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Power Hour Optometry
How I Increased My Profit By 30% While Cutting Down Staff: Dr. Lauretta Justin & Eugene Shatsman
00:55:00
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- [00:00]
A
So many of us have a practice that have strong revenue, but we have no cushion in the bank, no energy left at the end of the day, no peace when you close the door at night. That is not success. We build a practice where we pay everybody else more than we pay ourselves. That creates a big discrepancy. Where you are building a business, you kind of become the least paid employee.
- [00:25]
B
In the business, or at least the last paid employee.
- [00:27]
A
The last paid, paid employee. I used to be in a situation where my staff would come to me for just about everything. And, you know, the craziest part was my staff always complained that they were overwhelmed. There was just way too much to do. And then we always needed more help. And the more help I hired, the less efficiency we had.
- [00:45]
B
What does the practice look like today, three years later?
- [00:48]
A
So three years later, there are two virtual team members that answers the phone and do all of my billing. And then I have my niece who comes in part time, so sometimes she's my tech and sometimes she helps out. And then my husband and I, we pretty much run the practice.
- [01:05]
B
What's happened to your revenue?
- [01:07]
A
My net profit increased by 30%.
- [01:12]
B
As a doctor dispensing, you probably have a pretty high capture rate.
- [01:16]
A
My Capture rate is 78%.
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B
Wow.
- [01:19]
A
And unlike many practices, I have one price point for all of my friends.
- [01:24]
B
So what do they cost?
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A
They cost.
- [01:27]
B
And that's every frame on your board?
- [01:28]
A
Every frame on my board.
- [01:30]
B
Wow.
- [01:38]
Welcome to the Power Hour, Optometry's biggest and longest running show. I'm your host, Adrian Chatzman, and today's guest brings a really interesting and kind of an unconventional and honestly eye openening perspective. So in the first half of the episode, my guest, Dr. Loretta Justin, walks us through a set of decisions that many practice owners would never even consider, but it completely transformed her business. And it's worth looking at this really interesting perspective. I mean, what she did is she cut the staff in her office dramatically. She charges one price for every single frame on her board. And, and she has a really interesting model behind that. And she also personally handles a big part of the visit that most doctors hand off. And she has really good results. Her practice is very profitable. So I'm not going to spoil the full model here, but it's one of those conversations where I kept doing one of these. Wait, what type of questions? Because it really forces you to rethink how efficient a practice can be from a different perspective. And then in the second half of the show, we actually dig into the philosophy that helped Loretta get there. And it's really her work with Optometry Divas, which is a membership organization with thousands of women. And what she learned from serving hundreds of women about.
- [03:02]
Their biggest challenges, how Loretta believes that burnout actually comes from an identity problem, not a workload problem. We also get into her framework that's called the CEO of you. And then something she calls sip, Significance, Impact, Profit, which is she believes every practice should be SIP certified. Really interesting. And it's just a fantastic blend of practical advice and mindset shifts. So I think whether you buy into her philosophy or not, you're definitely going to walk away from this episode seeing the possibility of practice ownership a little bit differently. Quick reminder, if you have questions, ideas, feedback, you can always reach out@eugene shotsman.com or through the Power Hour website and make sure you're subscribed on YouTube, Spotify, or Apple Podcasts. All right, let's get into the show.
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All right, Dr. Loretta Justin, welcome to the Power Hour. Excited to have you on the show.
- [03:57]
A
I'm excited to be here, Eugene. Thank you for having me.
- [03:59]
B
Yeah. So you got. We've got so much to talk about on the show, and I think I want to start with the controversial perspective that you have on some of the things, some of the changes that you've made in your practice over the last three years, and maybe as we talk about it, that we'll get a chance for the audience to get to know you. And then we'll talk about the much, I guess, the thing you're building, not that the practice itself isn't awesome, but the thing that you're building that has impact on so many other practices and what you're learning as you're doing there. So tell us a little bit about this thing that you discovered over the last three years in your practice and some of the changes you've been making.
- [04:42]
A
When I started my practice in the very beginning, I always knew the reason I wanted to go into business was to have autonomy or freedom, which happens to be in the very top of my core values. I love to be free. I don't even like turtlenecks because I love to be free. And when I started my practice, I didn't really know how I can create that as a business owner. The school that I went to really taught me how to be an optometrist, but I didn't know how to be a business owner. So three years ago, I realized that I was not. I was working hard and I was generating pretty good income or revenue is a better word. But my take home was not as much as I wanted it to be. And a lot of the business required me and a lot of the staff management was such a nightmare for me and it was so, so stressful. And I just felt like I was not getting the reward for the amount of work that I was putting out. And I started looking at my practice and I thought, there's gotta be an easier way to do this, a better way where I don't have to work as well as. But keep more money ultimately is what I wanted. And that's when I started looking at the efficiency of my practice. I started looking at how much am I repeating or how much are the staff producing. I actually did not track that metric prior to that. What is the production of my staff? And I realized that I had way too many people for the number of patients that I was seeing and for the revenue that we were making. And, you know, the craziest part was my staff always complained that they were overwhelmed. There was just way too much to do. And then we always needed more help. And the more help I hired, the less efficiency we had. I knew something had to be done.
- [06:35]
B
Okay, this is a really, by the way, incredibly valuable point. The more people you hire, the less efficiency you have. We're going to come back to this point because I'm, I'm. But I want to get into some of the specifics. So you had a practice, let's say. Well, let's, let's paint the picture for people. Three years ago, did you start the practice, by the way?
- [06:54]
A
Yes, I started practice cold. I practice has been around for a hot minute. So I know I look really good, but I've been around for a while and I had a practice at that time. I had an associate and I had a team of 10 total. And I was seeing patients one day a week. My associate was seeing patients four days a week. And that's because I do have other businesses that I manage and run, but in this particular business, which is my practice, and I felt like the efficiency was not there. I had three people in my optical and the patients would still wait when they would come out the exam room to be seen by the next optician. And it was just at the end, there were still orders that was not submitted on time and the claims were still running behind. It was just a complete chaos just because there were too many people doing the same thing. And I realized that is not working out for me. And it was just very expensive having all these people. That payroll was ridiculous. It was over 45% of my revenue. That's insane.
- [08:05]
B
Yeah. So what does the practice look like today, three years later?
- [08:09]
A
So three years later, there's me, the optometrist. I don't have an associate right now because I change what I do in the practice. There are two virtual team members that answers the phone and do all of my billing. So all my revenue cycle management is handled by my virtual team member and every telephone message, email, text is handled by my virtual receptionist. And then I have my niece who comes in part time because she's a college student. So sometimes she's my tech and sometimes she helps out in doing submitting orders through the lab. And then my husband and I, we pretty much run the practice the whole day.
- [08:55]
B
And how many days a week are you seeing patients?
- [08:58]
A
So I see patients four to five days a week. I'm off every other Friday, and I see patients between 10am to 2:30pm So I see about 10 to 12 patients within that time frame. And so I do 10 to 2:30 Monday, Tuesday, Wednesday I do 12 to 4:30 to 5. And then Thursday I do again Thursday and Friday I do 10 to 2:30.
- [09:26]
B
Got it. And what, what's happened to your revenue?
- [09:31]
A
My. Actually, my revenue increased. Let me say it this way. My net profit increased by 30% and my net cash flow increased by 20%.
- [09:47]
B
Wow. Okay. And what you did is you basically got rid of. So the two virtual team members, I imagine, you know, that's a sad. That's a serious cost savings. But they're also dedicated. But who's the optician in your practice? Is it your husband then?
- [10:02]
A
No, me.
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B
Oh, okay. That's interesting.
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A
Yes.
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B
So revenue per patient on that. Are you better or worse than your. Than your opticians were?
- [10:14]
A
I've always been the best salesperson in my office.
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B
I'm shocked. I'm shocked knowing you just a little bit. Loretta, I'm shocked that you're the best salesperson.
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A
So I'll tell you why I'm the best salesperson. Because I'm the one who figures out what the problem is and offers the solution from the beginning.
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So as the optometrist, my optician is really my closer. They're not the one who do the cell. I do the cell. I've always done the cell because I tell the patients what they need, I communicate the solution that they need. And then they would go to my optician who would literally close the cell.
- [10:58]
B
So now take me through the patient flow in your office. Now. So a patient walks in the door, and if Your niece is there. So who does the test?
- [11:09]
A
My husband is in the front desk when the patient walks in the door. My husband's in the front desk, greets the patient, collect their co pays. So let's structure it this way. I see patients about every 20 to 30 minutes, depending on what we need to do. I set the practice in my optical, where I know the frames that I buy and I know the profit margin of all of my frames when I'm buying them. So I already know the price point of my frames. And unlike many practices, I have one price point for all of my frames. So it doesn't matter which one you pick. They all cost the same. So that saves so much time from finding all the different frames that fit my whatever.
- [11:55]
B
So what do they cost?
- [11:57]
A
They cost 349.
- [11:59]
B
Okay. And that's every frame on your board?
- [12:01]
A
Every frame on my board.
- [12:03]
B
Wow. Okay, that's interesting. That's another. This is so fascinating. This is another, I'll call it controversial perspective. I love this.
- [12:10]
A
It is. It is 349. So when you come in, we have, we have a price. We create three packages already. So we have three packages for all of our glasses. There's just three set packages. And when you come in, you get the printout of the three packages. So you know exactly what it's going to cost. And then my husband would say, while you're waiting for Dr. Loretta to come and get you, please feel free to browse the frame in the optical. You can pick anyone you want. They all the same price. So the patient just goes out. Now all they have to do is find which one they like, which one they they think they feel good in, and no helps them do that. They do this on their own. And we give them a tray, they pick four or five, put it in the tray, and they're going to bring it to me in the exam room.
- [12:58]
B
Oh, wow. Okay. This is so interesting. Okay, so they, they pick their frames, they bring it into the exam room. Now.
- [13:06]
Let'S back up for a second. The. So they walk in, their appointment scheduled for 10am you're probably intentionally saying, I'm going to see them at 10:30 or something just so that they have time to shop.
- [13:19]
A
They walk in because our frames are situated. We have women, men. And I have my frames by plastic and metal. So I separate all the plastic in the metals and then I put all the colors together. So if you're a red person, you like plastic, you only go in one place. You don't have to walk around if you're a black frame person and you like metal, there's only one spot where you can get that. So I arrange them where? The way I've seen my patients select their frames, so once they walk in, they kind of hone in the area with what they want and they really just have to make three or four selections from there. That process literally takes about five to 10 minutes.
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B
Okay, wow. Okay. And then there's some pre testing.
- [14:03]
A
Yes. So once I come out, I pick them. And if they don't have time to select the frame, let's say I pick them up early. We do that right afterwards within that 30 minute time slot. So I will come out and I'll come in, get them. And I said, My name is Dr. Loretta. I'm going to help you out today. I'm going to take good care of you. Follow me. And then we go into the pretest room. So I do an auto refraction, I do a retina scan, and for the most part those are the two that I primarily do on all my patients. And I would talk to them while I do the auto refraction. I'm like, what brings you in? What's going on with your eyes and your vision? And they'll tell me. And then when I do the retina scan, I do the written exam with them. When I sit there, I go over what the retina looks like. I tell them, I check for this, I check for glaucoma. I'm looking to see if you have macular degeneration. This is what your eyes look like. So I'm cutting down on the exam time because I've already started it at the pretest.
- [15:02]
B
Interesting. Okay. And when you're. So you go through all of this and then they're in the chair and do you have any. Like, are you using technology? Do you have a scribe or are you just, are you handling all that yourself?
- [15:17]
A
I don't have a scribe because most of my exams are so repetitive. So I kind of categorize my patients into what they're coming for, if they're coming for glasses, prescription specifically versus glasses and contacts or versus some type of medical.
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Medical reason. And I have templates in my practice management system, my EMR that I've designed for each of these specific visits. So once I know what they're coming in for, I just upload that template and everything is generally put into the template unless I need to make a change.
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B
Okay, interesting. Um, okay, so then you spend some time in the exam room. Now if, presumably if the patient had Time to shop. They brought the glasses with them.
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A
They bought the frames? Yeah.
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B
Oh, sorry. They bought and brought the frames. And they brought the frames right in the. Right in the room. Yep.
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A
Yeah.
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B
And then you act as the fashion consultant. You're like, ooh, that one looks good. Let's put the right lenses in it.
- [16:20]
A
So I would tell them after we do the exam. So my first goal is to identify what exactly does this patient want? Why did they come to see me today? And I always ask them, if there's one thing I could do for you today, what would that be? What do you need me to focus on? Because there's so much we can do, I can't do all of it in one visit. But what do you need today? Whatever it is, is what I hone in, what the patients say. So if they're like, I really need glasses because my eyes get tired when I'm on the computer, we're going to focus on that as a primary or a chief complaint, and that's what we're going to do. So once I figure out what the chief complaint is, and then I said to them, based on what you said to me, here is the best solution that I believe is going to work for you. And I would explain what that is. These are the type of lenses I want you to have. And now we just need to find a frame that can house these lenses. So in my dispensing, I go from lens to frame.
- [17:25]
B
Okay. And then do you. You talk about the chief complaint, but if the person is like, well, you know, I think my prescription changed a little bit. How. How deep do you get into, like, lifestyle questions?
- [17:36]
A
I talk to people about what they do for a living, what they spend their time on, but it's really more conversational. So I would ask them, tell me about you. What do you do every day if you're retired, what did you do? Or what do you do on a daily basis? And that's all. I'm just really trying to see how you use your eyes every day so I can figure out how I can best help you today. So we have a conversation, and we talk the entire time. I learn about them. I learn if they have kids, I learned if their kids are in college, I learned. I learned all kinds of information and. But I use all those information to help them, to help create the lens that's going to work for their lifestyle.
- [18:20]
B
Got it. Okay. So I imagine as a doctor dispensing, you probably have a pretty high capture rate.
- [18:28]
A
I do. My Capture rate is 78%.
- [18:32]
B
Wow. Wow. A lot of multiple pair or. No.
- [18:39]
A
No, there's not primarily single. I do have some multiple, but it's primary one. One pair.
- [18:43]
B
Okay. So that's. And I. This is kind of the advantage, a big advantage of your approach, which is that you're still able to spend 20 to 30 minutes with a patient and you're capturing the money on the back end and not letting it walk out the door. Whereas I imagine, you know, contrast that for me. Contrast what you're doing for me right now. The 2. The reality that you were experiencing when you had three opticians.
- [19:13]
A
So before I had to do the handoff and the handoff. A lot of times things got lost in translation in the handoff. And we had checklists, we had care guide. There's so many tools that I had for my team. I would have them come into the exam room toward the end of the examination and then go over the solution of the patients and what I'm prescribing, what I want them to have. And then I tried going outside doing the handoff and I would go over it with the optician. But then when the patient left me and started speaking with the optician, in my experience, there was always this discrepancy between what I said with the authority that I spoke and the. The way the authority optician approach the patients. And we've done a lot of training, but I just felt like when I speak to the patient in the exam room and I tell them this is what I believe would help them, it removes a lot of the fluff from the process. My opticians would then sit with the patients, go over the three price points that we have, help them pick out a frame. That process can sometimes take between 15, 30, 45 minutes, depending on the patient they working with. That just used to take so much time.
- [20:36]
B
And what was your capture rate then?
- [20:37]
A
Their capture rate was 68%.
- [20:40]
B
Okay, so you've added. You've added 10 points and you've taken out the spec.
- [20:46]
A
I have added. I've increased my capture rate and in so many ways. Capture rate. And then what I capture on the back end as well.
- [20:57]
B
That's it. That's it. So then you've. And now so much more of that revenue is dropping to the bottom line as either. Right.
- [21:06]
A
Yeah.
- [21:08]
B
Which is awesome. So one last piece. You know, so patients. So then patients finish their transaction. Presumably they kind of, from an administrative standpoint, with your husband or whoever is at the. Or, Right. Your husband at the front desk. Do you. How do you get the patients to come back because I imagine this high touch experience is something they really enjoy. So what's your I tell home Eugene?
- [21:38]
A
I love to see all my patients every year because I know what can happen if I don't check you in a year's time. I've had it happen so many times with other patients that I've had that have made it a rule. Everybody comes back to see me in a year. So I'm going to pre appoint an appointment for you and I am going to harass you. I'm just letting you know right now because I care so much about you and your vision. I never want that to happen to me again. So in about a month before this time next year, you're going to start hearing from me. If you can't make it, it's okay, right? Because you know, life happens. But I do want you to know I want to see you every year.
- [22:22]
B
That's great. And you say that to every patient.
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A
Every patient.
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B
I love it. That's so good. And I mean when the doctor said, how long did that take? Maybe 15, 20 seconds.
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A
Oh yeah.
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B
Then I imagine your return rate is, is pretty high in the first year as well. If the doctor says it.
- [22:41]
A
If the doctor says it and you, when you say it, you have to really mean it. And I do mean it. I did have a patient, a child who actually three years we lost. You know, they were, they lost to follow up. And when they came back in three years, they had the tumor that grew into the size of a tennis ball. That really changed my perspective of the yearly appointment. So I'm not saying this just because I want them to come. I'm saying it because I know what can happen if they don't show. They don't show up.
- [23:12]
B
Wow. Okay. So this is like it super fascinating. And it sounds like you're running the practice you want to run. You're working 10 to 2, 30 and most days and you're. And it doesn't, it. It's a good balance with, with your life. What's your plan for the practice? Just like is there. Do you want to grow it potentially? Do you want to get. Keep it as is, as, as it stands? Like, you know, you always talk to practices and some people are like, I know what this is and I know what it's doing for me and I really want to double it, triple it, whatever, Or I know what this is and I know what is doing for me and I want to keep it as is because I want to keep doing more of that. So where's your perspective on growth.
- [24:00]
A
So for my practice I've decided to do more, a lot more specialty care. So myopia control is one of the specialties we do in my practice. Low vision is another one that I do as well. And I do a lot of specialty contact lenses. So in addition to the glasses, I do have those other specialties that allows me to do what I do at the pace that I do it as well. Right now I'm in the middle of a relocation for my practice. So the goal is to really turn it into a very boutique type of location. And I, I want you to imagine the difference between going and.
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Walmart versus Tiffany's, you know, so it's, it's a complete different feel. And when you go to a Walmart type of store, for example, there's a lot of people there, there's a lot going on, there's a lot of noise. And if you go to a Louis Vuitton, that's probably another example. It's not as crazy, it's not as loud, but there's a completely different feel. So that's where I'm planning to take my practice. And within five years my goal is, is to transfer that to a partner associate.
- [25:30]
B
Got it. Okay. So there's a couple other things that you pointed out that I didn't want to gloss over. And first of all, the question probably everybody's thinking about is what's your relationship with managed care like? Do you do I do I do managed care. Okay.
- [25:44]
A
I do. I. Yeah.
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B
And you said there's three packages. Explain this.
- [25:49]
A
So there are three packages that I offer to patients according to their co pays and the price points that I've set. So when you do managed care, you depending on which plan you have, you don't really have a lot of leverage on what your lenses should cost. Except unless you go really high hand high end lenses, which I recommend that you prescribe the progressive that is not in the tiers because then it gives you more leverage. But you do have a lot of options in your frames as well. And I have made my frames where they actually.
- [26:24]
Give me a lot of profit, you know, inside of them. So remind me your question again.
- [26:31]
B
So, well, I guess I wanted to hear the three packages that you do.
- [26:35]
A
Okay.
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B
And, and how you got there and then really like the whole 349 for every single frame on your board. That must have been an interesting decision to make.
- [26:46]
A
Yes, the 349 for my frames and my board comes from where I buy my frames and how I price the frame so I know what the profit margin in the frame is. So the 349 allows me to make a significant amount of profit regardless of what the patient does. The three packages come from premium. I have a standard and I have a value package. But I make sure that my value package is at the minimum of what I want the patient to spent. So all of my patients get polycarbonate AR lenses and they all have the level D AR if you go by vsp. So I start with what I believe is the best quality that the patient can have and then I put it, put that as my basic package. So my patients don't get bifocals. Nobody gets CR39. Everybody has minimum polycarbonate with AR INS lenses.
- [27:42]
B
Got it.
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A
And then we go up from there by adding either a high end lens like level 5 or even VSP have certain lenses that are not covered by their all of their categories. So either we do a category in lens or we go to a lens that's not even on their product index. So then the patient only get 20% off.
- [28:06]
B
Okay. And that's your highest level package or is there one more?
- [28:12]
A
What do you mean my premium?
- [28:13]
B
So what are the package prices, I guess?
- [28:16]
A
Oh, the package prices vary because it, because of the insurance on the patient's co pays and what their insurance plan provisions are.
- [28:26]
B
Got it.
- [28:28]
And your frames on your board, did you just, do you have any group like typical brands that most people find or did you, how did you decide what to carry in your optical.
- [28:40]
A
So all of my frames are millennium frames. I practice his name Millennium Mind Center. I sell millennium frames in my office. So I'm kind of like Barbie Parker. I only sell Warby frames. I only sell Millennium frames. I would say 80, 80% of my frames are millennium frames. I have a few others that are just designer like Gucci or a higher end designer, but most of them are millennium frames.
- [29:08]
B
And so you basically figured out private label relationship that makes it, that makes it profitable. But then I think with the private label side, in order for you to be able to maximize the insurance benefits, you have to have a certain price point that those white label frames come in at, right?
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A
Yes.
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B
What is that? How did you figure out how to do that?
- [29:34]
A
How do I figure out how to like the set?
- [29:38]
B
I think there's the wholesale price, right. To maximize that. Because I get the sense that your business acumen is so much about maximizing the profit and profit per transaction while still doing something that's very valuable for the patient. So when you think about that, like when you brought in all of your. Because I know the temptation. Right? Like, there's. If you go to Vision Expo, there's people selling frames for like, $3.
- [30:04]
A
Yes.
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B
Right. And there's wholesale price in which you actually buy it for, but there's the frames data, wholesale price, which then determines what you get reimbursed by the, By. By the Vision plans. So did you. Do you want to go through that calculation, or is that something you. You guys consider carefully?
- [30:22]
A
For my Vision Designer frames, I buy them on closeout. Right. So that already creates a profit margin that I'm looking for. And like I said, that's about 20% of my inventory. The other 80%, I actually have a relationship with. Like, I, I have a.
- [30:45]
Let's see. I'm trying to figure out what I can say.
- [30:50]
On this recording. I have a manufacturer that actually manufactures my frame line, and I have an actual.
- [31:02]
Other business that I created that actually owns the frame lines that I buy. So because of that, I can control the cost of the frame lines. Does that make sense?
- [31:14]
B
That makes perfect sense. Okay, so you're basically your own wholesaler.
- [31:17]
A
Essentially, I am my own wholesaler, yes. I decided to spend that money up front, front to do it, but it saved me so much money in the back end because I can do so much volume that I can never run, like, I never run out of frames. And if my patients ever had an issue with the frame, I can always give them a new pair of glasses. It wouldn't hurt me one.
- [31:38]
B
Right. So then you really maximize the margin. And I was going to ask you what your cost of goods is, but I'm not going to because it doesn't even make sense because your cost of goods and your practice is based on your wholesale price, but your wholesale price is based on what you're buying it for from a manufacturer. So, yeah, it almost. I can imagine that you. You've designed, have you done this private label, the Millennium frames since the beginning, or did you decide to do that?
- [32:01]
A
No, I didn't. I started doing that after I heard another optometrist. I was, I was listening to a podcast, and she has a line that sold in a retail store. I couldn't remember. I remember where it was. And I called her afterwards, I said, how did you do that? You have your own frame line? She said, yeah, you just got to reach out to the manufact and then you got to set it up, you know, create a business. So it's a legitimate business that buys frames and then Resell it to Millennium. Isaac.
- [32:29]
B
Yeah. Love it. That's great. Really, really interesting. Very smart. Okay, so I. I want to shift gears, so I'm going to do that after the break. So after the break, we're going to talk about your other business that has a ton of impact on the optometry community, and I'll ask you some questions about the optometry divas.
- [32:50]
A
Okay?
- [32:53]
B
All right, so we're back on the Power Hour with Dr. Loretta Justin. And I really enjoyed learning about your practice, which I think. Which I think speaks to your business acumen and also the acumen that you had to kind of create a practice that fits your life, your lifestyle, your ability to run other businesses. And I think that's one of the things that you're constantly talking about with the optometry Divas group. For those who are not familiar, talk a little bit about what optometry Divas is, how it started, and then we're going to get into some of the trends that you're noticing.
- [33:27]
A
So around. Let's see. I have been in practice for. Since 2006, so almost 20 years now. And.
- [33:38]
You know, about 12 years ago, my kids were much younger at that time. And. And in my practice, I used to be open six days a week. I used to see upwards of 50 patients per day. I mean, it was crazy. And there was just so much going on in my life at that time, within my practice, within my family, within my life, that I was always so stressed out and overwhelmed. And at one point, I thought, I can't be the only person who's going through this. I mean, there's going to be other women like me who's kind of overwhelmed and exhausted and tired and. And trying to figure out this private cactus thing or trying to figure out this motherhood thing, or just how do you be. How are you a professional and do all this stuff? I can't be the only one. And that's when the idea started coming to me. What if there was a place where women like me could come together? What if we could empower each other? What if we could connect with each other and promote each other's success? What if there was such a place where we felt safe enough to do that? You know, as doctors, we always have the facade of being a professional. And as optometrists, as doctors, we have to be smart. We have to be kept together. But as people, that's not always the case. And I wanted to create a place where people can be people in addition to being clinicians and doctors. And professionals, but we could be, you know, girls too. And that's really where optometry Divas was born, is out of that desire to create that place primarily for me. And it started as really like a hobby here in Orlando, just meeting within the ladies in my community that I didn't know at that time. And it just grew from there because people really like the idea of being in a space where they feel safe enough to share what's going on in their lives in addition to, you know, what. What's going on with their glaucoma patient.
- [35:44]
That's where. That's how optometry Divas got started is because I really wanted to have that type of environment.
- [35:50]
B
So where is it at now? How many. How many members do you guys have?
- [35:53]
A
Optometry Divas? We are at about 2:20, 100 members, I want to say, haven't counted in a while.
- [36:05]
B
All over the country, right?
- [36:06]
A
We're all over the country, yes. And it has grown really into something that I was not. I didn't. I can't say I had the plan for it to grow. It really grew in spite of really what I was thinking. And we have really spent a lot of time getting to know each other and building a community of sisterhood, people that, you know, that are now my friends.
- [36:33]
B
So how much of your connection is around business? How much of it is around, I don't know, family and other things that are going on and like, how does the community work?
- [36:45]
A
So what I've discovered, like, and, you know, I could talk about this survey that I did in 2024. I wanted to know what was the biggest challenge facing the women in my community. And interestingly enough, for a lot of us women, things kind of blend together. We don't necessarily compartmentalize. This is my business. This is my house. This is my family. This is my. That my. This. We kind of. Everything just kind of melt and blend together into one big thing. So I wanted to know what was the biggest issue that was facing the women in my community and a great percent of the people who took the survey, like I said, it was over 300, 378 responses. And 212 women said burnout was their biggest struggle. So just the idea that I'm building either a business or my work schedule is not sustainable. Sustainable. And I feel overwhelmed. And that that was an eye opener for me to realize that is an actual problem that we need to address as women.
- [37:59]
B
And what's the solution? So how did you shape the community to support that?
- [38:04]
A
So what I Realized I started asking questions to some of the women who insert the survey, kind of trying to hone in where exactly. Why are you saying this burnout? And I realized burnout is just a symptom of a deeper problem. What I discovered is that a lot of the women in my community were giving out way more than they were receiving, which is kind of where I was in 2022, putting out a whole lot more than what I was receiving. And that's what I began to call the exhaustion economy, where you're in the hustle and you gotta work so much, you gotta do so much before you can get the little bit that you get. And that's what was causing the burnout that I feel the women were telling us that they're experiencing. So.
- [38:55]
B
And you're saying burnout at work or burnout holistically?
- [38:59]
A
Well, it's all. It all kind of ties in together because you bring your fear, physical energy to work, and if your work is chaotic is going to affect your physiology, is going to affect you, and your spirit is going to affect you, and your soul is going to affect you everywhere, because really, everything you do is a representation of who you are. So you run your house, you work everything pretty much the same way. So if your work is chaotic, you'll probably have chaos other places in your life. So it wasn't just chaos in my office, but the chaos bled into my entire life.
- [39:40]
B
Now, I like how you said burnout was kind of a. And I think you simplified it to. To look at it as you're giving more than you're getting.
- [39:52]
A
Yeah.
- [39:52]
B
And I'm curious because I hear this all the time in the workplace. And I hear from, you know, when I do lectures, I hear people talk about the. I actually ask the same question. What's the number one issue? What's number biggest pain point in your practice? I've been doing that for the last seven or eight lectures that I've had. And so with hundreds and hundreds of participants a little bit different. But I. I'm sure that it's related because it's almost always one of the number one issues in the. In the group is always staff related. But people say my staff is burned out. So what does that mean? Is it the same type of burnout? Is it the. You know, how do you define burnout in a way that's, you know, a little bit more specific than this intuitive thing that we think it is? And it might mean something different to me than it is to you?
- [40:43]
A
I agree. It might mean. It means different Things for everybody. But ultimately it begins with an identity crisis. As to who do you believe you are? I find whenever there is, quote, unquote, a sense of burnout, if you peel back the layers, the person themselves has some form of identity crisis where they don't really know who they are and they have not stepped into that role. So I'll give you an example. We build a practice. A lot of my colleagues that I've worked with, some of them have been students that coach. We build a practice where we pay everybody else more than we pay ourselves. So that in itself is a big problem. A lot of us basically do all of our expenses, and what's left over is what we take home. That creates a big discrepancy. Where you are building a business, you kind of become the least paid employee in the business, or at least the last paid employee, the last paid employee in the business on what's left over. And the danger with that is if your overhead is too high, your leftover is very low. I once sat in a meeting and I was talking about this concept of paying yourself first. And I know you read the book Profit First. And so I was talking about it, and one optometrist asked me, how is it possible? How can you pay yourself first? You have to pay everybody else first. So your mentality, or should I say your identity, is where the issue begins. Are you the employee of your business or are you its CEO? And if you're. If you're just. If you just have a very expensive job where you come, you see the patient and you pay everybody else, you get, you know, a little bit left. That's going to create the sensation of burnout because you are giving so much in yourself. You may be making money, but then you tend to lose yourself in the process. You become emotionally, energetically bankrupt because you get so exhausted dealing with staff, for example, primarily when you have staff problems, which I could raise both my hands, both my feet, right? As one person who has dealt with that. But ultimately, at the root cause of my staff issues is I did not take my place as the CEO. And because of that, it was hard for me to lead my staff, and that was difficult. And that.
- [43:22]
B
So what are the kinds of things that happen when you. And when you teach people to become the CEO of their business? What are the kinds of things that immediately need to change? What, what advice do you give people.
- [43:33]
A
Right away so when they first start to become the CEO of you? So that's the concept that I talked about. Like I started writing about this Concept. Way back in 2015, I used to have a column in Women in Optometry where I would talk about become the CEO of you. And this really came from my own personal experiences, but I would talk about there's three steps that you need to do to turn your business around or create whatever success that you want. Step number one, you need to create a winning mindset set. That is the most important part of all. Three steps is the most important one is the one we ignore because it's the one we don't want to do. We all like to have numbers and no KPIs, no metrics. I shouldn't say all, because not all of us do, but we prefer to talk about that than to talk about what is your mission? What is your vision? What is your purpose? What I call the mvp. What are some of your core values? What are your core beliefs about yourself, about life, about people? These invisible things are guiding all the decisions that you make that shows up in your financial statements. So you got to know this stuff first. You got to know who you are. So the mindset is the first step. The second step after the mindset, you need to have the right strategy. That's very important. I always say, if you want to see the sunset and you start driving east, you're going to have a problem. It doesn't matter what kind of car you drive, it doesn't matter how fast the car you drive. And even if you're flying a plane, you're never going to see the sunset. So the right, the winning strategy is very important. One of my coaches taught me the five pillars of business success. When you have your strategy, that it needs to include the leadership, administration, operations, promotions, and sales. Those are the five pillars of business success. And then your strategy, we talk about, how do you set that up? And then third, you need to have a winning team. So I always compare your team to the tires in your car. You need to have the right size tires for the right car. If you don't have the right size tires, it's not going to work for your car. If the tires are not the right shape, it's not going to work for your car. If. If the. If the tires are not equally sized to balance the car, it's not going to work either. So you can build a very successful strategy. You can have the right mindset, but if you have the wrong team, your vehicle is not going anywhere. So you need all three.
- [46:05]
B
Yeah. That's fantastic. Like, what a great overview of so much business advice. Advice. And like, three minutes. So I love this. I want to talk about the mindset thing because I agree with you. It is the most important one. And you called it the winning mindset, but then you started talking about like purpose, mission, vision, core values, like that kind of stuff. So if somebody wants to kind of do a gut check and say, do I have this in place or not? How do you know if you have.
- [46:37]
A
Your the right mindset in place? I can tell you.
- [46:44]
If I walk into your practice within five minutes, I will know if you are living in what I call the exhaustion economy. Right. And at the CEO of you, all I do is really, I help practice owners develop what I call a SIP certified business. So they need to have significant impact and profit. A lot of times we don't have the third one. So the opposite of that is living in the exhaustion economy. What creates burnout? If I walk into your practice within the five minute tour that you will give to me, I will know exactly where your mindset is based on how you keep your own office space. I have walked into practices where when you walk in the lobby, the optical, you want to take your shoes off, you want to put gloves in. You just are so afraid to touch anything because everything is so amazingly beautiful, spotless, they sparkle light everywhere. And then I get to the back and then the doctor shows me the area where they work and they open the door and I'm like, oh my God, there's boxes everywhere, the paint is not finished, there's the decor on the hall, there's tons of paper on the desk. And this is where you work. That tells me a lot about your mindset. That tells me how you see yourself and it tells me you haven't quite yet developed the winning mindset.
- [48:09]
B
Yeah. So that's interesting. So you're saying, and it's relative to how the rest of the practice operates. And so in that particular case, we're linking back to profit first. It's like you're doing everything for everybody.
- [48:21]
A
Correct.
- [48:21]
B
You're the, the front stage, so to speak. When you're on stage, you're there for everybody, the staff, whatever. And then the doctor is kind of like that space is managed last. We don't really care what that you.
- [48:31]
A
Don'T care about it. And imagine if we kept our White House that way. Right. If you went to the White House, which is where the leadership of our country is, how, what would that make you feel? Or how much would you trust that leadership? So that tells me a lot about how you see yourself and how you treat yourself in your Practice, you have not seen yourself yet as the CEO of the practice. You, you are the last employee.
- [48:59]
B
What's another sign that you're not quite in the right mindset, not quite in the right space?
- [49:05]
A
Another one is having to solve your staff problems all the time. So I used to be in a situation where my staff would come to me for just about everything. There's a patient who needs a refund. Doctor, Dr. Loretta. There's a patient who needs a new copy of their prescription. Dr. Loretta. There's a patient who's having some issues with their glasses. This Dr. Loretta. Loretta. Dr. Loretta. And so I would come to work, it was, doctor, doctor, doctor. I go home and goes, mommy, mommy, mommy. Honey, honey, honey. How my life was all the time. I didn't have a system. You know, when I first started my practice, I didn't know the word standing operating procedure. I didn't know those words. I didn't even know there was such a thing as so as an sop. It wasn't until I was talking to my brother who was in the army, and I was just whining and complaining that my team bothers me so much. They asked me questions about everything. And he said, well, don't you have an sop? And I said, what's an sop? He said, well, you gotta have some way you operate. I'm like, what are you talking about? He said, you need to have certain steps and checklists on how to do things. I had never heard that and I didn't know. So I started looking that up and I created my first SOP that was back in 2009, and I've had a new version every year since then. So one of the things I could immediately see is depending on how many questions you have to answer, how much fires you have to put out every day.
- [50:34]
B
That makes perfect sense. And I think something similar where we think about, okay, do you have a business that's running itself? Is it set up for success without you? Are there accountability components in there? Are there ways for staff to keep track of issues without having to come to you for every single one of those issues?
- [50:53]
A
Absolutely. Your business should be like a well run vehicle. So when you get in your car, you just basically turn on the ignition, change your gear, put your feet in the gas and the brake and you go. So you should be the driver of your business, not the tires, not the engine, certainly not pushing it up a hill 100%.
- [51:13]
B
So I. And this concept of the CEO of you, it seems like it also captures not just the Business life, but also the home life too.
- [51:23]
A
Yes. It starts with you. Because you are the very first business. You are your very first business. And because you are an organ organism, so you are organized into system, into your physical body. So you are your very first business. And the way you keep your office tells me how you keep yourself. And the way you keep yourself will only magnify in how you let other people treat you. So it's not just about the business principles, but all of those are really a mirror of what you truly believe about yourself.
- [51:59]
B
Okay, so a lot of this information is super helpful. And I know you just went through so much so quickly. So if people want to learn more about some of these systems and some of this content that, that you're sharing or even the optometry divas, how. How do they get more information?
- [52:15]
A
So, so I just want everybody to know that I created Optometry Divas. I created the CEO of you to help women like me and maybe like you stop surviving and start structuring for significance, impact and profit. That's very important to me because you didn't start your business to feel stuck. Right. You started it for freedom. And that starts by leaving the exhaustion economy. You got to make an about turn and decide you're going to create the life that you want. And that's what I call SIP certified Getting the right sip. SIP stand for significance, which means you're doing work that aligns with your calling, your purpose, impact means you're making a real difference for your patients, your team and your community. And profit. The other P word, your business actually pays you. Just think about that for a minute. You have healthy margins, you have time, freedom, you have cash flow. But in addition to all those, you have peace. And that is what I believe your business should provide to you. So many of us have a practice that's have strong revenue, but we have no cushion in the bank, no energy left at the end of the day, no peace when you close the door at night. That is not success. That is what we're calling burnout. And that is what this whole CEO of you concept is all about. And what I teach in Optometry divas. If you go to Dr. Lorettajustin.com I actually created a burnout audit that targets these things. I called it burnout audit because that's the word everybody was using. But it actually helps you identify where are you leaking your energy, your profit and your time. So there's five metrics. It helps you identify so you can figure out how you can create a better practice a better life and get the success that you deserve.
- [54:13]
B
Yeah. It's fantastic. I will make sure to post a link in the show notes. Loretta, thank you so much for joining us today on the Power Hour. Amazing having you as a guest. You have so many interesting perspectives. Appreciate you joining us.
- [54:25]
A
Thank you so much for having me. I'm so glad to be here. And I always like to end with this. Everything I, I, I do, I always like to remind the listeners that you have the power to change your life. I just want to encourage you to actually do it. This is your time. This is your season. Go out there and make it happen.
- [54:47]
B
Inspirational words. Thank you so much.