Every once in a while, I like to sit down and type out my thoughts.  This one seems a bit overdue but timely nonetheless.  I have always taken pride in providing the best care to my patients, timely, efficient and always being available for whatever is needed.  I started with the Gee Eye Care Mission Statement in 2007 before I even opened the doors to the public.  To this day, my team and I subscribe to these three core principles:

Timely & Efficient Care

Moral & Ethical Decisions

A Memorable Experience for All Who Walk Through the Doors

Every team member that we bring on is presented with these core principles and is asked to revisit them regularly and uphold the standards that have been in place since the beginning of Gee Eye Care in 2007.  With every new team member the bar is raised because of the prior regime that came before them.  We didn’t make it this long and this far by not all pulling in the same direction.  I feel like I led the charge, and rightfully so as the business owner, but it has truly been a team effort.  I have much to owe to my current team and those that have worked alongside me over the past 14 years!

Over 14 years, these core principles have remained the same but some things have definitely changed.  I started the practice as a solo doctor, two employees and seeing patients all hours of the day.  Prior to COVID at one time we had up to 9 team members and myself seeing patients with extended hours—often taking appointments until 9 pm.  Over the past 14 years we have had to expand and move to a new location while staying in the immediate area to serve the patient base conveniently, our technology and equipment has changed and been upgraded to continue to care for our patients in the most technologically advanced manner and our knowledge of how certain eye conditions that are related to the rest of the body has increased.  Just as I would expect a practice/business to change over 14 years my life has changed as well.  Now married since 2015 with two little ones Isaac (4) and Audrey (2), I have embarked on a new season of life.  

I remain committed to upholding the core principles set in place from the beginning while still being a devoted husband and “daddy” at home.  Things have certainly changed since 2007 when I was a “lone wolf” bachelor! While I am not going anywhere, I cannot stress that enough, my days in the office are now limited to three days a week for the personal reasons I mentioned.  My schedule in the office is devoted to my patients, my schedule at home is devoted to my family.  I am always available to be texted or emailed though! My commitment to the community will remain the same as well! My team will work diligently to schedule those that desire appointments with me.  Please be patient because we are still struggling to catch up due to limiting appointments because of the pandemic.  

As a result, I am very fortunate to be able to bring back one of our very own.  Dr. Thuria Younis was previously part of the team as one of my assistants.  She understands and is a firm believer in what we have as our core principles.  I couldn’t be more honored and pleased to have someone of her character and moral standard join the practice to help care for those patients that have trusted me over the years.  It is unfathomable how seamless this transition has been over the past two months since she has started seeing patients.  Dr. Younis was brought on board to help alleviate the strain on the schedule.  However, Dr. Younis is not a substitute, she is a great doctor in her own right with a great bedside manner—what you have come to expect from Gee Eye Care.  And while her schedule is starting to book out as well, her availability is more open than mine at this time.  I am confident that you will be just as pleased as I am when you meet and are cared for by her.  

#SiennaEyeDoc

…but now it’s just a little different.  I’ll repeat, we have always had our trusted patients’ interests as our top priority.  During these times of COVID-19 it was even more important for us to continue that standard.  We reopened four months ago on May 18th since closing the office for two months and we set some protocols in place.  While we have received mostly positive feedback on these steps it’s easy to 1.) get complacent and retract from what has now become our new “norm,” and 2.) have some patients not fully understand that these steps are in place for their safety first and then ours.  I’ll address them here:

Masks

Masks went from being highly controversial, to accepted but mostly misunderstood.  Facial coverings, cloth, surgical masks or respirator masks are not all created equal.  While any type of facial covering is better than nothing the only mask that has been shown to have the most effectiveness is the N95 respirator that you will see our team wearing when they are face to face in direct patient care.  The N95 (without a valve) has been shown to filter out 95% of particulate matter both inbound and outbound.  What that means is that an N95 protects both the person wearing and the others in front of them.  Again, any facial covering is better than nothing but cloth and surgical grade masks only protect others, not the wearer.  This is why we ask you to wear a mask and often times provide a new, sealed, complementary surgical mask at our office—to help protect others that are not wearing N95 respirators like us.  

Scheduling

When we reopened, you can imagine we had quite a back-log of patients.  Closing for two solid months will do that.  We still are trying to catch up.  However, we are approaching this cautiously as well.  We have reserved the first slot of the day for our elderly patients.  I have two slots reserved throughout each day for emergencies/urgent matters and, if needed, a procedure.  We still continue to maintain social distancing and we are doing that by limiting the number of people in the building at one time.  By doing this it has only allowed me to see approximately one patient per hour.  Would I like to see more patients, absolutely, but I also am convinced we need to keep our office safe so we sanitize each room after each exam.  This is again for your safety first.  

Pre-visit screenings

This has really revolutionized how I practice.  We are now taking a case history, intake, “interview,” prior to you coming.  This minimizes the time you spend in the office (as referenced above) but it also has allowed me to better understand your concerns before you come in the office.  These phone interviews are conducted and recorded and I listen to them prior to you coming in.  This allows you easier access to medications, contact lens parameters, etc. that you may not bring with you to your visit and they are documented in your chart to help streamline the visit.  We also send out a COVID-19 acknowledgment that we ask all our patients to complete and sign 24 hours prior to their visit.  Basically, this is a screening that asks you to acknowledge whether you’ve been in contact with someone who is COVID-19 positive,  have had symptoms of COVID-19 or traveled to an area that is considered a “hot spot” for COVID-19.  We are doing this to keep everyone safe—but mainly you.  

Our attire

I hate scrubs. I loathe them, mainly because I believe they often times look sloppy and are worn incorrectly. Scrubs were designed to be worn in a “clean” environment (operating rooms, hospitals, etc.) where they could be worn, removed and laundered (if necessary) when they were soiled. They weren’t meant to be worn for comfort, style or uniformity. We prefer business casual but not during the pandemic. We wear regular clothes to the office, arrive earlier than normal to change into our scrubs and then change back into the clothes we came to work in at the end of the day. Our shoes are even left here. We are still putting you first by minimizing any opportunity of bringing something from home or anywhere we might stop on the way to the office.

All this to say, I have always been about customer service, taking care of the customer first. I do not plan on letting up. Although this COVID-19 pandemic has some extra hoops to jump through, they are all focused around and for you our trusted patients. Thank you for understanding and thank you for your patience. I really appreciate how my team has embraced these changes and followed them so strictly. I appreciate your trust and everyone that has verbally expressed their gratitude for our safeguards and protocols. We’ll get through this soon….together….

#SiennaEyeDoc 

Today marks two weeks since we reopened to patient care—what a relief it has been to be back at it again!  I have reflected on a number of things over these past weeks and observed some interesting things about the practice that I have been able to learn from.  First off, thank you for understanding my decision to close for two months while the COVID-19 pandemic was at its highest concern.  Mind you, I state, “at its highest concern,” not necessarily at its most dangerous.  I truly still believe that COVID-19 is dangerous and it may be more dangerous now as the public lets down its guard.  Just because “COVID-19” has become a household name does not change that it still exists, and people are still affected with it as we continue to learn more about it.  Rest assured we do not fear the virus in our office, but we are keeping to our protocols in place through the month of June and will reassess the next steps to move forward in July.

What have I learned?

• Masks are not so bad! While we are wearing them all day long we are also asking patrons to wear them as well. We inform and warn patients to come to our office wearing one and it has been universally accepted.  Thank you for understanding and thank you for helping us protect each other.
• Our phone interviews have made us more efficient and thorough! Once again, to help minimize the time a patient is in the office (to help minimize any exposure to COVID-19) my team has been conducting the patient history, asking the same questions and having the same conversation, over the phone prior to each patients’ visit.  They are recorded and I listen to them.  Just when we thought we couldn’t get any more efficient—we are always learning better ways.
  • This phone conversation allows patients to access their medications (strength and dosage) as well as their contact lens information at home when they may not have brought it with them to their visit.
  • Having the patients’ information ahead of time helps streamline the visit where there is no check-in and you are brought right back to the examination room to start your visit immediately.
  • My review ahead of time has helped me get a better grasp on how my team is doing with their conversation skills, charting and also help in my understanding of each patients’ needs and wants for the examination. This is quickly revisited by me with the patient in person.

I chose this route because many of my colleagues were doing the same.  I did not really think it would be 1. accepted and 2. as helpful as it has been.  I truly believe it may be something we stick with moving forward.  It only takes 5 minutes and it is so valuable for me to have prior to your visit.

• We really have an awesome team! I conducted a team orientation on May 18^th that lasted two hours.  We went over our new protocols and the steps to reopen.  Everyone was in attendance and attentive.  This participation has really helped aid in the reopening smoothly and successfully over the past two weeks.  I have always been thankful for my team but they really are shining through during these times.  Thank you all for being patient with these stars as we navigate through all this together—it is all new to us.
• Our technology really rocks! We have always taken pride in the technology we utilize but, to be honest, looking back we weren’t using it to its fullest potential until now—when we are forced to do so.  Eyecare is a different than other medical professions in certain ways.  Specifically, it requires a lot of close contact.  Social distancing of 6 feet is almost impossible with traditional means and equipment.  The slit lamp where I examine your eyes is no more than 4 inches from your mouth and nose to mine.  Extended times at that instrument cause my oculars to fog up and sometimes my diagnostic lenses I utilize.  I usually spend, in total, at least 5-6 minutes using that instrument with each patient.  That has changed.  We have universally utilized our Clarus UltraWideField imaging on all patients and that is reviewed with me on a computer monitor where patients are able to see the back of their eye at a safe distance for both of us.  The photoptor, which determines your prescription (you know the “click machine,” the ‘which is better 1 or 2’ black thing that you look through) would normally require me to be within arms length of you but our automated system allows me to safe distance from you as well.  Finally, to minimize touches and exchange, we have a stout HIPAA compliant/certified email server that allows us to eliminate interaction by utilizing online forms, patients are able to upload a copy of their insurance card and driver’s license securely and encrypted. Our credit card processing system is able to accept NFC/Apple Pay and we always can send an invoice to you as well.
• Change is good! It may have been daunting at first but so far it has worked out.  While I’ve been known to have extended hours for years to accommodate patients these times have called for some changes.  In order to “slowly open” back the office we have limited hours and spaced our appointment times apart.  This is in an effort to minimize body count in the building and allow us to sanitize our examination rooms, surfaces in the optical gallery, frames and continue to keep a safe environment for everyone.  This is taxing because we have 2 months of backlogged patients, new patients requesting appointments and additional protocols in place.  For now, please continue to be patient with us as we have altered the hours in June to safely proceed forward with more of “our regular” hours in the future.  Thank you for understanding that we may have a week or two wait for an appointment when this is not usually the case.

Once again, thank you for all your patience and understanding as we navigate through this new “normal.” Our efforts are to keep you safe and continue to serve you with diligence with minimal disruption and this is what I have learned so far, I look forward to continuing to learn through the process as well.

#SiennaEyeDoc

…Very SOON!  Trust me, I cannot wait to get back into the office to start taking care of patients while working alongside my team.  When folks state the term, “unprecedented,” I could not agree more!  This has certainly been an unprecedented time for me.  I do not ever recall, in the history of my 17 year career, where I stepped away from patient care for more than 2 weeks and we’re now going on 6!  When we eventually reopen the doors it will be just short of two months that I decided to cease operations and close the office.  That said, I believe it was the right thing to do.  I’ll be the first to admit that early on I didn’t really take this to be a serious issue much less turn into a pandemic.  I’ve been very fortunate to not know or have any of my family affected with COVID-19 and my deepest sympathies go out to those that have had a different experience.  I’ve always prided myself on making sound decisions based off of science and evidence I have relied on the guidance from authorities that subscribed to the same principles.  As I kept my pulse on the unfolding of the COVID-19 in America and around the world I started to feel uncomfortable with the direction and momentum of the virus.  Ultimately it was the recommendation of the CDC and Governor Abbott’s mandate that influenced my decision to cease operations on March 24th.

As I prepare to reopen the office on May 18th I am still keeping a pulse on the virus.  I truly believe that now is not the time to let up.  As much as I do not want to say it, if we do not closely watch and monitor our actions, we are headed for a second wave.  I am taking every precaution I know for our office to help minimize that risk.  With that, here is what we have planned for our reopening and why it is taking so long.

First off, I am in the process of reassembling my team.  Due to the financial strain on the office closing, all our of team was furloughed with the promise that they would have their jobs back when we reopened.  They will all be screened before each work shift and have all be properly screened thus far as for potential exposure to COVID-19.  We will have an orientation and deep cleaning of the office on May 18th and 19th before we go live with patient care on the 20th.

Secondly, as I mentioned previously we are going to do our part in mitigating a possible second wave.  Yes, we have PPE (Personal Protective Equipment) in place, sanitizing protocols, even some examination protocols will change but we are also going to be spacing the patient schedule out as well.  This means I will not be able to see the same number of patients as I used to.  This is an effort to a.) continue social distancing and b.) properly sanitize between patient interaction.  I ask your patience with us on this.  We have two months worth of backlogged office visits to get through along with the current patients that are due up for their annual examinations.

Lastly, as I have always been dedicated to caring for patients, I am doing the same for you during this time of reopening.  I am making sure that we have every “t” crossed and every “i” dotted.  I am sure that there will be some that do not agree with these measures.  I do not think any of our measures are extreme–just appropriate.  I believe strongly in the actions I am directing my team to take.  These actions are to give you a peaceful, comfortable and a safe environment to visit.  Until now, I have been able to navigate COVID-19 with my team, my family and myself safely and successfully.  I intend to do the same moving forward until, whenever, we get in the clear.

I can’t wait to see you soon!

#SiennaEyeDoc

From the beginning Gee Eye Care as a practice, and I as the owner and doctor of this practice, have always been here to set customer service as the first priority.  That is never going to change no matter what.  And so along the way some things may have to change in order to maintain that level of service.  We take pride in being able to provide an exceptional experience for our patients and we are trying our hardest to do so.  There are things that drag us down, we are all human after all, and there is only so much positive reinforcement and encouragement that can be shared to maintain morale in the building.   That lack of morale can easily affect and degrade the patient experience that we are trying our hardest to provide.  After months of consideration, factoring in different things I reflect…

I reflect on why my team and I exist for our patients.  We are here to provide services, medical services, optical services, arrange your appointments, send your prescriptions and, for our culture, provide a great experience for you when you visit with us.  What drags things out and drags us down, either on the phone or in person, is the confusion about insurance.  This has a lasting effect in the sense that we are not able to concentrate on the above mentioned to the fullest extent.  I must reiterate that I have been observing and measuring this for a number of months. The amount of time it takes for my team to verify insurance, explain insurance to patients and at times to the end result of not even seeing the patient or the patient getting upset because of the insurance.  One can imagine how this is a kick in the gut when you have worked at least 20-30 minutes (and sometimes up to an hour) on these tasks.  It adds up and it takes away from what is most important, taking care of you—the patient.

I understand that many people view insurance to be beneficial but some are finding it to be just as laborious as we do and share the same thoughts and sentiments.  Once again, insurance is not what we are in the business of doing, it is a courtesy that we provide but ultimately we exist to take care of eyes and eye health.  Insurance has increasingly presented a barrier for that and it has become more and more difficult to work with over the years.

I want to be very clear that I have spent hours and months thinking about what to do because this one facet has started to change our culture of customer service—and that I will not tolerate. I continue to look for ways to maintain our patient experience and customer service as the top priority with excellent care…please stay tuned.

#SiennaEyeDoc

It’s been a little while since I’ve logged an entry here but frankly I’ve got a lot to say and three blog posts that I have in drafts so stay with me over the next few weeks to months as we finish of 2019 with a bang. 

….Pulsed Light, as in IPL.  I’m excited to discuss what is called Intense Pulsed Light (IPL) today.  I’ve been investigating whether to bring this type of therapy in the office for over a year now.  I actually became quite interested over the past few years but was watching from the sidelines to see how it all panned out for eye care in general and where it might play a role in our office.  Our patients are not new to me bringing in new and innovative technology, you probably see something new every time you come to the office, it is always in an effort to better take care of your eye health.  As the tag line for the office has been and always will be, “dedicated to the health of your eyes,” the addition of this technology and previous technology is to stay “dedicated” for our patients.  That being said, I consider myself a mid to early adopter of new technology and therapies.  I like to stay up on the studies and see how things actually work and if it applies to our patients’ needs.  I want to be clear, I do not flippantly bring in instrumentation and look for ways “to pay it off.”  I’ve always thought of it quite differently, and if I bring in instrumentation it is to address a need for our patients and the cost of which will eventually take care of itself.

So, what is IPL?  IPL has been used routinely by dermatology to treat the inflammation related to rosacea.  Rosacea of the face results in rosy red cheeks, red nasal area and sometimes around the chin.  It is an inflammatory condition that affects mostly lightly pigmented individuals and may be exacerbated by heat, angst, alcohol, to name a few (figures 1&2.). Courtesy of http://www.rosacea.org

(figure 1.)

(figure 2.)

A few years back eye doctors started to recognize that IPL was effective on patients with ocular rosacea.  This is another inflammatory condition that specifically affects the eyelid and results in dry eye.  Ocular rosacea is nothing new, it has been linked very closely to meibomian gland dysfunction (MGD) and blepharitis for decades in eye care.  This is where I step in and explain the role of IPL in our practice.  Any patient that has seen me over the years has had at least one conversation with me regarding dry eye and MGD.  If you are one of those patients, do you recall me discussing with you the importance of lid hygiene, warm compresses, have I shown you images of your lids?  Have I also imaged your glands with our LipiView instrumentation, have I proposed a treatment like the LipiFlow thermal pulsation treatment?  Those discussions were all as a result of your MGD condition and likely linked to ocular rosacea.  I have been a leader on the dry eye front for a number of years now, I have been on various advisory boards for dry eye medications and devices.  My practice was the first private optometry practice with the LipiFlow instrumentation (4^th office overall in the city of Houston).  As a result, we continue to complement our treatment of MGD and dry eye with the implementation of the IPL treatment.  I can say that amongst optometrists with the LipiFlow and IPL technology that I have the most experience collectively with the two technologies having had them for the longest.  With that it should bring a sense of security and confidence as a patient, I am not trying to “pay off my instrument,” we have had it long enough.  Secondly, with the wealth of experience I am able to select the best candidates for the combined procedure to increase successfully outcomes.  Thirdly, this is likely something you’ve already heard about from myself or another eye doctor but has not been addressed because the technology was not readily available.

As to be expected, with all things that are new there is a great deal of excitement.  I can say that this is very true with the IPL treatment and I do not see that excitement changing in the near future.  Everyday, I am validated by my decision to bring this instrumentation in our practice because of, 1. the patients I continue to see with MGD and why, again, I brought it in and 2. the journal summaries I receive via email that consistently point toward this as an innovative and effective treatment for patients with MGD.

Do you think you could benefit from LipiFlow and/or IPL and would like to be evaluated?  Please do not hesitate to contact the office to arrange an appointment with me or just email me a photo of your face to DrGee@GeeEyeCare.com.