Q&A: Bryan Rogoff Principal and consultant for EyeExec Consulting

How did you get from math to optometry?

During my time at Stony Brook University, I had premed behind me along with theoretical mathematics. And when it came down to my senior year, my parents had asked me what I was going to do with my math degree. I said, “Well, a bunch of people are taking these actuarial type of tests, and I think I’ll take a couple of those.” They said, “Do you know how hard those tests are?” I said, “They can’t be any harder than the tests that I’m taking now.” “So, what are you going to do with your premed?” I said, “Nothing, really.” So they made some suggestions, and when optometry came up I thought, OK. It’s just contact lenses, glasses, not too much blood, I don’t have to be in school until I’m 38. So, I took the admission test and then I got accepted to Nova Southeastern University and that’s how the decision came about.

What plans for your optometry career did you have when you graduated?

A couple buddies and I were figuring out where we would want to open our practices, and that’s really what we wanted to do. We had to find jobs to pay back our loans, get our feet…just like life, it leads into different directions. I started working full time for a retail place, and I wanted to live in a more urban area. I was trying to move back to New York. I made my way to Raleigh and then all of sudden Washington, DC. Started working for a retail group there six days a week, over 50 hours a week, and was making good money. I realized that I enjoyed patient care but that I wanted to do more. I decided if I want my career to go in a particular direction, having a master’s degree would definitely do so. That’s when I had enrolled in the MBA program at George Washington University.

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What drew you away from clinical optometry?

I enjoyed patient care, but I wanted to do more with my career. I didn’t necessarily look at patient care as where I wanted my career to be. I was recognized to be able to marry clinical and business and mediate communications between the two. The company I worked for put me as a chairperson of the clinical advisory panel. So, I was privy to a lot of business and strategic modeling that really got me excited-that was exactly where I wanted to be because not a lot of people could communicate between both models. That’s how I got turned on to that.

Why is advocacy for optometry more important now?

Advocacy for optometry is a never-ending battle. If it’s not there, optometry will go backward almost immediately. Every year, we are defending what optometry does; we’re also defending the training, background, and all the clinical and didactic hours that we currently have. And it’s important for optometry to be part of the ever-changing healthcare reform system that is taking place right now because it can play an integral and very critical role to reduce costs and to advocate for better patient car. It is very important to make sure that optometry is represented in all those things that go on federally and also statewide.

What legislative and national billing changes do optometrists need to know about?

The current system of fee for service is just not sustainable, and that’s why we keep seeing healthcare costs constantly rising. The Affordable Care Act (ACA) introduced accountable care organizations (ACOs) to reduce a lot of administrative costs as well as redundancy in testing and increase the communications among practitioners. Unfortunately, fee for service doesn’t have that model. ACO models over the years have proven to save quite a bit of money on the CMS side, Medicare and Medicaid. I believe we will be seeing-not this year, definitely next year- starting on the private side billing or coordination of care vertical integration, and that’s how things will start being paid out.

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What do you do for down time?

When I have downtime, you mean. [Laughs] Being part of healthcare I do try to stay fit, obviously eating healthy but I also like to run, got into road biking, and exercising. I have three dogs and a cat, so I enjoy spending time with them. I have an 11-year-old son and spend a lot of time with him. I still perform part-time professionally as a dueling piano player-last year, I performed at the AOA as well as the Academy. I also enjoy traveling, and I am a certified skipper for sailing.

What future does optometric telemedicine offer today’s ODs?

Population health is going to be the key when you have limited funding. Getting retinal photos for diabetics is what we tested during this time for people with Medicare Advantage. We were able to determine high-risk and low-risk patients by taking pictures of the retina and determining if they needed to be seen tomorrow, in three months, in six months, or at one year. ODs have the background and training to be able to determine high and low risk, and it’s not to say this is lieu of a retinal or comprehensive exam. This is being able to monitor those patients who cannot be seen on a regular basis.

What’s something your colleagues don’t know about you?

My passion is that I want to be to transform the optometric industry to be part of healthcare reform. I don’t think anyone understands that I do lot of strategic work on being able to move that forward. We all can talk about it, we all can lecture about it, we can all write about it. It’s another thing to be able to formulate strategies and then execute them and follow up to make sure legislatively, business-wise, and clinically we are moving the needle forward.

Looking back on your career, do you have any regrets?

I do not have regrets on my career or general life at all. I’m a person who always feels that any experience that I’ve had is meant to be able to bring you to the next level. You can’t always have good experiences, you have to have the bad experiences to appreciate the good ones.

What’s one thing you would change about optometry as it stands now?

I wish that optometry as a profession could look forward altogether. On social media sites, we are looking in the past and saying, “We used to be able to get $X for an eye exam,” or “We used to be able to do this, and we’re pushing toward medical billing.”  We’re looking forward and looking back at the same time. Unfortunately, it keeps the profession a bit idle. If we’re really going to be able to push forward as a profession, we need to think of strategies to make sure that we’re current as opposed to always looking back.

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What’s the craziest thing you’ve ever done?

Oh boy…[Laughs] While attending optometry school, I worked in a dueling piano bar three to four days a week to pay for school and living expenses. When I was first starting out, I got a $100 tip to play my whole hour-long set with my shirt off. $100 back in the ‘90s was a lot more than it is today-I’d still do the set now with my shirt off for a hundred bucks-even though I had to split it with the other piano players. I’d really have to work out hard to be able to. And my fee is much higher now, I must say. [Laughs]

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