Optometrists Building Empires

[00:00:00]

Ankit Patel: I'm excited about today's guest. He's a managing partner with Prism Optometry Services and Director of Interventional Dry Eye Clinics at the Prism Eye Institute, the largest provider of medical and surgical eye care in Canada. He's a clinical adjunct faculty for the University of Waterloo School of Optometry, the Canadian Association of Optometrist Section Chair of Ocular Surface Disease Editorial Board member for the Journal of Dry Eye and Ocular Surface Disease and Chief Education Officer at [00:01:00] my dry eye ca and co-founder of for the Canadian Dry Eye Summit, a national conference dedicated to educating eye doctors in dry eye disease management. He also serves as a Chief Scientific Officer for AI for Eyes, developing artificial intelligence diagnostics for eyecare. As a published international speaker and clinical scientist on diseases of the ocular surface and the psychology of healthcare, he remains an active member of both the National and International Professional associations. welcome Dr. Richard Maharaj. Richard welcome.

Richard Maharaj: Thank you, Ankit. It's great to be here. Thanks for having me. Looking forward to talking.

Ankit Patel: Yeah. You're gonna bring a really unique perspective. I mean, you're combining a lot of my favorite things, dry eye, ai, um, optometry, even though I'm not an optometrist. It's a fun field. Um, so you, you grew your empire a little differently. So what made you want to grow? What is the most important thing that made you grow your empire?

Like, what was it [00:02:00] about what you did that helped you grow?

Richard Maharaj: You know, I've answered this question probably 10 different times over the last decade, and I think my answer has evolved so. The one thing that the, the through line I can say in my career, uh, as well as in my personal life, is as much as I would like to have thought that I had planned it or mapped it out, the one thing that became clear, and I think this is more in retrospect, really, is that I simply put one foot in front of the other, right?

I anticipated, uh, uh, what I wanted to do. I thought I always wanted to be in healthcare. My brother's in healthcare as well, and. I come from a family where that was sort of an expectation, not uncommon for, uh, for families like myself. So, um, that's always kind of, sort of been in my vernacular, but there was a pathway before me where I might've even gotten into teaching.

Um, and so the, the question I always ask myself was, well, how did I get to where I am now? And I truly believe that as [00:03:00] opportunities lay themselves before me, I simply went with the path of least resistance. Um, and by doing that, I continued to follow the things that were interesting most to me, right? And so by following the things that were of most interest, that challenged me the most, I think I naturally kind of stepped forward into this, um, in, into the world that I'm in right now.

Right? Where I, where, where I manage a, a, a large practice. But I mean, I've always sort of been dipping my toes into waters that I'm unfamiliar with. And I think that challenge has been sort of a guiding light here. So maybe that's a different answer from, from, from some previous guests where it seems to be more mapped out and and, and choreographed very well.

I don't know. I don't think I ever had a real clear map necessarily. I knew the destination, but I don't know that I had a clear map out.

Ankit Patel: I, I think, um, sometimes it's also, it's easier doing a retrospect, but in the moment it feels like, oh, I dunno what I'm doing.

Richard Maharaj: Yeah.

Ankit Patel: [00:04:00] So, so I think that, um. Um, yeah, you know, it's interesting 'cause I think a lot of folks I have a conversation with 'em, it's like, yeah, it's kind of, if you did the actual play-by-play, it, it didn't feel quite as planned during the moment.

Richard Maharaj: Yeah. Yeah.

Ankit Patel: so, so me a little bit about how you got into what you're doing now. Like, it, it's quite the background that you have teaching as well as optometry and being on the cutting edge of the field in a lot of ways. So tell, talk, walk us through your journey.

Richard Maharaj: Y Yeah. So I think, um, you know, for me it started when, so when I, if we just talk specifically about optometry, when I did my, my, uh, fourth year externship, it was down in, in, uh, Pinellas Park, Florida. And I still remember that environment, that clinical environment, which was a collaborative center, much like we are at Prism.

But again, this is 20, almost 22 years ago. So that environment was very, very different from anything that I had been exposed to optometry at all in Canada, right? So I remember being there that summer and really feeling like, wow, this feels. [00:05:00] Not easy in the sense that the, the, the, the clinical work was easy, but it felt easy in, in the sense that it wasn't a challenging environment.

It was actually a very stimulating environment and it really kind of got my, my neurons firing. And so that was sort of an imprint or left an imprint, I guess I can say when I entered practice, because when I entered practic. I kind of took a stab at all these different types of settings, corporate settings, private practice settings, medical settings.

Um, I, I spent a good deal of time with, uh, with a LASIK center in the greater Toronto area for several parts, several years of my early career where I was exposed to, to cornea. Again, not mapped out, but it just so happened that cornea became a fascinating area for me and it really paved the way for my interest in ocular surface diseases.

So with all those different experiences, I just kept on following the most stimulating environment. And then at some point I really kind of said, okay, I think I can craft out an [00:06:00] environment because none of those environments that I was in were. Were the, the, the, the, the genesis or the vision, I guess you can say of, of how I thought my end path would be.

So I, I got on the creative, uh, uh, I got my creative juices going and I started to create what I wanted it to be. And so that's where. I pivoted to starting my own medical optometry practice in 2011, which is called Eye Labs at the time. And, um, you know, I, I made that a medical only opto optometric service center where my clinical focus was dry eye, but we also had primary care and other services, but we did not dispense any spectacles.

Uh, we, we did medical contact lenses and things like that, but we, we really stuck to core services as our primary. Um, if we're talking about it from a business perspective as our primary revenue generator. Right. And so I did that for 10 years. Uh, and in those 10 years I developed relationships with ophthalmology that would inevitably serve me well.

Uh, I went through, uh, uh, an m and [00:07:00] a mergers and acquisitions with Prism Eye Institute, uh, just shortly into the pandemic, uh, because the, the, uh, uh, equity, I guess you could say, and the relationships that we had built at eyeLabs. Was, um, enticing and, and, and interesting to, uh, my collab, my now collaborative partners at Prism.

So that really was how I ended up here and, and now with my current role, it's, uh, uh, as a managing partner of the Optometric services and still doing my clinical work with Dry Eye, it's been great because now I'm able to kind of, uh, uh, do a lot more in terms of, of. Uh, research at Prism and, and my consulting work as well, uh, uh, continues to, continues to keep me busy.

So, you know, it's, it's been a interesting road for sure, but, um, and I don't know that there's a, a a through line necessarily other than I continue to follow what really stimulated my nain, hence the haircut.

Ankit Patel: Yeah. You have a great haircut. And for those of you listening, we're both

Richard Maharaj: Yeah.[00:08:00]

Ankit Patel: Uh, the, um, as far as the, uh, themes I'm seeing. So one thing that I'm really excited to talk to you about and I wanna dig into more is you've already had an exit and you're, you're a pretty young guy, uh, you know, and, and it is like, Hey, you've already transformed your career to almost like a second phase much earlier than many optometrists do. talk about the reas, like how did you get your business to the point where it was so like, attractive for people to purchase and why? Why did you sell?

Richard Maharaj: That is a great question. Um, so let me. Kind of covet that by saying a big part of this was time, uh, and place, right? So a big part of this was the pandemic really kind of put some stresses on the clinic, um, that weren't otherwise presented themselves. So I listened to that and, uh, I think we chatted about this some other time.

I'm like, I'm, I'm generally a person that tries to put myself in the happiest place. So. When, and by [00:09:00] happiness, I mean peace, right? So the most peaceful environment. So when those stresses were there, I really kind of made the decision that this is now in need of change. So I had that change in mind. I knew I needed to kind of transition.

I also knew that my mental equity was, was, um, best put towards business development. I knew that that's, that's what was the area that was really stimulating me. 'cause from a clinical perspective, I felt like, oh wow, I really get what I'm doing right now, but I really want to kind of stamp this out and, and make this bigger.

So, um, yeah, so time and place, the pandemic really kind of put those stresses. And then I knew I wanted to do business development, so, so the equity or I guess the, the, the, uh, reputation that I had developed at that point. And, and our clinic, I should say at that point was very unique. And I think that was the, the fundamental piece.

It was the, the niche aspect of what I was doing at the time. Um, and, and, and, and its appeal [00:10:00] to our medical colleagues, uh, because we were very evidence-based in what we did. We were extremely collaborative. We, uh, invested in our referral community by educating them, um, you know, and so we weren't just, you know, marketing to our patients.

Have done this and will continue to do this, uh, which is I believe that if you as a colleague, you as a patient, uh, you as a friend or a family member, if you're learning from me, I should be learning from you. Uh, and so with that as, as the sort of the core tenet of the philosophy of the work that I do. I think that really is what made our brand at eyeLabs, um, um, um, attractive.

Uh, and, and yeah, you're right. I mean, I'm not young. I don't think of myself as young, but yeah, having that exit there was, was a freeing moment, um, that I knew that I wanted to, to get to. And another piece of that as well was my family, right? My kids. Are, uh, are young, you know, the, at the time, uh, they were my dau, my eldest is, is 10, and, [00:11:00] uh, my son is, uh, was six at the time.

So, um, I knew that this is the next decade of life that I need to kind of grip and hold onto because boy do I love spending time with my kids. And, uh, I don't know that, uh, spending time behind a desk or in front of a, behind a computer, uh, you know, struggling away was, uh, was the best use of my time and would bring me the most peace and therefore joy.

Ankit Patel: Yeah, and I think, I think it's important to call out that building your own personal empire is not always about money, right? Sometimes time is its own currency. That's probably more valuable

Richard Maharaj: I would wholeheartedly agree with that. I would say that that is now my through line for sure.

Ankit Patel: Yeah. Well, I, I wanna go back. You, you dropped some like nuggets, like some gems there with, with, with your practice building. Let's, let's hone in on that a little bit more. 'cause I think a lot of folks are gonna be interested in your strategy, including me. Uh, the, the, uh, so you talked about, if I'm hearing correctly, you, you said medical only, no optical, no retail. Um, we're gonna, we're gonna put a lot of money in referral sources and [00:12:00] educate them and really build that network up. How else did you build this? What other things did you do? Like if you had to go back and say, well, this is kind of how we built the practice and made it successful.

Richard Maharaj: Yeah. Um, you know, when I started in 2011 at eyeLabs, um, social media was very different than what it is right now, as you can probably remember. Um, and so I wrote about it. You know, I started a blog and I, that was kind of how I got my first messaging out there and, and how I saw it was received by, by my patients and colleagues.

So once I knew the, the, the. Efficient ways to market, right? Because again, as a startup, you don't have, you're, you're kind of marketing from scratch, right? My, my, uh, 5% of gross towards marketing was, was minimal at best. So I needed to find various ways to market without having to do that spend. So the biggest way to do that, again, was writing about it, was creating, you know, I had a YouTube channel.

I even did those things then, um, and then I also invested with our industry partners. I said, [00:13:00] look. You know, to our pharma partners, I said, uh, put me in front of my, my referring community. Right. Put me in front of folks that are interested in, in the services that we provide at the time. Again, dry Eye services, primary care put me in front of family practitioners, family doctors, PCPs, that is for their diabetics.

Put me in front of whomever, is willing to listen to what I have to say about the services that we're providing from an educational standpoint. So industry partners. We're very, very, uh, critical in terms of getting the word out. Um, and then finally really it was fostering relationships. Again, I think everything starts with the individual.

You start with yourself first. Once you have that sort of clear vision as to what it is that you're doing, then communicating that clear vision to as many people as you can, as often as you can. So whether it was at a, uh, attending, uh, an association conference and having a one-on-one with a colleague, or whether it was giving a lecture at that same conference and having a one on a thousand with, uh, with colleagues, it was always predicated [00:14:00] on the same message, um, which was, this is what I'm doing, this is how you can do it in your practice.

And I think sharing became, uh, um, um, sort of the cornerstone of, of. Of, of, of, of my practice and what became attractive to, um, colleagues to refer to us. So it was really just making sure that we had a clear path to communicating and having it done in as many ways as possible when we didn't have the spend to dish out on, uh, on, on, on, uh, paid marketing.

Ankit Patel: Yeah. And, and just outta curiosity, we'll get in the weeds a little bit. Do you remember, uh, it's been a while, but do you remember like how many of your new patients came from referrals from patients, referrals from doctors, from cold marketing? Did you have remember rough breakout of that?

Richard Maharaj: Yeah, our referral source was, was large. Um, it was probably, it was over 50%, um, of our incoming

Ankit Patel: referring doctors or referring

Richard Maharaj: Referring doctors. Referring doctors. Yeah. So I mean, we, at the time we were the only referral based practice. Um. Uh, [00:15:00] certainly in the province, perhaps in the country, I don't know. But in the province we were, uh, so yeah, I'd say greater than 50% were referring docs.

Um, and the breakdown after that wa became increasingly, uh, patient referrals that ended up growing to, I think about 23% of our practice. But our bread and butter, really, it was and still is referrals. Uh, what, what was interesting, I don't know if our, if the listeners will find this interesting, but what what was interesting is at the beginning I really expected my, my opto optometric colleagues to be our largest referral source, but it turns out that it was Noah, it was our ophthalmology colleagues that referred

Ankit Patel: The other

Richard Maharaj: most.

Yeah, it was,

Ankit Patel: way around.

Richard Maharaj: and I, I do think at the beginning there was a bit of a scarcity mindset. Uh, with our colleagues worrying about, you know, will the patients come back? And I think that that just took time to build, to have them understand that, no, I didn't. I'm not interested in keeping this patient in the practice.

I wanna make sure that we take care of their condition, whatever that condition is, but you're their primary care provider, you know, when it comes to routine and, and ongoing [00:16:00] care. So that, that took a little bit of time to, I think, uh, uh, unpack with our colleagues, our optometric colleagues, but ophthalmology colleagues were on board from day one.

Ankit Patel: I like that. And, and, uh, it's, it's interesting 'cause you know, normally intuitively you would think that ophthalmology wants everything in medical, but really their, their, their metrics are, my understanding is really around surgeries. so that's where they make, that's what the doctors really are skilled at and trained for, and that's what they make the most amount of, like

Richard Maharaj: That's right. Yeah. They were really, um. Uh, they're certainly focused around surgical care and, and medical care as well, but even in the medical, so if we took glaucoma for example, I mean, glaucoma is increasingly becoming, you know, microsurgical. Um, but there's still, the burden of care is primarily in medical management of glaucoma, and that still is the case today.

So, having said that, um, complex glaucoma care and anterior segment care. Uh, still, uh, uh, uh, is, is, is overburdened, at least in, in my area here. And so the optometric community, uh, has an opportunity to step up [00:17:00] and, and, and receive that burden and take on these chronic illnesses. In fact, opt optometry in general, we're really managing chronic disease, right?

And so if we can really stamp that out and show the value to just our ophthalmology colleagues, I mean, if I'm, if I'm talking to an audience here that's looking to do something different. I would say, you know, the, the dissonance between optometry and ophthalmology, which is ever present, and depending on where you are, it can be quite tenuous.

but therein lies the opportunity. That is where the synergy really needs to begin, It's not finding what's different. It's finding the Venn diagram where there's overlap, right? And once you have that overlap, once you can establish that understanding, and maybe it's just one ophthalmologist in your community.

Once you have that, that is the beginning of a foundation of a relationship that will service the community, service your patients better, and ultimately patients do better. You do better. Right? It's a, it's a revolving door.

Ankit Patel: So if, if I have a [00:18:00] playbook for this, uh, and it sounds like I could apply it to anything outside of there, you just want that Venn diagram of what's important for the patient and how the doctor, you're talking to, what's important to them and what's important to you, and what's important to the patient, and where that intersects is where you can help.

Richard Maharaj: That's exactly right.

Ankit Patel: And, and I imagine it's different case by case. Um, 'cause if I were to go and talk to a dentist or orthodontist, or a pediatrician our area, I might have a different Venn diagram than if I talked to ophthalmologist. What, what were some of those things that you were able to get traction with, with the ophthalmologist?

Do you remember?

Richard Maharaj: Yeah, so I think the biggest thing, if I could just kind of put a stamp on it, it was accountability, right? So I made sure that when I had conversations with my ophthalmology colleagues, I said, look, I'm gonna manage their ocular surface. Whatever happens to that surface, I'm gonna take care of it. Uh, and, and you know, at with time I kind of had my track record behind me, so they believed that.

But, um, so I'm gonna take care of it. I'm gonna look after that. So if you're, if you have a, a surgical case and you know, you have your refractive endpoints met and [00:19:00] you're happy, um, and their optometrist is not managing their ocular surface, that's where I come in. So I made sure that I was accountable and I.

Back that up. Um, so that if the patient had a concern and they accidentally call their ophthalmology office and their, their ophthalmology teams, redirect them to me, we receive them. I never pushed a patient away and said, look, I'm too busy for it. I would take them in. The other thing too that I, um, presented then was, was my ability to sort of leverage, right?

So as I gained more and more specialty patients, because I had, and I carved out. At the time when I started, I carved out one day dedicated just for ocular surface. And so I was able to leverage this volume that I had accumulated. And with that accumulated volume, I was able to an and analyze it, excuse me, and, and, and publish some of my findings and some of my work.

So I leveraged what I had built behind me and I validated it. Uh, and then from that, so I had my accountability, I had my leverage. The third final piece there was just my [00:20:00] specialized knowledge, right? And I think, um. Uh, I've, I've heard this referred to as experiential wisdom, right? So having the volume of patients behind me, having the outcomes that I was having, um, and being able to leverage that, I was able to demonstrate that I labs represented specialized knowledge, right?

We were a source that you could trust. You were, we were a source that had and still has, um, the experience to back it up and, and that we were reliable. And I think those are the three things that really kind of stood out. Um, to ophthalmology because like you said, they, they, they really wanted to focus on the things that they needed to focus on.

Uh, and their staff knew that we were reliable, right.

Ankit Patel: That's pretty, that's pretty, uh, that's a pretty good playbook. Uh, and I imagine that, you know, I know in the US a lot of ophthalmologists are. They like to do a lot of these other services. They have ods on the staff too, so depending on where you are, sometimes they're, they, they can view that as competition or they already try to do these anyways.

But I, I could see these applying to, like I said, [00:21:00] pediatricians, uh, uh, dentists and other doctors that, you know, are trusted resources for people.

Richard Maharaj: Oh yeah, absolutely. I, I, I, I think this applies, I think those three things, accountability, specialized knowledge and leverage. I think that applies to any business building. Uh, I think that applies to being a student, right? I, I think it can apply to life.

Ankit Patel: So when you were building your business, aside from COVID, just normal day to day business building, what'd you run into that you didn't expect?

Richard Maharaj: Yeah. Besides COVID, COVID kind of dwarfs everything, but, um, you know what I'll, uh, you know, I'll kind of give everybody a, a peek behind the, uh, behind the curtains. The, the, when I started at Eye Labs, I had a relationship with, uh, a group of ophthalmologists that had, um. You know, had sort of overpromised and underdelivered in terms of being a, a, a constant stream of, of revenue, right?

So a referral source. And that dried out almost immediately because of various circumstances. And so my predicted, uh, [00:22:00] uh, financial planning really went down, straight down. So that was the very first thing that really kind of. Caused me to quake in my boot, so to speak. Uh, at the time, you know, my daughter was just born, you know, everything was just happening.

Uh, it was a very stressful time. And so a big part of me was like, okay, well do I pivot here? You know, this is uncomfortable. This is not something that I had predicted. Do I pivot to find my piece? Um, but by that point, you know, I had already done the build. I had already, you know, basically I had already leveraged myself sufficiently that.

I knew that I was in the best position to make this work. So once I realized that the volume, the anticipated volume of patients that I was expecting to have wasn't there, I then put the plan forward to, to start to figure out how best to market and get the message out that we're doing what we're doing.

But yeah, those first two, it was two and a half to three [00:23:00] years. Uh, my predicted growth was very, very, very different than, uh, than what in fact happened.

Ankit Patel: Nice. I That's a, that's a really cool, I appreciate you sharing that. That's a, that can be tough and pivoting like that is pretty impressive.

Richard Maharaj: Yeah, that was tough is a word I'll use now, but it was scary as hell back then. Yeah.

Ankit Patel: Yeah. You know what I tell, I tell people this and I tell my staff this too, is like, Hey, when you're working for doctors, you're not working for a giant corporation.

Richard Maharaj: Yeah.

Ankit Patel: You're working for people who, this is their livelihood. If they see a drop in patients, they feel that. And, and you know, and, and every entrepreneur, not just doctors, will be, will say like, oh my, there's this chain of thought that happens in almost every entrepreneur business goes down.

Then all of a sudden they think, oh, I'm gonna lose more clients. And then I'm gonna lose everything I have and I'm gonna be homeless. So, so just from like having one patient complaint or one bad review, uh, that spiral happens very quickly. I can speak from a personal experience, so it, it's hard to go through that especially and to be able to adapt.

It's, it's impressive.

Richard Maharaj: Yeah. No, it, it, it [00:24:00] is challenging. I agree with you. I totally agree. We, you kind of catastrophize for a while. Um, but that is, that is life. I think the greatest equalizer is time. Right? And it's as, as long as you can kind of have faith in the fact that time will continue. Um, and it is a commodity that you really wanna cherish.

But if you have faith in the, in that time will unfold that the story will unfold. I think that's really, uh, a crucial piece, you know, to be able to zoom out like that.

Ankit Patel: Gotcha. I like that. Um, so what, um, what are some challenges you're facing right now with the, the new organization you're a part of? Um, what do you see as operational business challenges that's happening out right now?

Richard Maharaj: Yeah, I think with, uh, I mean, as you would imagine with a bigger organization, uh, the bigger it is, the harder it is to, to kind of steer that ship. Uh, and plus we have now a, a, a board of of of seven. So there's, there's more voices, there's more multi-directional, uh, uh, [00:25:00] operational challenges. Um, so, so one of the, the, the.

And I, I, I'd say it's an opportunity rather than a challenge, but one of the opportunities that we're currently working with is really how to kind of carve out further, carve out specialized optometry, right? So we have our dry eye, uh, program, really kind of front and center, and that's just, uh, humming.

But there's other programs that we're getting off the ground, right? We're trying to get off the ground, um, you know, primary care of the retina. There's, there's a lot of upcoming um. Uh, modalities to treat things like a MD macular degeneration. In Canada, we have a, a device called Mac Mira, which is a, a, a, uh, electro ti stimulation to address a MD.

Uh, there's photobiomodulation to address a MD. So. These are services that we're looking at, Hey, wait a second. This belongs in Optometry's hands. And this could really, um, couple, well, with our medical ophthalmologists that are doing Avastin injections, et cetera. Um, we're also looking at, [00:26:00] you know, other subspecialties like low vision, um, and of course myopia management is, is ever present.

So where the biggest challenge is pairing our optometric, uh, specialties with the existing ophthalmology specialties. But also recognizing that, and again, this is more of a regional thing, so in Canada, uh, and Ontario specifically. Ophthalmology services are primarily funded by the government, right? So they're primarily covered or insured services, whereas the optometric services are primarily uninsured.

And so the strategies to, uh, both market and, um, uh, intake those, uh, cash paid services is very different than insured services. And so really kind of operationally, we're really trying to to, you know, bifurcate our, our intake process. So how do we have an intake or how do we develop an intake process for our optometric patients and how do we continue to provide the services to our ophthalmology [00:27:00] patients, but how do we keep a, a uniform brand over and above that?

And so that's, that's the conversations that, or sorry, those are the conversations that we're having with, uh, with, with my partners as well and, and trying to create something that's, that has some legs to it and longevity.

Ankit Patel: Excellent. And I you kind of, you kind of built, uh, built into. My next question was, what are you most excited about? Um, I've got, actually, you know, it's interesting you hear the doing the retina PR prevention and a MD treatments, that sounds exciting. I, I don't know. I don't, I need to have a better pulse for the medical. Situation in the us. I know the US is sometimes lags behind Europe and Canada, uh, but what else are you excited about?

Richard Maharaj: You know, honestly, AI really is the thing right now that's, um, that I find to be most interesting and most opportunistic. Um, for, for anyone. So. Here, here's the way that I see it. 'cause there's a lot of fear around it and I think that that's reasonable. I think fear is probably the word that everybody's putting to it.

But if we were really to dig deeper, I think the fear is probably just lack of familiarity or knowledge. [00:28:00] Um, but I think AI really represents an opportunity for us to unburden ourselves with some of the minutiae that we have to deal with. Whether it's filling out your forms, whether it's marketing.

Whether it's, um, you know, creating, um, uh, post, uh, treatment visit reports, et cetera, I think AI really helps, will help us to unburden ourselves from that. Um, even when it comes to decision making, right? So for example, you know, we deal with complex cases, and I don't wanna get clinical here, but we deal with complex disease and so patients are coming in with.

A docket that's like a hundred pages of their own personal history. I'll tell you this, I'll be the first one to say it. I will not be able to read those a hundred pages in the time that I need to to manage that patient. But I guarantee there's information in there, even if it's a sentence that will be useful, that may help in getting to a clinical endpoint or at least developing a, an appropriate treat treatment [00:29:00] strategy, especially for complex disease.

So. How can we actually marry AI and, and the, the, the powers of AI with being able to process through that and tease out information that would otherwise get left. Or for example, if you have, you know, if you're a doc and you have, you're, you're, you're seeing your patients the fifth year, chances are a good portion of that file is just copied over to the next year, and then you fill out the entry points that are different.

Well, with that comes a lot of lost data. And so I think that there's opportunities here for us to really kind of. Enhance our clinical stature as well as enhance clinical efficiency. Uh, and wouldn't it be better for our staff? Wouldn't they feel better if they were unburdened by it? What if you could strap an AI uh, backpack to every staff member that you have?

Empower them to have just a little bit more knowledge than they currently do to be able to maybe answer FAQs in a more humanistic way. Right. So I think the marriage of humans and ai, I think that's really [00:30:00] very, very powerful. I find it to be extremely interesting, uh, and a huge opportunity for practices and for patients.

Right? At the end of the day, we want patients to have accessible, uh, healthcare, and I really do think that this is, uh, uh, this is where, where it is.

Ankit Patel: Yeah, I, I laugh there because I went to a cardiologist recently and did the same thing I had. Uh, so I had, I had blood tests done and, um, basically long story short history of this in family and, uh, my normal blood lip is looked fantastic, like people were, would jealous of it. But there's, uh, certain secondary indicators that apparently, um, I, I, I did some research on. And found out that it's 20% of the population that everything looks normal, but because of these indicators are a high

Richard Maharaj: Uh.

Ankit Patel: And so I showed that to my doctor. I was like, oh, yeah, we should do something about that. This is the plan. And it gave record. It was pretty cool actually. It was a, it was a, it was using Claude code and some deep research methodology that I created. Um,

Richard Maharaj: Very nice.

Ankit Patel: Was really insightful. So it, it helped and I, and I, I was fully transferred. The doctors like, Hey, I don't know if this is [00:31:00] right. But can you just take a look at it and gimme some feedback based off of everything you were seeing on your expertise? And she's like, yeah, it looks pretty right. I was like, I would modify this versus that because of these reasons. But yeah, it looks pretty good. So, you know, it was kind of neat and it gave like a little executive summary. 'cause I knew she wasn't gonna read the whole

Richard Maharaj: Yeah,

Ankit Patel: Like I wouldn't read the whole thing either. I'm like, we only got like 20 minutes. I'm like, it's gotta be short.

Richard Maharaj: Yeah,

Ankit Patel: it was, I said, you could have the whole thing if you want, but like, here's a summary.

So it was kind of, kind of neat to see that, um. I, you know, I, I, but I, you know, I do find that, uh, with ai, we use it a lot too in our offices. Um, using it very carefully.

Richard Maharaj: Of course.

Ankit Patel: If we have noticed, um, it, it, uh, uh, people do atrophy, their thinking muscles if they rely on it too much. Uh, so we have to be careful with that.

We use it more for support, training and development and catching things they may have missed or helping with, like, presenting things or thinking outside the box. More like a assistant, like a guide, versus a replacement for work.

Richard Maharaj: Yeah, I absolutely agree. I think, um, you know, your brain needs to continue to work. You still need to have those fundamental tools. Uh, but there [00:32:00] are, uh, uh, tidbits that, uh, that we can certainly do without in a day to day.

Ankit Patel: That's

Richard Maharaj: Uh.

Ankit Patel: Uh, so I'm curious, what makes you tick, Richard? Like what, what's a story that you can share with us that's really impactful to you that made you who you are today?

Richard Maharaj: Um, yeah, you know, it's, uh, I go back to my childhood, you know, I, I, I, I, perhaps it's because I'm a, I'm a dad now. I, I, I think about the things and the way that I see the world, my worldview today. And, uh, I understand a little bit more. I have more context around where my parents were coming from. Um, but I would say that.

It, it, it has a lot to do with, with my parents. You know, my parents are from the West Indies. They came to Canada a very long time ago, in the late sixties. And, um, you know, nothing, nothing was handed to them, nor was it handed to, to, to me. But with that, there was always the intention to give us a better. A [00:33:00] better life.

I think that that is the dream of everyone is to, is to do, have the next generation do better than, than the generation now. Um, but what I remember very, uh, clearly is at a very young age and, and repeatedly in different ways. My dad would tell me things like. Um, uh, instead of, so for example, if I was learning to ride the bike and I fell off and I scraped my knee, um, you know, it wasn't the, you're gonna learn from this.

You've fallen off the bike, get back up and get back on it. I mean, of course that was there, but it was actually more of the cushion around that. Right. Softening that experience to a degree. Making me understand that there is a world of support. Around me and through and through that would happen again and again throughout life.

When I, when I, I didn't get into optometry the first time I, I applied, I got waitlisted and then didn't happen. And, and the same message was there. Just my dad would say, Hey, look, [00:34:00] just keep on going forward. Whatever happens, happens. Um, I'm not really paraphrasing it accurately, but basically that support was, was always there.

And so what I've come to learn from this sort of. Consistent approach, um, that both my, my mom and dad had, but I'm just highlighting my dad, was that, you know, the, the notion that we require. Bad things to happen to grow from it, that we require challenge to be great, that we have to have hardship and suffering in order to thrive.

I think that life has enough challenges that it's gonna throw our way. Life has enough suffering. Life can be malevolent and tragic. But I don't think that's a prerequisite for success. And I think that too often what I'm seeing now a lot with our students as well as just people that I talk to nowadays, it's almost this sort of glorification of, of suffering makes it a [00:35:00] prerequisite to success.

But if you really look at it. Most people under tremendous stress don't actually get to become that diamond that was carved out of the pressure. Most people will have scars. And so what I would say, and I heard actually, I heard the Trevor Noah say something to this effect, which is, yeah, you can suffer, but wouldn't it be better if you had fertile soil to grow in?

And so what I try to do now based on my life experience is really try to create. Fertile soil for the people around me, for my colleagues, for my students, for my family, my kids, uh, for my friends, and for anyone that I'm sharing with is, is really kinda using that analogy and, and trying to step away from the notion that, yeah, you know, you gotta suffer to have grit.

Uh, Angela Duckworth talks about grit, but if you really listen to her work, she talks about it in a, in a very positive frame, rather than you must suffer in order to have grit. No, [00:36:00] what she says is. Um, grit is, is, is a manifestation of, of life, but resilience is not. Necess does not necessitate suffering.

And so I think that that's one of the learnings and it's a long story. It's a long answer I gave you there, but that's really how I've kind of crafted my life in, in retrospect.

Ankit Patel: That's a really good insight. Uh, and it is interesting to hear you talk. It's almost like, um, you're ready. Uh, you're talking, uh, you know, some words around like legacy and what you're leaving back. I really think it's really cool. The, the, you're thinking about that. Uh, and like I said, you're, you're a fairly young guy. You know, you still got a long time left to practicing your career. I know you don't feel that way. I know your body probably knows you don't feel that way. 'cause we're a similar age. I know how you feel. Uh, but you know, you still got, you still got a few years ahead of you.

Richard Maharaj: Yeah.

Ankit Patel: Um, that's pretty cool that you have all this, uh, to give back.

And you're doing that with your teaching efforts.

Richard Maharaj: Yeah, no, I, I, I'm very grateful for it. Look, I'm grateful for every, uh, for every opportunity, every day, every time I get a chance to talk to somebody, uh, new and different like yourself, uh, and just share stuff. I think it's great. Also, like I said, I love to [00:37:00] learn, right? So I, you know, in talking to you, I learned about your business as well, and, and.

You know, took that to our team. We started talking about it. By the way, we might be in contact with you soon. Um, but, but no, honestly, learning about things I think is, as you said, you don't want to, to, to let the, the, the, the neurotransmitters go through any degradation. Keep that brain stimulated, keep thinking.

Um, and I think that's really key,

Ankit Patel: So advice would you give younger Richard, right out of optometry school?

Richard Maharaj: uh, trust yourself.

Ankit Patel: Okay.

Richard Maharaj: Right. Trust yourself. Um, and, um, you know, this sort of notion that, uh, you, you know, I don't think anybody coming outta school, myself included, came out with confidence in every arena. Um, but I think the, the, the. The promise of trusting myself and the ability to do that didn't develop until much later on.[00:38:00]

Um, but yeah, trusting yourself and, and, and not necessarily trying to give the right answer, but just giving an answer. Um, you know, I was talking to somebody recently about, uh, 'cause I was traveling in Europe and um, I, I was having dinner with, uh, uh, a German couple and they were speaking English and, and, um, I, I, I remember.

Talking to a colleague back here about, you know, this conversation and how when they were discussing whatever we were discussing, they're very matter of fact, you know, there was, there was no sugarcoating it. They were just stating facts as it were. They weren't looking for a happy response from me or a sad response.

It was just stating a fact. But meanwhile, my North American colleagues. And myself included, we always sugarcoat everything, right? We always try to make it sound great and sound attractive. We're always marketing. We have this sort of marketing mindset over here, but, uh, but trusting that what you have to say, whether it's great or not, is the best way to just be honest with whomever you're speaking to.

And that [00:39:00] honesty, that's how you leverage yourself, right, is by knowing, by sort of making the people around you know that what you say is what you, you mean what you say, and you, you, you say what you mean. Uh, and I think that that's, um, that's one of the things I would've told myself a long time ago.

Ankit Patel: Yeah, I like that.

Richard Maharaj: Yeah.

Ankit Patel: Good. And, and so Richard, if people want to get in touch with you, they wanna connect with you, where can they find you?

Richard Maharaj: Uh, yeah, the best way I guess would be, uh, you know, Instagram is always an easy way. It's, uh, dry I Jedi. Uh, that's my handle there. Um, and uh, yeah, that's probably the easiest way you can always find me on LinkedIn, Richard Montage on LinkedIn and, um. If you see you at a conference, if you see me come out and say hi, I'm, I'm certainly not shy.

I think, uh, I think I'd probably, I'll be at the academy the next, uh, next one in Boston. So anyways, uh, wherever you see me, just come out and say hi.

Ankit Patel: Are you gonna be speaking at that one?

Richard Maharaj: Yes, actually I'm doing a talk on, on AI of all things. So,

Ankit Patel: Oh,

Richard Maharaj: yeah.

Ankit Patel: Be fun. That'll be fun. Well, cool. Well, well, thank you again Dr. [00:40:00] Maharaj, for being on uh, guest on the show.

Richard Maharaj: Oh, I appreciate it, man. This is a great conversation and uh, uh, I love the podcast as well, so, uh, so keep doing what you're doing.

Ankit Patel: Yeah, I appreciate that. It, it's, it's been a labor love and it's been fantastic. So,

Richard Maharaj: Yeah.

Ankit Patel: And thank you audience, if you learn something today, laugh, please tell someone about the podcast or the YouTube channel. Uh, and thank you again, Richard. This has been another exciting episode of Optometrist Building Empires.

We'll see you next time.