Optometrists Building Empires

Ankit Patel: ​[00:00:00] today is someone I'm excited to introduce you to and I think you'll be, uh, excited to hear his insights. He's an entrepreneurial optometrist known for his expertise in dry eye disease, ocular surface health and aesthetic treatments. Uh, he is a nationally recognized speaker and key opinion leader from multiple dry eye anesthetic companies in the eyecare space, and regularly educates fellow doctors on cutting edge treatments.

He is also the co co-founder of OD Immersion, a program designed to help optometrists successfully integrate medical niches like Dry Eye and Aesthetics into their practices. He's optometrist and owner of Eastern Virginia Eye Associates. Please welcome Dr. Shane Swatts. Shane.

Shane Swatts: Thank you. Yes. Thank you so much for having me on. I appreciate being here. I love these opportunities. Um, and I'm excited to, uh, have this conversation.

Ankit Patel: Yeah, I am too. I, I think you, uh, you have some really [00:01:00] cool insights from our pre-call and so I'm excited to jump into it. And, and so what was the most important thing that helped you grow your empire?

Shane Swatts: it's a great question. And um, you know, there's kind of a story that comes along with that a little bit. Uh. So around 2016 I started doing, um, a lot of things outside of the optometry industry, kind of getting insight from other industries on how I can implement some of what they do in eyecare. and that led me to some events I used to go to in California, which were all married businessmen.

We did a lot of crazy stuff, but I got to interact with people who. in coal mining, owned coal mines owned, airlines owned, all these different things. So I got a a lot of really unique insights and when I came back from that meeting, I came back and I told my business partner, who's also my wife my administrator and all my team, I was like, guys, I'm done seeing primary care [00:02:00] patients. They thought I was absolutely crazy. They're like, what do you mean you see patients five days a week? And, uh, my desire at that time was to back out and really focus on specialty services. And so that's actually what led me into the dry space. There was a short stint there where I tried to run the practice myself and realized I was really bad at that. So we ended up hiring an administrator. Um, and I got back into my domain in the exam room. But, um, you know, the prac, the way I practice today is very different than before. I only do dry eyes. I only do aesthetic. I've removed myself outta primary care and that was probably the biggest change that my practice has seen.

Uh, you know, it's funny because I removed myself from primary care and our revenue went up and I wasn't sure first how to take that. Right? But it was because I was bringing in additional revenue, higher revenue, not getting these small copays from, um. From vision plans. And so that was a really a [00:03:00] shift in our practice in how we do many, many, many things. From training to presentations to patients, to, um, you know, I was the guy in the exam room that used to be really nervous when I was doing primary care. If a pa, if I was sitting there with a patient, they had a concern about a $15 co. I was really nervous to talk about that. I would go get my staff members to come in and talk about it. And so from being in that place to where I am now, which is presenting a $3,000 package to a patient without blinking, is a

Ankit Patel: Yes.

Shane Swatts: Seems like a long distance to go. Uh, but we just developed strategies, we developed ways to do it. We developed language to talk about it. And so that has been the biggest foundational change in my practice since I started.

Ankit Patel: Interesting. Um, tell me a little bit more how, how that all works. So, I, I heard a lot of different moving parts there. From getting yourself outta the business to having a str like I think it's a strategy is what you said.

Shane Swatts: Yeah,

Ankit Patel: like, we're gonna be cons, we're gonna have a focus on these patients. Um, tell me how, [00:04:00] how you implemented that, how you think about that.

You did mention something interesting that I want to hone in on. If you expand on more, you, you mentioned how everything sort of aligned and, and then you went to the story of, if I have to worry about a $15 copay, you know, I went from that to selling $3,000 dry or packages. Um, yeah. How, tell us, talk about the transformation, how that happened.

Shane Swatts: Yeah, it was very interesting. It was really trial by fire. You know, I was a early adopter of IPL. I remember when. this was when I was actually in the practice attempting to run it. We eventually hired an administrator who's much better at it than I am. I'm really a big fan of hiring the professionals, right?

I'm not a professional business operator, so I hired a CFO slash admin. um, I, I, I had read a little bit about IPL. One day a rep came in and. me about a three hour lesson on IPL. I bought it that same day, really kind of sight unseen, and that started my path [00:05:00] down this, um, specialty services. And we've branched out into myopia management and scleral lenses and all these other things.

But really it was, it, it was a bit of trial by fire, meaning that I had to learn really quickly what words to use, how to connect with patients on a personal level. to get them to truly understand their disease process so that they would want to invest in advanced treatments. Um, and so a lot of that, you know, we, we use as part of OD immersion, so we learned to do this and then we went out and started teaching other people. But there's a lot of neuro finance principles. There's a lot of really being specific about your treatment goals. Um, there's simple things you can do. You know, the first 10 seconds you walk in the room. Is really where the, we always talk about us judging patients. Patients judge us. Those first 10 seconds are really important, right?

Right. So what I used to do is walk in the room, shake their [00:06:00] hand, and I realized I was immediately then turning my back to them. Wrapping my cabinet, putting my gloves on while I'm still talking to them. Probably one of the worst things you can do, right? So I, I learned that I need to walk in, I need to shake hands.

That physical touch is important, that eye contact is important. Um, and there's this concept that we use an old ODI called the golden minute, which is really where you sit and just listen, right? We, as doctors oftentimes will, hear what the patient's saying. And then immediately interrupt with our, um, our advice or our input on that as opposed to just sitting back and listening. And I actually learned that from my consulting partner, Chantelle Garcia. And it's, it's great advice. So a lot of it is also speaking to the patient in a way that you are not speaking to the prefrontal cortex, right? You're not speaking to their analytical mind in the beginning. You're speaking to that crock brain. Right. That brain, the part of the [00:07:00] brain that really is determining fight or flight you want them to, you gotta earn their trust. And if you don't get in there and speak to that part of the brain using certain techniques, then they're starting to dissect. They're trying to figure out when you first walk in the room, can I trust this person?

Ankit Patel: Yeah.

Shane Swatts: Or can I not trust this person? And so my first, you know, my first two, three minutes in the room is just making sure they understand I'm there to help them gaining their trust. And that's again, through multiple, multiple means, um, multiple strategies,

Ankit Patel: How, how were, were you always naturally that way? Did you always like try? Okay, so,

what was a journey like that? How'd you get here? Right? Because that is amazing what you just said. Like it is that, that is like worth its weight in gold, what you just said. Um,

Shane Swatts: so it, it was a lot of studying, a lot of, uh, listening to books and podcasts that are not I related. Right. Just to see kind of how other, other people do it. So there's, there's books I've read Pitch Anything. Great book. Great. Great [00:08:00] book. Yeah, so multiple books, multiple, um, you know, listening to people outside of our industry, crucial Conversations is a really great book. And actually what we did with our staff, we were so impressed with it that we bought a few copies of the book and each week we would give a different staff member a chapter that they had to present, right?

And so not only were they learning, but they had to teach it to the rest of our staff. Uh, but simple, simple things like that. Getting outside of our industry. and listening to kind of how other people do it and what we can apply into our industry, I think has really been one of the strongest things.

Ankit Patel: what did you struggle with the most as you were growing at your empire? Like either you see, yeah. What was the biggest, like, most visceral, like, oh, that was hard.

Shane Swatts: it's that looking at the pa. So I'll tell you a couple mistakes I made 'cause I think, I think listeners would probably appreciate this. of the things I did in the beginning, so we bring people in for dry eye evaluations, right? I, when I first started, felt like I need to, [00:09:00] almo needed to almost overexplain everything. So my evals were an hour long. I was giving them all this education. Here's all the layers of your tear film. Here's are meibomian glands. And by the time I was done, my patient's eyes are glazed over. They're looking at me and you know, I, I learned this after I left the room and my technician was in there kind of closing. She finally said to me, Hey, they are so confused when they leave because of all the information you gave them. So one of the most important lessons I learned was, say less. don't need to convince them that they need this treatment. We need to educate them. Using the words that we know, and I oftentimes use, uh, and keep the, the glaucoma analogy, right?

If I have a patient sitting in the chair and they are 0.8 cups with retinal nerve fiber layer defects and pressures of 30, I don't go in the room and suggest treatments. I go in the room and I know exactly what I'm recommending. I also don't explain every single type of glaucoma to them, [00:10:00] right? Uh, I explain their main type of glaucoma, but I'm not going over angle closure, A chronic open angle, pigmentary. I think with dry eye, we feel the need to really explain everything. So my definition of dry eye, and I asked this to a lot of doctors I work with, I said, tell me, tell me if a patient just said to you, what is dry eye, what would you say? And I get these really long, drawn out explanations. Dry eye for me is the inability to produce quality tears. That's it right now. Does that cover all instances of dry eye? It doesn't, but explaining a patient, opening a glaucoma also doesn't explain all the different glaucomas. So I just want them to understand in simple, relatable terms what I'm referring to. and so what I found is when I started really backing off on trying to feel like I had to overeducate them because the price of the treatment was high, uh, that's when my conversion started taking off more.

Ankit Patel: Yeah.

Shane Swatts: Less is [00:11:00] more. And, and that's, that's really what I found is say less, give them what they need. If they have questions, I'm armed with all the information I need to, to give to them. But that was a big turning point for me too, not only from a time standpoint, but from a conversion standpoint.

Ankit Patel: Yeah. curious, so your practice, correct me if I'm wrong, you have five doctors now, right at the

Shane Swatts: We

Ankit Patel: or

Shane Swatts: to

Ankit Patel: four, five.

Shane Swatts: Given time.

Ankit Patel: Okay. Uh, ish. Somewhere around there. Which is a lot, right? There's a lot more than one, which a lot of folks listening may only have like one or two, and so. You work with a lot of doctors, right?

And so you've seen your own journey. What do you see when you work with other doctors to help them grow? What do you see as their biggest sticking points? Like where do you see the most common? Like, ah, they struggle. Like this is tough for doctors

Shane Swatts: It's the language.

Ankit Patel: Language. Okay.

Shane Swatts: Language is really, really, really tough for doctors to get because we, as doctors, I think even when we feel like we're speaking in simple terms. It's complex, right? It's so if I have a patient and, and I, I do this, uh, every day with, with docs we work with, [00:12:00] um, you know, I'll say, okay, well let's, let's talk about your presentation.

What do you say? And their response is, well, I show the patients their glands. I tell them that their glands are dying. I explain the three layers of the tear film and I say, stop, you already lost them. That's way over their head, right? And so, simplify it. simplify, um, and really try to, um, give the patient just the amount of information they need to make a decision. And again, we can always go back and educate them in other ways. Um, via emails, drip campaigns, all these other ways, and we do that. But, um, I will tell you, we work with three main buckets of people that reach out to OD immersion, and that is number one, the people who are interested in getting into the dry space, but really don't know the difference between IPL and RF and RF microneedling.

They don't know all the devices, so they're just like, okay, where do I start? we have the people who bought a device, uh, you know, made that investment great for them. And I'll say, awesome, how [00:13:00] many treatments have you done over the past year? And the response is, oh, I've done three. And it was my dad, my nephew, and a staff member. like, okay, that's horrible. We want to get you going. Well, let's get you going. That's an expensive device. We want ROI on that in three to six months. And then the last bucket of people are the ones who did really well from a dry eye perspective. And want to now advance into aesthetics. So all those categories of people have different needs, different questions, different uh, priorities. Um, so, you know, to answer your question, it really depends. Uh, but I would say the main thing that people struggle with is, what do I say? What language do I use during this dry eye evaluation? Right? And I'll give you a little bit more. We in our office never say dry eye.

Ankit Patel: Okay.

Shane Swatts: We call our evaluations gland and tear evaluations.

Why? Because if we haven't educated the patient enough on what dry eye really means, they simply think it means I'm not making [00:14:00] enough tears. I'm not really symptomatic. They don't know about glands. And so, you know, in that case, we haven't done a very good job. well, they just see dry eye as being a minimal condition. When we call it a gland and tear evaluation, they don't know what that means, but it sounds important. So that was another little shift that we made, which is when we were trying to schedule people for dry evals, our no-show rate wasn't great or was higher than we wanted it to be. We changed that to gland and tear eval and our no-show rate went way down.

Simple language can sometimes make all the difference in the world.

Ankit Patel: I'm gonna ask selfishly, how do you feel about ocular surface exam?

Shane Swatts: Uh, ocular surface exam sounds pretty good If the patient understands what does ocular surface mean, right? I mean, what, what does that mean? Is that cornea? Is it my tears? Is it my lids? Is it my lashes? Uh, but again, that's okay because they also, and I call it gland and tear vow. don't really know that you even have glands in your eye until you educate them.

So they're not sure what it [00:15:00] means. But, uh, and, and you, you know, we're not really specific for practices. Practices call all different things, and I love the

Ankit Patel: Yeah.

Shane Swatts: You know, names they come up with, dry eye I think is just such a, I think it just minimizes the significance and the potential severity of this disease. I think it undermines the. Daily struggles that patients go through with this disease. And so my goal was to call it something different. Um, you know, even when I'm looking at their eyes, I could say, man, I really see you have severe dry eyes. I say severe inflammation, or severe biofilm formation, or severe demodex, or, you know, something along those lines that's not just the, uh, catch-all dry eye phrase.

Ankit Patel: Gotcha. That's interesting. And, and so I'm hearing you have almost like a systematic approach of how you deliver the messaging, how you educate the patient. Um, you're viewing it as not a, oh, I've only got one shot in the chair. It's like, no, it's a relationship over time [00:16:00] with

Shane Swatts: Yeah,

Ankit Patel: posts next. Yeah. So it's a lot of,

Shane Swatts: Yeah.

Ankit Patel: Talk to us a little bit about.

You know, why'd you, why'd you start, why'd you do this, right? Like, you didn't have to necessarily grow, uh, what, what, what makes you tick in terms of wanting to grow? Shane?

Shane Swatts: I've always wanted to. So as far as wanting to grow in terms of just dry eye, I, so I worked in ophthalmology for years, um, worked in my private practice for years, one of the things that always just really aggravated me was this cycle that patients get on with traditional dry eye treatment. And what I mean by that is, you know, someone comes in, they have SB Sbk two and have some complaints.

Well, what do we do? We throw 'em on some steroids. We follow up in a couple weeks, they feel better. We put 'em on an immunomodulator. They're back in two months. They're symptomatic, right? You put 'em back on a steroids. So it's just this. It's not breaking the vicious cycle of inflammation. So that's part of the reason that I decided to kind of break off and try to run the practice, is I was [00:17:00] just so frustrated with, man, there's gotta be something more we can do for these people.

Right? Um, and so that's, that's when I found IPO and really it is a root cause treatment. Um, and so that's, that's part of what me to grow. But I think getting more to the foundation of your question. I love growing things. I am very much, I'm very much what you would call an 80 20 guy, meaning that love taking nothing, building something, but once I get to that 80% mark, I'm like, okay, let's start delegating.

You do this, you do this, you do this. I want to go now, work on something different and grow it. Right. So that's just always been something I've done even since I was a, I mean, I had a lawn mowing business when I was like 15 years old. Uh, so I, I've been starting businesses my whole life, but it is one of those things where I want to get to a point that, um, where the creativity part of it kind of dries up a little bit.

Then I start handing it off. I [00:18:00] love the creative process of how do we make this easy for a patient? What's our tech stack, right? How are we, what are we dripping to these patients? How else can we impress them along the way? How else can we educate them along the way?

Ankit Patel: Yep.

Shane Swatts: Uh, whether that's via ai, whether that's via drip campaigns, like however we do it.

Ankit Patel: How are you doing it? I'm just curious. Like whatever you can share, obviously, right? Like,

Shane Swatts: yeah. Many ways. I mean, you know, we do a pre-evaluation call, uh, with one of our technicians just to be sure that it is someone. Severe enough that we want to see. Uh, we do a drip campaign to them. So before they even come in for their eval, they're getting emails. Some of those are written emails, some of them are videos. But educating them on what this process looks like and really what is dry before they even get to the office. And that helps significantly with evals because we're not having to explain all this. For them to hear the first

Ankit Patel: Yeah.

Shane Swatts: Already seen it. Once they sign in up for a program, [00:19:00] um, then we drip a campaign to them. That starts talking a little bit more about skincare and

Ankit Patel: Okay.

Shane Swatts: And 'cause we also have a PA and we have a master esthetician. So beyond. IPL and rf. I mean, we're doing, uh, our, our master esthetician is really big at hair removal. Never thought in a million years on Kit that we would be doing hair removal in an eye doctor's office, but she had a huge following.

I was like, okay, do what you

Ankit Patel: Yeah.

Shane Swatts: Um, so we actually have a whole lot of hair removal, a lot of Botox, lot of, lot of dermal filler. Um, and those things didn't happen overnight. You know, these, these were things that when we first started doing IPL, I remember a patient asking me one day, Hey, do you guys do Botox? And we didn't. But my answer wasn't, no. My answer was not yet. Why don't we check back with us in about three

Ankit Patel: Yeah.

Shane Swatts: And within three months I found somebody, we brought them in, we're now doing Botox filler. So a lot of this comes from, I wish it was my brainchild, but it's listening. It's listening to the patients.

What do you need? What do [00:20:00] you want? And how do I make this work for you in the practice?

Ankit Patel: Gotcha.

Shane Swatts: But bottom

line is I just, I love growing things. I think it's fun. Um, I'm really, really big into ai, uh, and any way that, not necessarily diagnostic ai. I think diagnostic AI is beautiful, but how can it make my life easier on a daily basis?

Right? Like, what, what business tools can I use? Like I use a AI scribe every time I go in the exam room. and we also have, we have, uh, virtual assistants, but my AI scribe. Um, we call him Andy, just to give him a name, but I, I don't go in the room without my, uh, AI scribe and my, my, um, interpretations, my reports, my plans are better than they've ever been. Just from that.

Ankit Patel: That's fantastic. What, what software do you use for that?

Shane Swatts: So we use a company, it used to be called a Thais, now it's called Camu. C-O-M-U-R-E, I believe is the name of it. And they have, I mean, they have a huge set of [00:21:00] offerings. I also use CSI Dry Eye. I don't know if you've ever heard of that, but, uh, you know, AI is definitely in the dry space now.

So, CSI, dry eye uses algorithms and based on survey symptom surveys, and based on the data you've put in, you can click a button that says Analyze, and it basically spits out. This patient is mild, aqueous, or they're mixed severe, or basically what type of dry eye do they have? Here's all the reasons that support that.

Here's all the co-conspirators, and here's your plan, here's your treatment plan. Right? So it's a very cool technology and I think over time it is gonna level the playing field between those who are new to dry eye. Versus those who have been doing it for a while, because there are gonna have the treatment plans built in there for, Hey, here's, here's the, here's the, uh, I won't say appropriate way, but here's the, um, way that most patients are being treated, uh, currently using the [00:22:00] advanced technologies.

Ankit Patel: Yeah. Gotcha. Well, that's pretty cool. Those are some really good insights for folks to, to look at. Um, what, so what is it that you are most excited about the future of the industry? Like what are you excited about where it's going?

Shane Swatts: Yeah. Um, you know, I, I, I want to say aesthetics, aesthetics that comes with a caveat in that aesthetics is. A different world than what most of us are used to in the eyecare space. You know, aesthetics is, you know, you go to buy an aesthetic device and it's not like buying an OCT from Zes. It's fast, it's dirty, it's it's deal making.

It's, you know, it's, it's, it's a lot. It then it really understanding for eye doctors, and the reason I mentioned this and Kate is we have a lot of people who now call us OD immersion and they want to. Almost immediately just start in [00:23:00] aesthetics and almost bypass the whole dry eye part. Well, dry eye is the gateway drug to aesthetics. It really is. So we have patients come in and I'll kind of tell you how we do it. We have patients come in, we diagnose them with meibomian gland dysfunction, dry eye, whatever it may be. We'll recommend IPL and rf, we move them into monthly maintenance. So if you talk to some of the reps for these companies, they'll say, oh, your patients need like a six month or an annual refresher.

IPL Sure if you want to only address their dry eyes. But many of these patients, after they see some of the results from, um, treatments that we've done, mindset shifts from. Hey, my eyes are bothering me to, Hey, can you take care of this pig minute spot and this lesion, and this hemangioma and this? It just changes. And then once you start doing, once someone really gets into aesthetics from a patient perspective, there's an addictive quality. They want more, they want more, they want more. [00:24:00] So it's very little me talking about it and very much them asking for it, which. For me and my personality is great.

'cause again, I've never been a huge fan about talking about money. So when they're asking me, beautiful, yeah, let's do it. We can do whatever you want. so that's, that's been great for me. That's been great for the practice. Skincare is huge. Skincare is really huge. And there's so many, many revenue streams on dry, uh, doing dry that a lot of people don't realize.

Home therapy. Is a big one. So we break our home therapy treatments down into health hydrate, heat hygiene, four categories. If you've got those four categories covered, then you're covering all your bases. So every patient who signs up for a program leaves our office with a product from each of those four categories, and then we make it really easy for them to reorder. We track when they should be running out, when they show up for an IPL [00:25:00] visit. We say, Hey, are you running out of your sunblock? It looks like you bought it three months ago. I already have this in a bag for you, ready to go. Right? So patients consistently purchased through us. So skincare, makeup, if you would've asked me five years ago if I knew the first thing about makeup, I would say, absolutely not.

I have no desire. But if you're treating dry eye, you have to know about makeup and you have to know about skincare. And so those are things that, you know, people wanting to move into the aesthetic space. You really have to study some of these things. It's not as easy as pulsing an IPL light, and they're all

Ankit Patel: No.

Shane Swatts: You have to understand that all these things compliment each other. And a big part of aesthetics too, is oftentimes people think of aesthetics as being a treatment process. For those people who don't have IPL or don't have any of these advanced devices, you can still practice aesthetics, but it's by informing the patient things that they're doing that are contributing to their disease process. Botox in the crow's feet area, [00:26:00] mascara, know, taking makeup and tight lining right over the glands. Those are all things that people do every day that contribute to their condition, and they just don't know. It's not good to do. So simply educating on those things is a form of practicing aesthetics, right? Um, you're, you're, you're improving their overall eye health. You're improving their overall appearance by removing those

Ankit Patel: Yeah.

Shane Swatts: Much like prostaglandin analog serum for lash growth. do it with the intention of having nice, long, beautiful lashes, not realizing that they're gonna get the raccoon eyes, they're gonna get the loss of periorbital fat, they're gonna get the color to the, uh, irises changing.

And so they don't know that. Once they understand that, they're like, oh. Well, what else can I use? And so we have a whole list of things in the office that are alternatives to, that are IAF alternatives for makeup for skincare. We have our own skincare lines, uh, that we offer to the patients. So [00:27:00] there's a, there's a lot that goes into the aesthetic part of it, but it's also a very cool part of what we do every day.

Ankit Patel: Excellent. Yeah. Um, so I'm curious, what keeps you up at night right now? What are some challenges you're currently facing?

Shane Swatts: What keeps me up at night? Um, thankfully for my practice, I have many other doctors there. I have my administrator. I can leave my practice for three weeks and it's still running just fine. So what keeps me up at night are, is really the people we work with at ODI, you know, and, and my, my, our doctors that we work with. That's what keeps me up at night. I'm thinking I'm, I'm, I'm, I'm like visualizing floor plans. I'm visualizing, okay, well what should their packages look like? Or what, what should their fees be? So really, you know, a majority of my time is spent. Figuring out how to make this work in other people's practices so that they're most efficient and they really get value from, from, um, you know, the information that we're providing from [00:28:00] them. Um, yeah. So that, that's really the main thing that keeps me up at night. Thankfully, I'm far enough along in my career.

Ankit Patel: Yeah.

Shane Swatts: Not worried so much about is the schedule full or is, you know. And, and that's a blessing. That's a true blessing. Uh, and we've had those times, of course we all have, where we're like, oh my gosh, the schedule's not full.

What are we gonna do? Let's get on recall. But, um, thankfully I don't have to worry too much about that now to really. My main focus is how do we make the experience as good as we can in these doctor's offices? Because we don't have a set template, we don't have a cookie cutter. Every practice does things differently. Uh, every patient flow is different in each practice, and so we're really trying to dig into those practices and find out how can we do it most efficiently.

Ankit Patel: Gotcha. Okay.

Shane Swatts: Yeah.

Ankit Patel: That sounds like a fun, uh, fun challenge. So

Shane Swatts: It is, it's a fun challenge, especially for someone who likes to grow things.

Ankit Patel: Yeah.

Shane Swatts: Like, you know, I, oh, I get this practice, let me see what I can do to like, elevate this.

Right? So it, it keeps you on your toes [00:29:00] and really, I get such great questions from the docs we work with. I don't have the answers to all of them, but if I don't know, I have to go research it.

Ankit Patel: Yeah.

Shane Swatts: And so for me it's really, uh, challenging and educational because I have to go find out these answers. Uh, and get and report back to them.

So a lot of what I do is research on a daily basis too, which is where AI comes in really handy, right? So I have, you know, I, I'm sure you know this if you're into ai, but you can create your own GPTs. You can create your own agents. And so I have my own dry agent. I have my own, um, um, nutritional agent for dry eyes. And so I can just go in there and say, Hey, I have a 56-year-old. Um, skin type two female with rosacea. What are the recommended settings? And it'll spit it out for me. Right. So it's beautiful.

Ankit Patel: One of the way we found it helpful in office and outside of office is to understand, diagnose, or not diagnose, but to understand based off what they're saying, what type of patient is this? You [00:30:00] know, do they value, uh, you know, are they budget conscious? Are they more health conscious? And we get, we actually can, it helps us reflect back, oh, this is what's important to you.

So we can talk in your language. Uh, ai, AI has been been great for, for our businesses, so.

Shane Swatts: One of the first things we do or, or one of the things we do for anyone who signs up for a treatment program, uh, and this is very important, is we get treatment goals. Uh, and the reason we do that is as doctors, you know, we evaluate a patient and our goals may be, Hey, I need to get rid of that keratitis.

I need to, uh, I need to, to get the glands, I need to get some oils moving in the glands. I need to get rid of the demodex. Patients don't know what any of that means. And so their goals are, I wanna wear my contacts longer, I wanna be less light sensitive. Right? Whatever it may be. So aligning those goals and making sure we're on the same page is really, really, really important.

So one of the things my team asks a patient after they sign up is in their own words. [00:31:00] what does a successful treatment look like to you? Right? They don't say those words, but they find that out from the patient. so at the end of a treatment series, we don't walk in the room and say, how's the dry eyes?

Right? We walk in and say, how's the tearing? And every visit they come in. We don't say, how's the dry? We focus

Ankit Patel: Oops.

Shane Swatts: On their treatment goals because if we meet those at the end of X number of sessions, then we are, we've succeeded. now are they, could they have other symptoms? Of course they could, and we're gonna address those. But we want to know in the beginning what is aggravating you the most on a daily basis, and that's what we're gonna attack. setting those. And, and the second thing, um, is setting realistic expectations. Right?

Ankit Patel: Hmm.

Shane Swatts: If I had a 65-year-old, or let's say a 55-year-old perimenopausal post LASIK autoimmune patient, you're already severe in my book. In, in my mind. So you don't have to have keratitis. You already have all of the workings of a severe [00:32:00] dry eye patient. And so my initial conversation with them is gonna be, look, we're gonna put you through these first four

Ankit Patel: You.

Shane Swatts: Of, for example, I-P-L-R-F, whatever it may be. And I think we're gonna turn the dial a little bit.

You know, clinically you're gonna improve symptomatically, it may improve a little bit. But you're gonna need to be under my care for the next eight months to really tackle this. And so setting those expectations from day one, not something I did in the beginning. the beginning, we didn't have anyone teaching us this stuff, right?

We were, it was wild, wild west. We were like, okay, I don't even know what this eye pill thing is. I was telling patients, four sessions in your golden, we're gonna cure your dry eyes. Lot of really uncomfortable conversations after that. So again, that was just live and learn, right? Uh, I learned really quickly not that, that, that our expectations have to be aligned, number one, and number two, I have to give them realistic expectations for what this treatment is going to do for them.

Ankit Patel: Okay.

Shane Swatts: And those two things helped tremendously,

Ankit Patel: [00:33:00] We

Shane Swatts: in terms of, uh, uh, communicating with patients.

Ankit Patel: I was gonna say communication seems to be a core piece here. Setting expectations, communication, alignment. Yeah.

Shane Swatts: And just, and, and you know, I, I think that is so true just in practice in general, which is why I go back to crucial conversations and things like that as being so important.

Because if you can't communicate to the patient in simple terms what their problem is, um, I forget there's a saying out there. If you can't explain it in simple terms, you don't understand it very

Ankit Patel: Yeah.

Shane Swatts: Right. And I always go back to that. And so I'm always trying to look for ways to. Simplify, that conversation so that they truly understand it and, and they don't have to use all the, all the technical terms that we use. That's hard for eye doctors because if you and I are just talking, you know, I can say, oh, they had MGG, their expression was a grade three patients are clueless to what any of that

Ankit Patel: Is that.

Shane Swatts: And so we really have to change that, uh, when we're going in the room.

Ankit Patel: Yeah. I, [00:34:00] I, I love this. I think this is a really meaty, uh, conversation for folks. Um, and let's, I, I want folks to understand and get to know you a little better too.

Shane Swatts: Sure.

Ankit Patel: Can you kind of take, take me through any story in your life, uh, could have been when you were younger or older? Give me a moment that you felt was formative for you that made you who you are.

Shane Swatts: It's a little bit of a story, but it's, it's, it's, it really was, uh, if there's a point in my life where I could say I had a transition, this

Ankit Patel: Okay.

Shane Swatts: So, um, I don't know if I mentioned, but I used to go to California, meet with married businessmen, do all that, and we did a lot of crazy things. everything we did was called an evolution.

And when I say crazy things, I mean they would, um, you know, blindfold us and take us into an MMA gym and people would start attacking us. These were all to break you down physically and mentally so that they could build you back up. one of the evolutions we did was called the last letter. Have you ever heard of this

Ankit Patel: I have. Yeah, lets explain.

Shane Swatts: And so the last letter is for me. With this group of, of really powerful men. They took us to a [00:35:00] cemetery. They had a uh, or a, uh, tent set up. They had a casket and they had chairs. All of us sit down. Our coach comes up and he says, okay guys, here's what we're gonna do. I want you to imagine that we leave here today in the, in the bus, and we get hit by a tractor trailer, and you all, you all die. Well, this is you in the casket and you have one opportunity to write your last letter to your family and your kids, to your wife and your kids. I want you to now take the next two hours, go off and with your notebook and write a letter. That was one of the most transformative things I've ever done because it really puts priorities in order. I mean, so for me, if you ask me why I do what I do, it's my wife and my kids. Why do I wake up in the morning? Why do I wanna start businesses? Why do I go to practice? Why do I do all these things? It's my wife and my kids, and I think. We as business owners, we as eye doctors get so [00:36:00] wrapped up in the day-to-day chaos that sometimes we forget what's important, right?

And so that exercise, that evolution, I think about all the time. 'cause it brings me back to why do I do any of this? And it is, it is my wife, my kids, my family,

Ankit Patel: Yeah.

Shane Swatts: My relationships, you know? And so that was a turning point for me and it was really interesting, again, to see all these powerful men. I mean, we got, I, I was working with guys there who owned airlines, right?

These are powerful men sitting in a cemetery, bawling their eyes out, writing a letter. Now you don't give it to them. I never gave it to my kids, never gave it to my wife. This is for me. Uh, but it has stuck with me since the moment I wrote that. And it really put things into perspective in terms of, you know, you know, one of the things I hear a lot about is the ability to say no, Like, sometimes you gotta say no to things. so part of what I look at in everything I do is, okay, how does this impact not only me, how does this impact [00:37:00] my family? Should I say yes to this opportunity? Should I say no to this opportunity? And this comes for speaking engagements and all kinds of things.

You know, is this gonna take me away from essential time that I need to spend with my family or I want to spend with my family? Or is it not? So I don't know if that's what you were looking for in terms of, uh, of, of an answer, but I mean, that was a turning point in my life. Whereas before I was a workaholic,

Ankit Patel: Hm.

Shane Swatts: Workaholic, you know, I got home in the evenings, I was on my computer, um, up early at the practice, working five, six days a week. I mean, I see patients a day a week right now, which I love, and I do OD immersion, which is the rest of my time. But I don't miss a lacrosse game. I don't miss a swim meet. I don't miss a practice. I don't miss any of those things because those are the things that I realized through that evolution. Are really important to me. So if I have to cancel a few patients to go to a go to a lacrosse game, that's gonna happen.

Ankit Patel: Yeah, I, I love that. And I'm curious, [00:38:00] kind of building on that, what advice would you give to yourself, uh, if, uh, when you first graduated OD school? So go back in time, week after you graduate, what advice would you give yourself now knowing what you know now?

Shane Swatts: You know, uh, the first thing that comes to my mind is, um, kind of. the process, everything's gonna work out. You know what I mean? Because I mean, we got into, I got into some really interesting not so great deals right after I graduated, uh, where we actually had to pay money to get out of contracts and things like that, right? And so, um, I'm trying to, I'm trying to, to marinate on that question for a minute 'cause I got something in me. I just gotta pull it outta there. But, um. Yeah, probably pro, probably realizing priorities earlier would've been great for me I did miss some things that I wish I wouldn't have missed, or I can't say I missed things.

I wasn't as present as I could have been [00:39:00] not only my family, but with staff members. Right. My staff is wonderful. They're the ones, they're, they're the, they're the ones that people come to see. I mean, they don't come to see me and my practice. They come for the experience and my staff does that experience.

And so, you know, I would say when I was a younger practitioner, wouldn't treat them as an equal necessarily. It wasn't mean. But if I didn't think that what you were saying to me was important, I wouldn't even look up at you. I'd be at my computer doing this.

Ankit Patel: Hmm.

Shane Swatts: I now make it a point. If you come to talk to me, we're locking eyes.

I'm gonna stop everything else I'm doing. I do not believe in multitasking.

Ankit Patel: Yeah.

Shane Swatts: Uh, I don't think you, I don't think the brain is capable of it. If you're gonna do anything, well, I don't think you can multitask. And so it's really learning to, um, focus on what's in front of you at the moment, really be present. And I'll throw this in there for me, meditation is my medication, so I do a lot of it. [00:40:00] And my staff knows when I don't because I'm a

Ankit Patel: You can tell. Yeah.

Shane Swatts: Yeah, you can tell.

Ankit Patel: That's cool. Well, Shane, I, I really appreciate, um, you spending your time. It's being so generous with, with your insights, uh, on this practice. So if folks wanted to find out more, reach out to you about, uh, growing the business or learn more about you, where can they find you?

Shane Swatts: Yeah, so there's a couple ways to find me. One is just going to the OD immersion website, that's od immersion.com. Um, they can also reach out to me personally anytime, and it's drswatts@evea2020.com. I guess we can put that somewhere. Um, but yeah, I, I talk to docs all day long. I love it. It's, it's part of what I do.

So even if it's just some advice on, hey. Which unit should I get? Or Hey, we're, we're making this move. What should I do? Um, I, I just love having conversations, so I'm, I'm pretty open to them anytime. Um, and yeah, there's, there's, I, I, I, I like to share with people. [00:41:00] Um, you know, the, the what I'm, the most recent thing I'm studying is called the Signs of People.

Have you ever heard of this?

Ankit Patel: I have not, no.

Shane Swatts: Yeah. You should look it up. It's really cool. It's a lady who's a Harvard professor. And she really talks about the communication process. She talks about the importance of eye contact. She talks a lot about, so what I, what I'm really doing when I'm going in the room with that eye contact and that physical touch I want some dopamine and oxytocin going off in that patient's brain, right?

Because those are the, those are the trust emotions. Those are the warm, I want to know more about you emotions. And so there are ways to trigger. and oxytocin in patients that are techniques that you can do. And it's not manipulation, right? We never want to manipulate anybody. We want to encourage and we want to inspire.

That's really our goals and you can do that through certain techniques, but there's, there's a lady out there who I really love and it's called the [00:42:00] signs of people, and so I'm going through all of her courses right now. I'm just digging into it.

Ankit Patel: Is that Vanessa Van Edwards? Is that right? Yeah.

Shane Swatts: yeah. She's really the reason I'm standing up right now. Is one of the things she says is, when you are on video, you need to be standing up. If you're sitting, I know, but she's got studies to prove it. Right. I always sit down in podcasts. I always sit down in the videos we do. But she has convinced me enough that you, um, are gonna get more through to your audience if you're actually standing up and looking where you're supposed to be looking.

Right. Making eye contact. Those are the ways that you stimulate dopamine and oxytocin virtually.

Ankit Patel: Interesting. Yeah. Camera.

Shane Swatts: interest.

Ankit Patel: And that's a good point on camera 'cause it's like you gotta make sure your screen is right where the camera is, right? So it's line,

Shane Swatts: got it. You

Ankit Patel: looks like you're looking at them. You might be looking at them, but if you're looking over there, I.

Shane Swatts: You got it. Absolutely. A hundred

Ankit Patel: So we'll put a lot of these resources and the way people connect with you in, in the show notes.

So

Shane Swatts: Yeah.

Ankit Patel: That. Thank you again for that. And so, [00:43:00] and Dr. Swatts, again, thank you again for being a guest.

Shane Swatts: Yeah. I, I really appreciate you having me on. I mean, I love doing these, so if you ever, if you ever, uh, wanna chat again, I'm open to it. Um, you just let me know. I love it.

Ankit Patel: Yeah. I think we can go so much deeper with the, uh, dry eye piece. Yeah. There's so many questions I wanted to ask. I was like, oh no. We'll, we'll keep as a teaser today.

Shane Swatts: the

Ankit Patel: Yeah.

Shane Swatts: And the aesthetics

Ankit Patel: Yeah.

Shane Swatts: The aesthetics piece we could probably do five episodes on.

Ankit Patel: Yeah,

Shane Swatts: uh, but if you ever want to, to do another one, I am, uh, I'm, I'm totally up for it.

Ankit Patel: yeah. Thank you for that.

Shane Swatts: It. Yeah.

Ankit Patel: And thank you audience. If you learn something today or laugh, tell someone about the podcast and the YouTube channel. Uh, thank you again, Shane. This has been another exciting episode of Optometrists Building Empires, and we'll see you next time.

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