Olympic skier, ophthalmic industry CEO endorses comanagement

Ryan Heckman

Ryan Heckman, president and CEO of ICON Eyecare, was raised in Colorado on the Western Slope, where he grew up skiing.

As a Nordic combined skier, he competed in the Olympics in 1992 and 1994. For the last 20 years, he has built health care companies, either as an owner or CEO.

“A lot of people would say that being in the Olympics would be an education that no one could take away,” Heckman told Primary Care Optometry News in an interview. “I always thought it meant I would be cool ... but now I’m 44 years old with two kids and I’m not cool. It did teach me absolute resolve and dedication, commitment, resiliency and a competitive spirit.”

ICON has more than tripled its presence in Colorado during his first 4 years as president and CEO.

“Without those qualities, I don’t think we could have accomplished that,” Heckman said.

Heckman and his team have spent countless hours working on and improving the culture at ICON, to improve the environment for employees and patients. “One of the things we’ve tried to do here is instill pride in our care teams,” he said. “My theory is that if our employees are inspired and fulfilled they will provide an awesome patient experience. The patients will see and feel that.”

PCON: Tell us about ICON and the services you provide.

Heckman: ICON Eyecare has been serving Colorado since 1999. Principally, we were a LASIK provider until 4 years ago, when we made a strategic shift to be more of a medical provider of eye care services. They built a state-of-the-art surgery center in Denver and acquired a practice in Grand Junction, Colo. Today we are the largest provider of medical and LASIK eye care in the state. We have eight surgeon doctors and six optometrists.

We partner with the optometry community, in a comanagement relationship. About 60% of our work is done in concert with local optometrists, which is particularly the case for rural Colorado.

We are based in Grand Junction, but we serve everything west of Denver. It’s a massive half of our state. Local optometrists are very important to the delivery of care.

We don’t sell glasses; we provide advanced eye solutions: LASIK, cataract and glaucoma treatment, anything that an OD needs to refer out, we perform. If someone needs eyeglasses they would go to their local optometrist.

The optometry community is so important to us as an ophthalmology practice. Our older population doesn’t want to drive 4 or 5 hours for a postop or preop appointment. They want to be able to have the security and relationship with their local optometrist and make sure we are coordinated with that local practice so the patient doesn’t feel like it’s a separate practice, but just an extension of it. The patients can feel that.

One of the things our doctors try to do is elevate the OD, to talk about how coordinated they are and aligned with the care plan. The local optometrists are the ones that have the relationship with patients. They are closest to the patient and their community.

Our relationship with our doctors is very athletic. I know they are very smart and way smarter than me, and in my role, as CEO I work for them. It’s my job to make sure they have everything they need to be successful. I can empathize with them when they have a bad day. Being a surgeon is every bit like a sport, but with even higher stakes. I treat our doctors with great reverence.

Communication is also essential. Whether it’s a marriage or friendship, it usually comes down to making sure we are all on the same page to work together. In areas like Grand Junction, patients may drive 4 hours to see doctors. We want to make sure when they come they aren’t waiting for an hour and a half. It puts pressure on our delivery of care. We must be on our game.

Recruiting doctors is also very difficult in rural areas. We are very lucky to have two of our strongest doctors located in Grand Junction, who participate in clinical studies and are leaders of the industry.

PCON: What is flat light and how does ICON help skiers see better on the slopes?

Heckman: At the beginning of the Olympics, during the first week, all alpine skiing events were postponed because the wind kicked up snow and even further reduced visual contrast, to the point where a skier cannot ski. If you talk to recreational skiers, a lot of injuries happen at the end of the day, not because of muscle fatigue, but because the light gets flat; you cannot see obstacles. Skiing is one of the sports where you need to see well to do it.

It’s very cumbersome to wear eyeglasses. They fog up due to the elements; they don’t fit well under goggles. Skiers really have a tough time in flat light at around 2 p.m. to 5 p.m.

From an optometry standpoint, the effects of flat light can be a leading indicator of either cataracts or dry eye. A patient may not sense their poorer vision driving around, but when they are skiing, fly fishing or biking they notice it. It can be a great leading indicator because flat light exacerbates other conditions in the eye that you may not be aware of.

Bode Miller, the most celebrated male alpine skier in the history of the sport, is a patient of ours. He sought something like LASIK to improve his vision. In that sport, 1/200 of a second can win a race, which comes down to only 2 or 3 inches at the finish line. If he can see a touch better than the next competitor, it’s worth it.

A lot of athletes approach us from similar sports where contrast and flat light is a big deal. LASIK or Visian ICL (Staar Surgical) is a good alternative when they don’t want to worry about another piece of equipment.

There are also many eye wear technologies that optometrists sell, such as sun goggles and glasses, that we would recommend a patient tries first. If they want something more, we have surgical solutions.

PCON: What else would you like optometrists to know?

Heckman: Coordination of care and communication between the optometrist and ophthalmologist is so important, and we both play a role in serving patients by giving each other input and ideas on how we can do better.

Have a conversation with an ophthalmologist about not just the technical aspects of the work, but also their soft skills – how can we communicate better and serve the patient better. What things can the ophthalmologist do to promote the optometrist, and how do we work together better?

As a CEO, I’m not a doctor. What the patient feels is often the softer things, which aren’t getting talked about. This may be something like a surgeon picking up their cell phone on their way home to let the optometrist know how the surgery went. Now, the optometrist has first-hand knowledge of it. If an optometrist doesn’t request that, they may not get that phone call, and that can make a big difference in term of patient confidence and the continuum of care.

Be demanding of your ophthalmologists, because the patient will get better care because of it.

You hire the best people, you make them even better and you provide great care to patients and win. It’s in a nutshell how simple it is. The execution is difficult, but I’m really proud of what we’ve accomplished. – Interview by Abigail Sutton

Disclosure: Heckman is president and CEO of ICON Eyecare.