Do you know how mental health is affecting you, your practice, and your staff?

In this episode of The Power Hour, Bethany speaks with Dr. Dennis Pardo, an optometrist, social worker, psychotherapist, and founder of Tranquil Wave Psychotherapy, to discuss the impact of mental health issues on optometric practice owners and their staff. 

Together they explore how mental health concerns affect things like productivity, absenteeism, and retention within the workplace as well as the growing awareness and reduced stigma around mental health as a whole. Dr. Pardo shares his unique journey from optometry to psychotherapy, emphasizing the importance of addressing mental health in the optometry profession and provides valuable insights on creating a psychologically safe work environment and dealing with potential mental health issues among employees. 

Mental health issues can be hard to detect, but by learning how to identify and address these pervasive concerns early, it’s possible to avoid the potential problems they cause and keep your practice running smoothly.



August 2, 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

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 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 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 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.

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