Optometrists Building Empires

OBE_Juawana Hall
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[00:00:00]

Ankit Patel: Today is someone I'm excited to learn more about with you. an award-winning clinician, educator, and community advocate to excellence, and both in and outta the exam room. She specializes in dry eyes, specialty contact lenses, and comprehensive family eye care. And she's known for a personalized approach, tailoring treatments based on her patient's lives.

Work in play with a focus on patient first care. is passionate about helping individuals of all ages, seeing more clearly and enjoying better ocular health. She's the owner and [00:01:00] optometrist of Hillcrest Vision, which has two locations. welcome Dr. Juawana Hall,

Juawana Hall: Hi.

Ankit Patel: Welcome.

Juawana Hall: Hi. Thanks so much for having me.

Ankit Patel: I, I'm excited about this conversation. I think you have a, a unique perspective on running some, your practices uh, with that, what's been the most important thing that's helped you grow your empire?

Juawana Hall: You know, I, um. I think it's funny that you call it an empire. I've never considered it an empire before, but I guess maybe it sort of is. Um, maybe one day it'll feel more empire like. Right. Uh, I think for me, the biggest thing has been to be very, very clear and defined about what my mission and vision is, and then share that with my team and include them on every conversation and decision.

That we make, we, we operate very much as a cohesive team where I am kinda knight of the round table style. I'm one person at the table [00:02:00] and, uh, every voice is equal. And, uh, when we, when we conclude our decision making and, and we've settled on something, then we come out of that room and forge ahead as a team.

Ankit Patel: I like it. Tell, tell me a little about what that means. Like, that sounds interesting in theory, but can you tell me some, maybe a story associated with it or give us, give, give us an example of what that feels like or what, what that might look like in practice?

Juawana Hall: So

Ankit Patel: Um.

Juawana Hall: We, um, as an example, we decided that we were going to put in an edger, uh, a couple of months ago, probably four or five months ago now. And as we were pondering that idea and just really trying to figure out. Is this something that's gonna be right for us? You know, I did all of my research. I was prepared, but I also told the staff, I said, look, this is something I'm considering.

I want you to think about it, research it, look into it, and we're gonna talk about it as a team. And we sat down, uh, my leadership team sat down and we talked about [00:03:00] pros and cons. We talked about implementation. We talked about ROI. And we all agreed that yes, this is the right way to go. And they had some blind spots that I really wasn't considering.

That helped me to change the way that we implemented, change our plan. Uh, I tend to be a person who's like, Hey, I have a great idea. Let's jump in. We're gonna do it tomorrow. And they really put p, you know, pushed pause on it and said, let, let's make sure that we implement this smoothly so that we don't promise more than we can deliver.

And so we, we held off originally, like the first time we had this conversation was a year ago. I. And I've never waited that long to implement something, but it just didn't feel right. We just didn't have the plan. Lots of moving pieces. A year ago we were also opening our second location, adding our third doctor, and they were like, this is a cool idea, but this timing is terrible.

Let's revisit, you know, farther down the line. And so we did that. And as [00:04:00] a result of that decision, our implementation was incredibly smooth and our ROI on, I mean, it's already paid for itself, which is absolutely incredible in four months.

Ankit Patel: What, what were some of the things that they caught that gave you pause and pause? Uh, pause the project.

Juawana Hall: Well, for one thing we didn't, so we were moving from two doctors in one location to three doctors in two locations. And in order to accomplish that, we were gonna have to hire and train new optical staff. And one of my key optical. People who would've been someone that I would've had run the instrument was going to be moving to the new location.

And so they were like, okay, well, like logistically, who's gonna do this? And I'm like, well, they say anybody can do it. And they're like, yeah, right. That's great. I'm sure that's what they say and I'm sure anyone can do it, but, but we do need some, you know, someone with some solid optical expertise. And the people that we have remaining in this office are going to be training new people.[00:05:00]

And so we can't train new people and start a new process at the same time. And they're like, we wanna do it a hundred percent. We don't wanna do it. 64%.

Ankit Patel: I like that. interesting, um, because I know as, as an owner, it might have felt like, well, why can't we just do it? Right? It's, it's, it's like it's just an edger. Guys, have jobs.

Juawana Hall: Yeah. And, and you know, looking back on it now that we're four months in. You know, the process is pretty straightforward. And if I had pushed forward and said, Hey, let's do this anyway, I think they would've figured it out and it would've been fine,

Ankit Patel: Mm-hmm.

Juawana Hall: There would've been a lot more concern and frustration.

There would've been a lot less confidence in what they were doing, and they would not have been able to devote the attention to it that it deserves. And so now we have an entire plan that they developed. For packages that we can offer, same day options that we can offer things I hadn't even considered that, you know, [00:06:00] our, our same day sales and, and on the spot edging and, you know, next day service.

All of those things, um, are happening a lot more frequently than what I had even originally envisioned.

Ankit Patel: Wow, that's fantastic. And, and it sounds like, you know, it's, it's, it's almost sounds like that, uh, I think it's an African proverb. Bu tu I think is what it, it is. Uh, if you want, I, well, for it's, I think that's, that, that one, and that's a different one. I'm gonna butcher this one. Um, I think theto means for many, for many, one or something to that effect.

But there's another one that says, if you want to go fast, go alone. If you want to go far,

Juawana Hall: Go together. Yeah. It's really funny that you mention that because, uh, I actually used that proverb in a talk that I gave back at IDOC in the spring.

Ankit Patel: oh,

Juawana Hall: Yeah.

Ankit Patel: Nice. cool. What was your talk? I'm just curious.

Juawana Hall: Um, it was basically how to go from single location to multi-site and, and kind of what we did, how the changes that we made and, and what the implementation looked like.

Ankit Patel: Nice. Yeah, that's um, uh, [00:07:00] that's actually something we're gonna get into next. I'm curious what you ran into when you went to multi-site that you didn't expect.

Juawana Hall: Um, I think the biggest thing for me is that, you know, we were very, very intentional about our culture and we made sure that we had culture carriers that went into the new office. We were very focused on that and sort of replaced them in what I would call our, our. Main home location. Um, and so those people went into the new office and they were amazing from day one, but then we had a whole bunch of new people in the home office that we had to kind of reorient.

I. Teach them culture. So we actually had a little bit of a culture situation because we had taken some of those, those people that were such strong culture carriers out of the original equation. And that, I mean, our team rallied, we had a good base of people, but there was just a ton of training that had to happen.

[00:08:00] And we, we have long said that, you know, excellence is average for us. We don't, we don't stand by. Good enough is good enough. We go above and beyond for our patients and a lot of people are just, that's not what they signed up for. And so, you know, we went through some turnover and found the right team.

It's very important to me that we have the right seats on the right bus, you know, in the right butts, in the right seats on the bus. And for us, that took a little bit of time, but we had the foundation, we had the systems in process. So it wasn't difficult to kind of multiply that into the new location.

What we found though is that even though the two offices are 25 minutes apart, the patient bases are very, very different. And although we were busy from day one, because we did move into a location that had really no, um, significant providers in the area, there was kinda a part-time doctor at the Walmart, but that's [00:09:00] all in this town.

So it was kind of ripe for the picking in terms of opportunity. We had a full book of brand new patients. When everybody is a new patient all on the same day, you know, 20 people a day. It's a whole lot of getting to know people. It's a whole lot of, you know, setting that groundwork and over and over again laying that expectation.

So even when we start out seeing less patients. Just to get our feet underneath us. It was, it was exhausting, you know, because you kind of light on the established patients that come back, they already love you, and you're like, okay, I don't have to like win them over this year. I can just carry on, pick up where we've left off.

Ankit Patel: Yeah.

Juawana Hall: So starting from scratch, all new patients is, it's, it's a little more tiring. And so I think there were, there was some of that that was struggle, you know, a struggle for us in the beginning. And then the, you know, people don't know who we are. You know, in, in, in our, in our home location, [00:10:00] everybody knows us.

We have a good reputation in town. Everyone was kind of wary initially, you know, when we opened the new office. And so the, the good news is that in a small town word spreads fast, and so if you're good, you'll grow fast. And I, I love small town optometry for that reason. It's really, really easy to be successful if you have the right priorities.

It's, it's a little harder in a, in a larger town where you have a lot more competition and, uh, and so they're kind of two different beasts. They're two different animals. And, and we do have to manage them with the same core values, with the same things that make us, us. And, you know, we want our patients to have the same experience in one location as they have in the other, but each office does have its own flavor.

Ankit Patel: Yeah, that's interesting. Um. That, that's, uh, and how far are the offices apart?

Juawana Hall: Uh, they're 25 minutes.

Ankit Patel: Okay, so 25 minutes in urban areas is pretty

Juawana Hall: Yeah,

Ankit Patel: uh, non, and you're, are you in an urban or non-urban

Juawana Hall: [00:11:00] so, so my, my home, my home office is in a small city, my kind of primary, uh, location. And then my satellite office is in a, in a small town.

Ankit Patel: So it's, it is, it is a very different, uh, model almost, uh, you're, you're going from. Probably someone with a decent amount of competition to being probably one of the sole care providers for medical and vision

Juawana Hall: Absolutely. Yeah. Yeah.

Ankit Patel: So that, that's, that is a lot. Uh, uh, more to, to do. I, I wanna talk a little bit about, was it an existing practice that you bought or was it one that you started

Juawana Hall: I started cold.

Ankit Patel: Oh, interesting. So you brought people over to be cultural champions that you had to turnover because they didn't meet your cultural expectations.

Juawana Hall: Well, yeah, no, so,

Ankit Patel: I hear that right?

Juawana Hall: So, so I moved people from my, my main office,

Ankit Patel: Okay.

Juawana Hall: Them out, moved them to the small office. They were great. They've been amazing. But then I had to replace them in the home office.

Ankit Patel: And that's where

Juawana Hall: [00:12:00] where the challenges came in and, you know, just, just helping. You know, people would come in, oh, I've been, I've worked in eyecare three or four different times.

And then they get in and they're like, wait, you, you guys do a lot. This is, this is more than I was bargaining for.

Ankit Patel: Yeah. Yeah. We, we, we've noticed that too sometimes. Sometimes there's gems. Sometimes it's, especially if they've had a lot of, um, only big box experience. It's a very different feel and environment that you're right about that level of care. It's just, you know, when you, we'll, we will go, I, I've been in several times with our offices.

When I was working more day to day, I would just take, I would drive the. Uh, the jobs to the patients sometimes. you know, and, and I'm sure you all did something similar, but that that was a lot of folks like what you did what, so yeah, it, it's, it's, um, it can be a challenge. So how'd you, how'd you solve that?

Like, can you talk about some tools or tips that, if someone's struggling with that now, how, how did you come overcome that journey?

Juawana Hall: So for us, I think that we had a strong foundation of this is who we are. Before you go in, like, you [00:13:00] know, we're gonna, we're gonna have your first day, you're gonna have a very easy thing that you learned to do, so that you have a good first day. What'd you, you know, how was your first day at work today? Oh, I learned this.

So the first thing we do is we teach them something so that they can go home and say, I learned this today. Not, you know, I filled out 10,000 pieces of paper. You know, or I watched videos all day long. Um, we, we want them to go home with a win on the first day. But the second thing that we do is we teach them this is who we are.

This is what we stand for, this is what we believe, and these things are posted all over our office and all of the non-patient facing areas. So in case you're not sure if you forget, these are, these are our rules. This is what we live by. These are our, our kind of code of, of standards that we, we hold everything up to.

So if you question something, come look at the list. Is it, if it's, if it's a no based on this list, then it's a no. Don't even, like, don't even go. And um, and I think starting with that, [00:14:00] starting with that why the, why we do what we do, the how comes a little bit more naturally. And so sometimes that's overwhelming for people sometimes, you know, you get someone in and they're like, I just wanna punch the clock and head out the door and, you know, not worry about doing a whole lot more than just being present and saying, hello.

Uh, that's just not the way that we operate. And it was very easy to see when you start training. Okay, this is how we answer the phone. This is the way we interact with our patients. You know, teaching someone that our patients are people first and beyond. You know, even that person that comes in in a bad attitude, like they walk in the door and you just know that they're like, they're hot.

You know what? You didn't make them mad. Something happened. You don't know. It could be that you know their dog died this morning. It could be that they got a flat tire on the way in. You have no idea. You have no way of knowing. So we're gonna treat everybody with dignity and respect. We're gonna help.

Deescalate when we can, when there's a situation. [00:15:00] Um, and, and then we're going to, to shift the focus back to them and how we can take care of them and make this part better because we can't always fix what's wrong with them, but we can maybe make, make the next hour a solid experience. And so we just, we have them have a buddy.

And that's probably been the best thing that we've done to kind of, I feel like things are more taught than taught. And so we have them paired up with a buddy. This is your buddy, and you're gonna shadow them. You're gonna listen to the verbiage that they use. You're going to, you know, they're gonna teach you how to do things as you go and, and we'll shift, slowly switch to you doing it.

And, and they become your shadow. But, but they have their buddy. That is their, their point of connection. And any questions, any, anything that you're not sure about, you know, this is your contact point. And that way they don't feel like they're on an island or just kinda left out there to sink or swim.

Ankit Patel: Gotcha. I, I like that it's a, it's almost like an apprenticeship type program.

Juawana Hall: is.

Ankit Patel: And, but it also makes sure that that person [00:16:00] that you like and knows they follow the culture, they're gonna be shadowing them and, and tied to 'em so they, they understand the expectations either subconsciously or overtly, right?

And so that's, that's kind of a neat system.

Juawana Hall: Yeah, absolutely. Yeah. And we tell people from the beginning, Hey, you're gonna learn a new language. Optometry is its own language. We speak almost entirely in acronyms and abbreviations. Everything is backwards and upside down. It is. It is weird and don't worry, because all of us learn the language too.

And so it's okay if you don't know all the, all the words on the first day, you'll get there. And I, and I think just encouraging people in that, helping them to understand that, you know, we don't expect you to understand the breadth of what you just walked into, but this is, this is like a, a, a dual immersion program.

And, and so you're just gonna have to get in here and, and kind of pick it up as you go.

Ankit Patel: Yeah, I think, uh, it's interesting 'cause it's funny, the first time I saw a, um, a plus sill, I was like, what is this? And I was like, wait, okay, wait, people do that. I was like, I guess that makes [00:17:00] sense. But yeah, things like that you don't expect, right? It is

Juawana Hall: Okay.

Ankit Patel: These little details.

Juawana Hall: Yeah.

Ankit Patel: Uh. And now if I was looking outside in, I might think that's a lot of time and money to train someone. Uh, you know, especially, I mean, you're taking someone else out who could be much more productive if they weren't shadowing, you know, that, that person. How does that, um, talk to me about that. Like, if, if I were to tell you that, what would you tell me and

Juawana Hall: I,

Ankit Patel: would you justify Yeah.

Juawana Hall: I would tell you that I can, oh, you know what, what if I, what if I don't invest in them and they stay? What if I invest in them and they leave? And that's happened. You know, I had an employee, she worked for me for seven months and then she got a job somewhere else. She was moving and, and it was gonna be an hour commute to my office.

So she got a job somewhere else and I invested in her and she got a better job as a result of that investment. But I look at it and go, you know what? She got me through the maternity leave of another. Technician that, [00:18:00] you know, without her, I, I would've been scrambling. So I'm grateful for the seven months that she gave me, and I'm grateful to move her, you know, let her move on.

And she's doing well and she's grateful for the opportunity to have worked with us. And, and, you know, we still have a great relationship even after, you know, she'll call me up and I, how you doing? How are things, you know? Um, I feel like. You, you pay it forward. You know, sometimes I get somebody, I, I got someone who came from another fantastic private practice in town.

She had, you know, been there for a long time. She left, she worked some other jobs and then I got her and she's a gem. She's an absolute rockstar. And I'm grateful for the training and opportunity that the last office did because it made my job so much easier. And so I feel like that's one of those things where you don't know.

You don't know if they're gonna, you know, you're gonna invest and they're gonna leave, but. What if you don't invest, and they stay, and then you're stuck with someone who's really has a lot of potential, but you haven't really tended that garden very well, and so you're [00:19:00] not getting a lot of that fruit.

Ankit Patel: Yeah, and how, I don't know, you feel free to share whatever you want to share. Uh, I like to normalize it to, you know, revenue or cost. Typically it's higher now, but the rule of thumb used to be non-doctor payroll is around 24% of, you know, revenue. Um, it sounds like you've heard of that. Are you in that ballpark?

Less, higher? 'cause it, people wanna kinda wanna know like, Hey,

Juawana Hall: Sure.

Ankit Patel: It gonna cost a lot to do that?

Juawana Hall: Yeah. Well, and it does. So, so we're at about 26% right now. Those are numbers that I track every month. Yeah, it's not bad. Um, inevitably, I feel like every time I hire someone new, that number will jump up to 28% for a few months. You know, while we kind of get that person trained, but then our revenues increase to match the training.

So, you know, my concern is if I'm, I'm, I'm going to pay my people, well, I'm gonna make sure that, you know, they're, they're not gonna leave me for 50 cents, you know, or something like that. [00:20:00] But, but if I need to bring someone on to improve the system, I have to make that investment ahead of time. So I have to be able to sweat 28, even 29% for a few months.

Until we can normalize it. But then once they're fully trained and I can see an extra couple of patients a day, and you know, we, we have a increased capture rate, increased annual supplies, all of those things normalize that pay rate. And, and we're very, very open with our staff, um, about our numbers. So, so we use EOS, uh, traction, that whole system and, uh, maybe not quite.

To the letter of the law. I implement most of the things, but I, I can't say that I am, I'm a hundred percent doing every single step of the process, but I love it. It's given us a fantastic framework for our team. And, and then we, we have, I, I won't say it's an open book, um, but our staff knows exactly what our revenue is.

They know, Hey, you, you know, we're at, we're at [00:21:00] 25%. We're at 26%. I can't go over 26%. So if we want, if we want raises, if we want more money, if we want another staff member, then, then we gotta work to get it down to 25, 24 so that I can afford to hire someone. Which will push us back to 26 for a few months until they're trained.

And we talk about that. We talk about, you know, cost of goods. We talk about, okay, you want me to invest in this new frame line that you think is so cool, great. Then I'm gonna need you to sell the living daylights outta some things so that I have it in the budget to buy this. Because as much as I have tried, I cannot seem to print money.

So, uh, I, I wanna invest in you, you gotta help me come up with the way to do that.

Ankit Patel: Gotcha. I like that a lot. Uh, it's also systematic, right? It's like, hey, this is, this is easy. This is a math problem.

Juawana Hall: Absolutely.

Ankit Patel: We do it.

Juawana Hall: Yeah,

Ankit Patel: I imagine, so you, it sounds like you do let in your, some of your folks into like at least some level of finances, right? So

Juawana Hall: yeah, yeah. I mean, they [00:22:00] don't have all of the numbers for everything, but they do know. What, like I said, if, if we're looking at, you know, oh, okay, it's time for raises. All right, well then we're gonna need to get these numbers to a point that, that I have the space in the budget to do that. Or, you know, with, with the edger thing, they were like, okay, so how much, how much can we, can we improve and lower our cost of goods?

Because my, my equation is cost of goods plus staff salaries is 50%. So I don't need to be at 25, 25 if I'm at, you know, 28, 22, like the math still works for me. And so we look at all the different ways that we can make that, um, that total number, 50% and, and go from there.

Ankit Patel: Nice. I like that. sense. Uh, actually it makes a lot of sense. So, um, as, as far as, um. What do you foresee as something that you're excited about that's on the horizon for you with, with [00:23:00] work and optometry in general? I'll let you start with either way, whichever one you wanna go with.

Juawana Hall: So I think with optometry in general, I'm super excited about scope expansion. And I mean, just watching that happen across the US I think that's really gonna change the next five, 10 years of optometry. I think we're gonna see, uh, kind of, obviously it's gonna go state by state, so there's that. But, but I think that I.

It's gonna be really exciting, particularly in small towns, to be able to offer a level of care to people that are not gonna have access otherwise. So that to me is exciting. Um, a lot of people get really nervous and worried about you, uh, telemedicine, taking away all of our patients and all of those things.

If anything, I have found, so we have a telemedicine office a half a mile from our home office. And I've had a massive increase in foreign bodies and emergency things. Diabetics who went in and tried to get an exam and [00:24:00] they can't, you know, all of those things. And so to me, I'm like, thanks, because they're actively referring, I.

To our office. So we went in there, handed them a stack of cards and I was like, Hey, if you've got somebody that you can't see, we're happy to see them. I'm not gonna say anything bad about your practice. Like, I'm, I'm not that way. Um, so to me that, that's been a really symbiotic relationship. And so that's exciting to me.

I'm excited about advances in scleral lenses and being able, so that's kind of my baby. Scleral lenses is the thing that I do that gives me such incredible. Passion in the exam room. If I, um, someone asked me, what if you could never see patients again, would you be okay? I'm an entrepreneur first and an optometrist second.

So I think I'd be fine, but the people that I'd miss the most would be my scleral lenss patients, because I feel like we've had just such an opportunity to change their lives. So seeing the advances in that technology, seeing that become more widespread, [00:25:00] more offices offering that. Being able to provide that level of care to people.

It, it's, it's fun. It's, and, and you build a patient for life, you know? And I think that, I think that, that, that piece of it is, is really exciting. There's some scary things on the horizon. Um, but, but I think that, that, that's really, that's really gonna be, it's gonna carry me to retirement anyway.

Ankit Patel: Fair enough. So tell me about some of the scary things. What are some of the scary things you see?

Juawana Hall: Well, you know, I think that I don't love the way that healthcare helps me decide whether or not I'm gonna treat a patient with a particular medication. You know, that I have to go, well, you know, we'll see which one's covered, and it doesn't matter really what my opinion is. It's. It's which one your insurance will pay for.

I, I don't like that. I, you know, I, I feel like we've taken the, the, the driver's seat away from the doctor and I, and I feel like that compromises care. And so I'm, I'm a little nervous to [00:26:00] see what the next few years bring in terms of healthcare reform. It could go one of 15 different ways, and I think 14 of them are probably not great, but.

We,

Ankit Patel: Yeah.

Juawana Hall: We'll figure it out. Um, I do think that patients are more aware of it, so, so in previous years it's been, you know, we're telling them that their health insurance is terrible. They don't believe us. Now, I feel like there's a lot more understanding of that. Patients are seeing that, and so they come in with kind of the expectation of, well, I'm not really surprised that they don't cover the refraction, or, I'm not really surprised that they don't cover IPL.

Uh, and I think that that's actually made it a little bit easier. It's not great for the patients, but, but it has made, it, made it easier for us to, to manage.

Ankit Patel: Yeah, it's, it's, it is, I think, um, you know, every market changes, so you're right. It's just a matter of adapting to new marketing conditions. So, uh, I, I, I like how you framed it as just excited about the scope expansion and opening up new [00:27:00] opportunities for, for doctors. Uh, so curious, right now, you know, there are challenges, reimbursements, you kind of alluded to it a

Juawana Hall: Yeah.

Ankit Patel: Um, staff. A lot of folks are having staffing challenges too. I'll start off with the reimbursement challenge. How are you, how, how are you dealing with that? I think you kind of alluded to some of the solutions, but I'll kind of hear your thought process on how you're, um, still able to maintain costs, are increasing, revenues are staying flat or, or going down in some cases.

How, how are you dealing with that?

Juawana Hall: It is, it's tough. I mean, I'm not gonna lie. It's a, it's a big challenge, but for us, you know, we are offering the very best solutions for our patients. And, and that has been from day one. We, we do personalized eyecare, and we're going to look at their lifestyle, look at their job functions, look at how they're, they're utilizing their eyes in their lives and offer them the very best solution.

Very best solutions often are not covered by insurance. And we're very upfront about that and we say, look, you know, this is what we think and this is why we think and [00:28:00] we've not had any trouble with, with getting people into those premium products, whether it be contact lenses or glasses, or whether it's a premium treatment option like IPL or low level light therapy.

Um, you know, those are, those are things that, that we've implemented over the past. I guess we've had IPL now for. Four or five years. And that has been a game changer for us just adding that and low level light therapy to, to give people an option to take care of their eyes in a different kind of way.

And, um, and so I think we have to embrace those things. I think we have to look at the ways that we can take care of people that do what's best for the patient first, and, and then the money will follow.

Ankit Patel: Hmm. I like that. And what about staffing costs? We, I mean, you kind of keep it pretty tight and pretty managed. How do you, uh, turnover, uh, pay raises, things like that? Can you touch on that a little bit more? I.

Juawana Hall: Sure. Uh, I think that for, you know, we, we [00:29:00] pay competitively and, and I believe that in much the same way that I am worth what I am paid. I think that my staff are worth what they are paid, and we try to encourage them and, and kind of give them additional carrots, ways that they can earn bonuses throughout the year that are tied to.

The metrics that we want to see move. And so, you know, we have, we have a, a goal each month. If we meet, if we meet our goal, they all get a bonus. And then we have individual incentives where, you know, for, you know, I never liked the idea of spiffs, but this is sort of a spiff program with a twist. Uh, so I don't like spiffs from, from the concept of it creates, uh.

Kind of some low level tension and competition between the employees, and we've always been a lot more collaborative. And so for us, we created a spiff program where, you know, every annual supply sales, $5, it [00:30:00] goes into the pot, every transitions, $5 goes into the pot, premium pals, ten second pair of sales, another five, you know, all these different things.

And we have metrics for every single area so that the front desk has metrics they can throw in the pot. The techs have metrics. Optical has metrics and so at the end of the month that pot gets kind of large and we divide it evenly amongst the team, and so they're all earning money for each other.

They're all sweetening the pot for each other, which is a great way to, for them to collaborate and not to compete, but also they know, Hey, if I do this, I'm moving the needle for myself. And that has been, that's been a great way to keep them engaged, to keep them excited about what they're doing. They're, they're invigorated by those little goals, those little tangibles, you know, to me, I like the big number at the end of the month, I'm kind of a bottom line person, but they like all those little wins throughout the day.

And so they, they post at the end of the, at the end of the day, they're like, you know, we [00:31:00] had, you know, eight outta 10. Contact lens annual supplies, guys, that was absolutely incredible. And they encourage each other with those sort of things, uh, which has allowed for a really collaborative environment where everybody feels like they have a piece of ownership.

And I've also given my team a lot of leniency. You know, each of them knows that they have $200 in their back pocket. They can spend that $200 any way that they need to, to solve a patient's problem or to meet a patient's need. And sometimes that has looked like, you know, we're gonna comp something that, you know, we, we screwed up, we're gonna solve it.

So they're gonna comp something. Sometimes it looks like they're going to, you know, send flowers because their husband just died. Or, you know, we're, we're gonna send a card around the office and everybody's gonna sign it because they just lost their cat. You know, little things that people do to reach out to, to wow our patients, and that allows [00:32:00] everybody in the office to have this.

This owner mentality, this, I can fix your problem. I don't need, I don't need approval. I can, you know, I can handle this myself. And I think that that translates to our patients and it translates to patient loyalty. But also, I mean, I've had staff look at me and say, look, I know it's your name on the bottom line, but I feel like my name's on that door too.

Ankit Patel: Wow.

Juawana Hall: And

Ankit Patel: incredible.

Juawana Hall: Yeah. And I'm like, I can't, I can't buy that. Like, there, there's no amount of money that can, that can be said that that's not worth so.

Ankit Patel: Yeah. Well, I, I think that's, um. Those are some really good media insights. So hopefully folks are taking notes when they listen. It's a rewind. I'm curious what makes you tick and so I always like to ask, can you share a story that's really impactful to you that kind of, it was formative for you, it felt like made you who you are today. It could have been when you were younger or more recent, but something that you felt as [00:33:00] visceral and like yeah, that that was impactful for me.

Juawana Hall: Yeah. Um, so my dad was an entrepreneur and he, he was a construction worker. He owned his own business and we were, we were a very kind of lower middle class family. Paycheck to paycheck, worked very hard. Uh, and then about six years into his business, my dad lost the entire thing in a fire. And of course six years in, he still had huge loans and lots of debt and it was really, really tough time.

But I watched him through that process and he immediately, you know, the next morning when he should have just been, you know, laying in his bed crying 'cause his life fell apart. He was out there looking for another job. He was talking to people on job sites. He was finding the next opportunity and he never owned a business again.

But he, he always worked and provided and, and served. And he, he said the, the same thing kind of that my employee said to me. He [00:34:00] was like, I don't own this business, but I treat it like it's mine. And that has always been so impactful to me because, because he did have it. He had, he had the business, he had the whole thing.

And I know that it can be taken away at any moment. I know that I am not the linchpin. That is Hillcrest Vision. I am a piece in this wheel. And at any moment that can disappear. So I have to honor the opportunity that's been given to me. I have to steward this responsibility, steward the people that I have the privilege to provide a workplace for, and, and hold very, very firmly.

The, the weight of their families depend on this income that we are providing for them. And, and their livelihoods depend on it because it, it otherwise Kim, it can be gone in a moment. And I feel like that [00:35:00] has, has really kind of guided me in this whole process. You know, my dad looked at me when I was in high school and he said, you know, I want you to get your education.

I don't want you to have to depend on anyone. I want you to be able to stand on your own two feet and make your success happen. And that. That's one of those moments where like, I remember where I was standing. I remember where that conversation happened. Uh, and I feel like it has been foundational for me just to see the way that he rose from, from that failure, from, from the ashes, literal ashes, um, of that, of that fire and, and how he carried on and lived his life.

And, and if my entire building went up in smoke tomorrow, I feel like I would, I'd respond the same way I.

Ankit Patel: That's a, that's a really, I think it's a really impactful story. 'cause you're right, it's always like, Hey, how do you, how do you get folks to get ownership? It seems like you've kind of [00:36:00] translated that to other folks too. It's neat to see.

Juawana Hall: It is been, it's been fun. It's not always easy and uh, sometimes I say that we've been successful because we've made every mistake you could possibly make. So we've just run out of mistakes to make, um, but we're still finding ways to make mistakes. We're far from perfect, but. But I think that that's, that's the kind of attitude that, you know, if you walk in and you have that level of respect for your staff and you have the, the leniency, like I, I give them breadth to do what I need them to do.

I don't micromanage them. I'm like, if you have a better way, if you have a plan that's different, like let's talk about it. Let's implement it. Let's test the theory. We run experiments all the time. I'm like, all right, let's try this for a month. We'll report back in a month and we'll see how we do. Let's test the theory.

I'm an, I'm a scientist, so let's run an experiment. And every time we do that, we learn something, whether it worked or it didn't. We learn something. And I think, I think far too [00:37:00] many people will listen to podcasts or go to lectures or whatever, and they'll sit there the entire time and think about why this won't work for them.

Ankit Patel: Hmm.

Juawana Hall: And why? Well, that's, that would never work in my office. Like I know, I know they said that worked for them, but that's just, here's eight reasons why my people would never do that. And my response to that is, do you know, do you know for sure? Have you tried it? Because if you haven't tried it then, then you're just hypothesizing the negativity.

And so I think you have to, you gotta test the theories, give it a shot, and then, and then you can tell me it didn't work. But don't tell me it's not gonna work if you don't ever at least shoot the ball.

Ankit Patel: Yeah, I think that's, um, that's a really good insight. You know, it's, uh, what is it? I forgot who said it. You know, it's easy to fool people and you're the easiest person to fool

Juawana Hall: Yes.

Ankit Patel: Yeah. I think, I think it's Richard Fineman. I wanna, I'm not sure though.

Juawana Hall: I have no idea, but it's a good quote.

Ankit Patel: Yeah. Yeah. I don't [00:38:00] know. I figured you might appreciate that.

I

Juawana Hall: Mm-hmm.

Ankit Patel: Like you scientific method.

Juawana Hall: Yes. Yes.

Ankit Patel: Knowing what you know now, take me back to a week after you graduated OD school. What advice would you give your younger self?

Juawana Hall: Don't be afraid to bet on yourself. I think.

Ankit Patel: More.

Juawana Hall: Well, when I came out of optometry school, you know, the first day of orientation, they had us draw this picture of what did you want your life to look like three years from now, five years from now. They gave us crayons and construction paper and we drew this whole thing out and, and of course, you know, what did I know as a first year optometry student?

But I drew my little pictures and then as I graduated, I drew the pictures again. And in every one of the pictures I was an associate. Three years, five years, 10 years. I was an associate. I never saw myself as an owner and I didn't know that that entrepreneur was in there. I. [00:39:00] Until I started working for a couple of years, I worked, I worked in ophthalmology for three years before I opened my practice.

Uh, and, and I looked at it and I had a great, great first work experience at a, it was a three location, six doctors. I was the only od. They treated me very, very well, but I just had this, I have ideas. I have ideas, and I think I can do this myself and. It's harder to move the ship when you, when you're not driving it.

Right. Um, and especially when it was that big, I feel like it was, it was definitely harder to impact, you know, when I'm the only OD and there's, you know, six ophthalmologists and they're all concerned about surgery. Um, and so optometry was like, okay, yeah, I do your, do your refractions and you know, carry on.

And so I left and I was just like, at this crosswords, do I become another associate? For someone else, or do I just do this on my own? [00:40:00] And I took the step and I bet on myself and, and to give you context, it was January, 2009 when I opened my practice. Looking back, not the best time to open a practice.

Ankit Patel: Almost as bad as the folks who started February of 2020,

Juawana Hall: Yes. Yes. Those that is

Ankit Patel: yeah.

Juawana Hall: Very similar. Uh, I signed my loan papers in November, the day before Lehman Brothers declared bankruptcy, and the whole thing started, but I was already signed it in and I was like, well, we're going. And, um, and so it was a rough start. It was, it was a long road, but I bet on myself and every single time.

I was like, there's too many people. I can't, I can't fail. This is not gonna fail. That's not an option. I've got kids to feed. This is not a choice. You know, and, and I think far too many people look at, particularly now, you know, students are coming out two, $300,000 in [00:41:00] loans and they're looking at that number and they're going, oh my gosh.

Like I couldn't possibly buy a practice. I couldn't possibly cold start a practice. You know, there, there's just no way. I cold started that practice with $200,000 in loans and I took out a $500,000 loan to start the practice. So I was $700,000 in the hole when I began, and I. You just do it because you're investing in yourself, right?

That that loan payment is an investment in your ability to provide for your family. It's an investment in your ability to do the career that you love. And it's no different than buying a mortgage, right? We, we all buy our mortgages and we pay that payment every month, but we get a nice big house to get to live in.

And we don't fuss about our mortgage payment because we see it. And I think sometimes people, because they can't see the investment, they get scared about it. But I've seen a lot of practices in my 20 years. I've [00:42:00] consulted with a lot of practices, um, talked people down from a lot of ledges, and it's really hard to fail at optometry.

Like you can screw up a lot and still be successful in optometry. Sometimes it blows my mind, uh, the practices that I'm like, wait, how are you? Like, how are you still in business? And so I feel like this is. This is a softball when it comes to being an entrepreneur. You know, it, it's work. I'm not gonna deny there's lots of work.

You gotta love it and you gotta love it more than you love the money. But if you want it, you can do it. And, and I think that your, your head will just get in the way.

Ankit Patel: Uh, it, it's interesting 'cause uh, I tell people all the time, I was like, this is a great industry. So it's, it's, it's, uh, I've been in other competitive industries. My background's not in, um, um, not in optometry medical side, but, you know, engineering and other businesses and it's, it's definitely, definitely a good business.

And, you know, patients, it's, it's nice because it's, nothing, you know, [00:43:00] it is usually not unethical. It's, you're helping people out. It's

Juawana Hall: All right.

Ankit Patel: And it's just, it's just a great all around thing that you can do. So.

Juawana Hall: I mean, you're, you're, you're, you're making people see, you know, you're helping them to see better. You are changing their lives, and I think that the more that you can. Really hold onto that and instill that in your team. You know, that's when, that's when it gets really, really sweet. I, I have one patient, um, she, she came into me.

She's keratoconus patient. She came for a scleral fit and we put her lenses in. She burst into tears.

Ankit Patel: Oh

Juawana Hall: I mean, just completely sobbing in the office, hugging me and just, you know, so excited. Brings her children in to make sure they don't have keratoconus. You know, her sister and her mom are now patients.

You know, this, this lady's an advocate for my practice, and she had a, she had a bill. You know, where insurance kicked something back. And so my billing person called her to [00:44:00] let her know, Hey, you know, insurance kicked this back. I just wanna let you know this is what this bill is for. And she found out that the lady had had, uh, an episode of acute hydro drops and had perforated her cornea and she was getting ready to have corneal transplant surgery two days from, from this phone call.

Ankit Patel: Yikes.

Juawana Hall: Yeah. Big. Yikes. And so she, she, she shares all of that with my billing person. And then, and then my, my billing person comes to me and she says, would it, would it be okay if I call her the day after her surgery and just see how she's doing and make sure she made it through surgery? Okay. And just see if there's anything we can do for her.

You know, maybe we could send her like a DoorDash, you know, something. Uh, just to kinda help her out. 'cause I just feel bad. She's had a rough go of it and I was like, absolutely you can do that. You know, you can do that. And, and that's the kind of investment, that's the kind of attachment that, that you wanna have.

[00:45:00] You wanna have team members that are willing to, to make a phone call to a person completely outside. You know, my billing person has no medical background, you know? Um. But she cares about this person. She cares about how she is gonna, is gonna do after a surgery, you know, and, and that's the kind of culture that changes things for people.

That's the kind of culture that builds an empire.

Ankit Patel: I like that. Yeah. Well, on that note, I, I, you know, and on the high there, Juawana, where can people find you and connect with you?

Juawana Hall: Um, so you can find me on LinkedIn. That's probably the easiest place. Uh, I try to stay off, uh, the other social medias as much as I can because it's kind of a black hole. Uh, but, but yeah, you can connect with me on LinkedIn, of course, and, and then, uh, certainly more than happy to have anyone reach out anytime.

Ankit Patel: Awesome. Well, we'll put that in the show notes as well. Uh, thank you Dr. Hall [00:46:00] for, for being a guest on the show. I.

Juawana Hall: Sure. Thank you so much for having me. This was great fun.

Ankit Patel: Yeah. And thank you audience for listening. If you liked, uh, laughed or Learned something, please like and subscribe to the YouTube channel or the podcast. Again. Thank you, Dr. Hall. This has been another exciting episode of Optometrists Building Empires. We'll see you next time. Thank