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Power Hour Optometry
From Legacy to Leadership: Building the Next Chapter of a 110-Year-Old Practice
01:01:38
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- [00:00]
A
Foreign. Welcome to the Power Hour, Optometry's biggest and longest running show. I'm your host, Eugene Shotsman. And today's episode is about legacy. It's about growth and the shift from being the doctor that everyone wants to see to becoming the CEO that your practice needs you to be. My guest today is Dr. Luke Small. He's a third generation optometrist leading one of the oldest practices in Canada, over 110 years old. His grandfather helped shape the profession in its early days. His father pushed the practice us forward. And Luke has taken that legacy to its next chapter. He's added a location, he's added a stronger medical model. He uses advanced technology, and he's developed a culture that ultimately drives the patient experience and helps him differentiate. But this is not just a legacy story. It's a practical conversation about what changes when you have to inherit and transform something meaningful and you have to modernize it without losing what made it special. So we talk a lot about patient experience. We talk about culture, technology, value, growing pains of adding a second location. And then at some point, Luke actually flips the interview on me a little bit and starts asking me about some strategies as he transitions from being a doctor in the practice to more of the CEO role in his practice. So we talk about things like creating a vision and having accountability and having rocks and getting the right people in the right seats. And the transition. How do you transition patients who are really loyal to you to associate doctors in a way that actually builds confidence instead of creating concern? So lots of really interesting conversation there. Before we jump in, quick reminder to subscribe on YouTube, Spotify, Apple Podcasts or wherever you listen. And as always, reach out to me@Eugeneshotsman.com or through the Power Hour website with questions, feedback, episode ideas, or if you're looking for help and would like to work together. And now here's my conversation with Dr. Luke Small. All right, Dr. Luke Small, welcome to the Power Hour.
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B
Well, thanks for having me. Really appreciate being here.
- [01:59]
A
Yeah. And I'll start with the remarkable fact that you happened to be at the helm of one of the oldest practices in Canada, which is quite a legacy. So maybe give. Give the audience a little bit of background on how this legacy came to be.
- [02:15]
B
Yeah, great question. The I'm a third generation. Grandpa and dad were both optometrists. Both practice in Winnipeg. I tried my hardest to get away from optometry. At one point I was environmental, environmental sciences, undergraduate degree. I actually had to think about my degree. I left Winnipeg to go. I was A swimmer and ended up in Texas, down in. At TCU in Fort Worth. I was a horn frog and wasn't. Wasn't sure if I was coming back, wasn't sure what I was doing. And I kept coming back in the summers and working for my dad. And he kind of fooled me, to be honest, Eugene, because you know, back then, in terms of finishing charts, he would write NCRX at the end of his assessment, no change rx and that was it. So in terms of staying late and doing all those kind of things, I looked at his time schedule, I was like, that's a great, that's a great way to work. And yeah, so now I stay much later than he ever did and those kind of things. So, yeah, it goes back to the days of my grandfather working on the floor of a jewelry store in downtown Winnipeg. Wanted to move across the street and become more medical, which he was able to do.
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A
So your grandfather was an optician?
- [03:25]
B
He was an. No, he was an optometrist, actually. Graduated in 38. From then the University of Toronto, now the University of Waterloo. And then back then it was two years, which is kind of crazy. And even for my dad, it was four years right on the train from Winnipeg to Toronto, four years straight out of school, saw 10 patients before he graduated. You know, when I graduated in 2000 from Cal Berkeley and I had to see 2000 patients. So it's just a complete reversal on those kind of things. Yeah. So it's been a long time coming. And I actually moved away. My wife is a proud Santa Barbara and we moved to Santa Barbara. Amazing that I, I got her back here somehow, but maybe that's.
- [04:03]
A
Somehow you got someone to move from Santa Barbara to Canada. That is an achievement upon it in itself. Like that could probably be the focus of an entire show is like whatever psychological tricks or compelling psychological powers you have, Dr. Small.
- [04:20]
B
Well, I don't know about that. So we've done both. We graduated, she came here, we were unmarried at the time. We were boyfriend, girlfriend, and worked for two years for my dad. Had an opportunity, she had an opportunity back in Santa Barbara. And we said, hey, let's do this. Without really considering the cost of living in California and all those kind of things. So in those five years that we lived in California, my daughter was born and I worked in 11 different practices. So I got every modality from working in Sears to LensCrafters to county hospitals, to getting to really involved with a refractive surgery center. It was a great experience. So then when we decided to come Back mainly because of the housing market in Santa Barbara at the time. It was a perfect time for my dad. He was looking to retire. He almost sold the practice a couple times. The very last one, it kind of fell through. And that's when we said, hey, maybe we should consider this. And that's been almost 20 years now. It's crazy.
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A
I see. So that's awesome. And so let's talk about kind of the evolution of the practice. You mentioned your grandfather started in the jewelry store. And then it's obviously transformed. So maybe talk a little bit about how it's transformed generation to generation and then most. What kind of changes you. You've put in and, you know, I guess kind of. What, what, what. You kept the same, too.
- [05:42]
B
Yeah. I think always putting patience first is a huge thing. And any of your guests would tell you that, obviously, but I really learned that from the two of them. It's interesting, you know, when he left that jewelry store, the. It was called Mitchell Cock Jewelers, and they were right downtown and they offered him an entire floor so that he wouldn't move across the street to this Boyd Medical building where he was. But for him, they had just finally got the doctor title for optometrist. Right. That he was involved in fighting for that and getting that and being able to, at least in Canada, get funding under the. Our government medical insurance. So that at the time, optometry didn't have that. Fast forward years later, when he was still alive and walking around our practice and looking at price tags on glasses and complaining, and I'm like, grandpa, you're not helping. You know, these are really expensive glasses. He was. Yeah. Known for doing that. And interesting. The next step with that was my dad, who wanted to be a standalone optometric practice. And we had the foresight, and my dad will probably get to see this. So he's going to walk out of here with this big old head that he was pretty smart in terms of looking for his own building. And so he found a former drugstore, a pharmacy, and they gutted it. That was 1979. And my grandpa really didn't want to move. He did not want to leave that medical building with all those other medical people. And. And my dad saw an opportunity and that's what turned into Armstrong and Small Eye Care Center. And it's interesting, he told me, you know, it was called Optical Armstrong and Small Optical. And when my wife Gina and I joined, we changed it to Eye Care Center. And that really kind of gave him a badge of honor. He was that guy that never had therapeutics. When therapeutics came in in Manitoba, he was like I'm not doing the hundred hours. I'm close to retirement here. So it's an interesting evolution. And now if you, for me it's, it's trying to, we've just, we've now four years into purchasing our second practice. I think I'm a little balder by going with that second practice. I know two is minimal compared to a lot of people but yeah, it's been definitely an evolution for sure.
- [07:43]
A
Yeah. And it's so it sounds like the things that stayed the same is more of like the focus on patient experience which I guess maybe I will ask you. I was one trying to decide because you got a chance to. When you said you worked in California at 11 different practices, how did that shape what, what did you see that you didn't like and what did you see that you liked that kind of shapes the way that you run your business today?
- [08:10]
B
Great question. And it's, it was huge. Really. I don't know that I, at least for me that I could be where I am today without having done that. You know, I, I, I, my, my own mom gets mad because I said I was born with this optometric silver spoon in my mouth and I left it all behind and it was great. And in the end it was probably one of the best things because you know, in each of those practices there was lots that I didn't like much more that I didn't like than what I liked and interesting. Not a single one of those practices was had an EMR at the time. So no one was digital. My dad went digital in 89 which is crazy. He was such a technophobe at home. But again an early adopter on technology to say hey, you know what? This black box because it was a DOS screen based, it was actually out of Edmonton, a thing called Genie and it was split screen. So you had your old stuff and new stuff and you just function keyed everything over and it was actually quite good and simple. Looking back at it and you know, to be able to have that knowledge, to be able to do that. And then when I went to California, not a single person I went back to having to write again, which I was not used to and then having the therapeutic, you know, at the time the therapeutics in California, Manitoba didn't have it. So I learned all those things and interesting when I came back, especially from a dry eye standpoint, I'd been working with a corneal specialist for quite a while. So suddenly I Had all this knowledge that a lot of people didn't, which kind of helped to set us apart and create a little bit an early stage of a specialty practice as well. I'd already been using Restasis for five or six years by the time it came out in Canada. So I had a couple, you know, little things like that that were really fortuitous for me to look and say, hey, I'm going to use this at my practice, but I'm not doing that. I'm going to do this, but I'm not going to do that. Lots of little things that I learned from a lot of great people in California, for sure.
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A
Yeah. So what are some things that very intentionally you've chosen to make part of your patient experience that help differentiate your practice?
- [10:08]
B
Yeah, you know, I think one that goes a little bit back to staff culture, staff, how they feel, what they are. We're very family oriented. We really trust them. I've, I've really early on stepped back from the optical side and said, hey, I've got experts for this. Obviously I keep tabs on it from a numbers perspective, but they are the ones making my in and out decisions, you know, and reps are obviously always coming to me with different things, but on that side of things. So I really feel that keeping them happy and hearing them laugh at work. I now work out of a front exam room for me to hear that in the clinic. Like, I have so many patients that I hear come to our little repair area that say, I want to work here. You know, there's no better compliment than hearing that. And interesting. When we, when we bought our second practice, I thought, oh, we're just going to take this culture and move it right over to the next one. We'll just copy it. But people are people, and it's taken me four years to realize that they can be very different practices and it can be a different patient base, it can be a different, all those things. So we're, you know, we've done these different strategic planning sessions and things with our staff, and it's been a long time since we did it. And the last time we asked, and I remember one of our, our I'll call her our legacy staff, although she probably won't like that. She's been with us over 25 years. Somehow she's only 25, as she says. But you know, she's, when she talks about a mission statements like, what would Luke and Gina do? Well, Luke and Gina would probably refund their money on this patient who's really not happy with these glass or whatever it is again, putting the patient first because we know that if we can make them at least leave with a smile if they're not happy with the product like everybody else. I think as soon as we start fighting them, they're going to tell a hundred people this is the same age old story but if you try to keep them happy, they're going to tell 10 people. And in the world of now Google reviews and things that's totally changed. And that's interesting when I talk to my dad about that, it's just like what. That's a whole other level of things. Right. So anyway, that's what we've been attempting to do.
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A
So we're going to come back to your second location momentarily. But you know, I am curious as a third generation because this is relatively rare to see someone who is. And also I'm sure you're aware of just kind of the stats are that the third generation of a family business is usually the one that does something crazy. Yeah. Blows it up.
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B
Y. Still waiting for it.
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A
So what, what's your. How much pressure do you feel and how. What's the kind of the. I guess the, the weight that you carry on your shoulders from this being like the. Because it's not just business. It's like it's also personal. It's your, it's your family's legacy that you're carrying on your shoulders.
- [12:51]
B
Yeah, I go back to my dad a little bit on that. He's very much a next chapter guy. When we told him that we were moving to California, he said, well I'm sad as your dad, but we'll take your name off the sign tomorrow. Like he, he's just like next chapter guy. My mom, that was a whole other thing. But you know, at the time, even my. And for my grandfather, he was sick in the hot. I mean was. And of all the things he, he said, what did he say to me at the time? Talk about pressure. You've stabbed me in the back and, and, and take. Ripped out my heart or some crazy thing like that. My grandma stood by my side and said, remember when you left the jeweler, you were trying to advance yourself. This is what Luke's trying to do now. So thankfully I had the women on my side to do that. But yeah, I think it is. There's pressure there. But now that my dad's been retired about 20 years, it has changed. It took him, you know, he said for six months he was still driving to work after 40 years of going There and now those questions and his involvement has changed. People are people. So from the staffs, the HR, all that stuff, somebody in the 1970s, there's the same personalities that still exist today. Some of it is changing for sure. That's a whole other topic. But you know, I think with that, I don't bear it too badly now. I just kind of keep on keeping on kind of thing and that I try to be as I'm fairly, I think, a positive person, get that from him as well. And so I really, you know, in terms of the third person screwing it up, it's interesting. You know, when he came home, he was home early. And that's one of the reasons why I wanted to be an optometrist because all my friends are like, does your dad work? Because he coached us in everything because he always had time. Now at the same age, that was difficult for me because suddenly the practice has changed and I'm writing letters to neurology and rheumatology and all these different kind of things. So that, that's made it more difficult. When my kids were young, obviously you tried to be the best dad that you can, but that, that, that's what weighed on me a little bit more. Because then when I would call my mom at 7:00 from the office, your father never did that. That was difficult. You get patients early on that said, oh, your father would have taken care of this. But that's all gone now. That's all. And amazingly, we have fourth and fifth generation families. It's incredible.
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A
That's cool.
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B
It's pretty neat. And you know, one of the, I think things that you'll appreciate is we actually created merchandise. And I didn't even tell him I should show you. I'm gonna little show and tell here. So that was his picture and that's cool. Well, you see it that little. And so I didn't even ask him, I just stuck it on his car and he's like, who, who the heck is that? He had no idea. He had a mustache for like six months of his life and didn't particularly like the picture, but it stayed. And so now we have, you know, beer koozies and stickers and badges and pins and, and staff and interestingly enough, industry asks for it all the time. It's pretty neat.
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A
Yeah, really. So it's so, so it really. And part of it is that legacy. But I think it seems like you guys really developed a brand around your name in both the community and, and I mean I'm, I'm Just kind of picturing the practice. It's sounds like it's a pretty fun place to work and you're. And you've got a reputation in the community as such. So that's it. Overall, I mean, kudos to you for, for, for continuing and seeing the next chapter of that. Of that legacy business now.
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B
Appreciate that.
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A
What are the. This is maybe a slightly harder question is like when you took over, what had to change right away? What were you like? Ooh, like, you know, it's kind of like when you.
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B
Yeah, we kind of took over twice because we. We graduated. We came in, dad, we got to get rid of this DOS system. We got to get to Windows. And suddenly we switched to a local company that at the time was doing more chiropractic type, EMR type stuff. And they just kind of made it optometry. And we changed the name, as I mentioned, in terms of. From optical to eye care Center. Therapeutics didn't come in until the second time we came home. So we came back. My dad never worked in 08, so we worked together in 2007. And a lot of those things. It was starting to look at metrics. You know, that was another big one that I. Not that he didn't. His was on paper. He kept track of things in pencil and graph and all those kind of things. He was probably a little bit ahead of his time, but that was a big one. I think we started to get more involved in the community surrounding the practice. You know, now we're, you know, from school stuff in the. In the. Recently we helped plant trees in the. In the area. And that's now gone on to the. The next one and did we really need the new practice? And that might lead into these other questions on that new practice, but we were just busting at the seams and it's only, I was going to say five kilometers. So it's like three miles apart, these two practices. But it kind of fell into our laps. Kind of a tough story because the previous owner had passed and his widow approached me about. And he passed early and she approached me and I was sort of like, oh, did. Wasn't even on my radar. Was not at all on my radar. And you know, again, I just thought, oh, we'll just cookie cutter this thing and make it the next one. And one of the greatest quotes I got from a good friend of mine, he says, you know, Luke, making those two practices exactly the same as like your two kids being exactly the same. And it's tough. It does happen. Yeah. But both.
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A
When you, when, when you got the second practice, what are some things that you noticed that you're like, okay, this is not necessarily up to my standards. And what were some things that you noticed that were like, oh, I kind learn from this?
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B
Yeah. Well, one, I was already in touch with him because he had brought in some dry eye specialty stuff he was doing. He was. It was a smart business play because when you drove by the practice, one side, there's two sides to the building, it's right on the corner. So he had the name of the practice in the front on the side. He branded that as I Spa. So I assumed it was two different complete entities. And what he was actually doing is he had an IPL device and an RF device right in one of his extra exam rooms. And he was just doing it in there. And so I was. Because I was doing so much dry at the time, I was referring those patients to him. So when we took that over, we also took over basically a specialty practice. Timing was great. And again, some things fall into your lap. I'd known our recently retired grad from Chicago. She was just coming back. She grew up near this practice. I said, hey, you can have full time. She was interested in dry eye. So things kind of fell into place. But, you know, there was no, you know, we've used an Optimap since 2004. So now this is 2022. And there. I. Geez, I'm so used to practicing with an optimap. I gotta have an optimap. I have a specific OCT that I like. Oh, we gotta get this OCT in there. Oh, I'm used to a digital phoropter. Let's get, you know, those kind of things. So some of those things he had done, but some of those things we definitely needed to change. And particularly operationally, we needed to change some things just to. Even from frame inventory. I mean, you go all the way through. You know, there's. There's lots of stuff that needs to be changed when you're dealing with that. For sure.
- [20:02]
A
Yeah. And. And you mentioned this whole concept of patient experience, which is started by the staff culture. Right. It's the. I think your hypothesis is that patient experience is the product of your staff culture. And was their culture similar to yours? Did you have to do something to change the culture? Did you have to. How did you adapt?
- [20:28]
B
Yeah, you know, I think we've become. We're so much more medical. And nothing against how he was practicing or what he was doing, but we were a much more medical practice. Than he was. So that that needed. And again, the technology he was just getting into that he had just brought in an OCT and was starting to promote that. Obviously he was doing a much quicker turnaround in pace than for sure that I was used to at my, my age, I'll say. So that had, was changing a little bit. You know, now a third of my patients are glaucoma patients and that's just because I've taken on my dads and as they've aged, those kind of things. So pulling those patients over to a new area in town, it's funny, it's only three miles away and a lot of my patients that have more birthdays, I'll say we're not so happy about having to, to change.
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A
Right.
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B
And those are those patients that are going to drive there the day before to make sure that they knew there was parking and all those kind of things. But yeah, so I think with that it was that that was a little bit tougher. And no, you know, now we're down to just one of the remaining staff that was originally with him and randomly she used to work for us, you know, a decade ago. So we kind of have come back together. She's one of our main dispensers there. So it's, it's worked out well.
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A
Got it, got it. So it sounds like the staff culture had to kind of come in from a outside sweeping gesture rather than necessarily inside.
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B
And, you know, his former manager was really close with him and I never really, and that was my mistake on a human side is that she had gone, they had all gone through this pretty massive traumatic event and so to stick around there was tough for them and that took me a little, I thought, oh, are you leaving? Because I'm changing things. And I remember that manager, she was very straightforward and she just said, no, I, I, this is really hard to come for me to come here every day. Right. We, we were making some pretty major changes to her for sure, but I think it was also the, the traumatic event of having that happen. Um, so then trying to continue his legacy as well a little bit, as, you know, as best we can and trying to. And then also now we've just rebranded, which I had a little bit of a hard time. So when we now call, it's in it's an area town called Osborne Village. Osborne Village has been around since the 70s. Kind of what used to be called a beatnik area, I would say is now there's some gentrification that have gone on with it and it's always changing, you know, and now I think we're going to be a part of that. And now we call it Armstrong and Small in the village. And I think we're all, you know, even the, even the staff there, suddenly they get to wear the logo and they're wearing the shirts and they're getting the merchandise and those kind of things. So they were excited for that from my perspective.
- [23:10]
A
Anyway. That's good. That's awesome. So we'll talk about your personal transition after the break. Kind of going from being an optometrist in one location to being kind of a manager of two. But before we do that, I just wanted to zoom in a little bit of. In this context of technology. You mentioned technology quite a bit. You've also mentioned that your dad was an early adopter of the EHR. And did you say the late 80s?
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B
Yeah. 89. Crazy, right? Like he was. And for him it was just to get rid of paper files. Like he was running out of room. That was his whole motivation. Let's put it in this black box. That's all he knew at the time.
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A
Yeah, no, and that's very, very tech forward. So talk to me a little bit about the role that technology plays in your practice or in both of your practices right now and, and really how you're using it as a mechanism of differentiation as well.
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B
Yeah, absolutely. We, you know, and everyone is catching up. It's. It's constantly, as you know, we've got a. What are we using? That's somewhat different and, and now there's so much out there. You kind of have to make a decision at these shows and expos and trade shows. Okay, what, what is actually going to help me and what piece of the puzzle is this going to be from whether that's a axial length measurement. Are we going to go down that road? Are we. We're going to do my biography on every single patient because we're trying to fill these dry eye spots. We're constantly thinking about that and then also trying to look at from. Okay, if we purchase, what's our return? Obviously the ROI on all those kind of things. So that we've gotten better at planning for. We recently just purchased a new oct. And my personal thing with that is because I use a local. It's a Canadian company called Care One, maybe a little bit of a shout out, but they have. It's a telemedicine AI platform that I'm using constantly for my glaucoma patients. And now within their. And again, if it's okay, I'm going to use some industry names here that it's a Zeiss forum platform that can automatically load right into that. So when I saw that I could do that, okay, then I want forum to be able to do these things. And not all of our associate ODs, and especially maybe even my wife is like, I'm not doing that right. So you have to kind of make sure that they're aware. I've made that mistake of. Of charging ahead with this. What I think is awesome and all excited. And you get back and telling the staff, and they're like, what are we doing? Why are we doing it? And then the. The whole other part of that is, how do you tell somebody over the phone? As you know, you and I have chatted about how do you make. How do you portray that, why are you more expensive? And how does that staff person say that or AI say that to that patient that's on the phone? Phone.
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A
Yeah, right, right, exactly. And I. And I think that's part of it is using the technology as a differentiator. But, you know, there are a lot of practices that kind of feel apologetic for saying things like, oh, yeah, we have to charge you this much money to do this and that during your exam. And there are some practices that are so unapologetic and so. And it comes off as like, we just believe this is the standard of care. And because everybody at that practice believes comes off as like, well, you know, sure, you could go to. To a different practice that doesn't really have these tests or doesn't have this technology, but we would be underserving you if we weren't doing this for you. And so, like, everybody in it, when. When it comes off it, it's really not even what you say. It's kind of how you say it, at least in my experience, when you're describing the fact that this specific patient experience costs more money. The truth is that there are patients who are going to be very excited to pay for it once they realize what the outcome to them is or what the benefit to them is. And it sounds like you guys are well on your way with that, but you're absolutely right. I think a big challenge is, of course, adoption internally, because it's not that you could buy it and you could provide the. Provide the service, but it's the fact that your staff need to be excited about it, your associates need to be excited about it. Because my wife needs to be. Right, right, right, right. Who also works in your practice. Right, yeah, yeah, absolutely.
- [27:26]
B
She's my. Yeah. Optometrist partner.
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A
Yeah. And. And so, you know, if, if everyone's not excited, then this thing just becomes a, you know, kind of an underutilized, a very expensive code rack.
- [27:38]
B
100%. Yeah. Agreed.
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A
Yeah. So when we come back from the break, Luke, I'd like to spend a little bit of time thinking about what your transition is going to look like and how you frame, how you see the future of this legacy practice and what your role is going to be in the future of this legacy practice. So we'll be right back on the Power Hour.
- [27:59]
C
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.
- [28:23]
A
You've heard the story of I Care
- [28:24]
C
Boss, and now there's an event, I Care 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 iCare 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 third things that keep people up at night. We're going after it and we're doing it in a room full of practice
- [29:03]
A
owners that are just as serious about growth as you are.
- [29:07]
C
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. Go to thepowerpractice.com click events, click apply now. This is invite only.
- [29:24]
A
It's not for everybody. So you have to apply.
- [29:27]
C
We'll ask you a few questions and if it's a fit, we'll invite you to register this event. Icare Boss Live is going to sell out. Do not sit on it. I invite you to apply right now.
- [29:37]
A
All right, we're back on the power hour with Dr. Luke Small. So, Luke, we talked about in the first half of the show, we talked a lot about how this legacy practice has changed Hands. You've made changes throughout the through, throughout the transitions and, and what the practice looks like now. So where do you see the practice going in the future? And by the way, do you anticipate that there'll be another generation that ultimately takes the reins?
- [30:06]
B
Well, I'll answer the last one first right now. No. So we've got a. Our daughter's in third year at McGill in Montreal, loving Montreal, doing psychology like her mom did an undergraduate degree, wondering what she's going to do. At one point she says, well, maybe optometry, but not in Winnipeg. You know, in your early 20s, Winnipeg gets a bad rap and then everyone moves back here because the cost of living when they're in their 30s and have kids, but who knows? And my son, he's about to graduate high school. He's off to the University of Minnesota. He's going to be a. I'm going to be a Gopher dad, which is only. Minneapolis is only seven or eight hours from here. So we're excited about that. But I really think what's different for my dad and myself is that my parents rarely ever talked about the practice. My wife and I, unfortunately, have to talk about the practice. We're both the two business owners. We're partners in life. We're partners at home. So especially. And we always seem to never be ready to talk. Like we've learned okay before bed so that we're both not. Can't sleep. We're not going to get into this HR issue or we're not going to get into those kind of things. So sometimes it's at breakfast and we're both racing to work. We're even going to the same building sometimes. We learned a long time ago not to go together. I'm probably too slow in the morning and I stay too late in the evening. Right. So we've figured that all out. But our kids have heard the business side talk for so long that be really curious if they ever were to go into a small business, because it could be overwhelming and they hear the stress that we have, maybe it'll send them off to a different. Who knows? And I never say never because I got out of it for a while. And at my undergraduate degree, I was going to sit in a lake and do water samples and be quite happy. And. Yeah, but I kept coming back, so I think both kids could do it. But whether. Who knows what that's going to be like? And how do we even plan for that once we get closer and closer to this retirement thing? I think in terms of where we're going forward. People ask me all the time, are you going to add a third? And really, after going through that second, I don't know that I may lose a wife if I decided to do that. I say that jokingly and unjokingly, but it's a lot. But right now, I think what I'm most excited about, Eugene, is all these back burner items that I'm finally going to have time for. So at 40, I wanted to work four days a week and do one day of admin. My goal at 50 was to be able to have three days. I'm just, I'm going to be 53 this summer. And finally just getting to that goal. We've got a couple great new associates that are movers and shakers and they do a great job and their capture rates are high and all the things that we would look for in associates, and we knew them during undergraduate, you know, they came to us looking for jobs, so we knew what we were getting when they were coming out of school, which has been great. We know how they're going to treat staff, we know how they're going to treat patients where there's no surprises. Back in the day when my dad would hire anybody with a pulse, that was his quote, because he just needed somebody to help him with his backload of things, of his backload of patients. Those times have changed. We're pretty picky with who we bring in as doctors and we're proud of our doctors team. And like we said with the staff in the first half, it's the same with the docs. They, they've got to have some buy in and they, they will, they'll hold my toes to the fire now too. Like, I, I really get them involved. I'm a big proponent of making sure the associates know what's going on and that they have a say in that too. We're, we're constantly now with two places who works where, those kind of thing. We want to make sure that everybody's happy and paid fairly and all those kind of things that go on. So as we move on, I think if I can go down to three days a week, a lot of those things that my manager. So we have a manager, our clinic manager, Chelsea. I'll do a shout out to Chelsea, who's been awesome for us. You know, she does both clinics and it's a lot for her and it's a lot for both of us. And along with my wife, we're managing all of that. And so we're constantly, oh, we should do this. And honestly, we're another shout out to ICARE Pro. We've been with ICARE Pro for nearly a decade and there's so many ideas that they provide us from marketing, from, oh, you name it, just about everything from social media to SEO, all that stuff. It's so much. I used to keep a list and I would have 50 things and we'd be able to do one or two. And I remember one of our reps at the time said, hey, if you can do one or two, that's great. And I would. Any new OD who's looking at being worried about spending money on those kind of things, partner with somebody who, somebody from industry who has 50 other accounts through North America sure knows what they're talking about, right? Learn from them, gleam from them, pull those things. So now I'm finally going to have ideas to finally be able to do that one idea we were talking about, how do we show what an exam is like? Well, I love meta technology. I'm a big outdoors guy. I love it for mountain biking, biking, cycling, canoeing, you name it. I love having my Metazone to do. It's replaced my GoPro completely. Skiing, snowboarding, all that stuff. So I want to walk through the practice with my metas filming. I'm sure this has been done, but we kind of like this idea of even putting your head into the optimap so that my new 75, 80, 16, 5 year old patient and then do we get a 5 year old to do the same thing and walk through?
- [35:08]
A
Right.
- [35:08]
B
It's all video. We know how important that is now. So anyway, that's where I foresee my role, that I can make it the best staff experience, best patient experience, best doctor experience. And so my flip to you for this and knowing your experience and what you, you know, in terms of as I tried to transition myself into the CEO, you now you've heard my story, what do you suggest that I focus on?
- [35:32]
A
Right.
- [35:33]
B
I've got lots of back burner items, all those kind of things, but if you had to give me some very specific things that I should be as I go forward, what do you, what, what are your suggestions? I'm going to flip this on you. I've seen other guests do this to you.
- [35:45]
A
Yeah. So this is going to be fun. So let's do it this way. I've heard you say a few things that you really like or that you want to do, but let's figure out from an impact standpoint. So if you're Going to be the best possible CEO for a practice. Let's start at the top. Is there a clear vision for the practice? Have you written a vision in present tense that's three years out, that everybody in your organization, both locations, can see clearly what the practice will look like, what the patient experience will look like, what the entire sort of feel of the practice is going to look like, and also how you're going to get patients and what you're. And what your kind of. All your metrics look like, too.
- [36:30]
B
I have not done that, so thank you. There's no step one.
- [36:34]
A
Step one is this. The CEO has to play the visionary role. Unless you have, you know, that some. Some combination between you and your wife, you. Somebody's got to play the visionary role. So that. And the reason I say that, Luke, is I start with the vision for you because I think you know what you want your practice to look like. But if you can document this and you can use this, you can use AI to help you. And I could probably even give you a bunch of questions that you can. And I'll happily share this with anybody who listens to the show, is that there's a. There's a few questions you can ask yourself about your practice. And then as you start answering these questions, I would just talk into an AI assistant like, you know, ChatGPT or Claude or whatever. And as you talk, you say, okay, now help me write a vision. Now the vision needs to be three years out, present tense. Very similar to the concept of Cameron, Cameron Herald's vivid vision, also from Canada, I believe, and that. That what will happen is it'll crystallize for you a picture of what the practice looks like, and then it'll crystallize for your staff a picture of what that practice looks like. And then you can start saying, okay, well, that's three years out. So that's present tense. So right now we're recording this in June of 2026, if we are. So now this will be, what does my practice look like in June of 2029? And so you say it's June, it's June 1, 2029. And what we. And we are X, right? And then all of a sudden all these things start flowing in. So that vision, why. Why do you need a vision? It sounds a little hokey, but like, it gets into real business concepts real fast. Because then you can say, okay, well, I said, we're going to be seeing X number of patients. I said, we're going to be, you know, a true dry eye center. Of excellence. And I explained what that means. So how do we go from where we are now to there in three years? Well, what that means is we have to start thinking about what's our annual goals, right. And what are our annual rocks going to look like for the next three years? What do we have to accomplish this year in order to even make that vision possible? Right. And so you start identifying what those rocks are, and then you start cascading those. And as you start cascading those, you say, okay, well, you know, for example, and I'm paraphrasing, but you might say, you know, we really want to make sure that one out of five patients that's. That we're seeing for a comprehensive eye exam gets treatment from us for dry eye. And we have lots of different dry eye modalities available, and we want to be getting referrals for dry eye from all the surrounding PCPs and possibly other ODs. And we want to have. So, okay, so what, what are the things that need to be done this year in order to make that possible? Well, there's probably a standard of care. We probably need to test some things. We probably need to figure out, well, what, what percentage of patients are now versus what percentage will be. Need to be in the future. And how do we, how do we, what operational change do we have to make now in order to enable that in the future? So this is what a, what I think the role of a good CEO is, is to look at that vision and then get their staff involved in having a conversation and say, what needs to exist today in order for us to be able to accomplish that vision in the future? Or the just as good of a question, and it's not a bad one, because what issues exist today that prevent us from being able to get to that in the future? And to me, issues are just opportunities, and they're money. It's literally just money that needs to be uncovered and figured out, cleaned up, and then put in the bank and resolved. And so you gotta be able to facilitate the conversations that ultimately lead that way. And that's where I would start as a CEO. And then once you kind of identify, okay, well, that's where I'm going. Who do I need to make sure that gets there? And so part of what you're doing is if you're stepping out of the exam room and you're taking a leadership position, you're probably also going to need to start looking for leaders in your organization to help you accomplish your growth goals. So then we turn to the Kind of the people side of the equation and say, okay, you were talking about, like, really cool, fun things you can do, like walking through the practice with metas and that kind of thing. I would do the. I would do the Zone of Genius exercise. We mentioned this in our book. I also think Dan Sullivan, another famous Canadian that I, That I admire quite a bit.
- [41:22]
B
There's lots of us who knew, yeah,
- [41:24]
A
yeah, great, great talent, great talent pool. So Dan Sullivan has this concept of unique ability, and we kind of translated it to zone of genius. But the reality is that, you know, whatever you call it, it's the work that you're both truly passionate about and that you're really good at doing. That's the stuff where you could spend as much of your time doing that then your work doesn't feel like work. You're in a. You're insanely much more productive and your output delivers the greatest amount of impact. And so the, the real challenge for a great CEO is to try to line people up into their zone of. Of genius. And I use this example because kind of, you know, it's kind of a silly example, but it's true. About me is for a while, Luke, in my business, up until we had, I don't know, about 50, 60 employees, I. I thought it was. I thought I was the best at doing payroll. And so the reason I believed I needed to do payroll was because, you know, first of all, I didn't want any drama on the staff of, you know, if somebody did payroll, then somebody knows how much everybody makes, and then, you know, that could potentially lead to drama. And what if that person, you know, ends up ends up at the bar with the wrong person and like, that kind of thing, Right? Like, so that was one. The second thing is I had just done it forever. Like, since the start of my business, I did payroll. So I was inherently pretty good at it. I was very efficient, although it was definitely one of my least favorite things to do. So if payroll was due on, you know, Tuesday at 7pm, what would happen is I would get it. I would start it on Tuesday at 6:32pm Because I knew that it took me approximately half an hour to do. And I, you know, and sometimes I wouldn't do as thorough of a job, and I, you know, would sporadically check certain things that I probably should have checked more. And, you know, and sometimes I would get distracted by really great shiny things that I enjoyed a lot more. Like, if a client called at 6:20pm of course I'm going to take the client Call. I love talking to clients. I don't love doing payroll. So when I'm off the phone at 6:55, I'm like, crap. I'm pretty sure, you know, people are going to be paid a day late and I'm going to have to apologize to everybody for no really good reason except for I procrastinate because I didn't really like this job or this work. But the thing is, this is what happens is a lot of people get trapped in doing work that they are competent at. So they're high skill, low passion, right? So I'm competent. I'm not, I'm not passionate about it. I'm just competent at it. So inherently I'm good. Therefore there's no performance issue. Therefore I just keep doing that work. And that could be you, that could be people on your staff. And the truth is that if I could free up that half hour or 40 minutes or you know, to do the job right, maybe it's two hours. If I could free up those two hours and move them into the zone of genius for me, which is competent and passionate, if I could just move my work there, you would get way more output and way more impact from me. And then there's probably somebody, and I actually found that person when I really started looking at it, who is extremely competent and also very passionate about doing payroll. And that person turned out there's not
- [44:50]
B
many of those around. So if you can find someone, there's not a lot of people, patches.
- [44:55]
A
Well, that's the thing is you got to find those people. And so for me, that person actually turned out to be outside my organization. I asked around and it turns out that of all people, my attorney was like, hey, actually there's this woman who wants this part time job and she's trying to build this payroll business and I'd love to introduce you guys. And she literally freaking loved it. Like this was her thing. She absolutely loved the, the, the act of doing parallel. And I was like, oh, this is great. And, and I was like, why I was so dumb to, you know, for, for what she charged me. I was so dumb to not have her do a much better job, a much more professional job and to answer all the questions that inherently came up because you feel like, oh, well, it's 30 minutes. But it's also like, then somebody else, somebody has a thing or somebody forgot to submit their hours or somebody did this and somebody didn't do that. And then all of a sudden you're like also stuck answering all the questions related to that task. And so that was also my least favorite questions to answer. And then my staff thought I was unresponsive. They send me messages about this and I'm like, I don't want to look at this right now. I want to look at this other fun thing that.
- [46:01]
B
That's the object over here. Yeah, well.
- [46:04]
A
Or the stuff that I'm just more passionate about. Right. Like a client. Client had an exciting development. I'm way more excited to work on their business than I am to look at your timesheet. Like, that's. Sorry. But like, that's.
- [46:14]
B
But that's how. Yeah. So let me ask you this. So our biggest issue for my wife and I is that we're transitioning out of that exam room. Those staff have seen our family for. Sorry, Those staff, those patients. Lots of our patients. I haven't had new patients in five years. I've been fortunate enough to do that. So I've created these long term relationships. So what's the best transition out of that? Is it me actually introducing that situation in the exam room with that patient when the time comes that, hey, I'm decreasing my load? Because once you look at, you know, every Friday, that, that's gonna be a lot of patients over, you know, a year's time, a two years time, or whenever they're getting recalled that I've gotta move over to somebody new. We also thought about videos where, you know, I would say, hey, this is, this is my optometrist. This is who I see. This is our associate. I have full fledged. We're not picking them just out of the blue. These are people that we trust and they'll do a great job with you. And I think I mentioned too in the past where once you start to look at capture rates, once you start to look at those kinds of things, I shouldn't say happy, but my newest associates are better at that than I am, I'll gladly admit. And because I've have these long term relationships, I'm chatting about their kids playing, their grandkids playing hockey. Right Then, oh, can you read the chart? And they enjoy it. They love it. You know, again, created the relationship that makes them want to come back. But how do I transition that to a new associate who I feel I've got full up? Most multiple associates. What are your thoughts on that? What you've seen enough practices do this. How. How do I transition my wife transition out of this?
- [47:56]
A
Best. Yeah. And I would be careful with saying things like I'm decreasing my load because you really don't want the patient to feel unimportant. I would frame it as a very positive.
- [48:11]
B
Picking them as a person. You're pulling out. I see. Yeah, true.
- [48:14]
A
Right, right. I would frame it as a positive. Luke. I would say something like, you know, Dr. Smith has spent the last few years really getting some additional training and some of the latest training in the latest technology that can help patients just like you. So I have hand personally selected Dr. Smith to see you going forward. He is going to be a little bit more available than I am, and that's why I want him to be able to see you. So what have I done? I've just given you three positives. Yeah, so and so is really smart. They're very well informed. Number two is they, they have more availability so it's easier to get in to see them. And number three is I have personally selected them, so I've transferred my authority to them. Right. So I've just given you three positives for how to have that conversation. You can have that conversation in three different ways. One of those conversations is you can, you can actually see the patient in person and introduce them and introduce the doctor and say, this is going to be, you know, Dr. Smith. And Dr. Smith is going to do the exam today. And I'm here observing. I don't love that choice. It seems like the most natural handoff. But like what. What will happen is the patients naturally kind of, they're, they're anxious the entire time because there's two doctors. You don't, you know, the, the person who's being watched doesn't really, that doesn't feel great. And I wouldn't ever do it at the end of an exam to say, oh, Dr. Smith is going to see you next time, because then they may never come back. Right. That's the. Because at that point they're like, oh, I'm not going to get to see my favorite optometrist anymore. So I would, I would do it either on the phone when they call to schedule or to confirm. And I would do it by. And you know, these are not mutually exclusive. I would do it like you said, by video and, or, and or letter is to when. When a patient calls or when you confirm that appointment for, you know, next Friday or whatever that. And they're going to see Dr. Smith instead of Dr. Small. What's going to happen is at that point, that's when the messaging comes in, is that, you know, Dr. Small has, has hand picked Dr. Smith to see you. Now, Mrs. Jones, you're going to be seeing Dr. Smith now. Dr. Small hand selected Dr. Smith to see you, and he's going to send you a video about that because he. That that's them together. Dr. Small is still part of the practice, but Dr. Smith is a little bit more available, has some of the latest training and has some of the best. And has access to some of the best technology. So. Doctor. So Dr. Small thought you should see Dr. Smith, and you'll certainly be able to provide some feedback on your visit to us after your visit. Right? So it's like, you know, I'm making it. I'm making it all about the patient benefit. Nothing about you. I honestly, I don't want to hear that my doctor is not. You know, I once heard this and a recorded call, and I ended up having to call the owner and tell them that this is, like, really bad. There was a patient who called and said, I want to see doctor. You know, let's call him doctor. And the person said, oh, well, you know, he's not really available for a while, so, you know, like, it's like two months out. And like, he only does one Tuesday a month. So, like, that'll be the. That'll be blah, blah, blah. And this patient's like, oh, well, okay, I could probably wait till then. And I was like, well, you know, but it's kind of hard to see because he's focusing more on the business now and less on the, you know, and less on patient care. And the guy was like, oh, okay. Well, I mean, I guess, you know, just like, book me when you can. I really like him. And then this person's like, okay, well, I'll book you that Tuesday. But if something comes up, we may have to book you, like, a month out from that. It was like, I heard this and I was like, focused more on the business and less on the patients. Are you kidding me? You can't ever say that. And so anytime you say I'm scaling back or I'm doing whatever, just like, it's not about. It's got to be about them. It's got to be about the benefits to the patient. And so I would do that. As you're framing the transition, when how
- [52:29]
B
many patients have said to me as they realize that I've. I'm having more birthdays, that are you retiring? And if you and. Or I, you know, if you are decreasing that patient as the patient picks up on that, even if I haven't said it. Well, for sure you should. You need to. You need to take care of yourself. You need to. I'm worried about you. So you're working too hard, but don't get rid of me. That's right.
- [52:54]
A
That's right.
- [52:55]
B
But, you know, sometimes two. I'll be at the practice. I'm there on a Monday. That's my administrative day. I've said hi to Mrs. Smith, who is there? And how are the grandkids? Oh, are they still playing hockey, whatever it is in our world that we're talking about? And then they go see the exam and now they've almost forgotten that they haven't seen me because they did see me. I almost just need to be like, we keep joking that I need some suspenders, like a Walmart greeter and just kind of hang out when you. When you walk into our main practice. Right now I've got a classic old baby blue optometric chair and the green one. And the blue one was my dad's that he bought out of school. The green one went way up northern Manitoba from where in our province for 20 years and somehow landed back with me. And so it's kind of neat. I could sit in those chairs and just greet people all day. I mean, that's not maybe the best use of my time, but people, and it's interesting, you just need a quick hello even. And they're excited. So I agree. I appreciate those, those points because that's honestly what my staff is probably most concerned about. And obviously losing patience when we say that you can't see Dr. Small for four months. Oh, we've got these great people handpicked, all those kind of things. Oh, I'll just go someplace else. That's the worst for us. That's what we're trying to avoid at all costs.
- [54:15]
A
So then that wording becomes, like we were saying earlier, it's the people have to believe. So it's just like if your people truly believe that this is. And this is up to you to make sure that they understand. So some things that you can do for the staff is they can sit in on the exams or they can go shadow an optometrist for a day, especially one that you're transitioning your patient load to, so they can see how great that optometrist, his or her bedside manner is. And I can see how much patients love them. So they can really buy in. And if they see any issues, they should very openly be able to tell you what their feedback is on that exam. But. But in general, it's the. I want to get to know how doctor, you know, Dr. Smith practices so that I can. Good idea. And very honestly refer Dr. Smalls patients to Dr. Smith, especially on that phone call. That could be one of your goals.
- [55:13]
B
Yeah, I like it.
- [55:14]
A
That could be one of your rocks, because in. In your vision, you could very well say that, you know, we, We've built. We. We've built out two or three associates to. To a point where they have a full schedule and an amazing capture rate and loyal patient base and they're constantly generating referrals and on and on and on. Right. And. And so how would you do that? Well, you would have to make sure that you start breaking that down and it's somebody's job this year. One of those goals this year needs to be to help make sure that that script is bulletproof. Luke. That, that you've tested that script and that it's. And it sounds good and you know, and you're. And you've tested it with a couple people who are kind of like, you know, who would tell you if it. If it's BS and you've tested. And you've tested the script and you've tested the approach, and it feels really good to the patient to say, oh, man, like, I'm getting a guy who, like, really specializes in the thing that I'm in the thing that I'm really worried about.
- [56:15]
B
Yeah, I. I like it. And I. And well. And now I'll be sending that script to you to make sure it's bulletproof too. But yeah, I think those are the Kind of.
- [56:23]
A
Happy to help.
- [56:25]
B
Thank you. Th. Those are the kind of things that, you know, that can just sit on a. On the back burner. I keep using that back burner items as, you know, and it's trying to tear that band aid off to get to them and to be able to have that time. And that's what I'm looking forward to is, is getting some time back. But I, I agree with you on all fronts. And you. And you talk about this with all your guests is how do you spin that to make it a positive. Right. How do we. How do we tear. Again, I use the. Tear the band aid off and flip it. And that's exactly right. And how. And how it's done wrong. Right. And how are we saying something? And we all. Every doc knows when they hear their staff sometimes the wording on the phone. Well, that's not how I would have said that. And then it, you know, I might make a little note on the side of the paper, but I don't talk to that staff person for three months. About it. Right. So, you know, those kind of things are trying to, trying to get better and goals and those.
- [57:19]
A
And I would go even a little bit further because as the CEO, you're going to have to zoom in. And this is, I would listen to calls where these types of things happened. I would have staff self document when they brought up, you know, Dr. Smith versus Dr. Small and how many times they scheduled the appointment. And I would just make sure that this is, this is just like anything else in our business is that if you say it with an apologetic tone, it's going to come off wrong. So it's not just the script. It's the, the second I say, ooh, this, this is all gonna cost, you know, $621. The second that I say that, I could have said exactly those words with a completely different tone. But like all of a sudden the patient is doubting their decision to, you know, go through all of this type of stuff. Whereas instead of completely different approach and like, I really believe that this is truly the best outcome for the patient, then it, then it's not apologetic, then it's, then it's just a matter of fact. And I'm, you know, and I'm just here delivering some really great news for
- [58:28]
B
you and look what you're getting out of this. And let's go. We can even go through this bit by bit to show you exactly what you're getting for this amount that you're paying today, you know?
- [58:36]
A
Yeah, yeah, exactly. And that's, I would, it's, it's as simple as like, you are going to see amazingly well and you're going to get to drive at night without halos and, and you have your, and your, when you work on the computer, your eyes aren't going to get tired anymore. And for just for the whole year, it's only $621. Completely different mindset than, you know, then, oh man, I can't believe this is all 620. Are you kidding me? Like, this is a lot of money. Like, I know it's a lot, but like this is, you are getting the best. Like that.
- [59:09]
B
That's a very all about presentation. I agree. I agree.
- [59:13]
A
Right. So, and then, and it's hard to fake. So that's why I say, you know, genuine belief. And this is where it goes to your earlier point kind of what inspired my, my point is that I think the genuine belief that patient, that, that's like that culture of patient experience and the culture of like truly enjoying what you do, there's Got to be the same thing. So I. I truly like working here, and I truly believe that we're doing great things for patients and they cost money, and that's okay.
- [59:43]
B
Yeah. And people. Patients feel that, right. When somebody doesn't enjoy their job. Like, you know, I'm constantly like, probably just like you. When you go to any kind of customer service thing, you're always analyzing and watching, and there are a lot of people out there who sure don't like their jobs. Right. And so when you hear that. And what we would run into, again, going back to the legacy, is you get a new staff person who has a ton of energy, is maybe quite extroverted, quite good at their job, good on the phone, all those kind of things. But they wear the heart and sleeve. So if the. If they feel like the patient is saying that they're wrong, then they start fighting with them. And then I want to walk up and tap them on the shoulder and go, Mrs. Smith has been coming here for 52 years. She wins every time.
- [60:26]
A
Right.
- [60:27]
B
And I've had that issue because now my staff realize that, okay, you know, the. The Dr. Smalls, Luke and Gina are always going to take that patient side because they are always right within reason. You know, that, that, that one of the big ones I keep coming back to, that's been really difficult at times. And this is kind of an aside, but I. Because my patient base is getting older and older, sometimes you see, you start to get concerned about some cognitive stuff. And so we get people that don't remember arguing with one of our staff. So we've had to kind of figure this out. And how do we deal with that and how to. Oh, it's one of Luke's patients, because it's the. You know, he's seeing a lot of those patients with extra birthdays and all those kind of things. So, yeah, it's. It's always a challenge. There's always something. It's always changing. Right. And trying to. And again, as I say, I'm excited to have more time to be able to do it right or as best I can.
- [61:17]
A
Yeah. Well, I'm excited about the next chapter in your story, Luke. Congratulations on all your success thus far, and thank you so much for being a guest on the show today.
- [61:26]
B
Thanks very much. Thank you for having me. Appreciate it.