Mind Matters: Nurturing Mental Health in an Optometric Practice and Beyond

Dennis Pardo: They did a survey in 2021. Over three quarters of working people that were in that survey reported at least one mental health symptom. And what they found is that when we don’t attend to the mental health issues that employees have, there’s an increase in absenteeism, there’s a decrease in productivity, and there’s a decrease in retention.

Bethany Fishbein: Hi, I am Bethany Fishbein, CEO of The Power Practice and host of the Power Hour Optometry podcast. And today’s episode, I get to not only have what I think is going to be a really interesting conversation, but I get to reunite with one of my optometry school classmates who we just decided we haven’t seen each other since our graduation in 1997 back in the day. So I’m glad for the chance to get to catch up with Dr. Dennis Pardo, who is an optometrist and is also a social worker, psychotherapist, and founder of Tranquil Wave Psychotherapy. And an expert on mental health. So Dennis, thank you so much for giving the time and doing this with me today.

Dennis Pardo: Oh, Bethany, thanks so much for inviting me. And it’s so great to reconnect with you as a proud NECO alum class of 1997.

Bethany Fishbein: Absolutely. So I mean, I’m curious about your path just because we haven’t talked in all that time. And I guess I kind of kept up as much as you kept up with any of the classmates. So I saw things on LinkedIn, or you’ve written an article here and there. But how did you go from training in optometry to deciding that you really wanted your career to be psychotherapy?

Dennis Pardo: Yeah, it’s not the typical career path for people who become optometrists, that’s for sure.

Bethany Fishbein: No.

Dennis Pardo: But my career path has never been typical, and I wouldn’t have done it any other way. I always had an inner therapist. I mean, I was the kid in elementary school that when other kids were being bullied, they felt comfortable to come to me. And people would say to me, like, you should become a therapist. But I was really passionate about optometry. And I didn’t leave optometry to become a psychotherapist because I wasn’t happy with optometry. I think that’s important. I loved optometry. And I did a lot of great things within optometry, clinical practice, I was an associate clinical professor at the school, was very involved with the school and mentoring students. But the last leg of my career in optometry was in medical affairs, which I really enjoyed working for Vistacon, J&J Vision Care, and other companies really traveling around the world, lecturing on the science behind our products and really educating peers about mechanism of action or new innovations in contact lenses when I was at Vistacon. And I just love that. It really combined my love of teaching and travel. And I was really in the zone. But most people do that for about five years. I did it for 13. And I was up to about 75 to 80% travel.

Bethany Fishbein: That’s a lot.

Dennis Pardo: It’s really a lot. And I loved it. But it was time to think about, okay, what do I want to do for the balance of my life? I’m not the kind of person that would ever want to retire, or at least not until I’m 70, God willing. And so I was like, okay, I’ve done this, I’m sort of going to sort of retire from that. And I went back to school to become a psychotherapist. I got my MSW, my master’s in clinical social work at Smith College in Northampton, Massachusetts. And after a lot of research, decided that inner therapist, I needed to make that happen. And so I look at it as two sides of a clinical coin. And because I love optometry so much, I wanted to keep my hands in the profession. And so I have been fortunate to lecture extensively at optometry schools and CE programs. I’ve written two articles, one in review and one in Optometry Times, which is actually the cover article of that issue. Because this is such an important topic, optometry and other medical professions like dentistry, podiatry, medicine, we don’t get enough psychology education to deal with the day-to-day mental health issues that we face as optometrists delivering bad news, right? Largely our profession is positive, but we have days when we have to deliver bad news with sight threatening or sight debilitating diagnoses. And so this is something that our profession is so hungry for, and it just combines my two passions. And so I really enjoy doing this.

Bethany Fishbein: And the concepts around mental health, I mean, it comes up in so many different ways in the life of an optometrist. You talked about delivering bad news to a patient and Jonathan and I, for a long time, did a lot of low vision in our practice. So we were constantly dealing with the grief of a vision loss and the adjustment to losing some independence. And I feel like one of the things that I’m hearing from practice owners lately is that they’re being exposed to this in a whole new way when it comes to managing their staff members.

Dennis Pardo: Yes.

Bethany Fishbein: Because I’m not sure, and I talked to Howard Purcell from NECO on a previous episode of the podcast, and we were talking about whether there are more mental health issues, or if it’s just, it’s lost some of the stigma, it’s become more acceptable to talk about. And so people are being faced with situations where a staff member is vocally talking about their depression or their anxiety, or like, there was a conversation on one of the big Facebook pages recently about what’s the most ridiculous reason your staff members ever called out. And then somebody wrote something about a mental health day, which sparked some debate about whether that was should be met with man up and go to work, or if that was something that really needed to be listened to. So I know I just threw a lot of things out there, but that’s what I’m thinking as you start talking about this. So what’s your take on whether mental health issues are more prevalent, or if they’ve always been there, and they’re just being talked about more?

Dennis Pardo: Yeah, that’s a great question, because I think they’re both true. I think we’re seeing, like my practice is pretty much at capacity, and most of my colleagues that run a private practice in mental health are seeing the same, and there are wait lists because the demand for mental health services has increased. And you really sort of highlight the confluence of two things that I think are important. One is certainly the stigma of seeking mental health care has reduced, and there’s more work that needs to be done to have that continue. But it’s a trend that I think is so important. And I think the combination of things going on in the world, particularly the pandemic, combined with stigma going down, I think has led to the increase in people seeking mental health, which if there’s anything good that came out of the pandemic, it’s the fact that people are talking more about mental health. We see sports figures, we see famous actors, we see politicians talking openly about their mental health, musicians, people that we look up to, right? And that lessens the stigma. But I think we’re talking more about our mental health issues and the pandemic, let’s face it, pandemic absolutely increased the prevalence of depression and anxiety and other mental health issues, social isolation, anxiety. And so because of all of that, it is the perfect storm that has led to not only people being more comfortable with mental health, but actually seeking the care. My practice is totally virtual. That’s a good thing because that gives more people access to mental health. We want to reduce the barriers and I’m able to have a very busy private practice that’s completely virtual from my home office, because that allows accessibility. But also, we think about major things happening in the world, political issues around the world, and including in our country, climate change around the world. These are issues, the economy, layoffs are all contributing to an increase in mental health issues. And the good news is more and more people are talking about it and seeking care.

Bethany Fishbein: So talk to a practice owner who maybe comes from a time where this wasn’t taken as seriously as it is now, and who is in an interview with a like, yeah, I left my last job because of my mental health, or I can work but on Tuesdays, I can’t start until 10 because I have therapy, which are situations that people are really in. These are things that I’m hearing and people are telling me and I’m seeing even in my own practice. From an employer standpoint, what’s the right way to look at that? How should an employer be treating those kinds of disclosures or requests, I guess?

Dennis Pardo: Yeah, both in people that you’re interviewing to join the practice and also existing employees, I would imagine.

Bethany Fishbein: Yeah, it could be either way.

Dennis Pardo: It could be either way. Yeah. I think, you know, let’s face it, practice owners during COVID have faced a lot. Shutdowns, you know, when COVID hit, I worked in university mental health. And so you mentioned the previous podcast with Howard Purcell and students having an increase in anxiety, depression, and other mental health issues is certainly true. And I saw that firsthand because I was working at a university counseling center, and we had to shut down and I had to go remote within 30 minutes of leaving my office, basically. And so practice owners have experienced an increase in stress from the pandemic, just that alone, right? And so I think first take a look and notice that, yeah, you know, my stress levels have increased. And maybe practice owners have noticed that their sense of their own mental health and maybe seeking care during the pandemic to alleviate some of the extra stress that has been caused by the pandemic for exactly what we do, you know, that that is something that I think gives you a mindset to understand that these things may be more important than we thought in the past.

Bethany Fishbein: And before you talk about staff, because you went to practice owners, and as you’re saying that, I’m seeing it, whether people I’m speaking to directly or even just reading online. I mean, I feel like some of the tone that’s changed a little bit from particularly practice owners could be related to that. I feel like when you own a business, bad things happen, and then good things happen. You have, you know, we talk about it, oh, you’re on the entrepreneurial roller coaster. We’ve always said that. But it feels like the reactions are so much more extreme. It’s, it’s not, oh, I had a bad day. It’s I had a bad day and then I don’t know if I can do this anymore.

Dennis Pardo: Yes.

Bethany Fishbein: Right? Or this thing that happened is horrible. And I think I might lose my business. Like, is that a mental health symptom? Or could that be I guess?

Dennis Pardo: It could definitely cause mental health symptoms. I see healthcare professionals, I list that as sort of a specialty, because I am one, right?

Bethany Fishbein: Right, you get it.

Dennis Pardo: Which is for many years, and I get it. So I see healthcare professionals across the board. And more so after COVID, because they were dealing with what’s going to happen with my business, I have to shut down, I have to go virtual. Some professions couldn’t go virtual.

Bethany Fishbein: I mean, for that time that I might have to shut down was very real. There was a period of time where all of us didn’t know would our businesses survive this. And maybe for the first time in some of our lives, we didn’t know that we were going to survive this in the beginning, because it was it was terrifying. And lots of people weren’t surviving. So how does that increased stress or maybe increased stress on someone who has an underlying mental health issue? Like how does that manifest now when the stress, like the threats are still there, but they’re not as big as they were in March, April 2020?

Dennis Pardo: Yes, yes. People are starting to roll back to their normal baseline. But many of these practice owners, just like most people in the US, have recognized that particularly, so let’s take up an optometrist who has a private practice. All of those things that happened in March of 2020, the unknown is what really exacerbates maybe pre-existing mental health conditions that weren’t attended to, or even if there weren’t, that sort of fear of what is going to happen. I spent all these years building this practice, or maybe I just started the practice and I’m just starting to see profitability. And then this happens. It exacerbates whatever pre-existing mental health issue was there to begin with, or makes us face, you know what, I’m really having severe anxiety and depression because I don’t know what’s going to happen. Because we didn’t know three years and here we are, we still are dealing with COVID. Yes, it’s been better, but the unknown is what exacerbates the mental health issues that might have been pre-existing, or creates them if they didn’t exist before. So I would say for practice owners that, you know, back to your original question about looking at employees who raise issues like, I can only come in at 10:00 that day because I have a therapy appointment, is to really look at maybe how your mental health might have changed over the course of the pandemic and to be more sensitive to those issues. And one of the things that’s important, I think, for practice owners is there was a survey done by an organization called MindShare Partners. Their specialty is looking at mental health issues and how it impacts the workforce, right? And they did a survey in 2021. Over three quarters of working people that were in that survey reported at least one mental health symptom. And what they found is that when we don’t attend to the mental health issues that employees have, there’s an increase in absenteeism, there’s a decrease in productivity, and there’s a decrease in retention. And so these three factors are critical to a successful business and for a successful optometric practice. And so treating these issues seriously in the long run will help with those three things to increase productivity, to increase attendance and reduce absenteeism, and to make sure we don’t lose good employees. And so if we can be flexible as a business owner to say, okay, we’ll work around that, that is going to lead to benefits down the line in keeping employees focused on maintaining their mental health for productivity for the practice.

Bethany Fishbein: It’s interesting that you talk about absenteeism, productivity, like those aren’t things that you automatically think about. Like when you hear about depression and you think, oh, okay, somebody’s sad and crying, or, you know, anxiety, somebody’s worrying about things that aren’t there. But this is somebody might be missing work, or somebody might be having trouble focusing. What are some other maybe indirect symptoms or things that are going on that could quite likely be attributable to a mental health issue that maybe people wouldn’t realize?

Dennis Pardo: Sure. Well, I’m going to answer this in two ways. First, your point is spot on. That same Mindshare partner survey showed that depression interferes with 20% of a person’s workday and 35% of reduced cognitive performance. So like you said, ability to focus, ability to stay on task, those are high percentages. Just for depression, we’re not even focusing in on anxiety, which often goes with depression. And so I think that’s important as a baseline. But one of the things to think about is what could present, you know, if we don’t know that a staff member has, or a patient has a mental health issue, what are some of the things that can present? Anger is one of them because anxiety and fear, that fear of what’s going to happen with the business and as an employee of the business, “what’s going to happen to my job?” now with the pandemic. “Am I gonna lose my job?”. Fear can translate into anger, irritability, less responsiveness, sadness. So these are things that could be indicative of an underlying mental health condition that’s not being treated effectively. And of course, all of those things are going to affect the work environment, productivity, how people interact with patients in the practice, the growth of the practice. So this is businesses are focusing on mental health issues and large companies are trying to do what they can, because there is altruism there, they want to help their employees, but let’s face it, businesses want to make a profit. And so this is profitable, this investment is important to increase profitability and reduce absenteeism and increase productivity.

Bethany Fishbein: So in that sense, it’s almost easier, better, when that staff member tells you I need to come in at 10 o’clock on Tuesdays because I have a therapy appointment, at least you know that this is being addressed and treated. I think it’s probably just as common, if not more common, to all of a sudden feel some personality change or performance change in an employee who hasn’t said anything. And you don’t really know why that’s happening. Somebody who really was very, very consistent starts making errors or somebody who was engaged all of a sudden really isn’t or is fighting with co-workers or being real short with someone. If you’re seeing that, how do you address it? You can address it as a performance issue, but if someone has an underlying mental health condition, threatening that they’re going to lose their job if this continues doesn’t feel like it’s going to make that a whole lot better. How can a boss, a manager, a practice owner who’s seeing this kind of thing deal with it in a way that is sensitive to the idea that this might not be something that the staff member can just control and might be a deeper issue than someone just deciding to be lazy that day?

Dennis Pardo: Yes, absolutely. It’s a really good question. There’s a term called psychological safety in the work environment. That term was coined by a Harvard Business School professor. Harvard Business School is focused a lot on the intersection of mental health and business productivity, right? Because they know that this is a really big connection.  And so, essentially, what the psychological safety in the workplace is about is giving felt permission for candor. In that situation, particularly if you’re noticing that an employee has really shifted in their normal personality, we want to have an environment where you have fostered, like, I want you to come to me if there are any issues and feel comfortable to come to me if there are any issues. That can include mental health issues. That can include personal issues. That’s really the start of it, creating that environment of safety where people feel comfortable. Right? They don’t feel stigmatized by sharing something’s going on. Let’s say you see an employee who’s like a model employee, and then boom, you start to see irritability, issues with communicating with other employees, even worse, issues with interface with patients right? because that’s going to affect the practice and word of mouth to build the practice. Really meeting with them and saying, listen, I’ve noticed there’s a difference in how you’ve been acting in the practice. I just want to say, is everything okay? What’s going on? I want you to feel comfortable to tell me. I don’t want to pry, but I care about you. You’re an integral part of this team. If it could be helpful, can you let me know what’s going on? Because I want to help. And I think that is the first way to address it because we can’t assume it’s a mental health issue. It might be they had a fight with their spouse right before they came to work, but if it’s more of a chronic issue, and it’s a real change in behavior, likely there is some underlying mental health issue. Just providing that environment where they know they can talk to you. They don’t suppress it because it’s only going to get worse, and it’s only going to continue to negatively affect your practice. I think that’s the most important thing a practice owner could do is creating that environment of psychological safety and in a way without prying, saying, I care about you. You’re an important part of the team. I want to help. Is there anything that would be helpful to tell me about what’s going on?

Bethany Fishbein: And I feel like we can’t totally just bring up that conversation without addressing the idea that somebody could then tell you something that could indicate that they’re really in trouble. So if you would just take a minute and think about as an employee is answering that question, what are signs that you need to do something beyond being sympathetic?

Dennis Pardo: Yes.

Bethany Fishbein: Because maybe you’re the first caring person who asked, or maybe they trust you, or maybe they’re just at a breaking point. And I’m imagining asking that and having somebody actually tell me and then not knowing what to do next.

Dennis Pardo: Yes. That’s a really great question. And a big part of therapy is understanding when something might need further attention, right? So of course, first and foremost, if any employee tells you that they feel like there’ll be a harm to themselves or other, that is an immediate referral to the hospital emergency room.

Bethany Fishbein: You just tell them; I hear what you’re saying. I think you need to be in the ER?

Dennis Pardo: Yes. Yes. Or if they are seeing a mental health professional, I would either suggest that you contact your mental health professional. And if not, bottom line, the first triage, if someone elucidates to you that they are harmed in themselves, that’s an emergency room referral. So closest emergency room, please go. I’m concerned about your safety. I care about you. I’m concerned about the fact that you might harm yourself or others. And this is something that as optometrists, we also need to do with our patients. So that’s important to know if we suspect something. If we deliver bad news and someone says something that they might harm themselves, we want to make sure that it’s an immediate referral to the hospital emergency room. Barring that, if you’re concerned that they can’t make it through the day, I’m concerned about you. You don’t want them interacting with patients because they may divulge to you that there’s something really going on that’s really weighing heavily on them, asking them, I don’t want to pry, but if you have a mental health professional, I’d like you to try and call them and see if you can make an appointment today for an urgent care visit, a crisis visit, because I want to make sure that this issue gets attended to. And I’d like you to go home for the rest of the day. So it’s really triaging like we do in eye care, right? What is a referral that we need to turf immediately? What is something that can wait? And what is something that we could actually, by unloading it to us, and they could say, I feel better. Thank you for asking. I just, I’m having a rough time. I had a fight with my spouse or my son got in trouble at school. I really appreciate you asking. I’m fine for the rest of the day, but this is why my behavior is changing. So we have to, just like you would triage any ocular condition, we as mental health professionals triage it as well. And as an optometrist working with a staff member, that’s really how I would recommend you triage it.

Bethany Fishbein: And do you feel like it’s, it shouldn’t be that different than if somebody says, oh, my stomach is killing me. Like you’re kind of making the same decision thing, right? If somebody’s in 10 out of 10 pain and you know, whatever you say, I think you need to go to the emergency room. If it’s less than that, why don’t you call your doctor? If it’s less than that, why don’t you go home today? See how you feel tomorrow? Like, I think sometimes, I think it’s new thinking that those are not all that different.

Dennis Pardo: Yes.

Bethany Fishbein: Because one is, is so obvious, right? If somebody’s wincing and hunched over, spent a better part of the morning in the bathroom or whatever, it’s like, okay, I understand that where something in somebody’s brain is pretty foreign.

Dennis Pardo: Yes. Yes. Which is why I’m doing these lectures and articles, because we just don’t, you know, you were my classmate. We had a psychologist who came in and did, you know, probably what, maybe one quarter, we had one quarter, we had a psychology 101 class.

Bethany Fishbein: Yeah. Do you remember Dennis, we had those kids from the high school drama club who came in, and that was our delivering the bad news class. And it was these 15 year olds dressed as elderly people. I will never forget that day. It was so funny. Because we just, we’re like, you know, I’m sorry to tell you, you have cataract and then they would fake wail. I just, I love that. I still think about that sometimes.

Dennis Pardo: Yes. And don’t get me wrong. There was nothing wrong with the training that we had.

Bethany Fishbein: It was just funny that it was high school kids.

Dennis Pardo: Yeah. Yeah. But it’s just not enough.

Bethany Fishbein: Right.

Dennis Pardo: You know, it’s not enough. And we need to know, like the question you asked, what do I do if I do ask this question with a staff member, is something serious? What do I do? We don’t have that training, but you’re right. We need to think about it the way we would triage a stomach ache, or just like you said, you have to go to the emergency room, call your doctor, or can you deal with it? Are you feeling better now? Did you take something for your stomach and can you make it for the rest of the day? And it’s really, you know, the way we triage mental health issues is very similar to the way we triage physical issues and the way we triage ocular conditions. It’s just we never, we didn’t get that training. And, you know, I can’t tell you how many optometrists after going to, when I do a CE lecture on this, this was really so helpful. And I don’t mean to say that to pat myself on the back. It’s just, we’re so hungry for that information. And there’s a dentist who does what I do, who ended up becoming a psychotherapist too, in the dental profession. And I had a chance to meet this person. And we were talking about like, it’s so great to be able to give this information to practitioners who want it.

Bethany Fishbein: Yeah. And I think another area where we’re really undereducated is the effects of treatment. So that’s another thing that’s come up in practices that I work with is they have this situation, a staff member talks about it, they go, they get treatment, in some cases, medical treatment, and then the meds make them a little bit different.

Dennis Pardo: Yes.

Bethany Fishbein: And so where’s the line of, I care, I understand, I want you to get treatment, and I need you to do a job if you’re going to be paid to be here. Like, how can some of the treatments for depression and anxiety affect someone’s performance? And how do you as a boss navigate somebody who’s trying something, like it takes a while sometimes to figure it out?

Dennis Pardo: Yes, absolutely. So, you know, the most common medications that are prescribed, and when I do the CE lecture, I have basic psychopharmacology for the ODA. So the basics of what are the major oculus side effects and that can be related to the most common psychotropic medications that you might see on an intake form. And so, you know, first of all, I think it’s really important that we do have a space for psychological conditions and for psychotropic medications on the intake, because that gives us a sense for our patients, what might be going on. But for employees, it’s the same thing. So yes, so let’s say a typical SSRI, which is pretty much the standard of care for depression and anxiety, actually, you know, that’s selective serotonin reuptake inhibitor, you know, so the most common antidepressants. And it can take three to four weeks to equilibrate in the system. And there may be side effects while it’s going to that. So if you have a good enough relationship with the staff member, and they share with you that you know what, yeah, I’m a little lethargic because I’m sort of ramping up with this new medication that I’m taking, I realize it, bear with me, because that will sort of equilibrate once the medication equilibrates in their body. If that continues for a long period of time, then it does become a bona fide work issue, you are right, you are paying the staff member. And we want to be, we want to be sensitive to the fact that they’re seeking treatment, which in the long term, as we talked about before, is going to increase productivity and keep things moving. But, you know, it can’t go on forever. And so that’s the responsibility of your employee to keep the follow ups with their psychiatric provider, and make sure that, okay, we need to switch to another medication, we need to lower the dose, we need to increase the dose, whatever tweaks need to happen, because that shouldn’t go on for more than the requisite period that the adjustment would take place. And so very sensitive topic. And the way to broach it is very carefully, but it does need to be broached because if it’s impinging on their performance, and their interaction with patients, that’s going to affect the practice. And so on one hand, you know, I care about you, I’m really glad you’re seeking treatment. But when is the next follow up with your psychiatric provider to see if anything needs to be changed with the medication while you’re adjusting to it?

Bethany Fishbein: In my head, I can see our compliance friend Joe Deloach, like, kind of internally freaking out a little bit about what’s appropriate to ask and what isn’t. I think if somebody is telling you this, it’s really critical to have that information, right? If somebody says, listen, I’m going to be trying a new medication, they expect this for a period of about six weeks, I’m doing this, I went to my follow ups, you can tolerate and find your way through that a lot easier than if somebody doesn’t tell you anything.

Dennis Pardo: Yes, yes, absolutely.

Bethany Fishbein: And like what you can and can’t ask.

Dennis Pardo: Yes, yes, yes. And that’s why this is assuming that, so let’s say you’re noticing that the employee is more lethargic than they normally are. That goes back to that psychological safety, speaking with them one on one and saying, listen, I noticed that you seem a lot more tired, what’s going on? And it’s not like you can say, are you taking an antidepressant? It doesn’t really work that way. So creating that psychological safety, hopefully they’re going to confide in you, you know what’s been going on, I’m taking a new medication, they may not say what it is. And that’s the entry point to be able to say, well, I appreciate you sharing that with me. Maybe you want to see if the dosage is right, because it’s not fun. I would imagine it’s not fun to be lethargic all the time. What’s going on with that? Do you have a follow up schedule? Then that could be for a psychotropic medication or not. But you want to make sure that they’re following the process. But you can’t just come out and say, are you taking an antidepressant? Because I noticed you’re much more sluggish. I mean, that’s not going to meet with protocol and compliance. So that environment that you have with your employees that creates the safety allows for them to maybe disclose things because they trust you, they know you have your best interests, and they’re going to share that with you. And that’s when you can say, well, so when’s your next follow up? How are you feeling? Do you want to see with the next follow up, ask the questions about lethargy? Is there something that can be done? And that’s the way to really do it appropriately, in my opinion.

Bethany Fishbein: So as long as they’re telling you, then you can respond as caring human. If they’re not telling you, you can’t ask specifically. But I feel there’s a little bit of a cliff here, because there is a point where someone can disclose too much. Yes. The place that we’ve seen it is in employees who are self-treating, especially in states where marijuana is legal. So somebody saying, I really feel like marijuana helps my anxiety, and so I’m treating it. That sounds like, oh, okay, that’s lovely. Versus I smoked pot in my car before work, which as an employer is, well, then you can’t come in. But those actions might not be the same thing. I feel like I keep asking this question in different ways, because it comes up. Just help me think through that idea of self-treatment a little bit.

Dennis Pardo: Yes, yes. And with the legalization of cannabis, I practice in two states. I’m licensed in Massachusetts, where I lived for 33 years in Boston. And now I’m in Connecticut, and we have legalized cannabis. And yes, people are self-medicating for lots of different things, but anxiety is number one, and then sleep, insomnia is number two. And cannabis will help you with anxiety. It will help you with sleep. But it’s unethical to smoke in the car before you come in to work in a practice where you’re delivering healthcare and interacting with patients. And that is definitely going to interfere with your ability to do your job. And so I am open. Cannabis is legal. I have lots of clients who are open with me that they do smoke cannabis for anxiety and for sleep issues mainly, and then for some physical issues as well. Many of them have a medical cannabis card. So this is sanctioned by a doctor. And so there’s no judgment there. This is legal. However, when it interferes with coming into work and you’re intoxicated, be it with cannabis or with alcohol, that is an ethical boundary that’s crossed. And so it’s great that cannabis helps them with their anxiety or sleep. You smoke it before you go to bed to help with sleep, and you smoke it outside of work time and not within a certain time period before you come to work, because obviously the effects of cannabis last hours after you take it. And so I really take a hard line with that as a therapist and as an optometrist. That’s important.

Bethany Fishbein: It’s so much to think about. Is there anything that you just want to share that you feel like you should have said you didn’t say or something that sums all of this up a little bit?

Dennis Pardo: Yeah. I think the most important thing is that as a practice owner, mental health issues are going to come up. And again, we mentioned the benefits of the fact that more and more people are comfortable to talk about mental health and just knowing the right way to deal with it in your practice to maximize your relationship with your employees, but to maximize the success of your practice. And to recognizing that, just ignoring mental health issues, both for yourself and for your employees, is going to affect the productivity and success of your practice. And so this is here to stay. And we need to be able to have the knowledge to deal with it. So that would be one of the overarching, most important messages that I would give to optometric practice owners. Another thing I would say is, and I say this in my lectures and in the articles I’ve written, is include a mental health professional, at least one, preferably two to three, in your referral network. And that’s really important, not only for if a staff member doesn’t have a mental health professional, but you have one to three that you work with in the community that you trust, you can not only refer patients, which I think is important, you can also tell employees, well, you know what, the mental health professional we refer our patients to, if you’re looking for someone, we know that this person is reputable and has worked well with our patients, you might want to consider going to that person if this comes up. And that would also be for the practice owner, because we started this with the fact that for practice owners, anxiety and depression increased during the pandemic as business owners. And so I think that’s really important. The other thing about that is, it’s a two-way referral system. Like when you refer to a cataract surgeon, they refer back to you, right, for the primary eye care, or at least they should. It’s the same with mental health professionals. If you include them in your referral network, you will get referrals back for eye care. And so that’s another pearl that I would recommend for all practice owners.

Bethany Fishbein: This is all good stuff, Dennis. Thank you for taking the time to just present it in a way that really underscores the importance not only to the individual employee, the individual practice owner, but also to just the overall success of a business. So thank you for sharing that. If somebody wants to learn more about you or wants to take one of those couple of open slots you have left for new patients, how do they find you?

Dennis Pardo: Best thing to do is if you do a Google search and go on psychologytoday.com and you put in my name, I will come up and it will tell you all about my background and insurance that I take. And that’s a way of contacting me. And if you have any questions, my email address is tranquilwavespsychotherapyatgmail.com. And I’ve written two articles in Optometry Times just published in May. So if you look my name up under the search bar, that article will come up. And then I did an Optometry Times article, which was the cover article, Optometry and Mental Health in March of 2021. And so a lot of the things I talked about and more are in those articles.

Bethany Fishbein: Thank you. Thank you for the resources. Thank you for sharing this time. And we are absolutely not mental health professionals at the power practice, but we certainly do work with doctors on decreasing some of the things that are stressful in the practice, increasing profitability, managing your time so you’re spending more time doing the things that you enjoy, and increasing your clarity and confidence around your business. And that’s something that listeners feel would be helpful. You can find us at powerpractice.com. Dennis, thank you one last time. Thank you again.

Dennis Pardo: Bethany, thanks so much. It’s been a pleasure and many thanks for inviting me.