applicants should request a copy of the job announcement and job description at firstname.lastname@example.org. Subject Line: LVC Admin. (06/19)
For Sale: Solo private practice continuously serving Solana Beach since 1977. Loyal patient base, many 3rd generation family members returning. Office noted for high-quality care and community service. Full scope optometry with high-end instruments and up to 3 full exam lanes. Attractive, well-designed office space with a large upscale dispensary, private pretest/contact lens area, finishing lab. Medical co-management and billing in place for years. The lease is under market until 09/22 with options to renew. The doctor is seeking retirement but is very flexible and would consider staying on part-time for patient retention. Please contact Mfoyleod@yahoo.com (06/19)
Dr. John Fitzpatrick, the Society Optometrist Relations Liaison, offers a unique service to the San Diego Optometric community. Several lists are kept on file for doctors seeking the following, or any combination: • full-time work • part-time work • fill-in work • purchase a practice • sell a practice • partner in a practice. There is no charge for this service. To put your name on the list, please contact Dr. John Fitzpatrick at email@example.com
ALL DOCTORS WILL RECEIVE A FREE 5 HOUR CE FOR EVERY SHIFT FOR WHICH THEY VOLUNTEER
Monarch School Screening
Next Monarch screening will be this Fall. Stay tuned for details!
Lion’s Optometric Vision Clinic
VOLUNTEER DOCTORS needed for flexible shifts throughout the year. 9-1:00 pm. Monday -Friday 1805 Upas St San Diego, CA 92103. Can’t volunteer at the clinic? See patients in your office. Call 619-298-5273.
Please bring to a CE meeting or contact the society office at 619-663-8439 for arrangements to pick up.
SDCOS keeps a list of all doctors willing to speak in front of groups about various topics, do home visits for patients, and assist in student mentoring. ODs interested in the Speakers Bureau, Home Visits, Student mentoring, and Low Vision OD’s, please contact the society office at 619-663-8439 or email firstname.lastname@example.org
Vision Mission Trip to Albania
Dr. Robert Meisel, SDCOS Public Affairs Co-chairman, joined thirteen other ODs from the US and Canada on a very interesting vision mission to Albania in early November 2018.
The request for a clinic to assist the Albanian people came from displaced Iranians, who left Iran in 1979 when the Shah was overthrown.
Many highly educated citizens were exiled by the new Islamic regime and after spending several decades in Iraq, were forced to leave there as well fearing personal safety.
Albania offered these dissident refugees (MEK) a place to live during the Obama presidency and a large community settlement was founded just outside Tirana, the nation’s capital.
A month after our vision clinic concluded, the Albanian government expelled two Iranian diplomats for plotting harm against the MEK personnel and community.
The MEK leaders offered to host a large vision mission team from Lions In Sight (www.lionsinsight.net) to help the Albanians in that region who needed eye care.
Besides the 14 docs, about 20 technicians joined the team to dispense the eyewear prescribed as several thousand pairs of glasses were sent many weeks in advance of the clinic dates.
Clinic sites were at the MEK settlement, 5 community center sites within Tirana, in Durres, and in a small mountain community of Zyra Postare.
It was a busy time as three teams performed over 6840 evaluations during the four days of clinic, with most every patient receiving eyewear or medical referrals.
The week of clinic activities was followed by tourism in Durres, a seaport and Berat, a UNESCO community in the mountains of Albania.
Several members of the team then ventured north along the Adriatic Sea to Montenegro, Bosnia and Herzegovina, and Croatia, spending several days in Dubrovnik.
Many Game of Thrones devotees will recognize the well-preserved Old Town of Dubrovnik as the “Kings Landing” site.
If you ever want to go on a clinic trip, please contact Dr. Meisel and he will explain how you can with Lions In Sight!
- Click here for most recent SDCOS Board Meeting Minutes
- Click here for the 2019 CE schedule!
- Click here for COA membership benefits!
Welcome, new members!!
- Jocelyn Tan
Please update your information on www.eyehelp.org
Phone: 619 663 8439
Fax: 800 643 8301