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MISSION VIEJO, Calif.—As is often the case, it was the behind-the-scenes work of its employee team that enabled Total Vision to quickly regain its footing in 2020 and finish the year with a strong surge. These efforts included securing PPE and facilitating vaccinations for team members, working with the California Optometric Association on practice and safety protocols and helping patients feel comfortable about their in-office experience at practice locations across California, according to Total Vision executives.

“We started getting back on track in June, and I would say we are very happy with the way we finished the year and with all of the protocols that we put into place,” chief executive Neil Collier told Vision Monday. “We felt we were able to safely see patients and we felt comfortable that our team and our patients were practicing safety, also.”





Collier, who joined Total Vision in early 2020, credited chief medical officer and founding doctor Steve Klein with leading the doctor-side of the effort to reopen operations and source all of the PPE that was needed.

“We’ve done extraordinarily well under any circumstances, but particularly under these circumstances,” Klein said. At the onset of the pandemic, Total Vision like other eyecare practices, could only offer essential services, but by early June its doctors began returning to their offices. What followed was “a pretty rapid ramp up” in business, Klein added.

Total Vision, which began 2020 with 32 locations, closed the year with five acquisitions in the fourth quarter and 41 locations overall. The group is backed by the private equity group Bregal Partners of New York. Describing the surge of partnerships in Q4, Collier said, “We saw the market coming back faster and, therefore, we felt comfortable going back in and going after acquisitions.”

Looking ahead, Klein said Total Vision has “relatively assertive plans to expand throughout 2021.” The group has focused its partnership efforts in five major regions of California—San Diego, Orange County, Los Angeles, the Bay Area and the Inland Empire—but it is not averse to moving into nearby border states. “We also are looking to go outside of those [markets] at this point,” Collier said. “Initially, we wanted the densification.”

An element of Total Vision’s operating model that is key to independent practices is the business improvement they experience after coming into the organization, Collier said. “There’s a reason that we continue to grow not only units, but we’re growing the overall business, too, because we have a lot of ‘best practices’ from the 95 doctors who we currently employ and all of the things that Dr. Klein has brought.”

Klein added, “What practices did 20 years ago that brought them relative success cannot be done the same way today. So many doctors felt that, ‘Hey, I’ve done it this way before and I ‘m going to do it the same way.’ And they have been very successful practices. But we bring them into the Total Vision culture and tent, so to speak, and we help them to see through analysis and through observations that some of the things they are doing were perfectly fine 20 years ago, but today they may not be as applicable.”

As part of its operating model, Total Vision allows new partner practices to keep their name, but does move to a co-branding program that identifies the practice as “a part of Total Vision.”





Building a Plan for 2021
Collier said one of the key objectives for 2021 is to work toward becoming a high-performing team. “Dr. Klein and Mike Stein, our director of operations, are actually going out and setting certain behavior and patient experience metrics that we want to deliver on in 2021.”

They also are working on validating, coaching and training in the field. “As we put everything back together in 2020, now we’re looking at 2021 to make sure that we have high-performing teams that are delivering the best team member experience and the best patient experience that we can,” he added.

More Vaccinations Yield More Exams
As the number of people who have received a vaccination has increased, Klein said he has observed a corresponding increase in the comfort level of doctors, staff and patients. And this phenomenon is likely occurring across the eyecare sector.

“We’ve seen a gradual process, as many others have seen, that as vaccinations have ramped up, the comfort level has rapidly increased,” he noted. As the comfort level increases, exams increase, too. “So, we made it a priority to try to help our 450-plus team members get vaccinated. It’s quite a maze to go through, but we made that a high priority.”

Taking the Dealmaking Pulse
Klein said from his perspective private practice optometrists today are more assertive in terms of reaching out and talking to management groups about potential partnerships. Often, the conversations touch upon “doing an early exit strategy and then continuing to work.” He added, “When I look at three years ago [when Total Vision was launched] versus today, we have far more practices wanting to reach out to us than previously.”