The Optometry Money Podcast

Tackling Conflict Head-On To Improve Your Optometry Practice with Dr. Bethany Fishbein

• Evon Mendrin • Episode 101

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On today’s episode, Evon is joined once again by Dr. Bethany Fishbein to talk all about how to push through conflict and confrontation to improve your optometry practice and your career.

Ultimately as business owners and professionals, or just when working in a team, there’s going to be a time where conflict comes up or uncomfortable conversations need to be had - with team members, managers, patients, or vendors. 

And avoiding that conflict can lead to issues with patient care, profitability, the culture of your practice, your stress as an owners, 

Bethany and Evon dive into all the different places this shows up in your business, how avoiding important conversations impacts patient care, your practice, and your career, and how get better at tackling conflict head on. 

Have questions on anything discussed or want to have topics or questions featured on the show? Send Evon an email at podcast@optometrywealth.com.

Check out www.optometrywealth.com to get to know more about Evon, his financial planning firm Optometry Wealth Advisors, and how he helps optometrists nationwide. From there, you can schedule a short Intro call to share what's on your mind and learn how Evon helps ODs master their cash flow and debt, build their net worth, and plan purposefully around their money and their practices. 

Resources mentioned on this episode:


The Optometry Money Podcast is dedicated to helping optometrists make better decisions around their money, careers, and practices. The show is hosted by Evon Mendrin, CFP®, CSLP®, owner of Optometry Wealth Advisors, a financial planning firm just for optometrists nationwide.

Evon:

Hey, everybody. Welcome back to The Optometry Money Podcast, where we're helping OD's all over the country. Make better and better decisions around their money, their careers, and their practices. I am your host, Evon Mendrin, Certified Financial Planner(TM) practitioner, and owner of Optometry Wealth Advisors, an independent financial planning firm, just for optometrists nationwide. And thank you so much for listening. Really appreciate your time. And on today's episode, episode 101, I am joined once again by Dr. Bethany Fishbein. And we talk all about how to push through conflict and confrontation to improve your practice and your career. Ultimately as business owners and professionals, or just when working as a team. There's going to be a time where conflict comes up or uncomfortable conversations need to be had with team members, with managers, patients, vendors. And avoiding that conflict can lead to issues with patient care, profitability, the culture of your practice and your stress as practice owners. So Bethany and I talk about the different places this shows up in your practice, how avoiding important conversations impacts patient care, your practice and your career, and how to get better at tackling conflict head-on. And I'll put all of Bethany's new, updated contact information into the show notes, which you can find at the education hub at my website, www.optometrywealth.Com. And while you're there, check out all of the other resources and episodes we've done. And if you're curious about what it looks like to work with Optometry Wealth Advisors, you can schedule a no commitment introductory call, and we can learn about what's on your mind financially and share how we help optometrists make better decisions around student loans, proactively plan around taxes, make prudent investment decisions and so much more. Without further ado. Here is my conversation with Dr. Bethany Fishbein. Welcome back to the Optometry Money Podcast. I am your host, Evon Mendrin, and I am thrilled and excited to welcome back to the podcast, Dr. Bethany Fishbein. Bethany, thank you so much for coming on.

Bethany:

thank you so much for having me, Evon. I'm excited to be recording on a podcast again.

Evon:

Once again, yeah, and you are, so you are formerly host of the Power Hour Optometry Podcast, formerly CEO of the Power Practice. What are you up to now?

Bethany:

Yeah. So, I left the power practice in January of this year, and unfortunately the Power Hour Optometry Podcast goes with it. So I had to give that up as well. what I'm up to now is I am still doing practice management consulting, just working independently. I'm doing some writing. I'm doing some speaking coming up and recently certified as an executive coach, which I'm super excited about and can't wait to use to benefit our, our industry.

Evon:

Awesome. Awesome. Yeah. And you had mentioned that this is the first public appearance, sort of announcing that, right? So you heard it here, folks. This is, this is breaking news, uh, this new direction you're taking your career, which is fantastic. I think a huge benefit to, to optometry, to, private practice ownership. I think it'll be a huge benefit. And. in our conversations, Bethany, and just, and just things you've mentioned to me and, and me thinking through my own experience, I think you and I have come to realize something. And that is that, in business ownership, in working and leading teams and just working with groups of people in general, in relationships, there's a lot of room for conflict. Or at least things that we perceive as conflict. And there are times that we have to have uncomfortable conversations with people, with co owners, with, team members, with patients or clients, with vendors or, or business partners, and. The thing about uncomfortable conversations is that they're really uncomfortable and easy to want to avoid. And I've definitely seen this in my own personal relationships. Not, not necessarily in business, but in personal relationships I've seen where, rather than engage in a uncomfortable conversation or quote-unquote conflict with family or friends I'm more willing to just stay silent and kind of wait for the moment to pass, right? I'll just wait the storm out and wait for it to go away. And and you had talked to me about things you've seen and how conflict or conflict avoidance can negatively impact optometry practices. And, and as I prepared for this conversation, I just saw that, more and more about how common that is in businesses in general and just organizations in general. So talk to us just about what you've seen in terms of how conflict or perceived conflict can show up in an optometry practice and how you've seen practice owners respond to that type of conflict.

Bethany:

comes up in so many different ways, and something that I've seen practice owners do is almost take on, I'm non confrontational, or I avoid conflict, I hate conflict, as a, as an unchangeable character trait, and use that to explain a way in which why all kinds of things are happening or not happening around them. So things that they might perceive as confrontation are, some of them are obvious, like a situation with a staff member, something's happening the way that they don't like, or they don't want it to happen. And exactly what you said Evon, they, go and, just go about their day and choose not to deal with it. I've met practice owners who will go in their office and shut the door to avoid having to have a difficult conversation with a staff member. So those are kind of the, that's the obvious one. That's what people think about, but they take it further and they consider confrontation to be coming up in encounters with patients. some are confrontations. An unhappy patient, you cheated me out of my money. Okay, that's, that's a legit confrontation. But, even talking to a patient about a difficult diagnosis, breaking news that the patient might not believe at first. Talking to a patient who's not following the treatment regimen you recommended. Even telling a patient something that they weren't expecting to hear. Like, here's treatment or management options for your myopia, here's treatment for your dry eye, when they know that the patient was expecting to talk about drops or glasses. So, it becomes about presenting fees, and then in all kinds of personal interactions as well.

Evon:

So interesting. It, it, a lot of times can come out where an owner can take on the identity as someone who like they, they put upon themselves this identity as someone who's, who doesn't like, conflict or, or, or anything like that. And so they'll avoid that by sometimes literally a physical barrier of closing the door or just, or just, avoiding tough conversations altogether. Rather than seeing this as something that they can improve about themselves and the way that they handle their, their business and improve about their, their skills. And, and you've mentioned it shows up in staff conversations and in team conversations. It shows up in patient care, even to where they're reluctant to provide the care that the patient actually needs because it's, it's uncomfortable. It's, they, they'd rather not, have that kind of, conflict in their, in their conversations. clearly it can impact the patient. I mean, clearly it seems like it can impact the patient not getting the care they need, but How can this impact a business if these kind of conversations are avoided? Like, what, what have you seen there?

Bethany:

In the business, everybody has different jobs to do, and the practice owner's job, or in some cases the manager's job, is to lead the team, to set direction, to course correct when things are off. So, having conversations with someone who might not agree with you, is part of that job. When the leader isn't doing it or is avoiding it or is doing it but only because they have to and they hate every second of it and so they haven't put the effort into learning to do it well, then the practice is kind of functioning like a football team without a, without somebody calling the plays, right? If it's like kind of go out there and do your best.

Evon:

All players are running their own routes. Yeah.

Bethany:

and everybody's doing their own thing. So, the practice is not achieving goals. It's hard to implement new technology or new procedures or new process. things aren't getting done. Sometimes the practice owner is doing everything themselves because they don't want to have a conversation. The Money, the pricing isn't, they're not getting the deals they should be from vendors. They're not charging patients what they should be. Nobody's running the show. And more often than not, that practice owner is unhappy because they're putting all this work in. They might be working nine, 10 hours going crazy to just get everything done and keep all the balls in the air doing not only their job, but everybody else's. and not seeing the return that they should be seeing.

Evon:

And it sounds like what you described, I mean, it impacts a lot of places in the, the owner's just relationship with their business and their enjoyment of going to work each and every day. their stress levels, it impacts the business financially and the owner financially, because they're, potentially not getting the revenue that they should for the services that they provide, or their costs are higher than they need to be sometimes. inefficiencies in a business because hard decisions aren't made to improve it. you know, potentially loss of staff down the road because staff end up leaving because these decisions aren't, aren't, these conversations aren't had. So it definitely seems like this, this, not being able to get comfortable with what's uncomfortable can impact a lot of places in a business. And it's interesting what you said in that it can lead to, rather than rather than me looking at the problem directly, which is just me not being comfortable having these conversations, it can turn to me as the owner, making it about something else. Like you said, it's, it's about, it's about the prices. Like I'm just uncomfortable, you know, showing the prices or the patients don't like the pricing or something like that. Rather than, well, no, it's just about me not being comfortable having difficult conversations. And. At times, it may not even be difficult to the patient or to the team member. It's just sort of in our heads, right? It's just sort of head trash that we, we can kind of tell ourselves. Like, do you, do you see that?

Bethany:

So much of it is that. So, something that you said in there, that yes, the, the practice owner, it is so easy to blame anything and anyone else, right? I can't get good staff people. The last six people I hired haven't been able to learn and still, even after two years, keep showing up late. Well, what do all six of those people have in common? They all work for the same guy, right? So, you know, my staff can't sell this. My optical can't do CAPS rate. My patients won't accept that price point. And Really taking that step to look and see how much this is you is super valuable, because unlike height and hair color, conflict is not a fixed physical trait. It's something that you might not enjoy, you might not be naturally, like naturally aligned with. But, it's, it's a skill. And that's the thing. Going into optometry school, none of us had the skill to diagnose an eyeball, to fit a contact lens, to come up with a prescription. And we spent all this time learning it. This is something that can be learned also.

Evon:

Right. Rather than putting that identity on yourself as just someone who doesn't like it, you can Take on the identity as a business owner and leader who, who's willing to improve and just think of this as something that needs to be improved on. Cause, I think the average person is probably uncomfortable having uncomfortable conversations. And I think that can be perfectly natural with most people, right? And so that is a skill that we can improve on as, as owners, as, as leaders. That's people in relationships and in teams, we can improve on and get better at. And, and it's, it's so important because of all those different parts of a business and just your life and stress levels that, that you just mentioned, Bethany, I, I was reading through a Harvard Business Review kind of in preparation for this, and it brought up some really good points. And I'll just kind of list them off here and get your thoughts on it. And part of it, the way that described it is part of it is coming from, the leader or owner is just uncomfortable with conflict or hard conversations. another part of it that they mentioned is that we are really overly enthusiastic about creating this sort of happy, engaged team or workforce. That we sort of overly cater and are overly uncomfortable with, with conflict. so some of the clues of conflict avoidance that they mentioned was, we, you know, the least bit of discomfort in a meeting causes someone to suggest that you should take it offline or take it elsewhere, you know, have a meeting after the meeting. We don't want to talk about that. That's uncomfortable here, right? Let's, let's not bring that up. Allowing priority lists to balloon for fear of saying no to anyone, which I would imagine it leads to a lot not getting done, creating unfair and inefficient workarounds rather than dealing with an unproductive team member, which is hugely important and not directly addressing an unproductive team member, but also just not having the, training conversations to improve that team member's performance. I think a lot can be said about that. And then employees letting their frustration and resentment toward one another fester rather than working through it, which I can imagine is Deadly for any relationship. Like I can just think through my wife and I, if we didn't communicate hard conversations or hard topics, like the amount of resentment and just frustration that would build up, would be really bad to that relationship and imagine that in a business where you're relying on these team members to, to work and work as a team and, to show up every day and, and to perform, you know, what that sort of festering frustration and resentment can, can do, you know, as much as we talk about like compounding interest and compounding returns. Well, frustration and resentment compound too, and the cost down the road can be much worse than having that tough conversation early on. Do you agree with some of these points? Like, what are your thoughts on some of these points? I

Bethany:

agree, and I've seen it in many practices, honestly, including my own, because this is something that evolved on tremendously. And if I think back to the leader I was 24 years ago, 23 years ago, when we opened our practice, and even to the leader I was 24 hours ago, there are always things that you can look at and and piece apart and want to do better next time, because this is ongoing in life. I think you're always dealing with things that are wonderful, balanced by things that aren't as good as you need them to be, and you can't always control the things that aren't as good as you need them to be. But you absolutely can control how you're handling them. So you can't control a staff member doing something you don't want them to do the first time. You can control how you're going to deal with it. Are you going to go hide in the back? Are you going to ignore it? Are you going to talk about it immediately? How are you going to talk about it? if you don't know how to talk about it, are you okay with that? Or, Are you going to learn and get better at it? So these are things that can be improved, but there is a, a combination. You gave a list. I'll add people just don't know how. So, by the time they think about how do I have this conversation, the situation has passed, and then you feel silly a week later, 10 days later, thinking about how you put 10 days into addressing this thing. Now you can't even talk about it because it happened so long ago that it feels ridiculous to bring it up. So you'll just wait for next time and repeat the cycle. I think the, the desire to be liked is important. And something that I've heard from multiple people recently is that because there's a lot of emphasis in our industry, in our literature about building positive culture, They're afraid to do anything that they feel would be un positive, right? If I address this, then I'll ruin the positive culture. But a culture where everybody's doing whatever they want and getting away with it and the team is not winning isn't a positive culture either.

Evon:

Yeah, I would even say like that festering resentment that's unsaid between your team can kill whatever culture you're trying to produce. You know, that, that will destroy whatever positive culture you're thinking is, is being produced. You know, that sort of festering resentment and frustration that goes unsaid, I think can easily destroy whatever you're building in

Bethany:

Yeah, and there's like long term, sorry, there's long term versus short term thinking here. So in the short term today, in this minute, it is absolutely easier and happier to not deal with this. However, not dealing with it today creates bigger problems down the road. So it will destroy the culture Eventually. depending on how badly you're doing it, sometimes quicker, sometimes longer. And so you're, sometimes it's a conscious decision to say, I'm not going to deal with this, But you have to look at it as a short term or long term decision.

Evon:

Yeah, and it's this sort of avoidance of this uncomfortable stuff is a good way to put off hard decisions. And, you know, imagine if your, your patients just didn't come in when they had issues with their eyes. You know, they didn't, they didn't want to hear what you had to say. They didn't want to get the advice from you on how to improve their eyesight or, or, or solve the, the issue, the medical issue with their eyes, I'm sure as a practitioner, you optometrist would be pretty upset with that patient. You would say, why didn't you come in earlier and help us so we can help you address this? Well, That same thing's happening when you sort of avoid these uncomfortable things in, in life and in business. And, and so we, we've talked about all the ways this shows up and all the ways it can impact a business. How can a leader or practice owner sort of self evaluate and say like, okay, I need to improve in this area. And then how can they start to improve it? Cause I don't think it will solve all the issues here in this episode, but how can they start to improve that?

Bethany:

That self awareness comes first. Is this really about them? The staff, the patients, or whatever? Or is there something that I'm doing as a practice owner that is maybe contributing to this? Practice owners who don't see any role of themselves in this, and it's all everyone else's fault all the time, are going to be really, they're going to struggle with this forever because you have to get to that realization first. of some of this is me. So to me, that's number one. If somebody came to me, you know, my staff, my patients, my this, my that, and I said, oh, you know, you think maybe you could have a role in this? Absolutely not. I'm perfect. That's somebody who's probably not coachable. They're not going to be a great consulting client. They're not going to make it better. And I see some of those personalities kind of manifesting online. You don't know people for real, but you see what they post over and over and over. And I'm like, yeah, okay. That's one of those. Once somebody sees it, they have to be able to acknowledge that. Okay, there's a situation here. If someone knew how to deal with this, I'm pretty sure they could resolve it. Just in this practice, if I look around, no one knows how to deal with this, including me, right? So, you know, it's a, an exercise. If somebody was hired to come in and fix it, or the practice owners who say, I'm so frustrated, I just want to sell to PE, Okay, if you sold, what are they going to come in and do? Well, they're going to get rid of Brenda and okay. Right? So sometimes it's easier to take it outside of yourself and not think about what you have to do, but what would somebody else do or how, how would somebody else handle this? So then you get a pretty good idea from that of here's what needs to be done. Where are you starting as far as being able to deal with it? And kind of how far do you have to go and then you can go into a framework of getting better at dealing with conflict or confrontation. When somebody comes to me with one of those situations, something that I'll ask them first is, okay, taking the right words, politically correctness, worrying about offending somebody, take all of that out of it. What do you wish you could really say to this person if you didn't have to worry about the after effects? And usually they say something, there's a couple of curses thrown in there and some colorful language and it's, you know, why can't you just get your whatever together and do this, this, this, and this? And why do you have to be so So it's like kind of a, a freeing session because people feel like they have to say it just right. And when you get to that actual conversation, you kind of do, but just what is it you really wish you could say? And it's helpful. You can do that with a coach. You can maybe do it with a colleague. You could probably do it. in a journal or, you know, there's ways to do that. What do you wish you could say? So now we've established the point that they're trying to get across. And from that, if you said it to somebody just like that, what would happen? They would probably be shocked and offended, and they might get up and quit. Right? So you can't do that. So let's talk about how you're actually going to say it. And here, people have to do some self awareness work and figure out, what are they What are they afraid of here, right? Is it, are they worrying too much about the relationship they have with this person? And they're so afraid that the person's going to be hurt, that they're not going to tell them the truth.

Evon:

Hmm.

Bethany:

the thing that's popping into my head at the moment, we had a staff member years ago, like 15 years ago, and I still remember, and she said, one day she said to me, do you have patients scheduled this afternoon? And I said, yeah, of course. Why? Like, of course. And she says, oh, and, and was like weird about it. And I said, why, why are you asking if I have patients this afternoon? Well, and she's hemming and hawing. So I had lettuce in my teeth. So afraid to have that conversation. So that kind of became our euphemism. When somebody had something in their teeth, there is a code for it. But anyway, yeah. So, you think about how am I going to actually say this, and sometimes it's a little bit of prep work or rehearsal, not that you need a script going into a conversation, but you want to make sure That you at least are going to get your main points across in the way that you want to get them across without being afraid of hurting someone, without apologizing, without, you know, taking too much on yourself. Just, hey, Here's the issue that we're having. We want to be aware of it. So, that's, that's next. Once you do that, now you've established what the problem is, and you want to put you and the person that you're talking to, ideally on the same side of the problem, right? You guys against the problem rather than you against each other, right? Not, you can't sell glasses, It's worth your life. It's our capture rate has decreased 5 percent a year over the last three years. We're well below the national average. It's something that we need to talk about. So it's you and your optical manager fighting the capture rate. Instead of, I noticed you all of a sudden stuck at selling glasses because it's going to be received differently.

Evon:

Interesting. So make it a common enemy rather than personal, sort of a personal attack. It sounds like, yeah.

Bethany:

Yeah. So even, you know, there are things that could easily sound like a personal attack, right? You're late every day. In an initial conversation, you can acknowledge We need to figure out the issue with you getting in on time because when you're not here on time, you're missing our little huddle in the morning and you're, you're going into the day without the knowledge that everybody else has about the patients. So help me understand what we can do to get you here. And sometimes that leads to a positive answer. Like, well, you know, really the issue is like my kids and I have to put them on the bus and the bus comes late and it's okay. If we started you at 9. 30 instead of 9 o'clock, would that fix this? Well, I'd still miss the morning meeting. Yeah, you'd miss the huddle. What could we do about that? What if we have this guy in the huddle just be responsible for letting you know? Or what if we put post its on the key patients that you need to be aware of? Yeah, then I'd know. And all of a sudden, together, you've created a situation, a schedule that works, you've addressed the problem of not having the information, and you've come up with a workable solution. so, yeah, you and the person kind of working against a common enemy.

Evon:

Hmm.

Bethany:

Once you've said your initial piece, my next bit of advice is then to shut up and listen. Help, let the person help you figure out what's going on. So our capture rate is, is down, it's dropping 5 percent a year. It's something we need to address because if that, if we can't get that back up, we're losing profit, we're going to have to make some tough decisions about staff. Help me understand what's going on. Stop,

Evon:

Hmm.

Bethany:

because there might be things that come up that you didn't know. Well, ever since that big factory in town started giving their employees gift certificates to go to this online site, their employees aren't buying. Oh, okay. How are we going to address that? So that's the owner only sees what they see. There's probably something going on that they don't know. And because of that, one other piece of advice that I give owners is you can't prepare for all of the potential answers. You've got to prepare your initial statement, I guess, to get your, get your point across, but you can't prepare for, well, what if they say this? And what if they say this? And what if they say this? There's no way to know what they're going to say. And now you're putting the entire burden of solving this on yourself. leading to that stress, that overwhelm, that burnout, instead of letting your staff member work with you to come up with a solution to the problem.

Evon:

Right. Interesting. It's, I like what you said about taking yourselves out of your own shoes and sort of out of the emotion that you're feeling and saying, well, if someone bought your practice, like what would they do? Well, they would, they would do this and you kind of think of it more objectively rather than sort of like in the state of mind that you're in. I really liked that. And, and then you go through this process of, of, Letting out some steam, you know, getting the, that's really a huge benefit of having a coach like yourself is getting just out of your head what you're thinking and then you can start to shape the communication to be more appropriate to, to the situation. And it really does seem like it's this combination of. Asking enough questions to get down to the root cause of something. Enough questions to go beyond the surface level. And, and even if the root cause is yourself, you have to ask enough questions to get to that point. something that comes to mind is there's, there's a book called The Lean Startup and they talk about in the book, this process of the five, the five whys in this method of like getting down to a root cause of something, and that you, you need to ask"why?" five times at least to get down to what is really the root cause of an issue. You know, if, if there's an issue with the patient, why did that happen? Well, this, this team member did this well, why did they do that? Well, the procedure says that they should do this. Well, why does the procedure say that they should do this? Ah, because I wrote the procedure and I, I didn't train the team that well on how to do it. Right. So you can. You need to get beyond this sort of surface level of the blame game and kind of get down to a root cause of something. And in combination with some humility to say, well, if it's me, then I need to be okay with that and figure out a way to, to address that. And, it sounds like you do a really good job of helping your clients, these practice owners get to the bottom of that and, and try to shape a solution in the best way that you can. very, very interesting. Well, I, you know, is there anything else you want as we sort of wrap up this conversation, anything else you want to leave with practice owners that are sort of thinking about, their own frustrations around tough decisions and tough conversations in, in life or in business or, or anything else?

Bethany:

I would just acknowledge that it is hard and I would really encourage practice owners to, yes, do the exercise, and those five whys is a great way to get there, because you're going to get down to yourself somewhere in between three and four, probably, right? Once you know that, that's progress. So being able to switch the negative to positive of Wow, now I have a much better idea of the actual problem I'm trying to solve, rather than, so you're saying I suck, like, we all, we all suck at this, when nobody is trained to do this in optometry school, or in dental school, med school, any, any practice owners. So, acknowledge the fact that you're doing the work as a positive. And it's hard once you start to get the self awareness. It feels fine to blame others. They, they're all terrible, but you can hold your head high at the end of the day when you start to realize that it's you. There is an initial bad feeling about that. Hopefully what comes from that bad feeling is a determination to improve it because it absolutely can be changed. As I said before, it's not an identity. And practice, I don't think ever makes perfect, but practice helps you get more comfortable, get to the point faster, get better at having the conversations, get better results, and you realize that having the conversation actually builds trust and builds culture rather than taking it away.

Evon:

Yeah,

Bethany:

So, just do it

Evon:

Yeah. Yeah. Interesting. Well, I, I appreciate you having this conversation because even I, I'm learning from it. Like, this is something I, I'm realizing about myself and in personal relationships and in business and, and I'm definitely trying to improve on. So I, I'm sure that the listeners will learn a lot from this. where can people find you and follow you and, and learn more about the work you're doing?

Bethany:

That's kind of the ultimate question right now, but something that I'm planning and I would certainly invite you is, I'm working on a workshop to help practice owners, managers, people in situations start to actually do the work to figure out how to address a conflict in a situation. So, for news on that and figuring out what else I'm doing as I figure out what I'm doing. I have a new website called leadersofvision.com and there's a button on there that you can click that says stay in the know, you enter your email. And as I have things to report, I will certainly email. I'm also on LinkedIn and looking forward to being a little bit more out there, than I have been the past couple of months.

Evon:

Perfect. Well, I appreciate that. We'll throw links to all of that in the show notes. And as you have, links to the workshop you're doing, we'll, we'll add that to the show notes as well. really appreciate your time, Bethany, and really appreciate to the listeners. Appreciate your time in listening today. We'll catch you on the next episode. In the meantime, take care.

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Evon Mendrin CFP®, CSLP®

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