How do you build a successful practice? Are you ever done growing as a business leader? Join Bethany and Dr. Nick Despotidis, founder and partner of Eye Care Professionals, for a discussion on practice leadership and the role of consulting services leveraging customized solutions for support navigating the constantly shifting landscape of practice ownership.

When Dr. Nick Despotidis, founder of Eye Care Professionals, realized that he needed a new kind of support, it led to a conversation with Bethany about how to reassess — and address — changing needs in the shifting landscape of optometry. Discover the importance of seeking guidance (no matter your experience), and the role of technology in shaping the future of the industry!

Every practice owner wants their business to grow — learn about the journey of practice growth and how to find fulfillment as not only an entrepreneur but also as a leader in the optometry field.



Read the Transcription

Becca Starks: We have the ear with the students to hear what they’re looking for. They’re very, very few students that we’re working with, with the class of 2023 that will even consider an opportunity that is not private practice.

Dr. Bethany Fishbein: Hey, I am Bethany Fishbein. I am the CEO of The Power Practice and Host of The Power Hour Optometry Podcast. And I just want to first congratulate all of the new optometrists graduating this week from the optometry schools across the country. It’s such an exciting time. It doesn’t feel like that long ago since I and my classmates at New England College of Optometry in 1997 graduated. It goes fast. It’s really an exciting time. So congratulations, first of all, and this show is inspired by and dedicated to you and all of the people that you are hoping will hire you. Once you get your licenses and get out there into the world. So I’ve invited a guest, I have Becca Starks, Becca handles Enterprise Accounts and Operations for KMK Careers. And she’s here to help me sort out some of the things that today’s optometry students are looking for, and help educate some of the optometrists who are looking to hire young optometrists about misconceptions they may have or differing perceptions of this graduating class. So, Becca, thanks for doing this your second podcast ever. That’s awesome.

Becca Starks: Yes, thank you for having me. This is exciting. 

Dr. Bethany Fishbein: Yeah, thank you. It’s an interesting time because we work with mostly established optometric practice owners. So most of the people that I’m speaking to day to day are employers of young optometrists, and they have this vision of what today’s graduates are like, and then I get the opportunity to speak with optometry students and recent grads and they’re not necessarily like that perception at all. So hopefully, you can help us bridge the gap a little bit.

Becca Starks: Yeah, absolutely.

Dr.Bethany Fishbein: So, talk about yourself for a minute here. I want you to just talk about KMK and KMK Careers because when I want to data on students, I knew you were the one to go to. And so I want all of my listeners to understand your involvement with young optometrists today. 

Becca Starks: Yeah, absolutely. So KMK for those that don’t know KMK’s foundation is the KMK board review, which was started 18 years ago by Dr. Kyle Cheatham. And now fast forward 18 years we are inside of all of the 23 optometry schools nationwide. We have a team of optometrist instructors that traveled to all of the schools and we have a relationship with both third and fourth-year optometry students and 98, This is a big number to remember 98% of optometry students utilize KMK to pass their boards. So essentially we have a relationship with almost every single optometry student nationwide from the board’s perspective. And so we now have a new division of KMK specifically on careers which is just a natural extension of supporting those same students and finding their first career.

Dr.Bethany Fishbein: So you’re initially talking to these students when they’re students studying for boards. And then they hopefully pass boards and you know, move on and take more boards and pass those and move on. So what are the services that you’re providing for these students once they’ve graduated as doctors?

Becca Starks: Yeah, so it’s really fun. Personally, I am mostly an employee you’re facing so those that are looking for these candidates. However, we have a team of career advisors and all day long, they’re the luckiest ones in the world. They get to speak to these upcoming grads. So right now they are around the clock talking to those that are about to graduate here and a couple of weeks or maybe have graduated just recently. And uncovering what they’re looking for in a practice is really it’s a one-on-one relationship, so it’s totally free to students. They sign up to get a career advisor. They have calls with that career advisor to uncover what are they looking for what type of practice is it specific specialties, just anything that may be the true motivating factor as to why they want to go to a certain practice. And then essentially we play matchmaker so the career advisors speak to students all day long. I speak to employers all day long, and then we come together and get to build a bridge between the two and hopefully connect great candidates with a great opportunity.

Dr.Bethany Fishbein: Maybe it’ll be the next Netflix show after Indian matchmaking, Jewish matchmaking. It’ll be optometric career matchmaking. And be a celebrity.

Becca Starks: I think some of us would watch that, at least your listeners would probably enjoy that.

Dr.Bethany Fishbein: My husband and I would watch it so 

Becca Starks: same. 

Dr.Bethany Fishbein: So I mean, you’ve got a line of sight into exactly who today’s optometrists or today’s graduating class, today’s brand new optometrists are, can you give some facts and figures of what that class looks like?

Becca Starks: Yeah, so essentially, from a demographic perspective, it’s highly female. The data is showing 70% female and 30% Male.

Dr.Bethany Fishbein: 70?

Becca Starks: 70 Percent.

Dr.Bethany Fishbein: Wow. 

Becca Starks: Yes. And there’s information I believe you are going to be able to put in the show notes. But there is a really robust report. I believe it’s lots and lots of pages. I don’t remember how many but there are highlights within that on pages nine and 10 that give a really good but really quick summary of demographics of this class, within gender within race. There’s even financial information about how many needed to have financial aid, that sort of thing, and some really detailed information even about by school breakdown.

Dr.Bethany Fishbein: Are you able to roll through some of the things in there that kind of stood out to you?

Becca Starks: So the biggest thing that stands out to me is female and how as you it shows kind of year over year how that transition has changed from much more female than male as it was in the past. Same thing with race, I believe I don’t remember how many years ago it was but just not too long ago. It was predominantly white for professionals graduating and now that’s shifted to highly other races, whether it’s Asian or black or other races that are included in that.

Dr.Bethany Fishbein: And what about the financial piece? Because I feel like that’s such a big topic for new doctors. Is this need to pay back student loans? Do you have any stats on the amount of debt that students are graduating with? 

Becca Starks: Yeah, so the report itself shows 85% of students are utilizing some type of support financial aid, loans, and the average for a graduate right now graduating is about $200,000 in debt. So definitely it is.

Dr.Bethany Fishbein: That’s just from optometry school or that’s including undergrad debt?

Becca Starks: That’s actually a good question. We just get the stat of 200,000 and I assumed it was just optometry school. But that’s a good question.

Dr.Bethany Fishbein: So young, female, and any change in like age demographic? Or is it typically right out of college a year or two out of college starting into Optometry?

Becca Starks: Yeah, So typically, it is kind of a typical route straight out of undergrad and to optometry school. There is about of the 16-1700 graduates there are about 150 of those that are considered you know, like other avenues whether that would be part-time or returning back in at a later point in time.

Dr.Bethany Fishbein: Okay, so out of 1500 you’re talking about? Very typically, right? 1000 young, female, probably non-white doctors. 

Becca Starks: Yeah. 

Dr.Bethany Fishbein: If you had to say this is what’s typical. This is the majority. 

Becca Starks: Yeah. 

Dr.Bethany Fishbein: With debt?

Becca Starks: Yes. A lot of it. 

Dr.Bethany Fishbein: Okay. So, when you talk to this typical doctor and are getting into the field of matching into a career of their dreams, what are they telling you that they want? 

Becca Starks: Yeah. So it’s been interesting to learn that so the things that I came into this thinking people would want my background was actually at LinkedIn for five years before coming on to help launch this division of KMK and I thought it would be very different. I would think pay would exceed everything else. But, interestingly, location is the top deciding factor for these new graduates in determining which practice they want. Obviously, that is the hardest answer because no one can do anything about the location of their practice. But we can touch on this later. Kind of some ideas and tips for those to try to recruit folks into harder locations but definitely the location. Again, before and above pay even this work-life balance coming into play that is much more of a topic. Then I think it has been in years past. Not necessarily meaning, Hey, I want to come in and I want to never work. But this generation is much more just passionate about having that work-life balance of the work to live not live to work mentality. And so location, work-life balance, obviously pay, and structuring pay in a way that is understood to the candidate as well too. So being very upfront about what that pay is so that they know before even applying and putting that in a way that they understand what they actually can make because sometimes it can be hard with percent of production, knowing what that means.

Dr.Bethany Fishbein: So let’s go into those a little bit more and I want to just go back one to work-life balance because I think that’s probably the biggest misunderstanding between a doc maybe in their 50s and a doc in their 20s. This idea of working to live instead of living to work and it’s respectable and it’s necessary and mental health is important and it’s and life has to work for you. But these older docs, that was not their world. And so when I hear it, it’s complaints. They won’t work weekends, they don’t want to put in 40 hours. They’re asking for a four-day workweek. They’re like it’s coming across as we’re lazy. We’re not dedicated to the practice. We don’t want to be here we’re not going to work as hard as you and it. It creates a disconnect from the start like somebody interviewing, who says I don’t want to work every weekend. All of a sudden has all these judgments thrown on them that they probably don’t deserve. Do you see that with the docs that you’re talking to and you’re matching?

Becca Starks: Oh, absolutely. Yeah, it’s the same thing I hear to have. You know, that’s typically the demographic of employers that I’m talking to all day long to have, you know, they came out and maybe cold started or they came out and bought a practice and they’ve been doing it for 20-30 years and like. What?

Dr.Bethany Fishbein: Right and they remember, or maybe they’re still working 70 hours a week and they’re there, you know, every day in the practice and their day off there when the cleaning themselves because that’s what the owners do. How do you coach of 50-something and 60-something-year-old practice owners into understanding that it’s not laziness and it’s not to they don’t want to work?

Becca Starks: Yeah, so that is it is a big misconception of the students that it is laziness, and specifically, most students are expecting to work at least one to two Saturdays a month. So it’s not that they’re coming in and saying I only want four-day workweeks, and I’ll never work a weekend. They are expecting a true full work week and one or two Saturdays per month. To your question about how to coach an owner in that situation. I think it’s just taking a step back and looking really high level at your practice as a business and I’ve had this conversation with many owners of I don’t know why we are open Saturdays, honestly, we’ve just always done it and so determined are we doing this because it’s just always been done or when determining this because it is a true business need. And so same thing with later hours or that sort of thing. If it is a true business need 100% voicing that to a candidate that’s a friend and that’s that’s great, but there may be situations where again, it’s just we’re doing this because it’s been done forever. And actually, our patients wouldn’t mind if we didn’t have a late night or we had a late night instead of a Saturday or vice versa.

Dr.Bethany Fishbein: Do you think docs have like a little bit of that? It’s like that hazy mentality? Like I went through it I put in my time therefore you you need to.

Becca Starks: I think it could be a little of that. Me not being an optometrist. I have to tread lightly because I have not earned my dues. But in the conversations that I’ve had, I think it is a little bit of that at least.

Dr.Bethany Fishbein: Yeah, I worked weekends for 23 years. I’ve never missed it Saturday. I’ve never called out sick. And now I’m going to change my whole practice because this 24-year-old kid doesn’t want to work, like there’s that so what are the students are the new grads thinking about these practice owners, doctors who are in a different demographic from them because there’s got to be misconceptions going that way also.

Becca Starks: Yeah, I don’t get to hear a ton of the misconceptions from the student side. But I think there’s just both sides can teach each other something right like maybe that student can come in and show this business owner who’s been doing this forever, like, wow, I could totally do this differently. And, wow, I’m kind of relieved that you came in and brought up the idea of work-life balance because I as the business owner, really needed that, and wow, my life is different because of it and vice versa. There’s obviously so much that the practice owner can teach and pour into these new grad optometrists. But as far as misconceptions from them, I haven’t heard any to be honest. 

Dr.Bethany Fishbein: I hear that they look at a private practice. They think they’re not going to be paid as much. So they’re thinking that not necessarily that the owner is cheap, but that it’s not. It’s not as profitable, therefore there’s not as much money in it for them. You didn’t mention the mode of practice. You talked about location, work-life balance, and pay. Are students coming out looking for commercial opportunities? Are they looking for private practice or looking for MD offices? I mean, obviously, students are looking for each of those, but what are you seeing most frequently?

Becca Starks: Yeah, great question. So motor practice is very important and private practice remains. Top of the list for I’d say close to 90% of the new grads.

Dr.Bethany Fishbein: Serious?

Becca Starks: Yeah, because I hear the same thing. I hear a lot from private practice owners that say that almost come to the call with me very nervous, like “Becca, what’s going on? Why might all the new grads want private equity and why do they want retail? And can I really afford to hire them? Because it sounds like they’re throwing all the money in the world with them.” And then it’s interesting because we have that ear with the students to hear what they’re looking for. They’re very, very few students that we’re working with, with the class of 2023 that will even consider an opportunity that is not private practice. So there’s just a handful of folks that have said all maybe look at private equity or retail, but the vast majority say I truly, truly, truly want to private practice and there’s even a really good group that says, “Not only do I only one a private practice, but I already know that someday I want to partner slash buy this practice as well.” 

Dr.Bethany Fishbein: Do you think though that it’s, it’s like self-selecting a little bit because retail opportunities are so easy to come by? That they might not even consider needing to work with a company like yours? They just need to go on Ziprecruiter, Indeed, and type in optometrists job and the geography they want and they have their choice. Are you talking to them before they’re job-seeking?

Becca Starks: Yeah, so we actually start a process with them a year before they graduate. And so we have them fill out a profile with us it looks just like a LinkedIn profile, but it’s specifically for KMK, and go in and select all of the different types of practices that they’re open to. And so, we have both from the data from what they input on their profile and then they all have a one-on-one call with a career advisor as well. And so that’s where those points come from, both in the data they enter and then the conversations they have with a career advisor.

Dr.Bethany Fishbein: And is that when a student should be starting their job search is early in fourth year?

Becca Starks: Yeah, so we were really surprised in the timeline as well that a lot of students start having conversations about the fall before they graduate. So this class of 2023 they were starting interviews, October timeframe, and then a lot of them were during their Christmas break, timeframe holiday break, going on visits to practice owners. And then as soon as the New Year transitioned over there were many that were in contract. So definitely, Fall time is like you can feel good. About yourself being ahead of the game, wintertime is still very safe, you still have a lot of opportunity to be reaching out to candidates, and then as we enter into more of the springtime, a lot of I’d say probably half if not more of those that we’re working with are 100% in contract ready to go.

Dr.Bethany Fishbein: When you start working with them. Is there any issue with students who are starting the search and still haven’t passed their boards or won’t have the credentials to work when they graduate?

Becca Starks: Yeah, Yep. There is information from ASCO also about passage rates. And it goes into detail even of school by school, but it essentially shows year over year the decrease in passage rates, and I think we’re at about 70% passage rate, right now. 73%. And so there’s a huge population of students that don’t pass typically it’s part one where the struggle is and so there are some students that will even graduate and still have not passed boards. And another misconception there is, “Oh, these students are lazy or they’re not understanding the information, and I don’t want those students because they won’t be good doctors”. And completely not true. Those are students that could either be not very good test takers. These are also the population that came into optometry school right in the heart of COVID. There are some that have just had really rough life events around the time that it is to take boards and so but they are all great people that will be great doctors, they simply just need to pass this test. Many of them have had really great GPAs some of them have other degrees that help them with the practice management side and so it’s just a matter of getting past that one test or many of them.


Dr.Bethany Fishbein: And how does, how did they navigate that with the job contract like, will an employer sign something with a student who hasn’t yet passed boards?

Becca Starks: Yes, we are running into that actually part one. Board scores were just released this past week. And it was a lot of that there was a lot of celebration and there was a lot of sadness around those that didn’t pass. And the good news is, I don’t know that I’ve come across a single employer partner that we work with that isn’t at least open to the idea of bringing on someone that’s graduated in kind of a super tech role. It’s kind of how we position it to practice under that optometrist owner until they graduate and we even have some that say, “Hey KMK I know that you, as an organization, do great at coaching them and helping them after they fail boards.” I will even invest in that side of the house to ensure that they can pass boards not only to show that, hey, I believe in you and the hardest time in your life student but also that gains them a really loyal employee that again, is going to be a great doctor has just had trouble taking this one test.

Dr.Bethany Fishbein: Coming in as a super tech though, obviously, they’re coming in at a lower pay scale and they would come in as an optometrist, and they have those student loans. So let’s talk about compensation of obviously it’s going to vary around the country and regionally and how many hours and all of that but what is it that a new OD is looking for as far as the ability to earn money?

Becca Starks: Yeah, good question. So, specifically with this new grad population, the way that I kind of coach, the employer partners that we work with private practice owners is, a lot of times they’ll come into the call and say why pay 16% of production, but with this new grad population, they aren’t able to really wrap their brains around what that is, you could have a $1.5 million, your practice and they still just don’t, they can’t really understand that. And so the recommendation that we give is to at least have some sort of salary and we have information and concrete data on specific areas of the nation. So by all means, if, if we can support you in any way with that, I’m happy to to make sure that you’re competitive, but having some type of salary listed up front is what’s going to entice these new grad population because they can wrap their brains around 140,000. They can’t necessarily wrap their brains around 16% of production. And so totally understand, then obviously the argument private practice owner, I hear you what’s going on in your head is. “Well, I need to motivate them to work hard. Like if I just give them a salary, then what’s the motivation to work hard”, and so there’s been kind of this really nice avenue that we’ve taken with a lot of partners that’s worked well in that advertising a salary a little higher than you probably would have normally, but then decreasing to a really low percent of production, so that there’s some salaries that’s there that’s enticing to a new grad, but a lower percent of production. So for the first year only, so year one higher salary and lower percent of production, and then having that shift for year two and year beyond your two to a lower salary, higher percent of production. And so what that does is again, entices this new grad to apply, and even want to learn more about your practice because there’s a salary, but that little bit of percent of production will get them to realize in their first year of working well. I’m doing the math, and if I would have went on the percent of production, I probably would have made more than my salary. This is making sense this is motivating me to work harder. And then again, you can even have it in the contract that upon year two that shifts to a lower salary that’s guaranteed and a higher percent of production. So as they’ve gotten their feet wet, they’ve learned they’ve been mentored that first year shifting then into percent of production.

Dr.Bethany Fishbein: So you’re coaching your doctors to do a salary plus a percent of production?

Becca Starks: Yeah, that’s pretty typical. 

Dr.Bethany Fishbein: And what about benefits and stuff like that is that important? Yes, it is important. Is that something that a brand new grad is going to give enough importance to that it’s going to help them decide one place versus another? 

Becca Starks: Yeah, such a good question. So I’ll give both sides just agree very important. I would say the majority of private practice owners that we’re working with are offering some sort of benefits, whatever that might look like. Some are very comprehensive, some are very “Hey, we will pay 50% of your medical and leave it at that.” But now that we are in this lane of there is competition from private equity and from retail. Those are just a no-brainer. In those avenues. And so to remain competitive from that regard. They will get a full package of 401K’s with matching with benefits with PTO, all of those things, if they’re considering a retailer or a private equity opportunity in comparison to your private practice opportunity. And so, again, I think most I talked to very few that say “Hey, I’m just percent of production and I don’t give any days off you just you if you’re here you make money if you’re not, you don’t but you can take whatever days you want type of thing”. I have a handful of those but for the most part, most private practices are offering the salary with percent of production, at least something towards medical, and then most do have a 401K whether there’s a match or not with that.

Dr.Bethany Fishbein: Are there other intangible benefits, other things that would make a practice more attractive?

Becca Starks: Yeah. So I think the thing that’s so such a great opportunity with all of the listeners that would have that are trying to hire than our private practice owners that have been doing this for years to a new grad specifically is mentorship. And so those that are willing to do that are excited about that. Well, maybe “Hey, I haven’t really even thought about that. But I’m gonna share over the last 20 years, I really have learned a lot that I could pour into this next upcoming generation”. And so being very vocal with that, even in a job description, or whatever it is that you’re creating, to entice candidates to come your way and some people put a really extensive plan behind, “Hey, we have a weekly meeting, and you get lunch hour with me every week and we will cover XYZ and some it’s kind of informal of just “Hey, I’m going to be with you I’m alongside you. You can call me when you want”, whatever that looks like, or even if you haven’t, some team members that are fairly recent grads, being able to vocalize that to have hey, we’ve got folks that I brought on board as new grads and couple years later looking them go and so the mentorship side is again that intangible free opportunity that I think a lot of people don’t even necessarily recognize they have the ability to give.

Dr.Bethany Fishbein: Is it mostly clinical mentorship they’re looking for? is it practice ownership? like when you say mentorship, what are they hoping to learn from you?

Becca Starks: Yeah, definitely medical at the top of that, but there are again, those those candidates that just know that they know that they want to be very involved in the practice management, the business side of the house. And so for those candidates that are interested in it, being willing to say “Hey, here’s I’ll show you all of our programs and all of our software and how I design the day and this is how I designed the business side of the house”, and so in those situations for folks that are interested in that side, I think it’s important to have just kind of an open door policy of “I’ll show you all that. I’ll show you that number. So I’ll let you in on this.”

Dr.Bethany Fishbein: So for practice in a particular geographic area, if you can get your salary and benefits close, but they don’t necessarily have to be higher. They just have to be within range and you can kind of check off all the other boxes. Is there a type of practice like heavy medical versus refractive versus specialty that people are looking for?

Becca Starks: Yeah, so definitely looking at highly medical. And then what I would also say is kind of another somewhat intangible, but if practice owners are open to new specialties that maybe you don’t have in your practice right now. But hey, if there’s somebody who comes in and is passionate about whatever it may be, and they want to bring that into my practice, that’s a really enticing thing for a candidate to really see themselves. They’re in the long haul of “Wow, I’m passionate about myopia management and this practice says, by all means bringing that on.” That’s such a great thing to be able to offer to a candidate and so definitely, medical and specialties are really where the candidates are wrapping their brains around of how do I see myself there.

Dr.Bethany Fishbein: And what if you’re in rural Wisconsin, where there’s just not a huge population of optometrists looking to settle? What’s the best way for a practice like that to set themselves up to find somebody to join because so many of those are great opportunities to become part of a community to ultimately partner buy a practice have a really low cost of living like it’s how do they make themselves attractive or show how attractive they are I guess I should say.

Becca Starks: Yeah, and I think that so often because I get the luxury of talking to these practice owners in some of these more rural areas. And every time I’m just like, Wow, if I could just record this and let all of these candidates see this owner care about the type of patients they get to see a lot of times it’s the smaller communities that because there’s not a nearby ophthalmology or another office like those are the most medically focused practices. 

Dr.Bethany Fishbein: Absolutely. 

Becca Starks: Yeah. And so, so often I feel better. Oh my gosh, if I could just package this up and get a candidate to truly wrap their head around it. So one of the things that we do on the candidate side is our current advisors do as soon as a student comes in and says, “I only want Miami in New York and LA”, we try to mentor as well and show your kind of cost of living and let’s truly take a look at this and let’s look at your lifestyle and look at

Dr.Bethany Fishbein: Miami, LA, how about rural Wisconsin?

Becca Starks: Right? Yep. 

Dr.Bethany Fishbein: And consider Minnesota.

Becca Starks: Exactly. We play that game all day long. Yep. And then to the practice owners, a lot of what I tell them is, they’ll tell me I say they get to brag. So give me your brag book, when they come on as a partner to me, tell me what’s so great about your practice. And then they’re typically ready to end the call and I say, “Okay, based on your area, we also want you to brag on the geographic location just as much as the opportunity and so getting a candidate to truly understand what their life is going to be like, not just when they’re at work with you all day, but once they leave work, and what does this community look like and what can I do there? Is it great for hiking, is it great for the music scene, and the art scene? Is it great to raise a family and maybe I’m not thinking about that right now. But in the next couple of years, I will be.” And so I always say “Somewhere in your job description, however, you want to do it. It’s a post that you’re putting on to kind of an Indeed or an AOA. Having information, just typed information about your geographic area and what makes it so great. And then also, the other added thing you can do is you can always create videos.” Videos are I feel like that’s kind of how we’re all digesting content at this point. And especially this generation of these new grads, and so if you can even do a quick it doesn’t have to be professionally shot but videos of you just speaking informally, almost as if you’re speaking to a candidate who wouldn’t be right in front of you talking about again, envisioning their life there, the more that a practice owner can make a job description or job post about the candidate instead of themselves. The better that that’s going to relay to the candidates have just really getting to understand “Okay, this isn’t what I thought I was thinking Miami, but now I can kind of envision how my life could be in Wisconsin.”

Dr.Bethany Fishbein: That’s a really strong and valid point. Because when I think about a job ad, it’s all about what we need and what we want. We’re looking for an optometrist to work these hours to do this and when I’m interviewing candidates for Associate optometrist, but really for any position I’m always sensitive to an applicant, who all they’re telling me is what this job is going to do for them. Right. So I’m very critical of it as an employer when they’re like, I’m looking to build my clinical confidence in myopia. I’m looking into, you know, whatever. And I think what are you going to do for me? But in the ad, maybe it should be the other way off, Here’s what I’m going to do for you so that they’re interested and intrigued by the post enough to then come in and want to tell me what they are going to do for me so

Becca Starks: Absolutely 

Dr.Bethany Fishbein: Cool. 

Becca Starks: We even have one it’s a Power Practice member that wrote a personalized it looks just like a letter you would receive from your grandma in the mail and it was so different and so eye-catching and so engaging. It was truly just a personalized letter, Dear Candidate, and then it just spoke really informally like, Hey, I get it. Words are hard, school is hard, but here’s what it would be like living here. Imagine if you could leave work and go out and do this, this, and this and your two hours within this big city so you can go catch a basketball game and be back home at night. And so it was just very, again trying to get that candidate to envision their life not only with that practice but in that geographical location. And so that was an incredible example. 

Dr.Bethany Fishbein: Did it work?

Becca Starks: We’ve gotten some interest. We don’t have anybody signed on yet, but it has enticed interest.

Dr.Bethany Fishbein: And talked about KMK a little bit again, just before we close. So if a practice owner is looking for an associate, they can reach out to you or how do they go about tapping into this database network matching service that you guys have?

Becca Starks: Yeah, absolutely. Yep. I would be the point of contact Becca Starks. And I’m sure you can put my email in the show notes, but it’s just And yeah, we typically just do a really informal introductory call and learn about the practice, learn about what they’re looking for. And then go over kind of our offerings. We’ve got two different offerings to choose from, just depending on what the practice owner is looking for. And then yeah, we just go from there. It’s really simple. It’s free to be in agreement with us and having us promote a practice. And so basically, we get that agreement going and then our current adviser starts promoting any of our partners that we’re working with. And then essentially once we have a student that is a great fit, we play the matchmaking game. 

Dr.Bethany Fishbein: I love it. Thank you. I think this is valuable information for new grads to help them understand what they’re going out into and some of the misconceptions they might be facing. But hopefully, we did our part today to try and reduce some of those and really give today’s employers a more real picture of new grads who are looking for jobs. So thank you so much for taking the time to do this and give this service to all of the optometrists out there.

Becca Starks: Absolutely. My pleasure, Bethany. Thank you. So much. 

Dr.Bethany Fishbein: Thank you


Read the Transcription

Nick Despotidis: This is what I want out of my practice. Do you know me well enough, number one, to guide me and number two, do you have the background and experience, and knowledge and base to guide me appropriately? And third, keep me accountable.

Bethany Fishbein: Hi, I am Bethany Fishbein, the CEO of The Power Practice and host of the Power Hour Optometry Podcast. And I’m talking today to Dr. Nick Despotidis. Nick is a repeat guest on the podcast. He’s the founder and partner of Eye Care Professionals, which is a private practice in Hamilton, New Jersey. And he’s the brain and the enthusiasm and the energy behind Supercharge Your Practice, which is a well-known, incredible seminar to help doctors grow their practice with Ortho-K and learn a tremendous number of life lessons along the way. So Nick, thank you for coming back.

Nick Despotidis: It’s my pleasure, Bethany. Thank you for having me.

Bethany Fishbein: So what led to us deciding to record this was a conversation that we had had a couple of weeks ago over lunch. And I have to say, we’ve known each other for a long time, and it was a meaningful, notable event to get an invitation to lunch and an opportunity to help you. So it was nice. We don’t get to do that a whole lot. Thank you for reaching out. 

Nick Despotidis: Yeah, I had reached out because I needed help. And I started with Power Practice with Gary Gerber decades ago. And true to form, my practice has benefited tremendously from the foundation. My practice is multidisciplinary, multi-doctor. And my area of the practice, as you know, is myopia management, ortho-keratology. And we’re very successful at it. But sometimes when you’re a leader, you feel the loneliest in the room. People look upon you, your partners, your staff, your patients for decisions. And the God’s honest truth is sometimes you don’t know if your decisions are going to be right or wrong. That’s number one. Number two is you don’t have the outside knowledge to make that decision. And I reached out to you. I said, Bethany, I need help, which is very difficult for me. I needed someone that I could be vulnerable with. I needed someone that I trusted their insight. And I also needed someone who had your background. And you’ve been doing this a long time. And we went out to lunch. And like many of these listeners, I listened to your podcast. I listened over a year ago to the podcast on virtual assistants. And that resonated with me over a year and a half ago. I listened to different podcasts on how to train staff and staff happiness. You know, that’s one of my goals is we’re only as happy as our staff. And we went out to lunch and we can expand on that. But just the two tips that you gave me during lunch just resonated throughout the whole office. There was a ripple effect. And then I realized the consulting that I got maybe 20 years ago is very different than the consulting that I needed today. 

Bethany Fishbein: Yeah, a lot of things have changed in that realm. But go back to what you said about leaders being the loneliest ones in the room sometimes because it’s resonating with me. When I had first taken this job with the Power Practice, a colleague who was CEO of another company reached out and sent an email, something. He wasn’t somebody that I knew real well. He just sent an email saying, if you ever need anything, I’m here. It can be lonely sometimes. And at that time, I thought, what is this? 

Nick Despotidis: Right. Right!

Bethany Fishbein: Like, I don’t know. Why are you sending this to me? And then as you take that role, you start to realize it’s hard running a business. And especially for private practice optometrists, most of them have never done it before. They have kind of this ideal of what the business owner is. Maybe they worked for someone and they saw them come and go and keep their own schedule and seeming to have a lot of money or a nice car. They kind of imagine this life. And then all of a sudden, it’s you. And the reality hits. Everything is your responsibility. 

Nick Despotidis: Right. You get on the treadmill. And then all of a sudden, you’re tired on this treadmill. You’re running. You’re working as hard as you can. But you may not see the results like you said that you visualized. But you’re still on this treadmill. And you don’t know how to get off. And you don’t know how to slow it down. So I think practice is like life. You go through different stages. So in the beginning, when we reached out for consulting services, we needed basics. How do we grow the practice? How do we hit our benchmarks, our gross? How do we look at leases and buy frames and develop a dry eye practice? Whatever the case may be. As the practice matures, you have a foundation. But then you want to say, is this practice fulfilling what I enjoy most in life? And that’s really harder than actually increasing your gross and net revenue.

Bethany Fishbein: Absolutely. I mean, the first set of questions you gave, I feel like I’m not calling you old but, we opened our practice after you did. So I’ll call us old and acknowledge you did it a few years before. But a lot of that how-to kind of information

Nick Despotidis: That’s correct.

Bethany Fishbein: That wasn’t easily accessible then is available now online for free.

Nick Despotidis: That’s correct.

Bethany Fishbein: How do I set up a frame board? Okay, there’s a million places you can go to get that. How do I? I don’t know. I mean, there’s so much free information out there.

Nick Despotidis: Yeah.

Bethany Fishbein: But what the second part of it is, where I think we really get into meaningful conversations with people and with our clients. Is this making me happy? Is this serving my goals? Is this helping me get to where I said I want to go? Is where I said I want to go where I actually do want to go? Has that changed? So how do you get into those conversations?

Nick Despotidis: I think that’s a great way to put it is how-to information. You’re right. When we first began, there was no internet. So yes, I’m dating myself. And there’s certainly no groups that we could post questions to. But I have found the information. I’m never on these sites for a number of reasons. And I teach why. I think they’re time bandits. And number two is when I post a question, there’s probably a lot of good information in the responses. But I don’t know if that information comes from a reliable source or someone that just likes to hear them or hear her speak. Number two is they don’t know me. So what may work in my practice may not work in your practice. We could agree on that, Bethany. So the reason I came to you is you know me. Forget about my practice. And you know the way I like to practice. You know me beyond the practice. So I really needed your insight on how do I train staff in this century, not just like office manuals. And you started helping me with software that’s available and recording the procedures. And just that little information resonated throughout my office because now I could train doctors. I could train staff. And then when I ran into difficulty, because it’s one thing is I do this and I suggest you do this. You need someone, and I needed someone to kind of hold my hand to say, not only is this a software you use, this is how we do it. Yes, you’re going to run into some issues, Nick. And you held my hand until my vision of how I would use this kind of took off. And that’s why I want to talk about this, because sometimes we feel either we should know everything as the leader. Or number two is I don’t know anything. Tell me what to do. That doesn’t work either because of what you said. It’s kind of like you can tell me, but if you don’t know me as someone who’s developed a relationship with me, then the advice you give me may only frustrate me. It’s like, oh, more stuff to do. And I just don’t have time to begin with. So I think this relationship that you’ve developed with your clients, including me, is critical because you know me and you know how to guide the advice. Just to take off on that, I have friends that own multi-million-dollar businesses outside optometry. Nothing to do with optometry. They go to a mastermind group, a group of like-minded CEOs like yourself, and they talk about they’re vulnerable. They’re safe. They feel safe to talk amongst one another, show their numbers to one another, and really develop thick skin when someone who really cares about you says, hey, I don’t think you’re going in the right direction, why don’t you try this? But they know you. So they commit to constantly self-improving in a very safe and structured environment as opposed to me posting something and saying, hey, I’m slow this week. Are you guys slow? I’m open on Monday. Are you open on Monday? And you get a lot of responses. In my opinion, that’s just quicksand because now you sift through these responses, but they’re not catered to you. And you don’t know the sources where they’re coming from many times.

Bethany Fishbein: It’s intriguing and hard for some people to think about those conversations, especially someone like yourself. Like, you’re consulting other people. I was a consultant for other people for a long time and had consultants for myself in my practice. It’s hard sometimes to be in a position, whether it’s the practice owner or a leader in an optometric group, in a state association, a Vision Source administrator. A lecturer, an author to say, I don’t know this. You kind of feel like you’re supposed to know everything, but you’re not. 

Nick Despotidis: No, true leaders know that. And the thing that I was missing, I always had either a business coach or someone to guide me. And then with the pandemic, things fell apart. You know, you go into survival mode like all of us have done. But now for me in particular, I’m sure for many of your listeners, the survival mode is over and we have to go back to foundational growth. And it’s different in my opinion than, how do I do this? This is what I want out of my practice. Do you know me well enough, number one, to guide me and number two, do you have the background and experience, and knowledge and base to guide me appropriately and third, keep me accountable. So, those are the three things. Do you know me? Do you know what you’re talking about? And number three, are you gonna keep me accountable? Those are the three major things in my opinion.

Bethany Fishbein: So let’s go back to the conversation. And I realize as we’re talking that we’re being kind of elusive about this, not intentionally, just because you and I were both there, but nobody else listening to this is there. So let’s fill everybody else in here. What were the things that you were questioning and looking for help with at that point and how did the story go after that?

Nick Despotidis: Sure. I said, Bethany, I’ve been looking for a virtual assistant. I’ve been thinking about this since I heard your podcast with Dr. Thanh Mai on virtual assistant. And I just have gotten so many opinions, but you know me best. You’re also experienced. And you started giving me sites to look at. You started to give me some tips to look at. And then I took off with it because, again, I’ve been thinking about it for a very long time. Then I did my due diligence. You said a few weeks. It was a few months. And I consulted with you and I said, Bethany, I’m more confused than ever. I’m frustrated. And you kept me accountable. You said, Nick, yes, this is hard, but just do it, Nick. Come on. You didn’t say it this way, but you said, put on your big boy pants and just do it. OK. And when I shut down the phone call, I said, you know, she’s right. It is time to pull the trigger. I have looked at this. I’ve done my due diligence. And since that conversation, it really has had a tremendous impact within my office beyond imagination. I just needed the tools because I had the vision. But without you giving me that step-by-step kind of approach to where I wanted to go, I still wouldn’t have done it. So that was one aspect of the conversation.

Bethany Fishbein: Now that you’re talking about it, I realize that that lunch was part two of that conversation. So you had called and asked about it. You’re right. A couple of months before that.

Nick Despotidis: Right.

Bethany Fishbein: And then lunch was, OK, I’m really ready to do that. How do I get my practice set up where this is going to work the same way in reality that it works in my head? 

Nick Despotidis: Right. And then I also knew from listening to your podcast, and this is not just throwing accolades to you. It’s true. The person you interview and said, hey, listen, you need to spend time training. So the reason I was hesitant to pull the trigger, I wanted to make sure that I had enough staff and me enough time to do this properly. How would this play out? I’m not one to act and then think about, oh, shoot, what should I do? I need my ducks in a row. I knew what I needed, but I just didn’t know how to execute. So you’re right. I said, let’s go out in person. We met in person. But it still wasn’t enough because I still came back to you and said, you know, we’re close, but we’re not close. We’re getting frustrated with the process. And that’s when you gave me some further tips. So the second tip you gave me was, well, Nick, we’re using this software, forgot the name of it, to train our virtual assistants and our staff. That was your comment. Just something as subtle as that. You said, I think it was Loom was the software you were talking about. Now we’re using it to train our staff. So that had a tremendous, because once I got my hands on it and saw how it worked, I’ve converted my whole training system for staff in-house, not virtual, and doctor training, keeping our Loom videos on different aspects of the office, just logging into our EMR, all the way to how we answer the phone. How do we write reports? So I don’t have to train staff by having someone there and they can revert back to this library. So these two tips that you’ve given us have really helped our office tremendously. You can’t put a monetary amount on it, in my opinion. And that’s why I feel so grateful to you.

Bethany Fishbein: One of the things that I think made it easier and more likely to be successful was that as you thought about it, you were really able to lay out what your vision was for how this was going to work. I think that that was really the turning point where it went from an idea to specifics, because it’s hard to give specific advice or tips to an idea. If you said, I want to use a virtual assistant and I jump in with, okay, you got to go to this website, here’s how you do it, do this, do this.

Nick Despotidis: That’s exactly right. This is where I get my staff. That’s right.

Bethany Fishbein: You’re going to shut down because you’re not ready for it. So you said, I want to use a virtual assistant. Okay, what do you want them to do for you?

Nick Despotidis: Exactly. That’s what you said.

Bethany Fishbein: And you said, well, I have this idea, I have this idea. I have to think about that. And by the next conversation, you said, okay, I’ve got this. Here’s how it works in my head. This person’s going to do this, this, this, and this. Staff’s going to feel this way about them. Here’s how it’s going to transform my life. Like in your world, it’s the same thing. Someone says, I want to fit more ortho-K. Sure. Okay. You need to see more myopes. That’s different than I want to spend my days doing something that challenges me and makes me feel fulfilled and happy. And here’s how my life is going to look different once I get there. That’s much easier to help.

Nick Despotidis: Yeah. And let’s go to ortho-K because that’s what I know best is, let’s say you said, Nick, how do I grow my ortho-K practice? I could say we use this brochure. This is our consultation process. But that is just like you say, how to, you can get that anywhere. The question is, is why do you want to grow your ortho-K practice? Why do you want a virtual assistant? Why do you want a different way to train your staff? It’s because what’s working now is not working well, but did at one point. So if you came to me, I would get a feel of your current practice before I would advise you. Because if I just give you how to, it’s going to fail. The one thing is you said, I could get frustrated, which I certainly got frustrated. But the worst thing is I do it without the right preparation, without the right background and say, oh, it didn’t work. I hear that all the time. I’m sure you hear it. I tried that. It didn’t work.

Bethany Fishbein: Absolutely. And then to some people carry that with them in the DNA of the practice, where now they’ve tried everything and it didn’t work. But I’ve always looked at it like, if this isn’t working for me, it is working for someone else. Whether that’s a technique, a strategy, a piece of equipment, a material, whatever it is, it’s working for someone all the way up to businesses are failing in an economy. Some of them are failing. There are some that are going to sail through it. What are they doing?

Nick Despotidis: Right.

Bethany Fishbein: Right? It’s you can’t, oh, that doesn’t work for us. If it works for someone, then the issue is you.

Nick Despotidis: Yeah. And why do you want it? Let’s pick a topic that’s hot on my head is should I drop insurance? That’s one of the things that is right now a lot amongst message boards and among meetings. And the answer is different for everyone. It’s not black and white. And what may work for you may not work for me or what may work for you may not work for me. So the question is, is why do you want to drop insurance? Well, I’m working very hard for pennies. Patients are taking their scripts and they used to get them from us. And now they’re taking them somewhere else. The companies that I am accepting insurance from are opening up storefronts near me or virtual storefronts. So again, if you have someone to voice your inner fears safely, the advice is extremely vital. Because like you said, you found that this has worked for some. Let’s see if it would work for you. Another commonly asked question, should I close Saturday? Should I close weekends? You know, my competition, my colleagues are open on the weekends. Well, let’s talk about that. We have a lot of experience with people closed on the weekends. They actually do very well. But this is the commitment they’ve made. So the answer is never as simple as should I drop insurance? Yes or no. Should I close weekends? Yes or no. The question is, are you willing to make the decisions or the choices to be successful? And you were able to guide me because you have this rich history of things that a lot of your clients have done and a lot of your coaches have done. And you said, hey, Nick, this is how I think it should play out. Just pull the trigger now. You’ve done your homework. You’ve done your due diligence. Go ahead. And I found that remarkably helpful in my practice.

Bethany Fishbein: Well, I absolutely appreciate and am honored by and humbled by the opportunity to help you and many, many of our clients really in that way. I think your words will stick with me that it’s tough to make those hard decisions and to be the one responsible for them and to have somebody that you can trust and you can be open with and you can share your fears and be able to know that if you end up having to say, OK, I screwed up, it is OK and that they’re going to stay by your side and get you on track is incredibly valuable. And I thank you, too, for being one of those people for me.

Nick Despotidis: Yeah, I want to thank you. One last point is when I brought up this idea to the doctors and staff, nobody thought it was a good idea. You know, very skeptical. It’s new, new software, new concept and I was convinced this was the way that it would help our practice. Now, I had no way of knowing if it’s going to be successful or not, but I had faith in your guidance. I really did. Because it came from an experienced place. You know me. And sure enough, now we’re winning fans, like you said, because the systems are taking place. So, for example, how we train staff, we have like many of us, we have what we call help guides, SOPs, standard operating procedures. And we have a protocol of how we train staff. They watch someone do a procedure. Then they read the help guide on how the proper way to do this procedure and then they do it themselves. So that’s the three steps of how we train staff. But that’s old school. When you gave me this idea of using modern day software, where people can see the key strokes of how to enter data in the EMR, as your trainer is talking to you, as they’re watching the key strokes, that really has so many areas where we could train doctors and staff. So really, just a little idea like that, and a lot of background, because I wouldn’t, there was many people, let’s put it this way, that recommended a virtual assistant. But no one had the depth of background you had to guide me to where I wanted to go. A lot of people have recommended this software called Loom. And no one was able to guide me like you did to make it helpful to my practice. Do you see what I’m saying, Bethany? It wasn’t recommending a virtual assistant. It wasn’t recommending this software. There’s dozens of softwares that did that. It is someone who was willing to keep me accountable, who had a solid background in doing this, and then actually guided me to make sure I implement it in my practice.

Bethany Fishbein: And have you seen that turnaround yet in your staff and doctors? Are they on board with you?

Nick Despotidis: No, but it went from skepticism to neutrality. And I find that a tremendous win. And no truer words were spoken is that you have to train, train, train. You have to prepare before you release it. But right now, today, months into it, we’re at neutrality. But I am telling you, as far as I’m concerned, it is a resounding success because I know where this is going to go. To me, it’s already executed. I just have to be very careful that I don’t let my guard up. And now I’m ready for the next evolution of my practice where it needs to be. 

Bethany Fishbein: Awesome.

Nick Despotidis: So be warned if I ask you out to lunch again, it’s not just for the company.

Bethany Fishbein: I would be happy for the invite anytime. I’m grateful for you. I’m grateful for our friendship. And I appreciate you wanting to come in and talk about this. It’s a funny topic because it’s really the heart of what we do that we sometimes have trouble articulating. What is it? Okay, what do you do for these clients? We were just up at a family occasion. And I realized that my entire family has no idea what I do for work. And because it’s hard to put words on sometimes. Oh, I went out to lunch with Nick and recommended a virtual assistant. That’s what I did for work that day. But the impact of what comes from synthesizing information, sorting it, applying it to your specific need at that time, and helping with that process is amazing.

Nick Despotidis: Yeah. And you’ve reminded me now, let’s elaborate. I came to you not for virtual assistant help or loom. I was asking you for help me refine my five- or 10-year plan. Do you remember that?

Bethany Fishbein: Yes. Yeah, you’re right.

Nick Despotidis: Yeah, this is how it started. You gave me some tools. But basically, I said, this is what I’m doing now. This is where I want to be in five years, 10 years. And we’re not talking about gross and net. We’re talking about quality of life, professionalism. I want to keep practicing. And then you said, oh, and I knew if I kept doing what I was doing today, it wasn’t going to take me to that vision. And so you can hear it in my voice. I’m back on track. And until I’m not. And that’s why I wanted to do this is talk about coaching is what it is. It’s not consulting, right? In my opinion, it’s coaching. It’s keeping me accountable. It’s giving me the tools so I can execute them. And then when things are not going the way I thought is to have someone to really be transparent with me and help me figure out why. It’s very different than just posting something or getting a generic consulting firm that gives generic how-to information, at least in our practice. And I would think of many practitioners out there. We know the how-to. The issue is, it’s not working as well as I want today in my practice.

Bethany Fishbein: Yeah. Or sometimes it’s there’s so much how to which do I implement and when.

Nick Despotidis: Analysis paralysis. Yeah.

Bethany Fishbein: Yeah. Because everybody’s telling you to do something and any of it would help your practice. But doing one over the other is going to help in a very different way than another might be.

Nick Despotidis: Yeah. And I talk about this, you know, should we do dry eye clinics? Should we do myopia management? Should we do Neurolens? Should we do medical and billing and coding? Should we do amniotic membranes? You know, it goes on and on. And then you end up being frustrated because there’s no focus. There’s no laser thinking, which is what you teach is laser thinking that will take you to what you value most in life, not just in your practice.

Bethany Fishbein: One of the things that you know better than anyone is it’s not even so much a decision of should I do this? Should I do this? Should I do this? That’s the hard one. It’s the what not to do decisions, right? And you’ve been on the podcast before to talk about your decision to stop selling contact lenses in your practice to not go down this path when you could. And that’s the part people struggle with because the should I do this? Should I do this? The world is open to you. You can do anything. It’s when you start saying, I’m excluding this one. I’m not going to do dry eye. I’m not going to sell contacts. I’m not going to bill insurance.

Nick Despotidis: Right.

Bethany Fishbein: Those are the tough ones. And those are the ones that are even more fun to help with.

Nick Despotidis: Yeah.

Bethany Fishbein: Awesome. Nick, thank you for another insightful conversation. I appreciate you taking the time and being the one really to want to make this happen. And just share how a meeting or a conversation can really change the way that you’re looking at something and can influence really the direction of your practice. There’s a quote I like. I wrote it down for this from Susan Scott, who’s the author of Fierce Conversations, which people who know me know is one of my favorites. And it’s “while no single conversation is guaranteed to transform a company, a relationship, or a life, any single conversation can”. And that’s what I like.

Nick Despotidis: Yeah. And to that end, I trust you, Bethany. I think you’ve always been transparent and sincere in your willingness to help me and so many other ODs. And sometimes you just need that safety to kind of open up and get valued advice. That’s very rare these days. Advice is a dime a dozen but, someone you trust and value their insight and know it’s coming from a good place is invaluable.

Bethany Fishbein: I appreciate that. I appreciate you. And to everyone listening out there, I appreciate you as well. Thank you so much for being part of this journey.

Nick Despotidis: Thank you, Bethany.

Bethany Fishbein: For more information on coaching and consulting to help you get to your dreams and your practice, you can find us online,

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