Posted On: 06/19/2018
Gayle Karanges, OD, '85, is a born entrepreneur. As a young girl, she started out making money teaching horseback riding lessons to kids in her neighborhood. After earning her optometry degree in 1985, she fearlessly ventured to start her own practice. Learn Dr. Karanges’s philosophy of running a private practice and how to thrive as an entrepreneur.
Q: Tell me about the entrepreneur in you?
A: I’ve always been an entrepreneur as a child. We had horses back in Illinois and I gave horseback riding lessons to kids in my town. We moved to Texas after high school and while in school I was always working and wanted to be in business myself. That was my plan. I always liked the medical profession and my mom was a registered nurse and she ran a primary care physician’s office for a number of years. I grew up understanding what that was like and I got interested in optometry and these two got merged.
Q: What brought you to UHCO?
A: I became a resident after moving to Texas, went for two years at UT Arlington, and applied and was accepted to UHCO. I had a really good education and a great experience at UHCO. Certainly, things have evolved a lot since I got out of school. Like anything, there wasn’t a lot of practice management taught then, just a few courses here and there. I think I had a good education and I just took a leap of faith. We didn’t do much medical at school. I took CE and always made sure I upgraded my skill set.
Q: How did you purchase your practice?
A: I was fortunate enough to find a local bank that was willing to give a small business loan. I didn’t have any student debt when I graduated out of optometry. My parents helped me with tuition and during the entire optometry school I worked. I always had a job and didn’t want to take any additional debt during school. I just made it work.
Q: What are some tips to start a private practice?
A: First of all, figure out where you want to live. What do you want to be; what’s your lifestyle? Research the area, figure out the location, and then figure out the start-up cost. Lots of doctors start a practice and work somewhere else part time and that’s a great way to start out. By the time you get your practice running after four or five years you can fully focus on that.
Assuming you are in a good location, by three years you should be getting a full load of patients. But you do your homework. You really need to study the demographics and now with the Internet it’s very easy as there are so many things you can do and there are so many services out there. You can understand things down to street counts and demographics by age… there is tons of data available. But it takes some time. Learn where you want to be and what your best chance for success is.
Q: What are the opportunities in rural optometry?
A: Rural optometry has tons of opportunities. I think students shouldn’t shy away from rural optometry as there is opportunity and living cost is very low. For someone with a high student loan debt they could rent there. The cost of living will be very low compared to other major cities. There is a ton of medical in those areas and once they are credentialed in those areas with Medicare and health plans, it can be very profitable. There is a huge need but they need to be okay with living in a small town and it is not a bad thing. They could be very successful and most of the big towns are not far. In small towns there is always a way around for your children’s education when a family grows. Public and private education opportunities are available.
Q: Tell us about your involvement with First Eye Care?
A: First Eye Care has a fairly similar business model like Vision Source. We basically have a management company and help people with vendor discounts, negotiate a lower price for various practices, HIPPA complaints, etc. I am one of 18 shareholders and that company is a profitable entity. There are around 170 offices that work with us and it’s regional in scope. Nearly 30 years ago, there were yellow page ads and we figured it might be good for us to collectively have one big advertisement instead of each one of us putting in separate advertisements. We recognized back then that branding was important. So we kind of got into the branding area. We don’t have the same fee structure like Vision Source and don’t charge a percentage. Instead we charge a flat fee based on what they buy. We buy everything a private practitioner will need in an office. It is a privately held company and we now have our own lab in Dallas. Our lab allows us not to have insurances cut income from us.
Q: What are your future goals?
A: One of my goals over the next five to ten years is to help doctors who are retiring. I want those older doctors to continue as I hate to see them close the doors. I am also looking at buying some more practices in Texas.
Q: What are the challenges facing optometry?
A: I don’t see many barriers. You have to continually stay current and make healthcare seem seamless for the patient. I don’t think virtual eye wear offerings will be a threat to our practices as patients will still rely on the touch and feel aspect. Besides, processes like refraction are an art and who has the time to unpack and ship boxes if they don’t fit you?
I am very much into fitness, wellness and passionate about people being healthy. The worst thing that can happen is to not have eyes… and the eye exam is as important as your mammogram or colonoscopy. What you do at 40 affects you at 60 and I try to educate people that way.