How can the field of optometry break down barriers and promote equity while addressing the complex issues of race and racism?
Join Bethany and Dr. Adam Ramsey, optometrist and co-founder of Black Eyecare Perspectives, as they engage in a candid and enlightening discussion on the often challenging topic of race and racism within the optometry field, focusing on the experiences of minority optometrists.
Dr. Ramsey emphasizes the importance of recognizing and embracing diversity while fostering safe spaces for open conversations about race. He underscores that discussing race doesn’t inherently make someone racist; it’s about the intent and context of the conversation. The episode delves into the pressures and challenges faced by minority students and practitioners, as well as the significance of building connections and rapport with patients.
This insightful episode encourages listeners to reflect on their own perceptions, biases, and the need for greater inclusivity in the optometry profession.
September 20, 2023
Read the Transcription
Becca Starks: We have the ear with the students to hear what they’re looking for. They’re very, very few students that we’re working with, with the class of 2023 that will even consider an opportunity that is not private practice.
Dr. Bethany Fishbein: Hey, I am Bethany Fishbein. I am the CEO of The Power Practice and Host of The Power Hour Optometry Podcast. And I just want to first congratulate all of the new optometrists graduating this week from the optometry schools across the country. It’s such an exciting time. It doesn’t feel like that long ago since I and my classmates at New England College of Optometry in 1997 graduated. It goes fast. It’s really an exciting time. So congratulations, first of all, and this show is inspired by and dedicated to you and all of the people that you are hoping will hire you. Once you get your licenses and get out there into the world. So I’ve invited a guest, I have Becca Starks, Becca handles Enterprise Accounts and Operations for KMK Careers. And she’s here to help me sort out some of the things that today’s optometry students are looking for, and help educate some of the optometrists who are looking to hire young optometrists about misconceptions they may have or differing perceptions of this graduating class. So, Becca, thanks for doing this your second podcast ever. That’s awesome.
Becca Starks: Yes, thank you for having me. This is exciting.
Dr. Bethany Fishbein: Yeah, thank you. It’s an interesting time because we work with mostly established optometric practice owners. So most of the people that I’m speaking to day to day are employers of young optometrists, and they have this vision of what today’s graduates are like, and then I get the opportunity to speak with optometry students and recent grads and they’re not necessarily like that perception at all. So hopefully, you can help us bridge the gap a little bit.
Becca Starks: Yeah, absolutely.
Dr.Bethany Fishbein: So, talk about yourself for a minute here. I want you to just talk about KMK and KMK Careers because when I want to data on students, I knew you were the one to go to. And so I want all of my listeners to understand your involvement with young optometrists today.
Becca Starks: Yeah, absolutely. So KMK for those that don’t know KMK’s foundation is the KMK board review, which was started 18 years ago by Dr. Kyle Cheatham. And now fast forward 18 years we are inside of all of the 23 optometry schools nationwide. We have a team of optometrist instructors that traveled to all of the schools and we have a relationship with both third and fourth-year optometry students and 98, This is a big number to remember 98% of optometry students utilize KMK to pass their boards. So essentially we have a relationship with almost every single optometry student nationwide from the board’s perspective. And so we now have a new division of KMK specifically on careers which is just a natural extension of supporting those same students and finding their first career.
Dr.Bethany Fishbein: So you’re initially talking to these students when they’re students studying for boards. And then they hopefully pass boards and you know, move on and take more boards and pass those and move on. So what are the services that you’re providing for these students once they’ve graduated as doctors?
Becca Starks: Yeah, so it’s really fun. Personally, I am mostly an employee you’re facing so those that are looking for these candidates. However, we have a team of career advisors and all day long, they’re the luckiest ones in the world. They get to speak to these upcoming grads. So right now they are around the clock talking to those that are about to graduate here and a couple of weeks or maybe have graduated just recently. And uncovering what they’re looking for in a practice is really it’s a one-on-one relationship, so it’s totally free to students. They sign up to get a career advisor. They have calls with that career advisor to uncover what are they looking for what type of practice is it specific specialties, just anything that may be the true motivating factor as to why they want to go to a certain practice. And then essentially we play matchmaker so the career advisors speak to students all day long. I speak to employers all day long, and then we come together and get to build a bridge between the two and hopefully connect great candidates with a great opportunity.
Dr.Bethany Fishbein: Maybe it’ll be the next Netflix show after Indian matchmaking, Jewish matchmaking. It’ll be optometric career matchmaking. And be a celebrity.
Becca Starks: I think some of us would watch that, at least your listeners would probably enjoy that.
Dr.Bethany Fishbein: My husband and I would watch it so
Becca Starks: same.
Dr.Bethany Fishbein: So I mean, you’ve got a line of sight into exactly who today’s optometrists or today’s graduating class, today’s brand new optometrists are, can you give some facts and figures of what that class looks like?
Becca Starks: Yeah, so essentially, from a demographic perspective, it’s highly female. The data is showing 70% female and 30% Male.
Dr.Bethany Fishbein: 70?
Becca Starks: 70 Percent.
Dr.Bethany Fishbein: Wow.
Becca Starks: Yes. And there’s information I believe you are going to be able to put in the show notes. But there is a really robust report. I believe it’s lots and lots of pages. I don’t remember how many but there are highlights within that on pages nine and 10 that give a really good but really quick summary of demographics of this class, within gender within race. There’s even financial information about how many needed to have financial aid, that sort of thing, and some really detailed information even about by school breakdown.
Dr.Bethany Fishbein: Are you able to roll through some of the things in there that kind of stood out to you?
Becca Starks: So the biggest thing that stands out to me is female and how as you it shows kind of year over year how that transition has changed from much more female than male as it was in the past. Same thing with race, I believe I don’t remember how many years ago it was but just not too long ago. It was predominantly white for professionals graduating and now that’s shifted to highly other races, whether it’s Asian or black or other races that are included in that.
Dr.Bethany Fishbein: And what about the financial piece? Because I feel like that’s such a big topic for new doctors. Is this need to pay back student loans? Do you have any stats on the amount of debt that students are graduating with?
Becca Starks: Yeah, so the report itself shows 85% of students are utilizing some type of support financial aid, loans, and the average for a graduate right now graduating is about $200,000 in debt. So definitely it is.
Dr.Bethany Fishbein: That’s just from optometry school or that’s including undergrad debt?
Becca Starks: That’s actually a good question. We just get the stat of 200,000 and I assumed it was just optometry school. But that’s a good question.
Dr.Bethany Fishbein: So young, female, and any change in like age demographic? Or is it typically right out of college a year or two out of college starting into Optometry?
Becca Starks: Yeah, So typically, it is kind of a typical route straight out of undergrad and to optometry school. There is about of the 16-1700 graduates there are about 150 of those that are considered you know, like other avenues whether that would be part-time or returning back in at a later point in time.
Dr.Bethany Fishbein: Okay, so out of 1500 you’re talking about? Very typically, right? 1000 young, female, probably non-white doctors.
Becca Starks: Yeah.
Dr.Bethany Fishbein: If you had to say this is what’s typical. This is the majority.
Becca Starks: Yeah.
Dr.Bethany Fishbein: With debt?
Becca Starks: Yes. A lot of it.
Dr.Bethany Fishbein: Okay. So, when you talk to this typical doctor and are getting into the field of matching into a career of their dreams, what are they telling you that they want?
Becca Starks: Yeah. So it’s been interesting to learn that so the things that I came into this thinking people would want my background was actually at LinkedIn for five years before coming on to help launch this division of KMK and I thought it would be very different. I would think pay would exceed everything else. But, interestingly, location is the top deciding factor for these new graduates in determining which practice they want. Obviously, that is the hardest answer because no one can do anything about the location of their practice. But we can touch on this later. Kind of some ideas and tips for those to try to recruit folks into harder locations but definitely the location. Again, before and above pay even this work-life balance coming into play that is much more of a topic. Then I think it has been in years past. Not necessarily meaning, Hey, I want to come in and I want to never work. But this generation is much more just passionate about having that work-life balance of the work to live not live to work mentality. And so location, work-life balance, obviously pay, and structuring pay in a way that is understood to the candidate as well too. So being very upfront about what that pay is so that they know before even applying and putting that in a way that they understand what they actually can make because sometimes it can be hard with percent of production, knowing what that means.
Dr.Bethany Fishbein: So let’s go into those a little bit more and I want to just go back one to work-life balance because I think that’s probably the biggest misunderstanding between a doc maybe in their 50s and a doc in their 20s. This idea of working to live instead of living to work and it’s respectable and it’s necessary and mental health is important and it’s and life has to work for you. But these older docs, that was not their world. And so when I hear it, it’s complaints. They won’t work weekends, they don’t want to put in 40 hours. They’re asking for a four-day workweek. They’re like it’s coming across as we’re lazy. We’re not dedicated to the practice. We don’t want to be here we’re not going to work as hard as you and it. It creates a disconnect from the start like somebody interviewing, who says I don’t want to work every weekend. All of a sudden has all these judgments thrown on them that they probably don’t deserve. Do you see that with the docs that you’re talking to and you’re matching?
Becca Starks: Oh, absolutely. Yeah, it’s the same thing I hear to have. You know, that’s typically the demographic of employers that I’m talking to all day long to have, you know, they came out and maybe cold started or they came out and bought a practice and they’ve been doing it for 20-30 years and like. What?
Dr.Bethany Fishbein: Right and they remember, or maybe they’re still working 70 hours a week and they’re there, you know, every day in the practice and their day off there when the cleaning themselves because that’s what the owners do. How do you coach of 50-something and 60-something-year-old practice owners into understanding that it’s not laziness and it’s not to they don’t want to work?
Becca Starks: Yeah, so that is it is a big misconception of the students that it is laziness, and specifically, most students are expecting to work at least one to two Saturdays a month. So it’s not that they’re coming in and saying I only want four-day workweeks, and I’ll never work a weekend. They are expecting a true full work week and one or two Saturdays per month. To your question about how to coach an owner in that situation. I think it’s just taking a step back and looking really high level at your practice as a business and I’ve had this conversation with many owners of I don’t know why we are open Saturdays, honestly, we’ve just always done it and so determined are we doing this because it’s just always been done or when determining this because it is a true business need. And so same thing with later hours or that sort of thing. If it is a true business need 100% voicing that to a candidate that’s a friend and that’s that’s great, but there may be situations where again, it’s just we’re doing this because it’s been done forever. And actually, our patients wouldn’t mind if we didn’t have a late night or we had a late night instead of a Saturday or vice versa.
Dr.Bethany Fishbein: Do you think docs have like a little bit of that? It’s like that hazy mentality? Like I went through it I put in my time therefore you you need to.
Becca Starks: I think it could be a little of that. Me not being an optometrist. I have to tread lightly because I have not earned my dues. But in the conversations that I’ve had, I think it is a little bit of that at least.
Dr.Bethany Fishbein: Yeah, I worked weekends for 23 years. I’ve never missed it Saturday. I’ve never called out sick. And now I’m going to change my whole practice because this 24-year-old kid doesn’t want to work, like there’s that so what are the students are the new grads thinking about these practice owners, doctors who are in a different demographic from them because there’s got to be misconceptions going that way also.
Becca Starks: Yeah, I don’t get to hear a ton of the misconceptions from the student side. But I think there’s just both sides can teach each other something right like maybe that student can come in and show this business owner who’s been doing this forever, like, wow, I could totally do this differently. And, wow, I’m kind of relieved that you came in and brought up the idea of work-life balance because I as the business owner, really needed that, and wow, my life is different because of it and vice versa. There’s obviously so much that the practice owner can teach and pour into these new grad optometrists. But as far as misconceptions from them, I haven’t heard any to be honest.
Dr.Bethany Fishbein: I hear that they look at a private practice. They think they’re not going to be paid as much. So they’re thinking that not necessarily that the owner is cheap, but that it’s not. It’s not as profitable, therefore there’s not as much money in it for them. You didn’t mention the mode of practice. You talked about location, work-life balance, and pay. Are students coming out looking for commercial opportunities? Are they looking for private practice or looking for MD offices? I mean, obviously, students are looking for each of those, but what are you seeing most frequently?
Becca Starks: Yeah, great question. So motor practice is very important and private practice remains. Top of the list for I’d say close to 90% of the new grads.
Dr.Bethany Fishbein: Serious?
Becca Starks: Yeah, because I hear the same thing. I hear a lot from private practice owners that say that almost come to the call with me very nervous, like “Becca, what’s going on? Why might all the new grads want private equity and why do they want retail? And can I really afford to hire them? Because it sounds like they’re throwing all the money in the world with them.” And then it’s interesting because we have that ear with the students to hear what they’re looking for. They’re very, very few students that we’re working with, with the class of 2023 that will even consider an opportunity that is not private practice. So there’s just a handful of folks that have said all maybe look at private equity or retail, but the vast majority say I truly, truly, truly want to private practice and there’s even a really good group that says, “Not only do I only one a private practice, but I already know that someday I want to partner slash buy this practice as well.”
Dr.Bethany Fishbein: Do you think though that it’s, it’s like self-selecting a little bit because retail opportunities are so easy to come by? That they might not even consider needing to work with a company like yours? They just need to go on Ziprecruiter, Indeed, and type in optometrists job and the geography they want and they have their choice. Are you talking to them before they’re job-seeking?
Becca Starks: Yeah, so we actually start a process with them a year before they graduate. And so we have them fill out a profile with us it looks just like a LinkedIn profile, but it’s specifically for KMK, and go in and select all of the different types of practices that they’re open to. And so, we have both from the data from what they input on their profile and then they all have a one-on-one call with a career advisor as well. And so that’s where those points come from, both in the data they enter and then the conversations they have with a career advisor.
Dr.Bethany Fishbein: And is that when a student should be starting their job search is early in fourth year?
Becca Starks: Yeah, so we were really surprised in the timeline as well that a lot of students start having conversations about the fall before they graduate. So this class of 2023 they were starting interviews, October timeframe, and then a lot of them were during their Christmas break, timeframe holiday break, going on visits to practice owners. And then as soon as the New Year transitioned over there were many that were in contract. So definitely, Fall time is like you can feel good. About yourself being ahead of the game, wintertime is still very safe, you still have a lot of opportunity to be reaching out to candidates, and then as we enter into more of the springtime, a lot of I’d say probably half if not more of those that we’re working with are 100% in contract ready to go.
Dr.Bethany Fishbein: When you start working with them. Is there any issue with students who are starting the search and still haven’t passed their boards or won’t have the credentials to work when they graduate?
Becca Starks: Yeah, Yep. There is information from ASCO also about passage rates. And it goes into detail even of school by school, but it essentially shows year over year the decrease in passage rates, and I think we’re at about 70% passage rate, right now. 73%. And so there’s a huge population of students that don’t pass typically it’s part one where the struggle is and so there are some students that will even graduate and still have not passed boards. And another misconception there is, “Oh, these students are lazy or they’re not understanding the information, and I don’t want those students because they won’t be good doctors”. And completely not true. Those are students that could either be not very good test takers. These are also the population that came into optometry school right in the heart of COVID. There are some that have just had really rough life events around the time that it is to take boards and so but they are all great people that will be great doctors, they simply just need to pass this test. Many of them have had really great GPAs some of them have other degrees that help them with the practice management side and so it’s just a matter of getting past that one test or many of them.
Dr.Bethany Fishbein: And how does, how did they navigate that with the job contract like, will an employer sign something with a student who hasn’t yet passed boards?
Becca Starks: Yes, we are running into that actually part one. Board scores were just released this past week. And it was a lot of that there was a lot of celebration and there was a lot of sadness around those that didn’t pass. And the good news is, I don’t know that I’ve come across a single employer partner that we work with that isn’t at least open to the idea of bringing on someone that’s graduated in kind of a super tech role. It’s kind of how we position it to practice under that optometrist owner until they graduate and we even have some that say, “Hey KMK I know that you, as an organization, do great at coaching them and helping them after they fail boards.” I will even invest in that side of the house to ensure that they can pass boards not only to show that, hey, I believe in you and the hardest time in your life student but also that gains them a really loyal employee that again, is going to be a great doctor has just had trouble taking this one test.
Dr.Bethany Fishbein: Coming in as a super tech though, obviously, they’re coming in at a lower pay scale and they would come in as an optometrist, and they have those student loans. So let’s talk about compensation of obviously it’s going to vary around the country and regionally and how many hours and all of that but what is it that a new OD is looking for as far as the ability to earn money?
Becca Starks: Yeah, good question. So, specifically with this new grad population, the way that I kind of coach, the employer partners that we work with private practice owners is, a lot of times they’ll come into the call and say why pay 16% of production, but with this new grad population, they aren’t able to really wrap their brains around what that is, you could have a $1.5 million, your practice and they still just don’t, they can’t really understand that. And so the recommendation that we give is to at least have some sort of salary and we have information and concrete data on specific areas of the nation. So by all means, if, if we can support you in any way with that, I’m happy to to make sure that you’re competitive, but having some type of salary listed up front is what’s going to entice these new grad population because they can wrap their brains around 140,000. They can’t necessarily wrap their brains around 16% of production. And so totally understand, then obviously the argument private practice owner, I hear you what’s going on in your head is. “Well, I need to motivate them to work hard. Like if I just give them a salary, then what’s the motivation to work hard”, and so there’s been kind of this really nice avenue that we’ve taken with a lot of partners that’s worked well in that advertising a salary a little higher than you probably would have normally, but then decreasing to a really low percent of production, so that there’s some salaries that’s there that’s enticing to a new grad, but a lower percent of production. So for the first year only, so year one higher salary and lower percent of production, and then having that shift for year two and year beyond your two to a lower salary, higher percent of production. And so what that does is again, entices this new grad to apply, and even want to learn more about your practice because there’s a salary, but that little bit of percent of production will get them to realize in their first year of working well. I’m doing the math, and if I would have went on the percent of production, I probably would have made more than my salary. This is making sense this is motivating me to work harder. And then again, you can even have it in the contract that upon year two that shifts to a lower salary that’s guaranteed and a higher percent of production. So as they’ve gotten their feet wet, they’ve learned they’ve been mentored that first year shifting then into percent of production.
Dr.Bethany Fishbein: So you’re coaching your doctors to do a salary plus a percent of production?
Becca Starks: Yeah, that’s pretty typical.
Dr.Bethany Fishbein: And what about benefits and stuff like that is that important? Yes, it is important. Is that something that a brand new grad is going to give enough importance to that it’s going to help them decide one place versus another?
Becca Starks: Yeah, such a good question. So I’ll give both sides just agree very important. I would say the majority of private practice owners that we’re working with are offering some sort of benefits, whatever that might look like. Some are very comprehensive, some are very “Hey, we will pay 50% of your medical and leave it at that.” But now that we are in this lane of there is competition from private equity and from retail. Those are just a no-brainer. In those avenues. And so to remain competitive from that regard. They will get a full package of 401K’s with matching with benefits with PTO, all of those things, if they’re considering a retailer or a private equity opportunity in comparison to your private practice opportunity. And so, again, I think most I talked to very few that say “Hey, I’m just percent of production and I don’t give any days off you just you if you’re here you make money if you’re not, you don’t but you can take whatever days you want type of thing”. I have a handful of those but for the most part, most private practices are offering the salary with percent of production, at least something towards medical, and then most do have a 401K whether there’s a match or not with that.
Dr.Bethany Fishbein: Are there other intangible benefits, other things that would make a practice more attractive?
Becca Starks: Yeah. So I think the thing that’s so such a great opportunity with all of the listeners that would have that are trying to hire than our private practice owners that have been doing this for years to a new grad specifically is mentorship. And so those that are willing to do that are excited about that. Well, maybe “Hey, I haven’t really even thought about that. But I’m gonna share over the last 20 years, I really have learned a lot that I could pour into this next upcoming generation”. And so being very vocal with that, even in a job description, or whatever it is that you’re creating, to entice candidates to come your way and some people put a really extensive plan behind, “Hey, we have a weekly meeting, and you get lunch hour with me every week and we will cover XYZ and some it’s kind of informal of just “Hey, I’m going to be with you I’m alongside you. You can call me when you want”, whatever that looks like, or even if you haven’t, some team members that are fairly recent grads, being able to vocalize that to have hey, we’ve got folks that I brought on board as new grads and couple years later looking them go and so the mentorship side is again that intangible free opportunity that I think a lot of people don’t even necessarily recognize they have the ability to give.
Dr.Bethany Fishbein: Is it mostly clinical mentorship they’re looking for? is it practice ownership? like when you say mentorship, what are they hoping to learn from you?
Becca Starks: Yeah, definitely medical at the top of that, but there are again, those those candidates that just know that they know that they want to be very involved in the practice management, the business side of the house. And so for those candidates that are interested in it, being willing to say “Hey, here’s I’ll show you all of our programs and all of our software and how I design the day and this is how I designed the business side of the house”, and so in those situations for folks that are interested in that side, I think it’s important to have just kind of an open door policy of “I’ll show you all that. I’ll show you that number. So I’ll let you in on this.”
Dr.Bethany Fishbein: So for practice in a particular geographic area, if you can get your salary and benefits close, but they don’t necessarily have to be higher. They just have to be within range and you can kind of check off all the other boxes. Is there a type of practice like heavy medical versus refractive versus specialty that people are looking for?
Becca Starks: Yeah, so definitely looking at highly medical. And then what I would also say is kind of another somewhat intangible, but if practice owners are open to new specialties that maybe you don’t have in your practice right now. But hey, if there’s somebody who comes in and is passionate about whatever it may be, and they want to bring that into my practice, that’s a really enticing thing for a candidate to really see themselves. They’re in the long haul of “Wow, I’m passionate about myopia management and this practice says, by all means bringing that on.” That’s such a great thing to be able to offer to a candidate and so definitely, medical and specialties are really where the candidates are wrapping their brains around of how do I see myself there.
Dr.Bethany Fishbein: And what if you’re in rural Wisconsin, where there’s just not a huge population of optometrists looking to settle? What’s the best way for a practice like that to set themselves up to find somebody to join because so many of those are great opportunities to become part of a community to ultimately partner buy a practice have a really low cost of living like it’s how do they make themselves attractive or show how attractive they are I guess I should say.
Becca Starks: Yeah, and I think that so often because I get the luxury of talking to these practice owners in some of these more rural areas. And every time I’m just like, Wow, if I could just record this and let all of these candidates see this owner care about the type of patients they get to see a lot of times it’s the smaller communities that because there’s not a nearby ophthalmology or another office like those are the most medically focused practices.
Dr.Bethany Fishbein: Absolutely.
Becca Starks: Yeah. And so, so often I feel better. Oh my gosh, if I could just package this up and get a candidate to truly wrap their head around it. So one of the things that we do on the candidate side is our current advisors do as soon as a student comes in and says, “I only want Miami in New York and LA”, we try to mentor as well and show your kind of cost of living and let’s truly take a look at this and let’s look at your lifestyle and look at
Dr.Bethany Fishbein: Miami, LA, how about rural Wisconsin?
Becca Starks: Right? Yep.
Dr.Bethany Fishbein: And consider Minnesota.
Becca Starks: Exactly. We play that game all day long. Yep. And then to the practice owners, a lot of what I tell them is, they’ll tell me I say they get to brag. So give me your brag book, when they come on as a partner to me, tell me what’s so great about your practice. And then they’re typically ready to end the call and I say, “Okay, based on your area, we also want you to brag on the geographic location just as much as the opportunity and so getting a candidate to truly understand what their life is going to be like, not just when they’re at work with you all day, but once they leave work, and what does this community look like and what can I do there? Is it great for hiking, is it great for the music scene, and the art scene? Is it great to raise a family and maybe I’m not thinking about that right now. But in the next couple of years, I will be.” And so I always say “Somewhere in your job description, however, you want to do it. It’s a post that you’re putting on to kind of an Indeed or an AOA. Having information, just typed information about your geographic area and what makes it so great. And then also, the other added thing you can do is you can always create videos.” Videos are I feel like that’s kind of how we’re all digesting content at this point. And especially this generation of these new grads, and so if you can even do a quick it doesn’t have to be professionally shot but videos of you just speaking informally, almost as if you’re speaking to a candidate who wouldn’t be right in front of you talking about again, envisioning their life there, the more that a practice owner can make a job description or job post about the candidate instead of themselves. The better that that’s going to relay to the candidates have just really getting to understand “Okay, this isn’t what I thought I was thinking Miami, but now I can kind of envision how my life could be in Wisconsin.”
Dr.Bethany Fishbein: That’s a really strong and valid point. Because when I think about a job ad, it’s all about what we need and what we want. We’re looking for an optometrist to work these hours to do this and when I’m interviewing candidates for Associate optometrist, but really for any position I’m always sensitive to an applicant, who all they’re telling me is what this job is going to do for them. Right. So I’m very critical of it as an employer when they’re like, I’m looking to build my clinical confidence in myopia. I’m looking into, you know, whatever. And I think what are you going to do for me? But in the ad, maybe it should be the other way off, Here’s what I’m going to do for you so that they’re interested and intrigued by the post enough to then come in and want to tell me what they are going to do for me so
Becca Starks: Absolutely
Dr.Bethany Fishbein: Cool.
Becca Starks: We even have one it’s a Power Practice member that wrote a personalized it looks just like a letter you would receive from your grandma in the mail and it was so different and so eye-catching and so engaging. It was truly just a personalized letter, Dear Candidate, and then it just spoke really informally like, Hey, I get it. Words are hard, school is hard, but here’s what it would be like living here. Imagine if you could leave work and go out and do this, this, and this and your two hours within this big city so you can go catch a basketball game and be back home at night. And so it was just very, again trying to get that candidate to envision their life not only with that practice but in that geographical location. And so that was an incredible example.
Dr.Bethany Fishbein: Did it work?
Becca Starks: We’ve gotten some interest. We don’t have anybody signed on yet, but it has enticed interest.
Dr.Bethany Fishbein: And talked about KMK a little bit again, just before we close. So if a practice owner is looking for an associate, they can reach out to you or how do they go about tapping into this database network matching service that you guys have?
Becca Starks: Yeah, absolutely. Yep. I would be the point of contact Becca Starks. And I’m sure you can put my email in the show notes, but it’s just Becca@kmkodcareers.com. And yeah, we typically just do a really informal introductory call and learn about the practice, learn about what they’re looking for. And then go over kind of our offerings. We’ve got two different offerings to choose from, just depending on what the practice owner is looking for. And then yeah, we just go from there. It’s really simple. It’s free to be in agreement with us and having us promote a practice. And so basically, we get that agreement going and then our current adviser starts promoting any of our partners that we’re working with. And then essentially once we have a student that is a great fit, we play the matchmaking game.
Dr.Bethany Fishbein: I love it. Thank you. I think this is valuable information for new grads to help them understand what they’re going out into and some of the misconceptions they might be facing. But hopefully, we did our part today to try and reduce some of those and really give today’s employers a more real picture of new grads who are looking for jobs. So thank you so much for taking the time to do this and give this service to all of the optometrists out there.
Becca Starks: Absolutely. My pleasure, Bethany. Thank you. So much.
Dr.Bethany Fishbein: Thank you
Read the Transcription
Adam Ramsey: It’s like, why do I need to even discuss this? I treat everybody the same. And what people of color would rather is, I want you to see color. I want you to see the beautifulness and the differences that color brings.
Bethany Fishbein: Hi, I am Bethany Fishbein. I am the CEO of The Power Practice, host of The Power Hour Optometry Podcast. And here with a guest today, this is Dr. Adam Ramsey. He’s medical director at Socialite Vision in Palm Beach, Florida. He’s a co-founder of Black Eyecare Perspectives and a speaker on diversity, equity, and inclusion. And I’m happy and excited that you agreed to have this conversation, Adam. Thank you so much for being here.
Adam Ramsey: Thank you, Bethany, for having me. I appreciate it.
Bethany Fishbein: It’s a little bit of a tricky topic, but I’m really hoping that we can talk today about race and racism as it comes up in optometry and with practice owners specifically. It’s something that I feel offices are starting to talk about more openly, sometimes in a positive way, sometimes in a negative way, because an incident has happened. And I’m hoping that questioning the status quo or questioning why things happen is really the only thing that leads to change. And so I’m hoping to be able to ask you or maybe have us ask each other some of these questions today that will get people to think a little bit differently about how they’re interacting with people of different backgrounds, different abilities, just people who are different than they are in their own practices.
Adam Ramsey: All right, thank you for that. At first, I want to commend you for even having a conversation. This could be not easy for some people to want to talk about, but one thing I want to say is it’s a safe space. You can talk about race without being a racist, right? It has to do what the conversation is. That’s like talking about sex and not being sexist. I can talk about gender without being sexist. I just can’t make sexist remarks. But just talking about women or talking about men isn’t sexist. Talking about black people and talking about white people and talking about Asian people isn’t racist. It’s what you say within the walls of that conversation.
So you can talk, have a discussion about it. It doesn’t make you a bad person, right? And you have to talk about it with people that are different than you because if everybody around you has the same thoughts as you, you learn nothing, right? You have to talk about it with people that think differently from you for you to get a different opinion. A lot of us grow up in towns and cities where everybody’s pretty similar. So you may think what you’re saying is okay. It’s okay for those people. It’s okay for the people that are within those towns and cities because y’all talk to each other. Y’all talk the same way. Somebody else may view it differently. Somebody else may have a difference of opinion about that same statement. And at the end of the day, what matters is how it makes the other people feel, not your intent, right? Because I cannot intend to hurt my wife’s feelings. Does it matter if I didn’t intend on it and she’s crying? No, I could be like, babe, I didn’t intend on hurting your feelings, but you did.
So do I have to apologize even though I didn’t intend on it? Yeah, because it’s how it made her feel, not what my intention was. And I think that’s where we get hung up is we make it, I didn’t mean it. I didn’t say it that way. Doesn’t matter what you meant. Doesn’t matter how you were saying it. It matters how it is received by the other person and putting yourself in the other person’s shoes and saying, well, will you say it like that? Yes, that’s how I’m receiving it. And that’s where the issue is, is putting yourself in the other person’s shoes. So we can have a conversation, relax. We’re gonna have a good conversation. This is fine. It’s better to have these conversations. I usually have these conversations with a glass of wine or a scotch, maybe a cigar. We’re not doing that today. Maybe for the subsequent conversation.
Bethany Fishbein: That sounds good. And Adam, thank you really for just establishing that right out front, that this is a safe space. I was actually talking to somebody yesterday, not related to this at all, just friends. And they were talking about the best way to be supportive. And at that point we were talking about gender and sexuality, and it just had come up. And they were talking about the importance of having those safe spaces and safe people. And it’s really, I think that feeling of not having that safety that prevents some of these conversations. I was talking to a practice owner recently who was interested in hiring a staff member who is transgender and had some concerns about it and went to ask questions and felt a little bit attacked for even asking the questions. And that was hard. She said, should I not have asked that? So I appreciate you setting that up right from the beginning.
Adam Ramsey: Yeah, I think you have to know what you can and cannot say. And you have to leave the door open to the conversation because sometimes you can have a conversation and it’s either you’re trying to educate somebody else or you’re trying to come and learn. Most times you can’t do it both ways. So your line of questioning has to also be, I’m coming to learn, not coming to direct, not coming to tell you what I think. It’s more, nobody would be mad if he says, hey, I am not sure how to do this right, but I would like your help in learning how to say the right thing and do the right thing. So can you help me in that process?
What transgender person is going to be mad at an employer saying, hey, I don’t know what to say and do, but I’m willing to learn. How should I address this? What should we do? What would make you feel more included? What would make you feel safer? What would make you feel more involved or invited into the workspace? What do I need to do? I have not told them my opinion. I have not gave up anything. I have left the door open. That person will say, wow, I have a great boss. They want to know what’s coming, but it’s a totally different way. I don’t know, do I need to have these kinds of bathrooms and we’re not going to be doing these kinds of things and I’m going to say what I’ve been able to say because I’ve been saying this my whole life. And it’s just the way I say it. You have to just receive it the way I was. That’s two different ways about having a conversation. So with that, I’m not saying I’m the best at that either, but I am open and willing to learn. I’m open and willing to understand for somebody else’s viewpoint.
Bethany Fishbein: Yeah, and that’s what counts. And that’s how I’m coming to this conversation. I’m interested to learn because so much of the conversation that’s out there is happening because somebody said something and it wasn’t received in the way that they expected. And so something that might not have felt like anything to the person who’s saying it, and it felt like a big something to the person who is hearing it. And so help me understand from your perspective kinds of things that are just sometimes said casually that maybe you know, okay, that probably wasn’t intended, but it doesn’t change that you feel that its impact is hitting different than the intent from things that you hear from people.
Adam Ramsey: So I am one of two Black optometrists in my county, right? When I got to Palm Beach County, there wasn’t another one, right? When I went to SCO in Memphis, I was the only Black male in the school. So I show up and a security guard tells me, hey, you know, you’re the only Black guy here? No, I didn’t know that. I was coming from Florida, coming to Memphis, Tennessee. There’s a lot of Black people in Memphis. And you’re in a world that’s different, right? And classmates would make comments and jokes about our patient population that are coming there and not realizing what you’re saying is making generalizations about people and not realizing some of those people in those positions, not at their own fault. Some things because of systems don’t allow them to get out of it.
And when people use comments like you people, who is you people? You know, like, what do you mean? I think whenever we make generalizations, that’s when you can get into trouble. Now, all of us have generalizations. We all work through life with general thoughts about people, about cultures, about places. I make a thought about what a biker bar is. I have an opinion about what a piano bar is. I have an opinion about what the difference between Target and Walmart is, right? There is a difference to those things. There’s nothing wrong with that, right? But there is a line in which something you can say, you can laugh at somebody or with somebody. And if all your jokes are at them instead of with them, that’s different, right?
When you’re talking about something that they have no control over changing and not understanding that, you know, I have staffers and they started off at one wage and they were doing so well that I said, hey, I want to give you a raise. And she came back to me and says, Doc, can you please not give me a raise? And I was like, what, why? Well, if you give me a $2 raise, I’m going to lose section eight food stamps and my voucher for daycare. So your $2 raise would cost me about $500 a month. So that’s a way in which a system is set up that doesn’t allow a person to advance to a certain point because you would, I would have to double her salary for me to be able to make up for the services that she would lose if I gave her a raise.
Now that same person, somebody may look at them and say, why are they on welfare? And why are they doing this? And not realizing that there is a huge drop-off that happens when people that are in certain situations have to actually move up. And when they do move up, the services that they lose and they have to make a choice between saying I want to advance myself or I want to stick within a system and stay where it is. So sometimes we can make comments and things without being educated.
Last week, I went to the Racial Equity Institute. They did a two-day summit here in Palm Beach. It was sponsored by the United Way. They do them all around the country. And we spent two days talking about race and how it affected this country and where we come from. And even as a Black person, that doesn’t mean I’m qualified to talk about racism, right? Just being Black doesn’t mean you have to do the work to put into educating yourself in a way in which you can understand how race affects people and how it is affecting systems in this world.
So it’s hard to make generalizations when I say, hey, these comments are bad. There’s a lot of bad comments. I don’t really think I should go into each and every comment that could be bad. I think the better use of time of the conversation is saying, hey, understand that we’re different. Understand that people are going to view the way you do something a little bit differently than you, right? Think of like there are doctors that may work in a predominantly minority city, but you’re a white doctor working in a minority city. Those patients are happy that you’re there because without you, there’s nobody to be seen. You’re coming into the inner city and you’re doing good work. You’re providing good care. You’re taking care of glaucoma. You’re doing the things that they actually need in those cities. But you have to also look at it that you then take those dollars and go back out to the suburbs and you sponsor the baseball team in the suburbs, not the baseball team in the inner city. You take those dollars and resources that you make off of those kids in the community and all those people in the community that you take and you go somewhere else with it. So somebody else views it differently.
You may view it like, look at the good work I’m doing. You’re right. You are doing good work. But what do you do with the resources from that good work? Are you hiring the people in the city? Do all your staff come from the suburbs? What do you do with the resources? Which baseball team do you support? The one your kids go to in the suburbs or the inner city one where all the patients are giving you the resources to support that baseball team, right? So there’s ways you look at it, but somebody else may not see that unless you look at it from an outside view. You’re like, what? I’m supporting the community. I love everybody. It’s not about race. Nobody said it was. It’s just somebody may view it differently. Somebody may see it differently and says, hey, you’re not realizing what you’re doing and how you’re doing and how it affects me, how it makes me feel. And I think understanding that people are different means you have to also be aware and cognizant of the things that you do and say, how it may affect somebody differently.
And you know, my analogy about my wife in the beginning, I use that to this day. Sometimes she’s mad at me. I have to sit down and be like, what did I do? I do not even understand why you’re mad at me right now. Then when she tells me, I’m like, okay, I didn’t mean it that way. You received it that way, but I didn’t mean it that way. This is what I meant. I was talking about this. Oh, I didn’t hear you. The shower was on. So she missed part of the conversation and got mad at me, but it doesn’t matter. I understand why you’re mad. I apologize. I’m sorry for that. And we have to start off with, I apologize. I’m sorry for that. I can figure out a way to do better. I can figure out a way to give some more context when I’m saying something. But you have to start from that, from understanding that we’re different, but it’s okay that we’re different. Celebrate the differences. Celebrate what makes us special. Celebrate what makes us unique.
Bethany Fishbein: Go back to what you were talking about, about when you started school, learning from a security guard at the front door, that you were the only black man in the class. It’s a situation that I don’t know that I’ve ever been in. So what’s the feeling sitting in a classroom at the beginning of a career, not having somebody else sitting there who looks like you?
Adam Ramsey: It is, well, I went to University of Florida. So it was a predominantly white institution. So I was kind of used to it to a certain degree. I’m an only child. So I’m used to being by myself and figuring it all out. It didn’t always have a negative effect until I really went to SCO. I remember one class in particular, I would study, I was there in all the classes. I wasn’t a student that didn’t need to study. I put in the work. I graduated honors from undergrad, but I had to do the work. I’m not the person that could just skip class and just get an 85 on a test. That wasn’t me. And I remember this one class I studied, but it wasn’t my strong suit. I was studying, I’m not going to say the classes. I don’t want to, the teacher still teaches there. So I’m gonna leave that out. And I studied and I tried and I bombed the tests. And I remember coming out of the test. Everybody was like, wow, that was so easy. It was just like the practice test. And I’m like, what practice test? Come to find out the previous year, students had, I guess, a copy of the test and everybody else got a copy except me.
So nobody thought to come and give it to me. They were studying in groups. I was not invited to the groups. I wasn’t invited to their house to study. I studied in the library by myself. And the class was based on a curve. So the test, if the best person got an 80, then that 80 became 100. That’s how the class went. So the teacher pulled me aside and says, Adam, why did you do so bad on this? Everybody else did good. And I just kept it to myself. I didn’t tell on them that they had the previous test. I didn’t do it. I just took that bad grade and had to figure it out on my own and everybody else, they didn’t know the material any better than me. They just knew the 30 questions and A, B, C, D and put it on there. And it was just one of those feelings of being by yourself.
It’s there and that is the question. I would say it’s the same feeling when there used to be no women in classes and there was a first woman that came into the class. They had to struggle. They had to figure their way out. Now we got 70% of women. So it’s not the same experience. But I would say it would be pretty similar to when there was one woman and 99 men in the class. There were some differences. There were some good old boys clubs that they would hang out and play golf together and maybe didn’t give her the test and figure that out. It’s a similar experience.
That isn’t the experience now for women, but there was a time in which 20 years ago that was the experience. So it’s just, there are differences. It’s not good or bad, but you make your way through it. It makes you stronger. And then now I have a nonprofit in which they’re trying to diversify eyecare and get more minorities into the profession so other students don’t have to have the experience I had. Now we have a club that meets with them on the 13th of the month, Black Eye Care Perspective. And we have a pre-optometry club that meets with the students on the 13th of every month. Even if they don’t go to school with another person of color, they can meet on a Zoom and you can have one person from every school but they get to meet together and be able to communicate, talk, help each other through different situations so they don’t feel alone. They don’t feel lonely. They have a support system there, which I didn’t have which is why I co-founded it and helped start that organization.
Bethany Fishbein: I know you gave the analogy of the first women in the class and we were actually talking about this a couple of months ago. My husband’s mom just turned 90 and she’s a physician. So at the time she was in medical school, there were two or three women in her entire class. And one of the other women was at her birthday party which was kind of cool. They’re friends all these years later. But I know that one of the things that they fought against was a perception that women couldn’t do this. They weren’t smart enough. They weren’t strong enough. Do you feel that that’s still out there with regard to race?
Adam Ramsey: Of course. You know, media shows you a person in a certain light and that’s how we are going to view that light. If I see somebody with tattoos on their face and they have a leather jacket on and they’re wearing a motorcycle, me and you both just thought and made an assumption about that person, good, bad, or indifferent.
Now I can sit and talk to them and they can be an art professor after I’ve had the conversation with them. But before you have the conversation with them, if their face has tattoos and their bald head and they have a leather jacket on and they’re on a motorcycle, I have a perception about that person. Now after I talk to them, I may feel differently. This person might be a lawyer, could be anything. I’ve seen that could be a lot of different ways. But before that, I might make an assumption about that person. And I think right now for race, that is the truth because a lot of people are in silos. A lot of people are where you don’t maybe interact with people that are different than you very often. Not everybody has a diverse friend group, a diverse set of people they hang out with. So your perception of people may be what you see on TV.
Now minorities don’t control what’s on TV. So the shows that are being shown and how you are being viewed are not controlled by people of color. So there are things on TV that make perceptions about people and that may be the only perception you get of people, right? The social media, that is a filtered view. Your social media, my social media, what I see on my timeline and what you see on your timeline is totally different. But that’s your world. That’s your perception of what’s going on today in the world. But what you see and what I see is different, right? So people’s perception of how it feels and what it’s like isn’t always reality, isn’t always what it is. So yeah, there’s a variety of how people feel about one another.
If you have three African-Americans in a class and one of them failed boards or two of them failed boards, to some people, that’s 66% of them are failing boards. But if you have 50 white people in the class and two failed boards, oh, it’s only a few of them failed boards. But in the world of it, you say, oh, black people can’t pass boards. There’s two people. It was still two people. It’s just a matter of the amount of people that were in the class. So there’s a perception that may be out there of people, but that’s not fair to the number of people. You have so many other people. It’s just a matter of who’s coming into the profession. So yeah, there’s a lot of preconceived notions about people. Some are right, some are wrong, but I think having conversations is where the starting point is.
Bethany Fishbein: So, I mean, do you feel like when you’re in that small number, so if you’re one of three African-American people in your class and you’re getting ready to take boards, like, do you feel that pressure that something that you’re doing is representing not just you as an individual, but is affecting how people are feeling maybe about Black people or Black optometry students in general?
Adam Ramsey: Of course, there’s pressure, everything. Now, you guys also need to know my backstory. I wasn’t born here. I was born in Trinidad in the Caribbean, right? I’m an immigrant. I came to the United States when I was eight, right? I look different. I talk different than how other people spoke. I was used to different things. I’m used to that. You know, when I get to the school and all the security guards are like, I’m cheering you on, all the custodians are like, all right, do it for us. Go, go, go, go. We want to see more of you guys out there. Yeah, that’s pressure. I’m used to the pressure. It’s there, but it’s there. Yeah, of course. You know, even the Black faculty that was there, don’t let me down, Adam. I’m counting on you. Yeah, that’s pressure. Some of that’s good. Some of that’s not so good, but at the end of the day, I would say it’s good. But there is pressure, but there’s nothing wrong with pressure. Pressure make diamonds. It can make something good or bad, you know, just a matter of what you’re putting pressure on. So that pressure was there definitely when you’re there trying to support.
You gotta also look, a lot of minorities are not just having to think about the next generation. They gotta think about the previous generation. You know, a lot of minorities are having to support mom and uncle and brother and sister and maybe support their kids. So they don’t have to only look in one direction. They have to make that money stretch two ways. So yeah, there’s pressure, definitely. But I don’t think there’s anything wrong with that.
Bethany Fishbein: Talk about when you got to clinic. Like, I’m remembering in our class, a lot of our clinical rotations were at VA hospitals. And that was really maybe the first time that I started to become aware of how people were being treated differently. And it was specifically some of the young female Asian doctors that were treated differently by the veteran population, which at that point was typically an older white man. That’s changed also. But what was your patient reaction when you were a student doctor?
Adam Ramsey: You gotta think, I never saw a Black optometrist until I got to Memphis. So I chose this profession without ever seeing somebody that looks like me. I never saw anything on the website, online, anything like that. So I didn’t choose this because I had a role model. I had somebody to look up to. There wasn’t enough.
There wasn’t anybody around me. There weren’t any in my county, Broward. When I was there, there was nobody. So I didn’t have any of those role models or people of color to look at. So when I get to clinic, most of the patients that come there, even if they’ve been coming there for years, you gotta think that there’s only one Black male out of the hundred that you could be seeing. It’s a 1% chance.
So you could come to that clinic 100 times and still never see a Black person, right? So for the patients, when they come in, when they would see me and we had a mainly Black population being in Memphis. So it was mainly Black patients with mainly white doctors. That’s what the patient population was in Memphis. And that’s probably a lot of the population in a lot of these schools.
Because a lot of these schools are in inner cities. A lot of these schools are in low-income neighborhoods. So it’s a lot of minority patients being seen by white doctors, which is most of eyecare. They would be shocked. They’d be like, you’re the student doctor? I get to see you today? Oh man. Yes. They were happy to see somebody. They would cheer me on. They’d be, you know, good job. Keep it up. I liked it. And at the end of the day, one thing I would say to anybody, it’s building that connection and rapport before you get started matters a lot. When you work with a patient, they have to know that you care before they care what you know.
I think a lot of times doctors skip that part. They skip the personalization of it. They skip the connection part of it, especially with minorities. Minorities are big on family. They’re big on connection. They want a doctor to be their friend. They want the doctor to have a connection. You know, I have a picture of my family in the office. So, you know, the staff get to see the patients. They come in and they ask about it. When my daughter was born, I emailed out a picture of her to all the patients and stuff like that. So now they come in every year.
Do you have an updated picture? I send out Christmas cards with my family on it so that they can see to the staff. So when they come in, but then when they come in, I ask about the patients. When we find out that patients pass away and their spouse is still a patient, we send flowers. When they come in before they even get started, I say, I understand. I know it’s been rough. It’s okay. You haven’t been here. I know. I get it. Let me know if you need something, right? Before I start talking about minus two, your new contacts, we got these new neural lenses in, blah, blah. That doesn’t matter in the beginning. It’s making sure that rapport and connection. And when that patient realizes that I remember her husband passed away, I had care and concern. And I’m like, did you get the flowers we sent? Yeah, I got the flowers. Thank you so much. I appreciate it. Blah, blah, blah.
Now, all of a sudden, when I start talking about neural lenses and I start talking about these new contacts that came in, she can get that out of the way because I have built that connection, that rapport. And it’s very important in minority communities. It may be important for everybody. I’m not saying non-minorities don’t care about that. But I would tell you when they realize that you care for them as a person, they come back for their follow-ups. They are much more compliant. They respect your time better. They’re on time for their appointments. Different things like that because, oh, I got to be there, Dr. Ramsey. You know, he’s counting on me. He doesn’t like when I’m late. Oh, I got that text message. I got to be there. Yeah, I do have to go. Oh, he’s going to get on me. I know he’s going to get on me. Oh, man. And then they come in and they say, Dr. Ramsey, I know this is why. And it’s because I built a rapport with those people.
So, I write little notes. I don’t remember every single patient. So, I write little notes at the bottom. Ask about this. Do this. We have little alerts that pop up. And we do that. They got married. We put a little alert because they tell us, oh, I want contacts for my wedding. Next time they come in, you should ask about the wedding. It’s a little thing. So, we put a little alert. I’m not going to remember the wedding. I’m not going to remember. But I have a little alert that pops up that reminds me. Ask the patient about the wedding. That’s, oh, you remembered. Oh, my gosh. Oh, yeah, I got to tell you. And I’m just typing away. It’s a little thing. And I’m not saying that non-minorities don’t care about it. I’m just saying that’s what sometimes is missing. That connection part that they feel and that understanding.
Bethany Fishbein: I’ve talked to doctors who are deciding where to open a new practice. And sometimes people will express concern about being in a community that is too much like them or too similar to them. Because they’re worried that having those kind of connections and showing that much care for patients that patients are going to turn around and be offended by charges or expect discounts or special treatment. Does that ever come up? Is there that side of it?
Adam Ramsey: People ask for hookups and discounts all the time. That’s normal. I don’t think that’s anything special or different. I had a patient this week and he had enough money to have a personal assistant with him day and night. She comes to all his appointments.
She drives him around in a big fancy car. And he still tries to barter and tries to do stuff in the optical. That don’t matter. And that person don’t look nothing like me. It’s going to be there. It’s okay. They can do that. But everybody knows come to my office. I have people that come to my house and you’ve been to my house and I still not give you a discount in the optical. Because it’s two separate things. Because when I go to your business, I pay full price. Now, if you’re going to give me free dental work, you can come get some free glasses. But if I’m going to pay for my Invisalign at your office, you’re going to pay for these glasses over here. I think that’s all personal. You can draw a line in the sand for whatever you want. I don’t think any patient population is any different for that. Just choose to put the office in the best place for you. Open and get going.
Bethany Fishbein: Do you ever get negative reactions? Like you said, most of the patients when you were a student doctor were happy to see you. And they kind of joined this crowd cheering you on. Did you ever see a patient who didn’t want to see you because you’re Black?
Adam Ramsey: Oh, yeah. White patient? Oh, yeah. I’ve had that. But what I try to do for that is like when you book your appointment, we send you a link and my picture is on the link. I used to have my logo from our office or a picture of the office on there, but I changed it to my face so that you know who you’re booking to see.
The city that I’m in is 3% Black, but my patient population is probably 65% Black. So, I pull from a large area of people, but the people in my city is only 3% Black. So, a lot of the people that are coming, if you’re coming to the closest office to you, that’s me. It’s most likely not going to be a person of color. So, I’ve had that happen, but the difference is I kill them with kindness and they come out and says, you know what? I’ve never had somebody of color be my eye doctor, but you did a great job. I’m going to tell all my friends about you, right? And at first, it may be different because it’s just not normal for them. You can make a random appointment.
Most likely, you’re going to see somebody that looks like you. You know, I had a patient, not a patient, a friend of mine, and I was like talking to her and she was a white woman and she was like, well, how come people of color say they want to find a black provider? Like, I don’t do that. I just look for whoever’s on my insurance and whoever has good reviews. And what I had to tell her was, well, you don’t have to try and find a white provider because 9 out of 10 chances the person you’re going to see without even trying is going to be white.
So, then you get to pick somebody with insurance that has good reviews and a 90% chance you’re going to see somebody that looks like you. It doesn’t have to be a thought process for you because most likely you’re going to do that. Now, go live in Chinatown and do the same thing. Are you just going to look at the best reviews and look at who’s on your insurance? Because it might be a 90% chance you’ll see an Asian person. Oh, yeah, maybe I would think of it differently. Yeah, because your normal environment is I am the majority.
Most of the services that I go to, most of the places are going to be welcoming to me or going to look like me or going to be conducive to something that I’m used to. And when you’re not in the majority, you feel differently about it. You see it differently from that review around me.
Serena and Venus Williams are tennis players, right? And there was a big story article written up about her and that when she was conceiving and having a child, she almost bled to death in the hospital. Now, this is a person of color that is very wealthy. They named the whole wing after her because she donated a lot of money before she had a child. And this person of color almost bled to death because the doctor felt like she could take the pain, right? That was what was in her story. The doctor didn’t feel like she needed the treatment. She didn’t need the treatment that they may have given to somebody else. And that’s where somebody of color feels like I need somebody that’s going to treat me like a person and see me differently and they may feel differently about things that affect them. And it’s disheartening, but it isn’t everybody. And this is where the tough thing comes in.
The person like you that is brave enough to have a conversation with it like me, most likely is thinking I don’t see color. It’s not a problem to me. I treat everybody the same, right? And it’s like, why do I need to even discuss this? I treat everybody the same. And what people of color would rather is I want you to see color. I want you to see the beautifulness and the differences that color brings. Instead of thinking about it like I don’t see color. I treat everybody the same. Everybody does the same for me. I don’t treat anybody differently. And people of color say I don’t want you to see everybody the same. I want you to understand that I’m black. Understand there’s differences. I understand you’re white. I see color. I know that.
I see somebody that’s Asian. I see somebody that’s Indian. I see somebody that’s Native American. I see that. And I learn about their cultures and I fully submit to their cultures. I fully love to be submerged and be involved and engaged with them for those things. It’s okay to see color. It’s okay to see the differences. There’s some beautifulness in those differences. There’s some funny stuff in those differences. There’s some cool, unique things in those differences. There’s nothing wrong with that. And that’s the tough part because a lot of times people don’t want to have tough conversations about how they feel and how they view the world. And it’s difficult. It’s not easy.
Every day I don’t want to talk about this. Like I have a lecture on this. I talk about this kind of stuff. But this isn’t what I wake up wanting to talk about. I don’t walk around the world saying, you know, I want to talk about racism today.
Bethany Fishbein: Even when I asked you to do the podcast, you said I talk about this stuff because somebody has to and not enough other people are doing it.
Adam Ramsey: People ask me why do I post it on social media? Why do I talk about it? And I said I talk about it because you don’t. If you talked about it, I wouldn’t have to talk about it. And I don’t want to talk about it. I started my non-profit because the students needed it. The non-profit is supporting the students. I’m not in school. My daughter’s two. She might not even choose to be an optometrist. I didn’t do it for me. I’m not doing it for me. There’s no benefit to me. I like business actually better. I don’t want to talk about it. I didn’t write a book on racism. I wrote a book on private practice because that’s what I would like to talk about. I like the creativity. I have some ideas and stuff that I’m doing in my office as unique and outside of the box and it makes my work-life balance where I can have a day off today and sit and talk to you and I’m still making money today.
That’s what I like to talk about but I’ll have the discussion because you need to talk to somebody that’s different than you for you to understand somebody else’s perspective. My roommate in optometry school was a white guy, Andrew. He was in my wedding and I was in his wedding and it was a beautiful thing. I was the only black guy in his wedding. He was the only white guy in my wedding but he’s one of my closest friends. We talk all the time. He’s about to open a private practice so I’m going to tell him to come talk to you. He’s buying somebody’s practice and it’s a beautifulness to it but we’re different and it’s okay to be different.
Me and him would sit down. I remember I got into optometry school in 2008 right when Barack Obama got into office in November so we started school in August. I remember sitting on the couch me and Andrew and they saying President Barack Obama is now president and me and him would go back and forth until like three in the morning four in the morning on different topics. He’s Republican, I’m a Democrat. He’s more to the center and I’m more to the center so we’re both on the centers on two sides of the aisle. He wasn’t far right and I wasn’t far left. We were kind of like right here but we would sit there and I would say Andrew I got to go to sleep. I actually got to go to class tomorrow. You’re going to skip class and it’s okay.
You’re going to sleep till noon but I have to actually go but we would sit there and have heated debates and heated discussions but there was some beautifulness in there and our friendship came out of that. That we’re still friends and I talked to him a couple days ago but we’re very different. It’s okay to be different. It’s okay. It’s not anything wrong and I say what I said in the beginning you can talk about race without being a racist. It’s what you’re saying in the conversation. It’s not the fact that you have the conversation. It is the what you’re saying and how you’re saying it and realizing that racism is when you use your power and authority over people of a different race. It is not just saying something. It is when you’re using that against them just because they are of a different color. That’s what people have a problem with.
That’s what people see is that you’re pandering to them. It’s different. It’s not the same thing. You can laugh with me or laugh at me. The joke is different. When you’re the butt of the joke it’s different. Oh, we’re just joking. No, we’re not joking. You’re joking. You’re joking about me. Not with me. That’s different. And I think it’s the way you say something, the way you color it, the way you view it that makes people be offended, that makes people not feel welcome.
When I come into an office and I ask you, do you have any frames for people of color? And you say, all my frames fit everybody. That’s not true because we have global fit frames for Asian people because we knew that Asian people were different and they needed a different thing because of their bridge on their nose. There are different facial features African Americans having wider and bigger noses a built-up bridge and need different things to fit them. So when somebody says, do you have something for me? It doesn’t work.
When I opened my office, I asked the frame reps, do you have any marketing materials with people of color in them? And they all said no. Every single one of the big manufacturers said no. Why? Because black people are going to buy it regardless. So why should I have to make career marketing materials for them? I don’t have to make it for a particular group and make it for the majority. Then what I did? I did a whole photo shoot myself. I hired a photographer. I hired models. I hired a makeup artist. I partnered with a local clothing store to get the clothes and we did our own photo shoot. And I created marketing materials for my office because people went to my website and the stock photos didn’t look like people of color. And they say, Dr. Ramsey, you have a majority minority patient base. Yet your website is all white men and women. All the flyers and all the stuff on the wall is white men and women.
How do I know that frame is for me if I never see a person of color looking like it? So you know what happened? I did the photo shoot. I posted the pics on social media. I posted it on my website and then I got white people messaging me saying, am I allowed to come to your office? Because all I see now on your social media is people of color. And I said, oh, I can’t win. I can’t win. There’s nothing I can do. I get beat up from the left. I get beat up from the right. And I had to let them know. I said, no, scroll a little further. I have it for everybody. I did a photo shoot and I’m using the pictures and I’m marketing materials. But then I had to go and find people of color. So you know what I had to do? I had to create my own frame line. And I partnered with a partner from Seyo Eyewear.
It’s called Ethnicity Eyewear. And they’re made in Japan because I had to make frames to the people of color because they were coming in saying, the temples are too short. It doesn’t fit on my bridge. The frames hit my cheeks. I need something that’s going to work for me. So I had to go out there and do it. Did I really want to? No. Did I make a million dollars doing it? No. Did it take up a lot of my time? Yes. But I had to create it for the people so they feel welcomed. They feel seen. They feel heard. They understand that I support a community and I’m there. And I try to make sure that I support people and organizations that are in the community supporting the community.
Bethany Fishbein: You were joking when you said it, but that feeling of I can’t win, right? I’m trying to do it one way and then I’m getting it from the other side. I think that’s something that prevents a lot of these conversations from happening or starting to prevent them. That somebody wants to ask a question and becomes afraid to ask it or they ask something once and somebody is offended. And it might be something that offends one individual. It doesn’t mean that everybody is offended by that. But it then becomes, okay, I better not say anything. And I feel like that’s really counterproductive to gaining understanding.
So where do you find that line between okay to ask, not okay to ask? I’ve seen on social media, there’s a TikTok creator whose name I can’t remember at the moment, but she does a role reversal thing. She does like if Eastern Europeans were the minority and she plays the role sometimes of a teacher. And she’s like, Jennifer, that name is so interesting. Where’s that from? And sometimes someone’s name is interesting and I’m curious about the background or a staff member comes in and yesterday they had short hair and today they have long, beautiful hair down their back. Like help me understand where that line is.
Adam Ramsey: It’s not as complicated as you may think. It depends on the way you ask the question. It depends on why you want to know.
Bethany Fishbein: Can you give me a good way, bad way?
Adam Ramsey: I got you. It depends on how you’re asking the question. Why are you asking the question? Is that your hair? Certain things are just inappropriate to ask in a certain way. Do you actually care about my community or are you just being nosy? Do you actually want to understand cultural norms and differences or are you just like, I need to know everything about everybody around me, right? It’s the way you ask the question. It’s the way you say it that’s different. You’d be like, oh, your hair is so unique. I love that you can just switch up your styles all the time. Like my hair is always the same. I don’t get to switch it up. I wish I could do what you get to do with your hair. It’s so unique that you get to try so many different styles.
Oh, all right, Bethany. Yeah, yeah. You know, I have a friend that does this. Well, you know, she can braid your hair too. Oh, I’m going on a cruise. I would love to get my hair braided. You think she’ll braid my hair? Yeah, yeah. She comes to your house and everything. She’ll braid it for you. That’s totally different than, what’s that? Is that a weave? How do you do that? The way you’re saying it, it’s what is the way you come across, right?
I think having the conversation is not wrong. Why do you want to have the conversation? What about that is something you would like to learn about? And I think having genuine friendships and genuine people that you can talk with, people that you are genuinely friends with are not going to have a problem with you asking a question about them. Asking a random stranger a very personal question might not get received very well. It depends, right?
So if I have a question and I want to ask Andrew about something, his family was farmers, and I call them and ask them something about farming, it’s going to be received pretty good because he knows I’m coming from a genuine place. I’ve been in his house. You know, he’s come down to see me. Our kids know each other. That’s going to come from a genuine place. Would I talk to a random person on the street and ask them that question? Probably not. It depends on why you’re asking the question. And I think what most minorities want is somebody to be genuinely curious, genuinely wanting to learn more, genuinely want to educate.
But there’s a difference between pandering. There’s a difference between, you know, they have a term like white savior complex where I want to save everybody. Sometimes these communities aren’t asking for them to be saved. That’s not what they want because you’re not going to be able to save it. You’re not going to be able to fix it, right? They can’t get a raise on their job because they’ll lose all these other services. So you’re not going to help them by saying, oh, I’m going to help you do this and I’ll help you do your resume. Fixing my resume, I can’t get a raise. Otherwise, I’m going to get kicked out of my house and I have nowhere to live. And homes in South Florida are ridiculously expensive. I would need to be a doctor to afford a house around here. Like, that’s different. So how you’re approaching the person, I think, start off with genuine relationships.
And then the rest of it, you can ask any question because you can ask them a question and they can ask you a question because you have a genuine friendship with that person that will allow you to ask those questions. But I think most people would ask, people that get offended, is why are you asking the question? Do you genuinely care or just being nosy? It really does matter when they want to, because like, why would I want to give out all this energy and educate somebody all the time on these different things? It matters.
And for people in eye care, when we’re talking and just center this around the eye care discussion, realizing that people of color are used to being in situations and being around people that are different than them. That’s the norm for us. So that doesn’t bother us. That is the norm. We’re good in those situations. I think most people of color, patients, doctors, anybody, just want somebody that genuinely cares and is genuinely compassionate.
If you’re genuine about it, the conversation usually doesn’t go to a place that’s wrong or harmful. And even if you meant it in a certain way, if it was received wrongly, then it’s still a place for you to apologize because you didn’t mean to hurt my feelings. But maybe you did hurt my feelings and what you said.
Maybe your off-the-cuff comment was not received well. Maybe when I come to your office and I see no people of color that work at your office, I think to myself, is this place inviting to minorities? Because there’s no minorities working here. If you’re in a community and you have a big Hispanic population, you should have your charts and forms in Spanish. You should have a translator. You should have one person that can translate if you’re in a huge Hispanic population, right? You should have a telephone service that you could call and you talk into the telephone and the telephone talks back in Spanish to communicate with the patients.
If you’re going to be servicing that community, then realize I want to make it easy for that community. But if you’re going to serve as a huge Hispanic population and you tell them you have to learn English to come to my office, then you’re servicing the population for the wrong reasons. You’re trying to take the money and the resources out of that community to go into your own community and that’s not because I care about the people there. That’s different. I just saw a need and I’m feeling the need but I’m not being compassionate to those people, being compassionate to the people in those communities. So, your why matters. Why are you asking the question and why are you doing what you’re doing? If you’re doing it from a good and genuine place, it’s going to be received well.
Bethany Fishbein: From the perspective of a practice owner, you have new employees. You don’t have that genuine friendship right away. There’s always that little bit of maybe like mistrust or something that comes from a previous employer they had before. I had a staff member and she jokes about it but she’ll do something unexpected and I think, what is that? And she says, oh, that was PTSD from my old job. So, people kind of bring their own baggage in from previous jobs. And so, that’s the part that’s hard to figure out. When you meet somebody new and it’s somebody you’re going to be working with every day, are you married? Do you have kids? Like, yeah, that’s being nosy but it’s also genuinely getting to know you and your family and how you have that connection. And sometimes it’s those kind of questions. Are you married? Why do you think I wouldn’t be?
Adam Ramsey: Now, the question I ask you is, did you ask them that question before they found out you had kids? Did you open up about yourself first? Or did you ask them about them first, right? Because somebody may think you’re asking about if I have kids because I need to leave early or if I’m going to be difficult to work with because my kids have to go to the doctor all the time, etc. So, the why you’re asking the question matters, right? So, the place in which you’re coming from when you ask the question matters.
So, if you open up with here’s my beautiful family, my kids, my son, he’s going to be going to this school, blah, blah, this is my husband, he works over here, blah, blah, blah. Then the person a lot of times opens up about their own family. Like, oh, yeah, I have a picture of my family. Here you go. Totally different conversation, right? If you just stand by the first day I met you, hey, my name is Bethany. Hey, you got kids? You married? Does it matter if I’m married or not? Like, what if they’re divorced?
At the end of the day, if somebody wants to tell you they’re married, they’ll tell you. If somebody wants to tell you about their kids, they’ll tell you. You know, I ask people, do you have any restrictions on work when I’m hiring you? Do you have any time restrictions that you need to leave out of here by a certain time? You can’t get here before a certain time, etc. Right then and there, if they need to leave because of kids, they’ll tell you, right?
So, the way you ask the question, you can still get the same information you want to get out of the person without asking it in an offensive way. It just matters in what you’re saying, how you’re saying it, and the way it’s coming across, and your why you’re saying it. Like, do you genuinely care? If I say I’m not married, are you going to help me find a husband? Like, why are you asking me? What does that matter to the… Like, you have to build that rapport, build that connection with the person. My staff have been to my house. Most doctors would not say their staff have been to their house, in their home, ate at my dinner table. I cook for them, right? Their husbands and spouses came over. Their kids go in my pool.
Most people don’t have that relationship with their staff, right? And that built rapport and relationship and connection with them, right? Because I care about them, right? Two of my staffers, I made phone calls so they can get homes. I called Habitat for Humanity and got one of my staffers a home. I called for the low-income housing and got another one of my staffers an apartment, and I made some phone calls because I cared to make sure they had somewhere to live, right? That’s the difference between asking what their living situation was.
I remember going to my staffer’s house and they were in a trailer, and the trailer was collapsed on one side, I think from one of the hurricanes, and they were still living in it. And I’m like, you’re coming to my office every day with a smile on your face and caring about my patients, and that’s where you live? Yeah, there’s no electricity on the left side of the house. There’s electricity on the right, so we run cable cords across. And I’m paying them fairly. I wasn’t unpaying them. They just started working with me. I called somebody that day. I said, I got to get out of there. You can’t fully give me everything I need from you if you’re living in there. I called somebody the same day. I dropped them off. I called somebody the same day. I said, I need a favor. I said, I don’t care how you do it.
I need this person to have another home, somewhere else to live. Because I asked somebody to live in a situation, because if it was bad, I would do something about it. If you ask me about something that you’re not going to do anything about it, then why do you want to know?
Bethany Fishbein: I hear you, and I hear the difference in tone in your answers, right? And the difference in tone in your answers, it can be the same question, right? So as you’re talking, are you married? If we’ve built a connection, are you married? And you say, oh yeah, here’s a picture of my family. And then are you married? You’re hearing it a different way. Why do you need to know if I’m married? So what if I’m not? What if I’m divorced? Is that going to be a problem here? The question is the same. So to conclude, what if it comes out wrong, right? And I ask a question and get the answer that I’m not expecting. When I ask, hey, so are you married? I’m expecting that you’ll tell me if you’re married or not. And if for whatever set of circumstances, your answer is, why would you ask that? What does it matter if I’m married? Like you’re obviously hearing something different than I’m asking as the employer or just as the other person in that conversation. What should happen then? Because the goal is to get to some kind of better understanding where a week from now I can ask something else and the perception is understood or where it can be an easier conversation. So how do you fix it when you’ve screwed up?
Adam Ramsey: If you screwed up, I apologize. Think of it. If I ask a new staffer if they have kids, maybe I said it the wrong way, right? They may take it the wrong way. Yeah, I got a bunch of kids. Is that a problem? My last employee had an issue with me having kids. Now I have a two-year-old. Before I had my two-year-old, I was not as understanding about staffers with kids because I didn’t really understand it and realize it. Now having to drop my kid to a daycare realizing that most daycares have to pick up by six and every minute after six is a problem. The reason I ask the question now is if you need to leave because nobody else can pick your child up, I totally understand. We can make sure you can leave here by five o’clock.
The reason for my question was because I understand now how difficult it is. I understand now as a woman when your child gets sick, you want to be home with them because when my child gets sick, I want my wife to stay home with my daughter, right? So, the reasoning for my question is coming from a concerning place now being like, if you have kids, I get it. Don’t take advantage of me because I get it. But I truly do get it. One-year-olds get sick a lot when they go to daycare for the first time, right? And then they’re going to get you sick.
So, you’re going to be calling in sick. It’s going to happen. But I’m coming from a concerning place but if I ask the question and it’s received wrong, first, you apologize. Say, Susie, I’m sorry. I didn’t mean it that way. You know, I really apologize that the way I said it came across wrong. That wasn’t my intention. My intention doesn’t matter to you. I’ll try and find other ways to talk to you and communicate with you in the future. But understand, I was asking you about your kids because I have a two-year-old and I showed you the picture of my daughter. And I understand, don’t feel like you need to be super mom here. If you need to leave, let us know.
We have other staffers here that have older kids or don’t have kids, etc., etc., that they can stay here for the last 15 minutes. If you got to go, I’m not going to look at you wrong because you got to go pick up your kid from daycare. It’s okay. I understand. I appreciate you coming to work and I appreciate you giving me all your effort today. The reason I was asking you about your kids or if you had kids, it’s just to let you know there’s a safe space. And it’s okay if you have to leave or you got to come in late because you took them to the doctor or they forgot their book bag so you had to go back home and then come in. I get it.
It’s going to happen. Those situations are going to happen. I hope it doesn’t happen every day, but I understand and I’m coming from a concerning place because I’ve had to do it and I’ve gone through that and my daughter got me sick last week, etc., etc. Now, all of a sudden, that staffer’s going to look at me different because for one, I apologized. And sometimes as a doctor, as the owner, you got to put on your big girl boy in pants and apologize and say I was wrong because the words matter. You can’t just brush it over. You can’t just say, let’s just move on. Let’s all be friends. That’s not how I meant it. Doesn’t matter how you meant it. Matters how it was received. So start off with, I apologize. I was wrong. I’m going to try and find a better way to communicate with you in the future. This is what I meant by what I said. Oh, okay. Now I get it. Okay. No harsh feelings. My last employer was just really a jerk about me having kids and my kid getting sick and it’s not my fault. My kid is autistic or whatever, whatever, whatever. My kid has a lot of illnesses and I have to be there for him, but I want to work. It’s just once in a while he gets sick and somebody has to be home and I have nobody else there to help me.
Bethany Fishbein: I have one more question and it’s when you get that reaction, then you know right away and you can course correct and you can apologize. In a lot of cases, somebody who is offended by the question or is offended by something won’t say anything. That makes it harder because then the person who asks, are you married? And they get back, no. And stuff goes on and you don’t realize. Help me understand. You can’t generalize. I get it. Everybody is different, but help me understand the reason that I feel anyway, like it’s so often silence instead of why’d you ask that or being able to have the conversation in the moment.
Adam Ramsey: Yeah. So what I would say is the only time a staffer is going to bring it up to you is if it matters that I bring it up to you. If you ain’t going to apologize and you’re not going to see it my way, why would I waste my time telling you, right? Nobody wants to be labeled the angry black woman. Nobody wants to be the militant black guy that’s always talking about race and talking about my feelings and making it an awkward, uncomfortable place. So they’d rather be awkward themselves and everybody else be happy than bring up the fact that you made some comments that were insensitive and make everybody else feel uncomfortable. A lot of times, minorities walk through the world and just say, I’d rather be uncomfortable because I’m used to being uncomfortable.
People will stay quiet because if I tell you a problem and it’s going to make it worse because you’re not receptive to understanding that there are comments and things that you do that are offensive, then why would I waste the effort? I don’t want to get fired. I don’t want to get written up. I don’t want to make it awkward here. I don’t want to get let go. I mean, you probably not going to let me go for that reason. But if I’m the outlier and I’m the one that feels different and is always offended and always sensitive, maybe I’m the one that loses hours. Maybe I’m the one that doesn’t get promoted to be your office manager. So the why matters. At the end of the day, be nice, put yourself in their position, put yourself in their shoes and be genuine about it. If you’re genuine about it, you shouldn’t have issues.
Bethany Fishbein: Adam, thank you so much for this conversation, for your openness, for your honesty, just for talking. I appreciate it and have some things to think about from here. Hopefully we get to do another one soon on a practice management topic. Don’t have to talk about race at all. But if someone’s looking for you, where would they find information to see your practice website that they spoke about, the book you mentioned?
Adam Ramsey: Yes, I own Socialite Vision, socialitevision.com. You can go on dradamramsay.com. I have a book called Play Chess, Not Checkers, The Practical Guide to Warm Start Your Dream Optometric Practice. It pretty much teaches you how to start a business. So, if you don’t know anything, you’re working in a commercial setting, you’re an associate doctor somewhere, or you’re in school and you want to start a practice and you want to know the basics to start, my book can help you there. And then there are other great books that help you once you get going. There’s going to be a part two to that book, I’m working on it. Maybe I’ll add some of these conversations that we talked about here today in a few of the chapters. But yeah, you can find the book on Amazon. I’ll be typing Adam Ramsey, it comes up too. And LinkedIn is the easiest way to connect with me, not on Facebook right now. LinkedIn, you can find me, Instagram, anywhere. If you want to find me, I’m not hard to find.
Bethany Fishbein: Thank you again so much. For more information on us, you can find us at powerpractice.com. Thank you so much for listening.