Podcast Summary: Power Hour Optometry

Episode: Why Getting "Back to Basics" Is the Most Profitable Move for 2026 — with Gary Gerber

Host: Eugene Shatsman
Guest: Gary Gerber
Date: January 2, 2026

Overview

This episode kicks off Season 14 of the Power Hour with optometry industry consultant Gary Gerber. In the wake of a challenging 2025, filled with economic headwinds, staffing headaches, and shifting patient habits, Eugene and Gary advocate for a strategic "Back to Basics" approach. The conversation unpacks how revisiting and perfecting fundamentals—like staff hiring, patient recall, pricing, and customer service—can be the most powerful and profitable moves for optometry practices in 2026.

Key Discussion Points & Insights

1. 2025 Recap: Challenges & Opportunities

[02:36]

• Tariffs shook the industry; consumer confidence hit record lows.
• Exam-only appointments were up, but optical capture rates down.
• Staffing remained the #1 issue cited by practices.
• Variability in practice performance depending on local factors.

2. Staffing Problems: Not New, Still Pressing

[03:56] – [06:22]

• Staffing headaches are universal to all small businesses ("If the guy has a gas station, bakery, retail store, pet shop, doesn’t matter—staff is always the top challenge." – Gary, 03:56)
• Mindset shift: Approach staff issues with the recognition that “we get to do this” (Eugene, 06:22), not that we’re forced.

3. Gary’s “Back to Basics” Analogy: Music & Habits

[07:01] – [10:09]

• Parallels between needing to retrain for a new style in music and practices needing to reset business habits.
• Habits that made you successful in the past aren’t always suited for the future: "You develop habits… It’s not necessarily gonna be the thing that’s gonna make you successful in the next." – Eugene, 09:09.
• Bringing in outside coaching for that “last 10%” performance improvement pays off.

4. Revisiting Practice Operations—Stop Running on Autopilot

[10:09] – [13:01]

• Challenge inherited routines: Office hours, pricing, recall schedules.
• Simple exercises: Don’t just self-select—gather real patient feedback the right way.
• Pricing tip: “Keep raising until they stop buying” (Gary, 12:06).
• Watch out for unnoticed manufacturer price increases and update your frame prices accordingly.

5. Budgeting & Financial Fundamentals

[14:09] – [15:28]

• Budgeting doesn’t have to be complicated; start simply.
• “You could say, I want to make 10% more EBITDA in my practice, and I want to keep my costs the same. Like that. That’s it. Now you have a budget.” – Gary, 14:53

6. The Growth Framework: Three Levers

[16:28] – [18:24]

• More patients
• More money per patient
• The same patients, coming back more often (“That’s it. Those are your options, because you won’t let me cut costs.” – Gary, 17:30)
• There are over 100 possible growth levers under these categories.

7. Patient Recall & Low-Hanging Fruit

[18:24] – [19:54]

• Focus on patients who had “exam only” visits—get them to return for optical purchases.
• Use targeted messaging: Adjust recall scripts based on patient prescription changes and frame trends.

8. Harnessing Feedback: Google Reviews as a Practice Diagnostic

[19:54] – [25:39]

• Poor average ratings (under 4 stars) signal systemic issues—usually staff or wait time.
• “If your reviews… are like four stars or less, and you have enough to say it’s a reasonable average… you got a problem.” – Gary, 22:43
• Use reviews for specific improvement; hold staff accountable.
• Sam Walton anecdote: Direct, in-person customer feedback is invaluable.

9. Modern Tools: AI for Review Analysis

[25:39] – [28:34]

• Use Google Gemini or similar AI tools to analyze practice reviews for recurring themes, staff mentions, and compare with competitors.
• Run ongoing analyses to spot trends and ensure continuous improvement.
• "You can leverage publicly available consumer feedback to help you figure out what you should focus on." – Eugene, 28:34

10. Technology & Human Experience: Using AI Without Losing Touch

[28:34] – [35:54]

• AI is a tool, not a replacement for genuine human connection.
• Unique practice differentiator: A real, standout customer service experience.
• “Have the world’s friendliest person answer your phone… I would pay more than I would ever pay for any AI engine.” – Gary, 31:19
• The real competitor in customer experience isn’t another OD—it’s Disney, Ritz-Carlton, Starbucks, etc.

11. Hiring for Customer Service, Not Just Tech Skills

[35:54] – [42:20]

• Reframe job ads away from “optometric tech”—seek “people with a customer service mindset.”
• Poach from outside industries (retail, banking, Starbucks, Nordstrom’s).
• Training for kindness is harder than teaching technical tasks.

12. Interview Process & Culture

[46:02] – [49:38]

• Include working interviews or shadowing; observe how candidates perceive and address the patient experience.
• Key interview questions assess mindset, not just task knowledge.
• Frontline staff (phone, greeters) make the lasting impressions and are often underpaid—the “voice of the practice.”

13. Getting Help: The Value of Outside Perspective

[50:55] – [55:29]

• Successful people, even experts, rely on outside coaches (Tiger Woods, Derek Jeter).
• ODs may have 10,000+ hours of clinical expertise but not in running a retail business—so seek external practice management help.
• “Don’t be afraid to ask for help and go outside your practice. The help is out there.” – Gary, 55:29

14. Action Steps: Profitable Moves for 2026

[56:23] – [58:22]

• Audit your basics: Pricing, recall, staff roles, patient experience.
• Test improvements on small cohorts before rolling out to all patients.
• Don’t overlook "hidden money" under your nose before investing in new technology or services.
• “Getting the basics right is going to be the most cost-effective way to grow a practice.” – Eugene, 58:22

Notable Quotes & Memorable Moments

• “If you’re a self-employed doc… you get to fix the problems. You have opportunities to fix them.” — Gary Gerber, [05:53]
• “Keep raising [frame prices] until they stop buying.” — Gary Gerber, [12:06]
• “There’s only three ways. You want basics: You either get more money, more patients, or more often.” — Gary Gerber, [17:30]
• “Getting feedback from your patients is so important and you can do it in so many different ways.” — Eugene, [25:39]
• “What a great practice niche—opportunity to be the UN-AI practice, or at least present partially to prospective patients that, yeah, we use AI, but we still have people in the practice.” — Gary Gerber, [29:32]
• “The thing they can assess… is maybe who got to the answer faster. Because they always think, ‘Oh my god, I should have said two, I shouldn’t have said one.’… That’s not a clinical skill. That’s an emotional connection.” — Gary Gerber, [32:04]
• “Most important person in my bank are the tellers. In a lot of industries, the most important person is often the least paid.” — Gary Gerber, [42:20]
• “If you don’t do this in 2026, we’ll kick off 2027 doing the same thing.” — Gary Gerber, [39:53]

Timestamps for Important Segments

• 02:36 — 2025 recap and opening challenges
• 07:01 — The musician’s mindset: why “back to basics” works
• 10:09 — Office hours, pricing, and operational habits
• 14:09 — Quick and effective budgeting for busy ODs
• 16:28 — The three levers for practice growth
• 18:24 — Patient recall and recapturing “exam only” patients
• 22:43 — Using Google reviews as a diagnostic tool
• 25:39 — Leveraging AI to analyze reviews (Gemini example)
• 29:32 — Customer service as the ultimate differentiator
• 39:53 — Why always be hiring for customer experience
• 46:02 — Interview process: shadowing and assessing attitude
• 50:55 — Why and how to get outside help for basics
• 56:23 — Testing improvements and targeting “hidden money”
• 58:22 — Summary: start with basics before new investments

Closing Thoughts

The episode champions practical, actionable steps for optometrists to drive profit and stability in 2026. Gary and Eugene urge listeners to challenge long-held habits, rigorously audit their “basics,” and invest in the patient and staff experience—before chasing new tech or fancier offerings. With the right mindset and a focus on core fundamentals, they argue, optometry practices can not only weather uncertainty but thrive.

For more detailed practice advice, visit www.PowerPractice.com or connect with Eugene at eugeneshatsman.com