Infinity Eye Care - Eye Care Practice in Twinsburg, OH

Running the Bases today with Dr. Ryan McKinnis from Infinity Eye Care - an eye care service and center located in Twinsburg, OH.  Infinity Eye Care’s mission is to provide individualized eye care to each and every patient. With a passion for research and remaining on the cutting edge of technology, they strive to provide full-service care to meet each patient’s needs and expectations. Dr. Ryan and his wife Heather opened Infinity Eye Care in January 2021 - in the midst of the pandemic and lockdowns.  Their level of commitment and service has set them on a path of success as their practice grows.

Dr. Ryan shares his passion for working with patients and providing comprehensive eye care for the entire family - but also his desire to grow a business.  We discuss the interesting world of an optometry practice - as a business, and how private equity is getting more involved in consolidating the industry.

Starting a new business during a pandemic is challenging to say the least.  Compound those challenges with a business that provides face-to-face, hands-on services - it’s daunting.  However, Dr. Ryan shares his optimism and strategy on how he and his wife have met and exceed their initial goals for the business.

It’s a fun show that gives light and hope to growing a business in any situation.  And…. we explore the best High School Senior Prank EVER!

Learn more about Infinity Eye Care and Eye Care Services in Twinsburg  at https://www.infinityeyecareohio.com

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Transcript

Randy: 0:01

I'm Randy Rohde and fascinated with entrepreneurs and small business owners. Plus I love baseball. Every show I sit down with a small business owner and we discuss they're running the basis of entrepreneurship. We throw the ball around on strategy management, execution and innovation, plus a little fun baseball tart. Hey, thanks for joining us today. Settle in, grab your Cracker jacks and you know what they say? Okay. It's a great day for a ball game. And, , you know, it really is actually the spring training is just around the corner. So I'm looking forward to that pitchers catchers showing up here in a week or two. And I'm Randy Rohde and you've got running the bases with small businesses. So glad to have you along today, today, I'm kind of excited because we've got, , A guest in a niche that we have never had before., which I think is always fun to go and explore some new kinds of things, things, and this guy, I tell you, you're either the most optimistic, and forward thinking individual, or you're just playing crazy. I don't know. So we'll figure this one out, but let me give you a quick little bio intro. He's got a degree. In molecular biology and I'm sure you were a hit with the ladies in college. Yeah, that that's really good. Uh, you've got a doctorate in optometry, another chick magnet. Yeah. However it must have worked for you because you're married. You've got four kids and you just opened a new business here. In Northeast, Ohio in Twinsburg, in the middle of a pandemic, which is incredible. And we want to dive into that. I'm really excited to have with us today, Dr. Ryan McGinnis of infinity eye care here in Twinsburg. So welcome Dr. Ryan.

Dr. Ryan: 1:50

Thank you. Pleasure to be here. And the spacious studios here.. Randy: Well, glad to Hey, so before we get started in learning about your practice and what you guys do at infinity eyecare, I understand that while you were in high school, we're going to tip back a few years that you were involved in a interesting prank. We'll say, tell us about that. And I want to know how you got away with it. Yeah. Well, we'll give you the abridged version, but, uh, My wife and I, and this is how, uh, with a molecular biology degree and an optometry degree, you can still get married. And that's that she knew me well before all that. So from back in high school, but yeah, we, uh, we grew up in Western pencil, uh, where there was more deer than people. And so in the middle of the woods there. And so, , Come time for senior pranks and wanted to be creative yet, not, , destructive towards anything. So myself and another gentleman who is now currently on staff as an MD PhD at Duke university of North Carolina. So the two of us got together and we literally submitted an ad to the local paper listing the high school for sale, but not by name, just with the address and made up a total, you know, farcical, you know, Uh, air conditioned, computer labs, plenty of gymnasium space available. We listed the guy who, uh, or the guy that we listed as somebody in the app was the principal. Uh, we, we gave the phone number of the, with the extension for while the local teachers at the school who would contact it. It went well. It really did. We got way more interesting than you ever would dream up from this type of thing.

Randy: 3:19

And they actually printed that they actually

Dr. Ryan: 3:21

printed print without payment. Cause, cause we put that we had to bill somebody and the bill showed up in the principal's mailbox a week later. And so local, small town papers, apparently the Goodwill extended too far for them. And, uh, so yeah, so, uh, long story short, , it's my claim to fame forever because I don't think too many people can say they, they listened to the high school for sale.

Randy: 3:40

Oh, my gosh. That is great. Did it come out somehow that it was you and this other now doctor

Dr. Ryan: 3:47

eventually? Yes. Eventually it didn't come out., it took a few days for them to, to ferret it out., and I owe it all to a, . This is so cliche, but literally a nosy librarian who read the classifieds, put two and two together and then photocopied it and shoved it in every teacher's mailbox saying, look what I just found in this paper. And so that's how it kind of exploded, but it's a good story.

Randy: 4:10

Yeah, that's a good sir. Hopefully mindful. Son we'll learn, uh, you know, something like that. That'd be good. A good one to go. Yeah. And now look, now you've matured into entirely respectable doctor of optometry, you've got quite a few, , accolades on your resume and things that you've done and more specifically, and this is where I think why I was saying in the intro, you're either the most. Optimistic individual and think, Hey, let's go. We can make this work. Or you are just playing crazy. You've opened a new local business in the middle of a pandemic, infinity eyecare in Twinsburg. So tell us, what do you do aside from the obvious of looking at people's eyes? What are your services? Just tell, tell us a little but about infinity.

Dr. Ryan: 4:54

Okay. Sure. So infinity, I care. You know, passion projects, the wrong name for a business. That's probably going to have to, , provide for four kids and the entire family, but it was born out of, , a desire to be my own boss. Really., I had spent a nine and a half years at Cleveland eye clinic, which is a, a well-respected renowned, uh, surgical center. With, with many offices around Northeast Ohio, , what I was seeing amongst healthcare field in general, and this goes beyond even what we had witnessed at Cleveland, I is, is healthcare is becoming quite fractured and private equity is playing a bigger and bigger role. We're seeing more venture capital dollars just dumped into healthcare and they're gobbling up of any business that that's worth having in all honesty. And so, , when you witness that and then, , You know, after nine and a half years of commuting from, , 45 minutes to an hour each way, and the kids are getting older, , We had been my wife and I had been looking at buying a practice. Right. But dollars were, were astronomical because private equity pays top dollar for some of these practices. Overpays in all honesty, , on the hope and the premise that they can sell it again to somebody else and make even more money. And so when we looked at that at all and tried to figure out where we wanted to go from there, really the, the option that was left was, , let's open this ourselves. Let's just, let's just do it ourselves. So we had pretty much settled on that. Uh, we had the vacation plan to Aruba, , sons' children. Uh that's that, that was just the wife and I, , but we, we said, you know, let's go on vacation. We'll come back. If we still are this solid on it, we're going to pull the trigger. We got back in the country on March the fifth and the world's shut down on the 13th. Yeah. And so. We, uh, delayed for about six weeks. They're waiting to see which way it was going to go. Right. And then eventually come early. May it became obvious that, , A lockdowns really didn't work as well as people had hoped, which made it less likely they would ever shut the world down again. So it's time., we started the process in may and then,, opened, , in January with infinity. I care.

Randy: 6:49

What do you do? I mean, so I. I wear glasses., and so, you know, I, I obviously I go to the eye doctor, but are you just like gazing into individual's eyes all day long?

Dr. Ryan: 7:01

That sounds creepy when you put it like that.

Randy: 7:02

Yeah. It's better than, you know, being a dentist, I think.

Dr. Ryan: 7:06

Right. Well, that's our go-to line. It's easier than going to the dentist, but, uh, yeah. You know, I mean, days gone by, you know, the eye exam was strictly revolving around glasses and contacts. Right. That's what everybody's. To a large degree, still thinks of it., but, but it's so much more than that. We are looking at the entire, the entirety of the eye and also how it interconnects with the rest of the body. So for example, if you're diabetic, we kind of have an idea of what's happening in your heart, your lungs, your kidneys, your brain, based on how we see those blood vessels looking deep within the eye. And so we, we really have. And the same goes for hypertension, high cholesterol. Also, we really have a way of getting a snapshot of, , of a person's systemic health just by doing a good, solid ocular health exam.

Randy: 7:47

Hmm. Now, are you seeing like some leading indicators when you're doing the exam that potentially maybe that an individual might not even know that they're sometimes hypertension or.

Dr. Ryan: 7:58

Yeah. Sometimes now, I mean, the majority are sent to us. They get diagnosed with being diabetic. The primary care doc says, Hey, go get your eyes checked. But I get about a half dozen a year, , where I've either diagnosed them with multiple sclerosis or hypertension or whatnot. And they had no clue. Yeah, except for what we found on eye exams.

Randy: 8:18

That is fascinating., so it really gives a whole new term of, you know, the eyes are the windows of the soul or something like that. It really is, you know, much, much more. Yeah.

Dr. Ryan: 8:27

Right. No, absolutely. And you know, the eye is really an extension of the brain. If you think about it, because that nerve, that connects your eyes to your brain, it's a short trip. And so what we're seeing is, is a very much so a snapshot of what's going on in the rest of the body.

Randy: 8:41

Yeah, I love that. It's a short trip and it's so, yeah, so I'm kind of fascinated on, , so much fascinated about your story in what you do, actually, the science and the medical field of, uh, and as Eve explained it,, what you can see through an eye exam, But as well, you mentioned something that doesn't, I don't want to say it. Doesn't always kind of stick with me. I think when I think about doctors and you said early on, you've always wanted to own your own business or to have your own business, not necessarily. And maybe you've probably have always wanted to be a doctor. I don't know. But I don't usually talk with a lot of doctors. I know a handful of doctors that say like, Oh yeah, I've always wanted to and not, , I've always wanted to be a business owner and I'm like, Oh, I think you're maybe one of the first few doctors I've ever choked with. I said, I wanted to be a business owner. So have, has that entrepreneurial spirit always kind of been part of you? Did you sell lemonade as a kid? I mean, did you, aside from selling the house, right? Yeah,

Dr. Ryan: 9:42

not entirely. I mean, and, and, you know, I wouldn't put. Sales is one of my top strengths, competence, , and friendliness and, and, you know, I, I tend to be very conversational, but I think what always appealed to me about being a business owner was just the chance to kind of forge your own path. And my sister, isn't an internal med doc., also does some ICU work up near Boston. And when I told her what I was going to be doing, she's also so encouraging when she said she goes, Oh, that's a death nail in my field. So you have no one that owns their own practice. We all, we all work for hospitals as she goes, you just don't get paid enough by insurance and the overhead. So crushing that, that hospitals have to be the driver of this, but it's not yet that way with optometry and optometrists tend to have a little bit of an independent streak in them that they want to work. When they want to work, they want to work how they. They best envisioned them doing their jobs. And so when I first came out of the school, the idea of owning a business was overwhelming to me for one the debts, crushing student loan debt. And, , we were, uh, we were having children way more yeah. Rapidly than we had anticipated. And that's, uh, that's that's for the biology podcast later. But, , but yeah, nevertheless, I don't think done it at age 26, 27 coming out of the residency, but you sort of grow into it. I mean, and, and after. Working behind the scenes, even at the practice I was at and doing a lot of the nitty gritty, you start to figure it out. And you're like, , if we do this right. And if we have the system set up correctly, we can do this, have a very comfortable living without having to kill ourselves at the job and not hate it. And that's kind of what it was born out of., Certainly we haven't figured it all out out yet. We're still getting there, but, , thus far, you know, five, six weeks in, I've been encouraged with how well it's flowed.

Randy: 11:19

Good. Well, I love, I love that quote., , that you stated, uh, forge your own path. I think that really kind of sums up, , in a nice way. Nice, neat box. The spirit of an entrepreneur. Right, right. They really are an adventurer one to forge that path.

Dr. Ryan: 11:37

Yeah. I mean, I mean, it's, there's high risk, high reward, right. As they always say, fortune favors the bold and, and, and so to some degree, I don't know the pandemic was part of the plan, but, , There's actually some perks to it, believe it or not. And we can get into some of that, , a lot of healthcare and people ask me all the time, would you tell your kids to go into healthcare? And my answer is the same if you love it. And if you love people, certainly. But if you think you're going to back the Brinks truck up and retire at age 45, the answer is no, because I mean, no matter what health care field you're in right now, Except a select few. You're largely taking marching orders from somebody, whether it be insurance companies or hospital administrators or somebody. And so, you know what I tell my kids to do healthcare well for the right reasons. Sure. But you know, that doesn't mean that you have to, you know, live a destitute lifestyle and, and you didn't go to school until you're 30 to then, , not have. Some of the nicer things, right. And this is a way you can still do it. And the way you do it is by taking those chances and sort of being the one to drive the ship and not just be a passenger.

. Randy: 12:36

Well, one of the other things that you mentioned that I hadn't thought about this, , the pursuit of private equity in the medical fields, and I knew, and I knew that from, uh, on the medical side, Like a gen, a GP, those private practices are going away, but they, from my impression are getting gobbled up by the hospital systems. Yes. And that just seems to be where they go. I've had several friends, that's the route that occurred with them. Versus I am curious about the private equity, because that actually is like really? So do they. Purchase and then, , pool and then potentially sell off to a hospital system or,

Dr. Ryan: 13:15

well, and that's always the question. I'm not an expert on private equity outside of what I lived through., and, and what I've seen happen in the field, it's, it's big in certain areas. Dermatology is big. Dentistry is we're seeing it. And then in ophthalmology, optometry is a little less, but ophthalmology has got a big private equity push right now., in the grand scheme of things, the thought with private equity is you get these venture capital firms who are very well funded at billions of dollars. Uh, in these firms, they will make a subsidiary that runs the eyecare part of it, and they will go out and gobble up 70, 80 practices, oftentimes pain dollar for dollar, what you brought in as a practice and that geographically, they try and do it geographically centralized, or like, for example, the one I'm familiar with, I mean, the. They're they're focused in Ohio, Michigan, Indiana, Pennsylvania. So they try and get, you know, geographics and just makes it easier, right. To apples, to apples. But, , at the end of the day, usually within five to seven years, the thought is they've now accumulated all these assets. They have tried to streamline some of the things such as HR and benefits and the operational eliminate any efficiencies is, is the, as the buzz word. And then they sell it to a bigger fish., The, the idea being that they'll make this lump sum investment and then hopefully five years from now recoup a two for one. Uh, on their dollars and whether or not it's successful, it really depends on what the market's like. And it also depends on who's out there looking to buy, because at the end of the day, someone has to be left holding the bag. There's only so bigger.

Randy: 14:48

Yeah, exactly. That's why I'm fascinated from this, from a private equity group, because , you start out small, but it's so specialized that it's like, you're going to build this. Kind of massive conglomerate of these, , practices. Well, ultimately, because this is what PE, you know, this is what they're trying to do is that they're, you know, they, they pull drive efficiencies, drive up the revenue potential and the profit potential, and then sell it at a multiple. And I'm like, well, who's going to buy that then at the end of the day from them. So a bigger private equity group, that's no.

Dr. Ryan: 15:25

The great unknown., the question's going to be, is it sustainable if it is for how long, or is it a bubble and are some of these guys going to be left holding the bag and what happens at that point? And those are questions. I certainly am not an expert in it, so I don't have all the answers to it, but. You know, in five to 10 years, I think we'll have an answer.

Randy: 15:43

Yeah, well that that's, , that's very interesting. So one of the other things you mentioned, your sister is in medical practice as well. And so, I mean, is this, do you have, are your parents doctors or no.

Dr. Ryan: 15:56

I mean, they're not, dad's an engineer and mom. Stayed at home with us and then became a school aid after we had been old enough to, you know, not burn the house down when she was gone. And so I'm the oldest and I have, as, you know, an eye doctor, my sister is the middle one and she's a hospitalist. And my brother is the youngest as a tax attorney over here near Cleveland. So the running joke is that a mum and dad, whatever they did, they did it. Right. And we'll put them in the nice home with the elevator later on in life. But yeah, I mean, it's a. They, they laugh about it. Cause like this, this wasn't some master plan. This wasn't like we went to work with mom and dad and said, Oh, what a great career field. Yeah, this, this is just the path we took.

. Randy: 16:31

How exciting though? Yeah. Your parents are so proud. Oh, they are? Yes.

Dr. Ryan: 16:36

They'll repost this podcast. I'm sure.

Randy: 16:39

Great. So here you are in the midst of this pandemic and you kind of told a little story a little bit and you just open up. The shop in January of this year. How many of your friends, your family saying Dr. Ryan? What are you doing? You are crazy right now, right? I mean, it's not like you were,, selling pencils on the corner. I mean, you had a very nice job with the Cleveland clinic. You are. Yeah. Yeah. What the heck?

Dr. Ryan: 17:08

Yeah. Well, and my. I I've learned that that family is much more blunt with you than friends often. That's just the way it goes. So are we crazy? Probably a little bit, , , who isn't, you know, who does this entrepreneurial stuff? You have to have a little bit of craziness to you. We don't do it by ourselves either. We we've worked with a consulting team out of Chicago called eyecare advisors. They specialize in doing what they call cold start practices. So you didn't buy anything. You just hung a shingle and got you off the ground. So they've been a. A wonderful resource and they have certainly saved us oodles and oodles of cash over the course of this process. And there's other groups that you kind of get into to, to help you through it. The downside of course, is it's a pandemic, right? And that adds a whole layer of stress. One of my rooms in my office, I have retrofitted to become the kids' space because. Our kids are hanging out at the office some days that thankfully they've been in school five days a week since the beginning and were beyond thrilled, but still at three o'clock kids are coming home from school. And like tonight we're in the office until seven. And so we've had to adjust our lives. And so, and in the middle of a pandemic, you can't send them somewhere kind of a tough thing. Yeah. The benefit of it being a pandemic, believe it or not is kind of threefold. One. The rates from the banks were better. Because interest rates had fallen a little bit commercials different than residential, but had fallen a bit. Secondly, we got pretty good deals on equipment because not that many people were buying equipment. Yeah. And then third, which I hadn't even thought of when I opened it, although I'll take credit for it because it makes me sound intelligent. You have lots of openings when you are starting cold, you don't have a bunch of patients. Well, that's what people want right now. They don't want to be jammed in there with 10 other people. And they kind of want to be able to go on your website and say, Oh, I need an appointment tomorrow. And you have availability. It's actually been a wonderful thing. We've got an excellent feedback because. They feel so comfortable. I mean, so they, they can wander in and we take care of them and they're out the door. And, uh, they, they may not have seen another human outside of the people in the office. So unintended consequences, but we've gotten excellent feedback from those who are a little more skiddish at this.

Randy: 19:10

Yeah. See, you are an optimist. So you turn the whole pandemic and you're like, wow. Listen, there are some benefits to this and yes, I love, I love your spirit.

Dr. Ryan: 19:18

It's either that or you need counseling. So we're going to go, I've been trying to talk myself through this now

Randy: 19:23

through my experience and through talking with so many entrepreneurs out here is, , having that. Level of confidence and a level of optimism. And that w , we will push on. I've been it's absolutely is necessary. I think, to, really kind of forge that path, to use your words and really attain success.

Dr. Ryan: 19:41

Yes, it is. And you know, when you're forging the path, it sounds, it sounds pretty nice and, and, and, uh, adventurous and sexy. And at the end of the day, you're the one driving the bulldozer. You're laying the asphalt you're, you're making, you're literally making the path. So, um, As I tell folks, you know, those, those first few weeks to months can be a real strain. You're the one doing everything when you own a small business. Yeah. We were laughing the other day. Like my to-do list included, changing the toilet paper roll and hanging up code hooks in the office. Like, , there's no one else doing it. So they teach you that. And uh, in med school I have learned so many things. I never dreamed I'd need to know, but, uh, but, uh, you know, by and large, I mean, The key is having good, solid help you can trust and both at the office and with the consultants we have. And we do. And then just, just trying to take a deep breath and just rolling with things, especially right now, because there's been curve balls thrown, and there will be, yeah.

Randy: 20:31

Hey, thanks for throwing that baseball. I'm doing what I can to help you out there. That was good. You know, I love the idea as well that you. Didn't just kind of say, Hey, we're going to do this and kind of isolated and went out and hung your shingle and just waited., you really saw it some outside resources to really help with the process.

Dr. Ryan: 20:51

Absolutely. Yeah. I mean, you can do it just yourself, but. Why not take advantage of just the cumulative wealth of knowledge that people have, have, , are willing to share with you. Even people who are unaffiliated, when they find out what you've done, other doctors, they're like, Hey, come meet me for coffee. Give me a call sometime. I'd love to tell you the five things I wish I had never done. Right. And you know, some of that. You take it with a grain of salt. It may have been just to their circumstance, but people are so happy to offer guidance and opinions. And , at this stage of the game, we're happy to gather them all and sort of see what works for us or, or what doesn't. But. Yeah. I mean, it sounds good to be a lone ranger and want to do things on your own schedule, but w why not make it life at least a little easier for you?

Randy: 21:34

Well, I think it's just a great lesson to give, , for folks who are just starting out on their business or thinking about it as well as. You know, yes. It may seem kind of, I don't even, I don't want to say attractive. I'm not sure, but it's not necessarily the best route to kind of like, I'm just going to do this and not kind of seek the advice and or assistance or consult from outside sources that can really help you kind of mitigate the risks you're taking a risk to begin with, but why not? Just kind of manage that risk as best as you can. And I, , I applaud you for, you know, being well, you're a smart guy, you're a doctor.

Dr. Ryan: 22:12

So, well, the, the number one quality I tell people you have to have, when you do this, believe it or not is yes, confidence helps and competence is mandatory, but humility goes a long way. Understand why you don't know everything and no one does, and there's, there's no shame in asking for help. And so we've certainly. Don just that

Randy: 22:30

now you also have help with, and maybe I shouldn't put it that way, but you've got to build it. It's in partner with your wife is involved in the practice with you?

Dr. Ryan: 22:41

Yes. And she's not a doctor., , she's been, uh, Well, I mean, by and large, uh, invested in our children for the last 10 plus years, she's been working for a nonprofit that supports pre , parents of premature children, because our first born was born, , at 25 and a half weeks of gestation. So thankfully, you know, he's the oldest and he's still rocking the role. And then we haven't had any long-term effects, but I mean, she, , she's been invested in that world, but she was looking for a new challenge and a change as well. I, I. Tell people that my wife has as many things, but she's a go getter. She she's a bit of a pit bull when you give her tasks to do. And so she has taken on the marketing and the website design, and that's been probably the biggest cost savings I could do is I literally have a built-in partner at night. We'll sit there and redesign the webpage and do all kinds of stuff that admittedly. I'm not paying for and I could do it, but my gosh, it's just not my skill sets. And so yeah, it goes a long way when you've got someone in the house who's as invested in your, uh, in your success as you are.

. Randy: 23:42

Do you ever feel like you get away from the business? I mean, with both of you and I'm sure she's there with you all day, you talk about the kids are coming because we're there, , do you ever feel like you get away from the business, from the practice?

Dr. Ryan: 23:54

Yeah. You don't date a business, you marry it. Don't ya. And, uh, but it's the biggest challenge in a marriage that we have is leaving work at work and, and then. Not bringing it home with us. It's getting better. Any tips there that you can share with that? The biggest, yeah. Oops, is that I could give at this point is sticking to a plan and just do not deviate from it. If you look at each other and say at six o'clock, we shut it off. We're not bringing it up anymore, hold each other accountable and don't bring it up anymore. And the other part that comes naturally is as the business gets off the ground and it's running a little more smoothly, there's less stuff to come home. And, and so, but do you ever totally get away from it? No. The emails are always coming in. It's a challenge. You have to actually have to actively make sure you're not talking more all the time. Yeah. But yeah. Work in progress, but it isn't.

Randy: 24:45

Yeah. I wonder, I, I wonder how that works. Sometimes one of the founders of Netflix, I was just, , I've read his book., , it's called that will never work. And he had a practice that he put into place a long time back that Tuesdays at five o'clock, regardless he was leaving the office and it was date night with his wife and, , and I thought, wow, well, that's it. That really is impressive. If that guy could do it, I think everybody could, but yeah. Don't want to do something like that.

Dr. Ryan: 25:13

Yeah. Now of course, pandemic, notwithstanding used to be, it used to be a lot easier, but yes. I mean, we try really hard that Wednesdays are the hardest cause it's our late nights, so we're there till seven. So you go home, you just sort of get the kids off the bed and you crash, right? I mean, there's not a whole lot of time, but the rest of the week, we try really hard. That six o'clock is kind of our drop dead point where we leave the office at four, four 30 and get home. I no longer have an hour drive to decompress. So I sort of, you know, decompress verbally to her now and vice versa between five and six, when six o'clock hits it's dinner time. It's homework time we're done. And so the date nights are forthcoming, , has as the vaccine rolls out and no things are safer. Well,

Randy: 25:54

yeah, be sure you carved that out. That's good. I think, and especially in the way, the way that you guys are now. So, you know, as we mentioned. You've actually have spent a good number of years in practice with the Cleveland clinic over 10. And you have this very interesting distinction that I've really unfamiliar with. You are a diplomat in the section of cornea contact lenses and refractive technology. With the American Academy of optometry, they make it sound impressive, though. It really is. I mean, that's a mouthful. What is it? How did you get it? And what do you do with it?

Dr. Ryan: 26:29

Yeah, that's right. So to become a fellow in the Academy, any optometrists can and there's requirements, usually writing case reports or, , certain presentations you do. So that's how you can become a fellow in the Academy, right. For those who want to specialize further or kind of. I would say broadcasts that they have a specific knowledge base that is greater than the average person. They have certain sections. And one of them is this cornea contact lens and refractive technology. And they have some on glaucoma. They have some on public health. So like there's different areas. You can do this in, , whenever I did this program, , they give you up to five years to complete it. You have to write 10 case reports, which the average is well over 30 pages on these case reports had the past two written exams. A practical exam where you did this type of stuff on patients. And the type of stuff I'm talking about is advanced contact lenses and disease management. And then you have to pass an oral exam. So it took a long time , it took me almost three and a half, four years to get through the process. But when you're done, you get this distinction of being a diplomates in that section. That diplomates. Yeah. And so, I mean, at the end of the day, do I get paid more because no, I do not know. Did you get at least a nice fancy certificate? I got a nice certificate framed on the wall. It depends when they go to the meetings, but you know, at the end of the day, it's just a way to differentiate yourself and to sort of say. I mean the total number of diplomates in this section, worldwide numbers in like the two hundreds, really? So like, congratulations, you're one of a select group that says, you know, I'm good enough. And I cared enough to go through the process.

. Randy: 28:03

So are you like one in Ohio? I mean, is there

Dr. Ryan: 28:07

Ohio, believe it or not, has more than you think because the Ohio state college of optometry where there's a schools there tend to be pushed, , this type of stuff. So I think I'm one of seven or eight in your particular section. Yeah. In that section.

Randy: 28:19

No kidding. Well, I guess we're fortunate to have you write a little Twinsburg, you know, here we are., all right, well, congratulations on the, did you get a little bump in pay with. The clinic when you were doing it? No. Heck no, no. You got a Pat on the back and said that a boy. All right. Well, very good. Well, so Dr. Ryan, it's that time of the show. Okay. Do you like baseball? Yes, I do. Okay. All right. Well, uh, you grew up outside of Pittsburgh, so. I'm assuming I pilots fan. Yeah. From, from birth, that was the pirates. Uh, but as we were talking before the show there, we used to pick up the am stations from Cleveland back when the pirates were so bad, you couldn't bear the listen to them. So, uh, when Cleveland was good in the mid nineties and whatnot, I've got a little L N L , action going on there. All right. Well, that's good. All right. So at this point in the show, we, we, my team goes out, they know like, Oh, you got Dr. Ryan. And, and they try to find a nice question in your. Area of expertise. All right., as it relates to baseball. So I want to ask you, and this is hopefully kind of get there., we're going to talk about home plate umpires. Okay. All right. And so these are the guys, right? They got the best seat in baseball. I mean, they're right there. Making critical calls, got to have good eyes kind in tying it in their home plate umpires. How often do you think that they are making incorrect calls? On balls and strikes as a percentage of overall calls.

Dr. Ryan: 29:51

I want to say, I heard about this because now as they've gone to more of the Kaizen and you see some of this on TV, I mean, by goodness, I look for sidebar in, in 10 years, balls and strikes would be totally automated and then not the, you have to call it, but I'd venture to guess that probably. I'd say 20% of the time. They're like

Randy: 30:11

you are right on the nose every once in a while. I get it, Dr. Ryan with a swing and a hit. Yeah, exactly. 20% of the time. This is based on numbers from the 2018 season. But yeah, they. On average, make 14 incorrect calls per game. Wow. Yeah. Pretty incredible. Now this actually, I want to tie in because I'm on your expertise and opinion on this. So you would think that the more years or more years of experience that you have sitting behind the plate, , that you actually would get better at it. At calling the balls and strikes, but in fact, what they found going over actually like 10 years of time, is that the older that they are, they actually more, that the percentage of incorrect calls increases. Yeah. So if you are the best callers, well, we'll state are those that have three years or less of experience, and that are like 33 years old on average versus guys that are 46 and above and have 13, 15 years of experience. So do you think that it is an age related degeneration of eyes? Do you think there's a medical connection?

Dr. Ryan: 31:29

There might be. I mean, it certainly plays a role. I mean, w as we age. Things slow down, things break, you know, that's just the way it goes. I think there's a couple different reasons behind it., one, I think we get all get this way when we've done a job a long time, you get into bad habits you can only imagine the wear and tear on these guys' knees from Neo and down there. Hundreds of times a game over the course of years and years, do they tilt to one side? Cause they got a bad left knee and it throws them a couple inches off the corners certainly possible. They get into bad habits. I mean, if you watch some of these games, I mean, some of the older ones are the ones that will throw you out for sneeze in the wrong direction because it's their show. And so I think that there's some behavioral stuff in there as well, but certainly, I mean, medically speaking someone's eyesight at 63 is not going to be as good as someone. 33. Yeah. Yeah.

Randy: 32:16

All right. Well, there we go. We've got the, uh, the low down from Dr. Ryan. All right. Thank you, Dr. Ryan, on that, you did, you played very well by the way, the seventh ending was great with you and your insights. All right. Well, let's get back into it. So as a new business, what type of marketing activities are you guys doing to try to get the word out, to really build the practice?

Dr. Ryan: 32:37

It's kind of a three-pronged approach. And one of the prongs been broken off because usually you go stop in, see doctors drop off goody box and stuff like that. Go visit the senior centers in the nursing homes and that type, you can't do it right now. Yeah. Yeah. They won't let you in the front door of a lot of these places and frankly, nor should they, I mean, with, with what's going on. So we've had to rely heavily on social media. Social media has been, been a real big push Facebook, Google, Instagram, you know, all, all the normal stuff. And my wife handles that, thankfully, because I am not a marketing whiz., maybe it's just the way we were raised, but I just get uncomfortable telling people I'm good at stuff where my wife has less of an issue. So, so it's, , it's a good thing to have somebody outside the doctor doing. At that type of marketing most of the time. And then the other thing which we've largely relied on is, , as you get on what we call insurance panels, which means you can see someone with a specific insurance, you are listed then on the, find a provider on their websites, right. That's where a lot of patients starts. They go to their insurance provider's website. They say, I need an eye exam. They punch in their zip code and it spits out the five providers that are the closest to them. And so there's no favoritism there. It's just based on who's closest, , you know, I would say 90 plus percent of our patients are coming from about a five mile radius around the practice and it's largely born out of convenience. Sure. Yeah. And so that's kind of how the marketing has gone so far. I almost wonder if this had been a, you know, a non pandemic, normal experience, whether it would be, had been skewed with us being able to do more in-person marketing, would it have been better or worse? Waste of money or money well spent. I don't know because I haven't lived it.

Randy: 34:12

So that is interesting because that's kind of actually kind of leads into the next question that I was going to ask in regards to that. So you, you really do have an interesting, almost experiment that's happening right now, which is., some of the things that I would think as well, that would probably play well for you, which is just getting out, going, knocking on doors, visiting, , various establishment,, getting involved with networking groups and those kinds of things. I would think that would play well as, as a new doctor in opening a practice. Yeah, I haven't been able to do that., in thinking about your practice and where you are today, , not even eight weeks yet, you're what five, six weeks into it. Are you where you thought you would be, or are you, , from that standpoint? And I'm not sure how you're measuring that, but. And of course you knew you, you know, as you opened the doors, you're in the midst of a pandemic, so you knew you wouldn't be able to do those things, but I am kind of curious if you have any indication, like, Hey, , six weeks into a practice where we are today versus, , practices,, similar to us that opened, , and maybe the consulting group that's talked with you, , to like, Hey, you're right on target, , even outside of a pandemic.

Dr. Ryan: 35:16

Yeah. I mean, and so money-wise, which is, , when rubber meets the road, what's the cashflow look like. To be determined on number of bodies through the door. And patient's seen, we're actually double what we thought would be great. And so for whatever reason, it's working, whatever we're doing seems to be working or whatever we're not doing., it seems to have not hurt the number of patients that have come through the door. And so I think that a lot of us will. I have to admit when all this settles that a lot of the things we did on a marketing side and sort of an advert advertising side, we did it because it's the way it's always been done. And I know no one usually does radio and , you don't advertise in the yellow pages anymore, , a lot of the stuff that we've done well is because 10 years ago it worked and nothing's broken. So why fix it? I think we may look back after this pandemic. We like., we couldn't go visit these people face to face, but yet it didn't hurt the numbers. Right? Why is that? Is that because some of us just aren't very good at it or is it really because people don't value that like they used to, right. And maybe patients are just more beholden to their insurance and they don't care. Who you are

Randy: 36:20

well, and some of it as a digital marketer myself, I would say, I think as well, human behavior is changing so that they're doing a lot more online activities and looking at stuff. So kind of that forced isolation as well as has forced them to go online and look for information or a tie into social media, even more than what they've done before. So. As you're getting deeper into those kinds of paths from a marketing standpoint, , your constituents,, your potential clients are kind of doing the same thing even. So it really is hard. And, I think it is interesting. And I completely agree with you. I think coming out of the pandemic, people are going to kind of examine what they've done, how they've had to make adjustments and , is it okay? Or do we go back to. Practices and activities that we did prior to the pandemic or to your point, Hey, we're making a rationalization. They're just, we don't need it

Dr. Ryan: 37:16

right now. Well, I think one of the things we're going to see with the travel industry in general is all those business travelers that was crisscrossed the country three times a week. Do you need to, at this point, and I still think at some level, the answer is yes, but at that volume. Right. And, and that's going to have a tremendous trickle down effect on hotels and airlines and the bottom line., we're looking at it in real estate too. Whenever we had to find space , for our office, it, it took several months to find space and a lot of it's because landlords don't know what to expect. In regards to what's coming, because I think a lot of these firms are going to look to have a smaller footprint, have less office space because they will rotate people through the office for a while. Maybe you go into the office two days a week and you work from home the rest of the week and you just don't need. 3000 square feet of cubicles anymore. He could do with half of that. Right. And that's a real possibility.

Randy: 38:06

I think you're absolutely right with that because I know already, , like Google has announced that they are not going to have a full-time back on campus until September at this point is what they're announcing September of this year.

. Dr. Ryan: 38:19

Right, right. Yeah. We're going to have to revisit things too. I mean, it is the old model of a medical office, the best model moving forward. Do you need someone answering phones at the desk now? Or is that something where with the, , these virtual high-tech internet phones, we can roll them to any one cell phone or rolled into any phone. So do we just have someone sitting. At a home office, right. Answering the phones and handling the schedule and take one body out of, out of the space. I mean, these are all things, we're all going to have to wrestle with that as we move forward.

Randy: 38:48

Christine. So I know with our medical insurance and our providers, they provide a. Online live virtual experience of, , if we have something or a question, whatever we could call or get online have a virtual consultation, do you think that that could be a potential in your industry?

Dr. Ryan: 39:08

I care it's tough because you just don't at this point, have a good way of looking. Into the eye. Now, now I will say Medicare. And what Medicare does most private insurers follow shortly after has reduced the regulations around virtual care greatly since the pandemic started. So, , there was a time when we were all sitting at home wondering when we were going to be able to go back to work where the only patient care I was providing was over FaceTime. And I got this red Mark on my eye. What is it? They've got this lump on my eyelid. Is it as good? No, but the real value in it is. You know, an elderly individual who may not have a ride or may not want to come out in the weather or just because of health concerns does not want to come out yet until at least they're vaccinated. We now have ways and it's ma it's sanctioned by the insurance industry at this point of examining people. Uh, virtually. And so is it perfect in my world? No, but if I was a dermatologist and you're just looking at skin lesions all day long, and at least you can get something started and my gosh, it would be a huge part of my business moving forward.

. Randy: 40:08

So starting the new business,, aside from the pandemic, what are some of the other challenges maybe that you've faced and what have, how have you attacked them? I guess?

Dr. Ryan: 40:17

Yeah. I mean, the, the biggest challenges with trying to get a new business off the ground, just feel like you have to wrestle it to the ground every single day., there, there's just so many nuances to it and , you'd like to believe that you could see patients five days a week and kind of run the business on the side. But what I have found, it's almost the opposite. You're running the business five days a week and Oh, by the way, I have patients in the next three hours. And because someone has to pay the bills and someone has to, go over invoices and, and look and make sure you recharge correctly. And that there's just not enough hours in the day at this stage of the game. Now, as the staff gets more comfortable and as, and as I get more comfortable delegating some of that stuff, it will become easier, but that's probably challenge. Number one is time management. And, and just trying to make sure that, that you keep things on track day by day. And then the other part which we had talked about earlier is just leave it at work and don't bring it home with you because this is shocking. But the four year old doesn't care whether I had a good day or bad day at the office, she lovely girl, but she just doesn't care. I mean, when dad's home, she expects that to be home.. And it's going to be a work in progress for, for months and years. But the, the biggest thing we have to do is try and compartmentalize and no matter how good or bad your day was your, when you're home, your dad firms.

Randy: 41:28

Yeah. It doesn't mean yes. And dad first, and then they're like, Oh yeah, you do other stuff, I guess. Right?. That's what's the age of your kids.

Dr. Ryan: 41:36

So 10 and a half nine. Nearly seven, he'll be seven next month and then four., , you have your hands full hands are full. Uh, Heather, my wife handles a lot more than I do, but yeah, but yeah, the hands are full, but in all honesty, having the office has been a good thing as a family, we spend more time together. Now they've begun to do jobs around the office. I mean, It was someone else's kid. I break child labor laws, but that's my kids. So, you know, they, they do the shredding. Do you have the room? simple tasks. And, uh, the, the nine-year-old back there doing dishes the other day. I'm like she won't touch them at home, but you know, in the office, all of a sudden it's, it's, it's a fun thing to do. Good for you. I love that. That's great.

Randy: 42:15

A year from now. Hopefully we're outside of the pandemic fingers crossed. I'm not exactly sure what that's going to look like, but hopefully we're out of there. Where do you see the business? What are the goals that you got?

Dr. Ryan: 42:27

Yeah, I mean, we're hoping for sustained continued growth. I actually don't want it to be a real steep growth curve at this point because , we're not staffed to handle. 25 patients in a day., there, there needs to be kind of a slow and steady increase so that you can get, get people on board at the right time. And that, that way you don't have cashflow issues either. You don't want to have the rollercoaster effect of these really high months. And then these months that bottom out, because that's a real struggle then. So we're hoping for a continued steady growth., we are hoping to be more embedded in the community , hopefully continue to branch out amongst,, with word of mouth referrals. Right. And then ideally kind of the, the master plan is sometime within the next two to three years to bring on another doctor and kind of have multiple doctors there., that'll allow me to run the practice without having to take time away from patient care. Good. Good. And that's, that's the master plan

Randy: 43:17

and ultimately set yourself up for private equity. Oh yeah. Well, we'll see what's happening by that point. Yeah. All right. So here we are. We're at the bottom of the ninth, , and this is a point here where, , you know, we're coming to the end of it here. What advice do you have for rookies in the game? Uh, Dr. Ryan, those starting out in business, similar to you, right? Thinking about, is it a good time to start a business during a pandemic, but what advice do you have for those folks that you could share

Dr. Ryan: 43:46

first off, do your research. Don't go into these things. Blindly, make sure that you have, , examine it from every angle. If you have family that at home, make sure they're on board with it because, , whether you'd like to think it's the way it is or not, they are going to be as invested in this as you are, because, , The hours can be long and the days can be longer. The other thing, as we had mentioned earlier is make sure you reach out to folks , sort of coordinate with folks who have been there and done that. Pick the brains of some of the folks that, that have gone down this journey ahead of you and, and sort of gleaned some of the pearls that, that, that they deemed to be or things that they wished they had known before, before they went down this path. And, and then the other thing is that, , Well, they say kind of burn the boat, , jump in with both feet., you can't halfway this stuff and I don't care if you open up a taco stand out here, , or, or whether you're in the medical field, if you're going to do it, you got to really do it. Right. And, and that can be scary, but I'm an analytical guy. I had researched the heck out of it. I had examined that every which way. And so when, when it looked like we could do it. We jumped in with both feet and we haven't looked back

. Randy: 44:48

I love that. Bearing the boat, you know, be committed, right? Yes. There's absolutely. Yes., good. Well, listen, I have enjoyed so much. I've learned so much about your business, your practice. I never really thought all that much. I've been going to my eye doctor for years and like, Oh, now I know a little bit more that's right., so thank you for being on the show. Really appreciate it.

Dr. Ryan: 45:09

It was my pleasure. And I look forward to the return visit down the road when we can talk about all the things we screwed up and what we wish we could for the next year.

Randy: 45:15

So, absolutely. Absolutely. All right. So that's the ball game. Hey, thanks for joining us today. And if you liked the show, please tell your friends subscribe and review. And as we like to say, we'll see you around the whole time. Running the basis with small businesses is brought to you by 38 digital marketer, a digital marketing agency, committed to client growth with lead generation higher conversions and increased sales connect with us today. At 38 digital market.com.