Episode 121 – Finding LEVERAGE POINTS In Your Business – Ankit Patel, My Business Care Team

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TTTP 121 | Leverage Points


Every business has processes and metrics that can be streamlined and improved. Ankit Patel calls these aspects of the business leverage points. Ankit is the founder of a company named My Business Care Team, which provides business process outsourcing services to optometry clinics. He also runs and manages multiple optometry clinics in the Atlanta area. In this episode, Ankit helps us understand how to define where our business currently stands, how to look at our metrics, where we can make changes to improve how we run our clinics, and how to get the right people in the right seats.

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Finding LEVERAGE POINTS In Your Business – Ankit Patel, My Business Care Team

Thank you so much for taking the time to join me. As always, I’m super grateful and appreciate you taking the time out of your busy schedules to join me and my amazing guest so we can all learn and grow. Off the top, I have a quick favor. If you could please leave a review, share this with a friend, send a screenshot, post a screenshot on Instagram, or send a link to your friend via Instagram, text message, LinkedIn, or wherever.

For some reason, all of our reviews got erased. We’re starting to climb back up. Thanks to the support of our amazing readers. If you wouldn’t mind, please leave a review and comment as well. That always helps us to get this out there and share it with more of our colleagues because the information we’re going to share is so valuable. I want to make sure as many people read this as possible.

My amazing guest is Mr. Ankit Patel who is the Founder of My Business Care Team and the Co-owner of Classic Vision, a multi-location optometry practice in the Atlanta, Georgia area. Ankit is a business owner business and manager. He works with his wife Mital Patel who is one of the optometrists within the practices. Thank you so much, Ankit, for joining me here. I appreciate you coming on.

Thanks for having me.

I’ve spoken to you a couple of times out and I get this real feel of your great business mind. I’m trying to soak up as much information as I can when you’re talking. We were speaking right before we started recording. I was like, “What’s the core theme of this? Was it business development? I want some good business advice.” You used a term that I would not have come up with by myself, which is we’re going to discuss leverage points for business owners in eye care.

Meaning, what are the places in your business where you can make the biggest change with the smallest amount of effort? I like that you also gave me the antonym or the opposite of that which is it’s the opposite of spinning your wheels like you’re on a hamster wheel or a treadmill. You’re not going anywhere. I like that idea because a lot of times, I feel that way.

I feel like I’m putting in all this effort and not seeing results where I think I should and it could be because I’m not identifying the leverage point. I’m excited to bring this up. There’s a lot. I made notes here. We could go on for hours. We’re going to try to condense this. I’m going to let you run with it for the most part but we want to create some definitions for people, “What size of practice are you in? Where are you in your practice?” Identify leverage points based on where you are.

Let’s start by maybe talking about your company a little bit first and then we’ll see where that falls into some of the leverage points that people can identify. My Business Care Team is a BPO, which is outsourcing. In some ways, it’s compared to having a virtual assistant but it’s much more than that. Let’s define that please and talk about My Business Care Team.

My Business Care Team is a BPO for optometrists and ophthalmology practices. The main difference between a VA and a BPO is a BPO is in charge of the actual process, metrics, accountability, HR, and all those functions. If you have a VA, you’re getting a body. With the BPO, you’re getting a service and it figures out how much staff you need, how to manage the staff, how to figure out coverage, vacation time, and all that. That is taken care of. That’s the biggest difference. BPO is like, “Do this for me.” VA is like, “I need a body and I can figure it out myself with them.”

That sounds to me like the difference between having a technician versus an office manager. The office manager is about business processes and understands what needs to be done. The BPO sounds like it’s able to take care of a lot of stuff for the business.

That’s a pretty good analogy because you give to your office manager, “Go figure this out,” versus saying, “I have a tech. I have to train and teach him everything.”

You have run the practices yourself Classic Vision Care. You were managing those practices. You have a lot of hands-on experience in the trenches and clinics. One of the things I wanted to define right off the top was there are people out there who are reading and have a single doctor practice. They may be making whatever their revenue is and then somebody might be reading who has a multilocation or multidoctor practice, which is a different ball game. I would like you to first define that so we can understand some of the numbers. When we’re talking about leverage points, people in different positions can recognize which ones are valuable to them. If you don’t mind, I’ll let you run with that.

What I tell folks is, “What is the goal?” Start with that. A person has a $1 million practice. Two people might have different goals. One person might want a lifestyle. They might want to take Fridays off and not work a lot. Another person is like, “I want to triple the size of this business, grow, and expand.” Start with that first because your leverage points are going to determine what direction you want to go.

We’ll pick one of those. We’ll pick the one that says, for example’s sake, the person who wants to not work every Friday. They’re the sole practitioner. They’re doing, let’s say, $750,000 to $800,000 a year. They’re like, “How do I take a day off?” What do I look at from that perspective? A little backup a step. Typically, I would categorize it.

If you want to categorize it, you can do it by revenue. There are different ways to categorize different growth stages. You got your first startup stage, which is roughly $0 to $300,000 or $500,000 a year in revenue. You have your second stage, which is anywhere from $500,000 to $2 million, depending on where you are and how much you can do off of one provider. You have more complex setups and multi-provider, multi-doctor, and somewhere in that range. The complexity determines where your main leverage points are.

No matter where you are on that journey, start with your goal. You can look at three different things in your business. 1) How do you get patients in the door? 2) How do you service the operations in the four walls and maybe even a little bit outside those four walls? 3) How do you get paid for that? It is important for a lot of US-based optometrists. Canada is a little different with the insurance system. There is still some of that as well and understand how it affects money flow.

TTTP 121 | Leverage Points
Leverage Points: Optometrists must focus on how to get patients to their door, bring them the best service, and how to get paid for doing that.


I remember you gave me a quote, “Get the work, do the work, and get paid for the work.” That’s what you’re saying here. Get people in the door. Do the exams and service, and then make sure you get paid for it. That’s an important little phrase to remember.

No matter where you are in your journey, you can assess this. If you want to grow the business and you have to figure out, “Am I getting enough work,” the thing is, “Is it consistent? Do I have a predictable system that allows me to know how many people are coming in?” For instance, for most ODs, if they’ve been in practice for several years, “I’m going to pre-point with the patients. If I have 100 patients this year, 70% of those patients are going to come back next year in the same month. I’ve got to fill the other 30% up somehow. If I want to grow, how do I grow that? How am I getting new patients? What am I doing?”

There are strategies around what you can do around that. We can talk about what works and what doesn’t in the industry. There’s the, “Doing the work right. You have enough staff. Am I paying them the right amount? Do I have enough work so I don’t lose people? I can do that effectively.” Most people will focus there the most because that’s where they can touch and feel the most day in and day out, especially doctors who are in the business.

Getting paid for the work is something that doesn’t get thought about other than building and filing but, keep in mind, if you’re doing the work and selling them glasses but you’re not getting paid on those glasses by your managed care providers until 15, 30, or 60 days out, that’s what’s called the cash conversions cycle. You’re acting like a bank for the insurance companies in that case. You are financing them because you’ve already paid for the products before they give you your money back. Those are things that you want to look out for.

You don’t always get the money back right away. You have to file for reimbursements and fight for your reimbursements. Canada is different. It’s a little easier there but a similar principle applies if you’re sending a majority of your billing out to the Canadian medical system, it’s going to be a lag before you get it back and you’ve already spent it on labor and utilities. All that has already been spent upfront glasses or whatever might be all your cost upfront. The more you can get paid when you do the work, the better. If you can figure out a way to shift that, that’s important.

That still applies in a lot of cases here. If we do bill something to the medical system, it’s at least two weeks or maybe a bit more because we submit it on a certain day and then it’s a couple weeks out from then when you get it back. It’s at least two weeks. If there’s something going to a third-party insurance company, you’re looking at probably a couple of weeks out before you get something back. That lag still exists.

You get the odd patient who says, “Put on my credit card,” and we’re like, “Yes, please,” but that doesn’t happen as often as we’d like. That’s an important thing to keep in mind. The difference in the cashflow there was like, “You’re not collecting that money right away for the sales that you’re making.” Moving forward then, let’s say, you have that practitioner who’s looking to take those Fridays off, that scenario that you brought up. What are some things that a person needs to start looking for?

First, “Where are you now?” We can talk about a couple of different scenarios. Let’s start with the doctor who’s still in the startup mode. Let’s say there is $300,000 in revenue a year. They’re working 5 days a week, maybe 6 days, even Saturdays. They just started. They’re not maybe 1 year into the practice, maybe 2 or more. They’re like, “I want to work less. How do I do this?”

There are a couple of different ways to set that up. It depends on the strategy they want to use. One strategy is to say, “We’re going to close the office.” Another strategy is, “I’m going to bring in another doctor who can fill the work.” In either strategy, the math has to work out. You can do a quick calculation, “How much does a doctor cost me a day? What are they going to produce? Are they going to produce as much as I can?”

What do I produce on a revenue-per-patient basis? As a rule of thumb I say, I count 80% for budgeting purposes. They’re going to produce 80% of what you produce. That’s not always true but from a budgeting standpoint, that’ll give you a good gauge of where the breakeven point might be. If they produce 80% of what I produce, I have to pay them. Does it make sense for me to bring them in and do all this? I also have my staff and everything.

If my normal day is $1,000 in receivables in total and all in, they’re going to produce $800 from receivables. It’s probably going to cost you more to keep the doors open that day than it is to have them there. If my average receivables are $3,000, then that makes more sense for me because my average cost you the doors open with the doctor’s going to be less.

You have to figure out, “Is that my problem?” We talked about leverage points, “Do I have enough volume and patience?” You can look at it from different perspectives. One leverage point is, “My average per patient is $200. I need more patients in the door because I only have four a day on average.” I’m making $800 in revenue. I’m just making up numbers.

I can either do either raise my average per person so I don’t have to see more patience, get more in the door, or do both. Getting more in the door requires effort and marketing. There are different leverage points there. In our industry, the best way that I’ve seen marketing work for us and other folks is boots on the ground, getting out there, speaking in the community, being a part of, “We have a $5,000. We have a tent set up to be there.”

Handing out flyers at least in the US like, “Here’s a sample of some over-the-counter dry eye drops if you want to try them out,” which we’ve done before. Collect information, market to them, and have that whole setup. From average per patient, it’s also assessing, “What are we selling? Is it the right product mix for our customer or patient base? Do we make a decision that we’re not going to be everything that we want? Are we going to be a high-end practice?”

Those are decisions that you’ll have to make as an owner of what you want and don’t want to do. Those are some leverage points if you’re in that zone to figure out, “Once you get your average for patient your revenue up, then you can make a decision, ‘Do I want to keep the office open? Do we have such a demand that I can reduce the number of days and not open it all? My staff is there to deal with walk-ins because we have a good visible location. I want to keep the doors open but I don’t want to be there.’” That’s an option as well. It depends. Everyone is different. It’s hard to give a prescription. Those are some things to look at.

That’s a great few points to consider at the very least because sometimes you have had this conversation with colleagues and they’re like, “Do I bring on an associate? Do I close that day?” A lot of people struggle with that, myself included. We go through these different phases with our practice. We’re deciding which ones to go but it’s at least good to know what to think about. At least, if you know what to think about, then you can make, at the very least, a more educated decision on what you’re going to do. You feel a little more comfortable and less lost when you make that decision.

I want to go back to something you said about bringing more people in the door on the marketing side of things. I talk a lot about digital marketing, whether it’s Google Ads or social media and stuff like that, and trying to bring people. Those things work but do require a level of experience, expertise, and investment money-wise that may be more nowadays than maybe did a few years back. It’s becoming more competitive.

This traditional boots-on-the-ground stuff that we’ve been doing for generations or decades still works the same way. It requires effort. We’re always looking for an easy way to get things done. I remember you saying something about the more effort it requires for you to bring a person in. If you remember what you’re saying, share that with me. It was like, “The less effort it requires to bring someone in, the less loyal they’re going to be,” or something like that.

That’s what I’ve noticed in our business. Online people, reducing the friction and getting them in, tend to be more transactional. People who value that speed want to come in but don’t value you as a provider. They want something transactional. If you’re in a transactional type of place, then great. That’s a perfect place to focus. In most private practice, it is very hard to compete in that space because most transactional folks are low-cost folks. They’re going to continue to put the price down.

TTTP 121 | Leverage Points
Leverage Points: Most private practices find it hard to compete in the digital marketing space because most transactional folks are low-cost people too.


There are optical buyers and those types of folks. We call them value buyers. It’s an inexpensive, bare minimum type of stuff. Not always but that tends to be the overlap that we see in our office. You mentioned the online ad spend. One thing I’ll give people is you want what’s called ROAS or Return On Ad Spend. If you are going to do that, you want to look for a 5X return on ad spend. It’s called a marketing funnel. You get so many impressions on your ad. You get many people to click and contact you. Some of those turn into appointments that pay money.

That bottom number has to be how much money they pay. It should be five times more than the top number. The first step would be to figure out what’s your average for patients. Let’s make up a number. Let’s say it’s $200. Your average per patient is $200. I’m going to use US dollars in everything I say. Let’s say we do the funnel. They show me the information and are like, “We’re getting ten clicks a day on this.”

On all those 10 clicks, I’m getting 2 appointments. Each click has cost me $4. I’m spending $40 a day but I’m getting 2 appointments. For $40, I’m getting $400 in revenue. That’s 10X ROAS or Return On Ad Spend. For me, that’s a great deal. Yours won’t be that good. It’ll be closer to the 5X. Most people will have close to 5X because that’s what the markets are giving out to because clicks are getting expensive.

From what I remember when we’re talking to our marketing ad people, we’re in the $35 range, which thought sounded pretty reasonable as far as the cost per click. It was somewhere in the 5X range that you’re talking about or maybe a little higher than that. We were pretty happy with where it was sitting. I’ve started to learn a bit more about those numbers and understand their value. The more of more metropolitan areas you are in, you are going to get more competition in that space. Certainly, we’re seeing that as well. There’s a lot of competition for certain words, keywords, and things like that. You get creative as well to find people to bring them in.

Where no one wants to be, it’s the easiest to set up shop because they have no other choice. It’s like, “You are in.” I was talking to someone who I potentially working with who’s in a rural area out in the Southwest area. They have a couple of locations. It’s crazy to build a base there because there are not many people there within hours of their locations. Locations are pretty far away. They’ve built a present practice out there.

I don’t think I ever still would do it. If I were to start all over again, I would try to go out a couple of hours away from where I am at least but then I think, “How realistic is that?” I’m so glued to where I live. It’s unlikely that I would move. That’s the benefit for people who are willing to move out to less developed areas or more rural areas. It’s going to be beneficial. Those practices tend to be a little bigger and do fairly well.

The quality of life is different. If you’re in the city, you have to be more mindful and strategic about where and what you play in. You may want to consider if you have a lot of competition specializing in something so you can go deeper into the market with that and not be everything that everyone has. If there are a lot of people, then there are a lot of people trying to be everything to everyone. There’s a lot of strategy that plays into that as well.


Be more mindful and strategic about where you play with your business. If you have a lot of competition, go deeper into the market.


Let’s shift gears a little bit. I want to talk about staff, team, everything in the business, and how you look at bringing people on and hiring the right people. One of the books you and I have read that we both like is Good To Great by Jim Collins. It’s one of the best business books I’ve ever read or at least one of the biggest-selling ones.

One of the biggest ideas that’s been taken out of that book is, “Get the right people on the bus.” I wonder if you don’t mind sharing that you’re a single doctor practice trying to hire people and bring a business manager. What types of things should I be looking for there when I’m hiring or what processes should I have in place? I bring on the right people and I get them in the right seats.

There’s a good way to analyze people. It’s called People Analyzer From Traction. It tells you how to do it. It tells you if it’s the right bus for them and the right seat on the right bus. How do you know that it’s the right bus? How do they compare to the values that you have as an organization? If you don’t have explicit values, you have implicit values because there’s always something that’s there.

“Is it the right seat on the bus?” is, “Can they do the job? Do they want to do the job? Do they have the capacity in all aspects to do the job whether showing up to work on time or do I have a degree that I can do that?” Those are types of things. From from hiring standpoint, the best way is, “Past success determines future success.” It’s a very high percentage of people that it’s accurate for. Behavior-based questions are the best questions to ask.

This is what we do. I’ll give you an example. We hired our GM at our practice. I interviewed several candidates. We do all the testing and everything but the behavior-based questions told me a lot. I knew in this position that whoever was coming on board would have to be able to create systems and processes on their own and learn the industry on their own because I wasn’t going to hold their hand through the process.

If they didn’t already have the experience, they would have to take the material that we have and say, “Go figure it out.” When I interviewed folks, I interviewed someone with experience in the industry. Our offices are a little bit different so we do things a little differently. We have different processes and some unique things. Whoever’s coming in would have to learn those even if they knew the industry. An example is, “How do we do our handoffs in the chair? How do we train to that and the playbooks that we have?” There are some new terminology and things that people in the industry are necessarily used to.

I interviewed this person and asked them, “When was the last time you learned something new?” When I started asking the questions, it turned out they had learned a new procedure. I forgot what the procedure was. It was an IPL or something like that. They learn how to do it but I was like, “Who initiated that learning?” She was like, “My boss wanted me to learn it.” I said, “How’d you learn it?” “They showed me how to do it.” “Did you learn anything on your own?” “No. They just showed me and that was it.”

This person also had a dance studio because he seemed very entrepreneurial. I was like, “Let me talk to you a little bit here. How did you start the dance studio?” “I like to dance. There’s one particular type of dance I wanted to do. I started doing this.” “How did you get down that path?” “This person had this course. I learned it from them and then I got out there. I opened the class as part of the program.”

I was like, “What did learn on your own?” There was nothing there. There’s a consistent pattern of not creating their systems and processes and a consistent pattern of not learning on their own even though on paper she was a perfect fit but when I asked those questions, she didn’t have that requisite experience. I was setting her up for failure if I had hired her in this position.

The other person I did end up hiring had no experience in the industry but had several years of experience and several places of creating systems and processes for multi-site locations, training, and developing people from scratch without having something already developed. He’s been fantastic that we’ve been in our offices.

Looking for somebody who has experience, especially in that managerial type of role. If you have to oversee other people, you’re looking for somebody who has taken the initiative to develop systems or processes before even if it’s inadvertently or without knowing what they’re doing but they did that. They have the capacity to find the information to go do something.

Demonstrate the capacity. It doesn’t always have to be work-related. I ask outside of work any questions because not everyone has that opportunity. If you have someone who has demonstrated that they’ve done that, then they can probably do that in your place because they’ve done it before. Opticians are interesting too. If you’re hiring an optician, depending on how you practice, one of the things you want to look for is humility and the ability to learn because you want curiosity.

You want them to understand the patient’s needs so they can get the right products and also, “I wonder why that person needed sunglasses but they didn’t get them from us. Why is that?” They ask a question. You’re looking for that trade of curiosity. They’ve had that sense of curiosity and how to learn and do that. Those are questions we ask our opticians in terms of how they learn and whether they are curious.

Curiosity and humility are two important traits for opticians. That’s people on the floor who are selling or other different areas within the business.

Those are the ones that are selling. We cross-train. Everyone has a sense of curiosity because there are a lot of questions that the text will ask and we want them to dig deep and understand the patient’s needs. Sometimes you have to read between the lines. We like to have that curiosity. That’s a trait that we look for. It’s one of our core values. Our CARE is Curiosity, Always on stage, Relentless, and Elevate.

Always on stage, tell me about that one.

You are leading the patient and you have a great stage presence. If you ask a question like, “Do you want this,” that is not leading the patient. It’s like, “Do you prefer this or this?” That is an example of leading. There’s a stage presence of, “If you have a bad day, everyone gets bad days. If you need time away from patients and make sure to take care of it, we can help you and support you. If you’re in the office, we don’t gossip about patience or talk bad about folks. Try to have a positive experience.” That’s always on stage. The people only see us once a year most of the time. If you’re having a bad day and they have a bad experience, you’re not going to get another chance for another year.

Going back to the office manager or the GM position and looking for somebody who has that trait or history of being able to develop processes for themselves or train other people not simply write memorization or read something and do what said, that’s an interesting thing. We haven’t looked for that specifically but I look at that. I look at our manager in one of our offices. We appreciate how amazing she is.

She’s been fantastic and is a good leader. She has developed a good culture in the office because of her natural abilities. Before she worked for us, she had not had other jobs where she would have necessarily developed those skills. We didn’t pick those traits up in her when we hired her because we hired her more as a technician and optometric assistant but as we saw those traits in her, we kept elevating or bringing her up, and then she ran the whole show.

I’m going to give myself a little credit for seeing that in her after we hired her and not when we hired her. I want to put that out there. You might have somebody on your team already who has those traits. It’s a good thing to look for that ability for somebody to take a lead, initiative, elevate, and bring them up within the ranks.

It depends on where you are and where you want to go. Let’s say you have the bandwidth of training and someone has raw talent. You have someone relative and out of school. They started all these nonprofits. These organizations are active like local community organizations. They’re a leader in what they’ve done. They don’t have a lot of work experience. They’re going to be pretty raw at work.

If you have the bandwidth, you’re able to do that and train them. They may be a great candidate to move up. If you don’t have the capacity or bandwidth to do that and you don’t have enough staff, then you’re setting that person up for failure if you’re saying, “Go figure it out.” You still have to keep that in mind as well. Understand your current situation. You guys sound like you’re in a good position to give her that authority. She had enough requisite skillset to be able to complete that but it’s not always a good match. A lot of times, it’s about fit and timing.


People with raw leadership skills will also be raw at work. If you have the bandwidth, do not hesitate to train them so that they may become a great candidate to move up.


Bringing the right person on the bus was looking for that certain experience, path, and history of where that person was coming from. What about getting them in the right seat? Are there certain things that we need to look for there differently?

Traction is the book I highly recommend people read to implement this and operationalize it. It’s by Gino Wickman. There’s a clear protocol. They call it Get It, Want It, Capacity. Those are yes and no to each 1 of those 3. Get It is, “What are the metrics? What are the 3 to 5 deliverables for that job?” Optician is, “You have to be able to sell glasses at a certain percentage rate. You’ve got to be able to do inventory and also tech,” or whatever it might be in your office. “You have to be able to follow up, manage jobs, and things like that.” Let’s say that’s your role. Get It is you can say yes if you’re hitting all those objectives. That’s yes.

TTTP 121 | Leverage Points
Traction: Get a Grip on Your Business

Want It is, “Do you want the job? Are you trying to do stuff? Are you learning? Are you being proactive?” “Yes.” Capacity is, “You’re here on time. You’re able to work all the hours that we have. You have the skills to do this job because you’re selling at a high level. In the areas where you’re weak, you’re showing a desire to learn because you want it.”

The Capacity is a little short in some areas but you’re getting there. “Yes, you have the capacity to do this job.” If it’s a yes to all three, then that person is in the right seat. If those all are good but they’re awful to work with like if they’re not always on stage or they’re the jerk, they’re on the right seat but not the right bus.

The core values determine, “Are you on the right bus?” That’s the North Star when you’re hiring someone or a lot of the decisions you’re making in the business. Traction is something that I wanted to talk about. You brought it up a couple of times. I’ve been going through it very slowly. It’s a process but if you could share a couple of quick highlights on how you developed your core values. That’s something that is a bit of a mystery for a lot of people. We’ll talk about the importance of developing core values but then everybody is like, “How do I pick curiosity, always on stage, or something like that?” How do you come to that conclusion?

The AI is useful for this. Ask ChatGPT, “What are these core values?” You can use it as a partner to talk back and forth. That’s a good use case of AI. The other thing is to ask your team, “What do you think we value here? What do I value here? What do I value in my life?” Ask other people what they see and what feels right to you. There’s no one way to do it. The way we did it was we revamped it. We rewrote it 4 or 5 times.


To determine your core values, ask other people what they see, what they want, and what feels right to them. After all, there is no one way to do it.


One of the values was around originally giving a crap like, “I give a crap about being here. I want to care.” That changed to elevate over time. We’re trying to get here. We try to make it a fantastic experience. Between relentless and elevate, that’s indicating you give a crap. You want to be here because you’re trying hard and producing. You’re trying to get things better. You don’t have to get it right the first time. Get the airplane in the air and then you can course correct it later on.

If you have something, it’s at least a starting point to learn from. Put something down and say, “Does everyone have these values?” The People Analyzer tool, the way they say to analyze it is to say, “Give everyone a plus, plus-minus, or minus on each one of the values.” Plus is you live the value 80% or more of the time. Plus-minus is 60% to 80%. Minus is less than 60%. There’s a bare minimum. It depends on where your minimum is. Ours are you have to have 3 pluses and only 1 plus minus as the bare minimum to be on the bus.

It’s out of those four core values.

If you’re not, we give you coaching opportunities like, “You’re missing this. Can we get this a little better? We’re going to check back in one month to make sure you’re there.” That helps keep people understanding what the expectations are on the bus.

From what I’ve read in Traction, it sounds like you guys are pretty close to what’s described in that book as far as checking in. If somebody’s not living up to those expectations, give them 30 days. If it’s still not working, then it’s probably time to make a decision one way or the other. Very good. I like that. CARE is Curiosity, Always on stage, Relentlessness, and Elevate. Sometimes we get stuck on like, “I want to pick a word that says everything about us.” You can have multiple and make sure that they work.

It doesn’t have to be an acronym. Use ChatGPT and it’ll create acronyms for you. It’s great for this.

I hadn’t thought about that. Use ChatGPT for all the other things that you might be using for but use it to also maybe come up with your core values or at least help you narrow them down.

Use it as a thought partner saying, “I’m trying to come up with my core values. Here’s what I value a lot. Give me some ideas what my core values might be.” Once you come up with them, “Give me 4 or 5 acronym that spells a word with these values.” They come up with stuff.

That’s a perfect segue because one of the other things I wanted to talk to you about was how you’re using AI in your business or how you might see others or optometrists perhaps using AI in their business. There are limited use cases. What do you see going potentially in a way that could support business owners?

The one thing you can do is have difficult conversations with your staff, vendors, or patients. Put it in ChatGPT and it’ll give you a way to handle that response. Put in there, “I’m having a challenging time with a direct report. This is the brief situation. What are some ways to handle this?” It’ll give you some ideas. “What’s a good way to approach this where I feel like I can get my point across but not be overbearing,” or whatever you want to put in there? That’s a great use case that a lot of people are using it for. It’s very effective.

Another use case is workflow automation. We’re using it a lot in our hiring process to that candidates and do a first-round interview right off the bat. We have a list of questions that we like to ask based on position. They type out the answer and then we use ChatGPT and a couple of other tools to automatically score their responses. We take the best candidates and interview them. I’m developing a tool where you can upload a resume. It’ll prioritize and give you a first interview for questions for that candidate based on your job and your company information.

TTTP 121 | Leverage Points
Leverage Points: Workflow automation is useful in the first round of interviews in the hiring process.


That’s something that you are developing as a tool. You’re taking existing AI or whatever software that’s available. You are tailoring it for that.

That’s a pretty good description. We’re using AI as a back-end engine to do the analysis.

Is that something that you’re going to use within your business or you might sell it for other people?

We’ll probably offer it to our partners and have it as a separate line of business for folks. That’s not necessarily optometry-specific. It’s something that we’ve had a building internally to get through a lot of candidates that we interview. It’s something that other people can benefit from.

Is there anything else that you’re seeing for optometry or eye care related where you might see AI as valuable?

This ties in a little bit to why we started My Business Care Team. It’s the cost of staff. The touch points are getting more. I don’t know about it in Canada. In the US, there are a lot of touchpoints, especially if you’re medical, Medicaid, or one of these managed care providers. Heavy practices have a lot of extra touch points with shrinking margins because they’re not reimbursing higher but the cost for staff, utilities, and overhead is going up.

We are making sure we are managing that. There are certain ratios that we like to maintain. One of our ratios is non-doctor payroll. Trying to keep it to 24% or less is the target. We’ve been able to do that primarily because we’ve taken a lot of the back-office phone answering and a lot of stuff out of the office to our remote team. That’s been helpful a lot. In our 24% number, we include all of our benefits. We offer healthcare, 401(k), and time off. All that is in there as well. If you don’t offer that, it might be lower.

That seems like you guys are doing a good job. That’s pretty efficient. Why don’t we lead towards wrapping up here? That’s a nice little segue. Let’s talk a little bit more about My Business Care Team. Where does a BPO perhaps come in and become valuable for a practice owner? What type of setting would that be a leverage point?

There are a couple of different places. The best place that is the most effective and quickest win is your overwhelming phone calls and you’re not getting to all of them. Calls are going missed. You’re missing opportunities and your staff is getting distracted. You don’t have enough staff to support the team. If you’re in that situation, it would work out great to have someone like a BPO come in and augment what you’re doing.

Over time, as we run the business, we offer more value to the organization. Let’s say you’re short-staffed, can’t find folks, and need more people. That’s a great fit for someone like us to come in to say, “Let us help answer your phones, alleviate some of that, take care of some of the things like confirmation appointments, pulling insurance and benefits, making sure that’s accurate, uploading into your systems.” You have all that information so it takes that burden off your team.

That way you either use us until you find someone if you want to go back to that or keep us and then say, “We need fewer staff so I can pay my staff in-house better,” which is what we did. We end up paying quite a bit more than the market pay for most positions. We also offer all these benefits, healthcare, time-off, and 401(k) match. By doing that, we’re able to get better quality more productive folks.

The one thing I don’t think most people realize is that you can pay 20% more than the market and you’ll get someone who’s way more productive than 20% better than the next person. You’ll get 10X performance, not just incremental performance. That’s something to consider too. The better you can manage your cost and the right people in the right spots, for us, that was a leverage point to be able to get good talented people that get us 10X more than someone who cost about maybe 20% less.

You are able to outsource a lot of those tasks so you are able to then focus on hiring better staff, pay them a little more but get a lot better results out of that, which makes sense. When you don’t have to do a lot of the mundane monotonous stuff, it allows you to be more creative and freezes you up to do more productive things.

I had all these other things to do. Part of the OS is accountability. “Your accountability is this because you do these things at your accountable to.” That’s the other side of this coin that may be difficult for some doctors because doctors aren’t trained to go to business school. They’re trained to go to OD school or be a doctor. That’s something to keep in mind, how that all fits into where you are. If you’re not the manager or even if you are, and you’ll need a manager eventually, can that manager do that effectively? Can they hold people accountable? Have they demonstrated they can do that in the past and previous jobs?


If you are not the manager, you will need a manager eventually for your team. This person can hold people accountable for you.


I imagine you would recommend people to read Traction and see if they can implement some of the strategies or fully implement them into their practice. I’ve heard multiple optometrists say that it has helped them, although it is a pretty rigorous and intense process.

We hired an external consultant. There are a couple of consultants that are eye doctors that do this as well. A guy named Larry Golson, who’s a friend of mine. I know he does some of that. There are several other folks. I also recommend reading the book Simple Numbers by Greg Crabtree. It’s a very generic version of any business and how to look at numbers.

IDOC consulting group has good numbers and most of the consulting groups. There are a couple of other ones out there that are pretty good like Akrinos and Acquios. They all probably have these numbers. They’re usually pretty good to work with as a starting point. The price point to entry is not as high as some other consultants. They may be good places to start at baseline where you are with your business.

There may maybe some hesitation amongst colleagues to hire consultants like that. Maybe they think they’re too expensive. They don’t want to feel like they’re wasting their money on something but I imagine that’s going to be very valuable to have somebody come in from the outside and evaluate what you’re doing and help you streamline.

A lot of consultants are shifting to more of a monthly model which is a per-month subscription, which is a little bit more affordable for folks. It may be worthwhile to keep them on for a couple of months to do a quick deep dive into business evaluation, figure out where you truly are, and help a business partner figure out what the next steps are. If anyone reaches out to me, I’d be happy to have that discussion as another practice owner with a different perspective. I don’t do the consulting side. I don’t get into that side as much but I’ll be happy to share my experiences with anyone interested as well.

You have a wealth of knowledge having run the practices yourself and figured out so many of these back-end things that you’ve done. Every time I talk to you, I’m trying to absorb. There is so much that most of our colleagues could learn from having a conversation with you. Please do reach out to Ankit. Before I do this, I would be remiss if didn’t give a shout-out to our friend. Big thanks to Dr. Steve Vargo. I found you through his podcast, ‎Eye Own A Business. Go check out Steve and everything he’s doing. Go buy his books because he’s great. Thanks, Steve. Ankit, where can people find and get in touch with you to learn more?

MyBCaT.com. If you go to the website and say Book A Discovery Call, you’ll get me into a conversation. You can book straight on my calendar. Anything you want to talk about, I’ll be happy to talk about it.

We haven’t met in person but this is the third time we’re chatting. You’ve been great and open to having the conversation. I’ve learned a lot from you. Thank you very much. Any final words you want to share before we wrap up?

This is a fantastic industry and business to be in. I enjoy it. It’s nice because you’re doing something that has a real impact on people’s lives. I’ve worked in other industries where you don’t get that. I do appreciate that. I’m very open to connecting with people on LinkedIn, my website, or wherever. Feel free to connect with me. I’m happy to share anything. If I can share it, I’ll be happy to share it.

Thank you very much. I appreciate the time. Thank you, readers. Don’t forget to share this with your friends. Put it on LinkedIn, send them a text message, take a screenshot, and put it on Instagram. Please don’t forget to leave us a review on Apple Podcasts. I appreciate it. Thank you so much. I’ll see you in the next episode.


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