What gets you out of bed in the morning? What drives your team? In this episode of the Power Hour Podcast, Bethany sits down with Gavin Rebello, an optometrist and renowned expert on leadership and management from the National Health System in the United Kingdom.

Together, Gavin and Bethany discuss 7 key psychological factors that drive motivation and how success as a business leader requires creating and cultivating an environment where all members of the team feel empowered to work towards common goals, have opportunities for personal growth, and understand the positive impact their work has on people’s lives.

If you have ever had trouble fueling your motivation or want to create more purpose-driven teamwork for your practice, you’re not going to want to miss this episode!

July 19, 2023



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

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

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

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

Becca Starks: Yeah, absolutely.

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

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

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

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

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

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

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

Becca Starks: same. 

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

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

Dr.Bethany Fishbein: 70?

Becca Starks: 70 Percent.

Dr.Bethany Fishbein: Wow. 

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

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

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

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

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

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

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

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

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

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

Becca Starks: Yeah. 

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

Becca Starks: Yeah. 

Dr.Bethany Fishbein: With debt?

Becca Starks: Yes. A lot of it. 

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

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

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

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

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

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

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

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

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

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

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

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

Dr.Bethany Fishbein: Serious?

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

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

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

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

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

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

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


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

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

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

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

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

Becca Starks: Yeah, that’s pretty typical. 

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

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

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

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

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

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

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

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

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

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

Dr.Bethany Fishbein: Absolutely. 

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

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

Becca Starks: Right? Yep. 

Dr.Bethany Fishbein: And consider Minnesota.

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

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

Becca Starks: Absolutely 

Dr.Bethany Fishbein: Cool. 

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

Dr.Bethany Fishbein: Did it work?

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

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

Becca Starks: Yeah, absolutely. Yep. I would be the point of contact Becca Starks. And I’m sure you can put my email in the show notes, but it’s just Becca@kmkodcareers.com. 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

Gavin Rebello: When we’re talking about motivation, we’re talking about engagement, we’re talking about going the extra mile, digging deep when things are really difficult, that getting up on a gloomy, rainy, windy Monday morning and still being able to deliver your best. That’s what we want with motivation is this engagement, this sense of ownership.

Bethany Fishbein: Hi, I am Bethany Fishbein. I’m the CEO of The Power Practice and host of the Power Hour Optometry podcast. And I’ve been waiting to do today’s episode for kind of a long time, months maybe, of just scheduling and getting it together. So I’m really excited to be able to introduce my guest. This is Gavin Rebello. Gavin is an optometrist based in the UK. He’s a presenter and speaker around leadership and management. He speaks for optometrists, as well as hospitals and surgeons in the NHS. He is a partner in eight optometric practices and such an incredible, valuable resource to me and to so many of our Power Practice clients. He’s been a frequent speaker at our retreats. And I’m really excited for the conversation that we’re going to have today. So Gavin, thank you for putting up with all of the craziness to figure out when we were going to do this and for being here today.

Gavin Rebello: It’s an absolute pleasure, Bethany. I’ve been really looking forward to chatting, actually. Yeah, chatting and talking about what we’re going to talk about.

Bethany Fishbein: Yeah. So really, what we’re talking about is employee motivation and employee demotivation. And this was kind of inspired by a visit that you had made to the US, probably going back a year. And so you were here and we’re having dinner with some of the leaders in my practice. And it was during that time after COVID where people couldn’t find staff and there were people in the office that were underperforming and you couldn’t guarantee that you’d be able to replace them. And so I think a lot of us here in the US had a low period of just feeling like you had the wrong people and feeling a little bit powerless to do anything about it. Did you guys have that in the UK as well?

Gavin Rebello: 100%. COVID made people reflect, it gave them the space to reflect on what they really wanted. It brought people down as well. You know, people, the mood sort of changed, their enthusiasm for what they did change as well. A lot of people certainly here over in the UK decided just to retire. So recruitment became a really big issue. So, you know, when recruitment’s an issue, when supply and demand is a real issue, people start asking themselves whether they should be earning more. They start looking elsewhere. All sorts of promises are made and bigger questions are asked of leaders as well. So yeah, it was a really tough time and continues to be. Recruitment continues to be an issue in the UK as well. And I think, you know, certainly, you know, the demographics in the UK and the US are similar. Recruitment continues to be an issue in our profession for the foreseeable future, because the number of people retiring is going to be more than the number of people qualifying. There are significantly less 15 to 19 year olds than there are, say, 50, 55 year olds. So that’s going to become a little bit of an issue. So creating a workplace where people want to work is going to be really, really important.

Bethany Fishbein: Gavin, talk a little bit about your own evolution on motivation, because the key to what motivates people isn’t what you originally thought and isn’t what most people think it’s going to be.

Gavin Rebello: When I first became a partner in my businesses, I very quickly realized  I knew nothing about leadership, business, motivating the team, because there was nothing in my clinical training for that. And it was all about optometries, all about eyes. I made a lot of mistakes on the way. So everything I share with you today is really learnt the hard way, the coalface. And I suppose my motivation is really the joy of helping other health professional leaders not make all the mistakes that I made. So the first thing that comes to mind when people say, right, I need to motivate the team. They go, right, I need to think about money, but I can’t increase my labour costs, because that’s going to make the business a bit more vulnerable. So what can I do? Let’s throw some more money at them through a bonus scheme. So the question I started asking, you know, when I started putting bonus schemes in place and not really seeing the uplift I expected was, well, does money actually motivate? There are various bits of literature, books you can read around money, which say quite opposite things. There’s a book you discussed recently on one of your podcasts, The Great Game of Business, talks about bonus structures and how well that was motivating for the whole workforce. And then you’ll go to Dan Pink on his literature says actually money doesn’t really motivate. It does for certain jobs. If it’s a very straightforward mechanical process, then money will motivate in those circumstances. But as soon as you’ve got a task that’s quite cognitive, which ours is, then money doesn’t really motivate. That puzzled me.

You know, I thought as a newbie leader, if you set up money and they achieve targets like improved conversion, improved ADV, improved productivity, and they got rewarded for it, then why wouldn’t that motivate people? Because I was thinking, I suppose, more as a leader where I’ve got skin in the game in the business. And so, of course, if the practice does it better, I do significantly better, get the reward of a successful business, I get the security of all of that around that. So my conclusion was with money, does it motivate? We all want 10% more. That’s the thing. We all want 10% more. Sure. If we’re underpaying our team members, that definitely demotivates. There’s an expectation as an optometrist will earn a certain amount and the staff fitting, measuring, styling on the spectacle side of things will earn a certain amount. So if there’s a lack, it’ll demotivate. But if you give a pay rise, or if you suddenly give a bonus, it will give a little bit of an uplift in the short term. And then everything seems to sort of settle back down. And that puzzled me. And it came up with this notion, we all want 10% more.

You know, when I was a student, I had a house share, and it was a cheap house. And it wasn’t the best house, you know, it was damp, it was cold. I shared the house not only with five other people with a whole menagerie of insects, and that side of things. And my 10% more as a student was just to live in a nice, a nicer house with central heating that worked, and just people not insects. So that was my 10% more. And then I got that house share, you know, as a professional qualified, I stayed sharing with other professionals, it was a nicer house, we had more money on the rent. And then I wanted 10% more. I didn’t want to have to queue up in the morning for the bathroom. I just wanted to be able to go and have a shower, go and use the bathroom when I wanted to use it without having a queue. I just wanted 10% more. You know, and then I was lucky enough as a professional to go skiing in the winter, and I wanted 10% more I wanted to go, I wanted to go skiing in the, in the winter and have a summer holiday in the summer, we all want 10% more, we all want something bigger and better. And that’s why money to motivate somebody to improve performance doesn’t necessarily have a lasting effect. It just opens up doors to need more.

Bethany Fishbein: Just to go back to some of the examples you gave. I mean, I think even when you were talking, I can hear it in your language, even when you were talking about, you know, as practice owner, I had skin in the game. I mean, of course I wanted and you didn’t say profit, right? It’s of course I wanted the feeling of success, the, the security. So even there, you’re right. It’s not money and great game, although it’s based on profit, the benefits are, it’s really very much not a money system. It’s not a money scheme. It’s interesting.

Gavin Rebello: For sure. I mean, the money is there, but really what’s happening in the great game of business is there’s trust because the owner is sharing the numbers. The owner trusts the whole of the workforce with the numbers. There’s an education. There’s, I’m going to invest in you. I’m going to educate you and improve your business skills. So the team feel important. They feel valued. There’s ownership, which gives them purpose. Once you get to the great game of business and the equity side of things, they’ve got ownership, they’ve got skin in the game and they’ve got purpose to drive that business forward because they’re all going to see the success of the business. So they, they’ve got something to believe in as well, you know, and then there’s growth and there’s improvement as well.

Bethany Fishbein: And there’s the fun of the win. And I was speaking to somebody almost an hour before we started this conversation and she wanted to do something and you know, what, what should the prize be? And it’s not about the prize. The prize doesn’t matter. I mean, if the prize is money and it’s a lot of it, nobody complains about that, of course, but there’s winning. And that’s, for me, is motivating too.

Gavin Rebello: And that, that fun of it is the, the team working together, this sense of belonging. We’re all in this together. We’re all going to succeed. And it’s, it’s that spirit that you get in sports, you know, when your team is, is doing well and doing, and has the potential to win the championship or the big cup. It’s that community, that feel, that rush of anticipation that brings us together. So yeah, the reward in the great game of business is money. Of course, money will bring a smile to people’s faces, but in itself, it’s not the money that motivates. It’s all the things behind the journey that gets the team motivated. And I suppose the difference we’re talking here is the difference between compliance and engagement. You see, if you use money just to, if you use money in itself to motivate, it’s really just still part of the income package. It’s all dressed in the income package, which the tax man will take a slice. So, and the team will be compliant because they don’t want to, you know, they don’t want to lose their job. They’re still going to do the job. But when we’re talking about motivation, we’re talking about engagement, we’re talking about going the extra mile, digging deep when things are really difficult, that getting up and not so much depending on which part of the US you live, but certainly in the, in the depths of winter in the UK, you know, getting up on a gloomy, rainy, windy Monday morning and still being able to deliver your best. That’s what we want with motivation is this engagement, this sense of ownership.

Bethany Fishbein: Gavin, talk about the other side of the coin, the idea of demotivation, because I don’t know if I’m totally on the right track, but an interesting thing that I’ve seen about money not being a strong motivator, I agree with everything you’re saying, is that I’ve seen in some cases where we’re trying to incentivize a behavior with money leads to a total turnoff for the people that you’re trying to motivate and the places that I see it in clients here in the US is just as an example for associate optometrists, where they, a production bonus is fine, that’s kind of a reward for doing well. But a, I’m going to give you $50 for each procedure you do or each thing you recommend creates this aversion, like, I am a professional and I will not recommend something because I’m going to get $50. I don’t want to be somewhere where I would be motivated by money. And, and they want 10% more too, right? But it’s such a turnoff. Is that the demotivating side of it?

Gavin Rebello: It can be because we have to look at the reasons why people do things. So first of all, again, just emphasize money has to be in place. If it’s not there, it’s a demotivating because we are, we have our worth. We call it a hygiene factor. It’s something that’s just a given. Once it’s there, it’s there. It won’t motivate you any more by throwing, you know, $10, $20 at someone necessarily. Optometrists, for instance, will do the job. Very few will do it because of a salary associated with it. They’re intelligent, talented, accomplished people. If they were motivated solely by money, they probably wouldn’t be an optometrist. They’d probably go and work in finance or in the city and be a trader or something like that. That’s a higher purpose to the health professions. And that’s that inbuilt caring, wanting to do the best for your patients. And that reward for the procedure, actually giving the best advice possible. Being able to look after the patient in the best way possible is probably a much more motivating factor than rewarding a procedure by an extra $10.

Bethany Fishbein: Right. Because in that situation, it puts the financial reward at odds with what’s best for the patient. So the other place I see it in opticals paid on commission, and the patient is between two frames and one frame looks better, but the other one is more expensive, which will lead to higher commission dollars. It’s the same thing. Like, I feel I’d never want what’s in the patient’s best interest and what’s in the team’s best interest to be opposite.

Gavin Rebello: Yeah, yeah. We want to, I think most people in our profession want to do the right thing and do it well. There will always be a percentage of any profession that’s solely money driven, of course, there will be that person. But, you know, again, as professionals, we’re looking for long term care, going home and knowing that you’ve done the right thing brings a sense of happiness and a sense of purpose, which is much more motivational than, say, that extra $10. So I try to think about when I was an employed optometrist and what actually motivated me as an optometrist, as an employed role, I started thinking about, well, what were the things that demotivated me? And this is a great time for somebody, you know, the listeners to maybe press pause and just get a notepad and just write down, you know, the things that used to motivate me when I was employed and the things that demotivated me. So things that demotivated me were unrealistic.

Bethany Fishbein: Before you get there, Gavin, can you just define demotivated?

Gavin Rebello: Yeah, no, that sense that you know, you can’t you can’t be bothered, you don’t want to do it, you know, you’re going to do your job. But are you going to go the extra mile? Things are running late? Or you’re really behind? You’re going to go in early of your own accord the next day and just catch up with things so that the practice runs better? You know, that sort of thing. Or just your heart sink, that feeling that you don’t really want to be there. You’re bored of the job, your shoulders are down, you haven’t got a spring in your step. The flatness, the emptiness, the press news in the morning going, you know, I don’t really want to go to work. So I wrote down the things that motivated me as an employee, being able to do a great job, seeing a smile on patients face, being able to save somebody’s sight. And I wrote down the things that demotivated me, unrealistic targets, not having enough time with a patient, squeeze-ins, unrealistic expectations, having a clinic that wasn’t very organized, that sort of thing. And these are all personal to me. And I looked at the list and I just asked myself, if I had more time with a patient, would I have felt more motivated in that job? And I went, well, yeah, of course I would have done.

And if my clinic flowed really nicely, if it was all booked really nicely, would I have felt better about that job? And I went, yeah, it did. And you see, I realized that you can’t motivate somebody. You can’t do something to motivate someone. Motivation is a free will thing. You know, if you ask me, Gavin, I want you to speak in your best American accent. And you try to offer me all sorts of incentives, money, whatever, flew me over to America or something. If I did not want to speak in an American accent, you could not make me speak in an American accent because it’s my choice. It’s my free will. So all we can do when we’re trying to have a more motivated team is to create an environment in which they feel motivated. So if my boss at the time I was an employed, when I was an employed optometrist, had actually taken the time to ask me how it was getting on and then I had more time with patients, my clinic flowed better. I could see the results of my work in the letters coming back from ophthalmology on my referral. So I could actually see that I’m making a difference. Then I would have felt much more motivated if I’d felt heard and listened to if I had a development plan, I would have felt more motivated.

So all of these things, I think we have to approach it from a well, how do I motivate people? And Simon Sinek has a great video on YouTube. He talks about Noah, Noah, the coffee barista. And it’s fantastic if you just Google this. And he says, you can’t, you know, it’s not you can’t ring people, can’t ring the effort out of people more than you can do. It’s just got to create an environment in which they blossom, in which they will give their best for sure. So write a list of what used to demotivate you. And the chances are be very similar to your team. The things that demotivate us as human beings are very, very similar in our in our profession.

We all tend to go into this profession for similar reasons, not the same, but similar reasons, and then try and create that environment in which they will feel motivated. And it’s a very individual thing. You know, some people will be more motivated by money than others. Somebody who’s younger in their career who is saving up a deposit for a house money is going to be forefront of their mind. Somebody who’s retiring, kids are flowing the nest, done all the university mortgages paid off, probably less so. So, you know, there is an individual thing here. So you do have to start getting to understand your team, understand what their passions are. But I do think there is one common thread amongst every human on the planet from a motivational point of view. And I think the one thing that we all want is to be happy.

I’ve never come across anyone that is striving to be unhappy, although sometimes when you look at some people, you think, well, maybe so. But no, I think everybody wants to be happy. And there are seven psychological drivers for motivation. There are seven psychological drivers that will bring us happiness. And the first one is to be loved. We all want to be loved. And the second is this sense of belonging. We all want to belong. And the third one is to feel important. Now, I list those three first, to be loved, to feel important and to belong. And I list those three first, because, you know, if you ask every single person or most people, sorry, most people, what’s the most important thing in your life? Most people will say my family, unless they’ve got challenging circumstances, of course, you know, I don’t want everybody in the same box, but most people say my family. So to be loved, to be loved by your family, to feel important, a sense of belonging. If you go back to school days, nobody wanted to be the person outside of the group. We wanted to be part of the group. And from a workplace perspective, that sense of belonging, that to each team member, feeling that they’re part of the family is really, really important. So what are we doing? Or what can we do as leaders to give it a more family feel? Well, to hear people, to see people, to listen to our team, to make them feel included. So perhaps a team huddle, rather than dictating how the patient journey is going to be and telling your team, why not just ask the question, how can we improve this part of the patient journey? I’d really love to hear your ideas because we’re one team here.

We’re looking after the patients as a team. So therefore, if we’re looking after the patients as a team, then surely, we need to hear our team because then they feel important because they’re being heard and listened to, and they feel that they’re included and they feel like the practice is their practice. And we refer back to the great game of business. And that’s where that was so successful because people were responsible for generating their targets. People were part of the family, all striving to achieve the goal or the mini game. And often they set the games themselves. Even better, part of that family fun.

Bethany Fishbein: Before you go on to the next ones, I’m thinking about this now as a practice owner. This is one of those that for me is easier to feel successful at as the owner of a really small practice versus a really large practice. And so one of the differences as we’ve talked about practices in the UK versus practices in the US is there are large multi-location, much larger teams, not exactly the same, but probably more akin to the hospital system or the NHS, like where the owner or the leader has layers of separation with some of the team. So I think about when we opened our practice and I had three people, there was no question. Of course, they were loved. We were spending every day together. We all loved each other. No problem. Belonging, it was so easy. As we got bigger, it gets harder. How do you keep that same feel in a larger company?

Gavin Rebello: You’re absolutely right. And some of my practices, we’ve got 15, 16, still small compared with the US. But because I’ve got eight practices, I’m not in the practices all of the time. So that becomes quite a challenge. But I’ve got managers or partners in the practice and they instill that same feeling. Team huddles is really, really important so that team members can contribute one to ones as well. So again, and really, and this is the hard thing for leaders is because we’re so focused on what we’re trying to achieve is we don’t often hear what our team members are saying. And Stephen Covey has this great, great quote, we often listen to respond, but actually, we should listen to understand. So that feeling of being listened to and heard in a one to one where the leader carves out time to spend with their team member and have a one to one. You see, one of the other drivers, psychological drivers is growth and improvement. We all want to be moving forward. So if the leader can create a personal development plan, and this ties in, there was another podcast site that you did, Bethany, it was a solo one, you didn’t interview anyone on this one. And you were talking about how do you keep hold of a valuable team member when they’ve hit the ceiling of their job remit? Well, this is growth and improvement. You created different layers that they could progress to. And that’s hugely motivating because they can see progression, they can see that the leader backs them, that they want them to be their best version, they want them to, in your case, to earn more here or, or to actually deliver more or stretch themselves and you were going to invest the time and the effort to help that. So having carving at that time to make sure that you understand your team member so that they grow and improve that they have this personal development plan is one of those key psychological drivers. And it does come down to that time. That time is actually helping the team member feel loved and important. Some owners will say, well, I don’t have the time, I’ve got to be in my lane, I’ve got to be seeing my patients. But what you’re really doing is saving yourself time having to recruit to replace, you need to look at the long term stability of the team and the family, the practice, rather than in and out, in and out, because you’re almost becoming a, you know, a hamster on a wheel, a busy fool. As owners, we have three hats, or two hats, we have our clinician hat, we have our manager hat, and we have our leader hat, and they’re all important. And we shouldn’t sacrifice the leader hat for the clinical sometimes because it creates more problems down the line.

Bethany Fishbein: So you’ve hit four here, we’ve got needing to be loved, belonging, feeling important, growth and improvement.

Gavin Rebello: So the next one, everyone wants to believe in something. Now, for some of us, that might be spiritual, but at workplace, it could be its purpose, it gives life meaning. So we need to believe now, this is really interesting. Sometimes in the business of busy in practice, we think our role is to examine eyes, and make sure they’re healthy. And if you’re doing optical as well to frame style and provide fantastic spectacles, but actually, we do more than that, we do more than that. And, you know, as optometrists, we know this, but I just wonder whether all of the team knows this, you see, what we do is we help the elderly stay independent. If they see well, they can continue to drive, which means they can maintain their independence, which means they’re not a burden on the family. If we help children focus better, and their eyes are better coordinated from a binocular vision point of view, then their eyes are less likely to get tired in the exam. Therefore, they can concentrate better. Therefore, they can probably do better in their exams. Therefore, they can reach their potential from a career perspective. We change lives. An office worker on screen all day. Well, again, if their vision is absolutely corrected perfectly, they’re less likely to make mistakes, they’re more likely to do well, they’re more likely to get their work done better, they’re more likely to be lined up for career prospects, which means they can look after their family better. We change lives. Now, as optometrists, we know this. I just wonder whether that higher purpose of what we do, that effect that we have on the public is distilled down to the team. Because soon as the team understands what they really do, what their contribution is, that’s absolutely a higher purpose, there’s meaning in their job, much more meaning than perhaps in many, many other jobs that they could get.

Bethany Fishbein: That’s a huge one. Because one of the things that tends to happen is as optometrists, we know this, and we’re constantly reminded of it, because we’re hearing those stories in the exam room all day long. You know, wow, thanks, Doc, last year, you noticed something and I went to my doctor and they diagnosed me with this and got me treatment before it led to a problem. Thank you so much. With my glasses, I can do better in school. I think that optometrists in general are really bad at then going out and sharing those stories. And I’m thinking now about my own practice. My partner does a lot of myopia management. And he has blocks of day where it’s just devoted to myopia. So the technicians that work with him during those times are hearing all of these stories and seeing the results and getting to know the patients long term, like they’re in there with him. And so all of them come out with this passion for myopia management, because that’s the thing they’re seeing make a difference. But that’s because their role in the office puts them in that direct proximity, where the person who made that appointment and collects the payments on the way out doesn’t know any of that unless we make the effort to tell them. That’s important.

Gavin Rebello: Absolutely. It’s a great thing to share in a team meeting and team huddle, the success stories, but for the whole of the team to feel like they’ve paid their part in that. And the person booking that appointment has had a massive role in that. They booked the appointment; they booked the right amount of time for that person to have the right amount of time with the optometrist to get all of the things done. They’ve had a huge role in that. And that sense of belonging, the company I work for changes people’s lives. That’s a great story about a job. And again, the other sense of purpose is we can build confidence or we can sap confidence in the frames that we encourage people to wear. So rather than approaching the frames just from a technical, optical, I can see better, we can think about actually this frame will help them feel younger. Who doesn’t want to feel younger? We know the impact of the right hairstyle or the wrong hairstyle. You go to a new hairdresser and it’s all gone wrong. How does that make us feel? And yet we look at the frames, we talk about the number of handbags or the number of shoes that people buy, and yet they still only buy one pair of spectacles. And when I’m having a conversation with them, I never look at their shoes. I look at their eyes. I’m making eye contact. And what’s framing their eyes is their spectacles. So we have a huge role in people’s confidence. We have a huge role in people’s lives. We have a huge role in independence. It’s a great story for the whole of the team to remember rather than just the clinical teams. Another psychological driver is we all need a place of our own, just simply a place, a place where we feel comfortable because it brings us stability. You know, a simple thing I’ve done with my optometrists is they’re in there for a few hours a day. I just say to them, how would you like your room decorated? Because it’s normally clinical white. Some of them keep them as clinical white. That’s how they like it. And some of them will pick some wallpaper and I’ll go, fine, let’s put some wallpaper up. I actually prefer a more softer feel to the practice. I think a lot of patients come in really nervous, apprehensive, and they walk into this sort of quite stark clinical room with all of these quite scary pieces of equipment. I want patients to relax a little bit. I think you get more, you get a better result if they’re a little bit more relaxed than if they’re really stressed. People don’t perform well when they’re stressed or nervous or worried. And again, I recognize that the optometrist is there all day. So I’ll encourage them to decorate the room within reason, of course. If they want to put photographs up, remind them of good things. I’m happy with that as well to make it more personal. Again, I want the patient to sort of connect with the optometrist. I don’t want them just to see them as an optometrist. I want them to see them as their optometrist.

Bethany Fishbein: I mean, it goes two things. It gives the optometrist a connection to their space. So, it’s somewhere where they like to be. And it absolutely does foster that connection and conversation because I see it all the time when I’m observing in an office. If they have a picture of themselves on a ski mountain in Utah, inevitably, someone will say, oh, do you like skiing? Do you like hockey? Is that your family? It’s just natural. And especially for a more introverted optometrist who might not be comfortable just starting that conversation, having some of those things is like props that somebody has to ask about. Maybe he will or won’t be embarrassed that I’m telling this story, but my partner Tobin was shy and introverted when he first started working with us as a technician 10 years ago. And so to try and help that, what we did was we took his name tag and we put his name and then under it we put pre-optometry student. And what it did was it made many of the patients say, oh, you’re a student. And it was just them now starting the conversation and that built connection. There are still patients now who remember him. He was their favorite technician. And now they come back and see him as the optometrist. So it works.

Gavin Rebello: One of the things when I took on one of my practices, my office was in the same room as the staff room. So if they’re having lunch and I’m on a I’m on an important call, they’re having to sit there in silence. They can’t relax. So one of the first things I did is I moved my office and I created a space where they could just relax and take time out from the business of the day and they can have a conversation if they want to have a conversation. They don’t have to just be quiet because I’m on the phone. And it was better for me as well because I could just work more freely in my office. So it was just about thinking about the structure of the practice.

Bethany Fishbein: How can you do it when you’re in a situation where you don’t have room for each staff member to have their own space? Because I see that even in my practice, there’s kind of the those who have desks and those who don’t. And not everybody needs a private space. How do you do that?

Gavin Rebello: Well, I mean, the UK is really tight on space, as you know, I’ve got some very small practices. I’m pretty sure the entire practice will fit in some of your consulting rooms. They’re so tiny. It’s a little bit of a challenge. These ones are very small community practices. They’re part time practices. So we actually close for lunch. It actually works better for everybody to be off at the same time. So there’s that downtime there. It’s not ideal. That’s the compromise we make. But it gives the team that space to be able to just go, right, calm, reset, set up for the afternoon. I also when I refit the practice in those sort of situations when I can’t carve out some real sort of space, they have inputs in the refit, you know, the colour, where we’re going with it, some choices, some ownership. It’s their practice. It’s risky, because you might have everyone saying completely different things. And you’ve got, you know, you’ve got your values of your practice, and you’ve got your corporate colours, your colours that you want to stick with. So often we’ll go, okay, I’ve got a choice of two, which of these two do you prefer? What are your thoughts on that one? That’s another way that can sometimes work. You’ve got to know your team on that one, be able to do that.

Bethany Fishbein: I think It could be as simple as clothing. During COVID, everybody was wearing scrubs. And then finally, I think it was our optical team came and said, like, can we wear clothes? Sure. Like, why? I’m just asking. And it was, you know, we want to feel comfortable, we want to show our own identities, we want to be able to show our own unique sense of fashion. Easy, right? Of course you can!

Gavin Rebello: Absolutely. And that’s that part of that feeling important, because you listened, you heard, you thought, well, yeah, that can that can work. There’s no negatives to that, really, in your practice. So that hearing them, being able to act on it is really important. I’ll took on one practice, and the owners were keen to retire, but they just took them a long time to actually finally retire. So that, you know, when often some owners, they take their foot off the gas, as they come up to retirement. So my first meeting with them was okay, you’ve all got a lot of experience here. I’m new, I’m the newest here, you’ve got a lot of experience. So what sort of practice do you want to be? And what are your frustrations? At the moment? What’s getting in the way for you to be the practice that you want to be? And I just wrote up all the frustrations on a whiteboard. And I tackled the easy ones first. And I left them all up on the whiteboard. But I just crossed off each one as I tackle them. And I was a new leader to them, I needed to build confidence, I needed to win trust.

My motivation was actually this was a great team, and I wanted them to be their best as well. So I called it the frustration board, and we left it up and I tackled them off. Luckily for me, all of their frustrations were the things that I wanted to improve anyway. But there were some things there that they knew the practice better than I did, because I was new in, there were some things on there that I truly wouldn’t have thought about. As a leader, I didn’t know some of their roles, the phones weren’t working. So we prioritise changing the phones, because then if the phones are working better, we’ll take more calls, we’ll get more appointments, we won’t lose patients. So it’s all common sense stuff. And your team, they want the practice to run better, and they see the glitches. And one of the other things I’ve done is I’ve forced myself to be front of house. It’s the scariest thing an optometrist can do, because it’s so hard, it’s all the multitasking. And I realized how inefficient the systems were, how many things the front of house team were putting up with, but not complaining, they would just get on with it. So there were some real simple improvements that we could put in place like a contact lens price, easy to find rather than having to pull out all the drawers and it’s all on different pieces of paper or different spreadsheets.

So, you know, simplify that to make life a little bit easier. So yeah, a place of their own, really, really important. Then this one’s a little bit strange. A degree of certainty and uncertainty. We sound a little bit contradictory, but we want some certainty, we want to know that we’re coming into work, we’ve got a certain number of patients, it’s a safe environment to work in. But if everything is certain, if everything is predictable, we can feel bored, brings on apathy, or we can feel trapped and hemmed in. And so there’s no freedoms. We want a little bit of uncertainty, because that’s the fun of life, the uncertainty, fun and interest. If we have too much uncertainty, of course, that’s too stressful. What mood is the boss going to be in? Are they going to be smiley? Or are they going to be really sort of fiery? No, we don’t want that sort of uncertainty. We want a bit of stability from that perspective. So a degree of certainty and a degree of uncertainty, a Goldilocks amount. And that’s the challenge for the leader. Not too much, not too little, just the right amount. That’s the challenge for the leader. And each team member will, you know, you’ll have some people that want things much more mapped out than others. If you decided to organise a college reunion for all of your university colleagues, and you sent out an email, an invitation, you know, that you’ll get an email straight back from one or two going, what’s the venue? What’s the time? What’s the dress code? Who’s going? What’s the menu? Is this, is there this option? Is that option? What time are we meeting? And there’ll be a million questions because they’re planners, they need to know everything is certain. And then we get a couple of other ripplers, you won’t even hear from them until the day before. You don’t know whether they’re coming or not coming because they’re sort of pretty easy going. We all have our comfort zone that we like to sit in. And some of us our comfort zones got pretty big. And some of us our comfort zones are pretty small. Some people like getting out of their comfort zone, they’re used to getting out of their comfort zone, and others aren’t. So we’ve really got to kind of test the water with the team. But we can’t make it too predictable. Otherwise, it can be a little bit boring. We want degree of certainty and uncertainty.

Bethany Fishbein: As always, Gavin, conversation with you leaves me with a spinning head, a list of things to think about makes me think about some things differently, more I want to share. And I hope that you will absolutely come back and do another episode with me sooner rather than later. This conversation today led to could lead to any number of additional topics. So for now, if someone wants to hear more of you, or get in touch with you, how do they find you?

Gavin Rebello: Well, I’m mostly based in the UK at the moment. I’m hoping to come over to see you guys and hook up with you guys in the near future at one of your conferences. I love coming over to the last one. It was fantastic. I haven’t even got a website at the moment because my big focus is getting my eight practices and mentoring my co-directors to get those practices reaching their best, getting their teams to reach their best. And then watch this space. I will be offering out more workshops, more mentoring. And when I’m there, Bethany, I’ll give you a shout.

Bethany Fishbein: Thank you. And more information on what Power Practice can do to help you have the practice of your dreams, whether that’s more money, more free time, stronger leadership, or whatever motivates you, you can find us at powerpractice.com. Thank you so much.

Gavin Rebello: Thanks, Bethany.

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