$800–$1,100+ Revenue Per Patient Across Associate Doctors: Build Your Specialty Growth System

Summary

Power Hour Optometry – Episode Summary

Episode Title: $800–$1,100+ Revenue Per Patient Across Associate Doctors: Build Your Specialty Growth System
Host: Dr. Eugene (Gene) Shotsman, The Power Practice
Guest: Dr. Todd Cohen
Date: June 19, 2026

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Episode Overview

This episode explores how Dr. Todd Cohen has built a highly successful, systematically run optometric practice where not just he, but all associate doctors consistently achieve high revenue per patient numbers (over $850, up to $1,164). The conversation focuses on building a specialty growth system, particularly with dry eye services, and how Dr. Cohen has created a culture and process for effective patient communication, treatment acceptance, and team-wide alignment. The episode is filled with practical insights for practice owners looking to elevate care and revenue—especially through specialty services—across all doctors, not just the lead clinician.

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Key Discussion Points & Insights

Practice Growth and Revenue Metrics

• Dr. Cohen reports all associates above $850 in revenue per patient, with numbers ranging from $865 to $1,164 per provider in Q1 of the current year ([05:05]).
• Practice growth has come from nailing down dry eye as the "lowest-hanging fruit" before expanding into aesthetics, where services like low-level light therapy, radio frequency, IPL, and skincare have been added ([03:41]).
• Despite economic "softening" seen in supply sales (contact lenses, multiple eyewear pairs), specialty and medical services maintain high acceptance rates and drive sustained revenue ([05:05], [08:34]).

Systematic Training and The "Trusted Advisor" Philosophy

• Dr. Cohen’s results aren't an outlier stemming from a superstar owner; he’s systematically trained even senior, acquired practitioners who previously had lower revenue-per-patient numbers ([06:44], [12:22]).
• Training focuses on transforming optometrists into "trusted advisors," prioritizing patient education and genuine concern—moving away from transactional sales and towards authoritative recommendations ([12:22], [15:34]).
  • Quote ([15:34]): “Sales is not a dirty word. Sales, in my opinion, is education and is giving people options and making them understand your level of expertise.” – Dr. Eugene Shotsman

Standardizing Patient Journeys

• Every patient receives myibography and a comprehensive, systematic workup regardless of age or symptoms. The team frequently reviews process and philosophy for alignment ([18:24]).
  • Quote ([18:24]): “Everybody should get the same level of care. I don’t care if you’re seeing Dr. Smith or Dr. Todd.”

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Patient Types and Communication Strategies

Dr. Cohen identifies core patient mindsets and tailors his communication to each:

1. Asymptomatic Minimizer

• Patients who don't recognize their dry eye because they're symptom-free or minimize issues.
• Uses analogies (“With a cavity, would you just wait until you feel it?”) and stresses prevention.
  • Quote ([20:00]): “If I’m a dentist, you have a cavity, should we just watch it till you can feel it?” – Dr. Cohen

2. Budget-Conscious

• Push back on price, want to know if insurance covers treatment, or prefer OTC solutions.
• Dr. Cohen uses social proof, comparisons, and economic logic (“Eye drops industry is $2.5B; let’s solve the root problem.”)
  • Quote ([23:46]): “Did you know they didn’t cover mammograms for 30 years?... Insurance doesn’t cover these treatments that fix the problem, but Alcon is making billions on eye drops.” – Dr. Cohen

3. Overwhelmed Information Processor

• Patients inundated by options or new concepts.
• Offers incremental steps (e.g., start with conservative treatments, provide education, and schedule follow-ups for progress).
  • Quote ([26:49]): “Let’s just try your way, some warm compresses and come back in a month.” – Dr. Cohen

4. Skeptical Researcher

• Wants more evidence or is distrustful, brings outside opinions.
• Provides studies, social proof, and patient stories without defensiveness ([29:54]).

5. Non-Committal / “I’ll Think About It”

• Doesn’t make an immediate decision.
• Staff uses systematic follow-up (content, check-in texts) to keep patient engaged ([31:28]).

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The Importance of Team Alignment and Handoffs

• Every staff member—front desk, pre-testing, coordinators—must understand and affirm the practice’s “why” ([34:01]).
• Staff can either reinforce or "kill" a recommendation. Regular meetings (every two months) keep everyone on the same page ([18:24]).
• The doctor carries authority and must make the recommendation, including pricing details, with clarity and confidence; awkward deferral to staff erodes trust ([34:49]).

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Prescribing Language and Behavior Training

• Good prescribing language: Direct, clear, and expresses concern (e.g., “I’m prescribing treatment because I’m concerned about your findings.”)
• Bad prescribing language: Hesitant, conditional, or ambiguous (“You can, but you don’t have to—totally up to you.”)
  • Quote ([40:04]): “We’re going to set up a further exam because I’m concerned about these findings. We’re going to prescribe you two pairs of glasses because you don’t have two pairs of shoes for everything.” – Dr. Cohen

Behavioral Training Points for Associates

• Listen more than you talk. Elicit patient engagement and agreement (e.g., “Where do you think your glands fall on this chart?”).
• Use storytelling and patient outcomes to provide social proof ([39:52]).
• Incorporate lifestyle information from pre-testing and refer to it—patients feel understood ([42:02]).
• Utilize a red/yellow/green system (based on prior purchase behavior) to challenge doctors and staff to “flip” patients with low engagement, not give up on them ([44:17]).

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Specialty Service Process Details: Dry Eye Example

Step-by-Step Patient Flow

• Myibography and comprehensive screening done on every patient.
• If further care is needed, recommend and schedule “ocular surface exam” before patient leaves ([53:03]).

Handoff Structure

• At specialty exam, more advanced diagnostics and thorough education via smart boards, images, videos ([48:08]).
• After doctor’s recommendation and Q&A, the staff assumes the close ("Dr. Cohen prescribed these wonderful treatments... Here’s what to expect..."), manages scheduling, financing, and all logistics ([50:38]).
• Ongoing follow-up, both clinical and administrative, to ensure completion.

Conversion Metrics

• 99% of recommended follow-up exams get scheduled; ~80%+ convert to some form of specialty treatment ([52:16], [53:03], [53:28]).

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Notable Quotes & Memorable Moments

• On systematic success ([12:22]): “This is a practice that wasn’t doing any dry eye whatsoever… We implemented all this new technology and I put the why behind it. Why are we bringing in OCT? Why are we going to do myibography on every single patient?”
• On trusted advisor role ([15:34]): “It benefits the patient if they see you as a trusted advisor… It would be to their detriment to buy less than they should.”
• On staff buy-in ([34:01]): “You have to have the why behind everything and have your staff trained to handle the aversions to treatment—cost, insurance—not just the doctors.”
• On conversion attitude ([53:47]): “What’s wrong with it? I didn’t—so, yeah, I think this is what you’ve been talking about for the last 50 minutes: you see that trusted advisor role… it’s almost like you don’t have an option not to schedule this.” – Dr. Shotsman
• On associate alignment ([56:10]): “There’s always a big dissociation between the doctor production, the associate production… putting the time in will reap benefits for your level of patient care across your practice.” – Dr. Cohen

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Key Timestamps

• 03:41 – Dr. Cohen describes growth, expanding services, and approach to aesthetics.
• 05:05 – Associates' revenue per patient breakdown; how these numbers are sustained.
• 12:22 – How Dr. Cohen systematically retrained acquired and seasoned doctors.
• 15:34 – Discussion of “trusted advisor” concept vs. transactional sales.
• 18:24 – Standardization of the patient journey, alignment between associates.
• 20:00 – Managing asymptomatic minimizers with analogies.
• 23:46 – Handling cost objections and insurance coverage conversations.
• 26:49 – Managing overwhelmed information processors; “try your way, come back in a month.”
• 29:54 – Addressing skeptical researchers and the importance of process follow-up.
• 34:01 – Why every team member must “believe the same thing.”
• 40:04 – Prescribing language: good vs. bad examples.
• 44:17 – Practical tip: color-coding patients based on prior engagement for targeted intervention.
• 48:08 – Dry eye specialty workflow: advanced diagnostics, education, handoff.
• 52:16–53:47 – Conversion rates at every stage, importance of scheduling before leaving.
• 56:10 – Final advice: “Constantly working on associate alignment benefits everyone.”

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Conclusion

This episode deconstructs a high-performing specialty optometry practice, demonstrating that systematizing patient education, recommendation, and staff alignment—not superstar charisma—drive both revenue and care quality. Dr. Cohen's comprehensive, “trusted advisor” approach paired with systematic training empowers associates to deliver similarly strong results. Listeners are left with actionable frameworks for understanding patient mindsets, scripting effective recommendations, supporting staff, and elevating acceptance of specialty services at scale.

Final Thought ([56:10]):
“Putting the time in will reap benefits for both your level of patient care and your practice—whether you have eight doctors or just two.” – Dr. Todd Cohen

Transcript

[A]

Foreign.

[B]

Welcome to the Power Hour, Optometry's biggest and longest running show. I'm your host, Gene Shotsman, and today we've got Todd Cohen back on the show. And the reason I wanted to bring

[A]

Todd back is because after the last episode that we recorded, I think about

[B]

18 months ago, a lot of people reached out about one number in particular, his revenue per patient. And in conversations with Todd after that, what's really interesting, that this revenue per patient number isn't just about Todd being Todd, a great doctor, a great educator himself. It's not just the owner producing at high level while everyone else trails behind. In this episode, Todd shares that all of his associates are actually above $850 in revenue per patient. And above that, he shares something that we kind of get to during the episode that the there's almost like a systematic approach to the way that Todd has an intentional way of training doctors to communicate with patients. And so we talk a lot about this system here in this episode. How to recognize what kind of patient is sitting in the chair, how to use what he calls prescribing language, how to talk with conviction without sounding pushy, and, you know, not the salesy component, but really the education, the preeminent approach. And also how to preempt objections about cost, insurance, timing, and the asymptomatic patient who says, oh, but I feel fine. And also how to make sure that the patient really understands the why behind the recommendation before they ever get to the front desk. So we spend a lot of time unpacking that system in the context of dry eye, but really this can be applied to dry eye specialty services exam only. These optical recommendations and the difference between casually mentioning something and actually prescribing is huge. And we get into how the handoffs work, why the whole team has to believe the same thing, and why the staff can kind of reinforce the doctor's recommendation or kind of unintentionally kill it. Maybe, but this is one of those episodes where the numbers are impressive, but the real value is in the process or the behaviors behind the numbers. So if you own a practice and you've ever thought my associates just don't necessarily do things the way that I want them to or that I do, or patients say yes to me, but the rest of the team needs a

[A]

little bit of a push.

[B]

This conversation is going to give you a lot to think about, so I hope you enjoy it. Before we jump in, make sure you're subscribed on YouTube, Spotify, Apple Podcasts, or

[A]

wherever you get your shows. As always, if you have feedback or

[B]

episode ideas, you can reach out to me directly@eugene shotsman.com or through the Power Hour website. And also a quick reminder to check out the I Care Boss book on iCare, careboss.com or Amazon. And now, here's my conversation with Todd Cohen.

[A]

Dr. Todd Cohen, welcome back to the Power Hour. Excited to have you on the show again.

[C]

Always a pleasure to be here and have stimulating conversations.

[A]

Yeah. So we caught up a year and a half ago or so on the show and at that point I had gotten, we talked about a lot of things and specifically about medical, but you touched a little bit on dry eye. But really the part that was kind of fascinating and I got a lot of feedback on was that you had a high revenue per patient and one of the higher revenue per patient numbers that practices and practices remarked on that and they were thinking, how do you achieve that? And so that's why I wanted to bring you back on the show. And first of all, give me a little bit of background. How has the practice evolved since last time we talked and you know, have you guys grown? What's, what's the, the, what's the latest on your practice?

[C]

The latest is we have myself, it was in the clinic. I reduced my clinic hours to 15 hours a week from 20. My other associate I took to fill my one day, my six hours extra during the week. We've added some aesthetic services and I always do consulting with practices and all these doctors want to start right into aesthetics. And I always say absolutely, nail down your dry eye, that's the lowest hanging fruit and then add esthetics thereafter. So we have our esthetician that's been with us for a year and we added low light there, low level light therapy, as well as our radio frequency lipo flow ipl. So that's been complimentary. We've also brought in some skin care lines kind of doing prosthetic services on that end. And we just continue to build our pillars. Your dry eye and myopia management pillars.

[A]

The. Now how is the, again, the thing that was very remarkable I think to the audience and again a lot of people wrote in about this was that you were, I think over $850 in revenue, sometimes hitting 1,000 in terms of revenue per patient. How is that? Have you felt a softening of the market? Are you, are, are you still able to accomplish that? And what's, what's been the pattern that you've observed?

[C]

Well, just to give you some numbers, quarter one this year, one of my practices. My senior doctor who's the practice I acquired three years ago, he was at, he's at 8:65 for the year. Another associate is at 10:34 for the year. And then myself, I'm at 11:64. Another associate's 891, another associate's 876. So those are pretty strong numbers. The fact that we're able to maintain that is highly due to our medically based approach in our practice and our specialty services. I've definitely seen a downtick in annual supplies. We have a close to 85% daily disposable practice. So, um, I've seen a softening of that. We've seen some softening of the multiple pairs in the optical. But our medical based practice continues to, I call it almost like a farm system, continues to stimulate growth. And we've added retinal erg for retinal screenings as well. Or not screenings, but testing for patients. So those types of things always add to our practice revenue per patient.

[A]

Yeah. And then your specialty services, have you seen a decline in treatment acceptance rates? Or I mean, again, looking at your numbers, if you can get all of your associates above. I think every single number you said was above 850, even the DOC whose practice you bought, who you likely had to retrain is my guess, because I'm assuming you didn't buy a practice that was doing $865.

[C]

I was doing about 575.

[A]

Okay. Yeah. So clearly there's a systematic approach here. But let's talk about specialties first before we go to that system. The specialty services, treatment acceptance rates and things like that. Have you found it more, less challenging over the course of the last few months to be able to convert patients to specialty services, or has it not been a big difference?

[C]

It hasn't been a big difference in terms of conversion, But I will say that we've had to have our patient education coordinators, which are the people that we do the handoff after we do the ocular service exam, come up to the doctors, mainly me, the owner, saying, are there any payment plans we can formalize with patients to get the acceptance? Because there's been more and more patients ask, how can I split up payments? Because usually what we did, Eugene, is we said if you pay all in front, you get a few hundred dollars discount. Right. But now we're having patients ask that discount if they could split it up for several periods, which kind of defeats the purpose of the discount people that they all at once. We're trying to cleverly come up with some type of middle ground between those two for patients to afford treatments. And a lot of times we have a couple patients where they want to kind of piecemeal it, which isn't ideal, but we're willing to phase it with different say. All right, Eugene, let's just do the IPL and lipo flow and maybe we'll do the radio frequency the next six months or something like that. And we do educate them. The full treatment will give them the most relief. But if it's financially more feasible, we're happy to split it up into different phases. Got it.

[A]

So that's interesting. So you're seeing more patients ask for financing and for mechanisms for financing, but overall it sounds like you're, I mean your revenue patient per patient has not gone down year over year or has it gone down a little bit?

[C]

No. So just looking at my Excel spreadsheet here, going back to, Even back to 2018, 2019, I mean we've worked consistently, you know, 994, 973, 1,400, 987, 936. So the last time was 2020, we were below $850 a patient.

[A]

Yeah, so. So it seems like you haven't really. Because I hear this all the time in the marketplace is, hey, you know, where patients are walking out, there's, they're not buying $200 glasses. I mean, and I, and I hear this all the time, but the reality is that if, because obviously exam only are factored into that rate.

[C]

Correct.

[A]

You must have a relatively low exam only rate and you must have a relatively high treatment acceptance rate. And it hasn't really impacted or the economic conditions haven't really impacted you. But, and I think for, for everybody's benefit, your practice is in a, in you're not in like a, I, I guess I'd call it like what, like basically a middle class community with, within, within a metro area. So it's not like you're, it's not like you're, you know, in the heart of LA or you know, Beverly Hills, California or something.

[C]

You know, I know what's interesting is that in my 25 years of practice, I'll say some of our most adherent and loyal patients are those not the upper echelon of, of south household income. You know, because, you know, we are really a trusted advisor for these patients. And patient the other day is like, I've been seeing you for 25 years and you know, she comes in and does everything and and she's, you know, a single lady on a fixed income, but she knows that we really deeply care and have the most comprehensive care in our area and follow suit.

[A]

Got it. And I think the, that's an interesting point is that the conversion machine doesn't necessarily need to target only the higher income patients. It seems like it's about something else. So this is what I want to get into for part of the episode today is, and I don't know which one you want to pick. Maybe we pick dry eye, maybe we pick another one. But I'm wondering if we can talk a little bit about the nuance of not how does Todd do it, but clearly you have trained other people to do this, right? Clearly, if you're listing off your associate revenue per patient numbers and they're as high as they are, you have trained other people to be able to be able to systematically convert patients and to be able to achieve those numbers. And so with that in mind, if it's okay and just wanted to spend a little bit of time thinking about how, what's this, what's that systematic approach look like, Todd? And let's pick one kind of core area. You want to, you want to go with dry eye? You want to go with something else?

[C]

Let's go with dry eye.

[A]

Okay, perfect. So if you're, if you're thinking of like if you, if you had to get a new associate tomorrow, let's do it this way. Let's imagine you have an associate that's starting tomorrow and you have to kind of work through the. And maybe I'm that associate. And you have to kind of explained to me that, Eugene, we're not just going to go see the patient. We're going to have a systematic approach to how we see the patient. In my practice, what are some of the things that you think about when or I guess where would you start?

[C]

Well, let's take this for example. When I bought the existing practice, that was 35 plus years in practice. A lot of us who have associates, they have quote unquote senior seasoned doctors. Those people can be sticks in the mud in terms of trying to change their philosophy. So I'll kind of go from there because this is a practice that wasn't doing any dry eye whatsoever aside from a retina camera, wasn't doing any medical eye care. So I sat down with this person and we sat down and he shadowed me and we implemented all this new technology and I put the why behind it. Why are we bringing in an October? Why are we going to do my biography on every single patient. Why are we going to do these extra tests, peripheral vision tests and everybody, things like that. So that set the groundwork and I said, look, we want to be a proactive approach of our practice. We're able to provide more comprehensive care and it should be exciting for you to kind of relay that to your patients. This is a practice that I said, has been there 35 years. You didn't even really know what Lipoflow was. And we were cranking out 12 to 14 lipid flows the first couple months. I own the practice, so that in itself generates a lot of revenue, but a lot of it base goes down to the practice philosophy. When we're doing my biography on every single patient as a screening, whether you're 6 years old or 66 years old, I'm showing those images in the exam room and all my associates do the same thing. I kind of look at it as a sales process. As much as we don't want to say that five letter word, we are in the sales business in terms of being a trusted advisor for our patients and being proactive. So when I say, look, Eugene, this is what your retinal images look like. We can catch high blood pressure, diabetes. This is an OCT that scans the retina. 80,000 scans an image. This looks at things we can't see below the surface. This checks your peripheral vision. We catch neurological issues like pituitary tumors sometimes. Those are the things that mentally show the patient how thorough we're being and kind of helps with the buyer's remorse. We never have patients leave the front desk saying, why is he charging me for these tests? Because they see the philosophy and the reasoning about why we're doing those tests. So, you know, when you go to the dentist, you get an X ray regardless if you want it or not. You're paying a hundred and some odd dollars. So the dentist is doing that for being catching early things that you can't see. So I think when it comes to dry eye, when we're showing the images, the mibiography, I'm saying, Eugene, I'm concerned about these findings. Your glands look like yada, yada, yada. And this is why we're going to schedule up further testing and schedule an ocular surface exam. And in that sales process and showing concern for the patient, I start to use some social proofing. And I also try to get agreement from the patient. So they mentally buy in and ask any questions prior to setting up that further exam. I think that goes a long way.

[A]

Okay, so we're going to unpack a few things you just said in a second. I did want to point out that I absolutely love the language of trusted advisor.

[C]

Right.

[A]

A lot of practices, and it's not always the doctors, but oftentimes it's the opticians that try to manage the patient's wallet, not necessarily the, the, their own area of expertise. Because it really doesn't always benefit the patient to get the cheapest service. It, it really does benefit the patient if you are, if, if they can see you as a trusted advisor. It makes them more loyal, it makes them more likely to refer, it makes them more likely to spend money with you and understand why they're spending money with you because they, you know, anytime a patient walks in and they have a chief complaint which is like, I don't quite see as well as I should or something, something hurts, itches, whatever. The reality is that your job as their trusted advisor isn't necessarily to say, hey, warm compress and eye drops. It's, it's, it's really to get them to understand and to educate them completely and then, and to recommend because it would be to their detriment to buy less than they should, to buy in a less quantity than they should, to buy a less quality service than they should. And that's where, you know, I think you called it is like sales is not a dirty word. Sales, in my opinion, is education and is giving people options and making them understand your level of expertise. And what you understand a good salesperson is somebody who is a true subject matter expert in the thing that they, and then they're really, really good at knowing what they're talking about and then being able to solve problems with their level of expertise. That's all sales is. And it's not dirty. I think that, you know, you get the whole sleazy car salesman, you know, whatever, but, but that's not, that's not what we're talking about. I think that there's a very honorable and, and valuable component of that, of, of, of that skill which is to really elevate in the patient's mind what your expertise looks like and to show them, to teach them, to educate them. And then from there, now you're on the pedestal in the patient's eyes of somebody who really understands what's going on and is now capable of solving their problem. So I love that you started with the concept of preeminence. Fricking loving that, Todd.

[C]

Yeah, it really goes a long way and creates a lot of loyalty with patients as well. Yeah.

[A]

So, you know, I guess the question is, if you kind of think about this is the you and you kind of alluded to this, is the patient journey relatively the same for all patients like you do? You said you do a mibraphy on everybody or like, what are the steps of the patient journey in your office? And again, are they the same for every single associate?

[C]

They. They're pretty much. I mean, I do a good job of meeting with our doctors. I take everybody out to dinner, the doctors, every two months. I was at a study group and a few months ago, and I asked the same question to a lot of my colleagues, and they meet me with their associates like once a year, which is like Monday morning quarterback. Right. So it's really important to get everybody on the same page in terms of philosophy. I don't care if you're seeing Dr. Smith or Dr. Dr. Todd, everybody should get the same level of care. And I was taught by Nathan Hayes years ago that, you know, our revenue per patient is the product of the quality of care we're providing. So I don't harp on this associate saying, you got to hit 850, you got to hit 900. I will say that if we're doing everything we should be doing, recommending myopia management, recommending dry eye treatment, recommending secondary pairs, those things will follow in terms of the medical follow ups and medical treatments that'll naturally happen. So across associates, it's pretty standard. Thankfully, there are always challenges. Eugene, I do want to mention that, you know, every single patient doesn't accept every single time. It would be really nice. But there are lots of subsets of patient core mindsets that you have to kind of navigate. And for associates, it's not the easiest thing. Right. They can easily get the door shut on them. In terms of when.

[A]

When you're talking about core mindsets, are you saying that there are different types of patients and you have to be aware of who is in your chair?

[C]

Absolutely. I'm kind of proud to say that, you know, back when we do a lot of Lipiflow as our mainstay, I'd say about 50% of our patients had Lipiflow were completely asymptomatic, which is the hardest type of patient to convince. Right. I'm fine, I wear my contacts fine. You know, I'm not having any issues. So kind of like the asymptomatic minimizer, you know, I don't feel like I need to treat it. And those patients, you really have to voice your concern. You know, I would say I use a lots of analogies in my practice. I say, gene, if I'm a dentist, you have a cavity, should we just watch it till you can feel it? Till it gets better? I think it's worse. No, you don't want to just all of a sudden be sitting there with your friends on Saturday night and your, your tooth is killing you when the cavity could have been treated proactively or if you're, if, you know, if you're choking on a chicken wing, I'm not going to give you oxygen. I'm going to remove the obstruction. So those are things that we proactively say to those asymptomatic patients. Like, look, I want to keep you feeling that way. I want to make sure you can wear your contacts so you're 120 years old comfortably. So those types of things and responses by the associate are ways to kind of tackle the asymptomatic minimizer.

[A]

I guess the discomfort that a doctor tends to feel is if a patient says, but, but I'm fine. My, my, I don't have any problems. The natural thing that you want to do is mirror that and say, well, that's great, you know, oh, okay, well, we'll just go ahead and monitor that or we'll keep an eye on it while, like, you, you want to, naturally, as a human, you want to mirror that. You don't want to create conflict. And many people are just natural conflict avoiders. And what you're saying again is that you have to adopt the mindset that you know more than the patient. Right. You spend, you spend 2,000 hours a year or working on this or helping, helping your practice work on this, whereas they spend, I don't know, maybe an hour every year inside of your doors, if you're lucky, maybe an hour every two years. And so this is a really, really key point is that if a patient is asymptomatic, they really, really do depend on you to do high quality education. And I like some of the analogies that you use the dentist one I think I'm definitely going to steal at some point for, for some of our clients because that's a, that's great. And it's like, we wouldn't, we really wouldn't watch a cavity. We would take, we would take care of it.

[C]

Right, right. Also another one, you know, was the budget conscious? Right. A lot of our, our colleagues, when I do a lot of consulting, it's like, okay, Gina, let's just do warm compresses. I understand. Or you know, why the patient's like, why can't I just use eye drops if my eyes feel dry? Those types of things. And again, as a trusted advisor, you have to really convey your knowledge base and also use some social proofing. Oh, I, a lot of patients say that, but no, after we do this and these patients come back and they say they wish they did it earlier or something like that. Because a lot of patients like I want. How many times have you heard either an optical or the exam room. I just want the insurance covers. Right. Whether it's optical products or whatever, those are the ways that you can respond as a doctor and associate to kind of counter that. Right. Because they're going to say, does insurance cover this? Or I'll just get drops at Costco or something like that. So you have to have the right mindset as a trusted advisor to convey and acknowledge those feelings from the patient, but also guide them towards the path of what's best for them.

[A]

Yeah. So how do you respond when somebody says that, well, if it's not covered by, well, it sounds like it's really expensive and if it's not covered by my insurance, I don't know that I, I don't want to pay for this.

[C]

So in terms of the ex, like the treatments that they'd have to pay out of pocket. Okay. So. And I was taught this years ago by one of the lead Johnson and Johnson trainers, national trainers, and she, she alerted me to this and this very eye opening. And it resonates with patients. I said, you know, Eugene, did you know that they didn't cover mammograms for 30 years? Insurance company just think about how many women's lives they could have saved. The reason why insurance doesn't quote unquote, cover these treatments that will actually fix and go to the root of the underlying problem is about, you know, eye drops. Prescription costs anywhere from 80 to $100 per month for dry eye. Unfortunately, in America most people leave check to check and about only 30% of patients actually fill those. And the over the counter eye drop industry is about two and a half billion dollars. So just think about that for a minute. How much Alcon and refresh is making it in their eye drops. So if we can go to the core of the problem and reduce your dependency on eye drops and prevent your eyes from getting worse, then it'll, you'll be way ahead of the game in the long term.

[A]

And I think this is a great opportunity to bring up something like a membership plan or financing as you alluded to earlier. I think that makes sense. Perfect, perfect. Perfect sense. Okay, so we covered, I guess how many mindsets are there? Because we covered somebody who's asymptomatic. We covered somebody who's budget conscious and kind of understanding who's in your chair. What's the next one?

[C]

I would say the Overwhelmed information processor. There's some people that this is a lot information. I can't make the decision I just came in here for glasses today or I've never heard this information before because, you know, according to Jobson, the average patient goes to 3.2 dry eye specialists before they find the right door to finally live in. So it's pretty eye opening and upsetting that a lot of our colleagues aren't providing the comprehensive dry eye care that patients are demanding and seeking out. I, you know, there's some Facebook groups with thousands upon thousands of members worldwide and they're all frustrated because they can't find the right answers. Obviously there's extenuating circumstances where people are really severe. But by and large the bell curve is this mild to moderate patients that just aren't getting the responses from their doctors and the treatment. So the overwhelmed information processor is like, this is a lot to take in. Can I think about it? I'm not understand all this. And to those patients, of course, I and respond to their concerns. I said, you know what, sounds great, let's make a plan. Let's start with a warm compress. Let's start with some eye drops. I'm going to send you some videos and information detailing your findings and your condition. You can watch on your own time. And then what I learned from one of our colleagues is that, okay, Eugene, we've tried your way. Let's have you come back in a month. We'll just check how you're doing. That relieves the ceiling in the bar. The patients have to make a decision at that point.

[A]

Point.

[C]

So you come back in a month and invariably, hey, Eugene, how those warm compresses go, how those eye drops go? Well, I did it a couple days a week, this and that and the other. So you say at that one month follow up. So you know, we've tried your way. Let's take a more proactive approach at that point. They've already gotten the videos of education. They've understand what would happen if they do nothing. What are different treatment options? Kind of segment it if it's going to make it easier for that type of patient mindset where they can take small bites before they take the whole bite of the whole big treatment. That Might be overwhelming for them.

[B]

Yeah.

[A]

And this is one of those things where, like, it sounds like for that person you just want to make, to help them make a micro decision. Like the micro decision is I'm agreeing to come back in a month or something like that, or I'm agreeing to do, to do something small that is like a, not a, not a huge commitment, not anything overwhelming, and you're kind of furthering their education. But yeah, we, we all know those people. And typically those people are structured, they're detail oriented, and they want to know every, every little detail that sometimes in sales psychology they call them the engineers. Right. Like, they're the ones who absolutely want to know everything about, about this. But they're different than like a researcher that these, these people are, they just, they don't make decisions quickly and you can't force them to make decisions quickly. So the only thing you can do is get them to make a small decision as, as a small commitment. And that would be the, you're, you're saying like, just schedule them for a month out for.

[C]

Yeah.

[A]

Now what do you call that appointment when you schedule them a month out?

[C]

You always call it an ocular surface exam because dry eye is a marketing symptomatic term. When you're saying ocular surface disease, that opens up the box to talk to patients like, look, your environment is affecting this. Your antidepressant medications are affecting this. Your allergy medications are affecting this. You know, you live in the Midwest where allergies affect this. So it goes into, you have autoimmune issue. It goes into the whole picture. We're not just fixing dry eye, we're fixing ocular surface disease. It affects the lids, the lapses, the ocular surface. So that kind of resin resonates with patients, saying it's a chronic progressive thing when needs to be managed. And also in my early days, I made a lot of mistakes, as we all do and learn from them. And I said, oh, lipo flow is going to fix your dry eye. Well, why that was. That went out the window after six months because half the patients, even according to J and JJ research, were 50% better. So 50% of patients are like, I feel anything even though the glands are working. And the other 50%, I go, this is the best thing ever. So in terms of describing that to patients, it's really important for the doctor to convey that the full circle approach and it never goes away.

[A]

Got it, got it. Makes, Makes sense. So what did we cover all the, all the patients? Well, probably not right because the only

[C]

other two things are like you just touched on as a skeptical researcher. I don't believe it. I need more proof. Or I've heard from somebody that you lipo flow doesn't work. Or I saw us online or can you show me the studies? And then that kind of. You can overload them with the studies and the videos. That kind of helps with that point and be happy to send it to them because you don't want to be too defensive. At the same time, you want to kind of give them a history of the background about why you do this and why this approach works. And again, social proofing is good for those people too. And I would say the last subgroup would be like, well, I'll think about it. If nothing happened, nothing bad's really going to happen to me and I'll just kind of, I'll call you when I'm ready types of things and I start next month or. But those are the things that a lot of us are so busy in our everyday practices. You have to have some type of process where you're your front desk or you're auto. With AI, you could automate messages a month later to send more information and just personally check in people. So, you know, you go look at a Toyota, for example, car dealership, you're kicking the tires. That salesperson is going to follow up with you in a week. Every couple weeks he's going to nudge, nudge, nudge you until you finally say, stop calling me, I got a different car. Or, you know, I'm finally want to come back in. So you have to kind of look at your patients and the experience, coming as a trusted advisor to caring for them, not pushing a product, coming in and checking in with them, saying, hey, Eugene, how are you doing? Let's. Any other questions I can touch base with and, and things like that.

[A]

So you're saying basically follow up. And the follow up is with content and maybe with like a text message a few months later to say, hey, how are you doing? How was your dry eye? Did you want to, did you want to learn a little bit more or did you, did you want to like, how do you frame it so that the patient feels like, oh my, my way, as you said earlier, like, well, your way isn't really working right. And so, yeah, how are your eyes feeling?

[C]

And you know, here's some, maybe some dry eye facts as you know that when your eyes are watery, you actually have dry eye, you know, and patients are like, what do you mean? I have. What do you mean and then you talk about the, the quality versus quantity thing also, you know, you know, talk about, I have tons of my patients that we've done treatments with and they're happy, go lucky, they're skipping through the fields, they're not using eyedrops, they're so comfortable. But I said, you know what, Mrs. Jones, I'm going to see you in October before the weather gets cold because I want to make sure your eyes, there's no inflammation going into the dead of winter in Chicago. And I'm also going to see you back in April because I know allergies kind of mimic dry eye symptoms. I want to make sure your eyes are looking good going into the allergy season, summer. And every single patient will keep those six month appointments because we are coming with a concern. And when they're in the office, as we know from a sales perspective, that's a time to sell products, sell their services, educate them that it's important to use that maintenance program. We sign them up with, with their every three to six month touch ups. In terms of the IPLs, for example, things like that are showing again concern for the patient and keeping them happy. And this is even talking about aesthetics. I mean aesthetics, you have to do maintenance, otherwise your money's kind of wasted. So.

[A]

Oh yeah, no, I think aesthetics is like once you, once you get good at it and you get out of the tox trap, which you know, I affectionately call the, the budget tox trap, where a lot of practices get stuck, you get into a real esthetics of which ultimately create a, almost a passive income because those patients, once they really like the person who's providing the service and they feel trust and value, they're coming back like they're, they're, you know, they, they have been conditioned very well that they're making an investment and they have to essentially in order to not waste all the investment that they've made before, they have to keep coming back on a regular basis. But you know, I think conveying that to dry eye patients is important too.

[C]

And I think it's important that. I did want to mention that it's very important that whether you bring in new technology or not, you have everybody from reception to pre tester to treatment coordinator on the same page. About your why, right. Why are we doing this? Why is this practice philosophy? Because, you know, there's been some practices where the staff cannibalizes the conversion. I know it's expensive. I, you know, I don't really, I agree with you. Or they're not going to follow through. And you have to have the why behind everything and have your staff trained to handle the aversions to treatment, whether it's cost or insurance not covering it. They should be just as well versus the doctor is in terms of that. And a lot of our doctors you hear about, you know, they talk people out of the sale too. So it's just not the doctors I

[A]

think the doctor has. And this is actually, I want to touch on this next because obviously knowing who's in your chair, whether you're a staff member or doctor, is really important. We covered that. But I think the doctor that this is, you know, I found this to be the case with just about every specialty service, but also with directly linked to revenue per patient when it comes to the optical is that the doctor has the authority, right? They came to see the doctor, so the doctor has to set it up. And one of the things that I really dislike is when the doctor just sort of mentions it and then says, but, you know, our so and so treatment coordinator, Susie, will talk to you about the rest. And you know, there's not. And she'll answer all your questions about both the treatment and the, and the pricing and all that stuff. And then all of a sudden, like, it's as if the doctor didn't know this. I was at one practice and it actually, one of the doctors were amazing at this practice, but they had this super weird thing of like, not talking about price and not talking about, like, specific details with the doctor. So like one of the I, I, I, I observed this patient and it was no joke. Literally, this, this doctor sees a patient and says, I recommend for you this, this, this, and this. And the patient's like, well, how much is that? And the, and the doctor is like, well, yeah, so, you know, Joni is going to talk to you about that and I'm going to have you see her and she'll schedule your treatments and she'll also and like, really, really uncomfortable. Like, super awkward, right? So I then follow the patient into, let's call her Joni's office. And I'm sitting there and Joni says, no joke, Mrs. Smith, the doctor gave you a great deal on these services because they're bundled together. And you're like, are you freaking kidding me? Like, so the doctor knew the price the entire, of course, that patient walked out without doing anything. But it was like that, like discomfort that patients sense that and they're like, well, if the doctor's not sure about this, what else is the doctor not sure about. And it all erodes trust. And so my, I think you make a really valid point that everything you do has to build, create and develop that trust at the highest possible level. And which is where that whole concept of being their trusted advisor comes in. You have to really believe that, and your staff have to really believe that. And the doctors probably have to have some key behaviors that ultimately drive the patient trust in the best possible way. So we already talked about one of those behaviors is understanding who is sitting in your chair. What are other things that the doctors have to be really good at doing. And that, by the way, like go back to my earlier question that I asked 30 minutes ago, which is, if I'm an associate that you're training, what are the behaviors that you're training me on? Todd?

[C]

Well, in terms of we all like to talk a lot and show our exuberance for treatment and our knowledge base, but most of us don't do enough listening from the patient. Right. So you want to get the patient to interact with you to even like I like to do like here, Eugene, this is what your images look like. Here's the picture that I have that's good, moderate and severe. Tell me where you think you fall in that in terms of the gland image. Because what you're doing mentally is you're getting mental buy in from them of acceptance of what their condition or status is, even of the basic glands, which is phase one of dry eye disease. And also asking for feedback. Hey, Eugene, do you agree with this or any questions you have? Does it sound like a good plan to you when you get them verbally to say yes, those are things that you can then go forward with the ocular surface exam when you do the optical handoff. You can't overwhelm them with information when they're just here to get their new glasses or contacts. So that's what I always tell the staff in terms of that. I always tell the staff to use examples when it comes to trying to use treatments or successful stories, because storytelling resonates with patients. I remember, you know, one of the lectures I, I go to frequently, optometry, and you know, I really can't remember what he talked about in terms of the subject matter, but I always remember the stories that he told in the beginning to open up or that drew an opening to what he's talking about. So storytelling goes a long way, too. But in terms of the associates, that's the key few points that I always try to convey. And also, you know, the warmth and that's coming into the doctors you're hiring, but how they convey their care for patients. We always give out our cell phones to patients. Those types of things kind of make the experience less commoditized, if you will.

[A]

Yeah. And I've also heard you talk a little bit about prescribing language. Let's zoom in on that for a second. What's the difference between non bad prescribing language and good prescribing language?

[C]

All right, so good prescribing language would be like, okay, we're going to set up a further exam because I'm concerned about these findings. And we're going to prescribe you two pairs of glasses because you don't have two pairs of shoes for everything, you know, or you need a pair of sunglasses. You need a pair for the computer, you need a pair for the progressive. And this is what they do and this is why you need it. Those are good examples. And fitting into the patient's lifestyle. Like you always talk about Eugene and preeminence. You know, we're just going to give you what your insurance covers versus let's find something that fits your lifestyle, going to fit your needs. You came in. We always work on pre testing and we use WhatsApp in our office to ask those key questions, which will then help the associates resonate. So, like, for example, like, I had no idea last week this lady that I've seen for 10 years was interested in contacts. I, you know, didn't know that her daughter's wedding's coming up. But now we got a contact lunch coming out of it and we talked about the options for that patient. So we always try to get the pre testers involved in different lifestyle questions or what they're here for or what they're hoping to get. Because very often doctors and associates get too busy and they miss a cheap complaint, which is why they're there in the first place. Right. Bad prescribing language. Like, oh, well, this is what it is. But you know, it's up to you what you want to do. Or, yeah, you know, if you want to start with one pair of glasses, that's fine. Or, you know, especially when it comes to myopia management, you really have to educate on the disease, the global myopia epidemic, why it's an issue. The eyes are getting longer, it's a health issue. But, you know, we can say the parent, well, we can just give your kids stronger glasses and watch it next year, something like that. So you have to have a smoldering fire of concern to resonate with patients, whether it's talking about secondary pears, dry eye treatment, myopia management. Those are things that will stick with the patient in your prescribing language.

[A]

Yeah, I, I love that. And I think the, that the word concern in itself is such an important word because it's automatically communicates that you care about the patient and that your concern is in regards to their well being. So if the patient trusts ahead of time that you understand who they are and that you've done, because I think you're. I don't want you to minimize the fact that your practice has gone through some extensive testing and some extensive lifestyle questionnaire stuff before the patient is ever in your chair. So if you don't, then this is the other mistake I see people make all the fricking time. And you know, this, this happened to me. I went to go see a specialist for a sinus issue not that long ago. And I'm not kidding you, like Todd, I explained my thing on the phone. I then the first person I saw, some sort of nurse. I talked to the nurse, I explained it to her. Then a nurse practitioner came in to do the first test and I had to explain the whole thing again. And eventually the next visit I saw a doctor and I had to explain the whole thing again. And it's like, I don't know, what do you guys think? Like, I'm just going to give you four different stories if you asked me four different times. Like, it would have been so much better if they like read the notes beforehand because they're all sitting there, they're not even looking at me. They're just typing away all of them, including the doctor. And it's like, why are you guys making the same fricking notes all the time? But I think about that from the patient perspective. I've also seen that when observing practices is that, you know, I, the patient has to restate and we're not building on it. What would be so, so much more powerful is if the patient told you that they like to play golf or patient told somebody else that they like to play golf. And then you start, you, you start the conversation with, I see that you're a golfer and how often do you play? Oh, that's great. A couple times a week. That's awesome. Well, and so how easy is it for you to xyz, whatever, like, and then you can continue that conversation. So it's not like you're starting from scratch. So tell me about your outside activities. And you're like, but I already did. I already told you.

[C]

Here's another pearl, too, Eugene, that we've instituted this past year from one of our meetings we attended and the day or two before when patients, we have a little routing sheet and what it tells us is lifestyle questions and things like that. But we took it from an. Either an article or someone said we use red, yellow and green stickers like a stop sign. And you know, if you bought from me last year, you got a green sticker. If you bought a couple of years ago and. But not last time, you have a yellow sticker. If you've never bought anything and take your prescription, you got a red sticker. So what that tells the doctor is it gives them a mental challenge about maybe they should do a better job about why they should purchase from us if they were a red sticker or if they were yellow, why they should update their glasses, for example. Or the green ones are, what else can we do for you? You know, because you got the office lenses last year was talking about sunglasses or something like that. Those are things that help our conversion, reduce our exam only, and obviously in turn helps our revenue per patient.

[A]

Well, and it's funny because some people would say, well, if you got the red sticker, then I'm just going to give up. I'm not even going to like, do a thorough exam, right? It sounds like you're saying the opposite.

[C]

Yeah, we said the opposite. And we kind of do a little a raffle at our monthly meetings to see who, who's flipped the most red stickers. And they get coffee cards or something like that because the staff sees it and the doctor sees it, right? So, you know, you get one little entry for each of those red stickers you flip because it's important, right? You're conveying your preface philosophy. And very, very often. And one of my young associates, well, she's been with me for almost eight years now. But in the beginning, she just like, oh, Dr. Cohen gets all the good patients. My, my revenue patient's lower because I get all the, the iMed only exam only patients and things like that. But no, look it as a challenge. Look about what you're doing in your presentation, your recommendations, and we can flip the script because, you know, I guarantee with that same exact patient, I could sell a neuro lens too, that you're missing. Or I could sell dry eye practice services because I'm using conviction and having that trusted advisor role about why it's important for you, Eugene, to purchase these products and help you out during a daily basis.

[A]

Right. Which it seems like, as you said, one of the core skills is listening, but it's really understanding who's in your chair. It's also being able to use prescribing language, as you said, and then really like not minimize the problem and kind of sweep it under the rug, but instead offer the findings with a statement of concern and making sure that you're positioning your staff to carry the ball forward as that patient leaves your room. So that's the last part I wanted to talk about is in some of these specialty service scenarios, you know, you mentioned during the comp exam, the first thing that happens is that the patient you just basically say, and they need to come back for Jacob. Ocular surface. Ocular surface evaluation. Is that what you said? Or ocular surface.

[C]

Ocular surface exam. Oscar.

[B]

Okay.

[A]

Ocular surface exam. Okay, fine. So they have to come back for that. Okay. So the staff knows they got to schedule it. Fine. At that exam, how does the process go to where you like who, who talks about what and how does the handoff happen between you or your associate? And again, we're talking about not just Todd, because Todd's the all star, but what have you trained your associates to do at that particular exam, at the follow up where that you get the highest treatment conversion rates.

[C]

So the patient will go through, you know, some more advanced testing that obviously we do more than just the mibogy screening that we do in the comp exam. So we do a bunch of other tests as well, thoroughly looking at their tear breakup time, looking at their inflammation, looking at the redness, all those types of things. The doctor will then take the extra time to really fully describe the disease process. We have these smart boards in our exam rooms that show images and videos and things to educate the patients so they get a physical view of what's happening in terms of the anatomy of the tear film. We'll show them videos from our websites to educate them about different treatments we think will be recommending. We'll definitely. A picture says a thousand words. So I've had Islam cameras for 25 years, even when they're brand new because they're really resonates with the patient that look at the redness, look at your glands not working, look at the gunk on your eyelashes. So the staff knows to utilize all those tools for education. And then, you know, they'll touch on the pricing, they'll talk about, you know, next steps and what we're prescribing for you. And then we'll do the handoff and we'll take the patient into our dry eye suite. We'll alert the staff. We're gonna be coming out on the WhatsApp, you know, hey, Polly, get ready for Dr. Or Mr. Smith. And then they'll get all the paperwork and all the things they have to sign and what they have to do ahead of time in front of them. And so the patient will be seated in the dry eye suite and they'll talk to them about that and financing and payment options and describe the treatments a little bit more and say, don't wear makeup to the appointment and those types of things and what to expect after treatment. So those are what the associate goes through. And then that's what happens in the handoff as well. Does that kind of make sense?

[A]

So is that it? Is it what, what we, I think what salespeople refer to as the assumptive close, meaning I, I am the doctor. I just explained all the stuff to you. Does it make sense? Do you have any questions? And then the person says, no, I'm good, whatever. And you say, okay, perfect. So Susie over there is going to go schedule you for the, for your first treatment and is going to go over some of the details with you. And then you walk over to Susie and Su. Susie knows everything about the patient. What are the first words that Susie has to say in order to make sure that the close goes well? And who, who is like, should every office have a dedicated person for, for each specialty service or.

[C]

At each office I have at least two people that can do the presentation and go through everything, because if somebody's sick or whatever. But most, my main office, we have three people that can do it. So the first thing is, is, hey, this is great, Eugene. Dr. Cohen prescribed these wonderful treatments we're so happy to be able to provide and have the ability to do good, just more than eyedrops and really get to the core of the problem for you? This kind of describes each of the treatments we're doing, the contraindications, what to expect afterwards. So the staff kind of rolls with it that way. Just like when we do the optical handoff, right? We never take into the front desk. We have the opticians meet us at a dispensing table. You know, we show them our cool measuring devices we have and we say, look, you know, now this is great. They get excited generally about picking out frames for patients to kind of help what we've talked about. Ag needs a workspace. He's on 17 computers a day. And this person, he does a lot of golf. Let's talk about the golf lens with polarized protection, things like that. So we try to get. The staff is involved and excited because that resonates with the patient.

[A]

Got it. And the. In the financial conversation, as you said, happens at that point. But it's an assumptive close to say, you know, Susie is scheduling you and she is. And she is going through the process now. How often if they showed up to the. To the ocular surface exam as you call it, how often are they going to convert to at least some of the services beyond that percentage in your.

[C]

You know, a lot of the patients during ocular surgery exam have some other stuff going on. So they have to be prescribed drops or something like that or procara or something like that. So it's not always at the end of the ocular surface exam they're doing treatment. Sometimes we want to. I say, look, you know, Eugene, you've got a lot of dry spots on your eyes. I'm gonna, I'm not gonna, you know, get these awesome tools working on a surface that's kind of smoldering on fire. So we want to calm the inflammation, get your eyes looking as good as we can before treatment. So just want to say that ahead of time if anyone's listening in terms of. Do they do it right away? No, we do it appropriate times for the patient, obviously. But assuming that we're going right into treatment, the. What was that you're looking for?

[A]

Yeah, what's. What's the percentage of patients in that system?

[C]

I would say over 80% in our practice.

[A]

Okay, so then going back because I just want to quantify this for people. So just let me back up for one moment. Of your patients who are recommended to get an ocular surface exam, what percentage of those patients actually end up showing up to an ocular surface exam?

[C]

99% probably. Okay, so I mean we were scheduling it. We're scheduling it before they leave. I mean the first thing they're doing is when we do the optical handoff. The opticians and the computer and the desks have the computers in front of them. Hey, before we forget, you know, again for the patient's benefit, before I forget to do this for you, let's schedule the ocular service exam.

[A]

That's the magic, right? Because there are that this is exactly where I see practices go wrong is I hear numbers like 10%, 10% of our patients when we recommend this end up scheduling that follow up. And. And you're saying yours is nine like you. You're almost like looking at Me, for people who saw this on video is like, you're looking at me like, why wouldn't they schedule? What's wrong with that? Like, what's wrong with it? I didn't. So, yeah, I think this is what you've been talking about for the last 50 minutes is that you see your pa, you see that, that trusted advisor role that you and your associates have. It's almost like you don't have an option not to schedule this because you, the patient, are going to benefit from having this, having this conversation with me. So it doesn't make sense to me why you wouldn't schedule. And so you going into that with that mindset and your associates going into it with that mindset absolutely explains the higher revenue per patient. Because the reality is that if they truly believe that it is their duty, their responsibility, their, their fiduciary kind of responsibility to the patient to take care of them and to make sure that they schedule this exam, if your staff believe that as well, then that's, you know, that's the first massive unlock. But to get there, obviously you have to make sure that you can understand the types of patients that are in your chair and that you're using the right language when you're talking to each of those patients. And we covered a lot of that on the show. So.

[C]

Yeah. And the Oculus exam will say, look, your insurance does cover this visit. There's going to be some out of pocket expenses for some extended imaging. We let them know that ahead of time so they're not kind of blindsided. But again, it's like 99% of people come in because they've understood the disease process and the reasoning behind the why.

[A]

Yeah. And that's, that's what leads to it. So it sounds like it's a well oiled, systematic, process oriented machine that allows both you and your associates to, to be able to accomplish this systematically day in, day out. Doesn't reply, doesn't require some sort of like, talented all star, which oftentimes the practice owner is to try to drag the rest of the practice kicking and screaming. So I love it. Todd, unfortunately, we're, we're out of time. So is there, is there any last, last piece of wisdom you want to share with the audience before we call it a day and possibly schedule a follow up?

[C]

Yeah, I think as all of us, as practice owners, there's always a big dissociation between the doctor production, the associate production, and, and I think constantly working on that and finding methods and putting the time in will reap benefits for both your level of patient care across your practice, whether you have eight doctors, six doctors, or even two three doctors. And it'll also be beneficial for your patients as well.

[A]

Todd, thank you so much for sharing so openly and so candidly all of the wisdom that's made you successful. Grateful for it, and I'm sure our audience is grateful for it. Keep you posted as the comments come in after this episode and appreciate you being on the Power Hour as always, anytime.