Discouraged by all of the doom and gloom on optometric social media? Dr. Nick Despotidis talks about having the courage to make your practice a place you love to be.

Date: June 1, 2022


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Dr. Nick Despotidis: None of our staff work for us for financial reasons because they could go across the street, especially in today, and make more money across the street. And what we found is that we needed to define what we value most in life.


Dr.Bethany Fishbein: Hi, Thank you for coming back to the Power Hour Optometry Podcast. I’m Bethany Fishbein, CEO of the Power Practice and Host of the Podcast. And I’m really looking forward to the conversation with my guest today. Dr. Nick Despotidis, who is arguably one of the happier people I know, one of the happier Optometrists I know, or else he’s doing a really good job of presenting it that way. But I’ve known Nick for a long time and I think it’s legit that he is genuinely happy. He is the owner of Eye Care Professionals a great practice here in New Jersey. He is the brain behind “Supercharge your Practice”, which is an incredible workshop that I’ll give him the opportunity to talk more about. He’s the author of several books. He’s a TEDx speaker, his talk called childhood disease worth presenting has been viewed 10s of 1000s of times, and he is spreading the word out there about Myopia Management and about professional happiness. So I am excited to see where our conversation will go. Nick, thank you so much for agreeing to do this with me.


Dr. Nick Despotidis

Thank you, Bethany, thank you for the kind words and for inviting me. I look forward to our discussion.


Dr.Bethany Fishbein: Before we get too far into it is the happiness legit?


Dr. Nick Despotidis: It’s legit, it’s legit. It is it’s not every day it’s butterflies and roses, that’s for sure. But certainly, inner fulfillment is definitely very legit.


Dr.Bethany Fishbein: I know so many of the conversations that we’ve had about practice and life kind of intertwine always have this message of creating a practice that serves your personal needs and creating something professionally that at the end of the day, you really enjoy and makes you happy. So talk about your practice now. What is it today, and how is it doing what you want it to do?


Dr. Nick Despotidis: Yeah, what it looks like today is nothing what it looked like even 10-20 years ago, we’ve been in practice for over 30 years we opened up called back in 1998. My partner and I Barry Tannin. And today I have to tell you, it’s a wonderful place. I’m in my early 60s. I feel great every day when I come in and turn on the lights and feel a sense of pride. I’ve designed a practice Barry and I and my partner Ivan have designed a practice that fulfills our values and life. And it wasn’t easy, and it took a long time. But hopefully we’ll discuss the key inflection points that brought us to that decision. So I come in early, I’m still the first one at the office. I’ve designed a practice where my staff who has been with me for a very long time no longer viewed as the enemy. At one time I felt the biggest challenges we all have in practice, I think it can be summed up into two points, cash flow, and staff. Every friend, and colleague I have I’m sure you hear this all the time. He is a staff and or I’m having trouble getting consistent cash flow. And we’ve I’m so proud to say we’ve solved those problems by making radical decisions in different points in our practice. So I come in, I work three days a week I see patients three days a week, Monday, Wednesday-Friday. I’ve developed my aspect of the practice is Myopia Management. We have a multidisciplinary practice my partner, Ivan Lee takes care of Medical Optometry and Primary Care Aspect practice. Barry Tannen, my partner that I started the practice with the Vision Therapy and Vision  Rehabilitation. the Newest partner Dr. Noah helps out with both the VT and Myopia Management. So we have this kind of segmented practice where we have these different subspecialties and we’re able to focus upon them so they fulfill the values of each partner within the practice. You know, it’s a goofy practice. I can’t wait to talk about how goofy it is, but I’m goofy. So we made a goofy practice. We have a dog that we raise an assistant service dog that we’ve raised, it’s our fourth dog we’ve raised and that was a big inflection point in practice. I treat my staff to lunch every week. I treat them to Bagels every Wednesday. We barbecue in the backyard. We do Cinco Demayo we do every holiday that’s worth celebrating in our office because we learned long ago, the staff really gauges or dictates how happy the doctors on the practice, spend more time in our office with our staff that will do at home. That was a realization we had 20 years ago. So if your staff is happy, your patients are happy and you’re happy. So that’s in a nutshell, what my practice looks like at today.


Dr.Bethany Fishbein: And I’m aware as you’re saying it. that this is so different than what you read about on social media sites were OD’s are posting I just saw this last week, a week before from an optometry student says I’m a second-year student at one of the optometry schools and I’m reading what all you guys are writing and I’m terrified so somebody who can’t wait to get it is working the amount that they want work doing the work that they want to do with long term staff members who are enjoying their day. Unfortunately, these days is a rarity. So let’s figure out how you got there. Go back to how you started.


Dr. Nick Despotidis: Yeah, We opened up cold so at that point, Barry and I, we knew each other very little I met him at SUNY College Optometry, we were both intrapreneurial he asked me “What are you doing when you finish your residency? I said “I’m gonna go in private practice” and he goes “Me too, I’ve worked with someone for a year, why don’t we start looking together?” and literally in less than a year with very little science with no demographic research. We opened up at Hamilton Square New Jersey and it was about 1988 and Optometry look very different back then. And everybody told us you’re going to suffer for five years before you break even and you got to work your butt off. Everybody was almost as discouraging as even back then. And fortunately, we had a lot of good colleagues and mentors and before you knew it we started selling glasses and fitting soft contacts and doing eye exams and we got busy, and we got busier. And we took on power practice just when Gary Gerber had come on and produced Power Practice we hired them and sure enough, we set goals and we were doing very well business wise. And that took a lot of stress off, Barry and myself because in the beginning of the first few years we weren’t making great income we have to work somewhere else. But very quickly, within three to four years. We were full-time in our practices and doing very well. We set financial goals based on gross. We will meet those goals and the following year we’d set new goals and we will meet those goals. It was amazing! You know some of you said you want to make $500,000 by the end of this year. It was amazing we made $502,000. So he said okay, let’s do 750 The next year, you know, let’s really go for it. And it’s amazing that you know we’d set these goals and it makes 750 and $5 or something like that. It was incredible, this magical goal set and we kept doing things


Dr.Bethany Fishbein: That’s what I think when we started too. I remember saying that is you know, whatever the goal was, you write it down and you end up right there, and then you’d think, Why didn’t I write down $30,000 more right? Yet you get a chance to do it again. So you guys have really a primary care practice at that point?


Dr. Nick Despotidis: That’s exactly right. For the first 10 years we dabbled, we dabbled in Vision Therapy. I had a VT background, Barry VT background. Barry brought in Orthokeratology in 1992. I thought it was crazy. Crazy! Everybody’s fitting single-use disposable lenses. And he’s going to start fitting a hard lens a gas-permeable and having people sleep with it. I remember not wanting to do anything about it. And so we dabbled in specialties, even Medical Optometry although it was very new at the time we weren’t really that type of practice still primary care glasses, soft contacts, eye exams.


Dr.Bethany Fishbein: Was insurance a thing at that point?


Dr. Nick Despotidis: No! good question actually, it was, we were struggling to get on panels and was struggling to get on Medicare and lose, and then a patient would come in and say do you take this plan? Called I don’t know, this vision plan? You know, we would join this and join that and literally went from not accepting any insurance when we open 12 years later we were up to 50 plans it was all vision plans, insurance plans. It’s just we didn’t accept you know there was a plan that we didn’t accept and we worked and worked hard busier and got more efficient to see more patients, and got better at what we did. And then it was about 1996 I remember, so we were in practice about eight years at the time and we were talking about 1.5 million, 1.5 million, 1.5 million. We got to do this. And sure enough, we did it. And I remember it because it was an inflection point in our lives and our practice. I had a theft in my office we had someone stealing from us. And when we looked very closely, Bethany. I’m embarrassed to tell you we found three people that were stealing from us.


Dr.Bethany Fishbein: From within your office? Employees?


Dr. Nick Despotidis: Yeah, absolutely. We were busy man. We’re very good Optometrists, not good business people and certainly didn’t know much about business. We had mass exodus. I remember one day one office person front desk said, “I’m leaving”. And I say “Good!” Cuz Yeah, I’ll find someone better. And then her sister worked for me left, you know, a few weeks later. And then there was this mass exodus. And I felt I said to myself, good for them. I’m going to hire the right staff. And I’m going to do this better now because I know what I’m doing, and I’ll get rid of you headaches because that’s what you are. So I hired this whole new staff with a whole new philosophy. And within a year, guess what? It was worse than it was a year prior because I was the problem. And it took us such a long time that we were so busy building the optometric practice, we weren’t concentrating much on the business aspect. Forget about happiness. That was you, you relate happiness to financial gain. You need money to buy a house to pay for your children’s education, etc. That’s what we’re focused on. That’s what we based our happiness on these intermediary and long-term goals. But concomitantly, Barry and I would always talk about retirement, even though we’re in our 30s. Like, we could do this until we’re 55. Maybe we’ll sell, get the hell out of here or retire, you know, and that’s what we’re talking about. So even though it’s 20 years away, we wanted out before we even materialized it. And then when we had this mass exodus, and, you know, really embarrassment of corruption within our office, not only financial corruption, toxicity, you know, we were the typical OD that if, if Reddit or one of these sites that you’re referring to existed, I probably post is that where do you get good staff? You know, I had this Office manager work for me for 20 years and she just quits just like that. And she didn’t even thank me and I have this other one who’s stealing from me. So I would if that technology existed, I’d be one of them. And thank goodness for Barry my partner. He found this crazy dentist called Paddi Lund in Australia. And he was lecturing at the time about building a practice that brought you happiness. And it’s like what? What do you mean designing a practice that brings you happiness? And we would start buying his audiotapes. This is back when there was audiotapes and talking with our staff almost a weekly basis. How do we turn this office around? We’re not happy here and none of our staff work for us for financial reasons because they could go across the street, especially in today, and make more money across the street. And what we found is that we needed to define what we value most in life, the partners, and that boil down to family and kind of our patients doing a good care feeling at the end of the day. I help patients uniquely and in our case teaching and it sounds corny, you know you hear it all the time, write down your mission statement ,write down your values. But we actually did it from 1996 to 2000. We realized that being busy did number one did not translate to profitability, which was a first you’ve really enlightenment that being busy, really busy for exams in our two checks, in that our six patient encounters an hour did not translate into profitability. That was the first enlightenment. And two, it certainly didn’t translate to happiness inside and outside the practice. So we just had enough courage at the time to start making huge changes between 1996 and 2000. 


Dr.Bethany Fishbein: I know that Paddi Lund an inspiration. Tell the story that he shared was that like, wasn’t he the guy who chopped his desk in half or something?


Dr. Nick Despotidis: Yeah, he basically I don’t know if he states it was clear. He had a nervous breakdown, right because he had two dental partners. He had a busy dental practice. He had a big staff and he was miserable. And one day he just decides to lock his front door, take himself out of the phonebook, drop all insurances. And as the story goes, he takes a chainsaw and cuts up his front desk because he didn’t want that barrier between his patients and himself. So he designed the practice totally focused on bringing him and his staff happiness. So at the time you think this guy’s a nut, I remember even have to listen to his tapes we have to call somewhere in Australia to find if he really existed, because can someone really design a practice where social medicine exists,that’s not based on accepting insurance? Can someone see less patients and make a good financial income? And we, we drank the Kool Aid. And, you know, that’s what we slowly took 20 years and that’s where I am today is his practice is very similar to my practice today where it was based totally on referrals. The patients he saw, were based on referrals from friends and family. In other words, he would only see patients that were referred by current patients. And it took me 20 years to muster up enough courage to develop the systems where the majority I mean, 99% of the patients I see on a daily basis, were either reoccurring patients or patients were referred by current patients, and I don’t accept any insurance. You know, I had one last insurance, Medical and back in 2000. As you may know, we dropped all eyeglass plants that was part of our misery we found out because we had paperwork and eel B’s and just doing all this song and dance to sell a pair of glasses sell the second pair first and do this and sell coatings and do you know sell the solutions and give the solutions free? It was just exhausting. Let alone as Optometrists, we have to make sure that we’re not missing Optic Nerve head issues, Macular issues, Retinal issues, and Neurological issues. In addition to thinking I have to sell the second pair first. It was exhausting. So we mustered up enough courage and developed plans. We’re in 2000, Now this going back 22 years ago, we dropped all eyeglass plans and over the next 20 years, I dropped all my medical plans.


Dr.Bethany Fishbein: So you hear about this crazy guy in Australia you get the inspiration he can do something that bold you can start to make bold moves, was dropping the eyeglass plans the first?


Dr. Nick Despotidis: That’s exactly right. Before we, that’s exactly right. And let me tell you very few people were on board including the optometric partners, you need to have had it you need to reach a point of exhaustion. My staff was petrified one of the vision plans was 20% of our practice. So you do the math if we were doing 1.5 million 20% was a big chunk. But all we saw Bethany, we were gonna get busier because we were good at what we did. We like seeing patients and I say Bethany, how are you? How is Jonathan, how are the kids? How’s the dog and I like to talk to you about it. And you like coming to me because of that interaction we would do that. And if you said, if I look in and see your vision plan and say all this in vain, and she took her script, and we get audited once a year. You start resenting this because you can’t change the optometrist you are so you start resenting that you’re doing your very best but not being it’s not being reciprocated. People are starting to take their prescriptions we were monitoring prescription flight at first it was 5%. Then it got up to about 7% Then it slowly through the years. was up to 28%. And it was looking so ugly, we stopped looking at it. And all our focus was to stop that. So we stopped vision plans. And we start focusing on how do we make a good income without based on volume and vision plans.


Dr.Bethany Fishbein: So after you make that shift, did you, was it awesome right away to do like, did you ever have a time where you went back and thought Oh, was that the right choice?


Dr. Nick Despotidis: That’s a great question. It was a dumpster fire. It was awful. Because we dropped all these plans. Barry and I built a building together to house this 5000-square-foot dream office. We had a space for some tenants that were going to help us offset the mortgage. We dropped all the vision plans now we had rehearsed that we needed to be better than most in catering to the patients that stayed with us. We opened the doors were very busy. The first month were even busier the second month, and then a series of events beyond our control happened and the realization that a lot of patients weren’t going to stay with us. So three months into it. We really hit bottom. Anthrax, 911 hit at 2001, we dropped all these plans thinking at least 50% are gonna stay with us, only 5% stayed with us that 95% of that 20% of practice went elsewhere. But you asked the key question. We never regretted it. Not my staff, not Barry not myself and Ivan had just joined the practice he sold his practice. Young OD who is booked out six weeks in advance building this beautiful 5000-square-foot office leaves his life joins our practice and hoping to become a partner and just the floor drops beneath us. But during that time, no one ever said. Oh my god. Let’s go back. What we did is say okay, we were like square one are we don’t have patients today? Today! We were six weeks out. We don’t have patients booked today. We got hungrier. And I started lecturing about Myopia Management back then Barry started lecturing to OTs and, and and anybody would listen to him about Vision Therapy and vision-related learning problems. And Ivan did an alliance share of the primary care that was left in our office doing a great job speaking to patients who came to our office, and sure enough, slowly and not smoothly. We started getting busier in 2002 Just a little bit to say. And then by 2004 it started getting busier. 


Dr.Bethany Fishbein: I mean, Sorry, there are so many things I want to ask you. I mean, one of the things that I learned from you years ago and have repeated many, many times is the value of that blank space. Like I know when you talk about building a Myopia Practice you talk about OrthoK, you know, set aside these couple hours a week where you’re going to see Myopia patients and everybody says okay, but what if I don’t feel them? 


Dr. Nick Despotidis: That’s right. 


Dr.Bethany Fishbein: And I know your answer is then to spend those two hours thinking about how you’re going to fill them for next week. And so this is that, right on a big scale. You didn’t have any patients. So you had the time to figure out how are we going to get some


Dr. Nick Despotidis: Yeah. And I think, yeah! 


Dr.Bethany Fishbein: The value of that time and that’s one of the scariest things we start to talk to people about dropping plans. And, you know, anthrax and 911 aside, although we can say, oh, stuff like that never happens because we just got through two years of it and maybe into another, but you know, they can drop a plan and then they go from six weeks to four weeks fine. drop another one. Now, your two weeks, and people start to get cold feet, but having that time to figure it out is so valuable.


Dr. Nick Despotidis: Yeah, that’s why it has to be based on values. It’s very scary. I lecture on this, and I do it I walk my talk but every time I signed that form that says I’m no longer going to participate. I literally shiver. I’m embarrassed to say it I shiver. I am scared because I associate success with being busy. And remember my office manager has been with me for 35 years going on 35 years. She was yelling at me she goes “Dr. D, Would you rather see a patient and make no money or have an empty space?” And I answered, “I rather see the patient.” And she goes, “Do you hear yourself?” You know, and but it was true. I would rather see the patient and let them walk out the door with their script and order their contacts online and get reimbursed nothing. Then have that empty spot that was what I felt because I was everybody asks us, “Are you busy? Are you busy? Are you busy?” Because busy used to translate to profitability, for us we did it slowly just like you said we dropped one insurance. We weathered the storm started dropping medical insurances. One it takes maybe a year or two to recover, but you fill up with better quality patients that are there to see you. Not because you’re participating in their insurance. That was my value. I want people to say “Dr. D, you’re the best doctor!”, not because I’m the best doctor. It’s to them. I fulfilled a value in their lives that they appreciate to acknowledge. “Hey, thank you very much for talking about cell phone use. To my child”. It wasn’t thank you for doing the best refraction, the best ortho K fit, seeing me on time and getting me out on time or fitting me with the best pair of glasses. It was you cared enough to spend five minutes with my son or daughter to talk about screen time or going to sleep on time or going outside for God’s sakes and stop looking at their phone. That’s what they thank me for but when I was just doing it, doing it, doing it. All I was thinking about is my god exam room two and three now have patience, but I still have to finish with this, but your mind is never where you’re at. And you can’t relax, you can enjoy things.


Dr.Bethany Fishbein: So, once you drop these plans, you intentionally slow down your schedule a little bit?


Dr. Nick Despotidis: That’s exactly right. And each time it’s scary, but with each dropping a plan. It’s kind of like with every pound you lose, you kind of get a little bit of encouragement. Maybe the struggle is over. You know, maybe I’m on the right track. So what happens is we started seeing that, we cut, we reduced. This is unbelievable. We reduced our volume of primary care by 25%. And we netted the same amount. So that’s counterintuitive. So for example, we closed Saturdays now, to me Saturdays when my kids were younger was everything and I only worked one Saturday a month, Ivan worked one, Barry worked one but still, I despised it because I had no shows. You know it was I was getting home late and aggravated because it’s something that may have happened the office so we closed Saturdays at the time. We would make three to $5,000 a Saturday times 50 weeks you do the math. We should have lost some net because we certainly lost gross. No! So we closed one day a week. We were literally close Saturdays. And at the end of the day, at the end of the year, we made as much so that to us was a winner. It was also a sign that wait a minute, volume may not be the answer here. It’s the quality of patient who’s sitting in front of me and it’s the quality of my state. So that was huge. That was really huge. So then, like you said our schedule refilled up a reduced schedule. And then I would say about almost 10 years ago, I built up quite a successful Myopia Management Practice long before Myopia manage became the thing and it was getting busier, much busier. And I was seeing Primary Care and OrthoK, and Wednesday nights,  I remember this was a tipping point. We had a very busy Primary Care night and we had a very busy OrthoK night. And I had to have to spend time with my OrthoK patients because remember, they’re the ones who feed my practice. So that’s a need we dropped all our Primary Care on Wednesday nights. And two doctors see only Myopia Management simultaneously. So in other words, we see three OrthoK patients an hour in the afternoon in lieu of Primary Care patients. So in our practice, we see six patients an hour between two doctors, we have time, it’s 20 minutes each plenty of time to do our due diligence with the exam, and plenty of time to talk with him. But we were shaking, because you see what we did. We cannibalized our primary care in lieu of something we really wanted to grow.


Dr.Bethany Fishbein: What was the outcome of that? 


Dr. Nick Despotidis: It’s just there’s no better feeling. I have to tell you. It was scary. It didn’t reap rewards right away. But I just finished saying I see three patients an hour. That’s compared to 6-10-15 years ago. I have time to talk with parents. They thank me. They tell me I’m special. It’s not Chuckie Cheese every day. I get the yelling that we all get. I get the upset parent because their lens broke and we want to charge them I get all that nonsense. But the difference is, I was reimbursed for that. I took it into account with my fees. I have control over my fees for God’s sake. When I lecture to people now and they tell me their fees have not gone up with the insurance that they’re accepting and everything around me has gone up. Gasoline, Ophthalmic lenses everything but yet we have a governor a stopping when we accept insurance where I was able to adjust my fees accordingly. So it’s not like every patient encounter is like I said roses and butterflies. But I am living my practice the way I want and this is one other important point. My staff went from seeing six an hour or if there are two Optometrists 12 an hour just seeing six an hour or half. So I keep my staff longer. They’re happier. There’s not this mill that’s going on. Our front door still remains locked, not only because of COVID but I like not having a reception area filled with patients which in the past I associated with success. Now it’s quiet. It’s peaceful. It’s like Paddi Lund’s practice. It’s by referral only. I see one patient I run on time every time but I couldn’t do that unless I took control of my practice. And it’s not just OrthoK or Vision Therapy. Ivan is designing that primary care practice because he’s also dropped all these vision plans and 90% of medical plans. So the patient he sees is the patient that wants to see him. So he could also spend the time talking about their ice cream store or whatever they want to talk about at the top. It was the funniest thing I had a patient long-term patient yesterday and I’m ask Ivan to consult because she had a cataract and she had macular issues. And all Ivan in this patient talked about was her ice cream store. So it’s it that’s what she wants to talk about. And that’s the practice we built so you could see it’s a ripple effect. It’s not one thing you do. It’s like you have to realize, seeing all these seen all these patients have planned that’s one business model. Build it to you get out. Now I’m in my 60s. And Barry and I don’t talk about retirement, why would we retire if we’re really honest, and say we enjoy what we do every day in the practice, which also supports a great life outside the practice. Why would you sell but it took these inflection points to really have enough courage or faith, not fear, not fear. Fear is a constant. But the faith that this decision you make is not the end of the world. I mean, it’s not the end of the world. Actually, Power Practice taught me that is that you’re not your practice. will not shut down if you dropped this insurance. And sure enough, I’m still here. So it’s having that courage to make a decision. Despite the fear. The fear doesn’t go away. I was blatantly honest with you. Every time I make a decision, I still shake in my boots. And I’ve been doing this a long time. But I have enough faith that I’ve done this before. Let’s make it what the hell and it reaps rewards.


Dr.Bethany Fishbein: Absolutely. So now you’re off the vision plans. You’re off the medical plans. But then there’s still stuff that comes up and you realize like, what’s the next level? What’s the next level? So what are some other big decisions that you’ve made or things that you’ve done for? pure not for pure happiness? Because it’s it’s not that doing something to create happiness takes away from the business. The decisions that you’re making are ones that make you happy and build your business too. So what have been some of the other big ones? 


Dr. Nick Despotidis: Well, I want to I want to be honest with everyone. It’s not like my practice grows and grows and grows and grows and grows. If Iwas if I was telling you that you’re full of BS. It’s not how business goes. It’s not how practice goes. So right now, my practice after the pandemic or during the pandemic, we’re not over it. We had enough experience where when our practice went silent for three months, we all took charge. We picked up the phone we called patients we did seminars, virtual seminars, we really never ghosted our patients, even though our doors weren’t open. And then once our doors open, slowly but surely keep crazy busy. And now we’re at a low and I don’t panic now. It’s like okay, what’s interesting, so I monitor my practice by how many new fills like if I was an orthodontic practice, right? How many new braces or people are coming in for braces, so I’m not just adjusting them all day, if you will. So the what we do is I have these meetings every week with different departments. And we say look, I noticed that our fill rate is not what it was last year. So it’s not like we’re always filled up it’s Chuck E Cheese every day. And then when the fill rate is 100% In other words, all those consults are filled. Like you just said, they’re they’re empty right now some of them so I could panic and put in I don’t know, emergencies or comprehensive exams, but I don’t. I said, What’s going on here? And what can we do about it? And then we come up with these crazy ideas like having a movie night and I say we can’t have a movie night because I used to have these Harry Potter movie nights screenings, I used to invite hundreds if not 1000s of my patients to Harry Potter premieres and then afterward I would do career seminars and I would do leadership seminars. And after COVID We stopped and we did virtual seminars for a patient that weren’t successful. So what we’re going to do is an outdoor, it’s crazy. It’s absolutely crazy. I’m so excited that my staff thought about an outdoor movie night on this premiere of “Screenagers”, which is a documentary on how cell phone use gets out of control. And what it was parents do about it because we know there’s no one answer. So just picture, you invite your current Myopia management patients for a movie night outside, there’s a popcorn guy, there’s a hotdog guy, it’s late. And what are we doing? We’re sneak attacking these kids because the parents love it. We’re talking about technology and there’s a side effect to being on Tiktok and Snapchat and Instagram. And this creates a buzz within my community. And it reminds my patient, this practice is different than most. So not only when we’re slow we’re thinking about how do I fill the practice like you thinking big picture. And it just you hear it in my voice, right? It’s crazy. Movies, kids outside in the parking lot, Popcorn machines, but we’re making our practice worthy of discussion. So the next time a patient says where do you go to Myopia control? The doctor across the street? the doctor down the road? doctor where my friend with? I’m hoping they say there’s only one practice you go to and that’s what pushes my buttons right now financially. Optometry has been so good to all my partners, even the youngest partner, Optometry has been very well to all of us financially. It’s not like we fly planes and drive Maseratis and you know, have multiple homes in multiple countries, but we’re very comfortable. We’ve paid the older partners have paid for their children’s education and master’s degree and weddings and all that stuff that came from Optometry. Now we’re based on how do we continue feeding our values and that’s what these crazy ideas come from, you know, bagels every Wednesday, little things like that mean so much to me, because I have to get special bagels, bagels that they rave about why tomorrow we’re doing it’s Friday, right? We’re doing a barbecue out back and I smell like barbecue because it’s something they go home and they tell their family. Hey, this is unbelievable. We grilled salmon steaks or burgers outback, but I did this crazy stuff long before we had a backyard. Because I know my wife thinks I’m crazy, but I have something to talk about. And then my staff has something to talk about. So they’re all interconnected.


Dr.Bethany Fishbein: And one of the crazy things you mentioned earlier that sounds wonderful to me, is having the dogs in the office talking about that.


Dr. Nick Despotidis: That took a lot of courage because when my children you know flew out of the nest if you will left the void on my wife and I, we started raising the service dog and at the beginning, I only brought the service dog in once a week. On my administrative days. It was shy I was afraid a patient would see this dog. God forbid I saw a dog hair on the floor. You know we really pride ourselves in cleanliness and then we raised that service dog past we adopted another service dog. And I brought him in maybe two days a week. So now we have the service dog comes in every day. And he barks he’s a barker. The other dogs weren’t and I thought patients would lose their mind. And patients have accepted him amazingly well. As you know, We sent out an announcement we have a new staff member, his name is Lionel and patients now at the end of the exam, say where’s that new staff member you talk about? And so it’s been great. We did this I bring him in the office because COVID-19 has stressed all of us out stressed me out to this day. You know, should my staff get vaccinated, my staff doesn’t want to get vaccinated they want to get they don’t want the booster. They’re getting sick. All the stresses you guys have in your office. Believe me, I have the same and I lecture to them but it’s still it takes time. The dog is the buffer. The dog is someone who they’re helping train or spoil or hug or feed or petting when something goes wrong in their personal lives. So it’s really been a blessing Bethany that I’m bringing them everyday hasn’t been easy. gotta walk in, train him, but we’re now, it’s like this family unit. We all have this common pride that we’re raising a service dog for a bigger cause than us but as I got to tell you, the benefit is more hours than the recipient of the service dog. So it’s kind of a sneak attack on my staff. Because bagels get old Cinco Demayo and Thanksgiving we fried turkeys in the office on Thanksgiving and twice the police have come because the smoke detectors come up. All those craziness is, is basically produced by me to keep my staff engaged in something bigger than just seeing patients and the dog was just a sneak attack on them.


Dr.Bethany Fishbein: And you said that your manager has been with you for 35 years. Are you feeling that you’re a little bit noninsulated because it sounds passive but do you feel like you’ve insulated yourself a bit against so many of the turnover issues that people are having when it comes to staff?


Dr. Nick Despotidis: No, that’s a great question. After COVID I would say we lost at least three staff members that retired they stayed with us after 96 we’ve kinda got handled of staff. The handle is “staff I feel” this is just my personal. You can’t rule them with a big stick they have personal values. You can have scripts, which we have, and procedures, but they have their personal lives. So I feel the staff is my customer just as much as my patients. And I got to make sure if I want them to stay in my office I have to fulfill their values in life. So they are my other customer if you will. So after COVID, We were short-handed just like everybody and we were competing about the Amazon that’s offering $25 An hour starting salary across the street from us because we’re in the state capitol was Amazon you know built a big facility and Mackay, www.mackay.com. McDonald’s is starting salaries at $15 an hour. So I wasn’t insulated, and I did have a hard time. Like we all did amazingly hard time bringing in stiff differences. I didn’t rush the process took us six months. Because I learned you fired quickly when someone’s not working out within their first three months. You know they don’t get better. And you hire slowly. And so we took our time to sure enough we’re over-staffed right now. Right now we’re on my purpose because we know we’re going to have some attrition. And you know, we’ve never bought into after we got a handle on this that staff is the biggest expense like you know, consultants when they came in. may tell us you know, staff your staff is 30% of your gross or whatever they would say we don’t look at it that way staff is the quality of our lives. We know someone’s gonna leave someone’s going to get sick. Summer is the worst time of vacations. Let’s be overstaffed. So the staff members we hired surprised us because they want to become certified optometric technicians. They want to take courses on organization on be more efficient with their time. They want to grow in other words, so it wasn’t just salary. It was I want a clean, professional place to work and here’s the key that I’m respecting, and I’m respected. So we have an insulated ourselves, but we are happy to say that right now. We are in a good place won’t stay that way but we are really in a good place.


Dr.Bethany Fishbein: And I know you’ve been in power hour before with Gary talking about one of the other big bold moves that you took for your sanity and happiness. I know you did an episode a couple of years ago about the decision to stop selling contact lenses. Is that still a thing?


Dr. Nick Despotidis: Yeah, definitely a thing. You know, it was also a very scary time. This office manager has been with us for 30 years. She’s a thorn in my tushy because she’s always telling me like it is and she was the one that asked me. Would you rather see a patient and lose money or have an empty slot? She’s also wants his voice listen to me. This is a game that we can’t win. Look at how much we’re paying for these contacts. Look how much I could pay for them online in all this effort to bid some patient you know, on and on and on. So about five, six years ago, I don’t remember how long it was we dropped it. We were making money. But you know what? Again, it left space in my brain. So I don’t have to tell people listen, get a year supply right now. We have coupons for you. Whatever I was saying at the time I just give them their script. And they asked me where to get them and I say you know what is readily available whether it’s Walgreens or Costco and 99% are relieved 1% still said like to get them from you. And we say No, unfortunately not. Unless it’s a specialty lens. It’s not where we’re at soft lenses are not where we’re at.


Dr.Bethany Fishbein: Awesome. Any other big decisions, anything I’m missing in your story here.


Dr. Nick Despotidis: Yeah, I just want to close on one statement. I really appreciate the opportunity to talk with everyone. When they come to my seminars. It’s a trick, right? They’re coming to learn about Myopia management and they want to grow in OrthoK  practice wherever they’re coming from. And my courses are not about that. It’s building a practice that fulfills your values and I use this IBM approach that I was taught by Franklin Covey, again over 20 years ago, the IBM is, if I say Bethany, I’m going to put a two by four on the floor. And I say Bethany I’d like you to step on the on this two by four and come towards me. And when you’re done, I’ll give you $20. And most participants say, Yeah, Nick, I’ll come over and here’s $20. That’s it, Bethany. Now I’m going to place this two by four sturdy one between two chairs that are about 20 feet apart. I’d like you to work for one to buy for to the other, and I’ll give you $500 And would you do that Bethany if they were bought for 500 bucks.


Dr.Bethany Fishbein: How high are the chairs?


Dr. Nick Despotidis: About three feet? 


Dr.Bethany Fishbein: Sure!


Dr. Nick Despotidis: Okay. So a lot of people say sure. So you come in this net so I keep doing the story, right? An IBM is a piece of metal I don’t know if you know what an IBM it holds up structures. So I take this IBM now and I bring it from my building to the other building and you’re on the roof. And I said Bethany crust, the IBM, I’ll give you $100,000 You know, if you cross it, you know, there’s a chance you fall but you know, most participants at that point say You know, I don’t know some say yes because $100,000 is a lot if you don’t have it they figure that out. They’ll cover some of the medical expenses. I don’t know what stupid reasoning they have, but some people will cross it. And then I take it all the way up to a skyscraper. And I say, I dropped this from one skyscraper to the other and I say, Bethany, if you cross it, I’ll give you $10 million $10 million. You know, there’s a chance there’s a chance you’ll fall there’s a good chance, but there’s $10 million and I’m not going to put you in that spot because very uncomfortable. Some people say yes, but almost 99% say no. And they say ok, $100 million $100 million cash, and I see you shaking your head. Everybody says no. And then this is unfortunate and I’m sorry if I offend anyone. I take your child and I say if you don’t cross that skyscraper, I will drop your child right now. And 99.9% Say, I’m going to cross that IBM. And when I get there, I’m going to kill you. No thoughts, right? No thoughts because they value what I’m holding. Yet in practice, I learned I was chasing something I would never cross the IBM for at the expense of ignoring my family. You see how ironic this was? It took this course that taught me it’s you better know what you value in life. And don’t ignore it because it won’t be there forever. So in business, sometimes we ignore things that we would cross the IBM but we would never cross the IBM for the things we spend the majority of our time with. And I think that gave me the courage to overcome my fear, to stop selling soft contacts to stop all these silly plans that I was accepting and make the decisions. And that’s why, you know, I’m speaking to you today. Yes, we are happy it’s not because every day is rosy. Because I learned that lesson long ago. That was the actual finish.


Dr.Bethany Fishbein: Amazing! Nick, Thank you so much for being you and for having that courage being a guide for so many people. If people want to hear more of you. People want to take your course how do they find you?


Dr. Nick Despotidis: Sure. I only give the course once a year and it’s at the Vision by Design Meeting, Ortho-K Meeting this year, it’s in Bellevue, Washington at the end of September. It’s an all-day course it’ll be on a Tuesday. So you have to make a big commitment. And they could find out about it with www.superchargeyourpractice.com .


Dr.Bethany Fishbein: And for more information about us, you can go to www.powerpractice.com Thank you so much for listening.


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