If you want to learn the What, When, Who, Why, and How’s of the Power Practice, this podcast episode is for you. Dr. Bethany and the team discuss what clients can expect if they consult with The Power Practice. Learn more from these clients turned consultants because this is a discussion you wouldn’t want to miss.

September 21, 2022

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Sarah Dau: Not only do the OD consultants understand owning a practice and owning a business in today’s environment, but they’ve been through that client process and really having someone come in and dig deep and find opportunity areas or take what you’re already doing well and take it to that next level.

 

Dr.Bethany Fishbein: Hi, I am Bethany Fishbein, CEO of the Power Practice and host of the Power Hour Optometry podcast. And today I’m talking with some of my favorite people in the world. This is our team of business coaches at the Power Practice. And we’re talking about the process of working with Power Practice as a client from the initial phases of reaching out, thinking you might need help, all the way to our greatest success stories. So I’ve got with me, Sara Dau, Paul Ferraro, Denise Kolker, Alison Kramer, who’s also Ali. So you’ll hear Ali and Alison interchangeably. They’re both her. And looking forward to hearing some of the wisdom and some of the stories that they can share. So thank you guys for being here. 

 

Paul Ferraro: Pleasure. 

 

****: Thanks.

 

Sarah Dau: Glad to be here.

 

Dr.Bethany Fishbein: Excellent. Let’s start at the beginning of the process. And actually, before we do, I just want to figure out our combined years of experience. Sarah, how long have you worked with Power Practice? 

 

Sarah Dau: Eleven and a half years.

 

Dr.Bethany Fishbein: How about you Paul?

 

Paul Ferrero: Eleven years. 

 

Dr.Bethany Fishbein: Ali?

 

Allison Kraemer: I think it’s been ten.

 

Dr.Bethany Fishbein: And Denise, the new girl? 

 

Denise Kolker: Six. 

Dr.Bethany Fishbein: Six years. So you’ve got 21, 31, 37, and throw in my 12. I think that’s 49 almost 50 years combined experience of working with independent optometry practice owners to help them make positive changes in their business. That’s awesome. 50 years. Go us! Yeah. All right. So let’s talk about it from the beginning. Sara, Ali, and Paul, I know you guys are the ones who are answering those initial calls when a doctor reaches out expressing interest in consulting. What are some of the things that you’re hearing on that initial phone call about? What situations are people in that make them want to look for a consultant in the first place? Or what’s going on in their practices that they’re looking for help with?

 

Sarah Dau: There’s a few top reasons that come to mind when you ask that Bethany. Number one is frustration. They’ve got a practice that is not where they would like it to be and they’re not exactly sure what steps to take to get to the next level. Another way would be or another reason is that they’re doing well. And they’re constantly looking for new ways and ideas to continue on that path and keep that momentum going. So they’re just looking for some additional guidance and thoughts on how they can keep moving forward and hitting new goals. We also have some that want to start their venture into Practice Ownership. So they’re working as an associate somewhere and they want to either open cold or they want to purchase an existing practice. Those are the top reasons.

 

Dr. Bethany Fishbein: Paul did you have anything to say? 

 

Paul Ferrero: Yeah. I’ll continue to build on what you had to say, Sarah. So when we get into conversation with folks who reach out to us, you could almost categorize some of the challenges or concerns that they’re calling for. It could be financial. It could be growth-oriented needs. It could be a staffing concern. It could be leadership development. It could be culture development. And through that initial call or discovery call, we try to isolate or define what that challenge is. Begin to understand a little bit more about their business before we could start to contribute any type of notion of an idea or a strategy to help them overcome that challenge.

 

Allison Kraemer: Yeah. I also find sometimes it’s just a general feeling of being out of control and they don’t even really know what it is that they’re looking for. So once we get into a conversation with them, we can figure out like what is creating that and what’s causing that “chaos feeling”. We really help identify what their opportunities are,

 

Dr.Bethany Fishbein: Ali keep talking about that a little bit because I think that that leads us into some of the first steps that we take. When somebody does come on as a client that there is that process of like, “I want to be better.”, “I want it to be different than it is now”, or “I’ve lost control.” Or “I’m just starting out.” and “I know I want my own.” but not totally able to define at the early stages what it is that that looks like. How do we help them through that in the beginning?

 

Allison Kraemer: I mean, we definitely do some staff surveys to find out what’s going on behind the scenes. So I think that that’s a really valuable tool that we use. They’re anonymous. So the staff is super comfortable in giving us feedback that comes directly to us. We also look at their profitability and their cost of goods and all the things that go around with owning a business. Then identifying that, we look at some of their billing and coding and what their general is. How they are diagnosing and how they’re clinically seeing patients whether it’s medically-based, or whether they have specialty care. I mean there’s just so much learning and that goes along with bringing somebody on board before we even get started with the process

 

Dr.Bethany Fishbein: So those are like the analysis things going on behind the scenes. What are the initial conversations happening with the new client when we first start working with them? While we’re looking at all those things, what are the things that we’re talking about?

 

Paul Ferrero: Yeah, in the early stages, we’re trying to understand what their goals and objectives are, whether they be professional or personal. So we could better understand where they see themselves in 2 years, 5 years, or 10 years out. Once we understand that and we learn a little bit more about what’s driving their reason for reaching out, it gives us a little more understanding and enlightening so to speak of where we can begin to help them achieve their goals.

 

Allison Kraemer: You’re right, Paul. I mean it’s really about like finding out what their vision is. A lot of times people don’t even know what they want. So first getting them to identify what does that perfect practice look like? Is a super important piece of the puzzle. 

 

Dr.Bethany Fishbein: Right.

 

Sarah Dau: And I think we do a great job at pulling that out. For some, it’s really quite easy for us to ask them, “What’s the vision for their practice?” or “How do you envision your “perfect practice” or ideal practice?” Others we have to ask some deeper level of questions to kind of really dig down and help them to pull that dream practice out of what their thoughts are and really put it to reality and make it come to fruition.

 

Dr.Bethany Fishbein: So when we’re having those initial conversations and determining if somebody is going to be a good match for the Power Practice and we’re going to be a good match for them, what are some of the green flags that tell us this is going to be somebody great to work with or I can tell that this is going to be successful from right off the bat?

 

Sarah Dau: I would say, “Gosh, that’s a great question.” Enthusiasm, being open-minded, willing to share, and carve that time out of working in the practice seeing patients, and working on their practice. That’s a very different role. So I think setting aside that time to be proactive is crucial to their business. And if they’re able and willing to do that, it gives us that time that we need to work together and strategize and implement and really move things forward. What else am I missing guys? What else are you thinking of?

 

Allison Kraemer: It’s got to be somebody that recognizes they’re part of this success. It’s not just us doing it.

 

Dr. Bethany Fishbein: Right. 

 

Paul Ferrero: And I also think, you know, being open to change. Being willing to change some things that they’re really set in their ways. In their practice, they may have been doing this for many many years but being open-minded, like you said, and willing to make those changes. You know, both Sarah and Denise touched on the word willing. You know, willingness and commitment. It’s a partnership when we work together. It’s a collaboration. Sometimes people believe that “We’ve hired a consulting firm and tomorrow is going to be better.” It would be better if we both commit to the goal and we work collaboratively towards that goal. And to do that, the two words that come to mind, as we’ve already said, are willingness and commitment.

 

Dr.Bethany Fishbein: Yeah. So those are the green flags. What do you guys pick up sometimes as red flags? That somebody’s reaching out but is not ready or is not likely to work well with the consulting process?

 

Allison Kraemer: I feel like when they want to place blame on everybody else around them is when you know it’s going to be a bit of a challenge. It’s you know when they say things like, “My staff doesn’t listen.” or you know, “Nobody does what I say they can do.” It’s a clear indication of they think it’s just happening to them.

 

Dr.Bethany Fishbein: Yeah. I think that’s one of the things that are pretty common to come in with. There’s gotta be some sense in there of, “Okay, maybe I have some part in this.” right? So somebody who truly believes that life is happening to them, you know? They have no control over this. I agree. That’s somebody who’s difficult to work with. But when somebody’s got that little light on, that says, “Your staff. What? Who hired them? Who lets them come to work every day? Oh! It’s you.” and they say, “Oh!” I find when working with clients, one of my favorite transitions to see is that change and feeling from initially, “Everything’s happening to me. I have no control of insurance company, staff, economy, blah, blah, blah” to “Okay. I’m the one driving this. All those things might be happening and now I’m in the driver’s seat deciding what we can do about them.” So those are things that absolutely have to be turned around. Anything else you guys would qualify as a solid red flag? How about you, Paul?

 

Paul Ferrero: Yeah. I think early in our conversations, you could get a general sense of whether the glass is half full or the glass is half empty. You always hear reasons why not to do something. But instead of and it goes back to open-mindedness. You sometimes like to hear, “That’s a good idea. Let’s figure out how we can do that.” rather than, “That won’t work here.” Because that’s a dangerous expression. That expression, “Because this is the way we’ve always done it.” It’s so dangerous. And if you’re not willing to be open-minded and try some ideas that have been tested through thousands of practices over 25 years, then we’re not a good fit and we move on. It was nice to know you. We’ll part as friends but we’re just not a good fit today.

 

Dr. Bethany Fishbein: Go ahead, Denise.

 

Denise Kolker: Yeah, I think. I mean I think the other thing too with that is that they have to be willing and be behind that change and willingness to make those changes. Because if they’re not completely invested in it, then their staff won’t be invested in it.

 

Dr.Bethany Fishbein: Yeah. And they’ve got to be willing to sometimes go through a little bit of discomfort of trying things a different way. Right? The way they’ve only always done it, it’s comfortable. And it got them to where they are which they’ve established isn’t necessarily where they want to be. So to get from where they are to where they want to be, they’re going to have to do some things a little bit differently. Whether it’s how they’re interacting with staff, sometimes with patients, looking at certain numbers within the practice, just all kinds of things. So let’s talk about the consulting process because I think that’s something that is really unique to Power Practice and something that we’re doing quite differently than all of the other I think optometric consultants in our industry. So once somebody says, “Yes.”, we go through those initial conversations. What happens next?

 

Sarah Dau: Well, when they say, “Yes.” and they join the Power Practice family, we get to work right away in really gathering a lot of initial information to help us, you know, understand and best prepare for that site visit when the OD consultant comes to the office for the day. So we send out something we call our Practice Profile that takes a lot of the information from the practice – financials, staff, how many lanes, equipment, specialty care. All that fun stuff and take a look at their financials. We, as Ali mentioned earlier, we’ll do a staff survey. We do a competitive analysis. We’ll take a look at their billing and Procedure Code report. Then we have an initial phone call with our new family member and our OD consultant and the coach that’s assigned to the team. And talk about that information, uncover any additional information that we need, ask additional questions, and really take the time to know that doctor and their staff to the best of our abilities before we come in for that site visit. It’s very important. Clients will come to us perhaps for the “same reasons” but the practice and the team behind those reasons or those goals are different with each and every client or family member that we work with. So that changes our approach to how we’re working with them because there’s a lot of different dynamics that we have to consider and take into account when we’re going to be working with them and coaching them towards goal attainment.

 

Dr.Bethany Fishbein: Okay. So you mentioned the team, right? So now we’re putting together a team to work with an individual doctor. Who’s on that team? And what does that look like? And how are they picked? Because that’s something everybody always wants to know who am I going to be working with?

 

Sarah Dau: That is a top question. So the team would be an OD consultant, as well as a coach or implementation business coach. So it’s a two-person team there that will work with the client and his or her staff as one big team. We take into account, I think, a lot that has to do with personality. We have a lot of different personalities on our team, which is what makes us so great, in my opinion. A lot of diversity there. And we get to know the client through talking with them about their goals before they agree to sign on. We do have several conversations and get to know them well and to understand their working style and personality type. And we’ll certainly take that into consideration when we look at our consulting and coaching team to make that right match early on within that process.

 

Allison Kraemer: And I think that’s the most important thing. That is that we really strategically plan who is behind that particular client based on the needs of the business, whatever specialties they have, and, like you said, personalities as well. That part’s really important for the success.

 

Paul Ferrero: I think an important member of our team is the consultant who’s an optometrist. And our consultants have varied backgrounds and experience in the industry, different sizes and scope of practice, and different areas of specialty. But one thread that is unique, they all started as clients here at the Power Practice. And, for the lack of a better term, have come through our process and methodology and we have a really good understanding of how to help other practitioners. So when we’re sitting with a new client and we’re gathering as much information as we can about them and trying to understand their goals and objectives, we’re carefully matching up skill sets and knowledge and areas of specialty that’ll nicely fit into what the client is looking for. And I think that’s pretty unique and is a major contributor to the success we’ve had with the thousands of clients we’ve worked with through the years. 

 

Sarah Dau: Yeah. And Paul that’s a great point that all of our consultants were clients at one point. So they’ve been through and not only do they understand what the client is going through. It can be. I do find that sometimes clients, new clients, will get a little nervous like, “Oh my! Okay. They’re going to come to visit my practice. That’s great.”  But sometimes there can be some angst that comes along with that like, “Oh my gosh! What are they going to find?” And not only do the OD consultants understand owning a practice and owning a business in today’s environment, but they’ve been through that client process and really having someone come in and dig deep and find opportunity areas or take what you’re already doing well and take it to that next level. So they truly understand. And we all need to vent, right?  We all need to. Sometimes we get frustrated and we need to kind of talk through those things. But I think in some cases, we can get into a trap. All of us, if you vent to somebody, let’s say on social media or another platform, and that negativity can grow and grow and grow. And then you don’t get anywhere, right? You just continue to get frustrated and you build on that. You might feel good initially when you start to vent but then you’re not taking things forward. But with your team, your OD consultant, and your coach, you can certainly vent to us with frustrations. But we’re always going to help guide those frustrations to solutions because we truly understand what you’re going through. So I think that that’s a great point, Paul, back to your initial thought about they’ve been in your shoes or in the client’s shoes before and there’s a certain level of understanding that really helps the process along.

 

Dr.Bethany Fishbein: So let’s talk about that site visit where a consultant actually goes out and visits the practice. And I worked as a consultant for many years. So I’ve done these. You guys asked me questions. What questions do you have that people ask you or want to know about what that site visit looks like?

 

Paul Ferrero: How do you prepare a practice for your visitation? How do you share with them what your goals and objectives are and ease a part of their practice, the staff? How do you ease their minds because they’re nervous about you coming in for many different reasons? 

 

Dr.Bethany Fishbein: They are. Although I’ll say it’s not as bad as it used to be when some of the consulting TV shows were popular like the Kitchen Nightmares and Tabatha’s Hair Salon. People got this expectation that a consultant was going to come in and throw the microwave against the wall and change up everything. And so when those were very, very popular, we used to get met with a lot more trepidation about the visit. We help guide the practice owner through those conversations. Because I’ll send an email or like our consultants will send an email introducing themselves and saying, “Hey, I’m an optometrist. I practice too. I have staff that work with me.” You know, I get it. We’re not there to change everything. We’re there to look at what’s going well. We’re there to see things that the practice might have already seen or sometimes things that they haven’t and make slow changes to help reach the goal. So we send information so they know who we are. They know our backgrounds and we talk through it with the doctor of how to tell their staff. And more often than not, lately, especially now that those shows are not so popular, we find that staff is excited for us to come and they’re ready to help make changes. They’re excited for an outside perspective and they might be a little nervous when we get there because they feel like, “I’m on stage. Somebody’s watching me.” But it settles down pretty quickly.

 

Paul Ferrero: That’s part of it, is it? You’re also spending time in the exam room with the doctor?

 

Dr.Bethany Fishbein: Yeah, we’re watching everything. So when we go into a practice, we’re first just kind of getting the overall feel of the practice, the vibe, the energy, or whatever you want to call it. And because we’re outside observers, we’re seeing it through the patient’s eyes. The example we give the clients sometimes is, you know, in your own house when you have a cabinet door that’s always open or something that’s a little broken or a corner of your wallpaper peeling. After a couple of weeks, you don’t even see it anymore because it’s just something that you’re so used to. And then somebody comes to your house for the first time and they’re like, “What’s with that wallpaper?” So we’re able to see things from a different perspective that’s pretty close to the perspective that their patients are walking in with.

 

Sarah Dau: Not to equate the OD consultant or the coach for that matter for a fly-on-the-wall like an insect but we really are trying to take that top down to just observe. So we’ll start off by observing the patient flow from beginning to end. So for instance, when your patient walks in, we’ll mark down the time that they walked in. We’ll observe. How were they greeted? What happened in the check-in process? How long did they wait? We’ll follow them through to pretest or yearly testing. What was said during that time? How did the tech do in explaining what was happening? If the patient is okay with us coming into observe, we’ll go into the exam room. Nothing from a clinical perspective obviously, that’s the doctor’s call. It’s just to understand the communication style with that patient. And then how are those recommendations that the doctors made, how does that then get relayed to optical? What happens in that handoff? What happens in optical? And then from there, how is that patient checked out? Any reference to their upcoming or follow-up visit? If they have one? If they need one? Or talks of perhaps their next yearly comprehensive exam? So we really pull that patient process out into different stages and look at it and each stage of the patient experience to fully understand. And then if we start to see some things that, “I want to explore that part of the patient journey a little bit more.” We’ll spend a little bit more time in a given area. But once we have a few patients under our belt, we get a really good idea of a patient flow and can start the ideas to start turning. And we marry the goals that the client has shared with us at the beginning of the process to what’s actually happening in the office. And that’s where the magic happens of really putting that all together and on how we can get them to goal attainment at the end. And we also do a staff meeting if anyone wants to go into the staff meeting part.

 

Dr.Bethany Fishbein: Throughout the visit, while everything that Sarah was just saying is going on and while we’re watching that whole patient journey, we’re also having conversations with the people in the office. Sometimes it might be the doctor in between patients pointing out, “See this is what frustrates me.” or “See I hate when this happens.” or “Did you notice that?” And sometimes it’s with staff that somebody will say, “Can I talk to you?” and let us know a key issue that’s happening or that’s preventing progress in the practice that either the practice owner didn’t know about or knew about and maybe didn’t think to share or sometimes chose not to share. It’s not all that uncommon where we find areas where the practice owner is standing in their own way of achieving their goals and they need to know that and have it brought to their attention so that they can help themselves get out of it. At the end of the visit, we sit down with the whole staff to really talk about some of the things that we look at to determine opportunities to help create additional success in a practice. So we might be talking about the patient journey and some of the things we saw that could just need a quick correction that could make the patient experience so much better. We might be talking about their physical space. We might be talking about some of the financials of a practice. Not getting into the nitty gritty of the financials with the staff but some of the things that we watch and look for with creating success. And it just gives them a taste of what’s to come and what we’re going to look at. We will sometimes work on exercises to improve service, to talk about leadership, to help them working together as a team. Based on the issues the individual practice is having that staff meeting changes a little bit. But for everybody, the goal is to really set the stage for what’s to come once we start to work with the practice.

 

Paul Ferrero: On that topic, you spent a full day of practice with the doctor and staff. You’ve engaged the staff. You’ve mentioned you have a staff get-together or a meeting at the end of the day. The day is coming to conclusion. As a practice owner, what can I expect now? What happens next?

 

Dr.Bethany Fishbein: So to finish out the visit, whenever possible, we’re trying to get a little bit of informal time outside the office with that practice owner. So ideally, what happens next is we go out for dinner. And it’s tough, right? It’s the end of a long day. Everybody’s expending a little bit of extra energy because it takes extra energy when you know you’re being observed and you’re watching a million things and it takes our energy to watch all those things. But when we go and sit down afterward, that’s really a chance to start to line up the reality of where the practice is now with the vision that the practice owner has given us for where they want it to go and start to pick out the path that gets you from here to there. So it’s a chance to ask questions based on things you’ve seen or heard. And sometimes we’re aware of something because we spent the day watching it that the practice owner has absolutely no idea is going on because they’re back in their exam rooms. And so something’s happening at the front desk and they go, “What?” So sometimes it’s concrete things. And sometimes it’s, “Wow, based on the team you have, we can totally do this.” Or sometimes it’s a discussion of something that’s really standing in the way that needs to be adjusted or corrected or fixed before we can even move forward. We’ve seen it in offices where the practice owner will have a staff member actively working against them for whatever reasons. Or you know sometimes. One of my favorite types of clients to work with is I love working with husband and wife practices probably because I am one. And just you know to hear and better understand the dynamic between the partners in the practice whether they’re married or otherwise, is very, very valuable to know how we’re gonna get to go forward. But once we go to dinner, usually what we try to leave the client with either at dinner or in an email shortly after is a list of what we call quick wins. These are things that you can adjust right now that are going to help you start to make more money in the practice or start to get you closer to your goals right away. Some examples of that are, you know, we’ve seen practices that by habit are asking patients, “Would you like to leave half?” and the patients are saying, “Okay.” And then they ended up with big receivables, patient receivables. So just an adjustment of, you know, “Your glasses are $612. How would you like to take care of that?” Instead of, “Would you like to pay half?” just brings that income to the practice sooner. Sometimes it’s a change in how the staff is speaking to patients about an insurance panel that the doctor is not on or charges for something outside of insurance. Sometimes it’s the doctor themselves. How are they presenting a small change in prescription? Or, you know, are they making a recommendation for a certain type of treatment or contact lens or eyeglass lens? Are they leaving it all up to the patient? The patient’s leaving confused. So we try to give them some quick wins. Things that they can do right away. And then it takes us a couple of weeks to put together a whole plan for the practice.

 

Paul Ferrero: I’d like to touch on that subject that you just mentioned. We’ll give them a few weeks later. They’ll get a business plan from us. I want to talk a little bit about what that is, what it looks like, and what it’s based on. We’ve had a full day of observation. We’ve engaged every aspect of the practice. We’ve gone to dinner. We have further discussed the current state vs future state and the path forward for the practitioner. Now we take all of this information and over the next few weeks, we carefully build a plan for this practice. A plan that’s customized to their practice that’s specific to the goals and objectives they’ve outlined.

 

Dr.Bethany Fishbein: So Denise you’ve been quiet over there. Once they get the plan in hand, talk about the process after that. What can they expect from us going forward?

 

Denise Kolker: So the first thing we do, you know, once they have the plan in hand and you know we asked them obviously to read through it. We have a call just to discuss any questions or things that you know, they might want to know about the plan. We start working on the things, the changes, or you know, the things that have been identified as areas of opportunity in their practice. But we do it in a way, again, that it’s at a pace that they can handle. We don’t try to make all these changes all at once. We try to do it at a pace that they’re comfortable with and every practice is different. Some practices are hesitant to even do things like that YTT meeting. They’ve never done it before. They don’t understand why it’s important. They don’t think that it’s something that their staff would do. And so sometimes it’s a matter of having to have them think about it and talk to them about it. Just like any of the,  you know, things that we’re suggesting so that they’re comfortable with it. And again, that they can stand behind it when they bring it to their to their staff because they have to believe in what they’re doing and the changes that they’re making in the office. So again, we just try to do it all at a pace that they’re comfortable with so that their staff also doesn’t push back. And sometimes the staff does push back and again, that’s why they have to stand behind their decision if they’re going to try something. And you know, sometimes it’s something that is easily implemented in the office where the staff you know, embraces it, but in other times it takes some time. So every office is really unique. And I think that’s what makes us different too is that we’re not we don’t have a cookie cutter plan. It’s not just the same for every office because every office has a different vision and a different goal. So it is unique to every office we work with.

 

Dr.Bethany Fishbein: Yeah, that’s so true. I mean, the piece about at a pace you can handle. We see clients on both ends of that right? Some get it and they want to do everything right away and they’re you know. And so there are some times when we’re telling them, “Slow down.” because something has to get done first to build the next thing and to build the next thing. And then there are some, where it’s a phone call or two to say, “Hey, did you read the plan?” You know, they invested in this. They got a document all about their business and the changes and they are too busy to read it. And I think that’s an area where it really helps that our consultants, the people working directly with them, are living the practice ownership life themselves. And so they get it. How the best-laid plans can get off track when six people on your staff call out the same day and all of a sudden you don’t have the day you are expecting. Or you know how deeply a patient’s situation can affect you. And you can be learning communication strategies and everything and you come in and a patient has a serious problem in their eye and you’re all of a sudden talking about the likelihood that they’re losing vision and nothing else in that moment matters. And so I think they’ve really got a good sense of the reality of day-to-day optometric life. And at the same time have the objectivity to say, “Okay. Yes, we get it. We get this is what you’re dealing with. Given that, here’s what we need to do to move forward.” Ali talk more about the process after. So is it ongoing phone calls? Is it emails?

 

Allison Kraemer: Yes, there’s a one monthly phone call with your entire team – so your OD consultant and your business management coach. And that’s a guaranteed call with your team. We’re obviously also available in between calls you know, with a quick text or email. The bottom line is we’re there to support the doctor in the office and hold them accountable. So yeah, we get on a regular cadence. We expect them to be on the calls and be prepared. And we also. That’s when we start really figuring out how we’re kind of creating a relationship and a trust between your team and the client. So you know, all of the OD consultants, as you mentioned, have been through the process and they’ve trusted the Power Practice process. And then we. They in turn and we in turn as coaches really expect that trust from our clients as well. So it’s an open dialogue. We want to obviously address all the concerns that are, you know, imminent and what’s happening in the office right now. But also keep them on the path of what we’ve asked them to do from the month before and really hold them accountable. And sometimes we have to say some really hard things, you know. And it’s usually received very well because you are holding them accountable and people like that, you know. Having some homework and having something to do that makes you feel like you’re moving forward and I think that part is really important.

 

Dr.Bethany Fishbein: So beyond the monthly phone calls with the team, what are some of the other great things that our clients are getting?

 

Sarah Dau: We have a closed private email distribution list with all of our clients and family members throughout the US. And I like to consider them, they’re just a very supportive group. They can be quite chatty at times but I mean that in a good way. There’s a lot of wonderful information and support shared on there. And everyone’s here for the same reasons to grow and build on their practices. But they are also here to help one another which I just think it’s a great community to be a part of. The other piece is we have a client retreat every year. And this is the opportunity for all of our clients to put faces to those email addresses and come together to learn about some or to participate in about a day and a half of being together and learning and receiving content, whether within the industry or outside the industry to continue building on their practices. So it’s just a great opportunity to kind of pull yourself out of the world when you come out of your offices and your hometowns and all come together and recharge the battery.

 

Paul Ferrero: I’ll add to that Sarah. I don’t think it’s discussed enough that we have an organization of like-minded practitioners clear across the country, in almost every state. They foster an atmosphere of sharing. They truly want to see each other do well. And they encourage each other to do well. And so they’re not opposed to sharing their own secret sauce. Again, if you’re a member of the family, the family wants to support each other and they’re willing in that capacity to share. I think that’s a big piece of the Power Practice family.

 

Sarah Dau: And something I mentioned earlier. You know, sometimes you can be on these social media platforms or chat groups, and sometimes there can be some negativity in there. And then it goes off on a somewhat of a negative rant, which we all can be affected by on various levels. And here, you can, our clients feel comfortable to share their thoughts and frustrations yet you’re met with solutions and you’re met with support versus just going into that never-ending cycle of negative talk. Which again, like I mentioned, we all I think at some point or another can get entrapped in but this is a vehicle where you can express that and then expect a bunch of emails to come back with support and guidance on how to turn that around. And that’s sometimes that’s a hard thing to overcome. But you have a network of clients, family members, and consultants, and coaches that are on all on that client email list to support and guide and bring things to the next level

 

Dr.Bethany Fishbein: That support and that willingness to share a secret sauce is something kind of extraordinary. We recently spent some time with an optometrist outside of our Power Practice network. We were working on something else and that was one of his comments, “It’s hard to believe all these people sometimes in similar areas don’t regard each other as competitors.” And with our clients, they don’t. When we have people who are close enough in a geographic area, we’ll often ask the established client before bringing on a new client, and such a high percentage of the time they say, “Oh yeah, sure.” Like everybody wants to see each other succeed. And everybody’s also open and sharing their struggles, which doesn’t always come up on the social media sites either, right? The people are all talking about how great they are, but not, “Here’s the stuff under the tip of the iceberg. Here’s what I went through to get there.” And it’s just such an amazing part of Power Practice. Paul, I know you get this question sometimes, how does somebody know when they’re done? When they don’t need us anymore?

 

Paul Ferrero: And before we get there, I want to touch on something you just said. It goes to the heart of why you would want to hire a business coach. Because in your practice, it’s perhaps going to be one of the biggest decisions that you make for your practice. So doing your due diligence and you’re asking the questions of organizations like the Power Practice, it has to feel right and it has to be right because we’re going to spend an awful lot of time together. We’re going to get to know a lot about your business and a lot about the people who work inside your business. We’re going to get to know about what’s going on in your family. We will be spending a lot of time together and that decision has to be based on trust and an organization that does what they say they’re going to do. So it’s, I would encourage anyone to do their due diligence. Ask the questions you need to ask. And at the end of the day, make your decision based on what we just mentioned. 

 

Dr.Bethany Fishbein: Just to close here, let’s go around the table or the screen real quick and without naming names, obviously. But share one of your greatest success stories. Something that you’ve done with a client that you’re proud of and really led to a fantastic result.

 

Sarah Dau: My first call with this doctor, let’s call her Betty. That is not her real name but we’re going to call her Betty. Betty called out of frustration. Her practice was not going where she wanted it to. And then by the end of the conversation, some tears started from Betty admitting that financially speaking, she was near bankruptcy. We figured out a way to make it work financially for Betty to work with us. And in three years’ time, we turned it around. She was out of debt. She was profitable. She hired an associate. And I’ll never forget this, the consultant and I had jumped on a call with Betty and she says, “Guess what? I decided to sell my practice and put it up for sale.” and I’m like, “What? We just hit your goals and we built it up to being profitable. Like, wait a minute what happened?” She’s like, “I just decided I don’t want to be a practice owner anymore.” But she sold it, paid everything off, and she walked away making money. So we took her from a very low point in her career to she sold on a high note. And that to me was, we really took her full circle. It is experiences like this where we help them to reach our goals, it just really touches the heartstrings and that’s why we’re all here. But Betty came to mind first because that was a real dramatic shift.

 

Denise Kolker: One of the things we hadn’t really touched on but one of the things that is very rewarding to me is watching our cold start clients start from the ground up. Just starting with looking and identifying a location for their practice, to going through the lease process, to going through the choosing a contractor, and choosing a design for their office and building out that office and hiring staff and buying their equipment, and doing all the things that cold start has to do. And then getting to that point where they’re ready to open. It’s incredible to be a part of that whole process.

 

Dr.Bethany Fishbein: Yeah, you’re really seeing someone’s dreams come to life. Like you’re having these initial conversations about what I want, often and they’ve got nothing at that point right they’ve got an empty shell, an empty square in an office condo, and being able to be with someone in that whole process and to get those pictures of them at an open house and then visiting the practice a month or two later. That’s incredible. And I will say my start with the Power Practice was as a cold start client. We started working with Gary Gerber in 2000. Probably 20 to 22 years ago, when my husband and I were trying to figure out if we could open a practice and had no idea what that entailed. And I can remember now the difference of having that support behind us from somebody who had been there, done that, and knew exactly what they were doing to advise us and guide us helped so much in attaining what we wanted. And also avoiding what we didn’t want. And I still can’t quite imagine that we’d be in a place we are today without that guidance 20 to 22 years ago.

 

Paul Ferrero: You know, it’s not one success story, but it’s the culmination of what the Power Practice has represented and done and demonstrated over 25 years. You know, we have the privilege to work with practitioners across the practice spectrum. Denise just mentioned cold starts. They’re just putting the shovel in the ground. We work with practices who are at the end of their careers and are looking to develop an exit strategy. And in between, we have practices of all sizes and scopes with lots of zeros at the end of their numbers, lots of staff members, lots of associates, and maybe even multiple locations. But the thing that’s a testament to what we do is the tenure and longevity of the clients we serve. A lot of people enter our relationship with a business coach thinking it’s going to be a 12-month to 24-month program. But I look back over the 11-plus years I’ve been here, and I would say the clients that we work with have an average tenure of 9 to 10 years with the Power Practice. We have clients who’ve been here for almost 20 years who started with Dr. Gary Gerber. Some 20-plus years ago and still are members of the Power Practice, that’s a strong statement and a testament to what we do. And of all the things we do, I love them all, that’s the one that really gets me excited to think about. And there’s so many other people out there that we could have an impact on their practice that I would say, “Don’t wait. Call us. See what we can do for you.” 

 

Dr.Bethany Fishbein: And Ali talk about some things that we’re working on now to make Power Practice even better. Some things that we’ve added in the last year and things we’re hoping to add in the near future.

 

Allison Kraemer: Yeah, so we are definitely trying to give more support to managers and leaders within the practice as well. So it’s not just about you as a doctor and the owner but really developing your leadership team in a way that helps your whole staff and it changes the entire culture of your practice and just moving it forward. It makes things so much more enjoyable and brighter and successful. You know, to Paul’s point earlier, you know, all of these work and all these practices are so you know, personally rewarding as well. You know, and I’m really passionate about working with leadership teams. We just have the opportunity to affect so many people sort of like a butterfly effect, you know, you work with a doc and then you work with a manager, and then you know, suddenly you’ve got an entire team of happy people coming to work and really creating this like amazing success together and it’s really just so cool to watch in every way. I had recently uh one of my clients recommended somebody who was purchasing a practice and you know, their best friend and they went to school together and listening to this doctor who was so miserable at her job. She’s so excited about this opportunity and now just watching her open her office and you know, just like all of these dreams that are coming to fruition within just a couple of months of time. It’s like that’s what it’s all about is how much we can help you and build this amazing office and dream that you’ve had from the very beginning. 

 

Dr.Bethany Fishbein: So thank you for listening for more information please visit our website www.powerpractice.com or email us at info@power practice.com to start a conversation about how we can help you reach your goals.

 

Read the Transcription

Sarah Dau: Not only do the OD consultants understand owning a practice and owning a business in today’s environment, but they’ve been through that client process and really having someone come in and dig deep and find opportunity areas or take what you’re already doing well and take it to that next level.

 

Dr.Bethany Fishbein: Hi, I am Bethany Fishbein, CEO of the Power Practice and host of the Power Hour Optometry podcast. And today I’m talking with some of my favorite people in the world. This is our team of business coaches at the Power Practice. And we’re talking about the process of working with Power Practice as a client from the initial phases of reaching out, thinking you might need help, all the way to our greatest success stories. So I’ve got with me, Sara Dau, Paul Ferraro, Denise Kolker, Alison Kramer, who’s also Ali. So you’ll hear Ali and Alison interchangeably. They’re both her. And looking forward to hearing some of the wisdom and some of the stories that they can share. So thank you guys for being here. 

 

Paul Ferraro: Pleasure. 

 

****: Thanks.

 

Sarah Dau: Glad to be here.

 

Dr.Bethany Fishbein: Excellent. Let’s start at the beginning of the process. And actually, before we do, I just want to figure out our combined years of experience. Sarah, how long have you worked with Power Practice? 

 

Sarah Dau: Eleven and a half years.

 

Dr.Bethany Fishbein: How about you Paul?

 

Paul Ferrero: Eleven years. 

 

Dr.Bethany Fishbein: Ali?

 

Allison Kraemer: I think it’s been ten.

 

Dr.Bethany Fishbein: And Denise, the new girl? 

 

Denise Kolker: Six. 

Dr.Bethany Fishbein: Six years. So you’ve got 21, 31, 37, and throw in my 12. I think that’s 49 almost 50 years combined experience of working with independent optometry practice owners to help them make positive changes in their business. That’s awesome. 50 years. Go us! Yeah. All right. So let’s talk about it from the beginning. Sara, Ali, and Paul, I know you guys are the ones who are answering those initial calls when a doctor reaches out expressing interest in consulting. What are some of the things that you’re hearing on that initial phone call about? What situations are people in that make them want to look for a consultant in the first place? Or what’s going on in their practices that they’re looking for help with?

 

Sarah Dau: There’s a few top reasons that come to mind when you ask that Bethany. Number one is frustration. They’ve got a practice that is not where they would like it to be and they’re not exactly sure what steps to take to get to the next level. Another way would be or another reason is that they’re doing well. And they’re constantly looking for new ways and ideas to continue on that path and keep that momentum going. So they’re just looking for some additional guidance and thoughts on how they can keep moving forward and hitting new goals. We also have some that want to start their venture into Practice Ownership. So they’re working as an associate somewhere and they want to either open cold or they want to purchase an existing practice. Those are the top reasons.

 

Dr. Bethany Fishbein: Paul did you have anything to say? 

 

Paul Ferrero: Yeah. I’ll continue to build on what you had to say, Sarah. So when we get into conversation with folks who reach out to us, you could almost categorize some of the challenges or concerns that they’re calling for. It could be financial. It could be growth-oriented needs. It could be a staffing concern. It could be leadership development. It could be culture development. And through that initial call or discovery call, we try to isolate or define what that challenge is. Begin to understand a little bit more about their business before we could start to contribute any type of notion of an idea or a strategy to help them overcome that challenge.

 

Allison Kraemer: Yeah. I also find sometimes it’s just a general feeling of being out of control and they don’t even really know what it is that they’re looking for. So once we get into a conversation with them, we can figure out like what is creating that and what’s causing that “chaos feeling”. We really help identify what their opportunities are,

 

Dr.Bethany Fishbein: Ali keep talking about that a little bit because I think that that leads us into some of the first steps that we take. When somebody does come on as a client that there is that process of like, “I want to be better.”, “I want it to be different than it is now”, or “I’ve lost control.” Or “I’m just starting out.” and “I know I want my own.” but not totally able to define at the early stages what it is that that looks like. How do we help them through that in the beginning?

 

Allison Kraemer: I mean, we definitely do some staff surveys to find out what’s going on behind the scenes. So I think that that’s a really valuable tool that we use. They’re anonymous. So the staff is super comfortable in giving us feedback that comes directly to us. We also look at their profitability and their cost of goods and all the things that go around with owning a business. Then identifying that, we look at some of their billing and coding and what their general is. How they are diagnosing and how they’re clinically seeing patients whether it’s medically-based, or whether they have specialty care. I mean there’s just so much learning and that goes along with bringing somebody on board before we even get started with the process

 

Dr.Bethany Fishbein: So those are like the analysis things going on behind the scenes. What are the initial conversations happening with the new client when we first start working with them? While we’re looking at all those things, what are the things that we’re talking about?

 

Paul Ferrero: Yeah, in the early stages, we’re trying to understand what their goals and objectives are, whether they be professional or personal. So we could better understand where they see themselves in 2 years, 5 years, or 10 years out. Once we understand that and we learn a little bit more about what’s driving their reason for reaching out, it gives us a little more understanding and enlightening so to speak of where we can begin to help them achieve their goals.

 

Allison Kraemer: You’re right, Paul. I mean it’s really about like finding out what their vision is. A lot of times people don’t even know what they want. So first getting them to identify what does that perfect practice look like? Is a super important piece of the puzzle. 

 

Dr.Bethany Fishbein: Right.

 

Sarah Dau: And I think we do a great job at pulling that out. For some, it’s really quite easy for us to ask them, “What’s the vision for their practice?” or “How do you envision your “perfect practice” or ideal practice?” Others we have to ask some deeper level of questions to kind of really dig down and help them to pull that dream practice out of what their thoughts are and really put it to reality and make it come to fruition.

 

Dr.Bethany Fishbein: So when we’re having those initial conversations and determining if somebody is going to be a good match for the Power Practice and we’re going to be a good match for them, what are some of the green flags that tell us this is going to be somebody great to work with or I can tell that this is going to be successful from right off the bat?

 

Sarah Dau: I would say, “Gosh, that’s a great question.” Enthusiasm, being open-minded, willing to share, and carve that time out of working in the practice seeing patients, and working on their practice. That’s a very different role. So I think setting aside that time to be proactive is crucial to their business. And if they’re able and willing to do that, it gives us that time that we need to work together and strategize and implement and really move things forward. What else am I missing guys? What else are you thinking of?

 

Allison Kraemer: It’s got to be somebody that recognizes they’re part of this success. It’s not just us doing it.

 

Dr. Bethany Fishbein: Right. 

 

Paul Ferrero: And I also think, you know, being open to change. Being willing to change some things that they’re really set in their ways. In their practice, they may have been doing this for many many years but being open-minded, like you said, and willing to make those changes. You know, both Sarah and Denise touched on the word willing. You know, willingness and commitment. It’s a partnership when we work together. It’s a collaboration. Sometimes people believe that “We’ve hired a consulting firm and tomorrow is going to be better.” It would be better if we both commit to the goal and we work collaboratively towards that goal. And to do that, the two words that come to mind, as we’ve already said, are willingness and commitment.

 

Dr.Bethany Fishbein: Yeah. So those are the green flags. What do you guys pick up sometimes as red flags? That somebody’s reaching out but is not ready or is not likely to work well with the consulting process?

 

Allison Kraemer: I feel like when they want to place blame on everybody else around them is when you know it’s going to be a bit of a challenge. It’s you know when they say things like, “My staff doesn’t listen.” or you know, “Nobody does what I say they can do.” It’s a clear indication of they think it’s just happening to them.

 

Dr.Bethany Fishbein: Yeah. I think that’s one of the things that are pretty common to come in with. There’s gotta be some sense in there of, “Okay, maybe I have some part in this.” right? So somebody who truly believes that life is happening to them, you know? They have no control over this. I agree. That’s somebody who’s difficult to work with. But when somebody’s got that little light on, that says, “Your staff. What? Who hired them? Who lets them come to work every day? Oh! It’s you.” and they say, “Oh!” I find when working with clients, one of my favorite transitions to see is that change and feeling from initially, “Everything’s happening to me. I have no control of insurance company, staff, economy, blah, blah, blah” to “Okay. I’m the one driving this. All those things might be happening and now I’m in the driver’s seat deciding what we can do about them.” So those are things that absolutely have to be turned around. Anything else you guys would qualify as a solid red flag? How about you, Paul?

 

Paul Ferrero: Yeah. I think early in our conversations, you could get a general sense of whether the glass is half full or the glass is half empty. You always hear reasons why not to do something. But instead of and it goes back to open-mindedness. You sometimes like to hear, “That’s a good idea. Let’s figure out how we can do that.” rather than, “That won’t work here.” Because that’s a dangerous expression. That expression, “Because this is the way we’ve always done it.” It’s so dangerous. And if you’re not willing to be open-minded and try some ideas that have been tested through thousands of practices over 25 years, then we’re not a good fit and we move on. It was nice to know you. We’ll part as friends but we’re just not a good fit today.

 

Dr. Bethany Fishbein: Go ahead, Denise.

 

Denise Kolker: Yeah, I think. I mean I think the other thing too with that is that they have to be willing and be behind that change and willingness to make those changes. Because if they’re not completely invested in it, then their staff won’t be invested in it.

 

Dr.Bethany Fishbein: Yeah. And they’ve got to be willing to sometimes go through a little bit of discomfort of trying things a different way. Right? The way they’ve only always done it, it’s comfortable. And it got them to where they are which they’ve established isn’t necessarily where they want to be. So to get from where they are to where they want to be, they’re going to have to do some things a little bit differently. Whether it’s how they’re interacting with staff, sometimes with patients, looking at certain numbers within the practice, just all kinds of things. So let’s talk about the consulting process because I think that’s something that is really unique to Power Practice and something that we’re doing quite differently than all of the other I think optometric consultants in our industry. So once somebody says, “Yes.”, we go through those initial conversations. What happens next?

 

Sarah Dau: Well, when they say, “Yes.” and they join the Power Practice family, we get to work right away in really gathering a lot of initial information to help us, you know, understand and best prepare for that site visit when the OD consultant comes to the office for the day. So we send out something we call our Practice Profile that takes a lot of the information from the practice – financials, staff, how many lanes, equipment, specialty care. All that fun stuff and take a look at their financials. We, as Ali mentioned earlier, we’ll do a staff survey. We do a competitive analysis. We’ll take a look at their billing and Procedure Code report. Then we have an initial phone call with our new family member and our OD consultant and the coach that’s assigned to the team. And talk about that information, uncover any additional information that we need, ask additional questions, and really take the time to know that doctor and their staff to the best of our abilities before we come in for that site visit. It’s very important. Clients will come to us perhaps for the “same reasons” but the practice and the team behind those reasons or those goals are different with each and every client or family member that we work with. So that changes our approach to how we’re working with them because there’s a lot of different dynamics that we have to consider and take into account when we’re going to be working with them and coaching them towards goal attainment.

 

Dr.Bethany Fishbein: Okay. So you mentioned the team, right? So now we’re putting together a team to work with an individual doctor. Who’s on that team? And what does that look like? And how are they picked? Because that’s something everybody always wants to know who am I going to be working with?

 

Sarah Dau: That is a top question. So the team would be an OD consultant, as well as a coach or implementation business coach. So it’s a two-person team there that will work with the client and his or her staff as one big team. We take into account, I think, a lot that has to do with personality. We have a lot of different personalities on our team, which is what makes us so great, in my opinion. A lot of diversity there. And we get to know the client through talking with them about their goals before they agree to sign on. We do have several conversations and get to know them well and to understand their working style and personality type. And we’ll certainly take that into consideration when we look at our consulting and coaching team to make that right match early on within that process.

 

Allison Kraemer: And I think that’s the most important thing. That is that we really strategically plan who is behind that particular client based on the needs of the business, whatever specialties they have, and, like you said, personalities as well. That part’s really important for the success.

 

Paul Ferrero: I think an important member of our team is the consultant who’s an optometrist. And our consultants have varied backgrounds and experience in the industry, different sizes and scope of practice, and different areas of specialty. But one thread that is unique, they all started as clients here at the Power Practice. And, for the lack of a better term, have come through our process and methodology and we have a really good understanding of how to help other practitioners. So when we’re sitting with a new client and we’re gathering as much information as we can about them and trying to understand their goals and objectives, we’re carefully matching up skill sets and knowledge and areas of specialty that’ll nicely fit into what the client is looking for. And I think that’s pretty unique and is a major contributor to the success we’ve had with the thousands of clients we’ve worked with through the years. 

 

Sarah Dau: Yeah. And Paul that’s a great point that all of our consultants were clients at one point. So they’ve been through and not only do they understand what the client is going through. It can be. I do find that sometimes clients, new clients, will get a little nervous like, “Oh my! Okay. They’re going to come to visit my practice. That’s great.”  But sometimes there can be some angst that comes along with that like, “Oh my gosh! What are they going to find?” And not only do the OD consultants understand owning a practice and owning a business in today’s environment, but they’ve been through that client process and really having someone come in and dig deep and find opportunity areas or take what you’re already doing well and take it to that next level. So they truly understand. And we all need to vent, right?  We all need to. Sometimes we get frustrated and we need to kind of talk through those things. But I think in some cases, we can get into a trap. All of us, if you vent to somebody, let’s say on social media or another platform, and that negativity can grow and grow and grow. And then you don’t get anywhere, right? You just continue to get frustrated and you build on that. You might feel good initially when you start to vent but then you’re not taking things forward. But with your team, your OD consultant, and your coach, you can certainly vent to us with frustrations. But we’re always going to help guide those frustrations to solutions because we truly understand what you’re going through. So I think that that’s a great point, Paul, back to your initial thought about they’ve been in your shoes or in the client’s shoes before and there’s a certain level of understanding that really helps the process along.

 

Dr.Bethany Fishbein: So let’s talk about that site visit where a consultant actually goes out and visits the practice. And I worked as a consultant for many years. So I’ve done these. You guys asked me questions. What questions do you have that people ask you or want to know about what that site visit looks like?

 

Paul Ferrero: How do you prepare a practice for your visitation? How do you share with them what your goals and objectives are and ease a part of their practice, the staff? How do you ease their minds because they’re nervous about you coming in for many different reasons? 

 

Dr.Bethany Fishbein: They are. Although I’ll say it’s not as bad as it used to be when some of the consulting TV shows were popular like the Kitchen Nightmares and Tabatha’s Hair Salon. People got this expectation that a consultant was going to come in and throw the microwave against the wall and change up everything. And so when those were very, very popular, we used to get met with a lot more trepidation about the visit. We help guide the practice owner through those conversations. Because I’ll send an email or like our consultants will send an email introducing themselves and saying, “Hey, I’m an optometrist. I practice too. I have staff that work with me.” You know, I get it. We’re not there to change everything. We’re there to look at what’s going well. We’re there to see things that the practice might have already seen or sometimes things that they haven’t and make slow changes to help reach the goal. So we send information so they know who we are. They know our backgrounds and we talk through it with the doctor of how to tell their staff. And more often than not, lately, especially now that those shows are not so popular, we find that staff is excited for us to come and they’re ready to help make changes. They’re excited for an outside perspective and they might be a little nervous when we get there because they feel like, “I’m on stage. Somebody’s watching me.” But it settles down pretty quickly.

 

Paul Ferrero: That’s part of it, is it? You’re also spending time in the exam room with the doctor?

 

Dr.Bethany Fishbein: Yeah, we’re watching everything. So when we go into a practice, we’re first just kind of getting the overall feel of the practice, the vibe, the energy, or whatever you want to call it. And because we’re outside observers, we’re seeing it through the patient’s eyes. The example we give the clients sometimes is, you know, in your own house when you have a cabinet door that’s always open or something that’s a little broken or a corner of your wallpaper peeling. After a couple of weeks, you don’t even see it anymore because it’s just something that you’re so used to. And then somebody comes to your house for the first time and they’re like, “What’s with that wallpaper?” So we’re able to see things from a different perspective that’s pretty close to the perspective that their patients are walking in with.

 

Sarah Dau: Not to equate the OD consultant or the coach for that matter for a fly-on-the-wall like an insect but we really are trying to take that top down to just observe. So we’ll start off by observing the patient flow from beginning to end. So for instance, when your patient walks in, we’ll mark down the time that they walked in. We’ll observe. How were they greeted? What happened in the check-in process? How long did they wait? We’ll follow them through to pretest or yearly testing. What was said during that time? How did the tech do in explaining what was happening? If the patient is okay with us coming into observe, we’ll go into the exam room. Nothing from a clinical perspective obviously, that’s the doctor’s call. It’s just to understand the communication style with that patient. And then how are those recommendations that the doctors made, how does that then get relayed to optical? What happens in that handoff? What happens in optical? And then from there, how is that patient checked out? Any reference to their upcoming or follow-up visit? If they have one? If they need one? Or talks of perhaps their next yearly comprehensive exam? So we really pull that patient process out into different stages and look at it and each stage of the patient experience to fully understand. And then if we start to see some things that, “I want to explore that part of the patient journey a little bit more.” We’ll spend a little bit more time in a given area. But once we have a few patients under our belt, we get a really good idea of a patient flow and can start the ideas to start turning. And we marry the goals that the client has shared with us at the beginning of the process to what’s actually happening in the office. And that’s where the magic happens of really putting that all together and on how we can get them to goal attainment at the end. And we also do a staff meeting if anyone wants to go into the staff meeting part.

 

Dr.Bethany Fishbein: Throughout the visit, while everything that Sarah was just saying is going on and while we’re watching that whole patient journey, we’re also having conversations with the people in the office. Sometimes it might be the doctor in between patients pointing out, “See this is what frustrates me.” or “See I hate when this happens.” or “Did you notice that?” And sometimes it’s with staff that somebody will say, “Can I talk to you?” and let us know a key issue that’s happening or that’s preventing progress in the practice that either the practice owner didn’t know about or knew about and maybe didn’t think to share or sometimes chose not to share. It’s not all that uncommon where we find areas where the practice owner is standing in their own way of achieving their goals and they need to know that and have it brought to their attention so that they can help themselves get out of it. At the end of the visit, we sit down with the whole staff to really talk about some of the things that we look at to determine opportunities to help create additional success in a practice. So we might be talking about the patient journey and some of the things we saw that could just need a quick correction that could make the patient experience so much better. We might be talking about their physical space. We might be talking about some of the financials of a practice. Not getting into the nitty gritty of the financials with the staff but some of the things that we watch and look for with creating success. And it just gives them a taste of what’s to come and what we’re going to look at. We will sometimes work on exercises to improve service, to talk about leadership, to help them working together as a team. Based on the issues the individual practice is having that staff meeting changes a little bit. But for everybody, the goal is to really set the stage for what’s to come once we start to work with the practice.

 

Paul Ferrero: On that topic, you spent a full day of practice with the doctor and staff. You’ve engaged the staff. You’ve mentioned you have a staff get-together or a meeting at the end of the day. The day is coming to conclusion. As a practice owner, what can I expect now? What happens next?

 

Dr.Bethany Fishbein: So to finish out the visit, whenever possible, we’re trying to get a little bit of informal time outside the office with that practice owner. So ideally, what happens next is we go out for dinner. And it’s tough, right? It’s the end of a long day. Everybody’s expending a little bit of extra energy because it takes extra energy when you know you’re being observed and you’re watching a million things and it takes our energy to watch all those things. But when we go and sit down afterward, that’s really a chance to start to line up the reality of where the practice is now with the vision that the practice owner has given us for where they want it to go and start to pick out the path that gets you from here to there. So it’s a chance to ask questions based on things you’ve seen or heard. And sometimes we’re aware of something because we spent the day watching it that the practice owner has absolutely no idea is going on because they’re back in their exam rooms. And so something’s happening at the front desk and they go, “What?” So sometimes it’s concrete things. And sometimes it’s, “Wow, based on the team you have, we can totally do this.” Or sometimes it’s a discussion of something that’s really standing in the way that needs to be adjusted or corrected or fixed before we can even move forward. We’ve seen it in offices where the practice owner will have a staff member actively working against them for whatever reasons. Or you know sometimes. One of my favorite types of clients to work with is I love working with husband and wife practices probably because I am one. And just you know to hear and better understand the dynamic between the partners in the practice whether they’re married or otherwise, is very, very valuable to know how we’re gonna get to go forward. But once we go to dinner, usually what we try to leave the client with either at dinner or in an email shortly after is a list of what we call quick wins. These are things that you can adjust right now that are going to help you start to make more money in the practice or start to get you closer to your goals right away. Some examples of that are, you know, we’ve seen practices that by habit are asking patients, “Would you like to leave half?” and the patients are saying, “Okay.” And then they ended up with big receivables, patient receivables. So just an adjustment of, you know, “Your glasses are $612. How would you like to take care of that?” Instead of, “Would you like to pay half?” just brings that income to the practice sooner. Sometimes it’s a change in how the staff is speaking to patients about an insurance panel that the doctor is not on or charges for something outside of insurance. Sometimes it’s the doctor themselves. How are they presenting a small change in prescription? Or, you know, are they making a recommendation for a certain type of treatment or contact lens or eyeglass lens? Are they leaving it all up to the patient? The patient’s leaving confused. So we try to give them some quick wins. Things that they can do right away. And then it takes us a couple of weeks to put together a whole plan for the practice.

 

Paul Ferrero: I’d like to touch on that subject that you just mentioned. We’ll give them a few weeks later. They’ll get a business plan from us. I want to talk a little bit about what that is, what it looks like, and what it’s based on. We’ve had a full day of observation. We’ve engaged every aspect of the practice. We’ve gone to dinner. We have further discussed the current state vs future state and the path forward for the practitioner. Now we take all of this information and over the next few weeks, we carefully build a plan for this practice. A plan that’s customized to their practice that’s specific to the goals and objectives they’ve outlined.

 

Dr.Bethany Fishbein: So Denise you’ve been quiet over there. Once they get the plan in hand, talk about the process after that. What can they expect from us going forward?

 

Denise Kolker: So the first thing we do, you know, once they have the plan in hand and you know we asked them obviously to read through it. We have a call just to discuss any questions or things that you know, they might want to know about the plan. We start working on the things, the changes, or you know, the things that have been identified as areas of opportunity in their practice. But we do it in a way, again, that it’s at a pace that they can handle. We don’t try to make all these changes all at once. We try to do it at a pace that they’re comfortable with and every practice is different. Some practices are hesitant to even do things like that YTT meeting. They’ve never done it before. They don’t understand why it’s important. They don’t think that it’s something that their staff would do. And so sometimes it’s a matter of having to have them think about it and talk to them about it. Just like any of the,  you know, things that we’re suggesting so that they’re comfortable with it. And again, that they can stand behind it when they bring it to their to their staff because they have to believe in what they’re doing and the changes that they’re making in the office. So again, we just try to do it all at a pace that they’re comfortable with so that their staff also doesn’t push back. And sometimes the staff does push back and again, that’s why they have to stand behind their decision if they’re going to try something. And you know, sometimes it’s something that is easily implemented in the office where the staff you know, embraces it, but in other times it takes some time. So every office is really unique. And I think that’s what makes us different too is that we’re not we don’t have a cookie cutter plan. It’s not just the same for every office because every office has a different vision and a different goal. So it is unique to every office we work with.

 

Dr.Bethany Fishbein: Yeah, that’s so true. I mean, the piece about at a pace you can handle. We see clients on both ends of that right? Some get it and they want to do everything right away and they’re you know. And so there are some times when we’re telling them, “Slow down.” because something has to get done first to build the next thing and to build the next thing. And then there are some, where it’s a phone call or two to say, “Hey, did you read the plan?” You know, they invested in this. They got a document all about their business and the changes and they are too busy to read it. And I think that’s an area where it really helps that our consultants, the people working directly with them, are living the practice ownership life themselves. And so they get it. How the best-laid plans can get off track when six people on your staff call out the same day and all of a sudden you don’t have the day you are expecting. Or you know how deeply a patient’s situation can affect you. And you can be learning communication strategies and everything and you come in and a patient has a serious problem in their eye and you’re all of a sudden talking about the likelihood that they’re losing vision and nothing else in that moment matters. And so I think they’ve really got a good sense of the reality of day-to-day optometric life. And at the same time have the objectivity to say, “Okay. Yes, we get it. We get this is what you’re dealing with. Given that, here’s what we need to do to move forward.” Ali talk more about the process after. So is it ongoing phone calls? Is it emails?

 

Allison Kraemer: Yes, there’s a one monthly phone call with your entire team – so your OD consultant and your business management coach. And that’s a guaranteed call with your team. We’re obviously also available in between calls you know, with a quick text or email. The bottom line is we’re there to support the doctor in the office and hold them accountable. So yeah, we get on a regular cadence. We expect them to be on the calls and be prepared. And we also. That’s when we start really figuring out how we’re kind of creating a relationship and a trust between your team and the client. So you know, all of the OD consultants, as you mentioned, have been through the process and they’ve trusted the Power Practice process. And then we. They in turn and we in turn as coaches really expect that trust from our clients as well. So it’s an open dialogue. We want to obviously address all the concerns that are, you know, imminent and what’s happening in the office right now. But also keep them on the path of what we’ve asked them to do from the month before and really hold them accountable. And sometimes we have to say some really hard things, you know. And it’s usually received very well because you are holding them accountable and people like that, you know. Having some homework and having something to do that makes you feel like you’re moving forward and I think that part is really important.

 

Dr.Bethany Fishbein: So beyond the monthly phone calls with the team, what are some of the other great things that our clients are getting?

 

Sarah Dau: We have a closed private email distribution list with all of our clients and family members throughout the US. And I like to consider them, they’re just a very supportive group. They can be quite chatty at times but I mean that in a good way. There’s a lot of wonderful information and support shared on there. And everyone’s here for the same reasons to grow and build on their practices. But they are also here to help one another which I just think it’s a great community to be a part of. The other piece is we have a client retreat every year. And this is the opportunity for all of our clients to put faces to those email addresses and come together to learn about some or to participate in about a day and a half of being together and learning and receiving content, whether within the industry or outside the industry to continue building on their practices. So it’s just a great opportunity to kind of pull yourself out of the world when you come out of your offices and your hometowns and all come together and recharge the battery.

 

Paul Ferrero: I’ll add to that Sarah. I don’t think it’s discussed enough that we have an organization of like-minded practitioners clear across the country, in almost every state. They foster an atmosphere of sharing. They truly want to see each other do well. And they encourage each other to do well. And so they’re not opposed to sharing their own secret sauce. Again, if you’re a member of the family, the family wants to support each other and they’re willing in that capacity to share. I think that’s a big piece of the Power Practice family.

 

Sarah Dau: And something I mentioned earlier. You know, sometimes you can be on these social media platforms or chat groups, and sometimes there can be some negativity in there. And then it goes off on a somewhat of a negative rant, which we all can be affected by on various levels. And here, you can, our clients feel comfortable to share their thoughts and frustrations yet you’re met with solutions and you’re met with support versus just going into that never-ending cycle of negative talk. Which again, like I mentioned, we all I think at some point or another can get entrapped in but this is a vehicle where you can express that and then expect a bunch of emails to come back with support and guidance on how to turn that around. And that’s sometimes that’s a hard thing to overcome. But you have a network of clients, family members, and consultants, and coaches that are on all on that client email list to support and guide and bring things to the next level

 

Dr.Bethany Fishbein: That support and that willingness to share a secret sauce is something kind of extraordinary. We recently spent some time with an optometrist outside of our Power Practice network. We were working on something else and that was one of his comments, “It’s hard to believe all these people sometimes in similar areas don’t regard each other as competitors.” And with our clients, they don’t. When we have people who are close enough in a geographic area, we’ll often ask the established client before bringing on a new client, and such a high percentage of the time they say, “Oh yeah, sure.” Like everybody wants to see each other succeed. And everybody’s also open and sharing their struggles, which doesn’t always come up on the social media sites either, right? The people are all talking about how great they are, but not, “Here’s the stuff under the tip of the iceberg. Here’s what I went through to get there.” And it’s just such an amazing part of Power Practice. Paul, I know you get this question sometimes, how does somebody know when they’re done? When they don’t need us anymore?

 

Paul Ferrero: And before we get there, I want to touch on something you just said. It goes to the heart of why you would want to hire a business coach. Because in your practice, it’s perhaps going to be one of the biggest decisions that you make for your practice. So doing your due diligence and you’re asking the questions of organizations like the Power Practice, it has to feel right and it has to be right because we’re going to spend an awful lot of time together. We’re going to get to know a lot about your business and a lot about the people who work inside your business. We’re going to get to know about what’s going on in your family. We will be spending a lot of time together and that decision has to be based on trust and an organization that does what they say they’re going to do. So it’s, I would encourage anyone to do their due diligence. Ask the questions you need to ask. And at the end of the day, make your decision based on what we just mentioned. 

 

Dr.Bethany Fishbein: Just to close here, let’s go around the table or the screen real quick and without naming names, obviously. But share one of your greatest success stories. Something that you’ve done with a client that you’re proud of and really led to a fantastic result.

 

Sarah Dau: My first call with this doctor, let’s call her Betty. That is not her real name but we’re going to call her Betty. Betty called out of frustration. Her practice was not going where she wanted it to. And then by the end of the conversation, some tears started from Betty admitting that financially speaking, she was near bankruptcy. We figured out a way to make it work financially for Betty to work with us. And in three years’ time, we turned it around. She was out of debt. She was profitable. She hired an associate. And I’ll never forget this, the consultant and I had jumped on a call with Betty and she says, “Guess what? I decided to sell my practice and put it up for sale.” and I’m like, “What? We just hit your goals and we built it up to being profitable. Like, wait a minute what happened?” She’s like, “I just decided I don’t want to be a practice owner anymore.” But she sold it, paid everything off, and she walked away making money. So we took her from a very low point in her career to she sold on a high note. And that to me was, we really took her full circle. It is experiences like this where we help them to reach our goals, it just really touches the heartstrings and that’s why we’re all here. But Betty came to mind first because that was a real dramatic shift.

 

Denise Kolker: One of the things we hadn’t really touched on but one of the things that is very rewarding to me is watching our cold start clients start from the ground up. Just starting with looking and identifying a location for their practice, to going through the lease process, to going through the choosing a contractor, and choosing a design for their office and building out that office and hiring staff and buying their equipment, and doing all the things that cold start has to do. And then getting to that point where they’re ready to open. It’s incredible to be a part of that whole process.

 

Dr.Bethany Fishbein: Yeah, you’re really seeing someone’s dreams come to life. Like you’re having these initial conversations about what I want, often and they’ve got nothing at that point right they’ve got an empty shell, an empty square in an office condo, and being able to be with someone in that whole process and to get those pictures of them at an open house and then visiting the practice a month or two later. That’s incredible. And I will say my start with the Power Practice was as a cold start client. We started working with Gary Gerber in 2000. Probably 20 to 22 years ago, when my husband and I were trying to figure out if we could open a practice and had no idea what that entailed. And I can remember now the difference of having that support behind us from somebody who had been there, done that, and knew exactly what they were doing to advise us and guide us helped so much in attaining what we wanted. And also avoiding what we didn’t want. And I still can’t quite imagine that we’d be in a place we are today without that guidance 20 to 22 years ago.

 

Paul Ferrero: You know, it’s not one success story, but it’s the culmination of what the Power Practice has represented and done and demonstrated over 25 years. You know, we have the privilege to work with practitioners across the practice spectrum. Denise just mentioned cold starts. They’re just putting the shovel in the ground. We work with practices who are at the end of their careers and are looking to develop an exit strategy. And in between, we have practices of all sizes and scopes with lots of zeros at the end of their numbers, lots of staff members, lots of associates, and maybe even multiple locations. But the thing that’s a testament to what we do is the tenure and longevity of the clients we serve. A lot of people enter our relationship with a business coach thinking it’s going to be a 12-month to 24-month program. But I look back over the 11-plus years I’ve been here, and I would say the clients that we work with have an average tenure of 9 to 10 years with the Power Practice. We have clients who’ve been here for almost 20 years who started with Dr. Gary Gerber. Some 20-plus years ago and still are members of the Power Practice, that’s a strong statement and a testament to what we do. And of all the things we do, I love them all, that’s the one that really gets me excited to think about. And there’s so many other people out there that we could have an impact on their practice that I would say, “Don’t wait. Call us. See what we can do for you.” 

 

Dr.Bethany Fishbein: And Ali talk about some things that we’re working on now to make Power Practice even better. Some things that we’ve added in the last year and things we’re hoping to add in the near future.

 

Allison Kraemer: Yeah, so we are definitely trying to give more support to managers and leaders within the practice as well. So it’s not just about you as a doctor and the owner but really developing your leadership team in a way that helps your whole staff and it changes the entire culture of your practice and just moving it forward. It makes things so much more enjoyable and brighter and successful. You know, to Paul’s point earlier, you know, all of these work and all these practices are so you know, personally rewarding as well. You know, and I’m really passionate about working with leadership teams. We just have the opportunity to affect so many people sort of like a butterfly effect, you know, you work with a doc and then you work with a manager, and then you know, suddenly you’ve got an entire team of happy people coming to work and really creating this like amazing success together and it’s really just so cool to watch in every way. I had recently uh one of my clients recommended somebody who was purchasing a practice and you know, their best friend and they went to school together and listening to this doctor who was so miserable at her job. She’s so excited about this opportunity and now just watching her open her office and you know, just like all of these dreams that are coming to fruition within just a couple of months of time. It’s like that’s what it’s all about is how much we can help you and build this amazing office and dream that you’ve had from the very beginning. 

 

Dr.Bethany Fishbein: So thank you for listening for more information please visit our website www.powerpractice.com or email us at info@power practice.com to start a conversation about how we can help you reach your goals.