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In this episode of the Optometry Money Podcast, Evon Mendrin talks with Dr. Neda Gioia, the owner of Integrative Vision. Dr. Gioia shares her journey into optometry, what led her to cold-start her own practice, and how a personal health crisis inspired her to adopt an integrative healthcare approach within optometry. She discusses how she blends traditional eye care with holistic health practices, addressing root causes of dysfunction rather than just treating symptoms.
Dr. Gioia also dives into her transition from insurance-based to a concierge model of care, the challenges of integrating holistic healthcare into an optometry practice, and how she navigates patient education and staff training to make her practice unique and impactful.
Key Takeaways:
- Integrative Healthcare in Optometry: Dr. Gioia explains how addressing root causes rather than just symptoms benefits patients holistically.
- Transition to a Concierge Model: She shares insights into moving away from insurance and creating a more personalized, patient-centered approach.
- Education and Patient Engagement: Learn how Dr. Gioia educates her staff and patients about the benefits of holistic health practices.
- Practice Management Tips: Practical advice on starting small, trial and error, and gradually building a holistic model within an optometry practice.
- Overcoming Challenges: Discover the biggest obstacles Dr. Gioia faced, from patient communication to system integration.
Links and Resources Mentioned:
- Integrative Vision Website
- Dr. Neda Gioia's Website
- American Academy of Anti-Aging Medicine
- Ocular Wellness and Nutrition Society
- American Nutrition Association
- Institute of Functional Medicine
Connect with Us:
- Visit our Website
- Send your questions to podcast@optometrywealth.com
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Thank you for listening! Stay tuned for more episodes of the Optometry Money Podcast.
The Optometry Money Podcast is dedicated to helping optometrists make better decisions around their money, careers, and practices. The show is hosted by Evon Mendrin, CFP®, CSLP®, owner of Optometry Wealth Advisors, a financial planning firm just for optometrists nationwide.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Evon (00:04):
Hey everybody.
Welcome back to the OptometryMoney Podcast, where we're
helping ODs all over the countrymake better and better decisions
around their money, theircareers, and their practices.
I am your host, Evon Mendrin,Certified Financial Planner
practitioner, and owner ofOptometry Wealth Advisors, an
independent financial planningfirm just for optometrists
(00:24):
nationwide.
And thank you so much forlistening.
Really appreciate your time andyour attention today and onto
today's episode I am excited towelcome to the podcast Dr.
Neda Gioia, owner of IntegrativeVision.
And what's fascinating about Dr.
Gioia is her integrativehealthcare patient care model
that she has adopted onto herOptometry practice looking not
(00:45):
just at the eyes and the ocularhealth of the patient, but at
the nutrition and health of thebody as a whole.
And Dr.
Gioia talks through what led toher adopting this type of
patient care model onto herOptometry practice.
How she went about doing thatand moving away from different
vision plans and into more of aconcierge type practice model.
All of the different trial anderror and adaptation she went
(01:08):
through and some of thechallenges that she faced when
working in this patient caremodel and I thought this was a
fascinating conversation in asuper interesting patient care
model.
If this is something you've beenthinking about adopting onto
your Optometry practice,hopefully this is helpful in
making those decisions foryourself.
And if you have any questions,reach out to us.
You can reach me You can checkout all of the links and
(01:32):
resources in the show notes,which you can find by scrolling
down in whatever app you'reusing or at the education hub at
my website.
www.optometrywealth.Com.
And while you're there, checkout all the other episodes and
articles and resources we puttogether.
And if you've been thinkingabout working with a financial
planning firm that specializesin optometrists and Optometry
(01:52):
practice owners, you canschedule a 30 minute no
commitment introductory call,and we can talk about what's on
your mind financially and how wehelp optometrists all over the
country navigate those samedecisions, and more.
And without further ado, here ismy conversation with Dr.
Neda Gioia.
(02:12):
And welcome back to theOptometry Money Podcast.
I'm your host, Evon Mendrin, andI am very excited to have onto
the podcast Dr.
Neda Gioia.
Dr.
Gioia, thank you so much forcoming on.
Neda Gioia (02:23):
Thank you so much, Evon.
It's really cool that you'rehighlighting this subject matter
today, and I'm really excited tobe a part of it.
Evon (02:30):
I, I'm excited to talk with you because you have a, to
me, to, to what I've seen areally unique way of, of
creating a patient experienceand creating a, a model of
patient care that's veryholistic.
That's looking at not just theeyes, but the whole body.
And so I, I'm excited to.
To dive in and, and learn moreabout what you're doing.
(02:53):
before we we dive into that funstuff, I'd love to hear just a
little bit about yourbackground, what got you into
Optometry?
Neda Gioia (03:01):
So I'm not gonna give you the classic answer of I
loved eyes and I wanted to gointo eyecare.
It was my passion.
It
Evon (03:09):
Okay.
Neda Gioia (03:09):
more through work.
when I was younger, I alwayswanted to go into healthcare and
I actually worked my way intoOptometry.
I first worked for a dentist inhigh school than I was thinking
about dermatology and, I gotreferred to a local optometrist
to work for and I enjoyed.
The patient care, but I alsoenjoyed the retail aspect, which
(03:32):
we don't really talk about toomuch in Optometry in terms of
enjoying both the medical sideand the sales side.
So, what ended up happening wasI had a retail background as
well and that really clickedwith Optometry.
So I kept with it and I justkept going and became an
optometrist.
and it was great.
Evon (03:54):
Interesting.
Yeah, there is definitely aunique blend of retail and
medical within Optometry, thatyou don't really see in other,
healthcare fields.
It's always interesting to hearsort of the story of why someone
gets into Optometry.
sometimes it's just they likedit more than the dentist and was
as simple as that.
You know, sometimes it's justthe childhood experiences that
got'em in that direction.
(04:14):
But, I appreciate you sharingthat.
And, and then what eventuallyled to you cold starting your
current practice IntegratedVision?
Neda Gioia (04:22):
so the cold practice was kind of where it.
Naturally went to, I worked in30 plus offices spanning three,
four states.
I had a very rich, associatelevel and practice kind of
collaborative, experience,whether it was in the retail
(04:42):
side, corporate private sector,and then.
All those years I've alwayswanted my own, practice.
So when I got that opportunityand settled in New Jersey, I
took that opportunity and trulyjust said the best way for me to
really inject all of myuniqueness as well as all my
(05:05):
experiences is by Start.
And that's really where you canbe the most creative, I feel.
you know, there's, there's no,there's no rules that are, you
know, predating your, yourstart.
And I, I enjoyed really gettingeverything under my watch that
was created by me.
(05:25):
Whether it was mistakes that Imade, which I feel like those
are the best things'cause youlearn from that.
or successful protocols ormarketing strategies that I, you
know, was able to execute.
Evon (05:37):
That's fascinating.
You, it's very often when youask that question to someone.
It, it, it's very often aboutthe freedom.
It's, you know, we, we talk alot about, I mean, for me
especially, we talk a lot aboutthe financial aspects of the
business and how that impacts anoptometrist and their family,
but it's also a lot about thefreedom of, the ability to build
(05:58):
the patient care and to buildthe business.
In the way that you want, right?
You make, you've mentionedthere's no rules from the what
came before, right?
You're not purchasing a practiceand taking on all of whatever
was going on in that practicebefore you, you're able to build
it from scratch and build it inthe way that you envision.
And, and you had all of thatexperience that you were able to
(06:19):
build into it.
And I love that you mentionedcreativity, right?
You're able to be, fullycreative, you know, as creative
as you want to in terms of thisis how I envision things
happening and this is the way Iwanna do it.
And you mentioned in, in some ofyour other conversations, you
mentioned cold starting justbefore COVID that that could not
have been an easy time to get abrand new Optometry practice off
(06:41):
the ground.
What was that experience like?
Neda Gioia (06:45):
I'm.
So, you know, COVID wasobviously a huge punch in
everyone's face, whether it wasfrom the financial side to the
emotional side, there was somuch, that you really had to
navigate during that time.
And me.
I mean, now when I reflect onit, it really pushed me to get
(07:06):
into digital exposure.
I was not social media savvy.
I still not, you know, for, forgeneral standards.
But it allowed me to reallythink even more outside the box.
So going back to that creative,tapping into, and it was not
fun, but it was also.
(07:26):
challenging in the sense ofwhere can I grow this time that
is not as standard as thebusiness plan that I originally
had.
You know what, one year markyou're here.
2, 3, 4, 5.
So I redid my whole businessmodel really at that point, and
(07:48):
it.
In retrospect it was, it wasgood because I really was able
to connect with so many morepeople that were not just within
my small com community, but evenexpand it more so.
so it really, you know, it wasscary, but I.
know, when you go into a coldstart, you're already like,
(08:09):
challenge oriented.
So, I'm always not afraid of thechallenge, so it, it was, it was
difficult, but I navigatedthrough it.
Mm-hmm.
Evon (08:22):
it's, it's interesting those times of, I don't know,
crisis is maybe a strong word,but those times of di difficulty
definitely make you thinkoutside the box and say, okay,
how can we improve in ways thatmaybe we've not thought about
before?
And I.
even just in my own, my ownbusiness, you know, I, I, I went
through Covid and kind oflearned a lot of those similar
things.
Okay, what can we dodifferently?
(08:43):
Knowing how the world haschanged,
Neda Gioia (08:45):
Correct.
Evon (08:45):
how most people are more comfortable online, most people
are more comfortable looking atthings through the lens of the
internet.
So there's definitely a lot youcan take away from those.
And tell me a little bit about"integrative health".
What is that?
How is that different from.
Traditional eyecare or otherspecialties, tell us about that.
Neda Gioia (09:07):
so integrative, I'm gonna put it, it's really
integrative healthcare,
Evon (09:11):
Okay.
Neda Gioia (09:12):
Because that's, that's the full scope of looking
at it.
And then eyecare is a part ofthat.
So integrative health is reallywhere you practice addressing
root cause of dysfunction,versus treating symptomology.
So you really, your, your goalis to try to support the body's
innate capacity to heal andreally be resilient to that
(09:37):
symptom of the disease.
And in eyecare, I mean, I, Iwould say most people agree that
the ocular system is very muchconnected to our systemic
systems.
And that that kind of reallyputs you in a place of then,
then everything we do, in ourlifestyle must also affect our
(10:02):
eyes long term.
Or even short term.
so really the integrative healthmodel is to try to get to more
root causes of the healthproblem versus really just the
symptoms.
now in eyecare, because there'sreally no, I would say no, black
(10:22):
and white definition of that, itcomes down to how comfortable
the practitioner is, and thatreally comes down to your
education.
What you've been exposed toalready in that space, and if
you have, advanced educationwithin that space, or if you
have a collaborative officewhere you have other
practitioners that do understandthat type of model.
(10:46):
So, yeah, it's more of thehealthcare role versus the
eyecare role.
I always try to make it moregeneral because it is, it's
connecting things that you wouldnever connect in a standard.
Strict, allopathic careapproach.
Evon (11:03):
Hmm, and, and I, I feel like it might be easy to sort of
segment.
That as someone, you know, someother healthcare professional's
job, rather than including thatinto an Optometry practice.
So what, what led you to thenincorporate that style of
patient care into your ownbusiness?
(11:24):
What, what led you to that?
Neda Gioia (11:25):
everything I do career wise after the age of,
I'm not gonna give you mycurrent age, but
Evon (11:31):
Okay.
Neda Gioia (11:31):
At 31, I had a massive, healthcare crisis.
Evon (11:36):
Hmm.
Neda Gioia (11:37):
And, you know, going back to, you know, sometimes the
bad things lead you to thingsthat good, things that you have
never planned.
After navigating classicallopathic healthcare and really
not getting anywhere with it, Iwas exposed to the functional
medicine and integrativehealthcare model personally,
Evon (11:57):
Hmm.
Neda Gioia (11:57):
that success, and I was, and I felt much better.
that success led me to beingthirsty for more and also
thinking, you know, I'm in thehealthcare field, I'm treating
patients.
Am I doing everything I can?
(12:18):
Is there more?
Is it just because I, maybe Ididn't learn about it in
Optometry school.
there more ways that I can startteaching these patients ways to
mitigate disease?
that was really, that was thespark.
So after that crisis andeverything I went through, it's,
(12:39):
it's kind of like my.
You know, long-term, lifetimemission of being able to
incorporate that mindset andthat approach into my classical
training.
I didn't wanna get rid ofOptometry.
Right.
but it's, it's almost like whenyou see the light, it can't, you
can't even think the sameanymore.
(13:01):
so the emotional and the, I'mgonna call it a little bit
spiritual, alongside thefoundational, education of
being, you know, touched by thistype of healthcare system, then
just gave me the.
(13:24):
Motivation and the courage toreally test whatever I could
test within the space ofeyecare, because at that point
I'm very, I was very comfortablein the standard primary care
practice of Optometry, as yousaid, I, I've.
Had my experience pretty full.
It was just now where can Istart injecting my new
(13:48):
knowledge?
And that's where I started goingback to school.
And I'm still in school.
I'm always in school tocontinuously push the limits and
expand that way of thinking.
And I knew if I don't integrateit, I, you know.
Don't try to figure out a way tomake this blended, then I'm
(14:11):
never gonna be happy with mycareer path.
Evon (14:14):
So that's,
Neda Gioia (14:15):
something missing.
Evon (14:16):
that's fascinating.
Your own experience personallyled you to learn more and more,
and through that learning, youhad realized, I can't not offer
this to, to my patients.
You know, you, you've, you'veseen the light.
It sounds like you've had thissort of aha moment and you
couldn't, you couldn't not offerit to your own patients, it
sounds like.
And.
(14:36):
How do you even begin to startto integrate that into an
Optometry practice?
Like where, where does thatstart?
Neda Gioia (14:44):
luckily.
Because during my education, Iwas, I was working, I, I didn't
take off.
I was working and educating atthe same time
Evon (14:54):
Hmm.
Neda Gioia (14:55):
different practices.
It wasn't my, my personalpractice yet, I started
dabbling.
It was, that's really how I juststarted dabbling.
You know, a patient that I knewwas probably deficient in
vitamin D, for example, assimple as that.
I would start asking somequestions.
this was in a very classicstandard primary care Optometry
(15:18):
practice.
And in, of, you know, thinkingthat it's like taking too long,
I would find ways to have thatconversation.
Evon (15:29):
Mm.
Neda Gioia (15:29):
You know, maybe we're not, you know, talking
about X, Y, Z, now we're talkingabout some mitigating factors of
health, improving your health,et cetera.
And what I started feeling was,and the, the response started to
become so, it, it was just sogood.
It felt so good.
(15:50):
'cause patients would startcommenting on, wow, I never knew
that, that, was something that'sconnected to eye health.
Or, I didn't even, I didn't evenknow that that existed.
or.
Thank you so much for commentingon this.
I always wondered what the real,what, what the real reason was
for perhaps y, Z symptoms.
(16:14):
or I, I've had so much issueswith my gut health and no one's
really asked me questions.
I just kind of deal with it.
So it was that response levelthat just made me understand
that this, you have to keepgoing with it.
So let's start thinking about.
Solutions.
Evon (16:33):
Hmm.
Neda Gioia (16:33):
So, you know, going back to the, to the cold
practice mindset, you know, I'm,I just started thinking of
solutions.
How am I gonna blend the models?
How am I gonna start microdosingthese questions and start
creating these little pockets ofprotocols where, and, and it
(16:53):
just kind of built.
And by the time I started my ownpractice, I was already doing
some things.
And then I just started creatingservice, service routes for
patients that wanted more.
and I was taking insurance atthe time, lots of insurance, and
blending it with insurance andunderstanding that, that
(17:14):
insurance model doesn't reallysupport some of these ways of
giving patients more educationin nutrition or lifestyle
medicine.
So it was, it was a challengeagain, but a good challenge
because I was, again,
Evon (17:31):
It, it sounds like, healthy amounts of trial and
error.
Starting small
Neda Gioia (17:36):
and
Evon (17:37):
and seeing what works and then adapting as you go.
Neda Gioia (17:40):
Mm-hmm.
Evon (17:41):
and so what is the, what is the patient experience like
now?
You know, as you kind of gothrough that, what does that
look like for a patient cominginto your practice and going
through that?
Neda Gioia (17:53):
So I've, going back to the pivot, I am like the
master of pivoting.
my current patient model is verydifferent than when I started
the cold start.
which again is, I like thatbecause it creates growth in my,
in the way I'm managing mypractice.
(18:17):
So.
There's, there's part A and nowI'm at like, let's just say in
the middle of the alphabet and Iwanna get to Z at some point.
Right.
but I would say right now I'mvery shifted.
I'm 100% concierge.
Like I don't take any ininsurance.
It's a one-on-one only.
(18:39):
I've reduced my clinicalin-person time.
I think that's not asapplicable.
your audience versus what I didin the beginning.
Evon (18:48):
Hmm.
Neda Gioia (18:49):
So in the beginning it was, the approach was
obviously always high levelattention and all the things
that we say in the primary eyecare space.
you know, giving patients thatfeeling that they're an
individual and we're giving themgood.
(19:09):
Good support, whether it's fromstaff, that phone call, the
website.
But in terms of the integrativemodel, the biggest start point
was educating the staffregarding our additional
services to the insurance model.
Evon (19:25):
Mm.
Neda Gioia (19:26):
So the primary insurance model, again, depends
on your demographic.
Obviously everybody worksdifferent states, different
areas, but whatever thatinsurance model was.
Then offering this, these add-onservices where a patient can
navigate a higher level ofeducation in nutrition,
(19:48):
lifestyle, supplements, whateverthat protocol would, would be
needed for their, for, for theirconcerns.
and adding that into theschedule.
So it was really trying tocreate.
A service based add-on systemwhere we were able to still use
(20:12):
the patient's insurance, alsogive them this hu very valuable
extra time.
Evon (20:19):
Hmm.
Neda Gioia (20:20):
And that's really where that's, was the biggest
system change that I did.
and the first thing is thequestions.
It's really the questions thatyou ask, the type of questions.
We asked, were outside of thestandard, ocular, you know,
complaints, et cetera, islifestyle questions, simple ones
(20:43):
not going too invasive, andoffering these services with,
with, you know, some transcriptsand teaching, the staff how to
approach it, and gettingpatients on board for it.
And also then once they, oncethey were on board.
Going through the, the newservice, ended up happening,
(21:05):
they're telling a friend,they're
Evon (21:07):
S.
Neda Gioia (21:08):
family member.
so improved referrals.
Evon (21:11):
So I I it, it sounds like there's been this evolution.
You, you, you enjoy the trialand error of like, of starting
something and watching it andimproving it.
And, initially it sounds likeyou took insurances, at least
vision plans, medicalinsurances, perhaps.
And now have shifted over tothis more non-insurance
concierge type service, which isinteresting there.
(21:33):
If you are in any of the onlinegroups around Optometry,
inevitably there's going to bequestions around, should I or
should I not take vision planswith a whole range of opinions
of what that person should do?
And at the end of the day, itdoes seem like it really just
comes down to what is your.
What is your practice going tobe like?
Who, who are you serving?
(21:54):
What is your scope of care?
And then you back into therequired relationships you need
to have.
If we're gonna call vision plana relationship, then you can
back into the requiredrelationships you need to have.
But starting with.
Okay, what is your vision forthe practice?
And who are you serving and whatare you providing to them?
And you definitely, you nailedthat.
(22:15):
You, you started with what areyou providing for who, and then
you decided to remove the thingsthat were unnecessary for that
or didn't contribute to that.
And, and is that additional,more holistic, type service, is
that still an add-on to theprimary, to the primary eyecare
model?
Or is it, is it, is it moreintegrated where every patient
(22:36):
now receives.
Receive sort of the full bundle.
Neda Gioia (22:40):
majority.
So, no.
I have my patients that justlike me as an optometrist
Evon (22:45):
Gotcha.
Okay.
Neda Gioia (22:46):
and, and that I, I still always have.
Let's just say an elevatedconversation, about whole body
health.
Evon (22:53):
Yeah.
Neda Gioia (22:53):
it's autopilot for me.
but I do, I have, because of myeducation in so much in optics
and know, I've navigated somegreat solutions and I do have
those very loyal patients thatare just my standard eye care
patients.
And some of my patients arealready.
Within the integrative space,and they have a very high level
(23:17):
functional medicine practitionerthat I, I probably personally
know, and they just want an eyedoctor that understands when
they give them their list ofmedication and supplements that
they're not in shock.
So that's the one biggest thingis, I did keep my standard.
Eyecare, services.
(23:38):
I still have the add-on model.
Absolutely.
I actually find it great becauseit, it kind of like makes my
practice stand out
Evon (23:49):
Hmm.
Neda Gioia (23:50):
and, you know, I, I also have very full scope, full
on nutrition, workups as well.
Evon (23:56):
Gotcha.
Neda Gioia (23:57):
a whole different.
That's a third part of mypractice.
So, no, I don't see myselftaking it away.
I think, I think, standardpractices, I think what's good
about this type of version isthat you don't force everyone to
do it,
Evon (24:13):
Yeah.
Neda Gioia (24:13):
but you give them the option You know what, if you
know one year they can't affordit, and it's okay, you may, you
may, you know, touch up onthings, but they don't need that
whole comprehensive, extra time.
but the fact that it's there isapproachable and it allows that
communica higher levelcommunication and again, makes
(24:36):
your practice stand out and youdon't have to dump primary I
eyecare.
Evon (24:41):
Yeah.
Okay.
Neda Gioia (24:42):
know, and that was one of the other things that I
did with my practice.
The goal was not for everythingto be under my watch.
It was kind of thinkingcritically, can this be, can
this replicate in otherpractices?
Can this happen a practice thathas like 10 practitioners higher
volume?
(25:03):
Yes.
And that was, that was the goalof this, is, is there a way that
this can be blended?
just the way I make it.
Of course I'm in this likecreative, you know, artistic
Evon (25:15):
Mm-hmm.
Neda Gioia (25:15):
pivot constantly.
But is there a way that this canbe used within other facilities?
And that that's the impactfactor that I always wanted with
my own practice, wasn't just mypersonal practice and success
and all of those things.
It was how can I increase thenumber of doctors that do this?
Evon (25:34):
Gotcha.
Neda Gioia (25:35):
long, long term impact, a much higher number of
patients.
Right.
Evon (25:41):
Yeah.
Neda Gioia (25:41):
So,
Evon (25:42):
So you, you.
You, you know, very often when,when some, when an optometrist
wants to bring in like a newspecialty or a new, a new area
of, of care into the practice,there's often some investment,
right?
It's a new equipment.
It's adding on an associate thathas experience within that, that
mode of practice.
So what are the investmentsneeded to, to provide care like
(26:05):
you're providing in terms ofspecialized knowledge in terms
of who you're hiring?
Like what, what does that looklike?
Neda Gioia (26:11):
it's comparatively to, you know, the fancy machines
that we have in eyecare
Evon (26:18):
Yeah.
Neda Gioia (26:19):
that you probably have heard of.
There's not as much of that, bigload of, you know, trying to get
some sort of, fancy machine intothe practice.
But I would say the biggest istime.
It's actually not so much money,it's time.
And when I say time, it's evenif you hired the proper team
(26:43):
within your practice, you wantto at least understand a little
bit of the language.
And that takes a little bit oftime, in terms of reading.
educating yourself in whetherit's nutrition and functional
medicine approach.
any, you know, so you have tonavigate some certifications if
(27:04):
you want, if you wanna do ityourself.
You obviously have to navigatesome, some advanced
certifications.
I think in terms of staffing,there's two ways of approaching
and staffing.
And I love the staffing of, in,in, in.
Integrative health becausetypically the staff to learn
Evon (27:26):
Hmm.
Neda Gioia (27:27):
So if you're, you have an existing staff member.
A lot of, a lot of the staff,they wanna get healthier, they
wanna learn, they're like, oh,nutrition, I want, I would love
to learn more about that.
So you can designate a staffmember to perhaps take some
courses that are within more ofa health coach level, very easy
online, and you could kind ofinvest in that.
(27:49):
And usually it's a couplethousand dollars at most.
or you can actually startnavigating hiring a different
type of staff
Evon (27:58):
Mm
Neda Gioia (27:58):
instead of going your classic front desk person,
you can navigate a health coach,
Evon (28:07):
mm.
Neda Gioia (28:07):
educated person who has admin qualities or, you
know, experience as well.
And, I have found with theincrease of, staffing, hourly
wages, et cetera, it's startingto kind of get closer and closer
where you're not spending, as,you know, as more than you would
(28:28):
think.
For, some Certified healthcoaches, within the staff too,
to help really support thesystem that you want to start to
create.
in terms of machines, there aresome, antioxidant machines out
there that are great for inoffice use.
they don't.
You know, they're not expensive.
(28:49):
It's really navigating yourwebsite, creating funnels for
whether it's supplement sales,which again, it doesn't really.
Increase, there's not much moneyupfront,
Evon (28:58):
Hmm.
Neda Gioia (28:59):
yet I would say there's not too much going on in
terms of money upfrontcomparatively to a lot of the
other specialties.
And it doesn't have to be somuch of a specialty tier either.
It, you can navigate this andcreate small, a smaller, you
know.
(29:20):
to almost every specialty in ofitself.
Like even though it sounds likethis is a specialty, it really
isn't.
It, it applies to almost everyaspect of eyecare.
Evon (29:32):
Mm, interesting.
Neda Gioia (29:34):
yeah.
Evon (29:35):
So, no, no.
Massive OCT purchase on thefront end.
It, it sounds like it's mostlyabout knowledge and education
and are, do you have examplesyou can share of specific
certifications that someonemight want to look into that you
know are, are really good?
I.
Neda Gioia (29:49):
So I, I navigate this a lot.
I get a lot of questions like,what did, where'd you go?
How'd you learn?
my first, first recommendationand going back to the health
coaching, some docs end uptaking on health coaching
certifications.
Now, I'm not saying that that isbad.
(30:09):
I just, I like to use mylicensing
Evon (30:13):
Mm.
Mm-hmm.
Neda Gioia (30:14):
to the utmost level.
So, for me it's why would I gothrough a health coaching, you
know, system, type ofcertification when I can just
hire somebody and they couldwork under me.
instead, I would like to beconnected to maybe something
that's for licensedprofessionals and that's a
(30:35):
little bit different.
So I would say the biggest, someof the biggest platforms are the
American Nutrition Associationhas multiple ways of getting
higher level education andnutrition.
The, Institute of FunctionalMedicine, that has a very robust
program for functional medicine.
A4M, which is for longevity.
(30:57):
that's another, very high levellongevity functional medicine
certification.
And then my favorite, of course,is the Ocular Wellness and
Nutrition Society.
I did serve as their pastpresident and we've navigated a
lot of ways to incorporateeducation to optometrists and
ophthalmologists to add,nutrition within their, their
(31:18):
scope of practice or even just,you know, streamline, some
recommendations and handouts, etcetera, for, for their clinics.
So, there's a few ways to start.
but the, the first thing is, doyou believe in it?
That's my, I always say that's,it's very important do you
believe in this, approachbecause that's going to really
(31:42):
come, come off with yourpatients.
And, you know, change is hard,know, changing somebody's, diet
or lifestyle management.
It's, it's not easy, but if youbelieve in it, there's a lot
more connection that you havewith, with the patient just
naturally organically.
And it does.
Evon (32:04):
Yeah, it's, it's interesting how you describe it
as if you are, if you are thelicensed professional, use your,
your time investments if you'regoing to get higher education on
things that only the licensedprofessional, more geared
towards a licensed professional.
other things, you can hiresomeone to do that, right.
Use your time in the best waypossible.
(32:24):
I thought that's an interestingway to approach it, and I'll,
I'll try to find.
And put some of these thingsinto the show notes or, if you
can email over that would begreat as well.
But, as you, as you look at yourexperience, sort of going
through trial and error, andespecially knowing that you've
added on a service or that youhave a business that isn't, that
isn't like the quote unquoteaverage or typical Optometry
(32:46):
practice.
So are, are there any particularbenchmark measures or KPIs that
you looked at?
In your practice that aredifferent than maybe the more
traditional Optometry practiceto see what's working and what
needs to be adjusted.
Neda Gioia (33:02):
Well, I mean, one classic, you know, one classic
thing is just your percentage ofpeople upgrading.
You know who, who is, who'sactually, how many numbers are
you getting per month with theseadditional services?
Evon (33:15):
Uhhuh.
Neda Gioia (33:16):
You know?
So that's a very simplebenchmark.
Evon (33:18):
Yeah.
Neda Gioia (33:19):
The other benchmark, which was actually unique, and I
was, and I might be doing a, alittle bit of a, an article with
a, a local optician.
What we found was, and again,going back into my retail mind,
when you, when, because I, Ialso had full optical too
because I, I did it all.
And you know, one of the biggestthings with the optical service
(33:41):
was are patients going toupgrade?
All of the bench, you know, allof the, upgrade features of
really high, high level lenses.
For example, when you sellglasses.
And what we found wa was thatour patients that had higher
level purchasing patterns withnutrition add-ons, they were
(34:04):
also at the highest tier intheir optical purchases.
Evon (34:10):
Interesting.
Neda Gioia (34:11):
think that that doesn't make sense, but it does
because at this point they are,they, they have a level, a sense
of this facility is reallytaking care of me,
Evon (34:25):
Hmm.
Neda Gioia (34:26):
and if we're gonna recommend.
Good anti-reflective coding and,you know, other ways of, you
know, wider channel progressivesand digital, you know, digital
progressives, et cetera.
Then the trust is there.
Evon (34:42):
Mm.
Neda Gioia (34:42):
our sales numbers in our optical upgrades were very
high too, which it, again, twodifferent worlds, but it
Evon (34:50):
Yeah.
Neda Gioia (34:51):
actually reflect on that.
A trust factor.
And it, it's not like you'reselling'em a bad product, it's
just that you want the best forthem.
Evon (35:00):
Yeah.
Neda Gioia (35:01):
so yes, there was some pretty, pretty amazing
benchmarks going, you know, comegoing along.
And also I phased out ofinsurance.
It wasn't like the plug, Istarted one by one.
And seeing how many you have to,you know, calculate how many
patients stay on, how manypatients leave, et cetera.
and it was, and it, you know,did what it had to do for us to
(35:22):
continue the practice.
the way that I thought was, wasgood and, yeah.
Yeah.
Evon (35:29):
So you're, you are essentially sort of watching
this capture rate of who endedup upgrading into the, the more
holistic model, and you foundthat there's a higher level of
trust with those that did.
And if they're going to gosomewhere for on the optical
side.
They already trust you as their,as their provider.
So they're going to, they'refully bought into your practice.
That's, that's interesting.
(35:50):
And what are some challenges to,to building this model?
It didn't sound like you had aplaybook of people that have
done it before.
You, you know, what, what weresome of the challenges?
Neda Gioia (36:01):
systems.
So the, because there's noplaybook.
There's no systems, So forexample, your EMR.
You know, the way you see apatient has to have all of
these, you know, specializedmodifications, right?
Or MR there wasn't a place toput X, Y, Z, so I actually had
(36:25):
to integrate a second.
EMR.
the level that I'm
Evon (36:28):
Mm.
Mm-hmm.
Neda Gioia (36:29):
because it didn't, you know, the standard optical
EMR didn't have that, so thatwas a huge challenge.
The other challenge waspaperwork.
So, I mean, we know paperwork,no one wants to do paperwork.
Right?
Evon (36:41):
Right.
Neda Gioia (36:42):
and when you start asking a lot of questions about
how you're doing, how, how lifeis going and, you know, are you
taking certain supplements andhow do you know?
You need to know that.
somebody has to.
Fill out something and where,what's the best way to get this
to the patient as streamlined aspossible so that they're not
(37:02):
burdened?
you know, so there there is afew, I would say, systems
challenges because of the factthat this is not customary,
Evon (37:14):
Hmm.
Neda Gioia (37:15):
but that's where I love to navigate, you know?
So I created some systems.
I created the, the way to funnelpatients in a certain, EMR that
than the standard one that we'reusing.
And, I think the other biggestchallenge is when you have staff
that's already well-versed inprimary care Optometry, it's.
A challenge.
(37:36):
This is something new.
Evon (37:37):
Mm.
Neda Gioia (37:37):
learn something new.
so finding staff members thathave that, you know, core
primary care, Optometrybackground, and now injecting
all this new information, youmay get some, some pushback at
first'cause it's not what'sstandard for them.
But once they get into it, I'vefound that they all like it
(37:58):
'cause they're learning a littlebit from, for themselves too.
Evon (38:01):
Yeah.
Neda Gioia (38:02):
and patients just tend to be happier.
You know, it's, feel happierwhen they're in your presence,
when you really engage with themat this level.
so those were the few highlightsof the challenges.
I'm sure there's more, but youknow, I probably forgot them.
Evon (38:18):
That's, I mean, that's, that is, I, I do see that that
tends to be the case, even againin my own business where when
you start to move out of themold of how all of these tools
and technologies are set to be,there's always going to be
systems challenges.
'cause you have to changethings.
You have to make new, you know,new tools.
In order for you to do all this,you have to create new systems
and processes.
(38:38):
So.
it sounds like you've navigatedthat very well and, and you
enjoy that again, trial anderror and trying things out and
adjusting and adapting as yougo.
And, what are some last wordsfor the listener that's maybe
hearing this, interested in thisapproach, wondering what to do
next?
What, what are some last wordsyou'd like to leave with them?
Neda Gioia (38:58):
the biggest is that integrative healthcare, I'm
gonna also call it the wellnesssector, is not a trend.
It's not going away.
If anything, going to only seeit increase not only in
Optometry, but within the wholescope of healthcare.
(39:20):
We see it.
the subspecialty, I'll call it,you know, within medical school
models are, you know, startingresidency models and hospital
systems.
Our local hospital here hasstarted a whole department,
about lifestyle medicine.
So.
To think that this is somethingthat you'll never hear or that
(39:42):
you'll never learn is not right.
So one, just know the wordsbecause it's coming to your
communities.
You're going to see it on theinternet and social media, and
if anything, it's only growing.
Evon (39:56):
Mm.
Neda Gioia (39:57):
The second thing is if you are able to embrace.
A partial model, then think ofyourself as special and just go
for it.
You will stand out, you will beliked by community, you'll be
liked by patients.
And frankly, we need as manypractitioners right now that we
can adopt because our healthcaresystem is really in a rut.
(40:21):
And, know, the, the time tochange is now, the time to start
is now.
And.
Go in with confidence and itdoesn't take too much to start,
especially if you're motivated.
Evon (40:34):
Well, I, I appreciate that and I appreciate your time
today.
This is fascinating to me.
As a consumer of healthcare andeyecare, I love hearing what
you're saying and that this isnow being incorporated into,
into healthcare as a whole.
And I think it's fascinatingwhat you're doing.
And one last question that Ialways ask for, for the guest
is, when you think about thefuture of Optometry and, and in
this context, private practice,Optometry, what excites you the
(40:58):
most?
Neda Gioia (41:00):
The exciting part of the future of Optometry is tech
technology adoption,
Evon (41:06):
Hmm.
Neda Gioia (41:07):
also in the wellness sector.
I know artificial intelligence,I'm not gonna get into that.
That's a whole nother podcastI'm sure you've had already,
that's our future to streamlinechair time.
And to improve patient outcome.
And I believe in that whole,very much so within the primary
care practice and also blendedwith the, integrative type of
(41:32):
practice that is what is goingto be revolutionizing how we
practice as optometrists andreally improving our, just our
profession.
Evon (41:43):
Well, I, I appreciate that.
and again, I appreciate yourtime.
For the listener, appreciate youlistening today.
Reach out to us if you have anyquestions, I will put, all of
the resources, links we talkedabout in the show notes and we
will catch you all in the nextepisode.
In the meantime, take
Hey everybody.
Welcome back to the OptometryMoney Podcast, where we're
helping ODs all over the countrymake better and better decisions
around their money, theircareers, and their practices.
I am your host, Evon Mendrin,Certified Financial Planner
practitioner, and owner ofOptometry Wealth Advisors, an
independent financial planningfirm just for optometrists
(00:24):
nationwide.
And thank you so much forlistening.
Really appreciate your time andyour attention today and onto
today's episode I am excited towelcome to the podcast Dr.
Neda Gioia, owner of IntegrativeVision.
And what's fascinating about Dr.
Gioia is her integrativehealthcare patient care model
that she has adopted onto herOptometry practice looking not
(00:45):
just at the eyes and the ocularhealth of the patient, but at
the nutrition and health of thebody as a whole.
And Dr.
Gioia talks through what led toher adopting this type of
patient care model onto herOptometry practice.
How she went about doing thatand moving away from different
vision plans and into more of aconcierge type practice model.
All of the different trial anderror and adaptation she went
(01:08):
through and some of thechallenges that she faced when
working in this patient caremodel and I thought this was a
fascinating conversation in asuper interesting patient care
model.
If this is something you've beenthinking about adopting onto
your Optometry practice,hopefully this is helpful in
making those decisions foryourself.
And if you have any questions,reach out to us.
You can reach me You can checkout all of the links and
(01:32):
resources in the show notes,which you can find by scrolling
down in whatever app you'reusing or at the education hub at
my website.
www.optometrywealth.Com.
And while you're there, checkout all the other episodes and
articles and resources we puttogether.
And if you've been thinkingabout working with a financial
planning firm that specializesin optometrists and Optometry
(01:52):
practice owners, you canschedule a 30 minute no
commitment introductory call,and we can talk about what's on
your mind financially and how wehelp optometrists all over the
country navigate those samedecisions, and more.
And without further ado, here ismy conversation with Dr.
Neda Gioia.
(02:12):
And welcome back to theOptometry Money Podcast.
I'm your host, Evon Mendrin, andI am very excited to have onto
the podcast Dr.
Neda Gioia.
Dr.
Gioia, thank you so much forcoming on.
Neda Gioia (02:23):
Thank you so much, Evon.
It's really cool that you'rehighlighting this subject matter
today, and I'm really excited tobe a part of it.
Evon (02:30):
I, I'm excited to talk with you because you have a, to
me, to, to what I've seen areally unique way of, of
creating a patient experienceand creating a, a model of
patient care that's veryholistic.
That's looking at not just theeyes, but the whole body.
And so I, I'm excited to.
To dive in and, and learn moreabout what you're doing.
(02:53):
before we we dive into that funstuff, I'd love to hear just a
little bit about yourbackground, what got you into
Optometry?
Neda Gioia (03:01):
So I'm not gonna give you the classic answer of I
loved eyes and I wanted to gointo eyecare.
It was my passion.
It
Evon (03:09):
Okay.
Neda Gioia (03:09):
more through work.
when I was younger, I alwayswanted to go into healthcare and
I actually worked my way intoOptometry.
I first worked for a dentist inhigh school than I was thinking
about dermatology and, I gotreferred to a local optometrist
to work for and I enjoyed.
The patient care, but I alsoenjoyed the retail aspect, which
(03:32):
we don't really talk about toomuch in Optometry in terms of
enjoying both the medical sideand the sales side.
So, what ended up happening wasI had a retail background as
well and that really clickedwith Optometry.
So I kept with it and I justkept going and became an
optometrist.
and it was great.
Evon (03:54):
Interesting.
Yeah, there is definitely aunique blend of retail and
medical within Optometry, thatyou don't really see in other,
healthcare fields.
It's always interesting to hearsort of the story of why someone
gets into Optometry.
sometimes it's just they likedit more than the dentist and was
as simple as that.
You know, sometimes it's justthe childhood experiences that
got'em in that direction.
(04:14):
But, I appreciate you sharingthat.
And, and then what eventuallyled to you cold starting your
current practice IntegratedVision?
Neda Gioia (04:22):
so the cold practice was kind of where it.
Naturally went to, I worked in30 plus offices spanning three,
four states.
I had a very rich, associatelevel and practice kind of
collaborative, experience,whether it was in the retail
(04:42):
side, corporate private sector,and then.
All those years I've alwayswanted my own, practice.
So when I got that opportunityand settled in New Jersey, I
took that opportunity and trulyjust said the best way for me to
really inject all of myuniqueness as well as all my
(05:05):
experiences is by Start.
And that's really where you canbe the most creative, I feel.
you know, there's, there's no,there's no rules that are, you
know, predating your, yourstart.
And I, I enjoyed really gettingeverything under my watch that
was created by me.
(05:25):
Whether it was mistakes that Imade, which I feel like those
are the best things'cause youlearn from that.
or successful protocols ormarketing strategies that I, you
know, was able to execute.
Evon (05:37):
That's fascinating.
You, it's very often when youask that question to someone.
It, it, it's very often aboutthe freedom.
It's, you know, we, we talk alot about, I mean, for me
especially, we talk a lot aboutthe financial aspects of the
business and how that impacts anoptometrist and their family,
but it's also a lot about thefreedom of, the ability to build
(05:58):
the patient care and to buildthe business.
In the way that you want, right?
You make, you've mentionedthere's no rules from the what
came before, right?
You're not purchasing a practiceand taking on all of whatever
was going on in that practicebefore you, you're able to build
it from scratch and build it inthe way that you envision.
And, and you had all of thatexperience that you were able to
(06:19):
build into it.
And I love that you mentionedcreativity, right?
You're able to be, fullycreative, you know, as creative
as you want to in terms of thisis how I envision things
happening and this is the way Iwanna do it.
And you mentioned in, in some ofyour other conversations, you
mentioned cold starting justbefore COVID that that could not
have been an easy time to get abrand new Optometry practice off
(06:41):
the ground.
What was that experience like?
Neda Gioia (06:45):
I'm.
So, you know, COVID wasobviously a huge punch in
everyone's face, whether it wasfrom the financial side to the
emotional side, there was somuch, that you really had to
navigate during that time.
And me.
I mean, now when I reflect onit, it really pushed me to get
(07:06):
into digital exposure.
I was not social media savvy.
I still not, you know, for, forgeneral standards.
But it allowed me to reallythink even more outside the box.
So going back to that creative,tapping into, and it was not
fun, but it was also.
(07:26):
challenging in the sense ofwhere can I grow this time that
is not as standard as thebusiness plan that I originally
had.
You know what, one year markyou're here.
2, 3, 4, 5.
So I redid my whole businessmodel really at that point, and
(07:48):
it.
In retrospect it was, it wasgood because I really was able
to connect with so many morepeople that were not just within
my small com community, but evenexpand it more so.
so it really, you know, it wasscary, but I.
know, when you go into a coldstart, you're already like,
(08:09):
challenge oriented.
So, I'm always not afraid of thechallenge, so it, it was, it was
difficult, but I navigatedthrough it.
Mm-hmm.
Evon (08:22):
it's, it's interesting those times of, I don't know,
crisis is maybe a strong word,but those times of di difficulty
definitely make you thinkoutside the box and say, okay,
how can we improve in ways thatmaybe we've not thought about
before?
And I.
even just in my own, my ownbusiness, you know, I, I, I went
through Covid and kind oflearned a lot of those similar
things.
Okay, what can we dodifferently?
(08:43):
Knowing how the world haschanged,
Neda Gioia (08:45):
Correct.
Evon (08:45):
how most people are more comfortable online, most people
are more comfortable looking atthings through the lens of the
internet.
So there's definitely a lot youcan take away from those.
And tell me a little bit about"integrative health".
What is that?
How is that different from.
Traditional eyecare or otherspecialties, tell us about that.
Neda Gioia (09:07):
so integrative, I'm gonna put it, it's really
integrative healthcare,
Evon (09:11):
Okay.
Neda Gioia (09:12):
Because that's, that's the full scope of looking
at it.
And then eyecare is a part ofthat.
So integrative health is reallywhere you practice addressing
root cause of dysfunction,versus treating symptomology.
So you really, your, your goalis to try to support the body's
innate capacity to heal andreally be resilient to that
(09:37):
symptom of the disease.
And in eyecare, I mean, I, Iwould say most people agree that
the ocular system is very muchconnected to our systemic
systems.
And that that kind of reallyputs you in a place of then,
then everything we do, in ourlifestyle must also affect our
(10:02):
eyes long term.
Or even short term.
so really the integrative healthmodel is to try to get to more
root causes of the healthproblem versus really just the
symptoms.
now in eyecare, because there'sreally no, I would say no, black
(10:22):
and white definition of that, itcomes down to how comfortable
the practitioner is, and thatreally comes down to your
education.
What you've been exposed toalready in that space, and if
you have, advanced educationwithin that space, or if you
have a collaborative officewhere you have other
practitioners that do understandthat type of model.
(10:46):
So, yeah, it's more of thehealthcare role versus the
eyecare role.
I always try to make it moregeneral because it is, it's
connecting things that you wouldnever connect in a standard.
Strict, allopathic careapproach.
Evon (11:03):
Hmm, and, and I, I feel like it might be easy to sort of
segment.
That as someone, you know, someother healthcare professional's
job, rather than including thatinto an Optometry practice.
So what, what led you to thenincorporate that style of
patient care into your ownbusiness?
(11:24):
What, what led you to that?
Neda Gioia (11:25):
everything I do career wise after the age of,
I'm not gonna give you mycurrent age, but
Evon (11:31):
Okay.
Neda Gioia (11:31):
At 31, I had a massive, healthcare crisis.
Evon (11:36):
Hmm.
Neda Gioia (11:37):
And, you know, going back to, you know, sometimes the
bad things lead you to thingsthat good, things that you have
never planned.
After navigating classicallopathic healthcare and really
not getting anywhere with it, Iwas exposed to the functional
medicine and integrativehealthcare model personally,
Evon (11:57):
Hmm.
Neda Gioia (11:57):
that success, and I was, and I felt much better.
that success led me to beingthirsty for more and also
thinking, you know, I'm in thehealthcare field, I'm treating
patients.
Am I doing everything I can?
(12:18):
Is there more?
Is it just because I, maybe Ididn't learn about it in
Optometry school.
there more ways that I can startteaching these patients ways to
mitigate disease?
that was really, that was thespark.
So after that crisis andeverything I went through, it's,
(12:39):
it's kind of like my.
You know, long-term, lifetimemission of being able to
incorporate that mindset andthat approach into my classical
training.
I didn't wanna get rid ofOptometry.
Right.
but it's, it's almost like whenyou see the light, it can't, you
can't even think the sameanymore.
(13:01):
so the emotional and the, I'mgonna call it a little bit
spiritual, alongside thefoundational, education of
being, you know, touched by thistype of healthcare system, then
just gave me the.
(13:24):
Motivation and the courage toreally test whatever I could
test within the space ofeyecare, because at that point
I'm very, I was very comfortablein the standard primary care
practice of Optometry, as yousaid, I, I've.
Had my experience pretty full.
It was just now where can Istart injecting my new
(13:48):
knowledge?
And that's where I started goingback to school.
And I'm still in school.
I'm always in school tocontinuously push the limits and
expand that way of thinking.
And I knew if I don't integrateit, I, you know.
Don't try to figure out a way tomake this blended, then I'm
(14:11):
never gonna be happy with mycareer path.
Evon (14:14):
So that's,
Neda Gioia (14:15):
something missing.
Evon (14:16):
that's fascinating.
Your own experience personallyled you to learn more and more,
and through that learning, youhad realized, I can't not offer
this to, to my patients.
You know, you, you've, you'veseen the light.
It sounds like you've had thissort of aha moment and you
couldn't, you couldn't not offerit to your own patients, it
sounds like.
And.
(14:36):
How do you even begin to startto integrate that into an
Optometry practice?
Like where, where does thatstart?
Neda Gioia (14:44):
luckily.
Because during my education, Iwas, I was working, I, I didn't
take off.
I was working and educating atthe same time
Evon (14:54):
Hmm.
Neda Gioia (14:55):
different practices.
It wasn't my, my personalpractice yet, I started
dabbling.
It was, that's really how I juststarted dabbling.
You know, a patient that I knewwas probably deficient in
vitamin D, for example, assimple as that.
I would start asking somequestions.
this was in a very classicstandard primary care Optometry
(15:18):
practice.
And in, of, you know, thinkingthat it's like taking too long,
I would find ways to have thatconversation.
Evon (15:29):
Mm.
Neda Gioia (15:29):
You know, maybe we're not, you know, talking
about X, Y, Z, now we're talkingabout some mitigating factors of
health, improving your health,et cetera.
And what I started feeling was,and the, the response started to
become so, it, it was just sogood.
It felt so good.
(15:50):
'cause patients would startcommenting on, wow, I never knew
that, that, was something that'sconnected to eye health.
Or, I didn't even, I didn't evenknow that that existed.
or.
Thank you so much for commentingon this.
I always wondered what the real,what, what the real reason was
for perhaps y, Z symptoms.
(16:14):
or I, I've had so much issueswith my gut health and no one's
really asked me questions.
I just kind of deal with it.
So it was that response levelthat just made me understand
that this, you have to keepgoing with it.
So let's start thinking about.
Solutions.
Evon (16:33):
Hmm.
Neda Gioia (16:33):
So, you know, going back to the, to the cold
practice mindset, you know, I'm,I just started thinking of
solutions.
How am I gonna blend the models?
How am I gonna start microdosingthese questions and start
creating these little pockets ofprotocols where, and, and it
(16:53):
just kind of built.
And by the time I started my ownpractice, I was already doing
some things.
And then I just started creatingservice, service routes for
patients that wanted more.
and I was taking insurance atthe time, lots of insurance, and
blending it with insurance andunderstanding that, that
(17:14):
insurance model doesn't reallysupport some of these ways of
giving patients more educationin nutrition or lifestyle
medicine.
So it was, it was a challengeagain, but a good challenge
because I was, again,
Evon (17:31):
It, it sounds like, healthy amounts of trial and
error.
Starting small
Neda Gioia (17:36):
and
Evon (17:37):
and seeing what works and then adapting as you go.
Neda Gioia (17:40):
Mm-hmm.
Evon (17:41):
and so what is the, what is the patient experience like
now?
You know, as you kind of gothrough that, what does that
look like for a patient cominginto your practice and going
through that?
Neda Gioia (17:53):
So I've, going back to the pivot, I am like the
master of pivoting.
my current patient model is verydifferent than when I started
the cold start.
which again is, I like thatbecause it creates growth in my,
in the way I'm managing mypractice.
(18:17):
So.
There's, there's part A and nowI'm at like, let's just say in
the middle of the alphabet and Iwanna get to Z at some point.
Right.
but I would say right now I'mvery shifted.
I'm 100% concierge.
Like I don't take any ininsurance.
It's a one-on-one only.
(18:39):
I've reduced my clinicalin-person time.
I think that's not asapplicable.
your audience versus what I didin the beginning.
Evon (18:48):
Hmm.
Neda Gioia (18:49):
So in the beginning it was, the approach was
obviously always high levelattention and all the things
that we say in the primary eyecare space.
you know, giving patients thatfeeling that they're an
individual and we're giving themgood.
(19:09):
Good support, whether it's fromstaff, that phone call, the
website.
But in terms of the integrativemodel, the biggest start point
was educating the staffregarding our additional
services to the insurance model.
Evon (19:25):
Mm.
Neda Gioia (19:26):
So the primary insurance model, again, depends
on your demographic.
Obviously everybody worksdifferent states, different
areas, but whatever thatinsurance model was.
Then offering this, these add-onservices where a patient can
navigate a higher level ofeducation in nutrition,
(19:48):
lifestyle, supplements, whateverthat protocol would, would be
needed for their, for, for theirconcerns.
and adding that into theschedule.
So it was really trying tocreate.
A service based add-on systemwhere we were able to still use
(20:12):
the patient's insurance, alsogive them this hu very valuable
extra time.
Evon (20:19):
Hmm.
Neda Gioia (20:20):
And that's really where that's, was the biggest
system change that I did.
and the first thing is thequestions.
It's really the questions thatyou ask, the type of questions.
We asked, were outside of thestandard, ocular, you know,
complaints, et cetera, islifestyle questions, simple ones
(20:43):
not going too invasive, andoffering these services with,
with, you know, some transcriptsand teaching, the staff how to
approach it, and gettingpatients on board for it.
And also then once they, oncethey were on board.
Going through the, the newservice, ended up happening,
(21:05):
they're telling a friend,they're
Evon (21:07):
S.
Neda Gioia (21:08):
family member.
so improved referrals.
Evon (21:11):
So I I it, it sounds like there's been this evolution.
You, you, you enjoy the trialand error of like, of starting
something and watching it andimproving it.
And, initially it sounds likeyou took insurances, at least
vision plans, medicalinsurances, perhaps.
And now have shifted over tothis more non-insurance
concierge type service, which isinteresting there.
(21:33):
If you are in any of the onlinegroups around Optometry,
inevitably there's going to bequestions around, should I or
should I not take vision planswith a whole range of opinions
of what that person should do?
And at the end of the day, itdoes seem like it really just
comes down to what is your.
What is your practice going tobe like?
Who, who are you serving?
(21:54):
What is your scope of care?
And then you back into therequired relationships you need
to have.
If we're gonna call vision plana relationship, then you can
back into the requiredrelationships you need to have.
But starting with.
Okay, what is your vision forthe practice?
And who are you serving and whatare you providing to them?
And you definitely, you nailedthat.
(22:15):
You, you started with what areyou providing for who, and then
you decided to remove the thingsthat were unnecessary for that
or didn't contribute to that.
And, and is that additional,more holistic, type service, is
that still an add-on to theprimary, to the primary eyecare
model?
Or is it, is it, is it moreintegrated where every patient
(22:36):
now receives.
Receive sort of the full bundle.
Neda Gioia (22:40):
majority.
So, no.
I have my patients that justlike me as an optometrist
Evon (22:45):
Gotcha.
Okay.
Neda Gioia (22:46):
and, and that I, I still always have.
Let's just say an elevatedconversation, about whole body
health.
Evon (22:53):
Yeah.
Neda Gioia (22:53):
it's autopilot for me.
but I do, I have, because of myeducation in so much in optics
and know, I've navigated somegreat solutions and I do have
those very loyal patients thatare just my standard eye care
patients.
And some of my patients arealready.
Within the integrative space,and they have a very high level
(23:17):
functional medicine practitionerthat I, I probably personally
know, and they just want an eyedoctor that understands when
they give them their list ofmedication and supplements that
they're not in shock.
So that's the one biggest thingis, I did keep my standard.
Eyecare, services.
(23:38):
I still have the add-on model.
Absolutely.
I actually find it great becauseit, it kind of like makes my
practice stand out
Evon (23:49):
Hmm.
Neda Gioia (23:50):
and, you know, I, I also have very full scope, full
on nutrition, workups as well.
Evon (23:56):
Gotcha.
Neda Gioia (23:57):
a whole different.
That's a third part of mypractice.
So, no, I don't see myselftaking it away.
I think, I think, standardpractices, I think what's good
about this type of version isthat you don't force everyone to
do it,
Evon (24:13):
Yeah.
Neda Gioia (24:13):
but you give them the option You know what, if you
know one year they can't affordit, and it's okay, you may, you
may, you know, touch up onthings, but they don't need that
whole comprehensive, extra time.
but the fact that it's there isapproachable and it allows that
communica higher levelcommunication and again, makes
(24:36):
your practice stand out and youdon't have to dump primary I
eyecare.
Evon (24:41):
Yeah.
Okay.
Neda Gioia (24:42):
know, and that was one of the other things that I
did with my practice.
The goal was not for everythingto be under my watch.
It was kind of thinkingcritically, can this be, can
this replicate in otherpractices?
Can this happen a practice thathas like 10 practitioners higher
volume?
(25:03):
Yes.
And that was, that was the goalof this, is, is there a way that
this can be blended?
just the way I make it.
Of course I'm in this likecreative, you know, artistic
Evon (25:15):
Mm-hmm.
Neda Gioia (25:15):
pivot constantly.
But is there a way that this canbe used within other facilities?
And that that's the impactfactor that I always wanted with
my own practice, wasn't just mypersonal practice and success
and all of those things.
It was how can I increase thenumber of doctors that do this?
Evon (25:34):
Gotcha.
Neda Gioia (25:35):
long, long term impact, a much higher number of
patients.
Right.
Evon (25:41):
Yeah.
Neda Gioia (25:41):
So,
Evon (25:42):
So you, you.
You, you know, very often when,when some, when an optometrist
wants to bring in like a newspecialty or a new, a new area
of, of care into the practice,there's often some investment,
right?
It's a new equipment.
It's adding on an associate thathas experience within that, that
mode of practice.
So what are the investmentsneeded to, to provide care like
(26:05):
you're providing in terms ofspecialized knowledge in terms
of who you're hiring?
Like what, what does that looklike?
Neda Gioia (26:11):
it's comparatively to, you know, the fancy machines
that we have in eyecare
Evon (26:18):
Yeah.
Neda Gioia (26:19):
that you probably have heard of.
There's not as much of that, bigload of, you know, trying to get
some sort of, fancy machine intothe practice.
But I would say the biggest istime.
It's actually not so much money,it's time.
And when I say time, it's evenif you hired the proper team
(26:43):
within your practice, you wantto at least understand a little
bit of the language.
And that takes a little bit oftime, in terms of reading.
educating yourself in whetherit's nutrition and functional
medicine approach.
any, you know, so you have tonavigate some certifications if
(27:04):
you want, if you wanna do ityourself.
You obviously have to navigatesome, some advanced
certifications.
I think in terms of staffing,there's two ways of approaching
and staffing.
And I love the staffing of, in,in, in.
Integrative health becausetypically the staff to learn
Evon (27:26):
Hmm.
Neda Gioia (27:27):
So if you're, you have an existing staff member.
A lot of, a lot of the staff,they wanna get healthier, they
wanna learn, they're like, oh,nutrition, I want, I would love
to learn more about that.
So you can designate a staffmember to perhaps take some
courses that are within more ofa health coach level, very easy
online, and you could kind ofinvest in that.
(27:49):
And usually it's a couplethousand dollars at most.
or you can actually startnavigating hiring a different
type of staff
Evon (27:58):
Mm
Neda Gioia (27:58):
instead of going your classic front desk person,
you can navigate a health coach,
Evon (28:07):
mm.
Neda Gioia (28:07):
educated person who has admin qualities or, you
know, experience as well.
And, I have found with theincrease of, staffing, hourly
wages, et cetera, it's startingto kind of get closer and closer
where you're not spending, as,you know, as more than you would
(28:28):
think.
For, some Certified healthcoaches, within the staff too,
to help really support thesystem that you want to start to
create.
in terms of machines, there aresome, antioxidant machines out
there that are great for inoffice use.
they don't.
You know, they're not expensive.
(28:49):
It's really navigating yourwebsite, creating funnels for
whether it's supplement sales,which again, it doesn't really.
Increase, there's not much moneyupfront,
Evon (28:58):
Hmm.
Neda Gioia (28:59):
yet I would say there's not too much going on in
terms of money upfrontcomparatively to a lot of the
other specialties.
And it doesn't have to be somuch of a specialty tier either.
It, you can navigate this andcreate small, a smaller, you
know.
(29:20):
to almost every specialty in ofitself.
Like even though it sounds likethis is a specialty, it really
isn't.
It, it applies to almost everyaspect of eyecare.
Evon (29:32):
Mm, interesting.
Neda Gioia (29:34):
yeah.
Evon (29:35):
So, no, no.
Massive OCT purchase on thefront end.
It, it sounds like it's mostlyabout knowledge and education
and are, do you have examplesyou can share of specific
certifications that someonemight want to look into that you
know are, are really good?
I.
Neda Gioia (29:49):
So I, I navigate this a lot.
I get a lot of questions like,what did, where'd you go?
How'd you learn?
my first, first recommendationand going back to the health
coaching, some docs end uptaking on health coaching
certifications.
Now, I'm not saying that that isbad.
(30:09):
I just, I like to use mylicensing
Evon (30:13):
Mm.
Mm-hmm.
Neda Gioia (30:14):
to the utmost level.
So, for me it's why would I gothrough a health coaching, you
know, system, type ofcertification when I can just
hire somebody and they couldwork under me.
instead, I would like to beconnected to maybe something
that's for licensedprofessionals and that's a
(30:35):
little bit different.
So I would say the biggest, someof the biggest platforms are the
American Nutrition Associationhas multiple ways of getting
higher level education andnutrition.
The, Institute of FunctionalMedicine, that has a very robust
program for functional medicine.
A4M, which is for longevity.
(30:57):
that's another, very high levellongevity functional medicine
certification.
And then my favorite, of course,is the Ocular Wellness and
Nutrition Society.
I did serve as their pastpresident and we've navigated a
lot of ways to incorporateeducation to optometrists and
ophthalmologists to add,nutrition within their, their
(31:18):
scope of practice or even just,you know, streamline, some
recommendations and handouts, etcetera, for, for their clinics.
So, there's a few ways to start.
but the, the first thing is, doyou believe in it?
That's my, I always say that's,it's very important do you
believe in this, approachbecause that's going to really
(31:42):
come, come off with yourpatients.
And, you know, change is hard,know, changing somebody's, diet
or lifestyle management.
It's, it's not easy, but if youbelieve in it, there's a lot
more connection that you havewith, with the patient just
naturally organically.
And it does.
Evon (32:04):
Yeah, it's, it's interesting how you describe it
as if you are, if you are thelicensed professional, use your,
your time investments if you'regoing to get higher education on
things that only the licensedprofessional, more geared
towards a licensed professional.
other things, you can hiresomeone to do that, right.
Use your time in the best waypossible.
(32:24):
I thought that's an interestingway to approach it, and I'll,
I'll try to find.
And put some of these thingsinto the show notes or, if you
can email over that would begreat as well.
But, as you, as you look at yourexperience, sort of going
through trial and error, andespecially knowing that you've
added on a service or that youhave a business that isn't, that
isn't like the quote unquoteaverage or typical Optometry
(32:46):
practice.
So are, are there any particularbenchmark measures or KPIs that
you looked at?
In your practice that aredifferent than maybe the more
traditional Optometry practiceto see what's working and what
needs to be adjusted.
Neda Gioia (33:02):
Well, I mean, one classic, you know, one classic
thing is just your percentage ofpeople upgrading.
You know who, who is, who'sactually, how many numbers are
you getting per month with theseadditional services?
Evon (33:15):
Uhhuh.
Neda Gioia (33:16):
You know?
So that's a very simplebenchmark.
Evon (33:18):
Yeah.
Neda Gioia (33:19):
The other benchmark, which was actually unique, and I
was, and I might be doing a, alittle bit of a, an article with
a, a local optician.
What we found was, and again,going back into my retail mind,
when you, when, because I, Ialso had full optical too
because I, I did it all.
And you know, one of the biggestthings with the optical service
(33:41):
was are patients going toupgrade?
All of the bench, you know, allof the, upgrade features of
really high, high level lenses.
For example, when you sellglasses.
And what we found wa was thatour patients that had higher
level purchasing patterns withnutrition add-ons, they were
(34:04):
also at the highest tier intheir optical purchases.
Evon (34:10):
Interesting.
Neda Gioia (34:11):
think that that doesn't make sense, but it does
because at this point they are,they, they have a level, a sense
of this facility is reallytaking care of me,
Evon (34:25):
Hmm.
Neda Gioia (34:26):
and if we're gonna recommend.
Good anti-reflective coding and,you know, other ways of, you
know, wider channel progressivesand digital, you know, digital
progressives, et cetera.
Then the trust is there.
Evon (34:42):
Mm.
Neda Gioia (34:42):
our sales numbers in our optical upgrades were very
high too, which it, again, twodifferent worlds, but it
Evon (34:50):
Yeah.
Neda Gioia (34:51):
actually reflect on that.
A trust factor.
And it, it's not like you'reselling'em a bad product, it's
just that you want the best forthem.
Evon (35:00):
Yeah.
Neda Gioia (35:01):
so yes, there was some pretty, pretty amazing
benchmarks going, you know, comegoing along.
And also I phased out ofinsurance.
It wasn't like the plug, Istarted one by one.
And seeing how many you have to,you know, calculate how many
patients stay on, how manypatients leave, et cetera.
and it was, and it, you know,did what it had to do for us to
(35:22):
continue the practice.
the way that I thought was, wasgood and, yeah.
Yeah.
Evon (35:29):
So you're, you are essentially sort of watching
this capture rate of who endedup upgrading into the, the more
holistic model, and you foundthat there's a higher level of
trust with those that did.
And if they're going to gosomewhere for on the optical
side.
They already trust you as their,as their provider.
So they're going to, they'refully bought into your practice.
That's, that's interesting.
(35:50):
And what are some challenges to,to building this model?
It didn't sound like you had aplaybook of people that have
done it before.
You, you know, what, what weresome of the challenges?
Neda Gioia (36:01):
systems.
So the, because there's noplaybook.
There's no systems, So forexample, your EMR.
You know, the way you see apatient has to have all of
these, you know, specializedmodifications, right?
Or MR there wasn't a place toput X, Y, Z, so I actually had
(36:25):
to integrate a second.
EMR.
the level that I'm
Evon (36:28):
Mm.
Mm-hmm.
Neda Gioia (36:29):
because it didn't, you know, the standard optical
EMR didn't have that, so thatwas a huge challenge.
The other challenge waspaperwork.
So, I mean, we know paperwork,no one wants to do paperwork.
Right?
Evon (36:41):
Right.
Neda Gioia (36:42):
and when you start asking a lot of questions about
how you're doing, how, how lifeis going and, you know, are you
taking certain supplements andhow do you know?
You need to know that.
somebody has to.
Fill out something and where,what's the best way to get this
to the patient as streamlined aspossible so that they're not
(37:02):
burdened?
you know, so there there is afew, I would say, systems
challenges because of the factthat this is not customary,
Evon (37:14):
Hmm.
Neda Gioia (37:15):
but that's where I love to navigate, you know?
So I created some systems.
I created the, the way to funnelpatients in a certain, EMR that
than the standard one that we'reusing.
And, I think the other biggestchallenge is when you have staff
that's already well-versed inprimary care Optometry, it's.
A challenge.
(37:36):
This is something new.
Evon (37:37):
Mm.
Neda Gioia (37:37):
learn something new.
so finding staff members thathave that, you know, core
primary care, Optometrybackground, and now injecting
all this new information, youmay get some, some pushback at
first'cause it's not what'sstandard for them.
But once they get into it, I'vefound that they all like it
(37:58):
'cause they're learning a littlebit from, for themselves too.
Evon (38:01):
Yeah.
Neda Gioia (38:02):
and patients just tend to be happier.
You know, it's, feel happierwhen they're in your presence,
when you really engage with themat this level.
so those were the few highlightsof the challenges.
I'm sure there's more, but youknow, I probably forgot them.
Evon (38:18):
That's, I mean, that's, that is, I, I do see that that
tends to be the case, even againin my own business where when
you start to move out of themold of how all of these tools
and technologies are set to be,there's always going to be
systems challenges.
'cause you have to changethings.
You have to make new, you know,new tools.
In order for you to do all this,you have to create new systems
and processes.
(38:38):
So.
it sounds like you've navigatedthat very well and, and you
enjoy that again, trial anderror and trying things out and
adjusting and adapting as yougo.
And, what are some last wordsfor the listener that's maybe
hearing this, interested in thisapproach, wondering what to do
next?
What, what are some last wordsyou'd like to leave with them?
Neda Gioia (38:58):
the biggest is that integrative healthcare, I'm
gonna also call it the wellnesssector, is not a trend.
It's not going away.
If anything, going to only seeit increase not only in
Optometry, but within the wholescope of healthcare.
(39:20):
We see it.
the subspecialty, I'll call it,you know, within medical school
models are, you know, startingresidency models and hospital
systems.
Our local hospital here hasstarted a whole department,
about lifestyle medicine.
So.
To think that this is somethingthat you'll never hear or that
(39:42):
you'll never learn is not right.
So one, just know the wordsbecause it's coming to your
communities.
You're going to see it on theinternet and social media, and
if anything, it's only growing.
Evon (39:56):
Mm.
Neda Gioia (39:57):
The second thing is if you are able to embrace.
A partial model, then think ofyourself as special and just go
for it.
You will stand out, you will beliked by community, you'll be
liked by patients.
And frankly, we need as manypractitioners right now that we
can adopt because our healthcaresystem is really in a rut.
(40:21):
And, know, the, the time tochange is now, the time to start
is now.
And.
Go in with confidence and itdoesn't take too much to start,
especially if you're motivated.
Evon (40:34):
Well, I, I appreciate that and I appreciate your time
today.
This is fascinating to me.
As a consumer of healthcare andeyecare, I love hearing what
you're saying and that this isnow being incorporated into,
into healthcare as a whole.
And I think it's fascinatingwhat you're doing.
And one last question that Ialways ask for, for the guest
is, when you think about thefuture of Optometry and, and in
this context, private practice,Optometry, what excites you the
(40:58):
most?
Neda Gioia (41:00):
The exciting part of the future of Optometry is tech
technology adoption,
Evon (41:06):
Hmm.
Neda Gioia (41:07):
also in the wellness sector.
I know artificial intelligence,I'm not gonna get into that.
That's a whole nother podcastI'm sure you've had already,
that's our future to streamlinechair time.
And to improve patient outcome.
And I believe in that whole,very much so within the primary
care practice and also blendedwith the, integrative type of
(41:32):
practice that is what is goingto be revolutionizing how we
practice as optometrists andreally improving our, just our
profession.
Evon (41:43):
Well, I, I appreciate that.
and again, I appreciate yourtime.
For the listener, appreciate youlistening today.
Reach out to us if you have anyquestions, I will put, all of
the resources, links we talkedabout in the show notes and we
will catch you all in the nextepisode.
In the meantime, take
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If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.