Q&A: Craig Thomas, OD: Optometrist Dallas, TX

Where did you grow up?

I was born in Houston, moved to Dallas for two years at age 8, moved to Los Angeles for five years, then came back to Dallas. I went to Houston for college and moved back to Dallas 33 years ago when I graduated.

How did you get into optometry school after you were rejected?

I became aware of optometry as a profession while an undergrad at the University of Houston. I wanted to be some kind of doctor, so I applied and did not get in. Three days before the semester started, I get a phone call asking if I still wanted to go to optometry school. I showed up and after a few days, I got a meeting with the associate dean of admissions. I said, “I got this fancy rejection letter from you in the middle of summer, then I get a phone call three days before school starts saying do you still want to come. What’s going on?” He told me. Apparently the school went through compliance with the government. They submitted their first-year class of entering students and out of 104 people, they didn’t have any black students. The federal government doesn’t like that for a good reason. So they thought, we got one or two guys that applied, we got to get them in no matter what. I don’t look negatively on it.

Why did you open a practice right out of school?

Actually, I bought a practice. I knew I wanted to be a doctor when I was 11 or 12 years old. Honestly, I did it because I wanted to make a lot of money. As I grew older, I realized I liked being a boss, too. So, that guided me from the beginning. The profession is built on guys like me, private practice regular guys.

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What is the biggest obstacle to growing a practice?

Lack of access to medical panels. Let’s say you’re an OD in a town where 70 percent of the people are on Blue Cross, but when you apply to the Blue Cross plan, they say the panel’s full; you can’t get on. Or, like what happened to me last year where I hired a new associate. The demographic around me is changing significantly to where 30 to 40 percent of my practice is now Medicaid. In Texas, HMOs and managed care plans closed the panels in a misguided attempt to save money. Their position is the less providers they have, the less money they’re going to spend. So, I hire a new associate to see all the Medicaid patients where I’m not really making that much money and keeps me free to see patients with higher revenue. They won’t let my new associate on the plan. It absolutely destroys my ability to stay competitive and to do what I want to do for my business.

Does your direct, no-nonsense style help or hurt your practice?

It’s a positive thing for my practice. I have a cult practice. My patients love me. You’ll find that a common thread to many private practices that are extremely successful. I know guys making $5 million a year being optometrists. They’re good at it, but the first part about being good at it is you have to be friendly. That makes a big difference in this business because it’s so service oriented. About 80 percent of my patients are black. They talk to me almost like I’m their preacher. They want their preacher in a fancy car. They want their preacher to be wearing diamond cufflinks. They don’t look at it like I’m making money off them and wasting it. They look at me like, “I’m going to a successful doctor, so that means I’m making good decisions.” That makes them feel better..

Why aren’t there more black optometrists?

Lack of awareness is the biggest thing. I was totally unaware until I went to the University of Houston.

What are the two biggest trends ODs should pay attention to?

My biggest thing right now is amniotic membrane therapy. It’s growing rapidly, lots of clinical benefits, lots of financial benefits to the provider. My next big opportunity is a different way of diagnosing and treating diabetic retinopathy. I may see 10 patients a day with diabetes. What you also get when you have diabetes is a phenomenon called neurodegeneration. And neurodegeneration is down at the cellular level, structural damage that you can’t see at all, but once the neurodegeneration starts you start to lose visual function. I have begun to teach that there are two kinds of diabetic retinopathy, the vascular kind we’ve been focused on for the past 50 years and the neurodegenerative kind that I learned about six months ago. The only way to assess and detect the neurodegenerative kind is to run a bunch of tests. And you can have neurodegeneration even in the presence of 20/20 acuity.

How did your CE program come about?

About 15 years ago, I was sitting at a meeting with Peter Shaw-McMinn giving a lecture. At that time he was the president of the AOA’s Practice Management Committee. After the class I said, “I have a complaint. I’ve been going to optometry continuing education for the past 18 years and not one time have I seen a black optometrist give a class. You’re in charge of the Practice Management Committee. Is there anything you can do about that?” To his credit, he stepped back a second and said, “You got a point here. Let me see what I can do.” He called me a few months later and took me under his wing for a year. That’s how I got started.

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

[Laughs] I was a Burger King manager for eight years. [Laughs] I would say I’ve been arrested but then people start asking, “Why?” [Laughs]

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What’s your guilty pleasure food?

Blue Bell Ice Cream. I eat a cup every night. [Laughs] I grew up on that stuff. It’s like drinking milk. [Laughs]

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

Got to change the education. Got to increase the number of patient exposures and the variety of eye disease that the students are consistently exposed to. They come out book smart, but they don’t know anything and they haven’t done anything. Have you heard the saying, “Never be the last eye doctor the patient sees before he goes blind”? That statement when I was in optometry school was pervasive. They would teach you to be scared and to refer to an ophthalmologist. If I was a teacher there, I’d be teaching these guys how to make $2 million a year. They’re afraid to talk about money. If you start talking about money or filing an insurance claim, then some OD will go, “What if you get audited?” You learn not to take responsibility or not want to treat glaucoma in optometry school. You learn to charge extra for dilation in optometry school. In the real world, you can’t survive like that.

Do you have any regrets?

That I didn’t get a better education in the beginning and it took me so long to figure it out. If I had to do it again, and I tell students this, rather than buying an existing practice, I would open cold and press my will on my people from Day One.

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

My best friend and optometric mentor Mike Hammond asked me to go to Las Vegas to a contact lens conference. I said, “Mike, I’ll go next time.” Tuesday morning comes and one of my opticians says he was killed in Vegas. He was in a taxi and a drunk guy ran a red light and T-boned them. I’m thinking, There’s no way he would have been running around Vegas without me in a taxi. I had a little Ford Mustang. In this little bitty car if I get hit by some big car, I’m dead. I left the office and drove the Volvo dealership. This is not me. So then I drove to the Jag dealership. I drove a sapphire blue XK-8 convertible right off the lot. It was a big, heavy car. They break down, they’re fragile. So I’m driving my Dodge Challenger now.

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