Although the pandemic’s intensity has waned, do the effects on optometry practices, staff, and business strategy remain?

In this episode, join Bethany as she reflects on the lingering impacts of COVID-19 on the optometric industry. Bethany delves into how the adaptations required to operate during COVID continue to affect practices to this day, often in ways that aren’t always obvious. 

From positive adaptations like shifting staff dynamics and enhanced safety measures to the challenges of decision paralysis and day-to-day uncertainty, evaluating whether these changes align with your current practice mission and vision is crucial to your ongoing success. Bethany also stresses the need for ongoing staff communication and the maintenance of adaptable strategies to remain competitive in the ever-changing landscape of modern optometry in the post-COVID future. 



August 16, 2023



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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

Bethany Fishbein: Are there still long COVID symptoms that you are feeling? And if you’ve made these changes, again, who are they for? If they’re the benefit of the practice, are they really in line with the mission and the vision for your business? Or are they something that you’re doing that’s convenient for your business, but really doesn’t help you be who you want to be?

Bethany Fishbein: Hi, I am Bethany Fishbein, the CEO of The Power Practice and host of The Power Hour Optometry Podcast. And a topic that has been on my mind lately is COVID. And it feels a little bit weird to be talking about COVID in August of 2023.

Not something that we’re hearing too much about anymore. But you still hear about COVID occasionally and the effects it’s had not only on people, but on businesses and the economy and things around the world. So, obviously, three and a half years ago, it was all we were talking about. And practices were closing and things were crazy for quite a while. It’s been over three years since most of us reopened our office. And I’m still seeing in many practices, in effect, or I’m still seeing in many practices effects of COVID, kind of like long COVID symptoms that people who had infections years ago are still experiencing. And I’m interested to talk about the things that people are still experiencing in their practices, because many people have found that COVID changed the way that they’re doing business forever. So where am I seeing effects of long COVID in practices? I’m seeing it in a couple of areas. I think the big ones are in service, staff, and strategy. Three S’s.

So, let’s talk about service. I think pre-COVID before we even knew what COVID was, a lot of great practices really had a very strong emphasis on providing amazing customer service as a way to differentiate. I remember reading books from Nordstrom. We went to a workshop to learn how to bring Disney magic to your practice. We had speakers from Ritz Carlton talking about how do you bring Disney Ritz Nordstrom level service to your optometric practice as a way to keep patients loyal to your practice. And COVID really completely changed how we were providing customer service.

It changed it while it was going on. In some ways, that led to good things. And in some ways, that led to things that were not so good. So obviously, when we reopened, all of us needed to find ways to take care of patients that were safer, that minimized the amount of human-to-human contact that people had, minimized the need for face-to-face time, and things that were less reliant on staff. Because even when we reopened, a lot of people didn’t have the same staff that they had when they closed. So some of those things are really good things for business. Coming up with safer ways to do something, coming up with a process that’s more efficient and doesn’t rely as much on individual people, those are things that are incredible. And some of those things that we still see were things like seeing a much wider acceptance of sending contacts to people’s homes as a default, instead of asking, instead of charging shipping, just set your pricing so that you tell the patient, go ahead, we’re going to order the contact lenses, they’re going to go to your home, or do you want them to go to your home or to your office, and not have to deal with ordering the contacts, the box comes in, opening the box, 50 patients on the same invoice, who’s making the phone calls, people have to come in during your office hours. So shipping contacts direct to patients was kind of amazing. And with that, finding ways for patients to order the contact lenses themselves so that if initially, we didn’t have staff available to take that call and do it, that might have been the reason. But now that allows patients to order their contacts or even look at or order their glasses online whenever they want to.

So now their ability to do business with you isn’t limited by your business hours. Online appointments, schedulers, same thing. This stuff existed before COVID, just like Zoom existed before COVID, but COVID pushed a lot of practices to really use it. And they used it and they liked it and found that they wanted it to continue. Some have continued telemedicine, offering patients a way to do a quick follow-up from their home without having to come into the office. The general cleaning procedures and protocol and having people be more aware of the patient who just left the exam room and what the next patient is walking into, I think was a good change that was needed in a lot of practices. And one of the others that we still use regularly was having a dropbox or lockbox outside the practice where we can put contact lenses or glasses or trials or a prescription, an envelope, whatever a patient needs, into a locked box, give them the code.

And then same thing, it’s convenient for patients to be able to pick it up whenever they want. So in these ways, we saw the service and practices change for the better. There are some ways that service changed for the worst as well.

When COVID was active, by necessity, a lot of our practices locked their doors and asked patients to call from the parking lot when they were ready to come in. We set rules for the number of patients who were allowed in the exam room at a time.

Instead of somebody being able to bring in both parents and grandma or the mom and three other kids, for safety, we had to be strict about one patient in the exam room for a child who’s not old enough to be by themselves having one parent. People who had little extras in the reception area, a coffee machine, a water cooler, candy, cookies, people stopped that because they didn’t want patients to take off their masks and be eating and drinking and talking with each other. And the thing about these is, although there was definitely reason we had to do those things three plus years ago, in some offices, what staff found is they liked them.

And from the staff’s point of view, sure, of course they liked them. Staff hates, as they should, when patients are sitting in the reception area, and especially when the reception area or wherever the patients are waiting, if they’re waiting, is right across from the front desk. And staff members will often say, they just sit there and look at us.

And staff feels like they’re being observed, they’re zoo animals or whatever, and they don’t like that. So having people outside and having a calm, empty office until we were ready for them, and then the patient would come in and be taken right away. So there are practices now that are still keeping their doors locked because staff preferred it. Not great, in my opinion, because for people who aren’t expecting that now, which most people aren’t, right, yeah, July, August 2020, people were assuming that when they went to a doctor’s office, they’d have to call from outside. That was the norm. But now people don’t even think about that. So they park in the parking lot, they go to walk in, and it’s an immediate first impression of, I’m not wanted here. Are they closed? Why is there a barrier to get in? Why is there an obstacle?

Another thing that we changed that the staff and sometimes doctors like is that number of patients in the exam room, same thing. It is easier, so much easier to do an exam when there is not an observer in the room asking questions, distracting the patient, eating snacks, turning their little Tupperware thing of goldfish onto the floor and rolling over it with the stroller wheel. It was nice. But is it the best customer service?

And same thing, sure, we’re saving money, not having to buy little bottled waters and K-cups, but who are those changes being made for at this point? So if there are changes that you’ve made in your practice that came as a result of COVID, I would really encourage you to just give some thought about who’s benefiting from these changes. If your patients are benefiting, then that’s a change worth keeping. If the practice is benefiting at the expense of the patient, that’s probably not such a good one. And then there are some that kind of fall in the middle, things like changes in office hours, that’s a tough one. A lot of practices, because of staffing and also because we were home for those weeks and kind of realized we liked having time with family, started to change their hours and decrease the amount of time they were available on evenings. A lot of practices shut their weekend hours and found that they were able to be just as, if not more profitable and work the hours that they wanted that felt better for their family. So on one hand, you could argue that’s a change for the practice.

That’s not benefiting patients to make appointments less convenient. And on the other side of it, if it creates a happier work environment, better staff, more consistent staff, because you’re not trying to have multiple people rotating to do a 40-hour week, just everybody’s there at the same time. And people have a chance to relax and recharge. Are they able to take better care of the patients during the times that they’re there? I don’t know. It’s an individual decision that every practice owner has to make.

Another change was the ability to do a quick glasses dispense. And before COVID, a lot of practices used to make the dispense an event. And it was nice. The patient would come in and they would get the new glasses and other people in the office would look at them and gather around. And oh my gosh, those are so cute and really help the patient feel good about their purchase. They were able to have their glasses adjusted so that they were fit and felt really, really comfortable and walk out with glasses, a gift bag, and all that. While COVID was very highly a concern, we totally changed the dispense.

Our office started doing a curbside pickup where they kind of rolled their car in front of the office, rolled the window down. We stuck the glasses in. They rolled up the window. They put them on, feel good, thumbs up on either side of the window, and they were off. So they weren’t able to get the whole experience. We didn’t know that the glasses were as well adjusted and well-fitted as they could have been, although we were trying to do some adjustment on the front end. But for patients, especially a dad with kids in the backseat or somebody who has trouble with mobility, that was really kind of an awesome thing that instead of me having to come into the office, you’re able to come out. And that’s one that a lot of practices have left as an option.

We’d like you to come in and pick up the glasses so we can adjust them. But if there’s a reason it’s not convenient or it’s harder for you to do that, we are still happy to bring them out, right? So all of these things are just things to think about, but it’s an interesting topic for a discussion with your staff of are there still long COVID symptoms that you are feeling?

And if you’ve made these changes, again, who are they for? If they’re the benefit of the practice, are they really in line with the mission and the vision for your business? Or are they something that you’re doing that’s convenient for your business, but really doesn’t help you be who you want to be? A big example of that one that I see are practices that are still wearing scrubs, which scrubs are awesome. They’re easy. They’re cheap. They’re comfortable. They don’t need to be dry cleaned. You can get your little logo embroidered and have the whole thing.

Scrubs also do give a very medical feel to the business. When you walk into an office and the entire staff is in scrubs, especially if they’re in same or similarly colored scrubs with the logo, it creates a very professional medical feel, which for some practices is exactly what they’re going for. And wearing scrubs forever makes perfect sense. Other practices, their vision, their identity has to do with fashion, especially in the optical. We want you to come in, we want you to get an eye exam, and then we are going to pick out a great pair of glasses that really help you show your individuality, show who you are, show your personality. For that office to have optical staff in scrubs, they’re losing out because that practice doesn’t want the professional medical feel. They want a fashion feel, an artistic feel, a style feel. Staff members, just like we do, like scrubs for the same reason. They’re easy. You don’t have to think about it. But is this fulfilling the vision for the business or is it standing in the way? I think a huge area where we’re still seeing effects of COVID is staff. Huge, huge effects.

While it was going on, as I said, we had to rely on a smaller team. Everybody went out. And then even when we started to come back, some people weren’t able to. They had young children and were doing school at home. They could come back, but only certain hours. They had different responsibilities to adult family members who couldn’t have their usual care, all kinds of things. So we had to work with whatever percentage of our teams were able to come back. And some people just didn’t want to. They found something else, whatever it was. And then even as people started to return to work, it became nearly impossible to find good people to hire. I remember pre-COVID putting out employment ads and we’d get 125 applicants the next day. Post-COVID, we put out employment ads and we would get four, three of whom were looking for something different than what we were offering. Like there weren’t people to hire. It’s getting better. We’re finding that we’re getting applicants. We’re finding strong people looking for jobs. But it still is difficult because the workforce is a little bit smaller. The competition is higher. Lots of people are trying to find good people. And some of the other companies that are looking to hire are offering things like fully remote positions that in our practices, a lot of us can’t compete with.

So as a result of the staffing changes, again, there’s some good things that happened. Some of the automations that really save staff time. We already talked about that. And something else really good that I think came of it was the acceptance of a remote workforce. So many practices now are working with virtual assistants outside of their offices, some nearby, but a lot of them overseas. And that’s been such a great opportunity for people to get a new entire source of smart, reliable, eager, great employees. And I know in our practice has really been a fun opportunity to just learn about someplace different and meet people that are starting to become friends and fully across the world. And I love that. And I love seeing the success that so many practices are having, utilizing a virtual workforce. So to me, that’s a very positive outcome. I think, though, there’s definitely a lot of negative on the staff side. And I think a big part of it comes from COVID changing how employees are thinking about work in general.

For many of us, that time in March, April, May 2020 was the first time that working adults had all of a sudden had weeks and weeks of time at home without a brand new infant to care for. I had maternity leaves, but that’s completely different than having time at home with teenage children or with no children. And so some people liked it. They enjoyed having that time at home. I think it made people reassess what was really important to them. If all of a sudden the whole family was home for dinner and you’re having game night and you think, well, I like that. I want to do that from time to time. And I think that some people are unwilling to give some or all of that up. And so we’re thinking about things differently and employees are thinking about things differently as well. It’s not even a matter of work-life balance. It’s this is my life. How does work help me live it the way that I want to, which is really very different. So people are thinking about work differently. And at the same time, because of everything going on in the office, a lot of people stopped talking with their staff as much as they were before.

One of the biggest long COVID symptoms I see is practices that stopped having staff meetings. And initially totally made sense. We didn’t want to have everybody in the same place breathing on each other because if one staff member got sick and they got other people sick, it really had the potential to shut down our practices. But then Docs who didn’t particularly enjoy the staff meetings to begin with realized it’s easier to just not do them. You don’t have to think about an agenda and what are you going to talk about? And is everyone going to be there on time? Should you bring snacks or not? Or do you have to stop at the bagel store? And what’s all the stuff that goes into making a staff meeting? They just found it easier not to do.

I’ve seen quite a few practices that still haven’t gone back. And when you’re not having regular meetings with your team, you’re really missing out on important things to the running of the business. One of them, the big one, and I won’t say the big one, but one of them is missing out on just the opportunity to connect for a couple of minutes as people instead of just as the doctor and the receptionist or the doctor and the technician. So that chance in a busy practice to sit with each other and say, how are you? How’s it going? How was your weekend? Like just to connect with your team and allow them to connect with each other.

Something else you’re missing out on is the opportunity to talk about things and catch them when they’re small. When you have that regular meeting, you can talk about something that’s an annoyance. A little nagging annoyance that’s just enough to talk about to hopefully change it and put it aside so that it doesn’t come up again. If you don’t have that, that little tiny nagging thing you keep noticing and then it becomes a bigger nagging thing and then it’s all you can see and you can’t even stand being there anymore because all you can think about is this and it grows until it blows up. So having meetings lets you eliminate that and just keeps everybody in the practice on the same page and aware of things that are going on or things that are changing. Without them, you tend to tell one or two people because they happen to be near you at the moment you think of this, you’re excited about it, and maybe they tell the other people, maybe they don’t, and different people know different things and it gets confusing.

The other big dynamic that’s changed is just how doctors are thinking about their staff or how practice owners are thinking about the staff. Because there was nobody applying, because it wasn’t as easy as it had been or it wasn’t easy at all to replace people who left, the idea of losing a staff member became a fear. I can’t lose any of these people because I won’t be able to replace them and I don’t know that I’ll be able to run the business without staff. So things that we used to say like, hire slow, fire fast, kind of got completely upended, right? All of a sudden, we’re talking about hiring fast. If you have a good candidate who seems like they’re going to do a good job and they’re interested, let’s just rush this process to get them in knowing there’s so much competition out there for someone else, which I think is still true to this day. But the other side of it, fire fast became fire only if they’re doing something really, really, really, really awful, like they have come into work cursing and drunk even after you told them not to the first three times. It got that bad for some practices.

Practice owners started to become afraid to even give feedback to staff, to make a correction, to let somebody know they’re not doing a good job because they were afraid that they were going to leave. And so what happened is everybody started tolerating really less than they were willing to accept because of this fear. And that still is perpetuated even to this day. There was a quote on LinkedIn recently that I saw and wrote down and it was from Steve Brunert and Todd Whitaker, who are the authors of a book on culture in schools. But the quote is that “the culture of any organization is shaped by the worst behavior the leader is willing to tolerate.” and it’s true. And what happens when you’re tolerating things that you know that you shouldn’t, but you’re doing so out of fear, is that you do still end up losing people, but the people you lose are the good ones.

That fear of losing staff and what if, and all of that, I think really ties into the third big class of symptoms that I see in the area of strategy. Because I think that when your strategy is motivated by fear of failure, you’re making very different decisions than when you are working towards success.

One of the huge advantages of being a small business owner is that you can make fast decisions. You’re super agile. So you can learn something, think it’s interesting. I’m going to do this. I’m going to try it. Great. Try it. It’s successful. Let’s do more of it. It’s not successful. Let’s change it. That’s running a business. That’s the fun side of running a business.

When you do run a business, the thing that I think is so important as a business owner, in a business owner’s mindset, is to know that, yeah, stuff is going to happen that you can’t control, but you always can control how you’re going to react to whatever that stuff was. So stuff happens in practices. Usually that stuff is fast and you can decide what to do about it. You can get through the cycle of here’s the circumstance. Let me process. Let me react. Very, very quickly. There’s the bathroom flood. Okay. Here’s your situation. There is a flood. What are you going to do about it? Okay. We’re going to close today. We’re going to call people. They’re going to tell us what to do. We’re going to be closed. This is how we’re going to do it. Done. A great staff member gives their notice. Okay. All right. I got two weeks to figure this out. Here’s what we’re going to do. And you have a plan. And I think COVID just didn’t make the stuff, the circumstances known as quickly because things were changing faster than you could start to make decisions about it. So staffing, the example I just gave, a great staff member quits and you’ve got your time and you know what’s coming and you got to think about it.

Well, when COVID was happening, it was, okay, we’re not going to have any income. We’re going to have to close our office. I guess we have to lay off all the staff. Oh, wait a minute. There’s a program and we’re going to be able to keep our staff, but there’s also a program staff is going to be able to do better on unemployment than they could if they were working. But like it just kept changing. And this change is long period of stressful change was going on at the same time that for a lot of people, some for the first time in their lives had this worry about survival. Like for some people, it felt life or death for their own health or their family’s health survival of the business. Usually our decisions are, is this going to make things better or a little worse? Not, is this going to shut me down? And also at the same time, just like staff members are thinking about what they want out of jobs, optometrists are doing the same.

A lot of practice owners moved up their retirement dates thinking, you know what? I don’t want to work until I’m 75, 80 years old. I want to start thinking about an exit strategy. I want to start thinking about a sale. So all this is going on and it was almost impossible during that time to make a decision because there would be new information the next day that would push your decision in a different way. And so everybody just kind of felt stuck and some practice owners still are. They’re just kind of stuck, like paralyzed in that decision-making where it’s not the usual, here’s the circumstance, here’s what we got to do, here’s the plan. It’s here’s the circumstance. Okay. I’m going to think about that. I’m going to wait. They’re stuck in that, like, what if I pick wrong thing, even though things now are no longer life or death or survival of the business.

And so what that looks like in practice is, the big things is, one is hoarding, not stuff like where you have to walk through little alleyways in the living room. Although for some I’ve been in offices where that’s not that far from reality. But what I see much more commonly is hoarding of information. They’re getting ideas. They’re learning about new things, pursuing the webinars that give information or access to technology. They’re learning about the business. They’re consuming, they’re attending workshops, they’re learning. And not being able to do anything with the information that they’re learning. They just keep learning more. So there’s some hoarding of information. There’s some hoarding of ideas. Like so much conversation everywhere these days about things you can do to improve your business and they can find a million of them. And either they’re one day trying one, the next day trying the other, the next day trying the other, the next day trying something different and not getting very far. Or they’re just kind of swimming in ideas and not acting on any. And the other thing I see people hoarding, might be guilty myself, is cash, hoarding money in the business, being more afraid than they were before to spend, to take a risk, to buy a new piece of equipment that is going to ultimately generate additional profit, investing in that renovation, investing in a new staff member, doing something that’s going to be a spend because the income for many people still feels less certain than it did before.

So people are doing that and it’s leading to some confusion and some uncertainty of really just kind of hanging out in a place where you’re unsure about what you want and where you’re headed in the future. And the seriousness of that, when that’s how the practice leader, the owner is feeling, especially when they’re feeling it for a long time, it’s not just them that’s stuck. It’s the whole team being stuck with them and actually working on a podcast with somebody just on that. But it’s that stuck feeling is standing in the way of being able to act and being able to progress. Which is what small business is all about, that cycle of acting and moving forward, even if you realize it’s the wrong direction, then taking a step back and picking another direction and trying something else. And I gave you a LinkedIn quote before, I’ll give you another one of my favorite quotes of, it’s “the road of life is paved with flat squirrels who couldn’t make a decision.” and that’s where I see some practice owners are, still three and a half years post COVID.

So those are my thoughts for today. And if any of this is resonating with you and you’re feeling stuck and looking for clarity around your business, more financial success, more time doing the things that you want to be doing, I would really love if you would reach out to us at Thank you so much for listening.

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