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Power Hour Optometry
New Season, Proven Strategy - Gary Gerber and Eugene Shatsman talk about Must-Dos for 2026
00:59:27
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- [00:00]
A
Foreign. Welcome back to the Power Hour, Optometry's biggest and longest running show. I'm your host, Eugene Shotsman, and we are kicking off, can you believe it? Season 14. With a guest who somehow makes it feel like both a reunion and a little bit of a reset button. So Gary, Gary Gerber, he's back on the show. And if you know Gary, you already know that he's got this rare and awesome ability to take something that feels messy and. And basically say, okay, so what? Let's go fix it. So last year was definitely somewhat messy. 2025 was the year of tariffs. Super shaky, consumer confidence exam onlys capture rate being down. Staffing is a major headache. And this episode is full of solutions. But we talk about getting back to the basics as our theme for those solutions. And we're not getting back to the basics in a boring way, but in a profitable and effective way. So some of the things we talk about, staff problems. What are new parts of that? What are not new parts of that? How do you find the hidden money that you walk past every single day? What rock should you be looking under? Whether it's your hours or your pricing or your recall, we talk about AI. We might have slightly different opinions, but we end up with talking about how you leverage AI to enhance the human experience and free you up to deliver a human experience. And of course, one of Gary's strong points and one of my favorite topics to talk to Gary about is why customer service is still the real competitive advantage, especially in this world of technology. And then we talk a lot about how do you hire for customer service if. Even if it means poaching talent from completely outside the industry. So Gary has lots and lots of golden nuggets that we talk about in this conversation, but we also together revisit a pretty powerful framework about growth. You can grow three ways. More patients, more money per patient, or the same patients coming back more often. And then we get super practical and tactical about what to do with that framework starting tomorrow, this week. All right, so quick reminder, make sure that you're subscribed on YouTube, Spotify, Apple Podcasts, or wherever you listen. And if you've got an episode idea or want to connect with me directly or just tell me what you're seeing in your practice right now, visit Eugene shotsman.com, drop me a line. And now, so let's get into today's episode with Gary Gerber. It's always weird for me to say this. Gary Gerber, welcome back to the Power Hour.
- [02:34]
B
And it's never weird for me to be here. Thanks, Eugene.
- [02:37]
A
It's so, so great to kick off 2026 with you. You know, the. As we were brainstorming for the topic of the show, I want to let our listeners just in on the whole recap process. Right. If you think about what happened in 2025, it was a weird year because we had earlier in the year we had things like tariffs that impacted consumer confidence. In fact, I think consumer confidence hit the lowest low that it ever had since the University of Michigan been tracking it. At the same time, you know, we got mixed results. Some practices did better, some practices did worse. The full numbers for the entire industry aren't out yet, but we know for a fact exam onlys are up. Patients, patient capture rates just across the board tend to be down over the course of the year. And practices continue to cite issues like People as their top issue of 2025 shortly thereafter. Things like demand generation. But I would say People is still a top issue across the board. And so, Gary, as you and I kick off season 14 of the Power Hour, my question to you is, let's leverage the thousands of practices that you've helped over the years. What advice would you give to people? Big picture. And then we'll dig in.
- [03:56]
B
So when you do a look back on 2025, very few of the things that you spoke about sounded positive. Sound like a lot of like kind of headwinds that we have to deal with in 2026. And I would say to that in a respectful way, like, so what? Like whatever the issue with people's practitioners saying they still have staff challenges or people challenges, I defy you to find any small business that wouldn't answer that as their top, top challenge in their business. If the guy has a gas station, bakery, retail store, pet shop, doesn't matter. It's always about staff, staff employees. That that's like forever.
- [04:42]
A
And it's not like a new problem either. It's just one that seems like it's hitting people harder for some reason. But it might just be that is more recent because that's the one that keeps hitting me every day.
- [04:53]
B
Yeah, and that look, when you decide if you're a self employed doc, listen to this. If you're a boss, you get staff headaches when you sign your lease. Like that comes along with it. You got to pay rent every month and you have to deal with staff problems. So it's an ongoing thing you have to deal with. And when you think about, oh my God, all these challenges, what am I going to do. I always go back to the worst thing that ever happened in my optometry career. It was one where it was Covid. And here we are almost six years. I can't say post Covid because it still exists, but post pandemic shutdown chaos, we're still here, we're still talking about staff problems. The future is bright, things are good, it's still a great profession. And if you focus, if you put all your energy on the negative things that may be out there that you need to get past, I'm not going to say you shouldn't ignore them. But the future is still bright and it's still a great profession. And what a way to. I mean, I'm honored to be here to kick off the first show of the year. It's like coming to this with some positivity, with all the great things that surround optometry and your ability to be self employed. Do whatever you want and you get to fix. You, you get, you get to fix the problems. I mean, they're in front of you. You have opportunities to fix them.
- [06:22]
A
And I love what you're saying. And I always, I always try to remind people too, when we have staff meetings internally, I always try to remind people we get to do this right? No one's standing there with a gun to your head saying, like, if you don't do this, you know, I'm going to pull the trigger. It's like you get a choice and we get to do this. And if we approach it with that mindset is you also get to do something differently this year than you necessarily did last year. And as people are thinking about, and maybe they're coming into the year with a lot of that energy, what are the kinds of things that you think they should be thinking about in terms of what am I going to really focus in on or what am I really going to do this year?
- [07:01]
B
Yeah, we only have one episode, so we don't have hours to talk about this. So let me see if I can condense it down. I'll give you a little story. I think the last time I was on a show, I told you I was playing with a Jimmy Buffett tribute band. I think I may have mentioned, I.
- [07:17]
A
Even included a link to the, to the, to the band in the show.
- [07:20]
B
Thanks. Thank you. So I'm no longer with the band. It's all, it's all good. I just, at my heart, I'm a rocker and if I had to play Margaritaville one more time, even though the band was great, the Guys are great. We had huge audiences, great venues. I don't want to play Martin Redeville. I want to play, like, rock. I want to play loud, hard, progressive metal rock. That's my jam. So after being in this band and doing about 50 or 60 shows with them, you start getting into that kind of keyboard technique of playing that style. So now I want to get some auditions with some touring bands, like I was doing before Buffett. So I had to go back to the keyboard, and I had to do what I did when I was 6, 7 years old, taking piano lessons, how to play scales. I had to do exercises. I got myself a keyboard coach, a buddy of another keyboard player of mine.
- [08:11]
A
Wait, why did you have to do that, Gary? Because, like, you know, you've been doing this for a long time.
- [08:18]
B
Yeah. So just, you know, the technique of how you would play something like a song like Margaritaville or Buffett songs, they're technically very easy to play. They're not real fast. There's not a lot of changes in them. And the stuff I want to play is a lot more intricate. And I hadn't played in a while. So you start to develop, like, bad Buffet habits of playing a certain way so I could do it myself. I mean, I knew what the habits were. I knew I had to change it to get my rock chops back. But a lot of times, unless somebody is observing what you're doing in your day to day playing, you may miss a little nuance. Like your hands may be like this instead of like this. You want to shred up the keyboard. You got to move your arms a little bit more than you would think and a little bit less with your fingers. Thank you. A little stuff. And I. I know all that, but sometimes you don't catch it because you're just so in the moment.
- [09:10]
A
So because you develop habits. Right. You like. And I think when I. When I last talked to you on the show, you were super excited about touring with the band and that kind of thing. And so you gave it your all and you developed the habits that made you successful in that. In that thing, in thinking about what made you successful in that thing. It's not necessarily gonna be the thing that's gonna make you successful in the next hundred percent.
- [09:33]
B
Right? That's exactly the case. So you take that mindset, and I call it getting back to the basics. I want to play at a level up here with a rock band of tours. Right. I don't want to play like in a. I'm not. I've. I've done everything underneath it already, right. I've, I've played in bars, I've played in restaurants, I've played, played in community fair. I was like, I want to, I want to go back on tour. So to, to do it, to get up here, I decided, okay, I'm, I'm kind of like right here, but I want to go back and I'll, I'll get from here to here really quickly. It was like a month and I'm here, right? And this last bit is what I got to work on. That's when I brought my.
- [10:08]
A
That's like that last 10%.
- [10:10]
B
Yeah. That's when I brought my coach buddy in. Right. So I call the concept of getting back to basics. And if you think about the practice and doing things over and over again, if I was, if a doctor was calling me up and said, you know, 2025 was like, okay, I was break even or I was up or down 2%, it was essentially a flat ear. We get back to the basics. I may ask them a question like, what are your office hours? And they could say to me, I'm open. I'm open 9 to 5 every day except Wednesday. I'm open 9 to 7, I'm open Wednesday night. So I would say, okay, how long those been your hours? I said, oh, since I bought the practice from the other guy 10 years ago. Okay, why are you open Wednesday night until 7:00'? Clock? I'm not saying it's a bad idea, but why? Well, those are the hours I inherited. So you're running your office hours on muscle memory. So what you should do is you should check with your patients because 10 years ago, maybe in your community, Wednesday night was a really hot night. Maybe now it's not. And for quality of life reasons, you would be happier, easier. Your life would be easier if you were open Tuesday nights. So you could send out email, questionnaire or something, some kind of survey mechanism to your patients and you could say, what's the best night of the week for you to come in? And that's like really getting back to basics. That actually is an interesting example because that's. Do I just frame that up? Is not the way. If you want to answer that question, not the way to do it. Because if you did that with my example, the surveys are going to come back and say Wednesday night is the best night. Because you've already self selected people who want to come in Wednesday who can.
- [11:54]
A
I was just going to ask you about that.
- [11:55]
B
Yes, but you kind of get the concept right. You Just you got to be careful how you phrase the question. Whatever.
- [12:01]
A
You don't necessarily take for granted everything you've been doing up to this point.
- [12:06]
B
Yeah, pricing is the same thing. So, yeah, a lot of pricing. If you deal with managed vision care, a lot of pricing is dictated by the contract that you sign, but not all of it. It's not all. And not every one of your patients, hopefully, is a managed vision care patient. So you have some latitude and pricing. My general guideline with pricing, I've said this a thousand times, is keep raising until they stop buying. If they're buying a frame for $139 and it's your number one selling frame, then try it at 149 for a month and track sales, try to 159. If you push it to 179 and prices start to drop a little bit, just roll back to 169. So you went from 139 to 169, same number of units, 30 extra dollars in your pocket for doing nothing other than a little bit of work by going into your software and changing the price. On appetite.
- [13:01]
A
Well, and I'll, I'll use this to kind of plug the idea that there were a lot of manufacturer price changes that happened over the course of last year because of tariffs. And sometimes those were announced manufacturer price changes, and sometimes maybe you got a letter that said, over the next six months, we're doing our best to serve you and you know, during these challenging times, blah, blah, blah. And you may notice some price fluctuations over the next six months, but your rep might have not told you explicitly that, hey, we moved this price for this frame from X to X plus 20 or X plus 10. And if you look at your EBITDA today versus what it was a year ago, you may be surprised to know that, like, you probably should have raised price on some of these frames where you didn't. And you may be surprised. And I don't know that manufacturers are necessarily being sneaky. It's just that they, they were all hit with it too, and, like, they didn't have a really great plan for how they were going to disseminate price increases. And so some of them, you may just be selling the same frame you were selling a year ago, but you may have bought it for $17 more than you did before.
- [14:10]
B
Yep. Yeah, it's Toby getting back to basics. Right? Stay on, stay on top of your pricing and your costs. I mean, for years when I was consulting full time, I would always insist doctors have a Budget. And when they hear the word budget, they, like, turn white and, like, they just freak Gallic. They're not going to do in the, in the budget process. If you're using something like QuickBooks or any, any of the big accounting packages, it. Look, it can be, as, you know, it can be a very complex process if you decide to do that, or it can be really simple. It can be a couple clicks, click out, hit last year's profit and loss statement, and just hit a couple projections, see what your major cost categories are. You know, the super easy way to do it. 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, but you can assign a number to it. I have this much for labor. I have this much for rent, for overhead, whatever. So, yeah, that's one of the most basic, basic, fundamental building blocks is to know where your money's going. And you can do with a budget that literally can take you as long as we've been talking about it to figure out. It's not that hard.
- [15:29]
A
I think it's interesting. Let's, let's play out that exercise for a minute here. If, if I had to go to a typical practice and say, okay, so, you know, last year's EBITDA was 10% to last year's cost. I'm going to make up a number. We're $500,000. Okay? And I wanted to go, I wanted to keep my costs the same this year, but I wanted to make more money. What, what are the first few rocks that you would look under? And for round numbers, let's make it a million dollars. So I had a million dollars in costs, and I made 10%, and now I want to make 20%, and I don't want to increase my costs. What are you going to do, Gary?
- [16:10]
B
So, right. So you had a, you had a million in revenue, you said, right.
- [16:15]
A
Nothing said, let's go a million in revenue. And I had. So I. And I had 10%. So I had. So I had $900,000 in costs. Let's go with.
- [16:23]
B
All right, just so we have the, the words right. All right, and you're saying we have to keep the cost fixed.
- [16:27]
A
Yeah, let's keep the cost fixed.
- [16:29]
B
Okay, well, the only way you could do it that I can think of is you got to get more revenue.
- [16:32]
A
Revenue, right?
- [16:34]
B
Well, yeah, but I mean, the revenue top line has to be higher because you won't let me play with the middle part of the spreadsheet. Okay, Right. Yeah. So that basics either get more money, which is raise your fees to the extent you can, you get more patients, or you get this, this is my favorite one that's usually forgotten. You get the same patients you have coming back sooner, spending the same amount of money. So that points to a good recall system, which has a lot of tentacles to it with how are you doing it? What technology do you use? Are you recalling patients the way they want to be recalled? Are you trying to get emails to senior citizens who don't have emails? Are you texting to people who never respond to texts? I mean, all those things. So, yeah, so there's only three way. You want basics. You either get more money, more patients, or more often. I mean, those are your. Those. That's it. Those are your options. Because you won't let me cut costs.
- [17:31]
A
Right. So, and that's the thing is you start looking under those basic rocks and you're like, okay, well there's, and we've talked about this a little bit, is that we identified 111 different, sorry, 117 different categories that fit into those three. Because I completely agree with you. Any, any business, it doesn't just have to be, but any business can grow with more customers coming back more often, spending more money every time they visit. Right. Like that's, that's basically it. And so under those categories, I think we identified like 117 different. And Jamie Rosen and I went through this and we kind of said there's 117 different growth levers that fit into each of those categories. But you have to be, I think going back to your point is you have to be intentional about pulling those levers. You can't just stay in the lane that you've always that. That you've been in on cruise control.
- [18:24]
B
Yeah. So if they look so good, good example. If, if you look back at 2025 and you look at how many patients, how many established patients in 2024 came back in 2025 like that. If it were my practice, that would be one of the first things that I would look at, given the problem that you put before me. Because to me, talking about low hanging fruit, that's a cliche, but man, that is because if they didn't come back, well, now's the time to go full court press and get them to come back in 2026. You already went through the work of getting them associated with your practice. So the biggest initial cost is spent. Now let's get them to come Back again. And I think you may have mentioned that or I read someplace that last year 2025, this year exam onlys were higher than usual. To me, I love hearing that because what an opportunity for 2026. Get them to come back. Because now their glasses presumably are 2 years old instead of 1 years old.
- [19:49]
A
That's a really good point. That's a great framing of that problem.
- [19:54]
B
Right. So put a huge lever on those patients specifically, very targeted, that says, Sorry, you missed 2025, come back in 2026 and you can even go deeper. One of the great things with EHR is now you could say, you know what, this patient had no change in prescription. So you could say, given that your glass, you know, lucky you, you didn't have a change in prescription. Let's hope you can do it again in 2026. Dude, your glasses are now two years old. And I've already change my frame style 17 times since you got those. I have new stuff. You know, you're like, you're wearing retro frames at this point. Yeah. And you could say it in a nice way. Right. But that, that could be the message doesn't have to just be about vision. You know, we're in a retail business and I'm proud to say that I don't think we should run away from that. So yeah, what a great opportunity. All these people just had an exam. You know who they are, you know that their prescription did or did not change. The flip side of that is if they had an exam only and had a prescription change, presumably they went someplace else and now you have to work a little harder to get them back. You could ask them again via surveys. Did you go someplace else? Why did you go? Which gets me back to another basic that I love. People are so hung up on Google reviews and just kind of reviews in general and yeah, I think they're super important. Is probably one of the bigger decisions, One of the bigger drivers for patients in a while to pick a practice I would guess is probably reviews. I mean, you would know more about that than I would. But just consumerism in general, I know reviews are pretty important. Talk about basics. If you're consistently getting Google reviews. Let's back up a little bit. If your Reviews are like 4 stars or less and you have enough to say it's a reasonable average around think about five or six. Let's say you got a couple hundred reviews and you're like a four or less, you have a pretty, in my opinion, a pretty systemic problem in the practice. And if you're careful and you look at the reviews, they will tell you what the problem is. So you want a big project for 2026. I think I lost you, Eugene.
- [22:14]
A
Yeah, another power outage. Gary.
- [22:17]
B
Beautiful dancing feeling.
- [22:21]
A
Yeah, just all flickered for a second here. Okay, so you were talking about Google reviews. I'm gonna mark it. Right. And I think what I heard you say was, you know, another basics. Let's talk about Google Reviews. And if you could start there again, that would be. You were starting to formulate a really good thought and then it just all sort of died on me.
- [22:43]
B
Yep. So let's talk about Google reviews and the benefit that they can have to your practice even if you don't have a lot of good reviews. That's kind of what the premise is here. So if you're getting, if you have enough raw numbers, and I would say 75, 80, 100 is probably a reasonable amount, if you have 4, 4 stars or less as your aggregate score, you got a problem. Because if you think about it, you're in 80% practice which is like middle of bell curve. Nobody's going to a three star, two star or one star, four star maybe, but there's gonna be other fives when they look. So you gotta get higher than a four. And this concept applies to any, anybody inside those hundred reviews there's a high likelihood you're going to find something consistent, typical. My experience is usually staff. The doctor was great. The staff, not so much occasionally to call them out by name. Hopefully they do that's beneficial for you because they know what the problem is. The key thing here is how about getting back to the basics. When you used to do paper surveys back in the stone age, I used to tell the docs, don't ask the question if you're not willing to fix a recurring problem. So if they keep saying that staff number X is just not happening and they were rude and they were harsh or whatever, you got to have a sit down or you got to ask that person to find their happiness elsewhere if they say that. Another common complaint is I had a 1 o' clock appointment, I didn't see the doctor until 2:30. It's going to happen every now and then, but again if this comes up consistently, you have a problem you got to fix, you need to fix it. You fix those. That person, if they gave you a four and you're on time, they would have given you a five. That was their complaint. In fact, very often they say I would have given you five stars were not for the fact that and Then they tell you what the problem is. So talk about a great teaching tool. It's coming from your customer patient to tell you what's wrong with your practice. So getting back to the basics, think of the most basic retail scientist, if you will, was Sam Walton, the founder of Walmart and one of his best techniques before Al Gore invented the Internet, what he would do is he would walk into a store and managers knew who he was. Some of his customers knew who, some of his frontline employees would know who he was, most didn't, but none of the customers knew who he was. And he would walk in and he would do what Mayor Koch used to do in New York City. He'd just walk up and he would say, how we doing? And they say, who are you? And he'd say, I'm the guy who runs the store. And they would tell him either this is good or this is not good. And if he heard enough, he would change it. Like that's how he did his consumer research.
- [25:40]
A
That's funny, that's great. But that's in itself. Let's back up for a second because you're absolutely right. Getting feedback from your patients is so important and you can do it in so many different ways. Number one, like I agree with you reviews. Now I want to add a little bit of technology to the approach on leveraging reviews. Because even if you have 4.8 stars, you know, even if you think you're a rock star and it looks like you're a rock star and you might be a rock star, here's the thing you can do you. Because it's hard for us, and especially for practices that have hundreds and hundreds and hundreds of reviews, it's hard for us to read those reviews and not react emotionally to one time things, right? But what we could do is we could go to Gemini, which is Google's AI tool, right? And we could ask Gemini, we put in a relatively straightforward prompt to analyze the reviews in my practice, which Gemini has access to because it has the same company that has your Google business profile where everybody's leaving the reviews. So you attack, you do tell Gemini, go read my reviews. And I would do exactly what you said, which is say, tell me why. If anybody, if anybody said I can do anything better, tally that up, how many times that happens and tell me what those things are. If any staff member is mentioned by name, good or bad, then tell me why and tell me how many times. If any doctor is mentioned by name, tell me why and tell me and tell me how many times can you kind of build out this prompt that allows you to do an analysis of your Google reviews? And then I would go back and I would say, and tell me how that's changed in the last year. Three months, six months, depending on how many reviews you have. It might not have changed very much if you only have 100 reviews. So you got a big practice with a thousand reviews that's getting, you know, 100 reviews a month. You can learn from those reviews, even if they're all five star. Even sometimes the five star reviews are like, great practice. I wish they would have blah, but, you know, I wish the glasses didn't take so long, but they've got a great selection. So listen to what your customers are saying and you can use technology to tally that up. And then the master. The kind of the ninja. The ninja kind of tip on that is, okay, so step one is do it once. Step two is do it multiple times throughout the year so you can identify trends. But step three is do it on your competitors and then have Google or have Gemini compare and say, how is my practice? How is this practice received compared to this practice by the customers? What is that practice getting? Doing better, seemingly, versus this practice? What is this practice doing? Seeing versus the seller practice? And you can get, you can leverage that publicly available consumer feedback to help you figure out what you should focus on to see how we're doing. I know it's the Sam Walton, how are we doing? But, like, now you have the opportunity to get hundreds and hundreds of points of input.
- [28:35]
B
Yeah, I couldn't agree more. And back in the Stone Age, we did it with pieces of paper and surveys. So what a great use of AI I'm glad you brought up AI because I knew eventually, sooner or later, every optometric discussion winds up, including AI not opposed to AI I use it. I use it in my music. I don't abuse it. I use it. Don't know if you know this, Eugene, that talk about AI in music. There is now a number one song on Billboard that was 100% created with AI it's called Walk My Walk. It's a country song.
- [29:16]
A
Is that 100% AI?
- [29:18]
B
100% vocals, music, everything.
- [29:22]
A
That's crazy.
- [29:23]
B
Yeah. Made to Billboard charts, right? None of my songs are made to Billboard charts. Maybe I should start using AI more.
- [29:29]
A
I don't know how you feel about AI but it sounds like it's working for someone.
- [29:32]
B
Yeah. So I think one of the things in the category getting back to basics is doctors are besieged with things that are generally new like, if you open up your email, they're not going to say, we have this really cool manual pump chair and stand that you should buy. Like, you're not going to get that email. So you're going to get. What's the latest diagnostic tool that may have AI inside of it or an AI connection. AI as a standalone with different tools that are using AI Customer service side of AI. Virtual assistants, maybe. Virtual AI assistants, if that's the right terminology. And I'm not opposed to any of that, but I think when you get so much of that in the entire world, every day, hear something about AI, What a great practice, niche, opportunity to be the UN AI practice, or at least present partially to prospective patients that, yeah, we, we use AI, but we still have people in the practice. And I know you can use telephones to pick up the practice and help book appointments. And maybe as a first step, that's okay. But, you know, here's a novel concept. How about having a crazy, insane, great staff member answer your phone like the most friendliest person on earth answer your phone? I would take that over AI and I would pay him a ton of money, and I would pay more than I would ever pay for any AI engine. Maybe AI is free to do that, but whatever. The point is.
- [31:19]
A
Oh, it's not free. And at the same time, I get your point, because it's an impression. And wherever you can deliver that impression, you're absolutely right. That that's the thing that helps differentiate. Now, if you can't do that right, fine, maybe AI can answer your phone. But you have the world's friendliest person greet the patient when they walk in the door, and they give them hot chocolate and freaking, you know, chocolate chip cookies and, and they give them a water and they. And they give their kids a coloring book or something. I, you know, whatever that looks like. But I think your point is, how about we take care of people with a human connection at some point in the patient journey.
- [32:04]
B
Yeah. And it's an opportunity that is right in front of you. I think about the fact that patients and prospective patients are exposed to this AI message routinely. And I remember I used to tell doctors we would always have. Our company philosophy at the power practice back then was highly focused on customer service. Like, yeah, you got to be a good clinician, but having good clinical skills are a baseline expectation of the patient. They think that you will know what you're doing when they come to see you, and they don't think that your phoropter is any better than a guy down the street. So if you ask him which is a better one or two, and the other guy asked him which is better one or two, they don't have the ability to make an assessment of who did that better. The thing they can assess with that particular task 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, wanted me to get the wrong pair of glasses. So who, in their dialogue addressed that concern? And that's not a clinical skill. That's an emotional connection with the patient. Those are the words that you use in the whole mojo with a practice. But take. Take that out of the equation. The whole customer service experience around the eye exam is something that you can really separate yourself from your competitors by going above and beyond. So I used to tell docs, they would say, oh, the guy down the street just bought an OCT and I can't afford an October. And I said, if patients go there, whatever they're going to go, you want them to come to you. Get the word out that you are the customer service Jedi. Because the way you're going to beat this guy, if you have an OCT and he has one, we're back to a faropter, except it just costs a lot more money. So the competitor. My point here, and getting back to the basics, this has always been the case. The competitor for your practice is not the guy down the street. I'm in Southern California, so if I was practicing, when I see a patient Monday morning, I'm going to really hope that they didn't go to Disney on Sunday or they didn't just come back from a Ritz Carlton vacation and see me, because that's where their brain is in this high customer service module. I don't know if I can beat that. We can do pretty good. I don't know if I can beat Ritz Carlton. I'm going to try and Disney, but that's the opportunity we used to get survey responses back. And they would talk about, the glasses were cool. My exam was good. But I can't believe what you said were hot chocolate. I can't believe that when I walked in, they had my coffee ready the way that I like it. And we did that because the first time we put it in the ehr how they liked their coffee so we didn't have to ask them the second time. That's right out of Carlton playbook. Forgetting the newspaper.
- [34:49]
A
That's. That's gold. That's gold, Gary. That's great. Right?
- [34:53]
B
And that's something that most people won't take the effort to do something like that. So yeah, getting back to the basics is realize that the real competitors in this industry are not guys freak out over online eyeglass sales and corporate optometry. If you're an independent, there's enough patience to go around. Like that should not be an issue. You want to really separate yourself. You can use AI on the customer service side, but don't let it be a substitute for what you said. A friendly face, a greeter, the person that pours the coffee, the person that's smart enough to put it in the ehr. It's another tool. Same thing with virtual assistants. I think they have a place and that's probably a hybrid someplace between AI and a real person as opposed to a fake person. I don't know if that's a phrase, but you get the idea.
- [35:44]
A
We call it agentic calculations. Right?
- [35:48]
B
Yeah. So it's such AI is great, but what an opportunity to not use it.
- [35:55]
A
Well or, or to enable yourself to be free for the human connection. That's my, My thesis is not that you should avoid it. My thesis is you should leverage it so that you can have more time to get the FaceTime human connection with the patient. So take the crap off your plate so that you can really be that customer service ninja. Now my worry is, Gary, and this is maybe a. Maybe you've got a solution for this, is that we're not really hiring or training customer service ninjas. And you know, I'm worried as I talk to more and more practices like they. I have a friend who likes to say, well, you know, our hiring policy is that we put a mirror in front of your. And if you can, if your breath can fog up a mirror, then you know, you're, you're hired. You know, like, that's, that's kind of the. That, that's. That's our hiring policy. So I'm a little worried that I think in today's environment we're on this downward spiral of like, I'm willing to pay for what I get and I'm not getting very much, not willing to pay very much. And that person leaves and whatever minimal skills they had leave with that person so that I'm willing to hire someone and then I'm going to not have the capacity to train them because my other staff are already overwhelmed. And so that person's going to do a crap job. And like, no one's even worried about customer service. We're like worried about operating the basic diagnostic Technology correctly at this point?
- [37:24]
B
Yeah, they hire under pressure. I tell doctors, you should always be hiring. Always. I haven't seen a patient in a long time. And when I had my practice again, pre Al Gore Internet, we had a standing ad in a newspaper, classifieds. We were always hiring. And what it did, it brought in a lot of good prospects. And it also kept our current staff on alert because the phone would ring once or twice a day. I'm calling about the add on a paper. And I would tell staff meetings, are we hiring? We're always hiring. We're always looking for somebody good. Jack Welch, the former CEO. Yeah. GE CEO. I forgot what he called it, but he had a process where every year he had his managers. You had to fire the bottom 10% of routine. It was. It was mandatory. So I didn't do that. My practice, I recommend it to our clients, but the concept, I think, is sound. Now, how do you. How do you break that cycle? Well, the first thing is the, the. The recruiting process. You have to recruit for customer service skills. I mean, one good thing about AI and technology, it's getting a lot easier for anybody to work in an office. And as far as, like, diagnostic technology, some of the stuff is like super uber autofocus. Like, you just need a staff member to tell the patient, go sit over there and look at the red light. And they're pretty much done. The machine does it from there. So technology is going that direction, which is great. But you need to hire somebody and you need to recruit for customer service skills. So instead of saying optometrist office, the headline would be optometric technician. So right away, he just took 85 million candidates down to like, 17 in your community. So that. That was a mistake right away. And you'll say, you know, we prefer somebody with experience, but if not, we will train. Well, you won't train because you don't have a training program. Your training program is do what that person does. That's your training program. And they learned it from the last one. That's bad. Telephone. Like when you're in kindergarten.
- [39:33]
A
Yeah.
- [39:34]
B
So what you need to do is you want the copy to say, we want to hire somebody who feels like they wake up every morning, they feel like they're on stage, they can't help but come to work with a smile. They love helping people. And, oh, by the way, we're optometrists. Like, that's a whole different mindset.
- [39:52]
A
Yeah, 100%.
- [39:54]
B
My office manager when I left practice was a previous manager from Nordstrom's. You Know when I saw that on a resume, I didn't tell her. She was like, immediately I had to verify she was telling the truth, but I don't want to tell her. Look, if I verify this and is it true, you're hired. I don't care about anything else. She was a manager in the shoe department in Nordstrom's. To clarify, which is obviously it's a high end retail business or was at the time. I haven't been in one in years. But those are the type of people we want in our practice. The other stuff is trainable. I think training somebody to be nice and having an outgoing, bubbly personality is probably not trainable. Maybe it is, but I think it's a lot harder than telling somebody, this is how you take visual acuities or this is how you, this is how you take a retinal photo. I think that's pretty easy to teach somebody. And telling somebody, look, if you're getting patients giving you a hard time because they think they're. Insurance should cover everything, including a doctor's car keys. That's a different skill set and it takes a different type of energy customer service DNA than the technical side. So you gotta, you gotta. Yeah. And it's, look, if doctors don't do this in 2026, we'll kick off 2027 doing the same thing.
- [41:12]
A
Well, no, you're, you're absolutely right. And the thing is, you know, to connect your previous two points is that I think if we focus less on the technical aspect of doing the job and focus more on the, on the customer service part of doing the job, then what you end up with is you're really managing the feeling that the patient has walking to your office. Right? But that coffee that you mentioned that like is made just the way I like it because you know it and you know, oh my God, I can't believe you. You guys care that much. You care enough about me to offer me that and to do it for me. That, that's a feeling, right? That's a feeling. And that feeling is only you can only achieve that feeling by people who truly enjoy serving others. Right. There's some people who are wired that way and we all know them. And those are people who have the jobs that ultimately allow them to serve other people. Now I just want to clarify, so your idea here from a basic standpoint is hire people who are great at customer service. You don't care. You don't advertise for an optometric tech. You advertise what, what do you call the job, Gary.
- [42:20]
B
Sometimes we'll say customer service rep. The challenge with that in this day and age, you get a lot of phone people like the guy who was on Verizon. Yeah, we had, I'm trying to think some of our better titles. I may have to get back to it because I'm pretty, pretty far away from doing that real time. But the concept, Eugene, you nailed the concept that you want to list the personality attributes that you're looking for. Like, that's the lead. And if we talk about burying the lead, bury the optometrist in the bottom part. Not that you're hiding it, but that really is a secondary skill set. I had a bank manager who was a patient way back, and he kind of turned me on to some of this. It was pretty big bank. It was a small regional bank, but it was one of the bigger ones in the town that I was in. And so a lot of people, a lot of locals used that bank. So it wasn't like Chase or Citibank. It was Westwood Bank. He said to me he was a patient. A lot of the tellers were patients. He said, how many of my customers? He loved coming to us. I mean, he just loved the experience. We always used to talk about stuff like this, which is another good basic. Learn from people outside optometry, not from optometrist. That's like a great, great one. So he said to me, how many people come to the bank you think know my name? And I said, I don't know, you're the boss. I think most of them. He goes up probably, probably close to like 5%. And the 5% are the ones that probably did something silly like default on a loan and had to talk to me. And they're the ones that don't like me. He said, the name that they know are the tellers that they come to see. So he goes, the most important person in my bank, people are the tellers. And he said, in a lot of industries, the most important person is often the least paid. And I thought about that. In a lot of OD practices, the person picking up the phone is often the one that's paid the least. And they are literally the voice of the practice. It could be AI be a better voice, but I never forgot that he said that. And he said, we are known for keeping people because we're one of the higher paying banks around here that pays tellers. And I thought that was a great example. You think about Starbucks is another one, or any restaurant you go to, any think of any fast Food restaurant where you might go to a lot or fast casual. Starbucks, whatever. If you go to the same Starbucks every single day, and if I said to you, what's the name of the manager? You probably don't know. If I said, what's the name of the barista? You probably do know.
- [45:02]
A
Yeah, well, that's true. And I actually, at one point, I followed this advice once and I, I did in fact hire a Starbucks manager and somebody who worked at one of the top performing Starbucks locations in the country, actually Starbucks location inside the Cleveland Clinic. But you got angry doctors shouting at you because their coffee's late. And you got, you know, and, you know, she, she was, she was fantastic because her, her mindset was service, attitude, get stuff done, get it taken care of for, for the client. And it's, it's true, I think, that you don't have to look inside your industry. And if I had advertised and her position was like a marketing project manager, if I had advertised for that, my, my pool is tiny. If, if I advertise for somebody who has that customer service attitude and who just gets stuff done and you list those attributes, then you know, you can train the rest of the. Yeah.
- [46:02]
B
And then like when they, when you do the interview over zoom or they happen to come in your office, whatever you want to ask your questions from that perspective, how would you handle a situation like this? And it's not so much in that case, probably is a big tangent, but I think it's important. It's not so much what's the exact answer that they give you, but how do they respond under pressure? Because they may know nothing about eye care. So if you said to them, well, how would you handle a situation where the patient comes in and their progressive lenses aren't working after the third redo, how would you handle that? And they're really angry. So a good response, in my opinion, to the Starbucks barista or manager answering that would be, I don't know what, doctor, I don't know what a progressive lens is. I don't know what a redo means, but it sounds like you have a patient who's not happy. So the first thing I want to do is I want to make sure the patient leaves happy. And then once I learned the technical ways of how I could do that, then I would do it. But my priority is going to be to make this person happy. So how did they respond to a question under pressure? Because to your point, when they have an angry patient, to me, that's the acid test. If they can do that then. Happy patients are easy. And most patients are happy. Yeah, most guys do a pretty good job. You know, it's the 25, 30% that keep us up at night.
- [47:20]
A
And it's interesting. I once. I talked to a dentist once, and his hiring protocol was at the time that he would invite people for an interview, and he would say, you're going to be here for 90 minutes, and if you need me to pay you for that 90 minutes, I'll pay you for that 90 minutes. You're going to be here for 90 minutes to two hours. The first 45 minutes of that interview, they actually shadowed, like, four or five key employees in their practice and supposedly watched. And they were told that the reason you're watching what's happening in the practices, because we want you to be super familiar with it, whatever. We're also going to ask you for ideas of how we. How. How we can make. How we can make the. How we can make things better. Right? We're looking for leaders, so we're looking for how we can make things better. And what this guy said. And, you know, you. So the patient watches the cleanings, and the patient watches. And the. One of the practical reasons why is if the patient got squeamish around dental crap, then, you know, they didn't really want the person, or the person got squeamish around it, and they didn't really want him working. But they said that one of the biggest things they learned, in addition to having the staff kind of evaluate that person and see if they, you know, they'd want to work with them and that they were courteous and kind to the staff, the biggest things they learned is when they asked the person, so what would you improve? Some people went to like, well, the process sucked, or some people were like, oh, the chairs are dirty, or whatever. And they got a lot of really great feedback for that. It was like, it was worth paying, you know, 20 bucks for that. But the other part that they found that the people they wanted to hire from a customer service standpoint is the ones who saw the experience from the patient's perspective, who are like, that person waited too long. Or that person seemed a little upset about the fact that, you know, their kid had to sit in the waiting room all alone while, you know, they were in there for their cleaning and the kid couldn't come with them, you know, like, that kind of thing. And it was like, oh, okay. Like, so that's the person who's got the right mindset. So I don't know. I Mean going back to the basics in terms of hiring. I like what you're saying is open up your patient or open up your pool of prospective hires by not advertising for an optometric tech or whatever other job specific thing and train that kind of stuff and really try to pull in people with the best customer service because that's ultimately what's going to differentiate.
- [49:38]
B
You in the world of AI.
- [49:40]
A
Any other basics you want to share, Gary?
- [49:42]
B
Well, you hit on something I forgot. But a second interview should be a working interview. That should be standard. Absolutely. And then yes, offer to pay them. I have what I thought you were going to say when he said he offered to pay him. He's separated by those who said pay me versus don't pay me. I've had this discussion with others. I think the person asked to be paid is probably a better hire than somebody that says they don't want to get paid because they. I think that they're going to put more value. They value themselves and their expertise, not that they want the $20. I'm like, I'm not going to work for free because I'm good. And you would have to communicate that during the process. Maybe that's a New Jersey thing. We just don't work for free in Jersey.
- [50:29]
A
In the Midwest, Gary, we're really nice and we go a long way to show people how nice we are sometimes.
- [50:35]
B
Yeah, well, optometrists across the country, they must all be from Midwest because they love doing stuff for free. That's which is.
- [50:42]
A
And we thanks them for it.
- [50:44]
B
Yeah, it's kind of the bane of being a consultant. They just like to give stuff away.
- [50:50]
A
Okay, so other basics that you think we should be focused on in 2026?
- [50:56]
B
Yeah, I think maybe a good wrap up that can put a bow around this whole thing is I mentioned that I had a keyboard coach that I worked with. It was just, it was just one session and that's all I needed. If I needed more, I would have to have him come over some more. Just sat in my studio behind me and we just watched me. I think one of the basics, especially if ODs go into this thinking I really want to turn around 2025, is to get help. And what I mean by that is which basics do you need to work on? So you need an outside observer to tell you that just like you had to. Prospective employee was an outside observer with a little bit less bias. So you think about Derek Jeter on the Yankees. Had a. Had a swing coach, a strength coach and an endurance coach. One of the best hitters in baseball, Tiger woods had coaches. If an OD is listening to this and he's self employed, he's got to start thinking about his taxes for 2026. Hopefully he or she. You're not going to do their taxes by themselves, you're going to hire somebody to do it for them. They probably could do it by themselves if they tried really hard and they spent hours on AI and Google to help them. But the odds are even with that they probably won't get as favorable a return submitted as if they had a professional do it for them. Let's hope they never get sued. But if they did, could they defend themselves in court? Yeah, that's an option. They could they settle with an insurance company. It's an option. But I would get an attorney who's got experience doing it. So getting somebody who can help coach you through this I think is a great idea. The Malcolm Gladwell book he talks about, it takes 10,000 hours to be an expert. I forgot which book it was.
- [52:46]
A
I think it was Outliers maybe.
- [52:48]
B
Yep, it was. It talks about the Beatles because I always think of music and he kind of tracks, they kind of, they kind of broke through at the Cavern in Liverpool like that was their breakthrough show. And he kind of subsequently spoke to the guys in the band, how long were they were together and sure enough was right around 10,000 hours when that happened, right. And they just started to gel as a band. And I think about how much time I spent playing when did I first get my first, you know, like real pro gig was probably somewhere in 10,000 hours. So you know, two examples in the music world but with ODS I think probably almost all of us, unless you just graduated school and you're just starting, have 10,000 hours of clinical experience. So we're clinical experts. There's no question that we know how to take care of eyes on a clinical basis. If our practice was the patient. Very few of us have 10,000 hours of practice management, building, fixing experience. So what you should do is find somebody who's got the experience, an outside expert to help you and help you get back to the basics and just drill down deeper into stuff that we spoke about. Pricing, maybe setting up a budget, which I know freaks people out, but it's a Couple clicks on QuickBooks and you're good and how to use the budget and stick to it hiring like we spoke about, what's the proper way to use AI for this particular brand of practice to keep your legacy mojo. That's been working for you not upset it. Marketing guys like yourself, who. That's all that you do. You wake up in the morning and you do marketing. You go to sleep, you're still thinking about marketing. Like that's what you do. And OD is going marketing. I can do marketing. I got a Facebook page. I'm finished. I have 700 Google reviews. I'm done. My marketing is really good. And look, maybe it is. A consultant doesn't necessarily go into a practice. A good one doesn't go into a practice, shake it by the ankles and make changes for the sake of justifying their check. They really want to support the practice to get to their state of goal, whatever it may be. In my case, I want them to transition from Jimmy Buffett to hard rock again, transition back. Just get that last kind of 10% of skill. I got. I was, I was down here with Buffett. I worked by myself. I got up to here. Can I get a little bit of help with this? And one session helped me do it. So now I'm back and I got the chops back. So I think the bow around getting back to basics is don't be afraid to ask for help and go outside your practice. The help is out there.
- [55:30]
A
Yeah. And I think one of the key parts of it, if you just want to do better in 26 than you did in 25, maybe one of the first places you look for help is getting help to figure out where you can actually do better. Maybe somebody can analyze exactly how you can do better and give you all the options. So you can say, oh, you know what? Yeah, that's the thing. And maybe people always, I think, start the year by saying, oh, you know what, I want to add this service this year or I want to buy that piece of equipment that's going to enable me to do this and this and this. And I think what you're saying is maybe that's the right move. But presumably if you look at some of the basics, sometimes the money and the hidden opportunity is under the rocks that you're walking by every single day.
- [56:22]
B
Yep.
- [56:23]
A
Yeah.
- [56:24]
B
Look what we spoke about here. Just looking at your exam onlys from last year and making a legit, concerted effort, say you had pick a number to keep it easy. You had 100 people who were exam only. Hopefully it was way, way more than that. Not that it's good to have exam only, but hopefully you had more than 100 encounters like that. So you pick a reasonable number and they said, I want to get 10% of them as something conservative. I want to make sure I'm going to really, I'm going to reach out to all of them, but I want to make a concerted effort to get those 10% back and get somebody who can help you. So if it was a marketing guy like you, they would say, okay, tell me about your practice. What are your goals? What's your practice Mojo? Let's do a couple tests. So instead of sending an email or phone call or a text, all 100, let's send only have 100. So let's send a text to two of them, an email to two of them, and a phone call. And the phone call worked a little better. Okay, let's change the script on a phone call to the next two of them. So you use of your cohort of 100, use up like maybe 10 or 15% of them by testing. And once you find the one that works the best, then you go to the remaining 85 and you stack the deck in your favor. That's something most ODs who are not expert marketers, and I'm not either. I would rely on guys like you and the team at the power practice, for example. I'm obviously biased, but they're a great bunch of folks to do something like this because they've got experience doing it. So, yeah, it's a great. You're right. You have to know, what should I be working on? And I think optometry is a pretty straightforward retail business. I mean, honestly. And I think we should call it retail because it's just a big part.
- [58:09]
A
That's where the money's made, honestly.
- [58:10]
B
Yeah, it's a big part of what we do, and we weren't trained in the nuances of retailing and there's no shame in that. So just get help from somebody else who, who has done it successfully and can help you.
- [58:23]
A
Well, Gary, I think that this episode's a great way to start the year because I think if you remind people what the basics mean and if we think about where the basics are in our practice, individually, you get a lot of value without having to hire extra staff, without having to go to go take on super expensive initiatives, you just got to find a couple key opportunities that are probably right under your nose that can help you do a lot better. And then once you've identified those, and if you really can't find them, right, maybe you get some help, maybe not. But if you really, okay, I've exhausted all those opportunities, then bring in the new stuff. Then bring in the stuff that ultimately makes a big splash but I think getting the basics right, it's going to be the most cost effective way to grow practice.
- [59:12]
B
Absolutely. Good episode, Eugene. Thanks for having me, man.
- [59:16]
A
Thanks for joining me on the Power Hour. Gary, always a pleasure.
- [59:20]
B
Anytime.