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Power Hour Optometry
Four Locations. Three Cold Starts. Launching an Alliance | Scaling a Practice & The Vision Behind View Optometry Alliance
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Welcome to the Power Hour, Optometry's biggest and longest running show. I'm your host, Eugene Shotsman, and today's episode is a really good one. My guests today are Dr. Tommy Lucas and Dr. Mary Kate Walters, a husband and wife team that have built something genuinely impressive in private practice. They've grown to four locations, including three cold starts, and not just cold starts that survived, but ones that really ramped up quickly and then taught them a lot about what it takes to scale beyond one office. And they definitely share some of those learnings in the episode. But what makes the conversation especially interesting is that underneath the data, the growth numbers, the whole story, you hear a very clear philosophy of business. They've definitely put a lot of thought into people, into systems, incentives, leadership, and really what it means to build a practice that can function beyond the owners being everywhere at once. So if you ever wondered what it takes to scale and whether you're looking to go from one location to two, two to four, or even if you're just looking to expand your current location or do a better job of incentivizing your team, there's a lot in there for you. The second half of the episode, the conversation shifts to something else, which is the launch of View Optometry Alliance. And this is an alliance that Tommy and Mary Kate have put together. And whether or not you agree with every parlor vision, I really think you should listen in. I think you'll appreciate that this not just a conversation about an alliance, it's really a discussion about independent optometry and kind of an alliance's control versus support and the kind of future that some practice owners want to help create for the profession. And that's exactly what Tommy and Mary Kate talk about. And they really talk about what they're trying to build and how they're going to get from four locations right now that are their own to maybe a thousand locations in an alliance that are functioning with similar viewpoints and values. But before we get into it, quick reminder to subscribe to YouTube, Spotify, Apple Podcasts or wherever you get your shows so that you never miss an episode. And I do respond when people reach out. So you've got feedback, questions, episode ideas, or just want to learn a little bit more about how teams can support you, please go to eugen.com or the power Hour website. Send me a note. And I always enjoy hearing from listeners. And now, here's today's Power Hour episode. Tommy Lucas, Mary Kate Walters, welcome to the Power Hour. Excited to have you both on the show.
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Thank You, Eugene. Pleasure to be with you.
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C
Thanks for having us.
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B
And I think it might make sense, as we do often when we've got a big thing to talk about in the second half of the show and I have a lot of questions about this thing that you guys are doing. But before that, I think it makes sense to give everybody some context about the practices that you own, maybe even talk about some of the learnings that you have. So maybe, Tommy, you can kind of go over your portfolio of practices and how that came to be and where you guys are at right now.
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A
Yeah, happy to. Thanks for having us today and the opportunity to talk with you. So Dr. Walters and myself, we're in Central Texas and we have a multi location practice. We're four locations, a little bit north of Austin and a little bit east of Austin. And those four locations are obviously have developed over time and are in various stages of their maturity and growth cycle. So our oldest location is our largest location. And after successfully growing and scaling that to a multi associate practice, we decided to go ahead and start practices in kind of the neighboring communities. And those are our second oldest practice. And now third and fourth are relatively new cold starts in that one is two years old and one we just started last year.
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B
So were all these, all four of these cold starts, Tommy?
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Not all four of them. No, three of them were. And the original practice was an acquisition from back when I got out of school 20 years ago. An opportunity came my way from a doctor that was retiring. I looked at the opportunity and decided to jump in with both feet and made that, that practice purchase and carried on that doctor's practice and his legacy there in Killeen, Texas. Right.
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B
And the two newest ones, you said they're, they're cold starts. Mary Kate, how old are those?
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C
Um, so we have one that's just about to cross the two year mark later this year, and the other one will be three years this fall. So just fresh practices.
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B
Yeah. And how did they do when, when you first started them?
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C
Yeah. So the first practice in Brenham, that's about two and a half years old. So it'll be three years old this fall. It was really exciting because we did just had a million dollars of revenue in our first full year at the practice. And that's, I think, partly attributed to being back in my hometown and having kind of that, that familiarity with my, my friends and my family and the community that raised me. The other practice, that's our newest cold start, it's about a year and a half old. It'll be Two years this fall and we are projected to do a million dollars of revenue this year in the second year of business, which is really exciting.
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B
Yeah. And I imagine that those two cold starts benefited from some of the learnings from the older practices. So we're going to talk about what works in a moment. Give me a couple examples of what that didn't work, that you learned from in your first, we'll call them the starter practices.
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I can describe that because the first and second were my bright ideas. First off, I can say getting the second practice is the hardest thing to do. And then third and fourth, based on what you learn, seem to come a little bit easier when you get some of the mistakes out of the way. Right. But getting that second practice, I guess the first lesson is obviously that you can't be in two places at once.
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Right.
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So you have to start thinking differently about how you want to approach practice and understand that you have to develop real systems that, you know, are there for the staff to utilize in your absence. Right. So being multi location means you're in the people business. And that is kind of one of the biggest, you know, secrets of success. Right. There is, you know, as a one doctor practice, you can be in control of everything and run it exactly how you want. But in a multi location, multi associate practice, you're really looking at how do you develop people and run a enterprise that is durable and not just built on your personality or what you expressly want individually.
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B
Yeah, so that, that second practice you mentioned, that was really hard. Talk about what you mean by that.
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A
Yeah, it's, you know, you kind of, you have that success from the first practice and you're like, okay, well, I know what I'm doing. I can replicate this. There's a market I want to go into. I'll just pull the trigger and make it happen. And that's kind of like the entrepreneurial way, right? Is, you know, you're a little more risk tolerant and less risk averse. Right. So you think you can do these things and, you know, quickly you kind of understand that, you know, not being able to be the doctor in two locations means that, you know, things are going to happen in that second location that may make you, you know, shake your head and may be like, why did, why did this doctor choose to do this? Or why did this manager choose to do this? And that goes back to the fact that, you know, when you start that second practice, you know, it is, it would be a wise thing to develop those systems and think those things through before you Just jump in with feet. Right. So that you are, you know, not live after an expensive build out or, you know, hiring, you know, a bunch of staff and, and ordering a bunch of product and then just not having a real plan.
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Right.
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So I would say, you know, develop that plan, you know, very strongly before you, you start that second practice.
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Yeah.
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And Mary Kate, I was going to say that's something that we've learned along the way as we've grown to four practices is having all the systems in place. Because while even with just two practices, you can kind of get away with doing things a little different as you start having more and more practices. If every practice does their own things their own way, it's really hard to be in that ownership or that leadership role and give guidance and direction if you have to do it in four different ways.
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B
Well, and it's interesting and very remarkable that you've gone through three cold starts. What did you do in your third cold start? So your latest practice, what did you do that you definitely didn't do in your. And aside from systems and processes, I guess the context for my question is I hear people make mistakes with cold starts all the time. Right. And sometimes it's I overspent on X or I, I made a I over committed on Y or I didn't negotiate the lease correctly or whatever. Like, so, you know, you're veteran cold starters at this point, going through it three times. What is the advice that you'd give to somebody who's considering a cold start and what mistakes can you suggest to them to avoid? Oh, sorry.
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You don't have to have every bell and whistle piece of equipment. And it's okay to buy used equipment, um, and build your Runway and build your success and then add in things as it comes. But I think it's really easy to get caught up in all the shiny equipment and bells and whistles that you can add to your practice. But you can have a thriving practice without having all of that too. And then you can grow into it.
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B
So just add equipment as it goes along is what you're saying.
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Yeah. And even for your frame lines, you know everything as, as time goes, you can add new things, but there's a lot of creative ways in the industry to outfit your office without purchasing everything top of the line to open your doors.
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Yeah. Tell me, what would you add?
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Yeah, and what I would add is a unique thing is from the first to the second to the third, every footprint got smaller. And I think that's because we got wiser. You know, you kind of want the big shiny practice. Right. And you know, all the, you know, niceties that come with that. But what is of top concern when you're, you know, scaling is cash flow.
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B
Right.
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So, and you know, we, we all understand that optometry in 2026 means that margins are tight and certain areas of the practices are being eroded, you know, through, you know, for various reasons. And you know, opening another location, you know, means hey, I got to get smarter with, you know, the initial spend that's going out the door either in the build out or the equipment, as Mary Kate mentioned, or personnel. How many people do I hire? So as, as we learned from the second footprint that we built out, the third even got smaller. And then for the fourth, we did kind of expand it out again a little bit bigger because we're, we're finally starting to hit that scalability where that, that, that, that's, we're able to do that now.
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Yeah. And oh, what about vendors? Like how, how is your perception of vendors or vendor partners and how have you leveraged vendors specifically? And maybe some way that somebody who's just thinking about a cold start isn't thinking about it.
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Yeah, there's a, there's a lot of different opportunities out there. We, we like to partner with, you know, like minded independent vendors because they tend to have a lot of flexibility if you kind of explain to them your situation. So you know, we, we use an independent glasses manufacturing lab. We use a lot of independent frame lines. We will look at used equipment to start with, you know, with a plan to replace with new equipment when the practice is stable and we're out of that, you know, kind of startup phase. So it's just making those kind of decision that will really benefit a person when they go multi location.
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Yeah, and that's clever. And I think that gives you more room, not just like safety net, but also more room to grow because at that point, like, okay, I'm not stuck with a massive rent bill or a massive equipment lease bill or whatever. I can invest some of that money into putting butts and seats potentially or getting a great associate.
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100%.
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Yeah. Mary Kay, what would you add in relationship to either vendors or any other tricks or tips for, for starting cold?
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I think just having those core people that are kind of your ride or dies, they're there with you through thick and thin and you can trust them. I think that's really important because whether you're the doctor in the exam room for that cold start practice, you can't be all places at all times or if you multi location and you're scaling to that second location and you're not the doctor there and you hired an associate. Having, having that core team there that you can trust to get the job done is, is going to be essential. And that usually takes your leadership to guide them.
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B
Yeah, I, I think you're one, one thing that you've mentioned and now I want to kind of zoom in on this is the whole people thing and I suspect that this is going to be a big part of the answer. But one of the things that's truly remarkable and not that, you know, having a large $7 million business with two really successful million dollar plus cold starts in the first year, two years is not impressive enough. But it's like the other side of this is that you run this whole enterprise about really showing up to that. Like we, what people don't know about you guys is that you're working on a different business right now. You're working on something we're going to talk about later in the show. You're not in the practices. These practices are basically running themselves. And I'm really curious because that's truly remarkable for practices to do that. So how do you do that, Tommy?
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Well, it took a lot of work to be honest, but a couple of things. First off, I was in the exam lane six days a week, you know, for a decade, right. You know, building the practice, building those patient connections. And that's what it took, you know, to get that first practice to grow beyond a million dollars and to be able to hire that second associate. So, you know, it does take that kind of grit and effort and sacrifice, honestly, you know, for a small business and especially, you know, a cold start. Secondly, the people. I think it's a cool story about how we have grown because at every location that we have, every single person has been homegrown from the day that we started the practice. So when I got the Killeen practice 20 years ago, I had a core team of people that I told them, hey, let's grow a business together. Let's. If you stick with me through on this journey, then, you know, we're going to grow and scale this business and more opportunity will come your way. So I'm proud of the fact today that, you know, those, that core team of people are now the managers at each of my offices, each of our offices. And you know, that's a story of people sticking with you for 20 years, not jumping to another job because they got paid a dollar more or not taking them off to where they want to leave. You know, it's, it's the whole story of staff development, leadership development, everything. So that is the secret to our success is our managers and our people and the whole staff, the entire staff, not just the managers, but those managers were started out as my lab tech, my exam tech, and my front desk person in our original business. And now they're managers at each locations. Yeah.
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B
And so what are some of the things that you all do for people management, people development? Because, I mean, that is a. I, I do think that if there are some points of wisdom that you can share, this is obviously a major pain point with the whole industry. And I don't have to tell you that you, you have people who look up to you all over Texas who, who probably tell you that all the time. So what are the kinds of things that you share with, with, with practices and what are some of the, I guess, what are some of your operating principles when it comes to managing your people?
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Mary Kate, I wouldn't say we're perfect. We consistently are looking at ways to grow ourselves so that we can continue to grow our staff and our team. But some of the things we do in our practices are we have weekly manager calls and doctor calls and really talk strategy, make sure everyone's on the same page, set the vision for what's happening in all the practices. We're available when they need us. But then more than that, we tell all of our staff, all of our doctors, everyone at all the offices when we're hiring. We make sure they feel it throughout the year. But we're a family, and so we try really hard to take care of our people and our staff. And we feel like if we don't take care of them, they can't take care of the patients. And so while patients are very, very important, so is our team and our staff.
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B
Yeah. So let's get a little bit more tactical. So, Tommy, what are the sort of things that you guys do for. We'll call it taking care of people or maybe those leadership development opportunities.
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Yeah, I mean, you know, part of it is wages. Right. So you're, you're, you know, with, with folks that are developing over time, you know, you're, you know, compensating them appropriately. That's always a piece of it. But as we all know, money is only one measure of satisfaction. The other or the top indicator, I believe, is appreciation. Right. So you're showing that appreciation through loyalty. You're showing it through acts of kindness. You're showing it through the way that you're leading the business. So all of those things make a difference in developing those people. I think a lot of practices, you know, might under communicate and we try to not over communicate but we, we have a communication plan, right. So weekly doctor meetings, weekly manager meetings, and then quarterly staff meetings with the teams. So we, we are, you know, in the offices not seeing patients at this point, but developing the people so the people can take care of the patients. That's, that's the kind of business development story that, that we have.
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B
So when you're doing those people development meetings, what are the sorts of things like, like give me an idea of how your quarterly staff meeting runs and what are some of the things that, that you include in that?
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A
Yeah, we, we start off by talking about our core values, right? So you know, we, we, we kind of have our mission, we have our, our values that we'll kind of reiterate to folks so that you know, people know they're not just a sign hanging on the wall, but they're what we're trying to, to live up to. And so that's a key. Then we'll talk about performance and data. We run our practices kind of mostly, you know, open book, especially on the revenue side, so that the team knows what we're trying to do here. You know, we tell them that, you know, that opportunities come their way when the business, you know, is more profitable and when it makes more revenue so that they understand that, so that they know that their personal growth at the company is tied to the company itself for as long as they work with us. And you know, so it's getting that kind of buy in that just, you know, you have to talk to your people in order to get them to buy into your vision. And so that's kind of what we're doing at our staff meetings. And then we'll, at our largest office, we break it down into departments because we'll have, we have multiple staff and, and key departments. At our smaller offices, it's kind of all hands meetings, you know, where we're, you know, honestly trying to cross train and get folks to understand the different departments and not be as specialized at those offices yet. So it's a lot of that. We'll pick topics to go over, whether it's, you know, our few KPIs we're tracking or what system we're implementing. And then, you know, throughout the year we're picking three or four major things that we're just trying to get done that year from an operational standpoint. Whether it's, you know, our. Our contact lens procurement system or, you know, improving our capture rate or our. Our handoffs or, you know, whatever it may be, you know, we're really trying to focus on a few of those, you know, rocks, if you will, throughout the year to, to really hit.
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B
Yeah. And, and I think one of the things that it sounds nice, but in practicality, you are always going to have high performers, and you're also going to have low performers. So, Mary Kate, how do you guys deal with low performers?
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C
So in general, right now at the offices, I think it's really cool that we've set our annual goals and we go over that with the staff at the beginning of each year, and we build out KPIs and we make them, you know, across the board. Some of them are. The entire staff can get behind and contribute to. Some of them are departmental, like, what is your capture rate? Or, you know, what is the percent of the schedule filled for refractive exams? And we actually financially incentivize all of our staff to hit those goals. And they're all based on growth metrics. What we think, you know, is reasonable. We want our staff to hit them. We want to pay them out those. Those metrics and those goals every month. And so having those KPI systems, I think, helps those lower performers strive. They have something to work towards. But then giving them those tools or the trainings or the resources to try to help them continue to develop into that role and grow into those roles are really important. But I think having everyone aligned in the same direction with our KPIs, we've seen has been really helpful for business growth over the last couple of years that we've been doing that.
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B
And it sounds to me like there's a financial incentive very closely aligned. So is that monthly and like, how much of their compensation is that financial incentive?
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C
Yeah, so it's a. We track it on a weekly basis. We felt like weekly was a nice time frame because daily felt like we were having to track it way too much. Monthly almost felt too spaced out. Like if we got halfway through the month and they were too far from the goal, they were just going to give up. So we felt like weekly was that sweet spot. So each metric has its own bonus amounts, but each of our staff members has the potential to take home an extra 5,000 or more dollars if they hit all the metrics throughout the year. So you're talking about an extra 1, 2, 3, maybe even $4 an hour to their salary that they get to take home with them. And we pay that out on a monthly basis to them.
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B
Yeah. Tommy, do you want to add anything?
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Yeah, no, it's, you know, depending on their wage level and honestly, you know, seniority and how long they've been with us, it's any. That that total KPI bonus potential is, you know, anywhere from like 7 to 12%. Right. So of their total wages. So, you know, we, we describe what the impact of that is. It's one of the ways we've managed this kind of, you know, wage inflation that we've been going through for the last couple years of like, hey, we want to pay you more money, we have to go earn more money in order to pay you more money. Right. And you just kind of, you know, tell the staff that this is the way that it is. There's no more money coming in, there's the wages, you know, can't go up in that respect. So we have implemented that, that kind of KPI bonus system, and I feel like it's really moved the needle for us in the last couple years.
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B
So what are the. In your. In your operating model right now, what are the current things that you're bonusing today? Because it sounds like you're hitting different rocks at different and different. So it looks like it's at this particular point in time in your practices. What are the things you're working on?
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Mary Kate?
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C
Yeah. So we rolled out new screening services this year for our patients in our offices. So one of the metrics that the staff gets bonus on is the percent of capture rate for patients who upgrade their screening services beyond their retinal photo. We bonus for the percent of the schedule filled both for refractive exams and then also for medical exams. So total capacity. We bonus on diagnostic testing because we found that our clinical team really likes having some financial incentive to sit there for a visual field when they run it, because they can be really boring. And I know some people will say, well, that's their job, but it still doesn't make it any less boring. We do capture rates and then average eyewear sell, we do call answer rate, contact lens capture rate, and then we look at overall deposits and collections for the practice. So we're measuring all of those and they're kind of segmented out for bonus levels, depending on which staff are most working in those areas. But things like total practice collection or deposits, however you want to define it, or call it, or things like call answer rate, the entire team has the opportunity to get bonus for because we feel like every team member doing those things.
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B
So if I'm an optician, I will get bonus. I'll have this week I can make an extra some number of dollars if 90% of the calls or more I'm making this up are, are answered if my capture rate is my personal or my whole department's capture rate department. Okay. So the whole practice capture rate is over X amount of. Now that's an interesting point by the way. We're going to come back to that in a moment. And, and also if my, and if the total collections for that week are above a certain amount, right. Like, so then I, I personally can get a bonus for that. But then if I'm on the clinical side, I might have the total collections and the answer rate, but also the number of medical, medical diagnostic procedures or medical diagnostic things performed. Right?
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A
That's right.
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B
So the talk to me about the logic, which I think is actually kind of brilliant, of bonusing a whole department rather than an individual. Tommy.
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A
Yeah. So you know, some of our bonuses are staff wide and some of them are department specific. And we chose to do it that way because we want to drive specific behaviors in those departments. And a lot of this comes from our largest practice, right. Where there's three, four or five, you know, team members in a department. You know, those departments, they're kind of like little businesses in themselves, right. And the people that work in those departments become close friends and you know, there's their own relationships going on there. So we want to drive that behavior where like, hey, you know, let's not fight running a bunch of diagnostic tests that the doctors order or you know, let's not fight answering the phone in our front desk department. Let's, let's put our shoulder into this all together, work as a unit, three, four, five people and hit this goal. And we've seen results. It's been remarkable. For a time we had the call answer rate solely bonused from the concierge team or the front desk team. And then once we broaden that out to say, hey, the text, pick up the phone if it's ringing three times or an optician, pick up the phone. You know, it's everybody's job to do that. Well, you know, our call answer rates have just gone through the roof since we've started that this year. And so we've been a little bit, has been an experiment in like what should be department level and what should be staff level. And we don't have a thousand KPIs either. It's basically two per department. And I think two or three, you know, global KPI bonuses.
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B
Yeah, that's. That's great. Really interesting wisdom from, from that vantage point, I'd love to keep talking about your practices, but you guys did a really big thing. There was a big announcement vision Monday, and I think I want to talk about it after the break. So we're going to take a quick break on the power hour and we'll be back and we're going to talk about this new chapter that you're trying to unfold for the entire industry and for optometry. Hey there, it's Eugene and I want to let you in on something. So you've been to conferences before. You come home fired up and then Monday morning hits and it's back to the grind. The ideas don't stick, the plan never gets made, and six months later your practice is in the same place. So I know that pain. I've been to those conferences with you and that is not happening. At this new event called I Care Boss Live. You've heard the story of ICARE Boss, and now there's an event, ICARE Boss Live. It's September 16th through 18th in Cleveland. Two and a half days. We're bringing together 200 of the best practice owners in eyecare for a one of a kind event that combines speakers, peer learning, mastermind groups and industry innovation, all designed around one goal. You leave with a 90 day plan and you can actually execute it and get stuff done. And we're going to tackle some real stuff. Exam only rates revenue per patient, people problems, leadership, AI and technology, specialty growth, the things that keep people up at night. We're going after it and we're doing it in a room full of practice owners that are just as serious about growth as you are. This is not a conference, it's not a seminar. It's something different. There are only 200 spots. So if you want to be in on this, this is not publicly announced, just on this podcast. We go to the powerpractice.com click events, click apply Now. This is invite only. It's not for everybody. So you have to apply. We'll ask you a few questions and if it's a fit, we'll invite you to register this event. I Care Boss Live is going to sell out. Do not sit on it. I invite you to apply right now. All right, we're back in the power hour with Mary Kate Walters and Tommy Lucas. And I think this is for people who have been following your story. This is the part that they're really going to be excited about, which is talking a little bit about View Optometry. And rather than me try to summarize it, why don't I hand it off to you and Tommy, talk a little bit about what View is.
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A
Yeah, happy to. So View Optometry is our practice name, but now we endeavor to turn our four location practice into a full blown doctor alliance. And now we have kind of rolled out the View Optometry alliance and it will be a, you know, a fully featured doctor alliance that, you know, any doctor would expect to, you know, have. And as far as benefits of an alliance, one of the main features, of course, is the alliance will have a buying group aspect to it. And, you know, that is the side of the alliance where, you know, we endeavor to improve our cost of goods, you know, amongst group members and, you know, develop vendor relationships like, like a buying group would, would do. And the, the hope for View Optometry, the alliance, is that we can create
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B
a,
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A
a business where doctors will join the practice and be involved in an alliance that is truly independent in a sense that the doctor autonomy is one of the most important features and philosophies of the alliance. In a world today where there's multiple alliances that can be joined by a doctor, we want to be an alliance that the doctor remains in control of their business, of their decision making, of what vendors to partner with, of how, what treatments they decide to deploy to patients and not be influenced unduly by, you know, large corporations that are vertically integrated and consolidated at this point. So it's what we want View Optometry to become as an answer and a counterweight to some of that movement that's going on in our profession now. Obviously we're just getting started and you know, we have years of development in front of us, but we do have a lot of friends in Texas and beyond that are interested in what we're developing. And we would invite anybody that has a private practice to talk with us and potentially join our alliance.
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B
Well, okay, and I'm just gonna, I think you sort of said it, but I'm going to ask it very directly. Why does, why does the industry need another alliance? Because, I mean, there's a lot of them already, Tommy. And I'm not gonna, I mean, I don't need to name them, but there's a lot of ways that optometrists, whether you call them buying groups or alliances or whatever it is, there's a lot of different ways that, that optometrists have sort of merged together for whether it's collective purchasing, buying group reasons, or for something. But you know, why does the industry need another alliance?
- [35:19]
A
Yeah, and I'm happy to answer directly as well. So, you know, any alliance or any buying group is going to bring value to a practice like dollar value to the practice. And it will be a system of, you know, running your practice. But what we want to be is a group that has values and those values are independence, protecting independent optometry, protecting the profession of optometry itself as we move forward, you know, and as optometry just kind of continues to, to morph and grow over time and enter into this kind of technological space that we're in. So all of these things that we're looking at in the marketplace now for a doctor that maybe choosing to join another alliance is, you know, who am I really aligning with? Am I, am I doing this to purely make, you know, an extra dollar of profit in my practice and that's why I'm joining a group or am I joining a group because I believe in their mission and I believe in the profession of optometry And I understand that if I can protect what makes optometry optometry, then profits and in your small business and dollars follow that. And if we don't protect that, we won't have anything left, you know, in 20 years, 30 years, 50 years. Right. So it's a little bit of that concern and it's a little bit of that, you know, watching the marketplace now and that's making us want to go ahead and launch this and, and come, come at it from a place where, you know, we are working with not only our minds but our hearts for what the profession is.
- [37:07]
C
Yeah.
- [37:08]
B
And you know, Mary Kate, you describe that one condition of membership is or one condition of joining the the alliance is an AOA membership. And that's a pretty bold stance. Why is that a non negotiable for you all?
- [37:25]
C
Yeah. So being a member of the AOA and your state affiliate is really important for the protection of the profession. We a lot of times like to refer to it as your preferred professional insurance policy. And so we feel like that aligns with what we're trying to do with our, with our group and trying to preserve independent optometry and our voice so that there is good practice for perpetuity.
- [37:53]
B
Yeah. And it seems like, you know, I've, I've heard from a, from the types of things that you've been involved in. Really, you both have been involved in TOA and aoa. I mean there's definitely a lot of influence that you all have had on the, I'll call it like the corporatization of, or decorporatization or maybe limiting the corporatization of optometry in some capacity. So I hear you say truly independent and fully independent. What does that mean, Tommy?
- [38:28]
A
Yeah, I mean, it's the conversation that's been had here on this podcast before about the fact that the largest companies in our space have multiple prongs and aspects of their business now. And those businesses now include the buying groups or the alliances themselves. So without naming names, we all know who they are, of course. And there's roughly, I mean, give or take, 15,000 private practices in America. Right. You know, and roughly 50,000 optometrists. So, you know, when you're just looking at the marketplace of what's possible and what is what, what is needed to, you know, continue a profession versus having it swallowed by, you know, a giant corporation, you really have to look at this and who you're aligning with and partnering with. And, and I understand that, you know, on a, on a one practice basis, yeah, there's advantages to joining XYZ Group. There's advantages to joining any group, or they wouldn't be a group. Right. But joining a group that has a certain mission at hand, which is the mission that we intend for View Optometry to be on. It's kind of the business side of what is being done on the advocacy side by our associations. So we need that political clout and, you know, muscle to protect the profession from all the things that are done in the, in the political and regulatory realm. But we also need the business side as well to, to, you know, be influential on, in that space. So that's some of the genesis of, of View Optometry is seeing the, the need for that out there, seeing the, the fact that, you know, the largest players out there, you know, feel that they can buy, you know, whatever it is that they need particularly. And we don't want the profession of optometry to be bought at the end of the day. We want the doctor patient relationship to exist in its most pure form. We, we, we want a doctor to, you know, be able to run the business that they want to run the business and not, you know, be chasing, you know, $3 for the, you know, because they're trying to pay their bills. We want to grow the profession in a way that those things come naturally as a secondary benefit.
- [40:48]
B
Right.
- [40:49]
A
So it's a little bit philosophical in that respect, but I believe that there is a, a market out there of doctors that want the same thing that, whether you're, you know, brand new, out of school and concerned about the future of optometry or mid career or late career, you know, there's a lot of different motivating factors as you, you know, age through the profession. But joining with our alliance is going to mean that we're always putting the profession first as a cardinal direction.
- [41:21]
B
I think it's a really clear definition of exactly what you are and what you're not. And it's kind of, I jokingly say. So anyone from a large corporate entity that's listening to this podcast, it doesn't sound like Tommy and Mary Kate are going to be selling you their, their alliance five years from now. Sounds like View Optometry is not going to be for sale. Interesting. So I am kind of curious to tie this back to the first half of the conversation. Mary Kate. When you all have practice, you both have practices that are, they're different and at the same time there's similarities in the way that you manage them and there's obviously similar processes and things that you've learned. How much of that are you bringing to the alliance side? And really, I think there's also this like managed, I think you guys call it the vso, the Vision Services Organization. Talk a little bit about what you've learned in your practices that you're bringing to the alliance conversation.
- [42:31]
C
Yeah, so each of our practices, because they serve a slightly different community, has a little bit of difference or uniqueness and that's what makes it special and locally owned in our communities. But we've really worked hard over the last several years to create best operational practices and operational efficiencies across our four practices. We've been building vendor partnerships really so that all of our practices in the alliance, or if you join the Vision Support Organization, can stay competitive in today's landscape of optometry and be a locally owned practice. The alliance is what we think of in that traditional buying group where you see cost efficiencies, vendor partnerships. We do focus a lot on having centralized billing, strategic partnerships, different avenues for your operational efficiencies. But if you want even more support than what the alliance offers, you can join the Vision Support Organization. You don't have to give up ownership or autonomy. I think that's a question we get and we're not asking for any of that. We're not like private equity. We truly are trying to empower you to remain in full control of your practice. You can use the brand View Optometry and then even get deeper into the best operational practices, whether that's alignment in the EHR system, have vendor partnerships and just have more, you know, just consultive or peer to peer resources and networks to help you maximize your practice and allow you to practice the way you find fulfilling.
- [44:23]
B
Yeah, and that's. This is the fine line and it seems to me like this is the line you're kind of like really trying to define which is there's a difference between support and control. Right. And like whether it's alliance, partnership, franchise, whatever, like that. Those are like the other things that exist in the industry. And there's this fine line. There's support on one end, there's control and at some point that support becomes control because you have to do this and you have to do this and you have to do this to get the support. And so how do you both navigate that line? Tommy, you go first.
- [45:00]
A
Yeah. You know, we're seeking maximal autonomy while still, you know, achieving, you know, performance, you know, through process. Right. So yeah, it is a fine line. On the alliance side it is complete autonomy in that, you know, to be a View Optometry member, all you have to do is agree to be, you know, to work with our consolidated billing partner, which is ABB in this case you have to be an AoA member and you also have to agree to use our data platform as well, which is ABB Analyze. So those are the only requirements of the group to join. And the reason for those requirements is so that we have the, the back end performance efficiencies of the practice where we have consolidated billing and that is how all the savings will come for the practice. And then we'll have the data through ABB Analyze to kind of develop out the support through consultation, mastermind all of those type of things to help those alliance members improve their performance. So it's very minimal things that you have to do to join the alliance. It's not a free alliance, but we describe it as a, an ultra low cost alliance, you know, that is aligned with, you know, the other, the cost of the other groups out there. So with all, with all dollars being equal, you know, we, we hope that people will join our alliance because of the reasons we've outlined for, for those heart reasons and for those protection of the profession reasons as much it is dollars and cents.
- [46:44]
B
And just to be clear, ABB does not own any part of you, right?
- [46:48]
A
No, no, no. We've, we've just chosen ABB as a consolidated billing platform. Great company that supports independence as well too, right?
- [47:00]
B
Well, they don't compete with optometry in that particular regards. Makes sense, interestingly. So from. Let's go back to the other things that I'm going to experience. So let's say I joined the alliance. Let's say I have a practice. I joined the alliance 90 days from now. What real benefit am I getting? Like, what is different in my practice tangibly? Like, did I drop my cost of goods? Did I, you know, did I get, like, staff training tools? Like, what? What did I get that I really am going to benefit from? Mary Kate?
- [47:37]
C
Yeah. So day one, your cost of goods should go down. For any vendors that we have relationships with. And we feel like these are great vendors that support independent optometry in the profession. And so there's a list of probably over 500 vendors that you can receive discounts to on a various scale. And then as you continue to go through, we talked about having data and metrics for your practice that's going to help drive decisions. You can have consultive services that we can offer to help you look at that, understand, create, you know, what works for your practice. We know that every practice is in a little bit of a different community, so it's not a one fit, one size fits all solution. And so those are some things. Then we do have great resources for marketing and other practice management solutions that will allow you to continue to grow and scale, if that's what you're looking for. And so we've tried to work really hard on all facets of the operational experience of a practice, from start to finish and top to bottom, to make sure that if you need something, there's a resource for you within the VUE alliance, within View Optometry, and that it's from a trusted and reputable resource in the community.
- [49:06]
B
Got it. Tommy, anything you want to add?
- [49:08]
A
Yeah. And whether that's, you know, business consulting, support, marketing support, choosing your technology platforms, all of those things, we obviously have a system that works for our four offices and we can speak to that, but we don't want to force any doctor in the alliance to use any particular system. But we will have partnerships with key vendors that we believe in and know that would be beneficial for that practice. So that's kind of that consultation. Mary Kate, I, you know, will be available ourselves to help any of the doctors in our alliance, you know, as we grow, you know, from where we are now to, you know, 50 and then 100 and, you know, hopefully beyond that, one day, you know, we'll. We'll be scaling the resources of the alliance itself.
- [50:01]
B
Yeah. And I guess maybe I'd piggyback on that. As you were saying, those numbers, what is the vision, Tommy, for the. For vue and take me, I don't know, wherever you want to go three years, five years from now. But what does VUE look like as a collaboration of practices?
- [50:21]
A
Yeah, one year it probably looks like 50 practices, and two years, it probably looks like 100. And the snowball should speed up from there if all goes well and people believe in our mission and we're delivering value to their practices. So, you know, going back to the fact that there's roughly 15,000, you know, private practices out there, you know, getting into the four figures is kind of the goal. Right. So you want to be a thousand plus, you know, to really be able to move the needle from a business perspective for these practices that are in the alliance and really kind of serve as that, again, that counterweight to, you know, kind of the consolidation activity that's going on in private practice now. Yeah.
- [51:05]
B
So if I am part of you, can I also be part of other alliances or you guys make me drop my memberships?
- [51:13]
C
There you can go, Tommy, if you'd like.
- [51:18]
A
Yeah, there's no restrictions in that regard. You know, I know the stats of the average, you know, private practice are in 2.4 groups or whatever it is at this point. So, you know, we don't have anything that restricts a private practice doctor from being in multiple groups. And it's common for doctors to be in multiple groups for specific reasons, mainly vendor discounts. Over time, hopefully, it'll make sense for doctors to not need more than one group if the group is strong enough in delivering the value that they're looking for.
- [51:53]
B
Yeah. And I think this has been such a strong message towards independent optometry. Independent optometry. At some point, I may be in your alliance and I might want to exit or I may want to sell my practice. Is your vision that I can sell to other people within the alliance, or is your vision that, you know, it's okay if you want to go sell to private equity and it's not that
- [52:20]
A
big of a deal? Yeah, all things, you know, it's that person's business. They have the right, of course, to do whatever they want with that business? You know, we'll be working hard to work on practice transitions. Mary Kate and myself, we have to do something with our practices at some point. Right. So, you know, these are all just logical things that you have to think through. And ideally, we want to transition those to our associates or the ones that express interest in owning those practices. And if not the associates, then another private optometrist that wants to continue working in private practice. So it'll be incumbent upon the group to develop those pathways, those consultative pathways to allow doctors to understand that that's possible. And that's a hope, right? We have to kind of perpetuate private practice. I'm actually encouraged by kind of what's going on. I see more kind of young folks wanting to kind of start their own practices now, to have that kind of control over their future. Students come out of school now, they kind of look around and sometimes feel like their hand is forced unless they just totally go out on their own and blaze their own path. So we want to encourage not only practice transitions to other ODs, but to help optometrists get out of school and start their own practices to constantly replenish that market share that is private practice.
- [53:57]
B
Mary Kate, are you seeing that shift back with your students to back? Because I had heard a couple years ago that no one coming out of school wants to own a private practice anymore. Everyone wants to work for corporations. I'm obviously exaggerating a little bit, but I've heard that was part of the sentiment. And what are you seeing with your students?
- [54:21]
C
So I would say that probably 20 to 30% of my graduating class has shown interest in ownership. I would say let's expand that number. 80% probably say that they want to work in private practice. So it's not that they necessarily want to be an owner, but they want to be an associate in a private practice, not in a corporate structure. And so there is. The students want that. They like what it feels like, what it means to practice in private practice and not burn churn refractive exams all day long. They want to use the full extent of their education, and they feel like they get to do that in a private practice setting. And so I think that there is definitely opportunity for private practice to continue thriving with the graduates coming out of optometry school.
- [55:09]
B
This is fascinating conversation. I think that it's so fun to have this conversation at the sort of the opening chapter as you just announced this to the industry, as you just start getting interest from. From optometrists and independents around the country who are curious about what you're building. I'm happy to feature you both here because I think this has been a really interesting conversation both about your experience as practice owners as well as your experiences to people who are building something that does not exist in that in the industry. So congratulations to both of you for being trailblazers. How do people learn more about View Optometry?
- [55:52]
C
You can go to viewoptometry.org yes.
- [55:56]
B
There you go. Okay, we'll put it in the show notes.
- [55:59]
C
You can reach out to Tommy or I. If you know either one of us, we're happy to talk and connect, but you can also reach out through the website, too. Whatever is easiest and most convenient for you.
- [56:11]
B
All right, we'll. We'll share all the details in the show notes. Thank you both for being on the show today. Amazing to have you both on the Power Hour.
- [56:18]
C
Thank you, Eugene.
- [56:19]
A
Thank you, Eugene. Good to talk with you.