June 29, 2022
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Dr. Bethany Fishbein: If you’re in the car and you’re going somewhere and you know where you’re going and you come up and there’s a road closed, you don’t turn around to go home and you don’t sit at the road closed sign and say, Oh, well, I guess I’ll just die here. You figure out how to go around it and in figuring out how to go around it, nobody else is doing that except you. And so you figure it out, and you go around it and you continue on towards your goal. And that’s, that’s how you get there. That’s what Power Practice is.
Dr. Bethany Fishbein: Hi, I am Bethany Fishbein, CEO of the Power Practice and host of the Power Hour Optometry Podcast. And today I wanted to share with you an episode of another podcast. This is the 20/20 Money Podcast. Many of you are familiar, I know a number of people listen to both. 20/20 Money is hosted by Adam Cmejla, who’s a Financial Planner who works specifically with Optometrists. And it’s always fun to be a podcast guest instead of the host. And this one was especially fun because it’s the first time and only time that I had recorded live. This is an in-person conversation that Adam and I had at Vision Expo East and it’s an important one. It always makes me a little bit sad when people online or in-person are down on the private practice. Either thinking there’s not going to be a future for private practice or that the stresses of owning a practice aren’t worth the rewards. And I feel like that because I loved having a private practice. Work with a number of private practice owners and hope that through Power Practice, my coaching has helped some other practice owners feel the same way as they develop as leaders and owners and learn to enjoy life in the process. So you’ll hear Adam and I talked about the importance of community and our Power Practice Community is one of the best so for information on how you can join please visit our website www.powerpractice.com and enjoy the podcast.
Adam Cmejla: Welcome to another episode of 20/20 money. My guest on today’s show is Dr. Bethany Fishbein. Bethany is the CEO of Power Practice and host of the Optometry Power Hour Podcast. Bethany joins me live from Vision Expo East to talk about her perspective on why we both love the model of private practice in Optometry. Why it’s important to surround yourself with a good community as a business owner and optometrist. The importance of learning about leadership and business and ways in which you can take action on all of the areas that we discuss. As a reminder, you can get all of the information discussed in today’s conversation by visiting our website at integratedpwm.com and clicking on the Learning Center. While there be sure to subscribe to our newsletter and you can also set up a 20 to 30-minute triage conversation. To learn a little bit more about how we help OD practice owners around the country reduce their tax bills, proactively manage cash flow and be prudent investment decisions or check out any number of additional free resources like our ebooks, blog posts, and webinars. And with that introduction, I hope you enjoy my conversation with Dr. Bethany Fishbein.
Adam Cmejla: All right, well, Welcome back to another episode of 20/20 money live from Vision Expo. I love doing these live shows and with me none other than Dr. Bethany Fishbein. Thank you so much for being here laying down some great content. You know, we’ve done 170 Plus episodes of 20/20 money when which is obviously all but a handful of episodes have been virtual. And there’s just something different about recording in person. Like when you’re on Zoom, you’re right there but there’s something about being two feet away and having a microphone in your face and having a three-dimensional conversation. That’s going to be a lot of fun. So thank you for being here.
Dr. Bethany Fishbein: Good, Thank you for having me. And this is my first ever live podcast recording. We certainly are doing Power Hour Podcast on Zoom all the time. So this is a whole new dynamic and it’s only been 30 seconds or so but I think it’s good so.
Adam Cmejla: I think it’s good and from a pure content creation standpoint, that was an awesome way to drop. Yes, the host of Power Hour Optometry Podcast as well, which we’ll put links in the show notes. And if you’re a longtime listener of 20/20 money, you know, this is not the first time that Bethany has been on the show. I’ve been on Power Hour Show as well. So we’ll have links to both of those episodes or both of those shows. Excuse me, in the show notes of this episode. So what we want to talk about here today, and this is something that as you and I were talking prior to hitting record, we probably could have just had the microphone set up and hit record and not had to do it over again, but it was a good dry run. We’re going to make the case for private practice today and for some of you listening right now, that’s probably not going to take too much arm twisting because you’re either an existing practice owner or you’re very much bought into it. I think what we want to talk about here is making the case for private practice in the current state of optometry because there are so many new factors, new factors at play, relatively speaking, that haven’t always been in Optometry. But what’s the classic phrase kind of the more things change, the more they’re still the same? I mean, we were talking before we had a record of being a practice owner in the early 2000s In the early 90s, and in the 80s. And every time that there was something at we had another colleague here that was talking to me, he said what 40 years of optometric experience in various ways. And yes, there’s always a new threat. There’s always a new challenge that exists in private practice ownership. But what are your thoughts when you think of, Why the case for private practice today? What are you hearing in the conversations that you and the coaches at Power Practice are having with practice owners or aspiring practice owners?
Dr. Bethany Fishbein: I think with aspiring practice owners there’s a lot of trepidation about what life in private practice is going to be like. And I think that largely it comes from kind of jaded practice owners complaining on social media. You know, you put it out there, and like, there are moments where being a private practice owner is tough. And you know, there are late nights and there are early mornings and there are weekends where you’re thinking about the business and that’s the reality of any business owner. You know, business owner of any type. But they read that and they think, is it worth it? There was just a post on one of those social media sites. You know, if you had to do it over again, would you own private practice the responses were pretty well split, some said absolutely! Some said no way! And, you know, it’s the I’m absolutely on the absolutely side. It’s the best!
Adam Cmejla: I’m trying to think of. If I could get into the mindset of someone that commented “No way”. What do you think are and again, not speaking for them, but in the conversations that you’ve had with OD’s that have you know, that would say that response? What are the most common, quote-unquote validations that they use to support that answer?
Dr. Bethany Fishbein: That’s a good question. I think the most common thing that I hear one is that there are a lot of things to deal with that either they weren’t expecting to have to deal with. They kind of knew they’d have to deal with but they don’t know-how. And so it’s uncomfortable or unpleasant. Or they feel like there’s a lot of stuff out there that’s happening to them beyond their control. Right.
Interestingly, the ones who say yes, it’s so totally worth it, are very often saying yes for the same reasons. There. Are all these things they have to deal with. What a fun challenge to figure these out, instead of just figuring out refractions I love this part. Or there are a lot of things to deal with that. I don’t know exactly how, I’m a good optometrist I’ve learned that let me challenge myself to be an awesome business owner and learn those skills. And they’re loving that side of it. And all of the challenges and also the freedom that private practice gives.
Adam Cmejla: This might be an extreme, like, splitting up personalities, but the former I would almost put as someone that is a blamer or a victim type mentality. What was me I can’t believe that the profession is happening to me? I can’t believe that reimbursement rates got cut again. How am I supposed to make money on these visions like, we can pick and pull probably half a dozen different narratives that people internalize, truly believe and almost feel like they just kind of succumb to? Wow! that’s the way things are. And then there’s the other side of the owner on the other side of that spectrum, that takes that not as okay, it happened. Great. Now what? how do I respond to that? How do I view that challenge? And how do I adjust my business accordingly, to ultimately the goal of every practice and or the goal of every business owner is to have that business serve you personally. It should be a vehicle it should be a platform to provide for your personal and financial quality of life, however, you define that, And if you want X Y, and Z criteria, and the business environment change to such that those two are now disconnected. You have two options. You can either just sit back and let life happen to you. Let business and external factors change the course of your money and your your business, whatever and then just kind of that victim mentality or you can own it. And say all right, things changed. How do I adapt? Is that too extreme? Am I being too harsh? Because that way I can I can be a little harder sometimes.
Dr. Bethany Fishbein: Maybe a little bit. I mean, I don’t. I don’t know that everybody’s having a tough time. Private practice has a blamer mentality. I think though, sometimes, you know, Misery loves company, and even the people who love private practice who are successful who are living their dream, most of the time, have those days where something happens. And adults don’t always post on social media. Oh, I had the best day 15 year olds, that’s exactly what they post but those don’t always come out on. So on some of these sites is Oh, the worst day this patient complained they didn’t get a check or whatever it is, and then there’s a lot of jumping on that. Me too. Me too. Me too. But for people who won’t like you said for their practice to serve, for not even their practice for their professional careers to serve their personal goals. I feel like the best way to do that is through private practice. Because if you’re in private practice with that mentality that you are steering the ship driving the bus, whatever transportation analogy, do here engineering the train that you know if you’re in private practice with that mentality. That’s how you make your practice serve you because there’s no one else making those choices for you. As you said, there are outside factors that are affecting you for sure. But just like if you’re in the car, and you’re going somewhere and you know where you’re going and you come up and there’s a road closed, you don’t turn around and go home and you don’t sit on the road closed sign and say, Oh, well, I guess I’ll just die here. You figure out how to go around it and in figuring out how to go around it, nobody else is doing that except you. And so you figure it out and you go around it and you continue towards your goal and that’s, and that’s how you get there. That’s what private practice is.
Adam Cmejla: We’re talking about them and you’re right. To be fair, we don’t always show our best colors online, especially if we’re wrong. We just kind of got knocked down the wind taken out of our sails a little bit there. I think one of the reasons that you could argue that there’s never been a better time for private practice is that the sense of community that exists and the ability to form and join a community is probably stronger now than it’s ever been. And largely obviously we have technology to thank for that the ability to connect with either the profession in general on a couple of big online platforms. Down to the niche type of treatment practice. I’m sure there are specialty contact lens fitting practice groups that exist on social media platforms. I’m sure that there are subsets within your client base. of power practice members that have their own little Power Pod. I’m making something up here. I don’t know if that’s something actually in your practice or not. You do?
Dr. Bethany Fishbein: We have that and up until now has not been called Power Pod but you might have just coined the term for.So now we call it our client email list is now our Power Pod.
Adam Cmejla: You’re welcome! You’re welcome!
Dr. Bethany Fishbein: Thank you!
Adam Cmejla: To that point, one of the things that I’ve learned early on in business ownership is that in the absence of having a community of other like-minded owners, it can get really lonely. It can get really, really loneny, A: you’d like to celebrate successes. And it’s it’s one of those things where you do some really awesome and you throw up your hands are like nobody’s here.
And equally, if not more important, when you are going through challenging times, having that support group and having other like-minded and I think that’s the key phrase in there like minded practice owners to lift you up when you’re getting ticked down a little bit and to support you when you are having that success. We understand that the importance of community and the right type of people is really, really important. When you think of some of the top ODs that you know that love practice ownership that thrive in practice ownership. What are some of the common qualities that you see in those types of owners?
Dr. Bethany Fishbein: I think the first is really that knowledge and internalizing that knowledge that they are in control of the situation and that things are not happening to them. There might be things happening.
Adam Cmejla: Oh, that’s a big distiction.
Dr. Bethany Fishbein: Huge, but they are in control of how they navigate those things. Right. We hear people complain about their staff, staff to assist after this. I can’t get them to rate. And so if you tell me you can reach your goals because of your staff, I’ll gently ask who hired and trained to your staff and makes the decision to allow them to continue working day after day. So they’ve got to know number one that they’re in control of the situation. Not in control of things that happened to you, but you’re in control of how you handle those things. The second is, I think that they relish enjoying, embrace the role of a leader or a manager, or business owner. I think, you know, in the past, it was kind of expected Oh, you’re an Optometrist. She’ll go into private practice and that’s just going to kind of happen they didn’t have as many options and a lot of people ended up being business owners that never intended to be, don’t want to be, and don’t like it. S o the ones that I know who are most successful see that role as something that they want to do that they enjoy and most importantly, that they want to get better at, because so many Optometrists spent four years of Optometry school,fifth-year residency, five, six years working for somebody to build their skills as an Optometrist. Then they get a bank loan they buy a practice. Poof! your a leader and have had not, not one course, on how to be that. So just like you can’t imagine somebody walking into an exam room with no training and being like, Hey, I’m going to be a great Optometrist. They think there is an Impractical Jokers episode like that. And then you can’t imagine they would never do that. But yet, they walk into being a business owner with that level or lack of training all the time. And don’t think anything of it.
Adam Cmejla: Yeah.
Dr. Bethany Fishbein: So just like optometry, it’s a job you have to learn and you can constantly keep learning educating yourself practicing, analyzing what you’re doing, what’s working, what’s not working and lifelong get better at .And that’s, that’s the qualities of most successful practice owners I see and the ones who enjoy it the most.
Adam Cmejla: I think there’s a really good thing to point out as it said, You’re, you’re in leadership by default, just by the fact that you have OD after your name. You’re the owner of the practice. You’re the one that made the hiring decision, but to your point, you have zero training in that environment. I mean, okay, yes, in schools, to their somewhat credit are starting to create a few more at least environments for these to create, but it’s still not part of the curriculum. I mean, at IU they have the Optometric Private Practice Club which still I mean, from a faculty standpoint and a leadership standpoint, I love the fact that they’re doing that. But it’s not people that own private practices that are involved or facilitating the conversations in the introductions, which is great, but it’s still at an arm’s length of the leadership and the in the trenches, so to speak. The best practices that are creating the best of the best practices that are out there.
Dr. Bethany Fishbein: For sure. And it’s also at a bigger than arm’s length of time between when the content is delivered, and when the audience might actually need it. So, you know, I spoke at the University of Houston. I think a great practice management program.
Adam Cmejla: They do, I went down there too, I love the guys down.
Dr. Bethany Fishbein: Hi Lorie! Credit to you guys, but, you know, what a privilege to deliver to this is your successful people love owning practices, teaching what they need to know. But even so, everybody in that room is at minimum, three, four years out, and more likely 8,9,10 years out from owning a private practice. But I will say just to make a case for leadership training, and leadership learning, that it’s not always just the practice owner. One of the things that I see we were talking about before about associates and what’s relevant to them, is that by default an associate in a practice very often becomes a de facto leader. Because a lot of times the associates are brought in so that the owner can work a little bit less so the associate Doc is there when the owner isn’t. And because they’re the doctor and they’re kind of leading the show, they’re getting questions asked of a leader. And so developing those, those leadership skills as management skills, even if you have no designs on owning a practice is going to make a better stronger associate who then even though they’re not the practice owner, gets to design a day that works for them as well.
Adam Cmejla: That’s awesome. What are some of the I have some ideas and if you want me to go first, I absolutely can? What are some of your favorite kind of timeless evergreen resources platforms, teachers, for lack of a better word, on leadership? Whether it’s optometric specific, or quote-unquote, just business in general, because it gives you the reason I asked that, is that, right? There’s all kinds of online communities and if it’s on the internet, it must be true.
Dr. Bethany Fishbein: Yes, and there is no bad advice on the internet.
Adam Cmejla: None, no,no. There’s never
Dr. Bethany Fishbein: Anything you read, you should just do. I mean, I think that the best leadership content that I’ve gotten firstly is kind of outside of the industry. Industry stuff is okay, but it tends to be focused on the leadership tangibles here are the metrics you can look at here at that rate but it doesn’t teach you the how to build a team, how to get people to follow you how to work with different adult learning styles, stuff like that.So I mean, there are there are some timeless books on leadership.
I love “Five Dysfunctions of a Team” , an oldie but goodie. I recommend “All over the place”, “Radical candor”, It is a great book about having the conversations that are going to make your team better , and how to how to help somebody be the best version of themselves by giving caring honesty, great book. There are some other podcasts focused on leadership. I used to listen to a lot of coaching for leaders and I don’t ever put that one. But listening to those or reading those, and then thinking about how do I put this in place in my own practice with my own team? That’s been incredibly helpful. And I think the other thing is really just staying in that correct mindset of this is something that I’m learning. So as an Optometrist, if you have those those cases, those patients who come in and you choose how to manage them, and you’re not sure about them. And so maybe you ask your colleagues, you ask your friends, hey, what would you have done? You follow up with them a little closer, you see them in the next day to make sure they’re getting better instead of the next week. Bring that mindset to your leadership development. And maybe I didn’t handle that conversation with that staff person in the best way that I could, hey, how would you have spoken to them about this? And just like you want to surround yourself with great clinicians that you admire, surround yourself with leaders who admire and that’s an intentional community, not putting it out there at large because you don’t know if the person replying is a well respected and well-loved leader. You need you to know, that just like you have clinical mentors, you can have leadership mentors that help you be the best version of yourself as a leader.
Adam Cmejla: I think that goes back to setting up the preface to that question. You know, if it’s on the internet, it must be true. Be careful, you’re taking advice from being careful about the responses that you get to these questions that are asked and the validity of who’s answering that to your point. That the person answering or the information that you’re getting, might be a very limiting belief type answer it might be it’s going to be put through the filter of the experiences that the person answering had right you and I were talking earlier about how some people just never really seem to like a million dollars in production for them is this. Oh my gosh, holy grail of practice achievement in revenue and then we sat here in about 11 and a half seconds on a phone and realize that if your average revenue per exam is $335, you do 16 comp exams a day, 48 weeks a year. That’s 1.4 million in top line revenue.
Dr. Bethany Fishbein : Right? And that’s the surrounding yourself with people. Right because you don’t know and I’m sure you see it in the financial space as well that you know, there are some people who don’t believe Optometrist can ever be financially successful there. So a student loans and it’s like, you put a question out and you want to make sure that the person answering it knows that there is absolutely no reason that an Optometrist can retire at 60 and live the comfortable life of their dreams if they choose to, or continue working if they want to know.
Adam Cmejla : I mean, my wife graduated from IU and 238,000 in student loans and she had a little bit from undergrad but the majority of that was from Optometry school. And she’s really not practicing anymore. She practices one-half day per week, just to kind of keep the keep the sauce sharp so to speak. And for her, there was some head trash around stepping away from optometry at this point in her life and her into her careers with our girls in the age they are and there was some guilt and head trash because I shouldn’t be able to step away look at it you know I I took out all those student loans and now I’m not gonna be practicing with Andrew when you made well over a million dollars in less than 10 years as an associate like not in ownership capacity right? As an associate with some breaks off from maternity leave and you know, some a couple of different lily pads in her practicing career but in less than 10 years to make well over a million dollars and always have the opportunity to go back. I know I’m deviating a little bit on a tangent here as we bring up student loans, but it’s yeah. Is it expensive to go to optometry school? Yes. Is that a whole other conversation in and of itself? Yes, it is. So I’m not going to go down that rabbit hole any deeper than we already have right now. But it’s still a very very profitable endeavor if even done accidentally successfully. You and I know there are a lot of accidental successes out there. There is a reason why most practice owners whether you’re doing 1.5 in top-line revenue, or four and a half million in top-line revenue, you probably have $140,000 of inventory. Like we know that there are a lot ODs out there that just don’t manage their books. They just don’t know the numbers and the metrics of their practice. And again, we’ve done a number of episodes on that you and I have talked in part on some of those topics. And I’m sure you and I will dive into future conversations about that as well. But my point in kind of bringing all that up years, I think I can distill some of this down into one of two types of individuals in almost an extreme effect. There are optometrists out there who just happen to be business owners. And then there are business owners that specialize in optometric medicine, and the people in the former be in optometrists that happen to be business owners. Like I just want to give them a hug,
Dr. Bethany Fishbein: So, we can add a third type of Optometrist who happened to be business owners and choose to develop themselves into business owners, who happened to be an Optometrist. So there are some who come to optometry through a desire to be an entrepreneur, and they think I want to own a business and this seems like a profitable one and as you said, I can make money despite myself. Alright, I’ll do this field. Ice are cool. But the ones that find business ownership, like when, I came into school, I had no knowledge of business none. And didn’t even know that it was something that I was going to be interested in. And as I started to read and thought, this is cool, huh? If I do this, I can impact change. If I do this, I can have the career I want. If I do this, I can have the life balance that I want. Oops, I did that. That pulled me in the wrong direction. But I’m the one who can change that. And that’s for me what private practice has given me is the ability to make those decisions. And some of those decisions are about ways to produce more revenue. More of those decisions are about ways to like what I do every day a little bit more. If there’s something going on in my practice that I don’t like if you’re employed, it’s probably gon na continue, especially if it’s a profitable thing. If, when it’s yours, you can change it and that’s, that’s the best part of private practice.
Adam Cmejla: That’s a really good distinction too, because in candidly I kind of found the same path in the advisory business. I mean,, I got into this business almost 15 years ago because I wanted to do what I could have. I want to do what I could to make sure that as many people as I could possibly help. didn’t end up in situations like some of my family members have been in where their social security check is basically their retirement. And that’s it. And I wanted to do what I could to help other people and what I found out as a byproduct of that is that I really love business, and I really love working on businesses and helping improve businesses. More than I love financial planning and guess what I can scale financial planning and teach other people how to do that type of planning just as good if not better than I am. And that’s what’s to your point. As an entrepreneur and a business owner. We have that flexibility and the authority to be able to pivot our professional and thus our personal lives. More so than, I say anybody else. So I think that’s a really, really good distinction to or a third, a third persona, the third avatar of ODs out there. Okay, so let’s wrap up the conversation here. What are one or two? Let’s make this about action. What are one or two action items that you would suggest to listeners besides continu ing to listen to 20/20 Money and the Power Hour Podcast, which again, links to both in the show notes. So aside from those two, obviously lay-up strategies, What are one or two other action items that come to your mind?
Dr.Bethany Fishbein: I think one of them for me is to look at your role as a leader if you’re a practice owner, or if you’re not to look at your position as a leader as a job that you can train for and get better at and find ways to do that. Whether it’s coaching, mentoring, consulting, books, podcasts, whatever it is, number one, and I think the second is to then as you’re developing those skills, look at the areas of your professional life, that maybe aren’t serving your personal life the way you want. Are there things that you’re feeling like this is happening to me, I have no control in this situation and take a step back and look at whether that’s truth? Because more often than not, I think it isn’t. And if you think about it, you have more control than you think and can change it. And the third one I think is to really take a little bit of an inventory of the community that you’re choosing and look at whether the people that you’re surrounding yourself with whether it’s in-person online through social media, believe the same type of things that you believe about life and business, not in terms of theology, religious beliefs, but in terms of, you know, art, are they positive people, are the people who love what they do, or are you putting stuff out there to people who are more likely to drag you down and build you up?
Adam Cmejla: I heard a quote when I first got into this business, and his name is Charlie and he had the nickname Charlie tremendous Jones and he was I think he was some type of insurance broker or sometimes some that he was a business guy, I think in Chicago and he, this is where I heard the quote attributed to him. You will be the same person you are 10 years from now as you are today except for the people you meet in the books you read. And I think that quote, I love that you said the third and if you hadn’t said that that was going to be my number one thing and a variation on that is be careful what you tell yourself because you’re listening. Like I haven’t said Things happen or they happen to me, my business coach, one of her favorite phrases that I’ve internalized from her is, Events have no meaning other than the meaning that we give them. And the idea of things happening versus things happening to you is a very powerful statement that I would ask listeners to reflect on how they feel about when things happen. What does that feeling is this, Do you take that personal or do you observe it more in a unemotional, stoic like moment of okay, this event happened, but I’m not going to have any motion to it. It’s not happening to me. It just happened. So those are really, really good pieces of advice, and I can’t think of a better way to close out a conversation than that. So Bethany, thank you so much for this conversation. This is fun. I’m going to have a couple more conversations here. Today. And then speaking a couple of lectures tomorrow morning. So this has been a fun trip out to Vision Expo. Great to see you and other friends in person three-dimensionally. So to keep doing it again. So thank you again for being on and we’ll catch everybody on the next episode of 20/20 money.
Dr.Bethany Fishbein: Thank you so much.
Want even more ideas, tools and resources on how to make smart financial decisions? Check out the Resource Center at integrated planning and wealth management’s website at integratedpwm.com. Financial knowledge and insight for optometrists, including our free ebooks and on-demand webinars. While there, you can also schedule a 15-minute free discovery conversation with Adam. If you’ve enjoyed the content, please leave us a review on iTunes and share with your friends and colleagues. Thanks so much for listening. Adam Cmejla is a Certified Financial Planner, Principal, and Founder of Integrated Planning and Wealth Management a registered investment advisory firm in the state of Indiana. All opinions expressed by Adam and podcast guests are solely their opinions and not the opinions of IPWM. This show is for informational purposes only and should not be relied upon for investment, tax, legal or other decision. Compliance with IPWM may maintain positioned and security as mention on this a podcast.
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Dr. Bethany Fishbein: If you’re in the car and you’re going somewhere and you know where you’re going and you come up and there’s a road closed, you don’t turn around to go home and you don’t sit at the road closed sign and say, Oh, well, I guess I’ll just die here. You figure out how to go around it and in figuring out how to go around it, nobody else is doing that except you. And so you figure it out, and you go around it and you continue on towards your goal. And that’s, that’s how you get there. That’s what Power Practice is.
Dr. Bethany Fishbein: Hi, I am Bethany Fishbein, CEO of the Power Practice and host of the Power Hour Optometry Podcast. And today I wanted to share with you an episode of another podcast. This is the 20/20 Money Podcast. Many of you are familiar, I know a number of people listen to both. 20/20 Money is hosted by Adam Cmejla, who’s a Financial Planner who works specifically with Optometrists. And it’s always fun to be a podcast guest instead of the host. And this one was especially fun because it’s the first time and only time that I had recorded live. This is an in-person conversation that Adam and I had at Vision Expo East and it’s an important one. It always makes me a little bit sad when people online or in-person are down on the private practice. Either thinking there’s not going to be a future for private practice or that the stresses of owning a practice aren’t worth the rewards. And I feel like that because I loved having a private practice. Work with a number of private practice owners and hope that through Power Practice, my coaching has helped some other practice owners feel the same way as they develop as leaders and owners and learn to enjoy life in the process. So you’ll hear Adam and I talked about the importance of community and our Power Practice Community is one of the best so for information on how you can join please visit our website www.powerpractice.com and enjoy the podcast.
Adam Cmejla: Welcome to another episode of 20/20 money. My guest on today’s show is Dr. Bethany Fishbein. Bethany is the CEO of Power Practice and host of the Optometry Power Hour Podcast. Bethany joins me live from Vision Expo East to talk about her perspective on why we both love the model of private practice in Optometry. Why it’s important to surround yourself with a good community as a business owner and optometrist. The importance of learning about leadership and business and ways in which you can take action on all of the areas that we discuss. As a reminder, you can get all of the information discussed in today’s conversation by visiting our website at integratedpwm.com and clicking on the Learning Center. While there be sure to subscribe to our newsletter and you can also set up a 20 to 30-minute triage conversation. To learn a little bit more about how we help OD practice owners around the country reduce their tax bills, proactively manage cash flow and be prudent investment decisions or check out any number of additional free resources like our ebooks, blog posts, and webinars. And with that introduction, I hope you enjoy my conversation with Dr. Bethany Fishbein.
Adam Cmejla: All right, well, Welcome back to another episode of 20/20 money live from Vision Expo. I love doing these live shows and with me none other than Dr. Bethany Fishbein. Thank you so much for being here laying down some great content. You know, we’ve done 170 Plus episodes of 20/20 money when which is obviously all but a handful of episodes have been virtual. And there’s just something different about recording in person. Like when you’re on Zoom, you’re right there but there’s something about being two feet away and having a microphone in your face and having a three-dimensional conversation. That’s going to be a lot of fun. So thank you for being here.
Dr. Bethany Fishbein: Good, Thank you for having me. And this is my first ever live podcast recording. We certainly are doing Power Hour Podcast on Zoom all the time. So this is a whole new dynamic and it’s only been 30 seconds or so but I think it’s good so.
Adam Cmejla: I think it’s good and from a pure content creation standpoint, that was an awesome way to drop. Yes, the host of Power Hour Optometry Podcast as well, which we’ll put links in the show notes. And if you’re a longtime listener of 20/20 money, you know, this is not the first time that Bethany has been on the show. I’ve been on Power Hour Show as well. So we’ll have links to both of those episodes or both of those shows. Excuse me, in the show notes of this episode. So what we want to talk about here today, and this is something that as you and I were talking prior to hitting record, we probably could have just had the microphone set up and hit record and not had to do it over again, but it was a good dry run. We’re going to make the case for private practice today and for some of you listening right now, that’s probably not going to take too much arm twisting because you’re either an existing practice owner or you’re very much bought into it. I think what we want to talk about here is making the case for private practice in the current state of optometry because there are so many new factors, new factors at play, relatively speaking, that haven’t always been in Optometry. But what’s the classic phrase kind of the more things change, the more they’re still the same? I mean, we were talking before we had a record of being a practice owner in the early 2000s In the early 90s, and in the 80s. And every time that there was something at we had another colleague here that was talking to me, he said what 40 years of optometric experience in various ways. And yes, there’s always a new threat. There’s always a new challenge that exists in private practice ownership. But what are your thoughts when you think of, Why the case for private practice today? What are you hearing in the conversations that you and the coaches at Power Practice are having with practice owners or aspiring practice owners?
Dr. Bethany Fishbein: I think with aspiring practice owners there’s a lot of trepidation about what life in private practice is going to be like. And I think that largely it comes from kind of jaded practice owners complaining on social media. You know, you put it out there, and like, there are moments where being a private practice owner is tough. And you know, there are late nights and there are early mornings and there are weekends where you’re thinking about the business and that’s the reality of any business owner. You know, business owner of any type. But they read that and they think, is it worth it? There was just a post on one of those social media sites. You know, if you had to do it over again, would you own private practice the responses were pretty well split, some said absolutely! Some said no way! And, you know, it’s the I’m absolutely on the absolutely side. It’s the best!
Adam Cmejla: I’m trying to think of. If I could get into the mindset of someone that commented “No way”. What do you think are and again, not speaking for them, but in the conversations that you’ve had with OD’s that have you know, that would say that response? What are the most common, quote-unquote validations that they use to support that answer?
Dr. Bethany Fishbein: That’s a good question. I think the most common thing that I hear one is that there are a lot of things to deal with that either they weren’t expecting to have to deal with. They kind of knew they’d have to deal with but they don’t know-how. And so it’s uncomfortable or unpleasant. Or they feel like there’s a lot of stuff out there that’s happening to them beyond their control. Right.
Interestingly, the ones who say yes, it’s so totally worth it, are very often saying yes for the same reasons. There. Are all these things they have to deal with. What a fun challenge to figure these out, instead of just figuring out refractions I love this part. Or there are a lot of things to deal with that. I don’t know exactly how, I’m a good optometrist I’ve learned that let me challenge myself to be an awesome business owner and learn those skills. And they’re loving that side of it. And all of the challenges and also the freedom that private practice gives.
Adam Cmejla: This might be an extreme, like, splitting up personalities, but the former I would almost put as someone that is a blamer or a victim type mentality. What was me I can’t believe that the profession is happening to me? I can’t believe that reimbursement rates got cut again. How am I supposed to make money on these visions like, we can pick and pull probably half a dozen different narratives that people internalize, truly believe and almost feel like they just kind of succumb to? Wow! that’s the way things are. And then there’s the other side of the owner on the other side of that spectrum, that takes that not as okay, it happened. Great. Now what? how do I respond to that? How do I view that challenge? And how do I adjust my business accordingly, to ultimately the goal of every practice and or the goal of every business owner is to have that business serve you personally. It should be a vehicle it should be a platform to provide for your personal and financial quality of life, however, you define that, And if you want X Y, and Z criteria, and the business environment change to such that those two are now disconnected. You have two options. You can either just sit back and let life happen to you. Let business and external factors change the course of your money and your your business, whatever and then just kind of that victim mentality or you can own it. And say all right, things changed. How do I adapt? Is that too extreme? Am I being too harsh? Because that way I can I can be a little harder sometimes.
Dr. Bethany Fishbein: Maybe a little bit. I mean, I don’t. I don’t know that everybody’s having a tough time. Private practice has a blamer mentality. I think though, sometimes, you know, Misery loves company, and even the people who love private practice who are successful who are living their dream, most of the time, have those days where something happens. And adults don’t always post on social media. Oh, I had the best day 15 year olds, that’s exactly what they post but those don’t always come out on. So on some of these sites is Oh, the worst day this patient complained they didn’t get a check or whatever it is, and then there’s a lot of jumping on that. Me too. Me too. Me too. But for people who won’t like you said for their practice to serve, for not even their practice for their professional careers to serve their personal goals. I feel like the best way to do that is through private practice. Because if you’re in private practice with that mentality that you are steering the ship driving the bus, whatever transportation analogy, do here engineering the train that you know if you’re in private practice with that mentality. That’s how you make your practice serve you because there’s no one else making those choices for you. As you said, there are outside factors that are affecting you for sure. But just like if you’re in the car, and you’re going somewhere and you know where you’re going and you come up and there’s a road closed, you don’t turn around and go home and you don’t sit on the road closed sign and say, Oh, well, I guess I’ll just die here. You figure out how to go around it and in figuring out how to go around it, nobody else is doing that except you. And so you figure it out and you go around it and you continue towards your goal and that’s, and that’s how you get there. That’s what private practice is.
Adam Cmejla: We’re talking about them and you’re right. To be fair, we don’t always show our best colors online, especially if we’re wrong. We just kind of got knocked down the wind taken out of our sails a little bit there. I think one of the reasons that you could argue that there’s never been a better time for private practice is that the sense of community that exists and the ability to form and join a community is probably stronger now than it’s ever been. And largely obviously we have technology to thank for that the ability to connect with either the profession in general on a couple of big online platforms. Down to the niche type of treatment practice. I’m sure there are specialty contact lens fitting practice groups that exist on social media platforms. I’m sure that there are subsets within your client base. of power practice members that have their own little Power Pod. I’m making something up here. I don’t know if that’s something actually in your practice or not. You do?
Dr. Bethany Fishbein: We have that and up until now has not been called Power Pod but you might have just coined the term for.So now we call it our client email list is now our Power Pod.
Adam Cmejla: You’re welcome! You’re welcome!
Dr. Bethany Fishbein: Thank you!
Adam Cmejla: To that point, one of the things that I’ve learned early on in business ownership is that in the absence of having a community of other like-minded owners, it can get really lonely. It can get really, really loneny, A: you’d like to celebrate successes. And it’s it’s one of those things where you do some really awesome and you throw up your hands are like nobody’s here.
And equally, if not more important, when you are going through challenging times, having that support group and having other like-minded and I think that’s the key phrase in there like minded practice owners to lift you up when you’re getting ticked down a little bit and to support you when you are having that success. We understand that the importance of community and the right type of people is really, really important. When you think of some of the top ODs that you know that love practice ownership that thrive in practice ownership. What are some of the common qualities that you see in those types of owners?
Dr. Bethany Fishbein: I think the first is really that knowledge and internalizing that knowledge that they are in control of the situation and that things are not happening to them. There might be things happening.
Adam Cmejla: Oh, that’s a big distiction.
Dr. Bethany Fishbein: Huge, but they are in control of how they navigate those things. Right. We hear people complain about their staff, staff to assist after this. I can’t get them to rate. And so if you tell me you can reach your goals because of your staff, I’ll gently ask who hired and trained to your staff and makes the decision to allow them to continue working day after day. So they’ve got to know number one that they’re in control of the situation. Not in control of things that happened to you, but you’re in control of how you handle those things. The second is, I think that they relish enjoying, embrace the role of a leader or a manager, or business owner. I think, you know, in the past, it was kind of expected Oh, you’re an Optometrist. She’ll go into private practice and that’s just going to kind of happen they didn’t have as many options and a lot of people ended up being business owners that never intended to be, don’t want to be, and don’t like it. S o the ones that I know who are most successful see that role as something that they want to do that they enjoy and most importantly, that they want to get better at, because so many Optometrists spent four years of Optometry school,fifth-year residency, five, six years working for somebody to build their skills as an Optometrist. Then they get a bank loan they buy a practice. Poof! your a leader and have had not, not one course, on how to be that. So just like you can’t imagine somebody walking into an exam room with no training and being like, Hey, I’m going to be a great Optometrist. They think there is an Impractical Jokers episode like that. And then you can’t imagine they would never do that. But yet, they walk into being a business owner with that level or lack of training all the time. And don’t think anything of it.
Adam Cmejla: Yeah.
Dr. Bethany Fishbein: So just like optometry, it’s a job you have to learn and you can constantly keep learning educating yourself practicing, analyzing what you’re doing, what’s working, what’s not working and lifelong get better at .And that’s, that’s the qualities of most successful practice owners I see and the ones who enjoy it the most.
Adam Cmejla: I think there’s a really good thing to point out as it said, You’re, you’re in leadership by default, just by the fact that you have OD after your name. You’re the owner of the practice. You’re the one that made the hiring decision, but to your point, you have zero training in that environment. I mean, okay, yes, in schools, to their somewhat credit are starting to create a few more at least environments for these to create, but it’s still not part of the curriculum. I mean, at IU they have the Optometric Private Practice Club which still I mean, from a faculty standpoint and a leadership standpoint, I love the fact that they’re doing that. But it’s not people that own private practices that are involved or facilitating the conversations in the introductions, which is great, but it’s still at an arm’s length of the leadership and the in the trenches, so to speak. The best practices that are creating the best of the best practices that are out there.
Dr. Bethany Fishbein: For sure. And it’s also at a bigger than arm’s length of time between when the content is delivered, and when the audience might actually need it. So, you know, I spoke at the University of Houston. I think a great practice management program.
Adam Cmejla: They do, I went down there too, I love the guys down.
Dr. Bethany Fishbein: Hi Lorie! Credit to you guys, but, you know, what a privilege to deliver to this is your successful people love owning practices, teaching what they need to know. But even so, everybody in that room is at minimum, three, four years out, and more likely 8,9,10 years out from owning a private practice. But I will say just to make a case for leadership training, and leadership learning, that it’s not always just the practice owner. One of the things that I see we were talking about before about associates and what’s relevant to them, is that by default an associate in a practice very often becomes a de facto leader. Because a lot of times the associates are brought in so that the owner can work a little bit less so the associate Doc is there when the owner isn’t. And because they’re the doctor and they’re kind of leading the show, they’re getting questions asked of a leader. And so developing those, those leadership skills as management skills, even if you have no designs on owning a practice is going to make a better stronger associate who then even though they’re not the practice owner, gets to design a day that works for them as well.
Adam Cmejla: That’s awesome. What are some of the I have some ideas and if you want me to go first, I absolutely can? What are some of your favorite kind of timeless evergreen resources platforms, teachers, for lack of a better word, on leadership? Whether it’s optometric specific, or quote-unquote, just business in general, because it gives you the reason I asked that, is that, right? There’s all kinds of online communities and if it’s on the internet, it must be true.
Dr. Bethany Fishbein: Yes, and there is no bad advice on the internet.
Adam Cmejla: None, no,no. There’s never
Dr. Bethany Fishbein: Anything you read, you should just do. I mean, I think that the best leadership content that I’ve gotten firstly is kind of outside of the industry. Industry stuff is okay, but it tends to be focused on the leadership tangibles here are the metrics you can look at here at that rate but it doesn’t teach you the how to build a team, how to get people to follow you how to work with different adult learning styles, stuff like that.So I mean, there are there are some timeless books on leadership.
I love “Five Dysfunctions of a Team” , an oldie but goodie. I recommend “All over the place”, “Radical candor”, It is a great book about having the conversations that are going to make your team better , and how to how to help somebody be the best version of themselves by giving caring honesty, great book. There are some other podcasts focused on leadership. I used to listen to a lot of coaching for leaders and I don’t ever put that one. But listening to those or reading those, and then thinking about how do I put this in place in my own practice with my own team? That’s been incredibly helpful. And I think the other thing is really just staying in that correct mindset of this is something that I’m learning. So as an Optometrist, if you have those those cases, those patients who come in and you choose how to manage them, and you’re not sure about them. And so maybe you ask your colleagues, you ask your friends, hey, what would you have done? You follow up with them a little closer, you see them in the next day to make sure they’re getting better instead of the next week. Bring that mindset to your leadership development. And maybe I didn’t handle that conversation with that staff person in the best way that I could, hey, how would you have spoken to them about this? And just like you want to surround yourself with great clinicians that you admire, surround yourself with leaders who admire and that’s an intentional community, not putting it out there at large because you don’t know if the person replying is a well respected and well-loved leader. You need you to know, that just like you have clinical mentors, you can have leadership mentors that help you be the best version of yourself as a leader.
Adam Cmejla: I think that goes back to setting up the preface to that question. You know, if it’s on the internet, it must be true. Be careful, you’re taking advice from being careful about the responses that you get to these questions that are asked and the validity of who’s answering that to your point. That the person answering or the information that you’re getting, might be a very limiting belief type answer it might be it’s going to be put through the filter of the experiences that the person answering had right you and I were talking earlier about how some people just never really seem to like a million dollars in production for them is this. Oh my gosh, holy grail of practice achievement in revenue and then we sat here in about 11 and a half seconds on a phone and realize that if your average revenue per exam is $335, you do 16 comp exams a day, 48 weeks a year. That’s 1.4 million in top line revenue.
Dr. Bethany Fishbein : Right? And that’s the surrounding yourself with people. Right because you don’t know and I’m sure you see it in the financial space as well that you know, there are some people who don’t believe Optometrist can ever be financially successful there. So a student loans and it’s like, you put a question out and you want to make sure that the person answering it knows that there is absolutely no reason that an Optometrist can retire at 60 and live the comfortable life of their dreams if they choose to, or continue working if they want to know.
Adam Cmejla : I mean, my wife graduated from IU and 238,000 in student loans and she had a little bit from undergrad but the majority of that was from Optometry school. And she’s really not practicing anymore. She practices one-half day per week, just to kind of keep the keep the sauce sharp so to speak. And for her, there was some head trash around stepping away from optometry at this point in her life and her into her careers with our girls in the age they are and there was some guilt and head trash because I shouldn’t be able to step away look at it you know I I took out all those student loans and now I’m not gonna be practicing with Andrew when you made well over a million dollars in less than 10 years as an associate like not in ownership capacity right? As an associate with some breaks off from maternity leave and you know, some a couple of different lily pads in her practicing career but in less than 10 years to make well over a million dollars and always have the opportunity to go back. I know I’m deviating a little bit on a tangent here as we bring up student loans, but it’s yeah. Is it expensive to go to optometry school? Yes. Is that a whole other conversation in and of itself? Yes, it is. So I’m not going to go down that rabbit hole any deeper than we already have right now. But it’s still a very very profitable endeavor if even done accidentally successfully. You and I know there are a lot of accidental successes out there. There is a reason why most practice owners whether you’re doing 1.5 in top-line revenue, or four and a half million in top-line revenue, you probably have $140,000 of inventory. Like we know that there are a lot ODs out there that just don’t manage their books. They just don’t know the numbers and the metrics of their practice. And again, we’ve done a number of episodes on that you and I have talked in part on some of those topics. And I’m sure you and I will dive into future conversations about that as well. But my point in kind of bringing all that up years, I think I can distill some of this down into one of two types of individuals in almost an extreme effect. There are optometrists out there who just happen to be business owners. And then there are business owners that specialize in optometric medicine, and the people in the former be in optometrists that happen to be business owners. Like I just want to give them a hug,
Dr. Bethany Fishbein: So, we can add a third type of Optometrist who happened to be business owners and choose to develop themselves into business owners, who happened to be an Optometrist. So there are some who come to optometry through a desire to be an entrepreneur, and they think I want to own a business and this seems like a profitable one and as you said, I can make money despite myself. Alright, I’ll do this field. Ice are cool. But the ones that find business ownership, like when, I came into school, I had no knowledge of business none. And didn’t even know that it was something that I was going to be interested in. And as I started to read and thought, this is cool, huh? If I do this, I can impact change. If I do this, I can have the career I want. If I do this, I can have the life balance that I want. Oops, I did that. That pulled me in the wrong direction. But I’m the one who can change that. And that’s for me what private practice has given me is the ability to make those decisions. And some of those decisions are about ways to produce more revenue. More of those decisions are about ways to like what I do every day a little bit more. If there’s something going on in my practice that I don’t like if you’re employed, it’s probably gon na continue, especially if it’s a profitable thing. If, when it’s yours, you can change it and that’s, that’s the best part of private practice.
Adam Cmejla: That’s a really good distinction too, because in candidly I kind of found the same path in the advisory business. I mean,, I got into this business almost 15 years ago because I wanted to do what I could have. I want to do what I could to make sure that as many people as I could possibly help. didn’t end up in situations like some of my family members have been in where their social security check is basically their retirement. And that’s it. And I wanted to do what I could to help other people and what I found out as a byproduct of that is that I really love business, and I really love working on businesses and helping improve businesses. More than I love financial planning and guess what I can scale financial planning and teach other people how to do that type of planning just as good if not better than I am. And that’s what’s to your point. As an entrepreneur and a business owner. We have that flexibility and the authority to be able to pivot our professional and thus our personal lives. More so than, I say anybody else. So I think that’s a really, really good distinction to or a third, a third persona, the third avatar of ODs out there. Okay, so let’s wrap up the conversation here. What are one or two? Let’s make this about action. What are one or two action items that you would suggest to listeners besides continu ing to listen to 20/20 Money and the Power Hour Podcast, which again, links to both in the show notes. So aside from those two, obviously lay-up strategies, What are one or two other action items that come to your mind?
Dr.Bethany Fishbein: I think one of them for me is to look at your role as a leader if you’re a practice owner, or if you’re not to look at your position as a leader as a job that you can train for and get better at and find ways to do that. Whether it’s coaching, mentoring, consulting, books, podcasts, whatever it is, number one, and I think the second is to then as you’re developing those skills, look at the areas of your professional life, that maybe aren’t serving your personal life the way you want. Are there things that you’re feeling like this is happening to me, I have no control in this situation and take a step back and look at whether that’s truth? Because more often than not, I think it isn’t. And if you think about it, you have more control than you think and can change it. And the third one I think is to really take a little bit of an inventory of the community that you’re choosing and look at whether the people that you’re surrounding yourself with whether it’s in-person online through social media, believe the same type of things that you believe about life and business, not in terms of theology, religious beliefs, but in terms of, you know, art, are they positive people, are the people who love what they do, or are you putting stuff out there to people who are more likely to drag you down and build you up?
Adam Cmejla: I heard a quote when I first got into this business, and his name is Charlie and he had the nickname Charlie tremendous Jones and he was I think he was some type of insurance broker or sometimes some that he was a business guy, I think in Chicago and he, this is where I heard the quote attributed to him. You will be the same person you are 10 years from now as you are today except for the people you meet in the books you read. And I think that quote, I love that you said the third and if you hadn’t said that that was going to be my number one thing and a variation on that is be careful what you tell yourself because you’re listening. Like I haven’t said Things happen or they happen to me, my business coach, one of her favorite phrases that I’ve internalized from her is, Events have no meaning other than the meaning that we give them. And the idea of things happening versus things happening to you is a very powerful statement that I would ask listeners to reflect on how they feel about when things happen. What does that feeling is this, Do you take that personal or do you observe it more in a unemotional, stoic like moment of okay, this event happened, but I’m not going to have any motion to it. It’s not happening to me. It just happened. So those are really, really good pieces of advice, and I can’t think of a better way to close out a conversation than that. So Bethany, thank you so much for this conversation. This is fun. I’m going to have a couple more conversations here. Today. And then speaking a couple of lectures tomorrow morning. So this has been a fun trip out to Vision Expo. Great to see you and other friends in person three-dimensionally. So to keep doing it again. So thank you again for being on and we’ll catch everybody on the next episode of 20/20 money.
Dr.Bethany Fishbein: Thank you so much.
Want even more ideas, tools and resources on how to make smart financial decisions? Check out the Resource Center at integrated planning and wealth management’s website at integratedpwm.com. Financial knowledge and insight for optometrists, including our free ebooks and on-demand webinars. While there, you can also schedule a 15-minute free discovery conversation with Adam. If you’ve enjoyed the content, please leave us a review on iTunes and share with your friends and colleagues. Thanks so much for listening. Adam Cmejla is a Certified Financial Planner, Principal, and Founder of Integrated Planning and Wealth Management a registered investment advisory firm in the state of Indiana. All opinions expressed by Adam and podcast guests are solely their opinions and not the opinions of IPWM. This show is for informational purposes only and should not be relied upon for investment, tax, legal or other decision. Compliance with IPWM may maintain positioned and security as mention on this a podcast.