Dr Julia Giyaur Of New York Laser Vision On 5 Things You Need To Know To Create a Highly Successful Private Practice

An Interview With Jake Frankel

Be passionate about what you do and be sure that you really want to be a business owner. There are a lot of ups and downs, good times and difficult times, but if you have love for what you do and a true desire to be independent it will be easier.

As a part of our interview series with prominent medical professionals called “5 Things You Need To Know To Create a Highly Successful Private Practice” I had the pleasure of interviewing Dr. Julia Giyaur.

Dr. Julia Giyaur is a founding director of New York Laser Vision Aesthetics. A board certified ophthalmologist and ophthalmic surgeon, Dr. Julia Giyaur has a high level of experience with cataract surgery, laser vision correction, dry eye treatment, glaucoma treatment, diabetic eyecare, and cosmetic eyelid procedures. Her patient-centric approach results in a highly informative and easygoing bedside manner.

Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you ended up where you are?

I’ve always known that I wanted to be a doctor. It probably helped that my mom was an ophthalmologist (in Russia) and I was exposed to it from early childhood. I still remember using her big glass syringe with a reusable needle on my poor dolls. As I was going through medical school, ophthalmology was always in the back of my head somewhere. I knew that I wanted to do something with my hands, some sort of a surgical field, but it is during my anesthesiology rotation in medical school , while observing the sight saving retinal surgery, that I truly and finally made my decision to become an ophthalmologist.

I have never looked back since. The more I practice ophthalmology the more I fall in love with the profession. It’s perfect in so many ways. I am so fortunate that I was able to find a profession that brings me so much satisfaction and pleasure 20 years later. Twelve years of schooling including residency were not easy, but now it feels like they are over in the blink of an eye. And now I am enjoying being able to save people’s sight, reverse the effects of aging on their eyes, help them enjoy life more fully, and improve their appearance.

I’m a huge fan of mentorship throughout one’s career. None of us are able to achieve success without some help along the way. Who has been your biggest mentor? What was the most valuable lesson you learned from them?

My mom was my biggest mentor, without really wanting to be. My parents never actually pushed me to hyper achieve, I grew up in a very laid back environment, allowed to explore my dreams and be as active or inactive as I wanted to be. They taught more by example than by pestering and pushing. My mom never wanted me to become an ophthalmologist or any sort of a surgeon. She wanted me to have a calm job, to not have to stay up at night worrying about my patients, and to have a family. At least that’s what she said out loud while I was applying. But I know that the day I graduated from ophthalmology residency was one of the happier days in her life and that she felt an enormous amount of pride. I am grateful to prove that I was able to combine becoming an ophthalmologist, having a family with three kids, and running a private practice. When there is a will, there’s a way. I am also very excited that now my niece is following in my mother’s and my paths and applying to ophthalmology residency! So in a way our family mentorship continues.

What made you want to start your own practice? Can you tell us the story of how you started it?

After graduating from residency, I worked at a hospital faculty practice for a couple of years. I am a perfectionist and like to have things done “just so”. While attempting to implement certain improvements in clinical care I found out that in a hospital practice, certain improvements are extremely difficult to achieve. It was a very frustrating experience. So, after having my second son (the first one was born while I was in residency), I decided to venture out on my own. Of course, being an immigrant, I had very little financial support. Actually none. Also I had no idea how to run a practice. Absolutely no financial education or knowledge. I also didn’t know anyone who could help me with that. So I started small. First I worked out of my mother in laws family practice office, doing ophthalmology consults and slowly growing my practice. I am grateful for my in-laws’ help in those early days. In that tiny two room place the idea to create New York Laser Vision was born. With time I opened my own separate office in Brooklyn, NY, expanded it, hired other doctors and eventually added another location in Manhattan. In between all these expansions and office openings I had my daughter, who is now 7. I believe in creating an aesthetically pleasing and emotionally supportive environment for my patients. Both of New York Laser vision locations were built with the high attention to aesthetics in mind. They are beautiful, well designed, airy and pleasant. All the staff are welcoming and supportive. Our motto is to treat others the same way we want our parents, grandparents and ourselves treated.

Because it is a “helping profession”, some healthcare providers struggle with the idea of “monetization.” How do you address the business aspect of running a medical practice? Can you share a story or example?

We help people, but it’s not easy to do that in today’s environment of high technology, especially in ophthalmology. We have to think about finances and make the practice profitable in order to keep the doors open. It is very expensive to operate a high tech ophthalmology practice. I invest in the best equipment which allows me to provide the best care to my patients and achieve excellent results, however, it is extremely tough financially. In order to provide good service, good happy staff is essential, and staff salaries and incentives are a significant expense for my business. New York Laser Vision is not a budget discount office. Our prices are competitive, but on the higher side. At the same time we provide incredible value for the price to our patients. I firmly believe that we provide much better care to our patients than a budget clinic and a LASIK mill clinic, and my patients understand and appreciate this. At the same time we offer premium services for a discount to our senior patients. I am also a volunteer for American Academy of Ophthalmology Eye Care, and anybody who signs up for eyecare through that organization can receive our services for free.

Managing being a provider and a business owner is a constant balancing act. How do you manage both roles?

Being a doctor is a lifestyle and so is being a business owner. I am managing, but, honestly, I haven’t found a perfect formula. Once you add a family and three kids into the mix, it all seems pretty impossible. LIfe is crazy, but I love it! My husband is also a doctor with his own practice, so he is juggling things as well, so at least there is no conflict there. Although sometimes, it does get tough as a lot of personal things get postponed, rescheduled etc. Having good staff that you can trust helps a lot. My manager has been with me since the beginning, she is amazing and makes things possible. We have a true “girl power” between us.

Ok, thank you. Here is the main question of our interview. What are the 5 things you need to know to create a thriving practice, and why?

1. Be passionate about what you do and be sure that you really want to be a business owner. There are a lot of ups and downs, good times and difficult times, but if you have love for what you do and a true desire to be independent it will be easier.
2. Be prepared to work hard and distinguish yourself. Running a medical practice at the time of HMOs and Medicare cuts is difficult, so think about how your brand / your practice is different. What will you do that your competitors don’t, what services will you offer that are in demand but not available on every corner (and be prepared to continue being creative and inventive to stay competitive).
3. Be a good doctor! Patients will always come if you offer quality service. Invest time into training, education, work for someone initially to gain experience (this will also make you more confident). Be excellent and they will come and refer others to your practice! This really should have been my number one advice! My first three offices were tiny rooms in other doctors offices, but I gave each of those few first patients my 100% and now 15 years later my practice has 20K patients in it.
4. Speak with people, be annoying, call older physicians, go and visit them at their practice, or better yet go work for someone whose practice model you like. Do it in a different geographic location so you don’t feel bad and they don’t feel like they are training a competitor. Learn from them. Invest time and effort into getting to know the business prior to jumping head first. Read financial books or listen to lectures. Medical school is such a bad prep for the real world out there.
5. Once you are ready to open, invest into good staff. Good staff is expensive financially and time-wise (for training). But good people in your practice can make or break your practice. You will spend 5–10 min with each patient on their visit, your staff will likely spend a lot more. My patients are a barometer of how well my staff is doing. It’s amazing what kind of insight they will give you (especially the older patients who are always ready to chat). Invest time into training the staff. Experienced new hire is always good, but having a staff member with a great personality is an amazing asset and will build your practice. My manager, who is juggling a thousand things, and family and kids, and getting a psychology degree online at the same time, still finds the time to calm down especially anxious patients prior to a procedure. Or even come in during the procedure to hold their hand.

As a business owner, you spend most of your time working IN your practice, seeing patients. When and how do you shift to working ON your practice? (Marketing, upgrading systems, growing your practice, etc.) How much time do you spend on the business elements?

Work ON your practice, day one! Otherwise you become just an employee of your practice, not a real business owner. I see it over and over again with my older colleagues and it’s a bit unsettling: a doctor works hard in his practice all his life, is well respected, loved by the staff, but then gets burned out and starts slowing down. Investment into practice improvements stops, patient number dwindles, equipment gets old, and by the time the doctor is ready to sell, there is not much to sell . So divide your time, some for seeing patients, some for working on your practice and administrative things. My practice at this point in time is mostly surgical, so I have my associate doctors see most of the patients in the office. I see patients a couple of days a week, do procedures a couple of days a week and have a full administrative day. That’s ideal for me, although more time wouldn’t hurt. But in private practice you have to be prepared for everything. There are times in the recent past and multiple times before that when I didn’t have enough doctors to see all the patients, then I work a lot more since I have to see most of the patients in the office, and do surgeries. LIfe is very hectic then: Administrative time is at night, early in the morning, business phone calls while driving between offices etc. Keeps you on your toes.

I understand that the healthcare industry has unique stresses and hazards that other industries don’t have. What specific practices would you recommend to other healthcare leaders to improve their physical or mental wellness? Can you share a story or example?

Burnout is real. Not only in healthcare, but in healthcare especially, since we all take our work home. Have a hobby, something that you love to do and SCHEDULE time for it. If you don’t schedule it, you won’t do it. I’ve enjoyed different things over time. Photography at first, then my babies, walks on the beach in any weather, gardening (lasted for a couple of seasons), audiobooks while driving, now learning Italian while driving (I am not sure why it’s relaxing, but it is), travel. Schedule sleep, schedule workouts, outings with friends etc. Maybe it takes away from spontaneity but if you don’t schedule, it will get hectic and you won’t do it.

Can you please give us your favorite “Life Lesson Quote”? Can you share a story about how that was relevant in your own life?

“Learn from yesterday, live for today, hope for tomorrow. The important thing is not to stop questioning.” — Albert Einstein’s quote on continuing to learn your entire life. I haven’t stopped learning, ophthalmology (even after 17 years I am still continuing to learn) , new procedures, aesthetic medicine ( I also started a medical spa a little while ago), business management. I am always learning how to be a good mother and daughter. Kids always throw something new at you and you have to constantly readjust. Learning and exposing yourself to new things keeps you on your toes, keeps you young, and I love it!

How can our readers further follow your work online?

Learn about my work on my sites: www.NYLaserVision.com and www.JunoMediSpa.com

Thank you for these great insights! We wish you continued success and good health!