PRACTICE PROFILES s THE REWARDS OF A CUTTING-EDGE MENTALITY Cleveland Eye Clinic and ClearChoice Custom LASIK Center focus on collaborative care and creative marketing to fuel their growth.

BY ROCHELLE NATALONI, SENIOR STAFF WRITER

he Cleveland Eye Clinic, when it opened in 1945, was a har- binger of things to come. Ophthalmologists worked collaboratively with optom- etristsT from the start, and the clinic’s original owners established this mutually rewarding model. This forward-thinking paradigm continued to flourish under the leadership of cataract and pioneer Robert G. Wiley, MD, who became the owner of the practice in 1990. His son, William F. Wiley, MD, who acquired the practice and became medical Figure 1. Cleveland Eye Clinic and ClearChoice Custom LASIK Center headquarters. director in 2002, remains committed to the clinic’s collaborative care model, but he’s also branched out into ancil- managing to retain the casual nature started back when RK was the refractive lary ophthalmic businesses and brands. upon which it was founded. procedure of choice, and Jeff was out in Given his lineage, the younger Dr. Wiley brought in medical part- the field selling RK instrumentation. He Dr. Wiley has been involved in ophthal- ners Shamik Bafna, MD, and Thomas viewed ophthalmologists more as part- mology and refractive surgery his entire M. Chester, OD, to help manage the ners than clients.” life. He underwent Cleveland Eye Clinic and Clear Choice The Cleveland Eye Clinic has seven (RK) in the pre-LASIK era; worked with Custom LASIK Center. Beyond provider locations, and ClearChoice has three. one of the pioneers of refractive surgery, partners, they engaged two nonphysi- The separate entities share a main head- Svyatoslav Fyodorov, MD, during a rota- cian partners: Jeff Kissinger as a manag- quarters (Figure 1) and an ambulatory tion in medical school in ; and ing partner in the LASIK business and surgery center (ASC). The Cleveland Eye grew up attending what has developed Michelle Nelson as partner and head of Clinic focuses on third-party reimbursed into the annual Caribbean Eye Meeting. marketing. Mr. Kissinger is in charge of and refractive cataract surgery, and That meeting began as an informal business development and works hand ClearChoice Custom LASIK handles cash- gathering started by his father and like- in hand with Ms. Nelson in marketing. pay procedures, including laser refractive minded eye care providers; they decid- “My father built a large referral surgery, corneal inlays, and CXL. The ed that their children’s yearly spring network of optometrists through the practices and ASC combined have more breaks were the perfect time to meet Cleveland Eye Clinic, and simultaneously, than 200 full-time employees. in tropical locales to share research and on a parallel path, he and Jeff started “Having two separate practices is a anecdotes about their cases. Today he ClearChoice Custom LASIK Center,” unique and effective business model,” leads the annual meeting, which has Dr. Wiley told CRST. “ClearChoice Dr. Wiley said. “If you are providing grown into a formal symposium while sparked out of their relationship that generalized care for cataract patients,

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providers within 50 miles.50 within providers LASIK deal with the economic fluctuations hurt that LASIK so many practices? MR. KISSINGER: startedwe When times. difficult some werethere Cleveland, in LASIK with LASIK 30 radioWhen five. about are there Today, collaborative care are part of the lifeblood Eye Clinic and of Cleveland ClearChoice Custom LASIK Center. How is system your structured? DR. WILEY: withcomanage we that ways traditionalthe There’s optometrists. patientsrefer doctors where way, another there’s Then us. to directly seesurgeons our that is which way, Onoffices. optometrists’ in patients toup visit will I Thursday, given any doand practices optometry nine minorsome and exams preoperative teamA facilities. their in procedures aboutthere gets technicians three of anup set to me of ahead hour half a unita Meditec), Zeiss (Carl IOLMaster for selective laser trabeculoplasty, and an apatients the saves This laser. Nd:YAG becauseClinic Eye Cleveland the to trip ClinicEye Cleveland a see can they office. optometrist’s their in surgeon HowCRST: did ClearChoice Custom JEFFREY KISSINGER: JEFFREY KISSINGER: LASIKwhen 1999 In createdwe off, took forbrand separate a wantdidn’t We that. lobbysame the in sitting patients LASIK awanted We patients. cataract as Nowfeel. and brand, location, separate hadhave patients LASIK these that atexperience boutique upscale that theyCenter, LASIK Custom ClearChoice whenenvironment similar a expect yearssurgery cataract for return they ourover making been we’ve So later. littlea feel and look to offices cataract centers.LASIK our like more and hipper and Comanagement CRST:

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both of those businesses plus an ASCan plus businesses those of both technologythe all have would we so sharenow We roof. one under betweencultures and staff, patients, that seeing We’re entities. two the muchnow is culture cataract the surgicalrefractive a of reflective more learnedwe lessons the and mindset, helpedhave LASIK of days early the in practice.cataract our in tremendously separate businessseparate arethey but entities, alignedclosely more Shortlyoriginally. were they than we2002, in practice the joined I after theof emergence the seeing started whenThat’s market. IOL premium pathsparallel the see to started we businessone in surgery refractive of anotherin surgery cataract and wewhen also That’s converging. toidea good a be would it decided housedthat headquarters a build collaborative care, guerilla marketing, guerilla care, collaborative cream.ice and success, for quest the CataractCRST: surgery more has of a refractive surgical component in recent years. Does this mean there is more interaction betweenCleveland Eye Clinic and ClearChoice Custom LASIK Center? WILLIAM F. WILEY, MD: - - - - , Dr., | AUGUST 2018 | AUGUST

CRST In an interview with interview an In Dr. Bafna; M. Amir Moarefi, MD; and MD; Moarefi, Amir M. Bafna; Dr. The past 15 years have been kind tokind been have years 15 past The left to right, left to right, Shamik Bafna, MD; William F. Wiley, MD; Jeffrey Augustine, OD; and M. Amir Moarefi, MD. Figure 2. The Figure 2. The Cleveland Eye Clinic team includes, from Wiley and Mr. Kissinger touched ontouched Kissinger Mr. and Wiley iceberg,” he said. “As long as the babythe as long “As said. he iceberg,” wethink I age, of coming keep boomers moreneed and grow to continue will plac more and providers, more doctors, surgery.” world-class provide to es Jeffrey M. Augustine, OD (Figure 2), and2), (Figure OD Augustine, M. Jeffrey centerstwo the at providers other the Kissinger,Mr. growth, this to integral are abate its of sign no sees he and said, theof tip the at just are “We ment. tion, and our combined staff forstaff combined our and tion, rangethe in was LASIK and cataract “Thissaid. he employees,” 15 to 10 of aboutup is volume LASIK our year, 20%.about up are cataracts and 10% enjoyto blessed really been have We growth.”steady and rapid some GROWING BUSINESS GROWING BUSINESS ClearChoice, and Clinic Eye Cleveland startedBill “When said. Kissinger Mr. loca one had we ago, years 15 about the early days of laser refractive surgery. refractive laser of days early the refrac in specialized that centers The betterdid alone LASIK or surgery tive bothdo to tried that ones the than makesit so refractive, and cataract distincttwo having that sense perfect us.” for well worked entities business as well as LASIK, it can be confusing to confusing be can it LASIK, as well as intrue particularly was That patients. CATARACT & REFRACTIVE SURGERY TODAY

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and newspaper advertising stopped working, and the phone stopped ringing, we turned to grassroots guerilla marketing. We bought an RV and wrapped it in the ClearChoice Custom LASIK logo. We would take it to places like the local convention center where an auto, boat, or golf show would attract anywhere from 50,000 to 250,000 people. These were perfect opportunities to engage with people. It would be the first time we would touch them, so to speak, and we would get their basic demographic information so we could add them to our automated digital marketing system. It might take Figure 3. The ClearChoice LASIK RV marketing vehicle outside FirstEnergy Stadium, home of the Cleveland Browns. 10 years to go from that first point of contact until they actually walk into the LASIK center, but we know where we first met them and how long it took for them to follow up because we track it. There’s no such thing as an old lead. We may first meet someone in 2006, and then a decade later they finally hit that tipping point and show up in the office. For whatever reason, they never unsubscribed; they just hung in there with us.

DR. WILEY: We also take the RV to the Cleveland Browns’ football games (Figure 3), where we have college interns handing out materials and Figure 4. The Mr. iSee ice cream truck provides answering questions. We’ll have a creative marketing plus charitable fundraising. Pentacam (Oculus Optikgeräte) and automated refractometer there, and we’ll screen people to see if they are piece, and we put about $50,000 into DR. WILEY: When Jeff suggested we candidates for LASIK. We launched the each one to restore them to almost buy these trucks, my kids were ages RV marketing campaign right around mint condition. The trucks are labeled 6 and 4 at the time, and I thought, the time of the LASIK downturn. It with the Cleveland Eye Clinic and “I’m going to be the biggest hero to was out-of-the-box marketing, and ClearChoice Custom LASIK Center my kids if I come home with an ice that was crucial because traditional logos and with their very own Mr. cream truck!” In addition to bringing methods weren’t working. That iSee logo. the trucks to fundraising events, we might actually be what got us out of We offer the trucks to local charities make them available to past patients the downturn. when they host events to raise money if they want to reserve one for a for their causes. We show up and pass graduation party or other event, and CRST: What is another example of out Popsicles, Nutty Buddies, and again any proceeds that are generated your creative marketing methods? Push-Up Pops, and all of the proceeds are donated. In addition to being great go to support the charities. Also, every vehicles for fundraising, they reinforce MR. KISSINGER: We have two 1959 Memorial Day weekend Bill takes one our brand in the community, and reconditioned ice cream trucks of the trucks and drives it around his they help people associate our brand (Figure 4) that we use for marketing. town, and any donations that are gath- with something that generally inspires We bought them for about $5,000 a ered also go to support local charities. happy, positive feelings.

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Executive Advisory Board —JEFF KISSINGER CRST Financial disclosure: None Private practice, Cleveland Eye Clinic and Member, Chief Medical Editor, [email protected] Financial disclosure: None Managing Partner, ClearChoice Custom LASIK Managing Partner, ClearChoice Custom LASIK [email protected] ClearChoice Custom LASIK Center, Ohio Center, Ohio Center, Ohio      going to be a huge step forward. step huge a be to going are we surgery, cataract in Currently upgrades, of number fair a doing enjoying are people think I and The this: is reality the but that, not they’re but good, are results to rate conversion The perfect. tethered is procedures upgraded not we’re and predictability, to was RK how like It’s yet. there quite LASIK then and great, not but good more much was it and along came going are Lenses safe. and predictable going we’re and better, much get to about confident more much be to patients that results the achieving has surgery lens Refractive want. forward, step major a taken already I and pop, totally to going it’s but horizon. the on that’s think refractive and cataract surgery markets? DR. WILEY: is lenses of exchangeability or n WILLIAM F. WILEY, MD n n n n n JEFF KISSINGER n n Robert G. Wiley, G. Robert

Bill has his dad’s desire for wantingfor desire dad’s his has Bill “BILL HAS HIS DAD’S DESIRE FOR WANTING TO BE TO BE WANTING DESIRE FOR HAS HIS DAD’S “BILL THE FUEL THAT DESIRE TO BE FIRST IS FIRST. ...OUR INNOVATE.” DRIVES US TO CRST: Based on your experience, BasedCRST: on your experience, the nextwhat’s big thing in the offer all-laser LASIK using the IntraLasethe using LASIK all-laser offer &Johnson (now laser femtosecond theof one was He Vision). Johnson ORAthe use to country the in first AberrometerWavefront Intraoperative (nowTechnology VerifEye+ with thein first the was he and Alcon), &(Johnson Catalys the use to region (Lensar)Lensar and Vision) Johnson refractivelaser for lasers femtosecond firstbe to desire Our surgery. cataract innovate. to us drives that fuel the is with optometrists, which was another was which optometrists, with the at controversial was that initiative and time, his of ahead was He time. well. as is Bill withcomes that Sometimes first. be to gowe when because tag price big a butwell, go always don’t things first a being for pay you price the that’s stayto try we risks, the Despite leader. tofirst the be to edge, cutting the on everything. about just with market toarea the in first the of one was Bill CRST: Cleveland Eye Care is known for Eye Care Cleveland CRST: is known for being first Can things. for many you give a few examples? MR. KISSINGER: ophthalmic first the of one was MD, phacoemulsification doing surgeons country—which, the of part this in intense to open him left way, the by that of opponents from criticism became he Then technique. disruptive comanagement in involved heavily | AUGUST 2018 | AUGUST

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We are keeping ankeeping are We I think it’s our unwaveringour it’s think I practices were even considering even were practices key that’s thing The this. like systems interested engages it that is this about the of beginning the from parties patient the where that’s and process, starts. experience MR. KISSINGER: patient the elevate we that ways online our through is experience our into ties that system scheduling initiated We operations. desk front other before ago years many this the overall picture. Our brand, ourbrand, Our picture. overall the ourand referrals, our reputation, excellentthan more about are future ofup made is success Our outcomes. sumthe than more it’s yet parts, many parts.those of the best possible patient experience.patient possible best the focusedsingularly were we on, Early result the that thinking outcomes, on soonwe but priority, patient’s the is journeypatient the that realized intoplays process entire the through DR. WILEY: everyin excellence to commitment alwaysare We practice. of facet whileoutcomes improve to working createto takes it everything doing also of private equity attention, but we but attention, equity private of thisat specific anything have don’t to.open are we that time the secret What’s CRST: makes that Eye Clinic and ClearChoice Cleveland Custom LASIK successful? two high-volume surgery practices,surgery high-volume two reputationexcellent an has he and abroad;and States United the in internationallyan has practice this definitelyHe’s brand. recognized lota drawing and calls phone getting diversified practices like yours. Is equityprivate your future? in MR. KISSINGER: ais Bill think I that. about mind open investmentthese of many for target runshe young, he’s because companies CRST: Private equity Private CRST: investors are scouringfor large, CATARACT & REFRACTIVE SURGERY TODAY

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