Role of an Office Manager

Beth Berman: Think how much more fun business would again become versus selling it, having to rebuild having to find the people set the processes, do all that stuff again, and you retain the place that brought you to this industry in the first place.

Dr.Bethany Fishbein: Hi, I am Bethany Fishbein the CEO of the Power Practice and host of the Power Hour Optometry Podcast. And something that I’ve noticed recently is I’ve had conversations, a number of conversations with optometrists who are considering selling their practices often to private equity company. And some of these make sense and they’re a couple of years away from retirement and really looking for an exit strategy and it seems like a good tactic, and that’s okay. But the ones that really got me thinking were the conversations that I’ve had with younger practice owners, sometimes in their late 30s, or early 40s, who are contacting me asking what do you think about selling? And when I’m asking more questions, why are you looking to sell? They’re answering that they’re fed up with the hassles of managing their practice, the day-to-day stuff. I hate dealing with staff calling out sick and training new people and hiring and just the day-to-day business of making things run. And then we talk further and I ask, well, if you sold it, and most of the time you sell and you have to work for a couple of years. What would you do after that? And I’m always surprised when the answer is well, I think I would probably open a different practice somewhere. It got me thinking and I know that there is an alternative that allows a practice owner to not have to deal with the day-to-day minutia of running their business while still being able to maintain ownership of their business. And so I invited my guest today, Beth Berman, to talk more about that. So Beth will introduce you officially in a second but thanks for doing this with me. I know it’s tough to get this on your schedule. 

Beth Berman: It’s my pleasure. 

Bethany Fishbein: Beth is an extraordinary human. She is an EOS implementer – EOS is Entrepreneurial Operating System, which we’ll talk a little bit about in a moment. She’s a phenomenal speaker. She’s one of the speakers at our 2022 client retreat. She’s a group facilitator. She’s an executive coach. She works with entrepreneurs, and business owners to help them build exceptional teams grow their businesses and enjoy their lives. So, Beth, I’m ready and kind of pumped for this conversation. I have a lot of great, great stuff to say and I’m excited to learn myself and share it with my listeners. 

Beth Berman: Wonderful! 

Bethany Fishbein: Before we get too into the management side of things, just introduce EOS a little bit and talk about it to people who may not have heard of EOS before.

Beth Berman: EOS is the Entrepreneurial Operating System as you stated, and basically it was created by Gino Wickman, who after turning his family business around, he discovered that he kind of had a formula, a playbook for helping business owners get what they wanted from their business. And I think that’s really key to the way you started this conversation to be around. It sounds as if these optometrists aren’t getting what they want from their business, but they still love Optometry. So what leaders want from their business it could be they want more profit. It could be they want more control. They went into an entrepreneurial practice because they weren’t in control of their lives and found that their businesses were managing them. It could be that what worked before isn’t working now or maybe the wrong people or they’ve tried everything but it’s just not fun anymore and life doesn’t feel good anymore because they’re running a practice that is really running them. So what Gino did is he took what he had done in his family practice and cobbled together a bunch of tools that he combined into a system that helps people get past whatever is blocking them from getting what they want from their business. It focuses on three things vision, traction, and healthy: Vision from the standpoint of getting everybody on the team 100% aligned with where you want to go and how you plan to get there. Traction, is about the execution of the vision, executing with discipline and accountability on division, on the plan, and to the point of this conversation, allowing others to manage the practice so that you can elevate yourself to do the things you love to do on our best day. And then Healthy is about open honest teams who bring issues forward early who have the real discussions and operate the business on facts and figures rather than politics, emotions, and those things along the way. So basically what Gino discovered is that, to the extent that you can strengthen six key components, you can get what you want from your business and to the extent, you can sort your issues into those components and then use the tools you devise very, very simple tools. That’s where you get the growth, the control, and all of these kinds of things, just to round out the picture. I also run peer groups. I’m a partner at Clark Leadership. And we do believe that every great leader needs three things: “A System” so the EOS system, “A Peer Group”, and I know that through Power Practice, there are peer groups and there is coaching. You have a  community you’re in a safe place where you can process issues even outside of your team and you have a coach guiding you. I guess together we create the trifecta.

Dr.Bethany Fishbein: Absolutely. Alright, so the piece that I want to go back to is this idea of, I guess, delegating but it’s elevating someone else into leadership so that you as the owner can elevate yourself to the things that you want to do. And I know that when we start to work with clients, and even my experience in my own practice is that it’s pretty common that the owner, at least initially, is also the manager. Whether there’s someone else there with manager title or not. And you work with multiple Optometrists in your coaching practice. What do you find? Do you see that same thing?

Beth Berman: Yeah, I find that when I come in, it’s normal that the Lead doctor or the owner is both working on the business, and in the business, and seeing patients. So really having to manage having to envision the future create the energy in the organization on the vision or visionary side, then they’re also doing the management of making sure that things are running well the people issues, the issues-issues, they had this issue crop up, and we had nothing to give us a clue about it, in the beginning, those kinds of things. And so I do see the frustration and often as you said, You know what you pointed out what would you do after you sell or after your two-year stint? Open another practice, they still have the passion for what they’re doing, and yet they’re mired and all of this stuff.

Dr.Bethany Fishbein: All this stuff. The part that seems unwieldy to them can be different from one business owner to the next. One might just want to see patients and one might just want to work on the business and not see patients. So it’s really about figuring out the pieces that you’re good at and the pieces that you want to do and the pieces that align with your strengths, more so than fitting into a mold of what you should do. Because everybody’s different, like different parts about this. Right?

Beth Berman: Exactly! And I think what you’re alluding to now is there is a tool, it’s an EOS tool, but I recommend it for anyone in your life and in your work and particularly pertinent to this conversation. To owners and leaders of Optometry practices. If you think about the tool: delegate and elevate. And basically what you want to do is think about everything you do in a day and divide it into four quadrants, because the goal is to put you to your highest and best use. So in the top left quadrant, four quadrants as I said, there are those things that you love to do and are great at and salient to your point, different people different things. So, one Doctor/Owner may be great, obviously about treating patients, but also a true leader in terms of building the culture, building the teams loving the relationships, loves to market the business, all of these kinds of things. And they’re great at it, but they’re stuck in another quadrant where they are doing things they’re not great at or they don’t like to do so. Top quadrant we identify all those things related to our business that we love to do and are great at for me it’s I absolutely love facilitating, I love coaching, I love helping groups of leaders move forward and have open honest conversations, and all of that kind of stuff. That’s my happy place. So quadrant one is your happy place. What you love to do and you’re great at quadrant two is what you like to do and are good at. So maybe you have a knack for is unlikely given the person I’ve just described, but maybe you have a knack for insurance or technology and doing the I.T. in the organization. Maybe you do so that’s cool. It might be something you like and you’re good at. And as long as those things are things that you have time to do that isn’t taking away from quadrant one. Maybe that’s something you could do for the company. Now on the bottom left. There are those things that dreaded things that you’re good at and everybody dumps on you. So I would go back to insurance because I’ve seen this over and over again. We find owners and partners and doctors who may understand the crazy challenging nightmare of insurance. And so they’re doing that stuff, but they don’t love it. They’re not great, but everyone’s bringing the insurance issues to them because they know they can do it. So this is the dreaded category of things that you love to do, but people dump on it because Oh, Bethany, I’ll do it and I know that’s not the case for you. And then the last category on the bottom right is things that you don’t like and just aren’t great at. That’s the obvious no-brainer. If you don’t like it, you’re not good at it. Don’t do it. The exercise though once you write out for however many hours in a day you’re going to devote to work those things that you love to do and are great at those things that you’d like to do and are good at and stay in that top half of the diagram. That’s where your highest and best use would be, The idea of doing those things that are in the bottom left quadrant things that you really just grudgingly do because everybody expects you to that’s not your highest and best use. And not only would you as leaders are happier if you are elevated to a place where you’re doing the things you’d love and I agree that but ROI will be higher because you’re doing the things where you have the most impact and the most capability and delegating to others at maybe lower salary at appropriate levels, those things where they have the passion to do it where they’re good at it so that you can rise above and do the things that are again your highest and best use. So to the extent that you can do this, think how much more fun business would again become versus selling it, having to rebuild having to find that people set the processes, do all that stuff again, and you retain the place that brought you to this industry in the first place.

Dr.Bethany Fishbein: So the crux of this is that it’s hard to do that it’s hard to delegate those things. And I think that that bottom left quadrant that you are describing is where absolutely, I’m seeing frustrated owners spend way too much of their time because the other piece of that is that a lot of times those are the things that have to get done or something bad happens. Like if you don’t envision the business, and build relationships, nothing falls apart, but you’re missing out on what you could be where if you don’t settle this insurance issue deal with this patient complaint address the staffing issue, the plates start to fall down. So they kind of get forced into that quadrant but struggle because they are good at it to let anybody else do it besides them because they’re the best at it. Or they think they’re the best at it. Like we used to foster dogs, right. And when we started fostering and you think how do you give up these dogs after you’ve grown to love them for a couple of days or weeks or whatever. And one of the pieces of advice that the people who had done this for much longer than we had gave us was you have to think of reasons why the home they’re going to is better than yours. Right? So maybe they’re near a beach and they’re gonna get to play in the waves or maybe they’re going to retire person who’s home all day and they’ll get attention snuggles all day long where you go to work. So for me to give up this quadrant. I need to think that it’s gonna get done better than if I do it, like how do you do that?

Beth Berman: Yeah. So first of all, the idea of delegation, it’s very, very frightening to give things away that you know you’re good at so a couple of concepts here one, perfect is the enemy of good. So the fact that you think you can do something perfectly or fabulously and no one can do it as well as you can. No one’s indispensable. So there’s that idea, but the next idea too is it’s very scary to what we call to let go of the vine because you have to have a level of trust that the person you’re delegating to, can do the job that goes back to a foundational piece. Then even before you can think about delegating is you want to build your organization in a way that makes sense, so that people have clear accountability for each of their seats or functions in the organization. So let’s say you’re delegating let’s continue with the example insurance to a more kind of systems process kind of person in the team, someone who’s managing your admin, and so forth. Sometimes it might even be within finance, but more like admin. So the idea is you want to define what does someone who’s great in that job looks like? And simplify that definition by saying okay, if this is the seat, this is the insurance seat in our organization. What does that mean? It means that they are accountable for four or five or six things. We want to get really clear on what they are. So maybe it’s claims, maybe it’s a system optimization, maybe it’s LMA because they’re leading and managing other people. So the idea is first, you get really clear on what does that person have to look like in that seat? So that you can delegate to it, but that’s still scary because now we’ve defined the seat. How do we know if we have the person in the right seat who can do this job? For that we have an acronym in EOS, it’s called GWC, and it applies in or outside of EOS. G stands for the person has to get it they have to get the five roles in that seat. They have to inherently just they’re hardwired to know how to do claims, how to optimize systems, whatever that is. They have to want it just as you don’t want to do that work. They have to want it they have to be the kind of person that likes filling out forms and getting stuff done and maybe some repetitive tasks and maybe following up on things. They’re very great on follow-through.

Dr.Bethany Fishbein: For them, that’s got to be their upper left.

Beth Berman: That’s got to be their upper left and then they have to have the capacity to do it. So capacity goes to so GWC – Get it Want it Capacity. Capacity goes to do they have the skills, experience, training, sometimes the physical ability, sometimes the intellectual capability sometimes the emotional capability to be able to deal with the job. Step one is to define the seat don’t build it to the people define the seat and what that ideal seat looks like under your seat so that these things can be delegated out to the people below you, and then when you have someone who in this case assumed they’re a great person, they fit your culture you would clone them if you could, but they GWC the seat that means that they will be fantastic at the job because they’re innately hardwired to do it. They get out of bed wanting to do a good job every day. In that job, they have the capacity to do that job. And one final point on that is sometimes people don’t have the capacity yet. So maybe they need some training. Maybe they need some support from others on the team. The question here would be as we delegate, will they be able to get up to the capacity, the right level, the capability level that we need, will they be able to get up to GWC in time, so maybe the training period is going to be a couple of weeks, maybe it’s a couple of months. Depends on how bad your backlog is, depends on what other kinds of support you have in the organization. But the idea is you’ll only feel good about letting go of the vine and delegating. When you know you’ve got someone in the right seat who GWC’s that seat and can do the job well.

Dr.Bethany Fishbein: Some jumping a little bit, but not really because I hear a lot of Optometrists talking about EOS and they’ve read traction and they’ve read Get a grip and these are like the EOS books, right? And now in addition to the overwhelm that they already feel, they start to feel like okay, now I’ve got to find seats and figure out who can fill them and you know, that feels like extra to take on so something that we really haven’t talked about yet is this relationship between the business owner and they’re second in command and EOS language. It’s a visionary and the integrator, talk about the visionary, the integrator, and kind of how you see those roles play out in optometry practices.

Beth Berman: “The Visionary” is someone who you would think of them as an energy person because they create big relationships. They love culture. They love big ideas. They hate detail. I can say this. I’m a visionary. So if I didn’t have a good team, I’d be sunk. We love going out and building relationships, maybe helping people, creating culture, love to operate at a 30,000-foot view, and truly 20 ideas before breakfast. Let’s do this. Let’s do that. Let’s do this. Let’s do that. And we can pull people in multiple directions in an organization with these strengths. of energy that we have. That could be a little bit jarring to an organization if we only had that and the visionary in their highest and best use in their top left quadrant is going to be doing those things just as I described. So enter “The Integrator” be think about it. Every business has a bunch of competing functions. You’ve got your front office, your back office, you’ve got your salespeople, the inventory, the glasses, the lenses, the practice, you’ve got all these things going on and every department pretty much has their own self-interest in mind, but they don’t always agree. So what we need in an organization is an integrator to do just that to integrate and harmonize the functions in the business and help define what those functions in the business are and what the structure of the business is going to be and what the seats are going to look like. Now, contrary to a visionary, with spurts of energy and passion and relationships and all those things. The Integrator likes to have the difficult discussion, they get their hands dirty, they’ll go to one department and say, hey, you know, I know this came in and it’s putting stress on your department, but this is a great new patient. This is a great new technology, whatever it is, let’s make it work and they’ll harmonize and integrate the competing functions of a business. They like to get their hands dirty. And visionaries, nails are going to be perfectly clean. They don’t want to get into the dirt. They don’t want to get into the nitty-gritty. And so when we can put people in the right seat, visionary being that person, charging the future looking at trends, looking at innovations, leading the culture doing those kinds. of things that they’re best at. And then you’ve got an integrator managing, and making sure that with all these ideas that come in from the visionary that your ship is still moving forward in the direction it needs to go. People are harmonized around the greater good of the organization. So you have those two seats separated, and all of a sudden your optometrists are getting their lives back. Those that want to elevate above those bottom quadrants are all of a sudden enabled to do that.

Dr.Bethany Fishbein: I think that’s what it is. Right? That’s the temptation when they want to sell is I want to get out of those bottom quadrants. And a lot of practices have Managers but in kind of wildly different roles and wildly different people. So one of the most common things that we hear about in a practice is the manager the person who has been there the longest, everybody else quit cycled through staff, but you know, this one person has been there. 16 years, they’re the manager, and in a lot of cases, they’re filing insurance or sitting at the front desk answering the phone they’re the ones all the new people go to with questions because they’ve always been there. Right, but they’re not managing. So in a practice that you describe that gives the optometrist their life back, Lovely. What’s a manager or integrator in that practice? doing day-to-day because it doesn’t sound like they’re picking up the phone 80% of the time.

Beth Berman: It’s true what they’re doing most of the time is this concept of LMA “Leading and Managing to Accountability”. And let me say this, visionary and integrator those positions are not who’s been there the longest. They are not what you think of is like the typical manager just making sure their front desk is working or whatever. These are leadership positions. So the person in this position needs to have leadership skills, they need to be able to manage the difficult conversations. They need to be able to create the opening, inspire people to understand what needs to be done, and how they need to behave all of those kinds of things. So day to day their day could look very different each day. Often they’re removing obstacles. Often they’re creating opportunities for improvement, but most of the time, they’re managing the leadership level issues in the business, not the nitty-gritty, but they’re managing the managers. 

Dr.Bethany Fishbein: You know, we deal with different size practices. So practice with four employees can’t have an integrator and three managers right? Because there are only four people in the business but in a larger practice. A lot of practices will have an optical manager an admin or like a front desk manager or lead tech. So the integrator is really managing them. 

Beth Berman: Yes. 

Dr.Bethany Fishbein: How does it happen that the visionary and the integrator get themselves aligned enough? That the visionary practice owner can go say like, Okay, I’m gonna go do my ideas and big picture things, and know that this person understands the goal enough to just trust them to work towards our goals. Like how do you get there?

Beth Berman: So a number of ways. First of all, there’s something in EOS called the VTO or Vision Traction Organizer, where the visionary and the integrator and any key leaders of the team and we’re really talking about people who can lead and manage so not necessarily someone processing in the back, we get aligned on where we want the practice to go. In the future long-term practice. Maybe with a 10-year target, a five-year target, we think about what are our core values. Who are we we’re gonna use that to hire fire, review, reward, and recognize all those things? We think about what is our sweet spot and make sure we stay clear on that. We think about our marketing strategy and get crystallized. Who do we want to go after we don’t want every possible patient or customer out there? We want the ones who we love working with and how do we find them? Where are they and how do they think what do they want? Then, where are we going in three years here we transitioned from this long-range kind of be hag target to the idea of where are we going to be in three years? Yeah, you have some metrics, but most importantly, what are we going to look like in three years? So you have something to aspire to. You have something to inspire you have something to hire into. You’ve got this clear picture of where you’re going to be in three years. So end of 2025 How many offices? What kinds of protocols are you running? Are you adding a Med Spa? Are you doing Myopia Management? What are you doing? Where’s the business? What are they saying about you in the press? What kinds of awards are you winning? What kinds of training and development are you providing for your people? What kinds of awards have you won, like best places to work? Those kinds of things. And the idea is when you can get clear on your VTO as a leadership team, whoever’s on it could be a leadership team of two about where you want to go then you can start planning and you bring it down from the vision side to the traction side of this tool called VTO or Vision Traction Organizer and you can set your priorities for the year. And you can also put some metrics there, but what are the three to seven most important things you must do? Because when everything’s important, nothing’s important. So you get totally focused, then what are we doing this quarter we prioritize what we’re actually going to get done to build towards the one year, build towards a three-year, build towards that Big Bhag of what you want, whether it’s a financial number, but more importantly, some level of X number of patients served or whatever it is something that the whole team can get behind. And then the eighth question on the VTO is let’s just have a parking lot for all those things we can’t focus on now, and stays focused on our rocks. So that’s one way that we get aligned as a visionary and an integrator. Another way to think about it though is the visionary and integrator. They should be two pieces of a puzzle. So if you go back to like the delegate and elevate chart, what the visionary doesn’t love to do, the integrator, it’s matching so that you get a complete picture as the two roles come together, as the two seats come together, and visionaries and integrators will also have their own meetings to make sure that they are on the same page continuing to be on the same page. And then anyone else on the team will be having together a leadership team for the larger companies weekly, just a never fail amazing ironclad agenda that I would think you would say has changed your world, the level 10 meetings. I don’t know if we have time to discuss that. But all those boring meetings that whenever we ask a prospective client, how would you rate your meetings? How effective are your meetings and we get threes, fours fives, well, we bring it up to a 10 with a level 10 meeting. No more boring meetings.

Dr.Bethany Fishbein: We don’t have time to get into the meetings. Maybe we can do that in another podcast here. But that visioning piece is critical. We do that with our clients too, right? Everything’s got to be so clear. Because that clarity lets you know everybody’s working towards the same thing. That’s what it is. So many practices. blunder along without that new clients, we start working with them we say, What are your dreams? What is it that you want? And people always say very general, things like to grow the practice to take it to the next level, to have better work-life balance, and they’re like good buzzwords, like Yeah, everybody wants to go to the next level. But if I don’t understand exactly what your next level looks like, I’m not going to be nearly as effective at helping you get there as I would be if I knew that that meant increasing your patient base by 25%. But with non-insurance patients who are coming in for aesthetic services, that specific vision really helps. You get there. 

Beth Berman: Yeah, and before we get off of that, you can describe and codify your vision one time when nothing’s gonna happen. The idea of vision, you want to get it shared by all and that means people need to hear it. Often they need to live if they need to be recognized, for example, exhibiting the core values, all those kinds of things. So in EOS and definitely recommend for your practices. We repeat it. We have a quarterly cadence, quarterly and annual, and the message is you know your people don’t embrace new things until they’ve heard them at least seven times. And that’s where the young ones older dogs, they say you can’t teach them new tricks, but it takes us a lot more repetition. So don’t expect that when you do this. Everybody’s gonna jump up and down and they’re gonna remember all the stuff that you said to them one time, it’s got to be an ongoing conversation. Part of the daily fiber with a business.

Dr.Bethany Fishbein: Putting this into place, though really can be a path to being happy again, owning your practice. So many of these decisions to sell. When you start the conversation. It’s about money, right? We got an offer. It’s too good to be true. It’s a lot of money, it would lead me to do the things I really want to do. But when the things you really want to do involve owning an Optometry Practice, and you already own a pretty good one. it’s hard to justify walking away from that to start over and give yourself a second chance to do it better when you can do it better in the place you’re in. So, Beth, if people want to learn more about you and us some of the stuff that you’re talking about today, what are some books and resources that you would recommend, and then if people want to find you how do they find you?

Beth Berman: There’s a whole library of EOS books with the founding book by “Gino Wickman – Traction: Get a Grip on Your Business”. Then there’s if you are more of a parable reader, maybe like a story better there’s “Get a Grip” we’ve got for the real basics of things. We’ve got that terminology book that we use when we roll it out to people within the company beyond the leadership team called “What the heck is EOS” and “Rocket Fuel” is a great one to describe the visionary integrator relationship. There’s also an assessment in that book, and online. If you’re wondering, are you more visionary or are you more integrator? If you’re visionary and you don’t have an integrator, you’ve got a gap. So it’s important to know that and be honest with yourselves when you take that those are the key books there. Are others. So I did want to say one thing though. Before I give you my information, what we want for your practice owners and leaders is we want the EOS life. I’m personally living it. So let me tell you what the EOS life is because I think you’re all gonna want this. It’s doing work that you love with people you love being compensated appropriately, making a difference, and having time for other passions. Sounds like that might float the vote of these owners that you’re talking to. So that’s something we want for ourselves and for our clients. And in order to reach me the simplest way is on LinkedIn if you go to https://www.linkedin.com/in/growthdc/ . My email is Beth.Berman@eosworldwide.com and also Beth@Clarkleadership.com. For other services, send me an email and connect with me happy to help. Help first is one of our core values.

Dr.Bethany Fishbein: Absolutely Beth, this was super helpful to me. And this has been something that has certainly enhanced my practice life and has allowed me to take on this role within Power Practice because we’ve built that leadership structure in my Optometric Practice, so that it’s not as dependent on me to be there and run it. I appreciate you for that for anyone listening. You can always reach us at info@powerpractice.com or on our website, www.powerpractice.com . We’ll put links to all those books in the show notes. And thank you so much for listening. 

Beth Berman: Thank you!

Links:

Traction: Get a Grip on Your Business : https://www.eosworldwide.com/traction-book

Get a Grip:  https://www.eosworldwide.com/get-a-grip-book 

What the heck is EOS : https://www.eosworldwide.com/what-the-heck-is-eos 

Rocket Fuel : https://www.eosworldwide.com/rocket-fuel-book