Multi-Location Optometry Growth: Systems, Leadership Layers & Cold Start vs Acquisition

Summary

---

Power Hour Optometry Podcast Summary

Episode: Multi-Location Optometry Growth: Systems, Leadership Layers & Cold Start vs Acquisition

Host: Eugene Shatsman, The Power Practice
Guests: Dr. Susie Lake, Kevin Whaley
Date: January 16, 2026

---

EPISODE OVERVIEW

This episode dives into the complexities, pitfalls, and strategies of growing an optometry business from a single location to multiple sites. Guests Dr. Susie Lake and Kevin Whaley share vivid, hard-earned lessons from expanding their own practices—Lake from one to six locations near Kansas City and Whaley from one to nine in Florida, using both cold starts and acquisitions. They discuss systems, leadership, bottlenecks, and how to recognize when you're truly ready to scale. The conversation is rich with practical advice, honest reflections, and memorable anecdotes about what breaks as you grow, and what to put in place so your "wheels don’t fall off" as you hit that three-to-four location mark.

---

GUEST BACKGROUNDS ([03:25]–[04:39])

Dr. Susie Lake

• Co-owner of a six-location primary care practice outside Kansas City, MO. Also runs a specialty vision therapy office.
• Responsible for operations, HR, and systems during expansion.
• Took about 15 years to grow from one to six locations.

Kevin Whaley

• Master optician, business-side leader, partnered with an optometrist in 2010.
• Expanded from one location with three employees to nine locations (a mix of cold starts and acquisitions), mostly since 2020.
• Location and team culture varied; significant growth occurred within a few years.

“We learned along the way as we attempted to do that second location... a lot of learnings happened in those first locations.” — Kevin [05:31]

---

GOING FROM ONE TO TWO LOCATIONS: LESSONS AND MISTAKES

Motivations and Early Challenges

• For both guests, a combination of opportunity and necessity drove their second location—with less strategic planning than they’d now recommend. ([06:28]–[07:27])

Cultural & Team Considerations

• Satellite vs. Primary Location:

  “Do not call them satellites. Those are other locations within your practice. You cannot focus on one as your primary. If for no other reason, the staff absolutely go crazy... They hate feeling like stepchildren.” — Dr. Lake [08:28]

• Staff Morale: Attention must be paid to language, culture, and parity between locations.

System Failure and Learning the Hard Way

• Kevin’s first expansion attempt resulted in a five-year financial failure due to poor location, lack of systems, and misunderstanding the required support and resources. Success didn’t materialize until they acquired and merged with a retiring local optometrist's practice. ([09:44]–[11:13])

---

COLD START VS. ACQUISITION ([12:10]–[14:47])

“Stick with what you know.”

• Kevin: Cold starts let you build culture but are risky. Acquisitions offer predictability if you verify financials and understand the seller’s intentions.
• Susie: Success depends on the departing owner’s role and expectations.

  “Are they prepared for the psychological changes that happen when you are not the owner...?” ([14:07])

---

KNOWING YOU’RE READY TO EXPAND

The “Why” Matters Most ([15:11]–[17:03])

• Mindset: Don’t expand just for the sake of growth.
• True Bottleneck: Expansion should only solve a real business restraint, like a capped patient base or revenue ceiling.
• Leadership Structure: You need at least one management layer before scaling, or burnout is inevitable.

“In my opinion, you need at least one layer of management in place before you can scale... Without that, you’re just going to have some level of burnout.” — Kevin [17:08]

---

MANAGEMENT AND SYSTEM STRUCTURE ([17:55]–[23:53])

When to Hire Management

• Management structure typically includes a dedicated manager before opening a new location—often sourced from within ([19:47]–[21:25]).
• Expanding teams sometimes means moving top players from the flagship location to new sites, especially to install systems and culture.

“We always... took someone from our most successful practice and moved them over to lead that additional practice.” — Dr. Lake [21:25]

Culture, Turnover, and Integration

• Acquisitions often see rapid turnover of existing staff; integration hinges on having your own “culture carrier” present ([22:21]–[23:37]).

---

SYSTEMS AND PROCESSES: THE REAL GROWTH CHALLENGE ([23:53]–[29:32])

Two Locations: Manageable, but Cautious Optimism

• 1 → 2 locations is a leap, but not as seismic as 3 → 4, where complexity “stacks up.”
• Advocates for rigorous bottleneck analysis before signing leases and taking on overhead.
• Use data and marketing experimentation to exhaust growth potential in a single location first.

---

KEY METRICS & FINANCIAL READINESS ([29:32]–[34:43])

Profitability & Staff Stability

• Crucial Metric: EBITDA must be in double digits before expansion—the pain of low profits multiplies with more locations.
• Solid Staff: Low turnover and flexibility essential, as staff movement between locations is almost inevitable; have compensation plans for split teams (e.g., extra $2/hr for cross-location work, per Dr. Lake [31:26]).

---

ROLES, TRAINING, AND OWNER’S MINDSET ([34:43]–[40:57])

Manager–Operator Balance

• Debate around whether managers can/should remain in clinical roles or need protected management time.
• Consensus: At some scale, managers must step back from daily clinical duties to focus on systems, observation, and coaching.

SOPs and Owner Bottleneck

“If your team is relying upon one person... to get [every] question answered, then that’s your bottleneck.” — Kevin [26:30]

Leadership Evolution

• Owners must transition from being star clinicians to genuine business leaders—a move many resist, to their own detriment.
• Key Reflection: “Do you want this job?” (i.e., building a business, not just practicing) ([38:33])

---

COMMON GROWTH PITFALLS

Promotions & the Peter Principle ([41:35]–[44:33])

• Promoting star performers (e.g., best optician) too quickly often results in failure.

  “You promote someone to the level of their incompetence. I have done that more times than I care to say.” — Dr. Lake [42:10]

• Require staff to train their replacement before they can be promoted.

Managing Diverse Doctor Preferences ([44:33]–[47:41])

• Allow some autonomy in pace and style, but require adherence to core business values and systems.
• 80/20 rule: 80% standardized, 20% individualized for creativity and care.

---

THE DREADED 3-4 LOCATION “WHEELS FALL OFF” MOMENT ([51:38]–[56:09])

• Going from 2 to 4 locations exposes every missing protocol and weakness.
• Fires at every location, staff confusion, and constant crisis-management are the norm until deep systems (SOPs, handbooks, training, recall protocols) are institutionalized.

“As soon as we put out a fire in one location, we were putting out another fire in another location... All you're doing is trying to get from day to day by putting out, you know, one fire after another.” — Dr. Lake [53:36]

• You no longer “know by feel”; structure must replace intuition.

---

FINAL ADVICE ROUND ([56:40]–[58:42])

Kevin:

• Take your time:

  “Beta testing marketing in a given location is much less expensive than buying another location... Make sure you are fully committed.” [56:56]

Dr. Lake:

• Invest in formal leadership training for management.
• Accept that with more locations, changes and new systems will take longer—the “big ship turns slowly.” ([57:42])

---

HIGHLIGHTED QUOTES

• “Do not call them satellites... Those are other locations within your practice.” — Dr. Susie Lake [08:28]
• “If your team is relying upon one person... then that's your bottleneck.” — Kevin Whaley [26:30]
• “You promote someone to the level of their incompetence. I have done that more times than I care to say.” — Dr. Susie Lake [42:10]
• “Beta testing marketing... is much less expensive than buying another location.” — Kevin Whaley [56:56]

---

TIMESTAMPED KEY SEGMENTS

• [03:25] – Guest introductions and practice backgrounds
• [08:28] – Cultural pitfalls: “Satellite” offices & staff morale
• [09:44]/[11:13] – Stories of failed and successful second locations
• [12:10] – Cold start vs. acquisition: pros, cons, decision factors
• [14:07] – Pain points of acquiring practices with lingering owners
• [15:11]-[17:03] – Knowing if you’re truly ready to expand
• [17:08] – Management structures needed before adding locations
• [21:25] – Best practice: move top staff from flagship to new location
• [23:53] – Why 3-4 locations is the real breaking point
• [42:10] – Leadership and promotion pitfalls
• [53:36] – “Wheels fall off” moment explained
• [56:56] – Final advice: take your time; leadership investment

---

SUMMARY TAKEAWAYS

• Multi-location growth is far more complex than duplicating a successful single practice; leadership, true systems, and SOPs are non-negotiable.
• Embrace a business owner mindset—or realize you may be happier (and more profitable) as a “super single.”
• Fumbling your way through expansion is survivable at two sites, but chaos prevails by the fourth location if structure, culture, and documentation are missing.
• Promotions and management must be deliberate, not just rewards for past clinical performance.
• Growth for growth’s sake is misery; expand only to solve a real bottleneck or serve new patients you can’t otherwise reach.

---

This episode is a must-listen for any optometrist considering geographic or operational expansion. The stories, warnings, and blueprints from Dr. Lake and Kevin Whaley will save years of pain and potentially hundreds of thousands of dollars in missteps.

---

Transcript

[A]

Foreign.

[B]

Welcome to the Power Hour, Optometry's biggest and longest running show. We're in our 14th season. I'm your host, Eugene Shotsman, and today's episode is by listener request. And what we're talking about is going from one location to two locations and then from two locations to four locations. And what actually is that like? And I couldn't think of any people who are better qualified to, to answer that question than Dr. Susie Lake and Kevin Whaley. Stephanie, these are two incredible individuals, great clients. They're friends, and they're also extremely generous with their advice. They talk about their mistakes, they talk about their learnings, and they talk about things they wish they would have done differently. But they have the credibility because Susie and her husband built a practice from one location to six just outside of Kansas City. And Kevin partnered as a master optician who partnered with an optometrist and helped grow from one location and just a couple employees to nine locations in Florida with a mix of cold starts and acquisitions. So they have really interesting perspectives. And in this episode we talked specifically about what are the kinds of things that break when you add a second location? And why isn't it always obvious at first? How would you should you do a cold start versus an acquisition? And what are the variables that actually matter when you're trying to make that decision? How do you know if you're ready to go from one location to two or from two locations to more than two locations? What management structure do you have to have inside of your practice? And how do you prevent yourself from becoming the bottleneck for the entire operation? And why is it so true? And it's a common, commonly known fact with a lot of people I've talked about, but we dig into why is it so true that going from two to four locations somewhere in that three to four is where many practices experience this whole experience, where the wheels fall off because you're leading a very different kind of organization. And so we talk about what systems and leadership layers need to exist before we move into that scaling mind. And if you're just at one location thinking about expanding, or if you're already multi location, feeling the complexity starts stacking up, or if you just want to get better at running your business, this conversation will help you think more clearly about what's coming, how to prepare for it. And so before we jump in, quick reminder to make sure that you're subscribed on YouTube, Spotify, Apple Podcasts, or wherever you get your shows so you don't miss out on future Episodes. And as always, if you have questions, feedback, ideas, or another request for another show, you can reach out directly@eugene shotsman.com I do read and respond to every single one of your comments. And now let's jump into it. Here's my conversation with Dr. Susan Blake and Kevin Whaley.

[A]

Stephanie.

[B]

Okay. Dr. Susie Lake, Kevin Whaley, Stephanie, welcome to the Power Hour. Excited to have you both on the show.

[C]

Glad to be here.

[B]

All right, so I think in order to make sure that we have a super effective conversation about our topic at hand, I think it probably makes sense just to give a really, really short background on kind of what it took to build your or what you did in terms of building your practice and just a little bit of background about you each. I don't know. Let's go 60 seconds. Susie, you go first. Just so the audience has context.

[C]

Great. I am a business owner of a six practice, six location practice just outside of Kansas City, Missouri. We do mostly primary care. We do have a specialty vision therapy office that we opened this year as well. Traditionally, my husband and I both own the practices and I was in charge of all of the operations, HR and setting up all the systems. When we would move from one location to two to three to four.

[B]

Got it. How long did it take you to go from one to seven?

[C]

It took us about 15 years.

[B]

Got it.

[A]

Great.

[B]

Kevin, your background?

[A]

Yeah, so I'm a master optician. More operating on the business side of things than the last several years. But I partnered with an optometrist back in 2010 with one location and three employees. And over the 15 years, I guess 16 now we've been together, we grew to nine locations. Uh, so a lot of growth, a lot of trials and tribulation. It was really two locations all the way up until 2020. And the other seven were all 2020 and later some acquisitions, some cold starts, but a lot of growth in the last several years.

[B]

Fantastic. And that's kind of. So these are the. And that's exactly what I wanted the audience to have as far as context from both of you because you may have similar perspectives than some of the questions I'm going to ask. You may have different perspectives, but really the main topic of the conversation today is what, what does it take to run a two location business or after you've been running a one location business and what needs to be different. And then we're going to talk about what does it take to go from a two location business to a four location business and how does all of that fit Together. And so really, the first place I want to start, and maybe this is the easiest question I could probably ask is, Kevin, when you guys went from one location to two locations, what were some of the key things that needed to change in the business in order to make that happen?

[A]

Yeah, I think the main things that, you know, we were looking for when we wanted to expand is, you know, we saw, you know, one location that was doing well and performing well, and, you know, we realized there was just a market that we were serving at that area. And so when we chose a second location, we were looking for something that was outside of that market to have a new group of patients to sort of draw from and pull in from there. And honestly, we didn't have it organized in together. We didn't do it the proper way. We just kind of winged it, you know, and went from there and learned along the way as we attempted to do that second location. And I think really the same thing for the third. We had some systems in place, had some organizational structure at that point, but a lot of learnings happened in those first locations.

[B]

Sand we're going to jump into those. Those. Some of those learnings as well. Susie, what about you? What. What had to.

[A]

What.

[B]

What motivated you to go from one location to two, and what absolutely needed to change about your business in order to make that happen?

[C]

Well, similar to Kevin, it kind of fell into our laps, actually. It was right after we got out of school. Jason got out one year ahead of me, and he knew I was coming. The office that he was working at did not really have enough business to support two doctors. He was, you know, at that point, still kind of moonlighting in, you know, with. With some weekend work as well at other locations. And we didn't have enough for two doctors to support. And one day an attorney called us from a town about 30 miles south of where we were currently practicing and said, hey, this doctor passed away seven years ago. His optometry office has been sitting vacant. All of his charts are still there. All of the equipment is still there. We'll sell it to you for, you know, pennies on the dollar. And it needs a lot of work. It needs to be redone, but do you want it? And we said, yeah, sure, because I would have a place to work. Then it was definitely still, you know, it was almost a cold start after seven years, but that's how we ended up with two.

[B]

Okay, so now let's zoom in on some of the advice that you would give people and think about somebody who's Operating a single location right now, and maybe that location is successful, and maybe that location is, you know, doing. Doing well. And they're saying, okay, I want to expand into a different market. And whether it's through acquisition or through cold start, let's not worry about that yet. We're going to get to the logic on that in the future. But let's just talk about mistakes that you made in your second location or mindset that didn't necessarily exist, that needed to exist, that could have potentially prevented some of those mistakes. What does that look like for you all? So, Susie, you go first, because your. Your story is kind of got thrown into it, and it was a little bit less deliberate, I think Kevin was saying. I, you know, they. They thought, okay, we're gonna. We have a successful location, we're gonna expand into another one. So, Susie, you go first. What. What are some of the lessons learned that you would want the audience to have when you go from one location to two?

[C]

So, without a doubt, one to two is you're still. Especially where we were, we were so young. We were, you know, still trying to figure out how to. How to run one location and so to jump into two quickly. What we learned was it's much easier to elicit change in an office when there's only one place that you have to do it, because you can touch everything. You can be there every day. You can see where you know, what things need to be, you know, altered or adjusted. The biggest thing when we went to two was also managing. I think this is something people don't talk about a lot is that you have a primary location and technically a satellite location. It's one of the biggest pieces of advice I give to people. As soon as you expand to other locations, do not call them satellites. Those are other locations within your practice. You cannot focus on one as your primary. If for no other reason, the staff absolutely go crazy. They hate that. They hate feeling like stepchildren.

[B]

Right, that makes sense. We'll talk about some of the systems and processes that needed to be set up. Kevin, what about you? When you guys made the deliberate choice to add a second location, what was that like? And what did you know you had to do? But also, what are some of the things that you wish you would have done?

[A]

Yeah, so actually, our second location was financially a failure. So for five years we had that location and I think had a lot of incorrect mindsets about it. Attempting to be a satellite office that was too far for that. Not having the proper setup and staff and resources for It So that second location didn't become a success until another doctor in the area was actually retiring. And then we acquired that retiring doctor's practice and moved what we had in that area into that location. And then that became a more viable location for our second practice. You know, when I think back about why that initial second location wasn't successful for us, it wasn't, it wasn't a great location. It was a cold start. We moved into a space that was formerly occupied by an optometrist and an optician and thought, well, they were successful here. They were open, you know, less than a year ago. Surely we can be successful here as well. And there was a lot that wasn't in place when we did that. Initially. We were lacking, you know, marketing systems infrastructure. I mean, all the things that you need to do that properly. And you know, it being 45 minutes drive time from our primary location that was growing and doing well and had a full time doctor and a part time doctor, it just became that it took a different amount of resources for the sort of the cold start and to get that going that we had really allocated for it. And so, you know, I think thinking back on, you know, how did we make that more successful, it's when it finally became large enough for us, is when that became a viable second location for us.

[B]

So would either of you say that it's better to cold start your second location? So again, you know, learning from your experience, let's not talk about necessarily what you did, but let's talk. So now that you know what you know and if you had to do it again, if you have a successful one location business or you're talking to a doctor, it's got a successful one location business, maybe they're doing a million, Maybe they're doing 4 million out of that location because it's a, it's a, hey, it's a successful business, right? And then the decision comes along and says, okay, I think I can expand into that market, whether it's across town. But I think both of you said, okay, 30 minutes or 30 miles away, 45 minutes away, whatever. Okay, so let's go say under an hour away, but more than 30 minutes away, it seems like, okay, we're serving a different population of patients. What is, is it better to cold start? First of all, is it better to acquire existing? What do you think, Kevin?

[A]

I would say you stick with what you know. So, you know, the first practice that my partner had when I joined him was an acquisition and it was a very successful acquisition. And that worked quite well for him. We did have a successful cold start after our first sort of, you know, financial failure, I'll call it, of a practice. And you know, there's a lot of advantages to having a cold start. You know, if you pick the right location, you get to do the build out, you implement your culture there. You know, there's a lot of advantages to a cold start. But if you've been successful with acquisitions, I would say stick with that. If you've been successful with cold starts, I would say stick with that. I certainly have colleagues that have been highly successful only doing cold starts. And I've had colleagues that only do acquisitions. And so, you know, the beauty of an acquisition is you kind of know what the target financially is. You should be able to produce what the, the former owner did, right? Assuming that their financials are correct and you've had somebody look over them. But you know, you should be able to take their existing business and slowly make some sort of improvements on that. So you do know, you know what that profitability is from day one.

[B]

And Susie, what do you think? Cold start or acquisition for your second location?

[C]

I would say it is completely dependent on the personality of the owner of the acquisition potential. Meaning are they leaving, are they staying? As an associate, I think those are huge questions that have to be answered. I mean, we've done both. A cold start is hard because you're grinding from day one. You have days of one patient on the books, right. And, and it's tough to see the money going out and not coming back in. That being said, to Kevin's point, you're building it exactly like you want it to be built. And there is a lot of great with that. Now personally, I think I would rather buy an established practice as long as coming in, I was well aware of the intentions of the current owner.

[B]

And doctor, what do you mean by the intentions?

[C]

So what is their personality? What do they intend to stay in practice? If they intend to stay in practice, do they fully understand what it looks like to not be the owner and the primary person making the decisions in that practice anymore? Are they prepared for the psychological changes that happen when you are not the owner and the person who's making those decisions anymore? We've had, you know, occasions for it to go both ways. We have had fantastic acquisitions where the doctors were dreams and honestly they just wanted out of the day to day. They were so happy to be acquired and be able to come in and a doctor that it, it was a wonderful situation. We have had nightmares where the doctor was unprepared.

[A]

He.

[C]

He thought he was ready to not be the decision maker, and that was not the case.

[B]

Let me see if I can. We can attack it from a different perspective. How do you know if you're ready to go to a second location? Like, what needs to be true about your first location for you to be able to say, okay, I can bring the show to another. To another physical space? Susie. What? You go first.

[C]

So I think that's a tricky question because, you know, we talked before about how we got to our second location, and certainly none of the things that I would tell you should be done were done in our location when. When that happened. I think, you know, to go to a second location. First of all, I always want to tell people, ask yourself why you want to do two locations or multiple locations. Because if it's just to say, oh, yeah, I have this many locations, that's not the right reason. You have to have a desire to grow beyond just the footprint that you have. Like, our desire was to grow, and we knew that our growth was capped because of. We live in a rural location. There just was no more people. Like, we couldn't grow as much as we wanted to in the space that we were. So we knew we were going to have to go to multiple locations. But if you were just doing that to have multiple locations, you are going to be miserable. Because it is a very different game that you play between one location and multi. And I have friends who have, you know, super singles who are. Are making as much money in one as three of mine combined easily because of just the structure of where they live. But that was just not possible for us.

[B]

Yeah, so what. So I think you're. You're saying mindset needs to be done first and you need to understand why you're doing it. And you're also saying just to be able to say that you have an extra location that's going to make you miserable. So the right reason is you've hit a bottleneck that can only be solved if you add a location. Is that it?

[C]

Yeah. If we wanted, you know, monetarily to grow to the places that, you know, we had set our goals to be, we were going to have to do that with more than one location. It wasn't going to be possible for us to do that in one space.

[B]

Okay.

[C]

Just with our. With our demographic.

[B]

Okay, Kevin, what are your thoughts on that? What's the right mindset for someone to go from one location to two?

[A]

So I think most practices in the US are still single doctor owner locations. Maybe 40, 50% of them are just set up that way. It's just the way optometry has historically always been. And so, you know, in that scenario, if you're a single owner with one location, like my partner was when I, when I started with him, if you want to grow and add a second location, it's sort of like you're riding a bike and you know you're pedaling. If you want to go twice as fast, you are pedaling twice as hard. There's only so much you can do. There's only so much output you can put in to your business as the single owner. And so in my opinion, you need at least one layer of management in place before you can scale and have the outcomes that you're desiring. And without that, you're just going to have some level of burnout from attempting to do it without that.

[B]

Okay, so great, we're getting into the management structure. So that actually opens a whole door to a whole conversation of, okay, so what is the right layer? Like? First of all, I think you need to reverse engineer this. In order for you to have the right layer of management, you need to have enough revenue. So what is a minimal amount of revenue that you think is necessary in order for you to be able to hire that management, which then says that you're ultimately ready for a second location?

[A]

Kevin, you know, I, you can have really great people and what you're paying them doesn't really reflect, you know, how great they are and what their capabilities are. And so we've had a lot of really talented team with my offices that I've grown over the years and they've gone from entry level positions to senior level managers. So, you know, you may have somebody on your team now that has all the capabilities of being able to grow and help be that management leadership. I think what you would need as the owner in order to do that is to have the mindset of what can they take on and what systems can they put in place to take things off my plate so that I can deliver more patient care or can we find another provider to then deliver that more patient care in the second location?

[B]

Well, yeah, and I think, you know, a lot of people think about, okay, well if I'm going to get a second location, I'm going to need another OD at least part time to be able to handle that. That's pretty obvious, but I don't know that people think about, okay, and what's the, what's the management structure need to look like in order for us to be able to go for managing one location to two. So maybe just. Kevin, comment on that a little bit and then I'll turn it over to Susie to get her answer on this. But when you're running a successful one door and let's call it, I don't know, like, let's call it a $2 million location, you're running a successful $2 million location. What's the right management? And then how does that management need to change before you know you're ready for location number two?

[A]

Yeah. So, you know, I would imagine there's, there's a manager at a $2 million practice. I mean, you've probably got north of 10 employees in that location. So, you know, somebody is leading the team while you're in the exam room. And maybe there's another provider there at that level as well. I do think you can scale before then. I think that actually there's an opportunity for a practice to actually open two doors at the same time and split time between them. They could spend a couple days in one and a couple days in the other. So you could actually start with two as opposed to starting with just one location. But you know, I think the tasks that kind of need to be in place to make the store run when you're not there are. There need to be some sort of systems and manager and somebody to go to besides the one owner when you're not there physically in that location.

[B]

Well, and I guess that goes back to the point of bottlenecks. Right. So if you're in a really small area and you can support, I don't know, patient volume for two doctors for three days a week, could you just take that whole team and that whole team at that practice leaves and goes to another location that supports another rural community for two days a week or three days a week at that particular office, or two and a half days here, two and a half days there. And then you don't really need two teams. You just have two buildings, which adds a little bit to your overhead. But you essentially have multiple full time doctors and multiple full time staff that essentially support both. And then you got to kind of test it out. Right. And then you hopefully expand both locations. So that's one way of looking at it. Then the second one is what then try to develop people from within or hire from the outside. Suzy, what's your take?

[C]

So we always, every single time we did an acquisition or a cold start, we took someone from our most successful practice and moved them over to lead that additional practice. And, you know, the main reason if it was a cold start, was to set up our systems, obviously. But even more importantly, when it was an acquisition, it was to have someone who understood our culture, our systems, our protocols, and could implement them with the current staff. You know, very rarely did we do an acquisition where in one year's time we hadn't rolled through the entire original staff. And I don't know, Kevin, if that has been your experience or not, but very rarely does the staff of the acquisition remain on. So having some. One of our people there to really say early on, this person is going to, you know, this person's going to make it, this person's not to go through and be able to identify that was imperative.

[B]

Kevin, what's your take?

[A]

So we, we really paid a lot of attention to the team when we went in to acquire a location. So, you know, essentially most of the purchase is goodwill, right? So that you're buying the existing patient base, you're buying the goodwill the doctors had in that community for 20 years when they're going to retire or, you know, typically something like that. So, you know, we paid a lot of attention to how long their team has been on board, how long they've been there, and we put a lot of time and effort into making sure that we understood what their systems and processes were and we honored what they were doing before we told them we have a better way of doing it. Right. So I think that that's one of the ways we were able to have a little bit less turnover. Now some people just don't want to deal with change. You know, we put in a coffee maker in one location, and we had employees crying, and it wasn't tears of joy. They were upset that there was a coffee maker in the lobby for patients to then use. So some people just can't deal with any change, even if it's a net positive, you know, so some of those things, you just can't adapt. But I think when you. When you take the time to really understand why they were doing what they're doing and then present a different way, the team is usually okay with making those changes. And they sort of say, hey, let's go ahead and do it this way, the new way you've presented, that sounds better.

[B]

Okay, so kind of going back to the question of what are the must haves that you have to have in place before you can go from one location to two. So we kind of touched on management and team Susie. What's. What's Another one.

[C]

You know what's funny to me, Eugene is 1 to 2. And, you know, Kevin talked a little bit about this too. I just, I don't know that I thought 1 to 2 was as big of a leap as when you get into three to four. Three to four for us was where everything started to crumble and we had to completely redesign and make sure that we had, you know, other layers of management in there. We 1 to 2, as long as we could take one of our original people and put her in that location to, you know, start it and make sure that our, our protocols were in place, one to two was easier, I think.

[B]

Okay, so you, you wouldn't necessarily discourage someone from going from one to two if they, if they've identified the bottleneck. And the bottleneck is patient, you know, patient opportunity, patient volume. And, you know, it's like, what I want to do is play a little bit of devil's advocate, right? Because I think about this through the lens of theory of constraints. And we had a guy on the show a little over a year ago is like the foremost expert in theory of constraints. And he just kind of talked about how you always want to find, like, what's the biggest bottleneck in your business and solve for that. And at some point, solving for that seems like it opens up the door to another location. And sometimes if you're like, okay, well, you know, I can't get enough patients at this location. Well, like, what have you tried for marketing? Like, for real, you know, like, are you gonna go spend another, you're gonna go sign a six figure rent agreement and you're gonna have to have additional staff and you're gonna have all this additional headache. But, like, you didn't try spending $10,000 in, I don't know, whatever Google Ads in this, in this market just to make sure that you've really depleted and exhausted the potential that you, you can't get more patients. Or some people say, well, you know, my physical space here doesn't allow for me to see more patients. Okay, but like, what if you just like, knocked down a wall or maybe you looked at a bigger space for your, for, for your location? Could that solve the same problem with a lot less headache? And so these are the kinds of things where I, I, I just want to challenge the common perception that oftentimes the easiest solution to, for growth is to go from, to go from one location to another. Like, I understand that one of the biggest challenges in today's environment is recruiting optometrists. So I'm leaving that to the side. I'm saying you've recruited the optometrist. You've got somebody who's ready to work, but, like, should they work 40 minutes away or should they work in your existing location? And you could just change something about the way that location operates in order to enable them to be successful. What are your thoughts, Kevin?

[A]

Yeah, I think when you talk about the bottleneck, sort of that, that one sort of processor person that's kind of being the bottleneck of the growth, it's typically the solo owner. You know, they have to then relieve some systems. I was talking to a colleague not that long ago, and he couldn't have a conversation with me because he had one of his employees knocking on the door with a problem that they could not answer, and they needed him to be able to answer the question so that they could go on with their day. Right? If. And I was. I said to him right after that that happened, I said, why don't you have an SOP for how that works? Why isn't there a process in place for a standard operating procedure to say, if this happens, here's what you do, why are they coming to you for that? And he was like, what's an sop? And I said, oh, okay, we need to have more conversations, clearly. But, you know, I think the, the. That's. That's essentially the issue is that there's not systems in place. And if your team is relying upon one person consistently to go to, to get the question answered, then then that's your. That's your bottleneck, you know, and if you have a layer of management in place to identify and say something, we need a process for, you know, that's something we need to document and make sure everybody knows how to do this and where to find that resource. So we're all on the same page that we do that consistently, every time for every patient.

[B]

Yeah, that makes perfect sense. Susie, your take?

[C]

Yeah. Well, I also think, you know, when I'm talking about, like, in our office going from one to two, the huge advantage that we had, right, is that there's two of us as, as doctors and as owners, and that makes a huge difference. We knew what our culture was. We knew what we wanted our offices to be like, because, you know, not only are business partners, we're married to each other. We knew what we wanted our workspaces and places to look and feel like. And so with two people managing two offices, that was much easier because at that point of our development, we didn't have Strong managers in place. We were the managers.

[B]

Yeah. And I think you've helped some practices go from one to two in some of the work that you do that you do in the industry. And I'm curious if they don't have that extra person. Right. Like I, I was just talking to an optometrist who's like, I hired an OD and I put them at this location and like the numbers all look like garbage and I just want to sell that location back. And it's like, okay, how can I help someone prevent that pain? What would you say to people? People.

[C]

I think you're going to have to be willing as the owner and as the instigator of the instigator is kind of a negative word, but initiator of the, the practice culture. You're going to have to be willing to spend time in both practices. You're going, you're going to have to split your time and maybe that's even just a day, a week to be down there with the other doctor, you know, talking to them and having your influence in that office. So to your other point, you better make sure that your income is ready to maybe shift out one day of practice care into management care of another location if it is just you as the primary owner.

[B]

Well, and that's what I was going to get to next is that there are some numbers that probably need to be better than average inside of your one location before you're ready for the second location. Right. And I think one of those numbers absolutely needs to be ebitda. I believe that if you're not in double digit ebitda, you are certainly not going to solve your problem by moving by adding another location and saying, okay, I'm going to, you know, just build my way out of this, out of this issue. So I, you know, because to your point, you're going to spend less time seeing patients, more time managing that is already going to hurt your, even in some capacity or in some way. But you know, what other numbers should we be thinking about that must be true at location number one before somebody is ready for location number two. Susie, you go first.

[C]

Well, I think your staff numbers need to be solid. Your turnover rate needs to be low in number one. And the main reason that I say that is because you, you will be utilizing if they're within a driving distance, employees from number one location to go to the number two location. It just will happen. I've talked to so many people that have said like, I'm not going to share staff I'm not going to have switching offices and, and I laugh because it's, it's just not reality. I don't think now Kevin's going to get on here and say, oh gosh, we never share staff between our locations, but we never found that to be a viable possibility. So I think you better make sure you have a solid staff and that the staff understands that travel could become a possibility for them and have a compensation package in place for what they get for doing that travel.

[B]

What would you suggest for that comp package?

[C]

So, I mean, you know, we're here in, in rural Missouri, so it's a little different, I think, probably from a big city, but we paid our people an extra $2 an hour when they would go to the other location.

[B]

Okay, Kevin, your, your take. What, what numbers matter?

[A]

Yeah. So I, I think you need to have a full time employee that's able to work four days a week with their primary, you know, level of care and one day a week on the management structure. And I think having that sort of time, so enough hours in the day to be able to make that and structure for that so that they can identify those issues that are coming up in the practice that we need to create something for and have the time to create it. I think a lot of people, you know, you sort of end up wearing two hats at that point, but you've got your one hat. That's patient care 80% of the time. And you've got at least that one day a week where you can take some time off and work on that. So it's enough labor to be able to grow and scale and have the time to dedicate to that and be able to itemize out and systematize everything that you're doing and create those training and resources. And I think it's enough training for the team as well. You may have a really skilled team member in one location and they don't really explain well what they're doing. It's just innate. They do it really, really well, but they can't really tell you how they're doing it. So in order to copy that, they've got to then have the time to sit down and go, well, what I was doing when I did this task was X, Y and Z. And you've got to be able to pull that out of them. So I think it's an amount of training time and amount of documentation of that process time that you really need to grow.

[B]

Yeah. And are you saying so I'm hearing you say the four days. So really like you're saying somebody is allocated 80% of the time to patient care, 20% of the time to, we'll call it scaling or optimization. And that. And is that somebody, everybody in the practice, Is that somebody like a practice manager? Is that the optometrist in the practice? Who are you talking about specifically?

[A]

Yeah, so I would say it's your primary level of management ownership and then your secondary level of management ownership. So you need two people in order to scale, in my opinion. And each of them need to have that structure and set up so they have enough time to work on growing the business together and have the same mindset. For here's what we're trying to accomplish and here are the things we need to put into place. So, you know, if you're a single doctor owner and you're trying to grow, you need to have the capacity to cut down to four days a week from five. And now you have a day a week to work on, on your practice, not in your practice. And then you're going to need a manager as well. And that manager could be another od. I have colleagues that don't have any managers and the ODs do everything, bless them, but you know, you need somebody else to be able to help you do that and see the things that you're not seeing and be that second manager in that second set of eyes to say we need to systematize this and we need to do this in the practice. So I would say it's two people that are able to step back from patient care at least one day a week to start location two. Now as you grow, you'll have full time staff that are part of that leadership team. But starting out, you need to have a level of dedicated time to put the processes in place.

[B]

Yeah, okay. And it basically means that your patient, that your office manager can't also be your lead tech five days out of the week. Right. It can't also be.

[C]

I disagree. I think it totally depends on the involvement of the managing doctor or the manager. So for years, well over a decade, I had a rule that I had no back office managers, meaning every one of my managers was also in full time patient care. And the reason was that I kept seeing these situations where managers were sitting in an office in front of a computer screen. And to me that's not managing. Managing is being out with your staff and with the customers and managing the flow of the office. Now we have since diverted from that because we have switched to a system where we do need more Computer time and task oriented time. But I really liked having a manager that understood what it was like when the front desk and the phones were ringing and the people were walking in and they could relate to the people that they were managing really well. It also helped with the relationships between the employees and the manager is that they knew they were in the dogfight with them, right? Like they, they knew that they had a complete understanding of what was going on. So we got to a large enough point where we did have to have a management system that pulled people out of those roles. But I do think it's possible to have someone who does both.

[B]

How do you get time for those people to lead, you know, to do. And when Kevin was saying there's the one employee who can't articulate what they do well, but they may be like the one optician who's consistently averaging a hundred dollars more per revenue per patient than somebody else or has the highest or the lowest exam only rate. So my, if, if I were the manager in that location, I would observe, right? Like I would fill out an observation form like we teach, and I would, I would observe that, that that person and I would observe some other people and be like, aha, that person is doing something that's different. But I can't do that if I'm in full time patient care. Susie. So resolve that.

[C]

Correct. So we would have to carve out time for them during the week. So we would, we would find specific time blocks for them to do those things, to jump out, to go observe, you know, watch optical, observe the front desk. You know, we, we would carve out moments during the week where they did those things. And you know, ultimately, like I said, we've pivoted away from that. But we, we did that for a long, long time.

[B]

Yeah, well, I mean, managers being operationally involved allows, allows a certain degree of, call it just like intuitive knowledge of what's happening inside of the organization. But then it gets to the point of what Kevin was talking about earlier is that you do have to systematize, right? And my argument is you have to optimize before you scale, right? So you have to be able to know what to optimize and what to work on first before you can, before you can then go replicate that thing. But I totally agree with both of you is in the context of your people are going to help you help you do that. Which then kind of takes me to the owner's mentality. At some point you have to go, as you're a business builder and let's even start talking about going from one location to two locations to three locations to four locations. At some point, you have to move, as the owner of the practice from, like, this is my job to be, you know, patient facing, and I'm the doctor. And, you know, I still do that 80% of the time. Or. Or I'm the, you know, the lead optician. I do that 80% of the time to, like, a CEO mentality building a business. And so what does it take to kind of, what are the. What are the places where most people fail to do that? I mean, a lot of people say, oh, I want to, you know, put on my business owner hat at this point, but. But a few people succeed at doing that well all the time. So, Susie, you go first.

[C]

I think the very first question you have to answer is, do you want to. You know. One of my favorite books is the E. Myth that, you know, talks a lot about, you know, working on your business and in your business and which one feeds your soul the most. And I know a lot of people who love being optometrists, and I still see patients, you know, one to two days a week, and I love my patient care time. I wouldn't want to give that up completely, but I didn't want to do it five days a week. I knew that I had, you know, a desire to. To really work on the systems, the protocols, the operations of our companies to make them better and more efficient. I knew I had that desire. So first and foremost, you have to decide if that's what you want. A lot of people became optometrists, surprisingly, to be optometrists and to take care of people and see patients. And if that's your primary goal and you want to continue doing that, dear God, do not put yourself into, you know, doing spreadsheets and writing SOPs and things like that, because it will absolutely suck the life out of you. So primary, do you want this job? Is this what you want to do?

[B]

Yeah, that makes perfect sense. Kevin.

[A]

Yeah, I would say a lot of owners will confuse their personal competence and their professional abilities with the organizational readiness, you know, and they'll jump into a second location before they have those things in place. Oh, we'll figure it out. We'll put in those systems later. It's what we did initially. Let's just figure it out. We'll be fine, right? We're intelligent. We'll be able to figure this out from here. But I think the mindset that has to shift is if you've got a Business that you're carrying, you really need to make it a business that carries itself. You've got to get to the level that there's a structure and a system in place that is greater than your abilities so that, you know, you don't need to be there in order to, you know, make that successful. Everybody knows what they're going to do and, and has that answer, you know, for you.

[B]

Yeah. And you know, that's, that's so interesting you say that, because I think I've talked to a number of optometrists who've said, you know, I was able to take a week long vacation because I had other things, but you know, when I got back, it was like I, I was just flooded with a whole bunch of stuff that was waiting for me. Right. And so what does that look like? What is that supposed to look like to your point, Kevin, where that business carries itself and it's all, and it's all happening without you necessarily having to make those decisions.

[A]

Yeah. I would say you're looking for predictable success, you know, that it, it's running and operating the way that it should, whether or not you're there for the, for that day, for that week, for that month. A month is a little long. But you know, I, I, I talked to a lot of owners as well that, that haven't taken a vacation in five or 10 years, you know, and I think it's sad. You know, they have never recharged, they've never been able to unplug. You know, if they're not there, the business is essentially closed and they're, they're trying to support staff that need hours for the week, you know, or two weeks or however long they're trying to take off. And so, you know, they need that, that time away to recharge and think big picture and understand what they want to do. They just don't have the ability to do it, you know, being the solo entrepreneur.

[B]

Yeah. So, and next question I'll ask too is that if you're going from one location to maybe even more, you're going to be taking some people who are working in your current location and you're going to be saying, okay, that person is really good at, you know, they're a great optician. So I'm going to promote them and I'm going to make them the lead optical or the optical lead and the new location because they'll get excited about driving an extra 40 minutes to work, but it'll be for a promotion. So talk to me about that. Decision. Suzy, you're shaking your head because I've.

[C]

Done it wrong so many times. You know, what's the Peter principle? You promote someone to the level of their incompetence. I have done that more times than I care to say. You know, we used to have a rule that you couldn't be considered for a promotion until you had successfully and fully trained another person to do your job if tomorrow you didn't show up to work. Meaning, like, not just. Yeah, I kind of know what that person does. No. Knowing the job inside and out, how to do it so that they could take it over tomorrow. And we kind of utilized that as an understanding of if someone was really motivated to be promoted or to have another job, then what they wanted to do was teach someone else how to do their job so that they would be under consideration for that. So, so many times I was like, hey, you're great at optical, so why don't I make this brilliant decision to pull you off of the floor and make you a manager of all of the optical where you have no ability to sell, which is what you're extremely good at and is really good for my office. I mean, I've just. I've made the mistake so many times. So, you know, please avoid that if you can.

[B]

Don't do that, Kevin.

[C]

Don't do that.

[A]

Yeah, no, absolutely. It's very uncomfortable to do something you've never done before in the business world. And so, you know, if you're really, really talented as a doctor or as an optician or as a technician, you know, and that's what you love and do and enjoy day in and day out, to then say, I can deliver more care to more people, you might not be able to. I mean, the only way to do it is to pedal twice as hard. Right. But the. The other way to do it is to create the systems and put those in place to then teach somebody else to do it and get them to do what you love. And I love that strategy you have, Dr. Lake, of, you know, finding somebody that. To take over your job before you can kind of move into that promotion, it makes total. But the person has to really want to do it, and they've got to have the capacity to do it. And some people aren't capable of upgrading to that level. And I think you've got to take the time and energy to, you know, develop them, to pour into them, to figure out the who, what, when, and why for they're not able to get this done and show them a path where, if we offload this. Then you have the time to work on the project you're working on. And when you've just kind of been locked into what you do really well day in and day out, you don't see those other opportunities. And so you need someone to coach you and guide you along the way.

[B]

So. And this is one area that I think gets exponentially more challenging when you say the same thing with an od. Okay, so I'm opening my second location or my third look, whatever, right? But I'm opening another location, or I've acquired another location, and I want to put an OD there. So I'm taking an OD who I've hired, and I'm going to put them there. And all of a sudden, truly, sometimes what happens is naturally the office kind of revolves around the preferences of that optometrist. Right? That optometrist wants to see patients. You know, they don't want to see kids before noon, or they don't want to do this, whatever. And that optometrist has, especially if they're. That's their location, they have certain things that they want to bring with them to that location, and sometimes those don't necessarily agree with yours. So how do you deal with that? How do you manage your associates? Especially if you're butting heads like, what. What. How do you resolve that? Tell us some war stories. Suzy, you go first.

[C]

So I have a pretty big personal belief that I don't want to alter how my doctors practice, meaning the pace at which they practice to a certain degree. I mean, they can't see one patient an hour. But, you know, I have doctors who fly through four patients an hour and doctors who see two patients an hour, and they are both incredib, incredibly valuable doctors to me. So things like that, I don't get too pushy on as long as I know they're. They're working up to their capacity and they have an understanding of the impact on their income, Meaning if they have concerns about how much money they're making, but they're not willing to see more patients, that's a. You know, that's a rub that we have to address. But as far as, you know, I like doctors to be able to work in a space that feels like their own. So to. For the most part, we have always let them so set the pace of the day, how their staff talk to patients, you know, things like that. As long as it was within the realm of our core values and what we know we wanted for taking care of people we were okay with a little individuality amongst the practices.

[A]

Yeah, I would say it's the 80, 20 rule. You know, I mean, you've got, you know, 80% of things need to kind of work the same way and be uniform so we can deliver a consistent, you know, product to the patients. But there's a lot of creativity. We gave our doctors a lot of freedom. And I did have doctors that saw a patient every hour, hour and a half, and we were totally fine with it. They had a ton of demand. It's what they enjoyed doing. And, you know, we were happy to have them in the practice. And we had some that saw, you know, more than four in an hour. And we were able to have that. That creativity and that flexibility because 80% of what they were doing was really the same. And if they wanted to do a specialty care or they wanted to do something unique, we embraced that. Happy for them to do that. You know, I think one of the ways that you can increase your revenue per patient is to offer all the specialty care that optometry has to offer. And so a lot of those examinations are more unique and take longer and require a lot of more creativity and more experienced team members that you need to have more senior team members to be able to help you deliver that care. And so embracing those things and not shying away from them is one way that you can sort of grow the practice. But it does require a lot more creativity and a lot more seasoned team members. Yeah.

[B]

Oh, go ahead. Sorry.

[C]

Sorry. Well, we had a doctor whose practice. He was an older doctor. We acquired his practice and he wanted to work for about five more years for us. He was a wonderful addition. And we used to call him, when we would have our numbers review, we would call him the optometry ninja because he could produce with 10 patients a day, similar to some of our doctors seeing 20 patients a day. Because his per patient revenues were, you know, through the roof. Because he spent time and he talked to people and he would go out and fit them himself sometimes in the dispensary, because he had the time to do that.

[B]

Yeah, it's interesting, you know, and then. But at the same time, I have to challenge you and say, well, okay, if you're. If you don't optimize, how can you scale, meaning if you're not doing the same thing? So there are probably some things that have to be done the same way. And, Kevin, and this one's for you, because I found it especially interesting in some of the stories you've told me over the years of how you've been able to manage doctors and, you know, you're not an odd. So you being able to get doctors to understand what's in the best interest of the company, also what's in the best interest of the patients, while also what's in the best interest of them. How do you. What were some of the mechanisms that you were able to do or to implement with your team of doctors?

[A]

You know, I've had a wonderful team of doctors over the years, and so I've always felt privileged to be able to work with so many that were so talented. But they're all unique. They're all a little different. They all like to do certain things their way. And, you know, I think we try to embrace those differences and still let them do what they like. You know, everybody wants to be unique and everybody wants to have their own way of doing it. Nobody wants to be pigeonholed into this is what we do. And I think at the end of the day, there's sort of this realization that I've always had and my team had with me that ultimately we're seeing comprehensive eye examinations and we're selling product. Right? I mean, most of the what we're doing is still that that is the 80% of what we're doing. And so we need to deliver that in a consistent, well thought out, professional way. And I think just communicating with the doctors because they don't want to hear that. They do not want to hear that more butts in the chair, as the corporate sort of says, are going to help the problem. Right? Nobody wants to just think of what they're doing as spinning and grinning in the exam room. One or two. That's all we do. I think there's a lot more complexity and uniqueness in the level of care that they're delivering. And I think you want to embrace that and you want to explore that as much as you can with them. And I think when we frame questions to them and thoughts to them, and maybe it is we're trying to increase volume on a certain day or increase the number of exam slots, they deliver such great level of care. Let's talk to them. How about they can deliver more care to more patients and is there a way we can do that because we offloaded some task they were doing or we, we opened up more capacity for them to deliver even better care?

[B]

What's the right frequency with which you would meet with each associate or do you have team meetings with all the doctors? Susie, both of you, give me your take.

[C]

On this, I think once a month, one on one with the doctor, even if it's just in passing, sometimes I'm just popping into an office saying, hey, are things going okay? Once a month, once a quarter, we have an in person. And we did it virtually for a while, and it just was missing something. So once a quarter, everybody travels to one location. We have dinner together, we sit in a room, we just touch base. And that has really, I think, had an impact.

[A]

Yeah, I would say two to three times a year, we all get together in person as much as we can and have CE during that time and discuss sort of best practices. We're meeting with the doctors on a monthly basis virtually, and sometimes in person if it's convenient to sort of see how things are going and what. What resources we can provide for them. But, you know, depending on if we're implementing something, we might be more. More frequently meeting with them or. Or chatting with them more about what we're trying to help them produce.

[B]

Okay, good. So shifting gears into kind of our. Our last focal point here for the episode is. I have heard this so many times, and I think, Susie, you alluded to it earlier in the episode is that, you know, when people go from two locations to somewhere between three and five, so I'm just going to call it four, the wheels just freaking fall off. Like you are in a completely different world and you are, you know, in some cases, fighting to stay alive, or at least this is what I've heard from several clients who have gone through this, who have gone through this successfully, and they've described those as some of the toughest years of their business career. So both of you reflect on that a little bit and talk to the audience as to what kinds of things can ease the pain of, or possibly even prevent much of that pain if you have them in place. Susie?

[C]

Yeah. So going two to three, we, you know, it was definitely more difficult, but it was a strong practice that we purchased, and so it. It blended in a little more easily. When we went from three to four, we essentially bought a practice, but then we immediately moved it to a new location about three to four miles away. So it certainly wasn't a cold start, but it also wasn't exactly the same as an established practice. And what that proved to us and revealed to us was our complete lack of protocol. Now, we thought we were. We thought we had it very dialed in and we were ready to go, but when we hit four, what we realized were that those formal SOPs, those, like, everything written out, everything formalized everything, you know, detailed down to, you know, we got a little carried away. We'd be like. And you push this button, like, put this finger in some of our written protocols. But, you know, we knew we had to completely revamp because it really did it. It just about broke us. The fourth location, it was terrible.

[B]

And what was the. What was the nature of the break? Like, the staff not knowing what to do, the locations different.

[C]

It was as soon as we put out a fire in one location, we were putting out another fire in another location. And to a certain degree, that always happens. You know, I always say every time one of my managers goes, oh, it's so great. We're fully staffed now. I like, am like, are you kidding me? Did you say that out loud? Because, you know, what's coming. Yeah, is like two. Two puddings within the week. But, you know, we were always just hopping from one fire to the next. And if you're only doing that, if you're only putting out the fires and you have no room to get creative with how you're going to grow or what new things you're going to try, because all you're doing is trying to figure out how to get from day to day by putting out, you know, one fire after another.

[B]

Kevin, your take.

[A]

Yeah. So when we acquired our second location, I think it's 2016, so we had the cold start that was sort of the financial failure. But when we acquired and moved that into its second location, we really had our one large established practice. And then, you know, 45 minutes away, we had at a location we'd essentially just acquired. And there were two different cultures, there were two different. Different systems for everything. And so I think that's why two is. Is so hard, is when you. When you do have two sizable offices that sort of have a different way of doing everything, that's when you've really got to kind of structure it and put it in place. And so we. We implemented core values and, you know, went through the traction process and. And spent a lot of time figuring out who we were and what we wanted and. And what was the best of those two methods. And we even went into some franchising education and online training resources. We created internally a lot of stuff that we did to try to create that. And so when we did 3 and 4, they were in 2020, during COVID and they were right back to back. One was a cold start, the other was an acquisition. And so we were so well prepared for that time that we had taken once we had acquired the Second one of creating those structures and putting them in place. And so we learned a lot from those two, but they weren't as difficult as the second one was for us when we had a whole different culture that we were trying to and a whole set of systems that were not documented that we were then trying to integrate into what we had.

[B]

So it's really about systems and system documentation and that sounds like that's the pattern for both of you. Okay, so you can always have a.

[C]

Way to go back to something then. Right. Like, you know, we've, we didn't talk about recall, but to me the one thing that's non negotiable, you know, we talked about variability. Recall is non negotiable in it's consistency. It has to look the same, sound the same, feel the same, no matter what. And if you don't have that written down when you have turnover of staff, you lose the process.

[A]

When you're small, I mean, you just have all that intuition. I mean, you know what's working and what's not working just by feel. You know, if you've got 10 employees, you know every one of them personally and you can lean on those personal relationships because you've developed them over so many years. When that complexity reaches a point where you haven't seen somebody in a month that you work with, you're no longer able to say, oh yeah, I know them, I know they're always going to do it this way. You have to have a system and structure in place. You know, you're just not able to spread yourself to a certain number of people or a certain number of locations. You have to have structure in place for that.

[B]

Yeah. So last thoughts for the audience. Anyone who is thinking about going from 1 to 2 or from 2 to 4, one crucial piece of advice that you would give them each before we wrap up up for the day. Kevin, you first.

[A]

I would say take your time with it. You know, as, as somebody that, you know, looked at a second location and thought we were going to find a slam dunk and it took five years to, to make that into a successful office. You know, I think that really, really thinking through it. You know, Eugene, as you said, you know, you were beta testing marketing in a, in a given location that is much less expensive than buying another location. Right. And, and doubling the size, physically the size footprint of what you're doing. You know, really take your time with it and really ask your those questions. You know, is this, are we maximized at our first location? You know, is this why Are we doing this? Are we really trying to deliver more care to this community that we live in? And this is really the right reason, because there's a lot of headaches that are coming your way, and you've just got to make sure you are fully committed to that.

[B]

Yeah, that's great.

[C]

Susie, two things. Two things I would say is invest in leadership training, formal leadership training for your management team. I would have done that. I would have absolutely changed that about how we did our, you know, multiple locations. And secondly, to further that point about making sure, you know that what you're getting into, it's even making a change, you know, I would go to a conference, we would learn about a new system. There would be four of us that were going to go back and implement the system. Two of the people who have super singles, that system was in and running by the end of that week. The people with multiple locations. You haven't even set up the meeting with all the managers to talk about the change. Right. So make sure that you're ready for the. Things are going to. The ships turn slowly. The big ships turn more slowly.

[B]

Yeah, that makes perfect sense. Great advice from both of you. Thank you so much, both for spending some time with me and for sharing some of your wisdom on the Power Hour. Great episode. And again, really appreciate your. Your insights.

[C]

Thanks. It was fun.

[A]

Yeah. It was an honor to be on with you, Dr. Lake. Thanks.