How do you define success for your business? Are you making time to balance your work with personal fulfillment, or are you stuck in the cycle of chasing endless profits? 

In this episode, Bethany is joined by Ali Nasser, founder and CEO of AltruVista wealth planning firm, entrepreneur, and author of the best-selling book “The Business Owner’s Dilemma” for a conversation on how to truly define success. 

Together they discuss an often-overlooked aspect of entrepreneurship: the relentless pursuit of financial gains at the expense of personal fulfillment. Speaking from his wealth professional expertise, Ali emphasizes the importance of measuring success by the concept of ROLE — “Return on Life Experience” — rather than solely on financial metrics. 

Nasser shares insights from his professional encounters with business owners who achieved financial success but struggled with personal issues like identity, relationships, and health. He suggests that business owners should focus on what truly matters to them, such as time management, relationships, and personal growth, rather than solely on financial gains. 

If you find yourself winning at business but struggling to find purpose outside of work, tune in to this episode to learn more about how to find the right balance for your life experiences!



January 3, 2024



Read the Transcription

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

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

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

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

Becca Starks: Yeah, absolutely.

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

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

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

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

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

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

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

Becca Starks: same. 

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

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

Dr.Bethany Fishbein: 70?

Becca Starks: 70 Percent.

Dr.Bethany Fishbein: Wow. 

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

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

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

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

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

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

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

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

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

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

Becca Starks: Yeah. 

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

Becca Starks: Yeah. 

Dr.Bethany Fishbein: With debt?

Becca Starks: Yes. A lot of it. 

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

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

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

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

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

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

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

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

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

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

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

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

Dr.Bethany Fishbein: Serious?

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

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

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

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

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

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

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


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

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

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

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

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

Becca Starks: Yeah, that’s pretty typical. 

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

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

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

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

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

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

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

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

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

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

Dr.Bethany Fishbein: Absolutely. 

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

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

Becca Starks: Right? Yep. 

Dr.Bethany Fishbein: And consider Minnesota.

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

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

Becca Starks: Absolutely 

Dr.Bethany Fishbein: Cool. 

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

Dr.Bethany Fishbein: Did it work?

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

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

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

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

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

Dr.Bethany Fishbein: Thank you


Read the Transcription

Ali Nasser: If your goal is to maximize financial success, then you will sacrifice everything else in your life or many other things in your life in order to get to that financial success. And the problem is your measuring stick is measuring the wrong item.

Bethany Fishbein: Hi, I am Bethany Fishbein, CEO of The Power Practice, host of The Power Hour Optometry Podcast. And I have been waiting to record today’s episode for quite a while. My guest is Ali Nasser. Ali is the founder and CEO of UltraVista Wealth Planning Firm. He’s an entrepreneur. He’s a speaker. He is a bestselling author of the book Business Owner’s Dilemma, which is really about turning financial success in your business into what feels like success in your life. And Ali was one of the speakers at our Power Practice retreat in October. His content was incredibly influential to a lot of people in attendance. Personally, I would dare say life changing for me. So I’m so grateful, Ali, that you agreed to do this, that you were up for a follow up conversation and to allow it to be recorded so we can share it with the podcast. Thank you so, so, so, so much.

Ali Nasser: Bethany, you’re most welcome. It’s a pleasure to be on podcast. It was a pleasure to speak to the summit in Utah, and I’m excited to be here. Thanks for having me.

Bethany Fishbein: Thank you. I’m excited to have you. There’s so many things that we could talk about between the book and what you spoke about, the work that you’ve done. But one of the things that really jumped out for me in the beginning was your personal emphasis on assigning. Purpose to acquisition of wealth.

You really put a different spin on success than I’ve heard a lot of people speak about it before. People talk about growth and percents and how much we’re up and numbers and profit. But you really put a lot of content and thought into why is that important? So will you just share some thoughts on that?

Ali Nasser: Sure. I had a few experiences. About 7 to 10 years ago in my professional career that forever changed my life. It led to spark, if you will, on writing the book, the business owners dilemma, expanding a lot of the thought, the thought IP, the thought leadership, the content around the subjects you mentioned. And what happened in these engagements is I had met business owners that had reached what everyone would think is the pinnacle of success. You built a company and you sold it for 50 million, a hundred million, 500 million, whatever the number was, and these were not small numbers and these were very large successes from these owners and working with them, consulting them, guiding them, advising them. I’m thinking I want to be just like you one day.

I want to build a company up to $50 million or a hundred million dollars and sell it. That’d be amazing. And as I got to know and go deeper with these engagements, I saw that the majority of them were actually suffering or struggling with their position. And I assume, you know, you reach the top of the mountain. You’ve made it. Life is good. The world is green and everything’s wonderful. And I noticed that these business owners vary all from different segments, but they were struggling with their identity. They were struggling with their purpose. They were struggling a lot of times with personal relationships. They were struggling in many cases with their health, with the financial dilemmas they were facing, with challenges with children and succession. And there’s all these challenges they were facing.

I was kind of terrified that I would end up in a similar spot. I was looking at some of these owners thinking, I want to be just like you one day, but now that I see behind the curtain, I’m kind of worried that I’m on the same path. So I was like, what led to this and what happened? And the best analogy I can give you is the mountain climbing analogy. Is that when I ask you or ask the audience at Power Practicing, what’s the goal of climbing a mountain?

Nine 9 of 10 people will say to get to the top. While that is true, you want to get to the top. The real goal is to get to the top, get back down safely and enjoy the journey. It might sound humorous to say, get back down safely. But 80% of the accidents that happen in mountain climbing, they don’t happen on the way up. They happen on the way down. Because we’re so focused on reaching the summit, in this case, building this wealth, this financial independence, that we forget about what happens when we actually get there or why we’re taking the journey in the first place. And I saw these owners reach the summit of their mountain, have these big, big exits. And what I found out in very dramatic fashion was wealth is a means and not an end. And if you’re not really clear about what your end goal is for the wealth that you’re building, no matter how much money you build, you will never be satisfied. It doesn’t matter if it’s $5 million, $50 million, or $500 million. It’s a bottomless cup. And I realized this going through this experience with these owners.

And I said, but what is the true goal? How can I help these business owners navigate the descent, navigate the next chapters of their life? And then how do I help the owners earlier on in their career build something in a more meaningful way? So they’re not sitting at the top of the mountain with a pile of cash and being unfulfilled. And that was what led to the work around the business owner’s dilemma and the wealth integration system for entrepreneurs is to give business owners that view of what’s coming around the corner, help them visit and revisit what it is they truly want from their wealth. Because there’s an outcome you’re seeking. It’s usually not monetary. There’s an outcome you’re seeking. So what is that outcome? And how do we bring that outcome to the surface? Because we all had to grind to build the company. But we may have. It’s shifted now from when we first started. So let’s be intentional going forward. So that was kind of the big event, if you will, that I went through personally and emotionally with my clients that led me to say, let’s really change the whole way this is mapped and create a new journey, essentially, and a better journey that you can start enjoying now versus delay for 20 or 30 years and then not fully enjoy it when you get there anyway. That’s my quasi-long-winded answer to that question.

Bethany Fishbein: It’s a good answer, though. And it’s something that, as a business owner, a practice owner, I can certainly relate to. And I wonder if you came across, as you started doing your research and putting thoughts together, whether this is kind of more often an oversight, like people don’t think about it, or I’ve certainly met people maybe in the mirror who will use building a business as a success that can replace everything else.

I know this goal because I can assign a number to it and I can measure it. And that’s much easier than saying something vague like, I want to be a good parent. I want to have a great relationship. I want to be happy. So I feel like some of the business owners who I meet will jump into the financial goals almost to avoid having to think about all the other goals. What do you see?

Ali Nasser: I agree with you completely. There’s an easy way when people think about what their goals are for next year. Any business owner or practice owner, when you say, what are your goals for next year? Usually one of the first things coming out of their mouth is a revenue growth for the business or some type of metric expanding the business. And I feel that people tend to do what they’ve always done. And most business owners or practice owners, when they get started, they have to… They are forced to build their business. It’s do or die. You’ve cut the rope.

You started a company and now you’ve gotta perform. So you start and you push and you grind. And that’s what you find satisfaction in is having the wins. You get to the next level. You reach the next financial milestone and you start to get this dopamine and this enjoyment from hitting the next target, the next goal. If you fast forward that, because there’s a certain period of time when you’re an entrepreneur, you just have to grind. It is a painful start. Call it the first five years. It’s part of the journey, but it doesn’t end there. You might get 5, 10 years in. You go, you know what? I don’t have to do this anymore.

There’s parts of this business that I really want to do. There’s parts of this journey that excite me and I enjoy them. And then there’s parts of this that really don’t serve me well. And let’s focus on the things that are contributory towards my life. And let’s remove the things that aren’t so that I’m not constantly exhausted having to do everything. Well, rationally, logically, that makes sense. But as I mentioned a minute ago, we do what we’ve always done. So if our subconscious is constantly saying, I’ve got to do everything, I’ve got to put it all on my back. I have to work bell to bell.

I have to think about business on the weekends and in the evenings, and you don’t put any boundaries together. I don’t make any change. Then you end up being a slave to your business and business can be a great slave. But if you’re the slave, it’s a problem. It’s a good slave, but a bad master. If you will. You want to be the master of your time. And I think too often, to your point, the goal is, what did you do before? Just bigger. And that defaults to constantly, how do I grow? How do I grow? How do I grow? And it’s all financial and it’s not life and it’s not experiential.

Bethany Fishbein: Right. And so many business books and other speakers and recommendations. And I know people are listening to this just in audio, but I’m looking at the books in your background and some of these. Yeah it’s the same thing? What’s your revenue goal? What’s your target for one year, three years, 10 years? What’s this quarter? And it doesn’t feel natural, especially when you’re working with a leadership team to put personal satisfaction goals on that list. So if someone finds themselves in this situation that you’re describing where they do feel like they’re serving their business in a way that they’re no longer happy with, how do you start to get out of it?

Ali Nasser: Great question. So the first thing is we have defaulted to assuming we want to maximize financial success. And I think that’s a fallacy. It’s a mistake. If your goal is to maximize financial success, then you will sacrifice everything else in your life or many other things in your life in order to get to that financial success. And the problem is you’re measuring stick is measuring the wrong item. So I think ideally we’re not looking to maximize our success. We’re looking to be successful, but maximize the things in life that matter.

So we reverse engineer that if you start with the one thing that is the most controllable thing that we can measure and that we can have impact with is our time. So if you start with, what do I want my time to look like? How many hours a week do I want to be working? How many weeks a year do I want to be working? How do I want that balance of time to be week to week? And you start with that and you measure that item because if you measure your time, you can control family time. You can control personal time. You can control work time. There’s a very clear controllable item there.

If you measure from what do you want your time to look like and you back into that equation for what your business goals are and what your growth goals may be and everything else in life, you’re actually measuring to a standard that is based on what you truly want versus the opposite. Which will inevitably take everything else in its path and suck it up and then you end up burning the candle at both ends and then you end up selling your company after 20 years because you’re just exhausted and you took too much on yourself and you don’t get proper value and you don’t get the life that you want. It all starts by measuring the wrong thing. I would highly encourage those individuals to stop measuring, maximizing financial success and start measuring towards what you want your life success to be.

Bethany Fishbein: I want to talk way more on that. But before I get there, there’s almost a little bit of contrast between that and the idea that the first couple of years you have to grind and you haven’t heard it because nobody’s heard it. I recorded a couple of weeks ago, but talking about docs opening a practice for the first time that sometimes we’re seeing doctors come in. Why do you want a business? Why do you want to own a practice? Why do you want to build this? And they’re saying. Because I only want to spend 20 hours a week working because I want to be home with my family because I want the flexibility of my time. And as a starting point, it’s a tough place to start because then you say, no, I can’t grind. I said I only wanted to work 16 hours a week. And then why isn’t my business growing? So is there a point where you have to earn the success to be able to start to control your time? Thinking about somebody brand new opening a business for the first time?

Ali Nasser: I think so. I mean, I don’t know every business, but I can only imagine unless you’re locking into some type of franchise institutional model where everything’s turnkey and you get a lower percentage of the revenue you create in some type of unique model, any independent business owner, even if it’s a solopreneur that just has their own practice and maybe administrative support. I cannot imagine starting your own business and not having an initial few years of personal sacrifice to create that independence and freedom.

I’ve never heard of anybody kind of starting their business and going, yeah, I just unless it’s a side hustle or it’s some real estate rent houses on the side or some type of more passive natured business. If it’s a company with a website and a service model and customers, you will have a period of time where you better put in the blood, sweat and tears to build the company. And then get the right people in place. Because even if you hire the right people, there’s still effort and energy to find the right people, fire the wrong people, get the business where you need it to be.

So there’s maximum upside with no downside. There’s a trade off. I view the early years of business, you better be ready to commit and put in the time and work and energy. And if you’re not, then go get a job and don’t have the stress of building out all the infrastructure and just go be a great practitioner, whatever it is that you’re doing, whether it’s optometry or legal or financial, go work for a good company and collect the check. If you want the independence and autonomy, you got to earn it. It doesn’t come with entitlement.

Bethany Fishbein: Thank you for that. I agree. It’s just funny, like the number of people that we’re seeing that want to start there and they want to just have what they envisioned five years or 10 years from now, buy all the stuff, do their schedule accordingly. But without that grind, without that commitment in the beginning, it doesn’t work.

Ali Nasser: You know, all things, Bethany, in the world, I feel work with the same basic formula. I would just use a gym analogy, right? You go to the gym. It is painful to strain the muscle. It hurts. But you got to put the muscle under strain to the point that the muscle fiber has those small tears. You got to give it the right nutrition. And then the muscle grows stronger, bigger, whatever fashion you’re doing.

You can’t get to the outcome without putting in the work and going through the pain. And if anyone’s ever been an exercise person for years. At some point, you’re going to get injured and you’re going to step backwards, just like you’re going to build a business. At some point, there’s going to be a key employee that leaves, or there’s going to be some legal issue that comes up or some customer problem, and you’re going to step back.

And what makes great businesses is somebody or a team persevering through the challenges and saying, I’m looking at the bigger picture. This is just a speed bump and let’s persevere through the challenge. And they continually go up and up and up and up. And that’s what creates a great company. No great companies were built because they were easy and no stress and instant. And if they are, it’s a temporary thing. The business isn’t going to sustain at that level. You might have had some great luck in an early stage, but you’re going to face tough times.

Bethany Fishbein: For sure. So once that building is done, you’ve got something established. One of the things that was most impactful to me that you spoke about was the idea of return on life experience. Talk about that a little bit. Because we’re used to thinking about return on investment.

Ali Nasser: Yeah, it’s my single favorite concept to speak on. I like to refer to it as what role do you want? What role standing for return on life experience? Everyone talks about ROI. You can search ROI and I can’t imagine how many billions of hits you’ll get on Google with respect to return on investments.

Books on everything, return on investment. There are spreadsheets to describe every type of business growth formula and model. We all know ROI. And ROI is really important. That’s how you build a company, is making sure that at the end of the day, your time, energy, and effort is yielding a return. But that’s not the most important return. We’ve got one life to live. And who we spend our time with, how we feel, the health we experience, these are all contributors towards the return we get on our life experience.

So if you have all the money in the world and no time, what’s it worth? If you literally are a billionaire and you’re stretched and working every day, 70 hour work weeks, and you have no time to enjoy it, you’re not getting the benefit there. On the flip side, if you have all the free time in the world, but no resources to be able to do the things you really enjoy, you’re kind of not getting an optimal outcome either.

Most business owners, they’ve reached a point where they’ve put in hard work. They have some financial success or a lot of financial success. And it’s time to start defining, well, what is the life experience you really want to live? And ideally, you define it at the beginning. But I work in the entrepreneurial world, and most entrepreneurs I know, they push to start something. They wanted to build a company knowing that this will one day create freedom or independence or better life or better income or solve a problem. Most of the time, they wanted that sense of freedom and independence, and that’s what pushed them to start their company, which is wonderful.

Now, you’re in a spot where you’re so engrossed in your business that you don’t have the money and you don’t have that freedom and independence. And the way you create it is you have to create a new anchor. The old anchor was, I got to just have more business revenue growth. The new anchor is, well, I want holistic life growth. So what do I want my time to look like? What do I want my relationships to look like? What do I want my health to look like? What do I want my financial position to look like? And measure to that outcome.

So return on life experience is revisiting the true goal, which is how you want to spend your time, how you want to experience life, and measuring toward that outcome. Versus ROI, which is, hey, what optimizes the most money? And one story that will forever be embedded in my mind was a business owner client of mine, very successful, built and sold a company. And a few years after he sold his business, his company that he sold was not doing well by the partner that had bought them.

There was an opportunity to buy back the business that he sold some five or seven years earlier at pennies on the dollar. So his previous executive team came to him, and he was the CEO. And they said, hey, the business is back on the market. We know the segment. We know the space. And even some of our old customers, we could come in there. We could buy this company. We could turn it around. We know it. We could turn a huge profit. And I mean, when I say, Bethany, a profit, this wasn’t like we’re going to make 2x return. They were looking at this thing like a 10x type return. And once you add in debt and all that, potentially even much more than 10x return. So huge financial impact of doing this deal. And he’s like, Ali, I really want to talk to you about it. Just get your input. Can we get together and have lunch?

I said, sure, let’s do it. And he had a spreadsheet with all the math on the return that this deal was going to create. And we get to talking, and he’s living the life that he’s always wanted to live. Doing some investment deals. He’s doing his physical activity and adventure, spending family time traveling the world, really enjoying this perfect balance of work and play and purpose. And we’re talking about how great things are. And he says, I’ve got this deal and I want to run it by you. And I just don’t feel like I want to be a slave to having to hop on a conference call on a day that I’m off or I’m hiking out in the nature and all of a sudden I got to stop that to do this.

But man, this deal has huge financial opportunity. And I could tell already where the conversation was going. I said, what is it you truly want? And he goes, I think I have what I want. And that’s the freedom to live life on my terms. And this has a lot of money attached to it. But I feel like it’s going to come with all these hooks that are going to take me away from what I really want. But I feel stupid for not taking advantage of this financial opportunity. My team is like, come on, we need you as a leader. We want to do this. This is huge. And he goes, I just wanted to look it over with you and get your thoughts.

And I stopped and he was about to pull out his folder from his briefcase. And I said, do we even need to look at the numbers? And he smiled and he said, no, we don’t. I’m clear. And he didn’t do the deal. And he had everybody from his old company. Are you crazy? This is like the opportunity of a lifetime. It wasn’t what he wanted for his life.

From a financial or wealth standpoint, it would be a no-brainer decision to do the deal. But he was at a spot where he had the financial independence that he was looking for. He had the life that he was looking for. He had met those goals. And he wasn’t measuring. Just how do I take my net worth from $50 million to $150 million? He was saying, how do I take my life experience from a seven to a 10? And that’s worth more than the financial outcome.

So when I think about return on life experience in action, it was that moment where I was like, someone has real clarity about what really matters. And it’s not an ROI decision. It’s a role decision.

Bethany Fishbein: That’s a great story to illustrate this. One of the things that was unique for me about hearing your story. When you speak about this was you had figured out a way to kind of measure and quantify it. That’s something that I hadn’t seen in that way before, which is why it was so meaningful. You know, when somebody asks the question, are you happy? Are you satisfied with your life? Very often the answer is based on the last 24 or 48 hours. Somebody asks that in the middle of your vacation. Yeah, I’m totally happy. Everything’s great. Somebody asks it in the middle of that work crisis you described where a key person’s leaving and you get pulled back in. No, I’m not happy with any of this. Talk a little bit about getting to a metric or a measurable on this, because I think that was the big eye opener for me.

Ali Nasser: Yeah, happy to. There’s a little exercise we walk through and I’m going to give you the skinny high level version summarizing it. I’ll try to do the formula as best I can. Over audio, it starts with what’s most important to you in life and writing out the things or the people or the outcomes that are most important to you in life. Then it’s what’s most important about money. As money provides a function, what is that function that it provides? Is it freedom, independence, identifying that? And then the exercise we walk through in workshops and in conference speeches, whatever it may be, is to put measurement on your time.

So the way that you can do this and you can do it right now as you’re listening is first you want to identify ideally, if you could wave your magic wand, so to speak, and have your time look exactly the way that you want it to look. And the way I measure this is hours per week and weeks per year. So how many hours per week would you ideally want to be working towards the things you love to work on? I’m not talking about working on admin when you hate admin. The things you love in your business. Let’s say you’re an optometrist.

I love taking care of patients and I love building teams. How many hours per week? Okay. Do you want to do that? Build teams and take care of patients. And then how many weeks per year do you want to be working? Meaning pursuing your purpose. Entrepreneurs typically don’t retire. They have a sense of purpose. They enjoy what they do. So I’m assuming that’s the case. So how many hours per week, how many weeks per year do you ideally want to be working?

So for me, it’s ideally, I’m not here yet. So not there amongst many others. 25 hours a week, 35 weeks a year is my ideal. Which means I’m only committed or forced to have to build business and do work 25 hours a week, 35 weeks a year. All the rest is optional. Travel, adventure, family, spirituality, whatever it is that I want to do. I might choose to work even more. That’s what I choose to, but I want to be optional. 25, 35 is my ideal. So I want you to write down if you’re driving, you can just mentally note this. Otherwise, write down the number of how many hours per week, how many weeks per year that you want to be working. So for me, again, it’s 25, 35.

Then what I want you to do is be honest with yourself. How many hours per week and how many weeks per year are you currently working? And I’m not just talking about the hours you’re at the office or at the clinic. I’m talking about the hours you’re working at home. The Saturdays, you might be problem solving for two hours while you sit on your couch, but you’re really thinking about business. Put all of it together. How many hours per week and how many weeks per year you’re currently working?

Now, if your number is 55 hours a week, 51 weeks a year, then we have a score that when we compare your ideal role versus your current role, we want to get a score one to five. So if you’re on my schedule, 25 hours a week, 35 weeks a year, and you’re currently working 55 hours a week, 51 weeks a year, you’re going to get a one on your one to five scale. And if you’re really close to alignment, maybe you’re a four or five. And the reason measurement is so important is, as I mentioned earlier, we only get one life to live. This is it. Life isn’t some part in the future. It isn’t 10 years from now or next year or when X happens or Y happens. Life is right now. So how we spend our time is the greatest contributor toward our life experience. What we’re doing, who we’re with, how we feel.

So put a number on where you are today, one to five. Don’t overthink it. And make a commitment to yourself. That I’m going to make some type of change in my life to get that number higher. And usually it doesn’t drastically go from one to five overnight. It’s usually iterative. Sometimes it does, depending on how bold of a decision you make and what options you have. But the reason I created this exercise is to get some measurable number for people, because I feel when they see a number, it’s motivating to say, how do I get that number higher? And when we make it measurable with hours per week, weeks per year, there’s actually something to tie back to. Versus it being high in the sky, hokey, are you living your ideal life experience? And it doesn’t turn into anything. You need to make it tangible. And something I’ll mention here is I do have the exercise laid out in one of my newsletters.

So if anybody joins our newsletter list from Power Practice, we can send you a copy of that in an initial email. Kind of like giving the exercise I just walked through, kind of a written version of it. That’s available for someone. If they join the newsletter, we can send that to them. And that’s at

Bethany Fishbein: Perfect. Ali, thank you for doing that. I will strongly recommend to everybody out there that you do join the newsletter. You get this exercise. You put some personal thought into where you are now compared to maybe where you want to be. And if you’re not where you want to be, you put some thought into how you can start to get there. Certainly, if we can provide any assistance, you have our contact information. But Ali, how do people get in touch with you? Is it just through that website?

Ali Nasser: Yeah. The easiest way is just go to There’s a Join the Community. It’s just a newsletter. I put out a newsletter specifically for business owners. It comes out every other week and basically covers certain lessons, thoughts, ideas that can really impact the entrepreneur, business owner. Along their journey. Kind of helping them navigate the intersection of business, wealth, and life. That’s the easiest way to connect. And we’ve had a lot of good feedback on the examples and tangible concepts we’ve brought forth in the newsletter. That’s the best way.

Bethany Fishbein: Awesome. I will put your link as well as a link to your book, which is also an excellent read for any practice owner, into my show notes. So hopefully people can find you through that. But thank you again for your time, for your wisdom, not only today, but for so much that you gave during the presentation and everything to come. I greatly, greatly appreciate it. Thank you so much.

Ali Nasser: You are most welcome. And I’m very appreciative for you having me on the interview, on the show, and at the conference. And look forward to continuing the conversation.

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