Why Myopia Management Needs a Federal Framework Now

Optometry Profits Reveal with Tony Sommer

Peter Precht speaks with Tony Sommer, the recently promoted CEO and CCO of Treehouse Eyes, about pediatric myopia management, category education, and how the eye care industry is evolving around early intervention. They also dig into contact lens history, online eyewear ordering, insurance, and why patient access is not the same thing as patient care. In this episode, Tony shares how Treehouse Eyes operates, why myopia management should be treated like a disease, and how education from optometrists, pediatricians, and even schools could change outcomes for children. They also explore the tension between convenience, business models, and clinical responsibility in modern optometry.

Key topics

• Tony explains Treehouse Eyes as a mission-driven myopia management organization focused on helping children get better vision for life.
• The company owns three clinics and also supports a broader partner network with coaching, mentoring, accountability, and operational guidance.
• He breaks down House Resolution 2527 and why a federal framework for early vision screening could mirror the success of early auditory screening in children.
• Tony discusses the medicalization of myopia, including the AMA resolution that declared myopia a disease and why that could eventually influence reimbursement.
• Peter and Tony compare monovision, multifocal, and the practical challenges of contact lens fitting, especially for presbyopia.
• They talk through Treehouse Eyes’ global fee model, including why the practice does not take insurance and how that gives clinicians more freedom to adjust therapy.
• Tony emphasizes that insurance improves access, but does not guarantee care, and that trained clinicians are what ultimately matter.
• The conversation covers how parents often know very little about myopia, even though screen use, low outdoor time, and genetics all play a role.
• They examine the gray area around online eyewear ordering, including the benefits and problems of direct-to-consumer models like 1-800 Contacts and Warby Parker.
• Tony shares how a strong in-person optical experience changed his own frame selection for decades, reinforcing the value of skilled opticians and personalized care.
• They close by returning to category education, pediatric referrals, and the importance of getting in front of families earlier before myopia progresses.

Timestamps

00:00 - Introduction to Tony Sommer and Treehouse Eyes
 01:00 - What Treehouse Eyes does for pediatric myopia management
 02:20 - Why early vision screening matters for children
 03:30 - House Resolution 2527 and the auditory screening model
 05:00 - Tony’s contact lens background and presbyopia history
 06:20 - Monovision, multifocal, and fitting challenges
 10:25 - How Treehouse Eyes uses a global fee model
 12:27 - Why the AMA calling myopia a disease does matter
 14:10 - Pediatricians, screens, and early family conversations
 16:20 - Myopia prevalence and the limits of single-vision correction
 18:20 - The challenge of online ordering for myopia management patients
 20:40 - Insurance improves access, but not care itself
 23:03 - 1-800 Contacts as a convenience-first technology shift
 26:15 - Warby Parker, showrooming, and the return to physical retail
 31:15 - Consumer ordering stories and why convenience drives behavior
 35:26 - Tony’s own frame selection experience with a skilled optician
 39:34 - How HR 2527 could create infrastructure for broader screening
 44:48 - Treehouse Eyes’ category education and new patient intake model
 47:40 - Why myopia education is still the biggest missing piece
 51:33 - Tony’s Appalachian Trail story and the value of recharging

Key frameworks

• Global fee model - A bundled care approach that simplifies the experience for parents and preserves clinical flexibility.
• Category education - Teaching the public, pediatricians, and local providers that myopia is a disease and should be addressed early.
• Referral matrix - Building stronger referral pathways between optometry, pediatrics, and other care providers.
• Locus of control - Tony’s way of emphasizing that practices should focus on what they can directly influence, like local education and referrals.

Notable quotes

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“Insurance helps with access, but insurance in and of itself is not care.”

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“Myopia is the disease and should be treated as such.”

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“What I loved was I got my eye exam and the optician looked at my face and said, we’re going over here because these will look better on you.”

Tony’s links

• Treehouse Eyes: https://treehouseeyes.com
• https://www.linkedin.com/in/tsommerjr/?lipi=urn%3Ali%3Apage%3Ad_flagship3_profile_view_base_contact_details%3ByRMefR4mQeyL0%2B3yAZOiKA%3D%3D

Talk with Peter Precht: www.eyecclearly.com

Transcript

SPEAKER_01 0:02

Welcome to another episode of Optometry Profits Revealed. I'm your host, Peter Precht. Today I'm with Tony Summer. Tony Summer has had a 22-year career in eye care. He started off as an Air Force Academy veteran, and there's several different things that you've gone through. Rather than me got diving through them, I think I'm just going to introduce you. Thank you so much for being here, Tony. Thanks for being here.

SPEAKER_04 0:32

You bet, Peter, and thank you for having me.

SPEAKER_01 0:35

I know, you know, we'll start off with where you are now, and congratulations to that you're the CEO and the CCO, uh recently promoted of Treehouse Eyes. Talk about the culmination of your journey getting there, but talk heavily about them right now, what your responsibilities are there, and how you guys function in the eye care environment.

SPEAKER_04 0:59

Well, Treehouse Eyes is very mission-focused on helping give children better vision for life. We are focused on, and no pun intended, on pediatric myopia management. And that covers a number of different products and therapies. We're agnostic on those. But we own three clinics where we see patients regularly. And we also have a large network of partners where we help them do their own myopia management programs, and we provide uh expertise, guiding, coaching, mentoring, accountability, and services to help them on their own myopia management journey. Our entire focus is on helping more children be seen. That's what we do.

SPEAKER_01 1:58

We know that that at least we're able to see something impact the you know the development of myopia. But at the younger ages, you know, talk about that. How how how are we you just mentioned the beginnings of this started in all in Audi, in audio, which I found kind of interesting.

SPEAKER_04 2:21

Um so what yeah, I what I found interesting, um, if you think through myopia management, it started as kind of I'll call it frontier science, right? Because we kind of don't know why we get myopic. Right, we know axial links involved. So as you start thinking about how quickly we can spot this, you've got that dynamic. So you've got kind of indications, and then you've got products to treat it, but nobody's starting at the beginning, right? So, what what I came across is something called House Resolution 2527, and um and I came across it because of advocacy by the Myopia Collective and the American Optimetric Association getting behind it. Now, what is House Resolution 2527? It provides a federal framework for vision screening and testing at a very early age. And why is that interesting? Because it is fashioned after a similar law that was passed in Congress and very importantly had some budget around it and a regulatory framework for auditory. So if you do some more digging on this House resolution 2527, you can find that auditory maybe 3% of the children at the beginning of this century were were screened for hearing. Um, and 97% weren't. Well now, 25, yeah, 25 years later, they had a similar piece of legislation and a framework that was set up, and now it's 97% of children are screened for auditory at a very early age, babies, and that way they can be treated if they have a problem. And it's not a bunch of money, because most people think, well, federal government brings money. It's not that, it is a framework and an environment that allows state and local governments to go ahead and build programs and have an anchor point, right? I'm not very much into government affairs, I'm I'm not skilled at that. I'm a sales and marketing guy. Um, but you know, myopia enthusiast, you know, but very exciting about that because it allows other people who do this thing to have that framework. Think about what will happen if we can do vision screening that early.

SPEAKER_01 4:48

Well, the implication is unbelievable. To me, like you talked about axial length, I bet you we can find other reasons. I bet there's other, you know, obviously the more you look at something, the the other data you're gonna find.

SPEAKER_04 5:00

I mean, there's tons of research.

SPEAKER_01 5:04

Yeah, so the opportunity is there to expand out in in eye care in directions that we may not even be aware of at this point. And that I think that that's to me that's fascinating. Now, most of your career has been contact lens, and obviously we talk a lot about frames and lenses in this environment. But I want to talk about something specific because I'm fascinated with it, but I want to talk about monofit. We we touched on it very briefly before we started recording. Talk about those experiences and then talk about the SEMA lenses and then your your bisticons, you know, just like what did you see? You mentioned a lens a few minutes ago that ended up being being ideal for another treatment, and it was a multifocal lens, and I don't remember the name of it.

SPEAKER_04 5:52

But right. Yeah, so um my own personal uh journey through vision care has been through manufacturing, right? The manufacturing side industry. I don't um I'm not a clinician myself, never worked in an optometrist's office. Um and and I learned about contact lenses and and you know just from being a user when I was very young, coming out of school. So when I started working in in vision care, I had products for presbyopia, multifocals. I had no idea what they're for because I was not a presbyopia at the time. It was uh I was much younger then. But I learned that ways to treat um presbyopia were to do mono monovision, right? One near, one far. My father, that's how he was treated. Most a lot of patients that I knew were treated that way. That was kind of how you were taught to do it in soft contact lenses at that time. Fast forward, we had multifocals that we were trying to market, and the magic of multifocals was that you didn't have to do monovision, right? Right. Um and and the interesting thing, even with that, is that for contact lenses in presbyopia, for the most part, it is time consuming. Um, it does not give the benefits that patients want because they're used to seeing perfectly, or with their single vision contact lenses, and they have crisp effective vision. Well, you have a lot of trade-offs with the multifocal, and even with monovision, you have an adjustment period. So a lot of uh optometrists shy away from doing contact lens fits, and they'd rather do progressive spectacle lenses. It you know, it was more impactful. You had an entire infrastructure to help train and for the patient to adapt. They had potentially uh a better effect. I've never worn them, I've always worn contact lenses. So it it was just that was what I learned, right, with monovision and monofits to your point.

SPEAKER_01 8:03

Right, right. And you know, it there's no question that there's a heck of a lot more flexibility, there's a lot of adjustability uh with a set of glasses, there's a lot we bring them in and out and up and down. You know, you don't have those kind of you know uh abilities with contact lenses, it's it's very finite. So you've talked about this multiple visits, you know, those scenarios that aren't a good fit for whatever may be going on, you know. I think of eons ago, when my when my oldest was born, I remember fitting a guy who was came in seeking a progressive lens. And the problem was that as I talked with a guy, he had had neck surgery, he was wearing an executive. I mean, I was telling a nightmare back problem back to myself. That you know, you know he ended up listening. Uh and and thankfully that it ended up going away that that you know that was seamless and easy. But that's not fun. It's not fun to take somebody and curve them away from what they want, which is exactly what people are probably dealing with at optometry. You know, if an OD is dealing with a monofit, that's it's challenging. We're back and forth, or they may not know distances that they live in, work in, whatever may be the case, you know. Tony, I'm gonna stop this crazy beeping for the cat feeder behind me, so this will get edited out.

SPEAKER_02 9:29

Hang on one second. No worries.

SPEAKER_01 9:48

Um so uh, you know, as you as as we as we talk about um that contact lens journey and and how you've been through different places and how that how that's plugged into. What did you bring with you from that that helped you get involved with the situation like Treehouse Eyes? Because that's I don't know, that seems like such a dream situation to me. But probably it it it probably you probably see uncomfortable things, but at the end of the day, you know there's answers coming. And and you and it's not has nothing to do with insurance. So talk about what you guys are, how does that work?

SPEAKER_04 10:26

Okay, so for um treehouse eyes, we are uh a global fee environment, and we don't accept insurance. So um uh a parent brings their child in, um, and they've been they've had education about the entire myopia management category, what to expect, uh, what the visits are going to look like. They come in, it's an hour-long workout, and it is a comprehensive exam. And uh at the end of the journey, they enter generally a um a two-year commitment with us because we set up follow-on and follow-up appointments. Um, the doctors, the clinicians um pick an initial therapeutic direction and they go from there. Now, why do we do global fee? Um, global fee is simpler for our patients and it is allows clinical freedom for our clinicians. So because the other thing is if the treatment, if the child isn't responsive and we're seeing them on their three month, their third month follow-up, right? The clinician can say, well, this isn't going where I want to go, or I need to do a combination therapy, and they just do it. So that's why we charge a global fee because it allows for um the clinician total freedom, and it is easier for the parents to understand.

SPEAKER_01 11:56

That makes sense. The well, the flexibility that you kind of need to be there. Um I know we're uh ping-ponging around a little bit here. Um back to myopia management. Uh, you had a post a week ago or something like that where you were kicking around, oh, so we should we make it billable? Should we not make it billable? Um I'm gonna let you kick that one around. I don't know. I really don't know. Uh I don't, I just don't know.

SPEAKER_04 12:27

So um I'm not an insurance guy, don't know much about it, right? But what really piqued my interest in June was the um American Medical Association in their General Assembly, they had a resolution called um 411 or 411, which I thought was interesting, right? Yeah. For information. And they they declared that myopia is a disease and should be treated as such. Yep. Right? So you've got the you've got the physicians saying it. Now, why was that interesting? So optometry pretty much has been the leader of myopia management, and and probably will continue to be that place. There are more optometrists practicing myopia management, and a lot of the products are focused on optometrists. And ophthalmologists they don't do that, pediatricians don't treat it, etc. etc. But what this does is it sets up a chain of events that could eventually lead to reimbursement through medical insurance companies. Now that's not gonna happen next month, it's not gonna happen next week, it's not even gonna happen next year. There are a number of wickets that you have to go through in order to have CMS take it on, um, get codes set up, um, have um funding by the federal government, adjudication on that, lots of commentary, the insurance companies have to take a look at it. There are tons of stakeholders and tons of moving parts in some of the world's largest bureaucracies, right? So this is not a this is gonna happen next year. Um but what I find fascinating is that though this is this is what I've always considered an optometry owned thing, it's taking the physicians are now interested in it, right? Which opens tons of doors for screening of children and referral at that point. Because a pediatrician, if they're um up to speed, motivated, educated about this latest uh idea of what's going on, might start talking about uh myopia with mom and dad, right, when they're bringing in their child, no matter what the age. And you've all seen this, you've seen this in practice, you see this in clinic, you see this in the dispensary. Children holding on to a phone. Everybody's glued to a screen, right? So that's gonna have that's happening at a very young age now. Um and so pediatricians will now start remarking on it, not just the optometrists or the opticians being the bad guy if you think about it, right? Because how many times have you been in practice been asked, well, can you give them the talk about it?

SPEAKER_01 15:26

You're right. You're all right, yeah.

SPEAKER_04 15:28

You get to get a bad guy.

SPEAKER_01 15:30

Yeah, share some of that, you know, schmutz. You you get you deliver the bambies too. I kind of that's actually a good thing.

SPEAKER_04 15:38

Um yeah, and then referral comes from that, right? Well, you should go to so-and-so, um, you know, uh another medical professional, and you should get this treated or looked at or what have you, and then it can enter the the uh referral matrix and co-management. So, yeah, I mean it's a good thing. Uh what category education is a good thing. And if category education is done by more people with authority, whether they're within um the dispensary, the lane, or now in your pediatrician's office, um, that's a good thing, right? Because most parents don't know about myopia. They don't.

SPEAKER_01 16:18

Well, that's exactly what my next question was like, you know, what percentage of parents have a clue? And you're right, it's probably pretty low. That's yeah.

SPEAKER_04 16:28

Some stats I've seen is 30% of our children have myopia, and less than 5% of them are in formalized treatment for it.

SPEAKER_01 16:36

Hmm. That's crazy. Or it's what's even more disturbing is to think that they could go and get it treated in a generic way and make it worse.

SPEAKER_04 16:45

I mean that single vision. Um, you know, and and there's so many factors that go into it. You got screen use, you got lack of outdoor time, you got a number of different things. You got genetics, which in the old days we thought it was just genetics, right? And then you can see the research from some of the earlier researchers talking about, well, no, it's visual demand, lots of visual demand.

SPEAKER_01 17:12

Which it's again, you know, what percentage of that is going to the pull, to the to the jump, you know, why, you know, like like we were saying, we know how to connect a few dots, we still don't understand what the beginning of it is. And that seems bizarre to me that we've been uh doing this as long as we have, not you and I, but the industry. And there's some pretty there's some pretty big holes there that that that maybe ought to make a little bit better uh sense than they do. You know, to me regarding the billing and the and the non-billing aspect of it, you know, the the fundamental non-component is that at the federal billable level, optician doesn't exist. So there becomes some problems there uh when it comes to implementation of products like any myopia management lens. Um you know we here's up here's ugly softball that neither of us have an answer to at all that we mentioned before we were recording. Okay, somebody comes in and they're they're they're it's blatantly clear you're gonna enter a myopia management uh uh program and uh they want to order their glasses online.

SPEAKER_02 18:43

I wouldn't Yeah, right right now they wouldn't be able to. Right. Uh but if enough of them want to.

SPEAKER_01 18:53

Yeah, it's I I don't I don't have an answer for this. And and hopefully, hopefully, right now that's easily remedied and built through, and I don't and I don't know the full ramifications of it. I I really don't. Uh I know that there are places where uh you know things can get built and things cannot get built. And the fact that 411 took place to me may open the door as we're putting legislation together to become certified here to actually acknowledge and put on paper that an optician exists, considering there's hundreds of millions of people that refer to their optician or themselves as one. So, you know, it it's a strange and mighty thing to think how uh political and insurance can can weigh in on the terminology, which ultimately creates a billing code, which kind of answers the question for us. You know, uh it obviously the optometrist has some vested interest in billing with this, but you hit on it earlier. If all the errors keep pointing back to some practices that maybe they knew or not, it didn't help people down the road, you know. Took little Bobby from a minus four to a minus twelve by the time he was ten, you know. Okay, whoops, sorry. Well, what again? How did this end up happening? If it's gonna be billable, is the insurance gonna be any better get to the bottom of that? Uh nice long pause. I think we kind of know the answer to that one, or at least what we tend to think. Yeah.

SPEAKER_04 20:41

Um well, yeah, insurance helps with access, right? But insurance in and of itself is not care. And we know that right, right, you've got what I have in my pocket or the the group number that I give when I set up the appointment does not guarantee care. It just helps you with access to the care. So I think you answered the question of whether it'll be any better. But uh for me, it really comes down to clinicians who are trained in this. Um, other countries it's done by opticians, right? Um particularly in the United Kingdom and Italy. Right. You know, so um yep. So trained personnel um who are committed to the craft, because this is a specialty. Um right now it's considered a niche, but it's not. I mean, it's all around us. And you know, you just need to educate the public so they know the questions to ask and the fact that they need to seek professional help and then enter the program and get it done. There's lots of ways to do this.

SPEAKER_01 21:56

Which is probably the best part about it. Um Um the uh how there are a lot of ways to implement care, to take it into action, and a lot of different tools, you know, that are at the fingertips. Um that literally Yeah, uh that that have been in use for a lot of years, and uh uh so it's not it's it's not as if some all techniques are bad, you know. It's uh thing things have been productive in helping curve, you know, some of the some of the problems with with my opia getting so bad from someone so quickly. So let's let's talk a little bit. I asked you to kind of kick this around in your head before we started going about a a tech experience uh uh over your time that was good and then maybe not so good, and then I'm gonna kick off a new segment with you after that. So give us a thought. Give us a thought of a of a contact lens or a dispensary experience, whatever. Give us a tech that that you think was a game changer and you loved it, and then maybe one that wasn't.

SPEAKER_04 23:03

So we could go really old school and talk about what is usually a taboo topic, which is 1800 contact lenses, right? Okay, so that's a huge, huge technological game changer because it first used the phone, but it went online pretty rapidly when online became the thing. And tech experience, it's really good. It's got a great user interface, it's easy to use, it is seamless for you as a patient. Um, I've had family members who've used it. I personally haven't because I was in the industry. And um and it's wonderful if you're direct to consumer. The biggest issue, of course, is it's not the what, it's the how. And the how is what it really falls down on because it becomes um not as inclusive. You have other stakeholders like the optometrist who needs to verify the prescription. And the way it was set up is that you know it's automatically verified unless you, you know, proactively deny it. And that's the biggest rub, right? That was the biggest rub because then you have you have revenue share and you have all sorts of issues and complications. So great technology that helps potentially a patient, but it may not help the patient because the patient has an old and expired prescription, so it's not the right prescription, and they haven't been evaluated by a trained professional. And then you've got you've got channel shift as well, right? Business-wise, um, both as an optometrist or the um or the manufacturer. So it's it's one of those double-edged swords.

SPEAKER_01 24:54

Um patient convenience pushed it, but there's those there were those stupid holes. Like the things I remember being super annoyed about as an optician would be somebody who s seasonally knew to order their year supply at 11 months.

SPEAKER_00 25:12

And would only ever have a contact lens exam every two years after they people blew a fit, you know.

SPEAKER_01 25:19

And you know, they had it staggered just perfectly. I mean, they knew they were never gonna be. They were professionally uh professionally lens exam and avoiders avoiders or whatever the call, but they're non-compliant, and you know, getting an eye exam is easy and efficient and effective, right?

SPEAKER_04 25:42

We just know we're we're all fans of that. So I you know, people who who who are dodging it as a as a lifestyle, I I don't I don't get that because you can't especially in the contact lens world. I just never could understand that at all. You're you're not gonna see as well, right? You you've got an old expired prescription. So yeah, so that was a bad one. Um good and bad. But convenience drew it, not pricing, right? It is convenience. Absolutely. And you know, and and that's where we're at now, and there's other ways of of doing that that are more compliant. Um so then the the other technology story that I thought was interesting from this is Warby Parker. So think about it. Warby Parker started as a direct-to-consumer play. Um, and people loved it. They loved the style, they loved the lifestyle, it was really, really well marketed and produced good results, right? So I had several family members who who got their who got their uh Warby Parker lenses, and they they they called them Warby Parker glasses, right? So that was the thing. Right. But yeah, but you could tell that there was something missing from the business model, because we talked about, you know, someone someone adjusts my Warby Parker glasses if I walk in in a at at any shop, and some might and some might not, on a matter of principle. You know, I didn't dispense them to you, so I have no obligation. But right, you could which was an unintended pain. Yeah, it's an unintended pain, right? But then but then Warby Parker saw the benefits of having a physical presence.

SPEAKER_01 27:19

There you go. And it they did a little zigzag. They started off then heavy online and came back and tried to like change their leases because they did cut all those leases for a small window of time. I don't really understand what the philosophy of that was. Maybe they were thinking they could shift completely to online, but you are so right. They came back with a presence. And if you go to a mall, you can watch and the the watch, particularly young girls, well, they'll look at all these frames online, they'll have three or four, they'll go in and try them all on and look in the mirror with them on, put them back and go to the bench out of the mall in order.

SPEAKER_00 28:01

And that's it's it's yeah, exactly. It's well, it's but it but it's also right. Mod pizza that way.

SPEAKER_01 28:14

Yeah, well, you know, that fits their lane, it's relatable, it it's important to them, and let's go forward to where where Warby Parker is involved in education in Indiana at the high school level. Um, okay, any other optical, you want to be critical, be critical, but talk tell me you're doing that. Tell me that you're educating high schoolers in Indiana. Warby Parker is, they're part of it. Of course, do they have a vested interest of stopping remakes early in the process? Absolutely. And cultivating it within your own business structure, it's smart business. So split if it ends up with a smarter optician, I don't care. That works for me and it will work for me every day. So I think that's really cool that you mentioned them because they fit in to some very unique places where they are destructive and they don't care if they are.

SPEAKER_04 29:13

Um and that's just that's just you know business. And I'm in I'm in the business of patient care. So for me, I mean, I get convenience, I get fashion, I get good marketing. I totally get it. For me, it's about patient care, right? So that's why I wasn't a fan of the the 1-800 practices, you know, in when they started. And watching Warby Parker create a physical model with optometrists doing exams, right, in beautiful, beautiful retail settings. Um, because I saw them in New York for the first time and I was just amazed, and they were lovely. Um, I'm like, oh, okay, we've gone full circle. We've gone from uh a direct-to-consumer internet grab to a more sustainable, I thought a more sustainable patient care model, right? So that's where I came down on.

SPEAKER_01 30:12

I think it inevitably ends up reintroducing some elements that may not have been in that first segment of their retail journey. Um and again, the all these are all opportunities for education and existing optician groups to get involved. Um turn the page, meet patients where they want to meet. Um this is a great time to start off that the the new segment. I'm kicking off a new segment, and you kind of segue to it, so you may actually repeat yourself, but um the basically the new segment is for to tell an online uh eyewear ordering uh experience or story that you've heard of. You mentioned uh family. Uh if you have any others, uh go ahead and lob one up there. Good, bad, great, it doesn't matter. I I want there to be stories that are told because quite frankly, they are talked about within the industry in an open forum format, like we're going to do here.

SPEAKER_04 31:15

Yeah, well, I mean, the the the one that uh so there was the convenience of 1-800 contacts, and that was a good experience. And they my my family's not non-compliant, they just needed more contact lenses and you know, they ordered them. They were wearing daily disposables and they just worn too many, which is which is a great problem to have, right? That means they were very compliant. Um for for Warby, it was a lot of I get to try on all these frames virtually, I get to showroom this entire thing, and they got what they wanted, right? Um when it comes to and and it comes down to um consumer satisfaction at that point, because that's you know, if if you haven't been seen for an exam and you're not sure what your prescription is, and you're not having an actual person line everything up, right? Um then it's not really patient care. It's you're buying a thing, right? And then your your thing, if you don't have the people that are trained to have it work properly, well, yeah, you're taking that risk. Um, didn't have that problem with with my family. So they they loved it, they loved the ordering experience. Everything was built around the pay uh around the the consumer experience, just like any online business.

SPEAKER_01 32:36

That to me, that is so telling, you know, it built around the consumer experience. It you know, that I think is a part of the journey of getting glasses if you've never gotten them before. You know, if you're 19 and you get a new prescription in your hand, you know, and and and you and you don't have a vision plan or or you're not on your parents, or for whatever reason, you know, but that that's a what do you do? You know, how is that handled? Who does what? How is how how do I go about that in my life, you know, and how things traditionally change, like you talked about? An ordering experience, you know, the the 1-800 experience changed that in a clunky, aggressive, ugly way because they were pre-internet, but the whole thrust of it didn't go away for the patients. And I like how you sort of connected the convenient aspect of it with a succeed and a win on both ends, you know, and and and and you know, regarding Orby Parker, it was a win to give life back to certain people that maybe have a little too much invested, you know.

SPEAKER_00 33:53

We while before we were recording, you know the the young family with a kid, you know, two eye exams on a Saturday. Uh no.

SPEAKER_01 34:05

Of course they're gonna want to do that in any other way that they can really do it. Get in, get out, get your script and go. You know, they want their Saturday back. It's not that they want to spy so much less, it's that they want some of their life back. And, you know, you're working 45 hours, you're raising a family, you're trying to make sure you're not gonna, you know, run out of everything. It's it's a challenge. So the convenient aspect of it, and like you talked about, how gorgeous that the retail experience was that you went into with Warby Parker, that was pretty right. What a good combination, you know, what a what an interesting way to meet the people's ability and want to shop this way, but still do this, you know. When when I was interviewing um the optical Jedi, Rick Peralta, he talked about how his daughter does that. She'll look here, do all her homework here. I don't know if you're if you're seeing that, or you know, my my children are in their 20s, and I do see that. It they analytically analyze what they're going to do with their money, and then they'll they're tangible with when they spend it. I think it's a good thing.

SPEAKER_04 35:24

Um but I but we just it goes to retail 101, though, right? I mean, which is which which is I think the key to to the commercial aspect of opticianry, which is I remember the first time I bought frames that I bought, to your point, right? So I have had to wear glasses for a long time, and I got most of my glasses in the military. They're literally handed to me in a bag, and it's like I had four pairs and they all look the same. And luckily I was an aviator, so they weren't black frames, they were the silver frames. And to this day I wear them, I wear those frames, and I just have the spectacle lenses uh redone because where I live, there aren't very many people who are Air Force veterans, so I don't look like a dork, right? So so I wear them. But when I when I got to choose my own frames, what I loved was I got my eye exam and the optician I was given to her, and she looked at my face because I'm Hawaiian Chinese, I've got a round face, and she's like, We're gonna go over here, didn't ask me how much I was gonna spend, we're gonna go over here because these will look better on you, right? And yeah, it was. It was she took me over there. I have no idea whether I overspent, but what I knew was this person took me and explained and showed me what she was looking at when she put them on me, right? Yeah, you know, and it wasn't the bag of frames that I was handed, um, you know, that I would get every two years, right? Right, right. As an aviator. So yeah, and that that has stuck with me for all my life. And I choose frames based upon her recommendation 35 years ago.

SPEAKER_01 37:31

Again, uh, it's fascinating that that you can have a single experience that wows you at any service level. Um you you spend a fair amount of time on the road, so you understand the service components, and it I used to say this all the time, you know, there are places that I'll go where the service is outstanding and the food is bad.

SPEAKER_02 37:54

Yeah.

SPEAKER_01 37:55

But I'm there for the conversation, I'm there for the way to watch seamless beauty in action, you know, for lack of a better term. I mean, the food is as average as could be. But the people really flow in a in a in a way that is, you know, when you see something run really smoothly like that, the operations that are run like that, practices that are run like that, um that's a really good example, actually, because they they are crazy, crazy busy, and they do get the they're designed to get people in and out very, very quickly, and they do a good job of it. It's not sloppy either. They're you know, they they do they do it in a very, very direct way. But but the production line part is encouraged in our industry, and and you and I tend to want to slow this down at some level to make sure that care gets introduced to the right people at the right times. Exactly. It's all the earlier that we can. Well, you know, it are the are there that you're aware of, are there are there parts of legislation that that are introducing? I know Pennsylvania is is they just had something passed recently where that care goes very early into place. I don't think it had anything to do with 411, but maybe it did. But you know, is there anything well uh I tell you what, uh how about myopia being recognized at a federal level that you just mentioned earlier in this interview? I mean the impacts of that have got to hit policy, I would think.

SPEAKER_04 39:34

So yeah, so that that'll start that chain, right, with 411, and that's with the the AMA making a stand. What's interesting to me though, because you know my life for the last 12 years, uh 11 years, has been focused on category education about myopia with optometrists primarily and opticians overseas. And the key issue for it is that I always get I always get this. Well, wouldn't it be great if my schools gave everybody a vision screening and referred them to optometrists automatically? Well, sure, that's great. So do you talk to the school nurses in your area and you know offer vision screenings for all the children? Well, no. Okay, you know, what are you going to do? Locus of control, because yes, that'd be great if they did that. And I've talked to, you know, I was on the board of uh Global Myopia Awareness Um Council GMAC, right? And we would talk to um the National School Nurse uh Foundation and everything, and it's just it's hard to get anything done on a broad scale. But this is where something like House Resolution 2527 can start that because it gives the infrastructure, and then states and municipalities kind of know where to go if they want to get involved in that, and there's a little money, but not much, but they can tap and they can organize around that, and and that's the big thing because there's so many demands. But people always say, wouldn't it be great if this category education began? And that's where things like HR 2527 can do that. But every time um I talk to my own clinicians, it's like, well, how do we get more referrals? Have we talked to the local pediatricians? Right? And sometimes people push back a lot, you know. I don't know. I said you're you're it's lunch with friends, it's coffee with friends, I'm in sales, right? So to me, it's like, oh, I'm just gonna go visit you and we're gonna talk and just educate because to get a referral from a pediatrician is a gold standard, right? Um because normally they just say, Oh, go see the ophthalmologist. Here's you know, here's their information. But with this 411, it might become optometry, and that would be great, but start now. Start talking to other uh providers in your area about myopia's disease. Here's the thing. Let's have some coffee and talk about it. By the way, this is what I do, right?

SPEAKER_01 42:24

So there are oodles of uh regularly meeting networking groups that are connected with forums like alignable and whatnot, um, as well as others. But they're constantly meeting multiple times a week at at places, events, you know, and anything. You know, sometimes it's just a regular lunch. You know, I know there's one that's in York, I'm in Philly, so I never get to it. But it it's good to know that they're meeting and the diversity of people attending is kind of kind of out there. I mean, it the the networking capabilities are quite genuine. You know, the sooner that you can connect in with the next generation, that we we know we have a myopia problem. We haven't eliminated it. Like we've talked about here, we don't even know where it comes from. Um but there's a management that's in place and we're moving towards that, and we also know that it starts young. So it starts young, lots of shit. Getting out there makes all the sense in the world. Being in their face so they know the signs. Um you know, and yet it's one of those topics that's so gray for new parents. I don't, you know, uh, you know, you you don't want to be scaring, but by the same token, nobody wants to watch somebody go down that that that that journey of of you know being a mild myope to, you know, someone who, you know, couldn't get behind a wheel without uh glasses at all. you know so it's a it's a it's a it's a topic that is continuously changing and moving in in in in in the direction I think is is huge. That you know thank you for hitting on both aspects the contact lens and the classes aspect of the online ordering story because they were both a direct impact to your world and your family and I think that that's that's kind of cool. That's a good way to start off that segment. Is there is there anything that we did not hit on that you specifically want to talk about I I am amazed at the fact that that Treehouse Eyes is able to be a self-standing on its own entity um which you know when I say on its own I mean not attached to uh policies and procedures that are going to be dictated by an insurance group.

SPEAKER_04 44:48

Yeah I think yeah the the whole thing about what I love about Treehouse Eyes is it's focused on category education in our local markets. And there's a lot of ways of doing that right but what I think is interesting for us is we don't think of new patient sourcing as one thing. We have an entire group of activities referrals. Referrals is a big one we do do some local advertising but not much. We do have SEO marketing on our website and we've also bled over into AI right so if you type in myopia management wherever we are we show up right into your AI bot. We also do category education so that because we charge a global fee so the parents aren't surprised right when a parent hears gets a message from school like they're getting in the next couple weeks depending where we are Georgia they started where I live they started school last week so in a couple weeks you'll start getting notes from school saying your child I had to move them closer to the whiteboard right you might want to get their eyes checked that's usually how people find out right so you'll find that out and you'll be like oh I have to go to the eye doctor well I've gone to the eye doctor I've got enter your vision plan here so I'm expecting a $40 copay some cute frames and we're gonna walk out you know um but that's not the case for myopia management it's a disease it's a it's a big deal we do a global fee. So when they encounter us as a place they're gonna go get treated we have um they call it telehealth but it's we literally educate people on a Zoom call about this is what it is here's the experience you're gonna have in our practice and here's what you can expect to pay right so they're completely informed and then they come in and they go through the consultation they get the therapeutic recommendation and then they start the follow-up but they know that it's a program much like braces right right we know what to expect with braces I started saving for braces for my children the day they were born right right as we know chiropractic yeah there's a lot of like times where you're education on a program education is it was the next one I was going to hit on that and that's which makes the most sense obviously as you're stepping along and progressing towards stuff and physical therapy chiropractic all of those you know there's there's a regimen moving you towards from A to B. You're heading towards a goal you know of hopefully better health healing range of motion whatever your goal that's what that's what we do right we educate um our our prospective patient base on what to expect and this is not this is not unique to us you just talked about chiropractic I know about PT same kind of thing physical therapy you have these expectations you get educated about this that is the biggest thing missing from myopia management in this country people don't know about it and sometimes if all you did was read the stats they'd get scared of it because you're you're gonna be blind at age 50 if you don't do something about it and then they shut down.

SPEAKER_01 48:18

Well exactly and how much of us get data about things that we don't know that way.

SPEAKER_04 48:23

You know we can get scary internet stuff.

SPEAKER_01 48:25

Exactly and you know whatever the algorithm is going to scare you some more woo you know yeah so let's get on X and get really scared on X, you know but yeah it's yeah and I it's yeah so I'm proud of us doing the category education and the intake and for me it's all about patient experience.

SPEAKER_04 48:45

You could tell from the way my family responded to the two examples I talked about I really follow how people encounter our services and go through our treatment. It's very important to me because I want them to get what they want so they can get their Saturday back.

SPEAKER_01 49:01

Well you ask difficult questions and that's one of the things that really attracted me to you on LinkedIn is that you don't shy away from some topics that aren't really fuzzy and warm and and you know how are things going to move past the gray areas past the the the closed doors you know how are we going to do that um in an effective way to connect and bridge those gaps uh those the build the bridges that that that are missing you know we always come back to no no well even with even in Pennsylvania when we submit this legislation uh 26 we don't expect anything to be implemented on the ground until well into 27 if it even passes um if it even passes if there's restrictions and pushback and and there that could well be something that we face then you know we s we we seek who we can we tell the stories that we can and I think that you know we have a few heavy hitters thankfully in our our lineup so I think we're gonna be fine but you know building a legislative roadmap you know that that can uh be implemented in other places is is is is what we're trying to do and and connecting that care to uh delivery rooms you know as you and I have have hit on is you know it's the natural extension of what we do so moving in that in that direction gathering data finding things out we probably don't understand right now and then changing our policies as we go um I think that's about everything that that that that we're supposed to do in that care environment and again you know um at least myopia care has shifted and moved towards it which I think is is wonderful compared to when you uh you know certainly when I started and and certainly 25 some years ago when you when you began was there anything else that you wanted to uh add into this mix uh I will add that that I vicariously follow you uh live through your uh AT trail experiences that I think it's completely awesome I love uh that you document when you do it I also like um your follow-ups you know um when there's regular posts and then there aren't any where there's those of us that are like oh crap is Tony okay that you pull a hammy an easy on a rock somewhere well I got I I got a really good one from um so I ran into a bear um last Friday and posted Oh you did yes you did you did that was that was fun um so yeah it's it's uh I love the Appalachian Trail.

SPEAKER_04 51:49

I love it because you can recharge you know a walk in the woods as they say um my friend Tom Arnold actually gave me that book um so yeah it's it's a great place to go so you can think we talked about that and I love the social aspect of the trail because I you know I I hike alone but you're never alone on the Appalachian Trail. You run into people that you're in their life for five minutes or five years. And um so cool. I I think it's amazing.

SPEAKER_01 52:16

I think it's amazing well well there's definitely uh the the trail stories the the human connections uh with the AT trail and the same with the I forget the name of the one the the outwest which is even longer but that you know yeah PCT yeah I mean those stories are tremendous and they're about people connecting reconnecting recharging um I have a friend that literally calls that whenever he organizes a guy's trip it's recharging the batteries and uh and you the great thing about it to your point is you have no you're you're not a you're not a role when you're out there you're not a title you're not your place in society you are a nickname and how you show up at that at that moment right so if you show up with a lot of negative energy people are going to avoid you and be like goodbye right and now you you're the jerk with the nickname they don't they don't know what you do whether you're you're you could you're you're not the plumber that owns this very successful company you're just you're just a dude that's out there who happens to be really good at filtering water right so well and and the people there the people there tend to know that too and uh not all but most most of them have a pretty good grip that that that's part that's a lot of why you're there uh it's with it it's certainly about the overlooks and the beauty but uh the the reconnecting uh with the the planet and the people uh in that way you know when there are these woohoo you know we we're we're doing something right at you know at least in my mind um yeah so I love it absolutely thank you so much for this interview I I've been waiting a while to do this uh this is very very exciting and you know to to talk about uh how how we can impact at an early age how it can go through uh the journey that will take place before us that you and I are a part of is is completely awesome. Any links uh links to Treehouse Eyes to you Tony will be in the show notes by all means participate in the profit prescription quiz it helps to talk about online experiences ordering and tools to remedy any leakage in the practice. Thank you so much everybody for another episode of Optometry Profits Revealed. Take care