
Loading summary
A
Foreign. Welcome to the Power Hour, Optometry's biggest and longest running show. I'm your host, Eugene Shotsman. And today we are kicking off a deeper series on something that Jamie Rosen and I have been working on for a long time, the eye Care Boss system. Now, if you've heard Jamie on the show before, you know that he brings a pretty rare perspective to eye care. He helped grow his family's practice from four locations to over 50. He's helped hundreds of other practices, and he's seen firsthand what it takes to go from being a successful practice to becoming a scalable and optimized business. And that's really the idea behind ICARE Boss. It's the business optimization and scalability system that we developed around five major systems that every practice needs. Accountability, revenue, people, experience and data. So today we're doing a deep dive on people because that's where so many practice owners get stuck. You can have great growth ideas, great technology, great marketing, great intentions, but if you don't have the right people in the right seats, operating with the right mindsets becomes very hard to execute anything consistently. So in this episode, Jamie and I talk through what it takes to actually build a stronger team. How to define the rules of engagement in your practice, how to evaluate whether people belong on your team, how to think about leadership development, and how to get people aligned behind the concept of change. And before we get into it, quick reminder, make sure that you are subscribed on YouTube, Spotify, Apple Podcasts, or wherever you get your shows so that you know that every single time a new episode drops. And as always, I'd love to hear from you. If you have any feedback, questions, ideas for future episodes, or feedback on this Icare Boss system really genuinely, please reach out to me@eugene shotsman.com or through the Power Hour website. Look forward to hearing from you. And now, let's go to the show. Jamie Rosen, welcome back to the Power Hour.
B
Eugene Shaftsman, it's good to be here. How are you?
A
All right, so this is going to be a fun episode and the first of five in our what we'll call the I Care Boss monthly series. And for everybody listening, we've already introduced the I Care Boss system kind of in generalities, and we introduced it first on the Power Hour, I believe, back in February. And then we introduced it in live in Orlando at Vision Expo. And at this point, the book is out, the book is written, and it is literally with the publisher ready to print right now. So you could get an early copy of the Book if you want to get a deep dive into some of these concepts that we're talking about. If you can't, at the time that you're listening to this episode, if you can't exactly buy it on Amazon just yet and just reach out to us, we'll make sure to send you a copy. One of the two of us, or on the Power Hour website. It is totally fine. We're. We're happy to take those requests, but we need to zoom in. As we promised, the audience and people asked us to do this multiple times. So we're going to zoom in on each of the five systems that makes up ICARE Boss. But before we do that, let's maybe zoom out for a moment. If people don't exactly remember the episode from February. And I know, like I said, I can't even remember what happened last week. So, you know, maybe it's. Maybe it's not exactly a fair ask for our audience to remember exactly what ICARE Boss is. So why don't we zoom in or zoom out for a second, Jamie, and explain how icare Boss, the business optimization scalability system, came to be. And then we will zoom in on the people so side of that, of that system.
B
So, yeah, taking us back to a couple years now, we had a cohort that was going in what we called the Accelerator program. And in, in that program, we taught a lot of growth levers. I mean, we identified over a hundred growth levers, and we were trying to take about 12 of them and put them into action with a cohort of about 50 practices at the time. And this was a. The course curriculum was sort of, you meet for three hours once a month, and then you try to activate what you learned in those three hours in the next month. And then we come back together and we'd ask people, how did it go? What did you try and how did it work? And about halfway through that program, we just did a perception check with the cohort. Hey, if there's anything we haven't covered so far. And again, keep in mind, we're trying to accelerate growth. That was the name of the program, the Accelerator program. And it was mostly focused on growth. And to a person in the cohort, they came back with, I love the material that I'm learning from you guys. I just don't know how to insert this into my practice. Cause I'm having a real hard time managing my people. So teach me how better to manage our people. And that resonated with Eugene and I, and we were like, God, we Missed it. Like, yeah, these growth levers are fantastic. But if you don't have a system to execute, implement, hold people accountable, monitor and measure progress towards the goal, you know, those are all the things that we weren't really covering. We had one session on change management, but it's much more than that that the cohort was asking for. So we decided we need to actually take an approach to writing a book that took all the learnings that we both had in our separate businesses that all are directly applicable to the eye care universe and have a book specifically focused on how do I manage my people in an eye care practice. So we all have read books. There's good to great. There's Execution by Ram Shram and Larry Bossdy, there's Jim Collins has a lot of good stuff out there. EOS has a lot of good stuff over there. It's not exactly directly applicable to the eye care system, to our business, essentially. And so we set out to take all these really good things that we had learned over the years, some from books, some from our own experiences, and put them into a step by step, if you will, book called the Business Optimization Scalability System. And that's what we came with the book because we figured the missing ingredient was actually how do we manage the people side of the equation.
A
Yeah, and I think that's almost always. That's the biggest issue when I go on stage and I get people to kind of do the interactive. What's the biggest problem in your practice? And almost always people is the number one issue in a practice. And the concept of the business Optimization scalability system is that optimization and scalability are kind of the operator words. And I think about, you know, super successful practices, including Jamie's, that have really scaled what it requires is a systematic approach to just about everything in your practice. And I think, you know, as Jamie and I watched some of the most successful practices grow, and we watched a lot of really successful practices make a ton of mistakes on their way to growth, we thought there's gotta be a shortcut to optimization and scalability. And again, that those keywords basically mean if you have a practice that's both self optimizing and self scaling, what that means is that is a practice that can run itself without one key person being the bottleneck. And it's also a practice that can continue to improve itself, get better every single day again without you or some key person being the bottleneck to that growth.
B
And, well, I would say, Eugene, the. The things that get in the way. So the narrative that we hear is a combination of these types of thoughts, like how do I get my people to do things more consistently? How do I get them to take care of things just like I would do? How do I reduce the drama and create a positive culture versus something suboptimal? All these things, how do I, how do I keep my best employees from burning out? How do I actually continue to have full staff even though I know I'm going to have turnover coming up, whether that's intended or unintended? And then how do I shift it to be more intended? Turnover versus unintended turnover.
A
Yeah. And I think what, what happens is, and this is why I think we wanted to cover the people side of the equation first. Five systems and they all, they all really work together. Right. When we talk about the hundred plus growth levers, that's the revenue system. But you can't activate the revenue system until other things are present in the business. What are those other things? Well, there's a model of accountability which doesn't really sound fun. We'll cover it in a different show. It actually is really fun once it's working. And it's like, honestly, it unlocked so much for me in my business when we went from like 50 employees to more than 50. It was like, you know, just like the thing that kept me from having to work 14 hour days. And then there's this concept of hey, patient experience. You really have to have a systematic approach to patient experience in order to compete in the marketplace as it stands now because good system, a systematic approach to high end patient experience really gives an independent practice a lot of, a lot of edge in the marketplace today. You also have to have a data system to measure all of this stuff. Again, we'll cover this in a future show. And I mentioned the revenue system and of course now this is where in today's show will cover the details of the people system. And really I think the easiest way to think about it is that the people system as we thought about it is comprised of five core components. And those components are in no particular order, change management, zone of genius. The core mindsets which are the rules of engagement in your practice, leadership development and the team fit calculator which basically helps you understand where you set the what, where you set the minimum performance standards in your practice. And a lot of these things, Jamie. Right. You did in your own practice. But we also watched a lot of other people do who are very successful and again we learned from some of the business greats as we implemented this
B
and these, those things that Eugene covered in the people system. The core mindset, the first change management. We talk about core mindsets, super important leadership development, team fit, calculator, zone of genius. These are all like, I would say the pillars within the people system. So if you get those things right, those five things right, or you start to get them better and better, closer and closer to right, you start seeing that you're practice is more able to take on initiatives because there's obviously accountability. Totally different system. But, but you're laying the groundwork for what kind of people do I want in my practice that can help me grow this practice. It's super important. And, and, and like Eugene and I in our first accelerator card, completely overlooked.
A
Yeah. And I think the, if, if you're really thinking about this in the context of how does this apply to my practice, let's just put it into something super practical. Everybody says I want great people on my team, but how do you really know if your people are good? And the reality is that this mindset, the concept of a core mindset, which is very different than skills, there's, there's a difference between people having skills and being capable to people having the right mindset in, in your practice, which I think is more like the rule of engagement. So why don't we talk about how to find out what your core mindsets are. But before we do that, maybe I'll set it up a little bit and just kind of COVID the, COVID the basics of what, what, what a core mindset really is. And I just give you an example. A high performer, someone with great core mindsets, walks into every patient interaction with genuine ownership. They look at every single visit as an opportunity to help patients basically get the best vision possible, not just get through their day or get through an exam or something like that. They use discovery questions to uncover lifestyle needs. They work with the optical team, they work with the doctors. They lean into the new solutions that you have for your patients and kind of the new initiatives that you have inside your practice.
B
Yeah. And the other thing I would, I would chime in is just they are the type of people that understand that the patient that's sitting in front of you probably has not been to your practice in well over 365 days. This is not something they do every day. And those people that represent the core mindsets start from the beginning with the idea that the patient is here, if we're lucky, once every 365 days, and sometimes it could be two years or three years. And what becomes really, really apparent to your staff, because they're doing it every single moment of every single day that they work is. They usually don't start at the beginning. So, for example, just think of when a patient walks in and your person that greets them is on the phone and are they met with that person politely putting the person on hold to do a warm welcome, or is the person hand them a clipboard with paperwork on it and signals to them while they're on the phone, fill this out? It's the. You know, or. I remember in. In my practice, we had dispensing booths, literally booths that had like, like five foot walls around them. And we had five of them. And I remember being early days at Rosen Eye care when a patient would walk in and the person would say, I'm here to pick up my eyewear. And they would say, take, take a seat in booth number five and someone will be right with you. And the person's looking kind of st. Crooks their head. Like, what is Booth 5? I mean, our booths weren't even numbered. And they were. They just happened to know that was booth five. What happened to be the first one closest to where the eyewear was being stored, the drawers we keep completed eyewear. And so the core mindset is like those people are displaying the. Have a seat in that booth, the one farthest to your left. We'll have an optician, he's busy finishing with another patient, but he should be there in less than five minutes. Make yourself comfortable. Would you like a cup of coffee? Not have a seat at Booth 5 or fill the paperwork out?
A
Yeah, that's exactly it. Patients can absolutely sense, and really like anybody can sense whether the person who is in front of you is basically just doing their job and checking a box. Right? Like the phone flat tone. Okay, over there, right? Like Booth 5 versus they're actually invested in your success as a patient or what the person you're working with. And the reality is, like, you can have the most refined, the most successful, I don't know, like, like, we always talk about how a optical handoff makes so much money for the practice or loses so much money for the practice, but you can literally script down to the freaking word exactly what those people need to say. But if it is not delivered with empathy, with charisma, with care, genuine care, the experience is not human and therefore the whole thing is lost. So this is the whole concept of core mindsets is people who are truly invested in the success of your practice. And you can, you know, we'll talk about how to find your own core mindsets in a second. But these are like people who are. Who. Who really embody the rules of engagement that you want to build your practice on. And for the most part, I imagine anybody who's got an independent practice, I believe you probably buy into the fact that experience, your patient experience, is a differentiator for your practice. And so in order for you to be able to differentiate between yourself and, I don't know, a corporate chain, for example, you need to make sure that your people are truly invested in the success of what it means to deliver great care inside of your practice. And so how do you find that? And again, I just want to say this one more time. The definition of a core mindset is the rules of engagement at your company. And everyone can have slightly different rules of engagement, but many of them are going to have similar patterns to being able to deliver amazing care and to truly actually care about the patients. Right, Jamie?
B
100%. So do you want to get into how to find your core mindsets?
A
Yeah. Yeah. And. And once you find them, one of the things that you do is you use this for, you know, basically hiring, firing, promotion, and difficult conversations. But one of the things that, you know, this is. This is one of those things where, like, you can't just have. We'll call it like, corporate speak on the wall. That's like, our core mindset is great teamwork, you know, or integrity or something like that. Because, like, come on, like, what. What practices? Like, our core mindset is not integrity. Definitely not. These are, like, basic rules of business. Great customer service. Okay? Like, that's. These are, like, totally expected and accepted rules of business. They can't make those your core mindsets. Your core mindset.
B
Core mindsets is not excellence in patient care. That is not a core mindset. You got to break it down further.
A
Yeah. So the way that you do this, right? If you. If you had to. If you had to think about how you. How you find core mindsets, step one is you got to look at all your people, and you got to be like, who are the best people on my team and why and what specifically? Maybe it's not even the entire person. Maybe, like, this one person is just, like, this one thing that they do is just freaking incredible. Well, let's talk about why that is. And, you know, we. We call this the sticky note exercise. We've. I've done this in my business. We've done this in a lot of other practices, have helped them through this. But the concept is you gotta just Jot down something that makes that, that, that you want to repeat that you want to clone in your practice over and over and over again. You write down those behaviors on sticky notes and then you just start sticking them on a board and you can do this exercise yourself. You could do this with a small group of people in your organization. I wouldn't do it with everybody in your practice, but I would do it with people who are in management positions. Yeah, yeah.
B
And, and it's really, if you think about it, it's like, how is it that we're gonna figure out what are the characteristics of the people we wanna hire? And so you start thinking about your people and you start thinking about who does whatever exceptionally well, that if you could, you'd love to clone em just for that one characteristic. Cause there may be other aspects of that person's characteristics that you don't wanna clone. And so, and it's a good, I think if with your leadership team, I think it's a really good workshop to go through to sit down and actually just write the name of that person, what that characteristic is to. And you, and you just don't even judge it. You just stick it up on the board and you, and, and you brainstorm no bad ideas. Just what are the. Who is it that I'd love to clone for this characteristic? Yep.
A
And then you get like, let's just say you get like 20 sticky notes on the board. You're not going to have 20 core mindsets. You're going to have like three to five core mindsets. Because if you, again, these are rules that are rules of engagement. And then you kind of have to ask what are the three to five most common behavioral themes among those particular team members? And how would you describe the underlying mindset? Within a few words. And then you're going to have to actually describe it in a lot of detail. So the first thing that you have to do is you have to basically take these sticky notes. You got to sort them. And I would recommend at this point, and I've actually looked at, literally did this a couple weeks ago, is we took a picture of the board and we let AI sort it and said, and said, oh, hey, you know, we're trying to sort this into three categories. And AI kind of struggled, but like it gave us an idea of how to take basically a messy board and to say, okay, let's put it into at least like three sides of the board. And then we. And AI is smart enough to read your sticky notes as long as your handwriting is not awful. And then we started by sorting it, and then we sorted again. And then we applied some human intelligence. And then you would end up basically with that call. Three to five rules of engagement inside of your practice. And the. I mean, there are a few examples we could probably give, but I think I'll take one from the book where I think this one's in. The book was like, you can say something like, patient first decision making. Okay, so fine, that's a core mindset, patient first decision making. But how do you, how does someone know if they have that or not? And the way that you do that is you have to make sure that, that, that, that you have a description of it. Right. So you have to say something like, we make decisions based on what's best for the patient, not what's fastest, not what's easiest, not what's most convenient for us. Whether it's scheduling, clarifying policies, resolving concerns, or patient needs. All patient needs guide our actions. Right. So for example, you would then tell a couple stories. If patient first decision making, you would have to then be able to take the words. So you can kind of say, is this patient first decision making or is this not patient first decision making? Then you add, you take the paragraph that your team can read and say, okay, that's a description of it. And then for the next, like, year, you have to identify different things that are happening in your practice and celebrate them as patient first decision making. And you need to say, hey, Susie was awesome at patient first decision making last Tuesday when she did that one thing right. She could have saved herself a minute in, you know, basically pointing the patient towards the to. Towards you know, cubicle number five or whatever, or stall number five. But she actually got up and walked the patient over and explained to them that, you know, it. That their glasses were ready and the optician was going to help them fit them and really made the patient feel comfortable. And really it was a patient first sort of scenario where that, where that particular thing happened. You can describe the smallest thing, thing that happens in your office that is a success and describe it in the context of those particular core mindsets. Hopefully that makes sense. Yeah.
B
And there are, in the book, there's a ton of examples of exactly the detail, but you guys, I think get the idea. Yeah.
A
And I think that's the, you know, that's the key part, is that you get, in order to make these things real, you got to constantly educate people on them. You have to reinforce them. You have to recognize people when they. And they do this well, and then like you said earlier, you got to be able to hire fire and, you know, promote and have difficult conversations with people when they're not meeting those expectations. But that's what leads into getting the right people on the bus. Because once you have your core mindsets designed, developed, right, we say you got to do that first because then you know what the rules of engagement are in your practice. Once you know what the rules of engagement are in your practice, then you can identify who is following those rules of engagement. And in the book, we kind of give you like a one minute way of, of figuring out whether people are following it. You want to kind of COVID that, Jamie.
B
Yeah. So that is referred to as the one minute team check. And basically, you know, we teach you to create a grid essentially that has on the X axis, performance, and on the Y axis going up would be the core mindset. And you take your core mindsets and you plug each one of your member team members and where they fit, what quadrant are they? You'll find is that if you think of that quadrant and it's easier to do if we had a graphic, but if they're high performers, but they. In the organization. So think, think about it. The high performer in the organization may be very difficult, may be very selective in what patients they choose to help, but super high performer, but they're low on the core mindsets. You put a star in the lower right hand quadrant, you know, if they. And what you're looking for are people that are high performers. So that would be high on the x axis to the right and high on the Y axis of core mindsets. And you sort of map out your staff and where each person resides. Take it from there, Eugene.
A
Yeah. So then you got your all stars, which are the people that you would want to keep at all costs, right? Then that. The easy one is low core mindset, low performance, right? Those are. We call them the rats. You got to exterminate them out of your organization at all costs. Again, you'll spend whatever you need to spend to get those people out there. Bad at their job. They're bad at. They don't have your. They're bad at following your rules. Get them out, right? And you'll pay whatever to get them out.
B
The tricky part, low on core mindset, low on performance. Those are. That's the only quadrant. That's the real easy one. Yeah, go to the. Go to the next.
A
So then the. I think the, the other two are equally hard, right? You got high core mindsets. So these are Great people. They're super, you know, they're super great at following your rules. They're awesome, you know, whatever, but they're just bad at their job. So. High core mindset, low performance. We call those guys the puppies. And they're like, they're exactly like puppies in that context of the fact that they're, they're gonna, they're really fun to be around. They're great, they're good people. They're, they're whatever. But like sometimes they just make a mess and like, you can't really always count on them to, to, to do what you expect out of them. And, and these are the tough ones.
B
These are, these are super nice human beings. They happen to be very high on the core mindset, but their performance is terrible.
A
So.
B
And they're the most, they're one of the most difficult because they're super nice people. They're just not going to help your business.
A
And that's the thing is sometimes those are the people that got you to where you are today, but they're not the people who are going to take you to where you want to be later. And it's possible that the business has evolved past those people. And they know everything. They're nice to everybody. The patients might like them or whatever, but they just, they keep making mistakes or they don't know how to operate the new thing or you switch dhrs and they refused, they basically refused to catch up. You know, whatever, whatever that thing is, you know, that's just not, it's, it's keeping them from, from being successful. The puppies. What we say is the puppies need a 90 day plan and you got to stick to that plan. As hard as it seems like you got to, you got to put that puppy up for adoption if, and let them, let them pursue excellence elsewhere. It's good for your business and it's also good for them in order to, in order to move forward. So you gotta have a 90 day plan.
B
And if you're, if you're listening, I'm sure you already know who your puppy dogs are just from that description. But they need to be put on a 90 day plan.
A
Yeah. And the other category that's really hard is that pull people who are really great at their jobs, but they operate on, on their own rules, right? They, they are an exception to all of the core mindsets, right? They, if you got three to five core mindsets, maybe they're good at one or two of them, but they, but they are generally just they because they're such high performers, they think they're untouchable. They're never going to get fired because, you know, maybe they're. Maybe they're great with patience and maybe they're jerks to everybody else and you tolerate them because they have a good revenue per patient. But the thing is, the problem with those people is that even if they have great skills but really bad core mindsets, the problem is they're driving away your All Stars. They are the people. They are the reason why the All Stars leave. Because the All Stars are like, man, that is a difficult person to work with. Or that person, I don't understand why we have rules because that person certainly doesn't follow them. I don't want to work in a place where I'm the only one following the rules.
B
Yeah. And I'm sure if you're thinking about it and you're listening, you know who your terrorists are. Those are the people. I mean, they could. So example that comes to mind. Really unbelievable. Salesperson never showed up to work on time. Always felt that they could leave early if they had some excuse to leave early while everybody else is staying till the end of the day to do the closeouts. And that closeout process like that was. The rules in this area don't really apply to me. And they are usually high performers. Right. That's what makes it harder.
A
Yeah. And that's. And so here's the deal. We actually, in the book, this is like your one minute check. In the book, we have a whole process by which you can figure out and essentially force rank performance across all of the different categories. And we talk about you, not just your core mindsets, but also the quality of work that people are doing, the quantity of work people are doing, reliability, the desire to get the job done, and the grasp that they have on the job. And so we allow you to kind of take your whole team, put them in a spreadsheet, and we call this the boss team fit calculator. We pop them in a spreadsheet and then from there, inside of that spreadsheet, what it allows you to do is to say, okay, what's the total score across all of those folks? And by the way, you can download the spreadsheet once you have the book. What's the total score that each individual has? And then you kind of have to ask yourself, what is the minimum standard that I'm willing to accept in my practice? And then you usually use that spreadsheet to start putting people on performance plans and giving them a plan by which you can measure, but I think that's. Jamie, one of the big things is that you have to be able to measure. You can't just kind of come out of the blue and say, oh yeah, your quality is terrible. Well, like define my quality or my quantity of work as terrible. If you're not measuring something, then you're not going to be able to have those conversations effectively.
B
So, yeah. And think of this as a grid that has, let's say you have five core mindsets in the practice and then you have the non negotiables. Quality, quantity, reliability and desire. And you start ranking each person. Are they, you know, are they below the minimum standard, which is a zero, are they at the minimum standard, which is a one, or are they above the minimum standard, which is a two? And then you would add up the all the categories for per employee and you get a score. This is what's great about this is you get a number and you get to decide what is the bare minimum number across all our key mindsets and the non negotiables that you're going to accept continued employment, essentially. And what is the, what are, what are the people that are sort of in the middle and what are we talking to them about to improve? So they get above that minimum core mindset threshold and if they maintain the below the minimum standard, it's an easy. You are, you are actively recruiting to replace them as they're on a course correction timeline and fee, you know, ongoing feedback, because you want them to be successful. At the same time, once you start to manage them and they tend to be below that minimum threshold, they start to look for another job. And so what's great about this is you can do this every month or every quarter and you know exactly who you're recruiting for before they hand you their resignation or you have to encourage them to pursue excellence elsewhere.
A
Yeah. And I think your, your lesson to practice, as well as I've heard it over and over again, is that you're always in recruiting mode. You're always looking for people. And even if you don't necessarily have a position open, you're always looking for people. Because the reality is that if you can bring someone on, you don't want to, you don't want to recruit out of desperation, you want to recruit you, you almost always want to have a bench.
B
Yeah. And, and, and as you grow and you have people that are managing different parts of your business and you, and many listening already do, I, I will tell you, if you put them on sodium pental, they would tell you that they will run way faster to some person they interviewed that they're excited about. It enables them to continue to course correct the people that are below the minimum standard. And without that glimmer of hope, they are going to be really slow to move on people because just giving everybody, including them, more work. And so it's really important to have this mindset that, you know, we are always recruiting because there's always going to be somebody that's falling below the line. So we're not waiting for the day they hand us the resignation to start the process of looking for someone. We're already ahead of that game. We're course correcting the below minimum threshold people and we're getting excited about the aspect of hiring this new person that I just interviewed. That seems great. Super important.
A
Yeah. So we're going to take a short break and when we come back, we're going to see if we can cover one or two more concepts inside the people system just to give our audience a little bit more detail. Hang in there and we'll be right back on the Power Hour. Hey there, it's Eugene and I want to let you in on something. So you've been to conferences before. You come home fired up and then Monday morning hits and it's back to the grind. The ideas don't stick, the plan never gets made, and six months later your practice is in the same place. So I know that pain. I've been to those conferences with you and that is not happening. At this new event called Icare Boss Live. You've heard the story of Icare Boss and now there's an event. I Care Boss Live. It's September 16th through 18th in Cleveland. Two and a half days. We're bringing together 200 of the best practice owners in eyecare for a one of a kind event that combines speakers, peer learning, mastermind groups and industry innovation. All designed around one goal. You leave with a 90 day plan and you can actually execute it and get stuff done. And we're going to tackle some real stuff. Exam only rates, revenue per patient, people problems, leadership, AI and technology, specialty growth, the things that keep people up at night. We're going after it and we're doing it in a room full of practice owners that are just as serious about growth as you are. This is not a conference, it's not a seminar. It's something different. There are only 200 spots, so if you want to be in on this, this is not publicly announced, just on this podcast. Go to thepowerpractice.com, click events, click apply now. This is invite only. It's not for everybody. So you have to apply. We'll ask you a few questions and if it's a fit, we'll invite you to register this event. Icare Boss Live is going to sell out. Do not sit on it. I invite you to apply right now. And we're back on the Power Hour. This is Eugene Shotsman, and I'm here with my good friend and co author of Icare Boss, Jamie Rosen. So we're talking about the people subsystem of the Icare business optimization scalability system. And as we're talking about it, I think what we've covered so far is the rules of engagement in your practice, which is the way. Which is core mindsets. We've also covered the ability to apply those rules, rules of engagement, to essentially force, rank and measure whether the, whether the people on your team are actually meeting minimum performance standards and really what's the minimum you're able to accept in your practice. Listen, these are foundational concepts, but the second that you apply the system, literally just follow the system step by step, then these start to fall into place. And the next concept is very similar to this as well. And this is called Zone of Genius. And actually learned this from a guy named Dan Sullivan. He has a similar concept and we've adapted it a little bit. But I think the concept is very much like you. Most people, the work that they do every single day, if they just logged every little thing that they do every single day, about 20% of the work is work that they both truly, truly enjoy and that they're really, really good at. And that's what we call the Zone of Genius. So for me, for example, recording this podcast is something I truly, truly, truly enjoy, but one example of something that I used to be good at and I used to do in my organization a long, long time ago. I thought that I was the right person to run payroll and approve payroll, payroll in my organization. And the reason I bring up that concept is I was like, okay, I had a lot of reasons why, Like, I had. Logically, I'd convinced myself that, you know, I didn't want everyone to know what everyone else made. I did, I wanted to catch mistakes. I didn't know what the patterns were that, you know, if somebody was doing something that I didn't, you know, I thought that, you know, and this was probably, we're at 200 people now. It is probably like somewhere around the 30, 40 person mark, I was still the person who had to get payroll in by 7pm you know, every other Tuesday or whatever it was. And so the employees could get paid on Friday. And so the, the reality is that that was something that I actually was good at it. I was competent at this particular thing, so I had high skill. But I fricking hated doing it, Jamie. And so because I hated doing it, it was always, number one is it was always left to the very end. Like, if it was due at 7pm at like 6:30, I'd be like, ah, crap, I got to do that thing. It's, it's. It's, you know, it's Tuesday, darn it.
B
You know, I gotta pay my people. But I hate this thing, right?
A
I hate the stupid thing. So, like, then I'm spending a half hour doing it. It's never done to the level of diligence that I should probably do it, even though I think I'm still the best one to do it. It's also like, every minute that I'm doing it, I'm like, ah, this sucks. You know, why am I doing this? And if something more exciting comes across, like an email comes across the screen from a client, I definitely want to respond to that client. I enjoy communicating with my clients. I don't enjoy doing payroll. So, like, I'll immediately, you know, I, I'll immediately sort of squirrel away from, from, from, from the task I hate to the task that I really like. And the problem is that, I mean, a couple times payroll was late, and it kind of cost me, you know, a little bit of face with my, with my employees. But also, it was just like, it was one of those things. I'm like, why am I doing this? Like, I, I am capable of doing a good job, but I am not the best person in my organization to do this. I'm clearly in the wrong seat if I'm the master payroll writer or the master payroll approver in my organization. And eventually the person that, you know, I, I like kind of worked through all of my. After I learned this concept, I kind of logged all my time and I figured out what, what are all the things that I'm doing that are. I'm really good at it, but I have very little passion to doing that. And that was the. And that was kind of the aha moment. The aha moment for me was when I realized that there are probably other people in the world, maybe even in my organization, but other people in the world who would love to do that job for me and be extremely passionate about it. And so, like, so think about this.
B
You're looking at. You're juxtaposing capability versus enthusiasm, right? And so to the extent. This is kind of what we teach in the book, to the extent, because it's never a perfect world because everybody has chores they have to do, but to the extent that you can maximize the high capability with high enthusiasm and minimize the low enthusiasm and super, you know, capable, you get your people in what Eugene's referring to as their zone of genius. Does that make sense?
A
And. And, you know, look, if somebody is bad at something, so they're low, low competence or low, low capability and low enthusiasm about a task that is clearly frustrating the crap out of that person to be doing that job. And so, like, they don't like it and they're bad at it, and you're still making them do it. What do you think they're doing in their off time? They're looking for another job. And maybe it's a person that you absolutely fricking love, but they just hate doing payroll like me. And, you know, maybe they're also, like, not so good at it. And so, like, that's. That person is super frustrated. And the reality is that there's probably someone out there. In my case, you know, I worked through my whole thing of, like, oh, like, I don't want, like, somebody on my team knowing everybody else makes whatever. I kind of got over that, obviously, as my business matured. But at the time, I thought that was a really big deal. So, like, I asked my bookkeeper or I asked my accountant, I said, is there somebody that you know? He's like, oh, yeah, this. This awesome lady, 35 bucks an hour. Like, she'll. She'll definitely do your payroll and audit and do this and do this and do this. I was like, oh, my God, that's awesome. So, you know, I ended up contracting this lady for, like, 15 hours a week for a period of time while my business kind of worked its way up to that. But that lady was so passionate about. She freaking loved it. She found all kinds of ideas and reports, and. And my employees were happier. And so that was like. Her zone of genius is doing something that was not in my zone of genius. And so my point in introducing this concept is if you have your people log the work that they do on a daily basis, and you just do this for, like, a week, especially if it's someone who says, I'm overwhelmed at my job, have them log specific tasks that they're doing in their day and assign the amount of time that they're doing to those tasks. You know, we would call this kind of an activity audit or mapping your time or whatever. And what we do is we say, okay, for every single one of those things and we'll even give you a little worksheet to, to go with this is for every single one of those activities that this person is doing. How much of that is in their zone of genius? How much of that is just something that they're capable at, but they frickin hate it? And how much of that is in the zone of frustration? Or some of it could be in that other category of they're really passionate about it, they just need some coaching so they can learn about it. So it could get into their zone of genius if you just invested a little bit of time and they could tell you, I'm really freaking passionate about, about explaining dry eye. I really like talking about it, I'm just not that good at it yet. Like my patients say no to me, but I really want to get good at it. And if that's something they really want
B
to get good at, like give them
A
the extra time, give them the training, pair them with somebody in a different practice, or give them a coach or do you know, or have them have them watch someone who's really good. But that person could go from zone from, from low capability, which is that zone of learning and high enthusiasm, to a zone of genius. And the idea is the more stuff you put on your team's plate that is inside of their zone of genius, that's when their work doesn't feel like work. That's when they love their job, they perform at their best and they're excited about coming to work every single day. And they'll recruit other employees to you and they'll tell everybody how great you are and your, and your patients are going to feel it as well because that person is excited to be doing the job that they're sitting there doing.
B
And you probably have people, what we found, Eugene and I, when we went through this, this concept is that you're going to have people that are low capable, low enthusiasm, that are doing some function, that there's someone else that is super low capability and low enthusiasm and what they're spending their time on. And it's almost like you create the swap of a task from somebody that hates it, may be good at it, hates it, is bad at it, to somebody that loves it and is super capable at. And so it's kind of a win
A
for the practice and for the listeners. I just, I want to Challenge you to do this, because this was really transformational for me and my business career is when I map my time. And I found that I was spending about 10% of my time in my zone of genius. And then I started looking at everything else that I was doing, and I was like, man, I would really do a lot better, and I would be a lot happier with the work that I'm doing, and I would be better, better for the clients. I would be better for everybody if I could just spend more than 10% of my time doing what I love. And then I started figuring out, how do I delegate? And what I realized was there were other people in my organization that were doing things that they thought were helpful to me that I actually really love doing. So I was like, okay, I'll take that from them, but they. They'll take this from me. But the thing is, if you map your own time, you'll probably find that about maybe 20. I guess most people, when they first start this exercise, they find that about 20% of the work they do is in their zone of genius. I don't care if your zone of genius is seeing patients, fantastic. If your zone of genius is, you know, looking at practice reports, fantastic. If your zone of genius is something else, coaching people, fantastic. Whatever it is, it's different for everybody. But you got to spend more than 20% of your time in it. But how do you know until you start logging it? You really don't. And so, again, we encourage you to go grab the, Grab the book, read through it, and talk about the. And look at the tools that. That ultimately help you get there. So the other concept, and I think this kind of nicely leads into the concept of building a leadership team. And Jamie, I mean, you have built a leadership team before, and you've watched people kind of start, stop a lot of leadership teams. And I think the biggest mistake that people make is what. When. When building leaders.
B
Well, I fall in love with people that are not capable. But I, I. And I would also say that, you know, part of the bulletproofing of making that mistake is really the team fit calculator that we talk about. And then this whole concept of highly capable ear. Zone of genius. Highly capable and love it. Enthusiastic. And I think a lot of times, you know, I. And, and I do think that understanding who your puppies and terrorists and people that just need it are the rats basically, is super important as well. I think that, you know, when you start moving into measuring ways of measuring people's performance, I think it's. It it is enlightening and eliminates the disillusion or the saving souls, if you will, of saving souls. So that would be a pretty regular mistake that I see.
A
Yeah, I totally agree. I think the other mistake that I've seen practices make is that they say, hey, you're really good at one particular thing and now you're going to be the manager. And because you were just.
B
Yeah, people ascend to their level of incompetence essentially, as opposed to merit based. I think that's very important as well.
A
So. But, but that's, but that it's like a double whammy because when you say you are the best optician, like you were so good, you are the best with patients, you made the most amount of revenue per patient. You just like patients loved working with you. And so because you're so good, I'm going to make you the optical manager because you deserve the promotion. Right. Like, that's what people do all the time. But now you've double whammied yourself because you're like, I now just took a great person off the floor and I. They probably, in some cases they don't have any business managing anyone. And so because they have no business managing anyone, they now all of my people who are working for them are miserable. And this person's kind of miserable because they feel like they, they have to take the promotion because, you know, why would they say, no, it's more money. And now, you know, everybody, everybody is in a, in a mode to fail. So I think that's a, that's another one where it's like, man, if you. And I've seen that mistake made, I've made that mistake myself.
B
Me too. My best salesperson now is the manager of everybody. Terrible manager. Does not have those capabilities. Was really a great salesperson and they really should be a great salesperson, not the manager of people because they just have the capabilities. And this is what's great about the team fit calculator and the zone of genius. I mean, you start to get feedback from your people in the zone of genius where they see themselves, what they love doing, what they hate doing. And then you, and then it, then you bounce that against the team fit calculator, which is, you may love doing this, but actually I put you in the low performance category and low core mindset category. So you start to use these things as tools that interact with each other to give you a clearer picture of your people and where they should be ascending to and where they should not be ascending to. And then that whole idea of we are constantly recruiting for those people that are below the minimum threshold. You know, these different pieces work together to give you a better picture of who you should be course correcting and working with to get better on a timeline and who isn't worth that trip and who is per should be switched from doing something they really hate but they're good at to something they really love and they're good at.
A
Yeah. And in the book we kind of give you a three step process to kind of root out early leaders, meaning the people who have a lot of leadership potential in your organization, but do it in a kind of a lower risk way. And so one of those things is, you know, you build the structure as Jamie's talking about and you start using the tools and you're like, ah, this person's good at this, this person can be better at that. And as you start going through that, you realize that these are people. Like for example, if somebody understands the core mindsets and just like fully embodies them and is coaching other people just not because they're just excited to show a new hire how to get some something done. Okay, great. There's somebody who regularly gives shout outs. Okay, great. Somebody who knows their numbers. Okay. That's somebody who, who has leadership potential. Somebody who gives credit to other people on a regular basis. So we, we give you this whole list in the book of you know, kind of leadership indicators that are early and then instead of promoting that person, what we suggest you do is we say you got to create kind of a, a middle ground. Right. We kind of call them like low risk and high learning leadership opportunities. Like you could give somebody a responsibility like a, you know, a goal for a particular quarter that or maybe for multiple quarters to say, like for example, we're bringing in dry eye and you're in charge of figuring out our patient experience protocols for dry eye or you're in charge of solving why this particular. You get to own exam on these for a quarter. Right. Like you, you are the exam only police for a quarter. And then, and then see how they do. Right. Instead of promoting them and saying, and you know, a lot of people would ask us, and I guess I'll ask you Jamie, is when, when you give some of these additional responsibilities. So like for example, giving them, giving them a chance to lead a portion of a meeting on a regular basis or maybe be part of new higher training in some capacity, do you immediately compensate them additionally for the additional responsibility or what do you do?
B
Well, so it's a Mix. It depends. But I would say it's a combination of either the role is big enough where based on their compensation level they need to be compensated for, but it might be a special project. I like using special projects for people if it's a new area that they are interested in being in. So I think that sometimes works with a bonus variable comp if they accomplish the goal, which then leads to a more permanent position within the organization with that type of, that type of role. I think this sort of leads nicely into change management in a little, in a way.
A
Yeah, perfect. We got like two minutes to cover to cover one of the last sections. So let's do.
B
So what we would do is what you would, what we subscribe practice is doing is they, they have a carved out time where the leadership of the practices works on the business, not in the business. They actually make an hour every month, every quarter to talk about ways in which we could help grow the practice, enhance the experience for the patients and enhance the experience for the employees. And there, there always needs to be a metric driven approach. So for example, you may say well we could increase prices by $5, that's something we might be able to do. And then you look at what would that impact the business? What kind of impact does a five dollar increase mean? What kind of impact would getting just 5% better at exam only or 5% better at annual supplies, or 5% better at multiple pairs. And so through this group you are listing these ideas to grow the business and then you're calculating what's in it for the business. Is it worth, let's say you had an initiative that was going to generate 500 of savings or 500 of incremental sales in a period of time, call it a quarter. And then you trip over other ideas that when you said if we just got a little bit better, use the 5% rule, got a little bit better, 5% better, this would generate 30 or 40 or 50 or $60,000 for the practice. Clearly you're going to choose the biggest opportunity from a revenue perspective or a cost saving perspective. And then once you do that, we teach you and we don't have time to go through it all, but we teach you basically how to plan for the rollout of this new initiative. Not just decide to roll it out tomorrow, but actually plan, intentionally plan, making sure you have identified a point person which could be that person that you think has high capability and high enthusiasm for this particular change. And they became the point person. And their job is to report back every single day. On how we move the needle before you've rolled it out. Then we go through, what is the rollout strategy? Why is the practice turning directions? In other words, this is not the flavor of the month. Because if you're in a practice where you come back with a lot of great ideas after a conference, your people know, if I keep my head down low, this too, will pass, and we can get back to the routine stuff that we were doing before. This is you actively identifying, you know, how are we going to roll this out? Why are we doing this? What's the benefit? What's in it for my staff? If we hit the goal, that $60,000 goal, what's in it for them? So you align incentives, and then you start looking and thinking about what are the behaviors that lead to the goal. So that's a very short version, Eugene, but essentially, this is a tool that you use every time you want to change a direction in the organization and add an additional incentive, an additional initiative to help build and grow the practice. And we go through that in. In a lot of detail. We spent a whole hour on that.
A
Yeah, yeah. No, this is. And this is such a fricking powerful concept. I think a lot of people. What. What they. What this allows you to do, and we'll cover this in future shows, is it allows you to get the whole team unified behind an initiative for growth instead of having a shower thought every single month or every single week and to say, here's another thing we should do. Here's another thing we should do. Here's another thing. What this allows you to do is focus, because you know that, as you say, Jamie, it's worth the trip to focus on that particular initiative and then to go through the process of actually executing the initiative to its fullest potential, rather than just saying, oh, we should, and then leave it there. So I think we have to call it a day for the. For. For this one of the monthly series. Hopefully you enjoyed it. We are very much looking forward to your feedback. If you're listening, Jamie and I want to hear from you. We want to hear your thoughts. We want to hear what else you want from us as we kind of continue this series, because over the course of next five months, you're going to hear from us once a month. And we want to make sure these episodes are as useful to you as possible. And if you already got the book, you could probably kind of listen along and double check here, you know, after you. Some people learn by reading. Some people learn by listening. Some people learn with both but we're excited to share these concepts with you. And honestly, part of it is just, it's a roadmap that is a bunch of shortcuts that prevent that hopefully help prevent a lot of mistakes that we made and also a lot of mistakes that we witnessed other people making on the road to. On their journey to success so that you can get to where you want to be faster. Thank you all for listening. Jamie, any final words?
B
No, I just say that, you know, you should probably at least give it a quick read because I think what you'll find is a these are thought compelling. The tools are there to give you a starting point. Don't feel free to tweak the tools. But I would just say this is not like theoretical stuff. This is the reason we did this is because we wanted super applicable actionable things you could do and take back to your practice without having to go through. As Eugene said, the bumps and bruises that we went through as we were trying to approximate success in our businesses.
A
And the key part is that the book is accompanied by a whole bunch of tools and toolkit that is complete. So every single thing we talk about, there is a tool you can download, you can use at your next meeting and just implement, implement, implement. That would be the. Jamie and I are both not fans of informational entertainment or infotainment. We are big fans of taking action and we hope that you have enough from this show to do so. We'd love to hear from you. Thanks everybody for the for listening today and we'll be back at you in a month. See ya.
Host: Eugene Shotsman | Guest: Jamie Rosen
Episode Date: May 22, 2026
In this episode, Eugene Shotsman and Jamie Rosen kick off a five-part “I Care Boss” series focusing on the critical systems that help eye care practices scale—zeroing in on the “People System.” Drawing from their own industry experience, they outline how to intentionally manage and build high-performing teams in optometry practices by developing core mindsets, establishing clear standards, and building systems for accountability, leadership, and change. The conversation is packed with actionable insights and real-world examples.
“The missing ingredient was actually how do we manage the people side of the equation.”
– Jamie [06:43]
“You can have great growth ideas, great technology, great marketing, great intentions, but if you don’t have the right people in the right seats, operating with the right mindsets, it becomes very hard to execute anything consistently.”
– Eugene [00:59]
Five pillars:
“You can literally script down to the freaking word exactly what those people need to say. But if it is not delivered with empathy, with charisma, with genuine care—the experience is not human, and therefore the whole thing is lost.”
– Eugene [15:21]
“Core mindsets is not ‘excellence in patient care.’ That is not a core mindset. You gotta break it down further.”
– Jamie [18:23]
“The puppies need a 90-day plan and you gotta stick to that plan. As hard as it seems, you gotta put that puppy up for adoption… It’s good for your business and it’s also good for them.”
– Eugene [27:39]
“If you have your people log the work that they do on a daily basis… you just do this for like a week, especially if it's someone who says, ‘I'm overwhelmed at my job,’ have them log specific tasks… The more stuff you put on your team's plate that is inside of their zone of genius, that's when their work doesn't feel like work.”
– Eugene [44:36]
“You build the structure as Jamie is talking about and start using the tools and you're like, ah, this person's good at this. This person can be better at that… If somebody understands the core mindsets… is coaching other people just because they're excited to show a new hire how to get something done—okay, great. That's somebody who… has leadership potential.”
– Eugene [51:46]
“This is a tool that you use every time you want to change a direction in the organization and add an additional incentive, an additional initiative to help build and grow the practice.”
– Jamie [56:29]
On the biggest issue in practice management:
“Almost always, people is the number one issue in a practice.”
– Eugene [06:43]
On practical application of mindset:
“Patients can absolutely sense… whether the person who is in front of you is basically just doing their job and checking a box… or they’re actually invested in your success as a patient.”
– Eugene [15:21]
On “puppies” and low performers:
“They are the most difficult because they’re super nice people. They’re just not going to help your business.”
– Jamie [27:33]
Culture killers:
“They’re the people who are the reason why your All Stars leave. Because the All Stars are like, man, that is a difficult person to work with. Or that person, I don’t understand why we have rules because that person certainly doesn’t follow them.”
– Eugene [28:41]
On recruiting:
“You are always recruiting because there’s always going to be somebody that’s falling below the line… We’re not waiting for the day they hand us their resignation to start the process of looking for someone. We’re already ahead of that game.”
– Jamie [33:52]
On actionable tools:
“This is not like theoretical stuff. This is the reason we did this is because we wanted super applicable, actionable things you could do and take back to your practice without having to go through…the bumps and bruises that we went through.”
– Jamie [59:33]
All referenced tools are available in the “I Care Boss” book and accompanying toolkit.
Conversational, anecdotal, highly practical, transparent about mistakes and best practices—designed to be a learning resource for growth-minded optometric practice owners.
Summary prepared for Power Hour Optometry listeners
For more, go to PowerPractice.com