Why you can’t ignore AI as a practice owner (and a beginner’s path to using it) with Eugene Shatsman

Adam Cmejla (00:21.504)
Welcome to another episode of 20/20 Money: The Business of Optometry joining me back on the show here today Eugene Shatsman managing partner of national strategic group Eugene it is good to connect with you again sir how are you

Eugene Shatsman (00:54.122)
Happy to be here, Adam. Very, very excited for our conversation today.

Adam Cmejla (00:58.464)
Let’s keep the theme of what we observed in 2025 going here into 2026, which we would be remiss to have some type of business conversation if we didn’t either directly or indirectly reference AI in some capacity. let’s keep that, keep that cliche train going, if you will, in all seriousness, I am excited to dive into the conversation around a topic, the topic of AI. And as we continue, being, dare I say humans.

And specifically in the context of this show in this audience for ECPs and owners of practices, how do we start better understanding the capabilities, the limitations, the best practices, the uses, the hesitations and limitations around it on the other side of that? how do we, how do we continue to think differently about the role that technology is playing in the practice and how it has been really evolutionary or revolutionary, I should say.

Evolution takes a long time. Revolutions happen really quick. And I think we could plant AI into the latter camp there. So I’m just excited to explore this conversation. And as I joked with you before we hit record, this is largely going to be a true Q &A session. I don’t know that I will have a significant amount of color commentary, if you will, in our conversation, because you have, I want to give all credit due to you and the work that you’ve done. You’ve spent a lot of time in.

Eugene Shatsman (02:01.09)
Mm-hmm.

Adam Cmejla (02:26.88)
this space from a research standpoint and a curiosity point of view. mean, I certainly use it a fair amount in, uh, in, the strategic side, if you will, for, for my, for my use as a thinking partner, but I’m really curious to dive into your head space and your experience and learn a little bit more about just what you’ve been up to and what your, what your group has been up to and how you’ve seen ECPs and practice owners alike embrace this. So

That was a meandering and a little bit of a long-winded introduction there. But I think where I would maybe begin the conversation is what surprised you about, what has surprised you about your involvement in AI, what you’ve learned about it as you’ve done your research, as you’ve, as you’ve continued to learn more about the capabilities. Are there any major surprises that were like, Holy cow, I didn’t see this coming or.

capabilities are bigger and better than what I even thought or maybe in the other direction they’re like wow this is all sizzle no steak it seems really cool but there’s really not a lot of value there

Eugene Shatsman (03:34.038)
Yeah, and you know, there is a I guess maybe where I want to start out of is that I as I did lectures on this topic across the country over the last year. One of the things I found consistently is that a lot of people are really

They’re aware that AI exists. They may have used chat GPT. mean, even, you know, Google forced the feature on us last year where essentially Gemini searches are now or Gemini is part of your Google business or Google search process for many topics or questions that you type into it. But I think what surprised me the most is that, you know, we still haven’t found a really great way to adopt it in eyecare, but other

Adam Cmejla (04:00.883)
Right?

Eugene Shatsman (04:21.936)
industries are already taking taking advantage of it and I also think that we know don’t necessarily realize as consumers right like wear two hats for a second if I think about your audience right some some of them are or many of them are going to wear the practice owner hat and that’s the practice that’s the hat they’re trying to listen to the show with but at the same time if you wear the hat of the consumer you are using AI more and more and more and more in your day-t0-day life

And I think we don’t always realize that and it’s kind of crept into our daily lives in such a simple and straightforward way that it’s kind of like, what did we do before the internet? But now I think that the part that really surprises me to get at your question is that there’s such a big gap between what we do as consumers, like we’re really using the internet as consumers, right? To use that analogy.

like as business owners sometimes we are not really embracing it at all. We are still an analog like maybe dial-up connection but like sometimes we’re like faxing stuff back and forth to each other and hoping to get a response. So this is this is the gap that I’m seeing over the course of last year not really been filled all that well and so you know anybody who’s heard me speak probably heard me talk about like how much how much we all need to be on

forefront of this technology because I do think that consumer expectations, especially in 2026, are going to continue to change and shift towards businesses that leverage AI and create essentially convenient experiences for patients.

Adam Cmejla (06:11.828)
I want to tap into that a little bit more consumer expectations because I feel like that is, that’s something that practice owners should be thinking of right in the context of.

understanding the patient experience and the expectations that come along with that patient experience. think if you were to ask any practice owner out there what sets your practice apart and they would say either directly or indirectly we provide a great patient experience. And a lot of that I think they to go back to use your metaphor there they are thinking of that in the analog space meaning once the patient shows up at the practice we’re greeting them we’re smiling good patient flow good interaction they they they’re feeling a warm

and fuzzies in the office, but if I’m hearing what you’re saying, the consumer expectations is changing and starting earlier and earlier in the patient journey and experience with the practice. And the challenge that I’m curious to explore, I’ll take a little bit of a right turn in the conversation here and dive down what you had said also, or another point that you had mentioned in your open answer there, which is how Gemini has changed search.

what that means for practice owners that have spent the time, energy and resources to build out websites and build out a digital footprint and make their digital footprint part of the overall patient experience. And now you have Gemini coming in here specifically to Google. And I’ve seen it happen where at least in our space, in the advisor space, it’s, well, if somebody asks chat GPT

who’s the best wealth management and consulting firm for optometrists. That’s something that I need to be aware of. Now, if I’m being fully transparent and honest, as I say that on this recording, the mental Adam behind the note is, you should write that down, Adam. You better make sure you’re paying attention to that. How have you seen that evolve or maybe the revolution of that change as well? Does that make sense?

Eugene Shatsman (08:17.377)
Yeah, well, so there’s a couple components. I think that…

You have to really think about the fact that the patient journey in its entirety starts from the moment the patient has a problem or Is prompted in some capacity to potentially? Think about starting to get an eye exam right like way before it’s not when they walk in the door It’s way before then and the patient journey doesn’t really end when you’re done with your visit the patient journey ends way after that particular visit so really I would

Probably say that less than 50 % of the patient journey actually happens within the walls of your practice and we have to keep that in mind and The parts that you really could have control over that many practices don’t necessarily is what happens before and after they visit your practice and how are they being communicated with and what are they finding and so if your question about Google search I think is one of the things we should consider as patients are as patients start thinking about an eye exam or as patients

and start thinking about getting help. like just let’s walk down the patient journey maybe for part of this episode and figure out where AI can be a resource for the practice versus an obstacle. And I guess my thesis to you is that…

practices that our patient experience, our expectations that as consumers are continuing to evolve towards a more customized world. In the same way that the internet made data and information convenient and the mobile device made that same information and data accessible, in today’s environment, AI has made that information customized. And so when you think about, know, the days of me clicking on a website, scrolling through that website, hitting the back button, going to the next website, scrolling to that, reading that website. God forbid I read like six paragraphs of a website, go back and that kind of thing, right? In today’s environment, if I’m trying and this is true for like an easy fix, right? If I have, you know, if I, I don’t know if my remote control is broken or something like that, and I’m trying to get it to work, you know, I might take a picture of that remote control and send it to Chat GPT and say, Hey,

this isn’t working, can you help me? Or I might ask a question through a Google search and then the Gemini output might give me a solution. And the thing is, and this is inherently true for us as consumers, is that that oftentimes, that information has become more and more reliable. And in 2025, the output of those searches, when you think about how to, how do I, what are suggestions that you have, those suggestions from AI

have become more and more reliable, more and more convenient, and more and more customized to my specific situation. Because in that same story of the remote, and I’m just using the remote because I have one sitting right here, but in that same, in the same point of the remote. You know, I think in the past I, you know, if I take a picture of it right now, AI will know exactly which TV, which remote, what do you know, what category, why it’s not working simply by looking at this particular thing instead. I wouldn’t have to type in LG remote, you know, such and such, such and such model number. And then I’d have to look at a bunch of webpages. So now take the parallel to eye care. So what are our patients doing? Well,

It is true that patients are still using Google search about 80 % of the time to try to find to try to find an eye doctor. That is true. But they start asking questions like I find me an eye doctor who takes who takes VSP sees kids and carries Tom Ford’s. And how does AI get that information? The problem is it AI will give the patient.

An output. It will not always be the most reliable output in some of my talks. I show an example and people at the AOA absolutely love this is I’ll type in and say best eye doctor Cleveland, and sometimes the list of eye doctors that I get all have an MD behind them.

And how did and but this is an issue, right? Like this is a real issue. But I decided and I have real screenshots and we’ve actually talked to Google and work with Google on this particular issue. But.

Adam Cmejla (12:45.524)
Really?

Yeah.

Eugene Shatsman (13:00.001)
Sometimes, and so if you type in who is the best optometrist in Cleveland, it’ll respond with, well, you know, there’s not single best, there’s a lot of different criteria, here are a few optometrists for you to consider and that kind of thing. But the reality is that oftentimes the results when it comes to medical are not so reliable and both Google and chat GPT and OpenAI, guess, clawed to less extent, they have recognized

that the medical output that they provide needs to constantly be surrounded by guardrails. So this is both good and bad for us. So all that is to say is that if you have a practice and your practice is trying to figure out how do I adapt to this new patient behavior, to the thing that a practice information will show up in the, we’ll call it the AI overview,

of the search. And if the practice information shows up in that particular category, how do I show up? How do I get my information to show up there? I’m gonna give you a hint or a kind of there’s a lot of little factors, but I’ll give you a trick that seems to be working for a lot of our clients right now. And it’s a little bit, I’ll call it maybe.

Counterintuitive is probably the best way to put it. So early on when people said, oh, hey,

AI is looking at content on your website. So what I should really do is I should really put a bunch of content on my website. So people said, OK, I’m going to use AI to write a bunch of content on my website. I’m going to plug it in and it’s going to and now I’ll have a ton of content on my website for the AI bots to read. Here’s the thing. There are clients who are ranking the best in a lot of the AI search results. They did something different. They created video rather than AI generated content.

Adam Cmejla (14:44.553)
Right.

Eugene Shatsman (15:02.218)
So why, why does that work better? Well, specifically for Google search that works better. And in that video, you can talk about your specialty. So for example, my specialty and dry eye, my specialty and, you know, you can talk about your optical, you could talk about all kinds of things, dozens and dozens of ideas. but they created content that Google knows to be true and authentic because it is harder to fake video. Although of course you can come up with AI based video, but this is a doctor.

Adam Cmejla (15:28.256)
Okay.

Eugene Shatsman (15:32.162)
as long as you have an authorship component to it. This is a doctor who is talking about a particular procedure or a offering and all of a sudden that content seems more authentic than the mountains of content that have been created from competitive sources. And so.

At that point, it becomes easier for Google to answer the search with content that it knows to be authentic because that content was inside of a video. Does that make sense?

Adam Cmejla (16:04.434)
It does. Tactical question, how perfect, for lack of a better word, does that video have to be? this, hey, I’m hiring a videographer and bringing people in to stage this interview style component or film my office, or is this, hey, I’ve got a phone here, let me do a walk and talk.

showing a virtual tour of my office or I’m doing this on Instagram and I’m linking my Instagram profile to my practice as a way to build a social presence. Any thoughts on the lift required if you will to build that authority.

Eugene Shatsman (16:38.397)
I’ll tell you this super super simple answer.

And in fact, usually, even if I told you, it was just your phone, most people would say, well, I’m never going to have time to do that. It takes a long time to build a video, to make a video, that kind of thing. I’m not good on camera. need to, you know, I’m going to have to do a hundred takes. Here’s the thing. This is the magic of AI today is that let’s say I, so the answer is needs to be anywhere between one and four minutes. And in order for it to, in order for it to do well, it needs to be somewhere between one and four minutes.

and in addition to that it also needs to have a completely clear way for it to be transcribed. So it does not need to have high production value. So here’s the trick. Let’s say I’m a, I don’t know, scleral lens. I want to record some videos on scleral lenses. So how about this?

Adam Cmejla (17:24.595)
Okay.

Eugene Shatsman (17:36.832)
I go to chat GPT and I say, Hey, Chad GPT, I need a two and a half minute script on scleral lenses. I’m an eye doctor. This is my practice. Here’s the, here’s the website. Ask me five questions, one question at a time to get my perspective on what this video should be about or how I would potentially position it. So that’s really important. Interview me, ask me five questions, ask me five questions, one question at a time. That’s the technique, which is that that prompt allows you to personalize that

by simply answering some questions and then all of sudden Chat GPT spits out a script.

in your tone, your voice, your, and in with your content. And here’s the thing. All you gotta do is take a laptop, sit it up like this, then take your phone, put it on the screen of that laptop, hit record on your phone. Maybe set it up so that you’re, you know, it’s a little bit higher. So you’ve got like a decent background behind you. Maybe put your, put yourself in your optical or in one of your exam rooms. So you look like a, and then you say, Hey, this is Dr. Jones and I’m here to talk to you about sclera lenses.

Adam Cmejla (18:29.706)
Yeah. Yep.

Eugene Shatsman (18:42.042)
And then all of a sudden you’ve got the content right there of exactly what you need to say. Exactly. Exactly.

Adam Cmejla (18:44.66)
and you’re using ChatGPT as essentially your teleprompter, right? That’s what you’re, yeah.

Eugene Shatsman (18:50.72)
And then you’re the one who, know, Chat GPT did help you formulate cohesive thoughts, but it’s in your tone, it’s in your voice. And if you want it to sound more like you, don’t ask five questions, ask eight questions, one question at a time. But you’ll be impressed at how clearly it gets your tone and your voice and what you want to talk about and kind of your take on scala lenses as long as you can answer the questions during the prompt.

Adam Cmejla (19:16.286)
And then, let me continue to play marketing and video ignorant here. Next step, upload that to the practices YouTube channel and embed that link on your scleral lens specialty page on the website.

Eugene Shatsman (19:26.542)
You got it.

Eugene Shatsman (19:31.692)
Yep, embed that video into the Escalera Lens specialty page. Ideally, put transcript of the video somewhere as a blog or something like that in your practice with the video on that same blog. Upload the video onto your YouTube. Make sure you’ve got the right description, the right keywords. Link it all to your Google business profile as well as your website specifically from your YouTube page. And then do it again.

You can’t just do one video. You got to do it again. The client, one client that I can think of that just dominates his area has got, I don’t know, 50, 60 videos on a particular specialty. And the great part is that you can give ChatGPT the script that you used before and you want to say, want to create a meaningfully different video on a different angle of this particular topic. I want to be seen as the local expert, ask me seven questions, one question at a time to help me come up with a different script on this video.

and then publish another video next week.

Adam Cmejla (20:34.333)
When you say dominating his space, that like new patients are coming into the practice because they have found him or her online or via AI search? mean, do you have the granularity on how they are finding them, whether it’s through just…

Eugene Shatsman (20:46.956)
Yeah. yeah, yeah, no. So what happens is we saw when this particular strategy was used for this particular client, we saw a 22 % increase in phone calls to his practice, as well as maybe an 18 % increase in traffic to the website. And then appointments from that particular, from the digital assets that would rank as a result of his…

As a result of his publishing those videos went up by anywhere depending on the month by anywhere from 10 to 25 percent

Adam Cmejla (21:24.074)
So it’s funny, as you were talking, was listening. I can somewhat multitask here. as you were talking, you sparked an idea that I wanted to quickly type out and share in live time here. So I’m a, I don’t know what level I pay for chat. It’s not the free version, and I use it extensively. it knows, we have a very good relationship. Let’s just say that.

Adam Cmejla (21:53.402)
And so a new chat I started, said, I’m in Westfield, Indiana, just north of Grand Park Sports Complex and need a comprehensive eye exam. My VCP is, I inserted an A, just a name of a common VCP that we would all know. And I’d like to be able to book my exam online. I don’t want to travel more than 20 minutes to get to my appointment. What are my options? And I got a list. I have one, two, three, four, five, six different.

names of practices in Westfield and then other nearby options that are still 15 to 20 minutes away. I just, I think it is interesting how, as I was typing that out, how much more surgical we as consumers can be in our searches, utilizing this type of platform and technology compared to what it meant by just typing in eye doctor near me or optometrist near me.

Eugene Shatsman (22:47.042)
Yeah, and what’s interesting is that what.

It’s it’s really fascinating because Chat GPT said I was doing that. Well, Chat GPT and this is kind of back to the point of AI is giving the consumer a it’s taking available information which was made available by Google and the Internet. Right. It’s making it convenient because you can do this from anywhere on any device and it’s making it customized because you now know that you can have that particular prompt. Now most consumers are still not looking

Eugene Shatsman (23:20.986)
for it that way. They’re not yet, but 2026 they will. And what’s interesting is chat GPT initially because of the partnership that they had with Microsoft, they were using Bing search to kind of power the results that you’re going to get. Currently they are using Google search and this is, you know, in the first quarter of 2026, they’re currently using Google search results to power that output that you’re going to get. So the techniques that I just suggested, they work for chat GPT for the moment.

although know chat GPT may decide that it’s going to have a different and is going to have its own browser and maybe it’s going to have its own search platform and it’s going to have its own different thing that it could potentially use in the future.

Adam Cmejla (24:04.188)
I have seen, and again, this is just purely an observation from a consumer’s point of view, not from a marketing or professional point of view. Just in my day-to-day life, I think it was during the NCAA, when, sorry for any Oregon fans that might be listening, when IU thumped the Ducks and ended up winning or going to the national championship game, go Hoosiers.

Hopefully I’m still singing that same tune at the, we’re recording this the week before the national championship game coming up here against Miami. So, but as I’m watching that game, I think there were a handful, I know I remember at least one chat GPT commercial, just emphasizing the power of what it can do and the relationship that you can build with it, et cetera. And I point that out because to what you had just said, it’s no secret that they are, that they do have, like they’re,

one of their goals seems to be being viewed as a search engine and not quote unquote just, it’s weird that we’re saying this, not just an AI tool. My how quickly things change.

Eugene Shatsman (25:10.424)
Well, and I’ll submit that.

in the future, we won’t need a search engine. We will need a personal assistant who answers questions for us. And whether that personal assistant starts with a C, a G, or another C, guess, or another G, like I’m thinking of the top four. But it really doesn’t matter, right? But I think about the role that a search engine plays in our lives. I submit to you that in 2027,

if we were having this conversation a year from now, we are going as consumers, we’re going to start viewing the search engines as more of personal assistants that can do more than just find information for us, but assist us with actually getting stuff done, agentic solutions. And in some cases, so wouldn’t it be great if your answer was, would you like me to check availability at this? So here are the three available.

Pick one, would you like me to check availability at one of those or two of those or three of those?

And you might say, yes, I would. And it would say, OK, great. I’m looking at your schedule right now. And it looks like you have next Friday at 2 available. Would you be OK if I your eye exam for that period of time? And you might say, well, no, because my daughter has a concert that I have to go to. And it might say, well, I didn’t notice that.

Adam Cmejla (26:41.234)
say it should have noticed that because it should be able to see my calendar, right?

Eugene Shatsman (26:46.67)
And I didn’t see and I don’t see your your kids school calendar here Can I confirm if I can load your a kid school calendar into your personal calendar? Is that okay? And like that’s the type of conversation you could potentially be having as a consumer and now Let me take you to the practice Where if I call an optometry practice today and Adam I think we had this conversation a while ago, and it is still true

We don’t answer the phone 27 % of the time during business hours. It has gotten worse. We have gotten worse. Well, it’s actually what happened is over the course of last year, more people are calling. And this is an interesting. Right, so we’ll talk about this in a second. But more people are calling. The reason they’re calling.

Adam Cmejla (27:20.49)
did have this conversation. Has that changed?

really?

Adam Cmejla (27:32.98)
good problem to solve.

Sort of, I guess.

Eugene Shatsman (27:42.942)
Versus booking appointments online is because I don’t think they necessarily trust the information that we have on our websites or they want to confirm maybe they’re a little bit more wallet conscious so they want to confirm that you take their their Benefits or that or how much an eye exam is going to cost without benefits or something like that They’re just a little bit more cost-conscious. So maybe they’re trying to ask more questions during the calls, but listen We’re getting worse at answering the phone and we’re

getting worse when we do answer the phone, we’re getting worse at scheduling appointments. So for 100 appointment opportunities, today we’re scheduling 73 of those 100 appointment opportunities. And for new patients, we’re scheduling out of 100 new patient opportunities, we’re scheduling fewer than 20. So here’s the thing. You take that beautiful integrated experience that we just talked about where you’re chatting with your buddy, Chad GPT, and your buddy Chad GPT is recommending this practice and is asking you whether you want the appointment to be next Friday and whether that’s okay with your kids school schedule. All this beautiful integrated thing.

And then like now you call the practice and it’s like, well, I’d like to schedule an appointment. What insurance do you have? I don’t have my card Andy. Why don’t you call back when you do? You know, like that that’s and in some cases it’s like.

Adam Cmejla (29:10.954)
I hope practices aren’t actually doing that.

Eugene Shatsman (29:13.801)
my gosh, Adam, the only time.

Adam Cmejla (29:16.417)
I live in a very naive and altruistic world, don’t I?

Eugene Shatsman (29:20.47)
Yeah, the only time my team has probably heard me raise my voice is when I’m screaming in my in my closed office when I’m listening to calls because I just I really hate the sound of my clients money being set on fire. But that’s exactly what it is. It is exactly what it is. We’re burning so much money on the phone because look, everybody knows their optical capture rates, right? Everyone knows what, you know, out of X number of refractions, how many glasses or how many pairs of frames or lenses did we sell?

Adam Cmejla (29:27.328)
the

Eugene Shatsman (29:50.394)
People know their optical capture rate, but nobody knows their phone capture rate because it’s an arduous thing to get manually. The only way you would get an optical capture rate as a piece of information for your practice, as an operating metric for your practice, is if you listen to a statistically significant number of calls, which is a difficult thing to do as a human.

But I submit to you that this is one of the first places that is the leaky part of every bucket. If I look at each practice as a bucket, there’s one of the first places that is a leaky part of every bucket that I look at where you got to be able to look. And so if you knew that your optical capture rate was X and that X was less than you wanted it to be, you could at least work on it and you could decide how to work on it based off of, you know, coaching with your team or outsourcing call center or having AI.

answer the phone and try to schedule those appointments. That technology is now newly available. But at the very least, you got to know your optical capture rate and that’s a perfect place to deploy AI to listen to the phones to figure out how much money you’re setting on fire.

Adam Cmejla (31:01.024)
Where did I go from here?

Gosh, that was so good. I really hope that, look, regardless of what kind of listener you are, and what I mean by that is how much you have already been thinking about this and identifying the different areas in the practice where, right, I think of the, one of my favorite quotes from Peter Drucker, right? What gets managed gets measured. And.

Eugene Shatsman (31:29.857)
Mm-hmm.

Adam Cmejla (31:30.804)
So if you are somebody that knows that this is important, that maybe this is a reminder to go back and make sure you’re actually tracking that. If you’ve been, I say, oblivious to that, hopefully this was a little bit of a proverbial wake-up call and you give attention to it and realize, again, I’m I’m in awe that a practice or a team member in a practice would have that type of conversation with a patient.

with a potential patient, a new patient. Hey, I’d like to book, well, I don’t have my benefits card. Call back when you have it? I mean, my gosh.

Eugene Shatsman (32:01.746)
every all the 20 %

Eugene Shatsman (32:10.044)
it’s so much worse than that. That’s like the, that’s not even the percentage of bad calls that we hear with that. I will say that.

That number of 20 % for new patient optical phone capture rate. That number has not gotten better. We’ve gotten worse and and then you have something like 80 something percent for existing patients. That number stayed relatively flat in 2025, but that basically means that an existing patient is calling your practice and at least 15 % of the time you’re talking that patient out of an appointment with your

And oftentimes that’s because

We couldn’t find a time on the schedule or the doctor that they wanted wasn’t available or they didn’t have their insurance card or for whatever reason the process was so arduous to schedule the appointment. I have literally heard people say, well, you know, we’re really busy in the office. If you go online, you can schedule an appointment there. Is that OK? And the person’s like, well, I guess I don’t really have a choice. Like, bye. And did they schedule an appointment online? I don’t know. So.

My point is that,

Adam Cmejla (33:23.838)
Yeah, but didn’t exactly leave that conversation with the warm and fuzzies that you’d want a new patient to have.

Eugene Shatsman (33:27.015)
Exactly.

So then when you think about can I solve this problem? Of course, I can solve this problem. I can answer the phone for you. Right. At the very least, it will deliver a better patient experience to some percentage of the patients because simply it will answer the phone if we’re missing 20 percent or more of the calls that are coming in from during business hours. We’ve already missed that opportunity. We’ve already we’ve created one out of five people that call our office are already having a terrible experience.

Right, so AI can answer the phone.

Will it be perfect at scheduling appointments? No, that’s why you need an AI ripcord. This is this is you. You have some patients that would be happy to talk to AI and schedule an appointment with AI. You have some patients that would never want to do that until they’re ready and it might take their you know, there’s just like with practices, there’s consumers and some are early adopters. Some are late adopters and you will have the late adopters want to say representative and they want to get transferred to the office. Fine, great.

Adam Cmejla (34:28.018)
Yeah, that’s kind of me. I’ll be honest. I have question for you when you finish this. I’m curious to hear. OK, keep going.

Eugene Shatsman (34:31.67)
Yep.

Eugene Shatsman (34:35.669)
Yeah, but that’s the thing is that that’s fine. Let’s let 50 % of the calls go to the staff and let’s let the other 50 % that are comfortable doing their business with technology now because they’re in. I’m telling you that number will continue to increase over time for patients, but patients will get more and more comfortable finishing transactional type of. I’ll call it like everyday tasks with AI.

And so if they’re comfortable booking that exam with an AI agent, great, take that burden off of your team, deliver a better patient experience. It’ll cost you less money. And guess what AI will ask every single time? Is there somebody else in your household that would like an eye exam? While I’ve got the schedule open, Adam, is there anybody else? Because I guess because guess how many times the staff is asking that question. They aren’t.

Adam Cmejla (35:29.16)
Not 100%.

Eugene Shatsman (35:30.123)
But when they ask the question, if they do ask the question, anywhere between 10 and 15 % of the time, somebody will say, yeah, yeah, no, let me see. Do you have something available for so-and-so? And that’s just like, again, money that we set on fire simply because we don’t have the, we don’t have the, we’ll call it like the operational discipline, where a robot would have the operational discipline because they’re specifically programmed to do that. Yeah.

Adam Cmejla (35:56.544)
It’s programmed for that, yeah. okay, so my follow-up question, where are we in the, I’ll use a baseball metaphor, like what inning are we in, technologically speaking, where we can have the confidence that it will do it correctly and in a way that provides a, I’ll use the generic word, good patient experience. And here’s where I’m going with this, Eugene.

One of my frustrations that I have seen with these agents, right, I’ll use the, with the AI agents, and it’s more so with chat, and as I’m just kind of rattling my brain right here, nothing is coming to mind where I’ve either been able to explicitly pick it up or feel like I’ve been talking to an AI agent, but it always happens with chat. The amount of back and forth that happens,

the conditional logic that I feel like exists within the current agents is so cumbersome that I don’t care that something’s answering me right now because I would rather wait three, four, five minutes for a real human to come into the chat and talk with them rather than have an agent instantaneously come here, please provide your name, type my name, and your email, email. What seems to be your issue? And I type out my issue. Here are the help, here are the help, like.

It just feels like it is a half step above me doing my own search within their help library. And all it did was just take me more time to eventually have it say, in very similar words, I’m sorry I wasn’t able to help you. Let me connect you with a human that can help you from here.

Eugene Shatsman (37:43.467)
Yeah. No, I totally get that frustration.

Adam Cmejla (37:44.32)
Let me take that frustration from my point of view back to the idea and the forecast. Yeah, yeah.

Eugene Shatsman (37:52.525)
The phone agent example, yeah. Okay, well, I’ll tell you what’s new in 2026 that wasn’t available at this time in 2025, and you be the judge. So step one, what…

There’s been hundreds of billions of dollars invested in we’ll call infrastructure for AI, right? And so that infrastructure creates an agent that has less latency So there’s fewer awkward pauses I don’t think I don’t think it would be a good idea to try to fool someone and say hey This is like the real Eugene talking not Eugene the robot talking or whatever, right? I think you just you make it clear. You don’t want to you don’t want to try to trick the consumer

But so that’s step one is latency has been solved which then makes the agent more responsive number two is that EHR connections so in order for the agent to be inherently useful it needs to be able to connect to I care EHRs so there is

And so that software was developed over the course of 2025. So now that exists in 2026. It didn’t exist before because before that agent might not be using an integrated EHR connection. If it doesn’t have an EHR connection, it can’t be that useful to the, it can’t do what a real person would be able to do. Another component is training. And so you think about who do you want training this agent who’s answering the phone?

want it to be someone who is like trying to set logic or like a tech person who’s trying to set logic or do you want it to be the best call center the call center that has you know when I’m talking about a national average is like 70 something percent in terms of phone capture rate the best call center that I know of has an average of about 110 percent of phone capture rate because they ask the question at the end of every call of who else do you know and that kind of thing. And they’re naturally good. So you’d say, OK, well, why don’t you take the hundreds and hundreds of conversations that those people have and use those conversations to train the agent to come up with still, I think there still needs to be a call flow that the agent is trying to push. But you go from the call flow to okay, this thing is responsive. It’s hr connected. Is it perfect? No But can it do better than not answering the phone? Of course, can it do better than some of your people at the front desk? Probably because it’s got one very specific job But this is where I put the word of warning is that you also don’t want to give the agent too many jobs to do This is this is the problem with ai that i’ve seen and I think this is the biggest limitation

of AI that I’ve seen in my experience so far is that if you want an agent that does everything, that can schedule calls and check on order status and check on what you’re really trying to do is cobble together multiple agents that have very, very specific jobs. And this is true across the board is that if AI has four different jobs to do, if you’re just simply designing a very simple workflow, if there are four different jobs to do, you’re better off

having four specialist agents to build specifically with AI that one might analyze, one might pull the data and it might be excellent at pulling the data. One then might analyze the data to identify trends. One might then reference the trends.

and identify and reference a library of information to build some sort of recommendations. And then one might then write you an email, might be really good at taking all that information and writing you an email that captures all of that information. And I would say having one agent that does all of those things is a fool’s errand right now. It just doesn’t work. And that’s the limitation of modern, what I call it, 2026 Q1 AI. It might not be true a year from now.

But currently right now you would want to program a single agent to do a single task really really well and consider that you know That’s the one employee and this their their measure of success is that one particular thing that they need to do really really well And then you take that agent and that agent so in my experience or my My example is if you want more appointments because you can quantify the impact on your practice that agent isn’t going to be able to check on Whether your glasses are ready that agent isn’t going to tell you

Eugene Shatsman (42:36.899)
you know, a million different driving directions to the practice. That agent is simply going to focus on here is where, here is what we’re gonna do. Can I help you schedule an appointment? If you say no, it’s gonna do the human ripcord and take you to the office.

Eugene Shatsman (42:55.903)
And I think that’s best in class implementation for AI today.

Adam Cmejla (43:09.504)
It’s not I’m trying to put myself and maybe I’m doing a disservice to practice owners listening right now, but there I assume that there are a handful listening or a certain segment of the listeners right now that are maybe having a version of what I’m having right now, which is like, so what do I do about it? Like, how does all of this bolt together? And where do I start to measure. you know, going back to what you had mentioned in the beginning of this dialogue or towards the beginning of the dialogue where you mentioned, I can’t remember what the percentage was, but you know, let’s call it 50 % of the patient interaction actually happens or patient experience is actually happening in your office. There’s so many other, there’s so much of the patient journey, as we’ve been illustrating, that happens outside the walls of the practice.

So in the spirit of asking that question, where does one even begin? I do want to come back to a tactical question that I had, and I hope this doesn’t derail conversation too much, but I’m very personally curious about this and…

because I think it, I think, I’ll ask your opinion on this, that it matters. When I was going back to my experiment that I did with you on the call here and I typed in, I live on the north side of Westfield, I’m looking for an optometrist that takes this VCP 20 minutes away, blah, blah, and it gave me the names of practices and the links. And one of the practices that I clicked on, it brought me right to their location, they’re a multi-location.

I know these owners personally, they’re wonderful individuals. They’ve grown a phenomenal footprint in the greater Indianapolis area by buying practices of retiring ODs and essentially being their own mini version of private equity. But they’ve kept the brand and they’ve kept themselves, they’re running a great practice. My point with all of this is the link in chat brought me directly to…

the Westfield location and the schedule appointment page of their website. When I look in the URL bar, it says nameofthepractice.com slash Westfield, and then it gives me the UTM, source equals chatgpt.com. Is that something that practice owners, if they are at the beginning of this journey, I do want to come back to my overwhelmed question based off of what you had just said of like,

Adam Cmejla (45:52.042)
In the beginning here, if I look at that and I say, okay, so I assume that this practice is tracking how many people are coming to their website via chat GPT in my example. Or if they’re not, their website is, because it’s clearly showing up as a UTM. UTM is a, what is it, unique, a Urchin Tracking Module or Urchin?

Eugene Shatsman (46:19.467)
Yeah, yes, yes, yes.

Adam Cmejla (46:22.464)
Is it Urchin or Urkin? don’t even know. Urchin, okay, okay. So there’s that identifier in the URL. a practice owner that has a website, is that something that they need to build into their infrastructure to track this or is that happening automatically?

Eugene Shatsman (46:24.874)
Urchin, urchin.

Eugene Shatsman (46:41.399)
Well, so there’s two things. Number one, chat GPT wants to make itself known. So there’s a lot of websites where it’s absolutely done that automatically. It is, it has, but I’m also going to tell you that because it wants the people who are looking at analytics to say this is all chat GPT stuff, but there are like, first of all, like the fact that it is super impressive that you knew the Urchin Urchin tracking module terminology.

I don’t think most people know what that is. I don’t think most people even have UTM parameters set up on anything. If you go to their Google business properties, there’s probably not a UTM associated with the thing that comes up in Google, which kind of leads me back to a previous point, is, to your previous question, which is, where do I start?

Right. And I get this question a lot because I I lecture on AI all the time. And again, rooms of people are like, I’m aware that something exists. I’m aware that I need to do something. Right.

Adam Cmejla (47:32.392)
Yeah.

Adam Cmejla (47:42.846)
I’m an eye doctor and I own a practice. I just like, yeah.

Eugene Shatsman (47:46.751)
But the cost of change and the cost of uncertainty is not something that’s lost on me at all. So you can’t go try everything out there. What I recommend to people is this. Number one is identify the biggest pain point in your practice.

And it could be, I mean most practices are going to say probably one of three things right now could be staff, staffing, staff related issues. Number two could be patient volume. I want more patients. I need more patients. have empty slots on my schedule. Or number three could be revenue per patient, which we did see a substantial decline in revenue per patient across the industry. And we saw a decline in capture rates across the industry last year.

So yeah, that is, you know, for people who are paying attention to their numbers, they may be seeing this in their reports. So pick a problem, right? And then once you pick that problem, you say, okay, how can AI help me solve this problem?

And then you look at your possible opportunities to solve that problem. And so maybe when it comes to more patients, maybe it is, hey, I’m going to connect all of my digital properties and record some videos. I’m going to connect all my digital properties to all the AI search tools that are out there. I’m going to make sure that all of my tracking is set up correctly. I’m going to have a Google Reserve program. We don’t even talk about this. I’m going to have a Google Reserve button on all my digital properties. That’s a freaking gold mine.

these things together.

Eugene Shatsman (49:24.629)
could help me with my patient volume. But before you take any action, this is the trick. And I think you’ll appreciate this, is that you have to make sure you understand what your baseline is before you implement any AI tool to solve any problem. So you’ve got a baseline today. And as it always happens with integrating technology into a practice, is that we have serious amnesia six months from now. We’re like, this thing’s not working. It’s a piece of crap.

we need something else. But if you look at your numbers beforehand…

Adam Cmejla (49:54.91)
Yep. Six months, giving people, you’re giving people a lot of credit. Usually that’s maybe what a two to three month like, I tried it for a couple months and it’s not, screw that, rip the band, rip it, rip.

Eugene Shatsman (50:00.705)
Well, right, true.

But that’s actually, that’s another point is that oftentimes it’s, I tried it for a couple of months means I put my credit card in the thing and I hit submit and I got that auto bill three times in a row and then now I’m sort of like pretty frustrated that it didn’t do anything even though I literally didn’t tell a single person on my team that we bought this tool and we didn’t, and I may have sent the welcome email to my office manager or something. But I think the step is identify the problem, baseline yourself at how you’re gonna measure that success. And even for something as simple as patient volume, are you gonna use schedule fill rate as your example, or are you gonna use new patient’s percentage as your metric of success? So identify the metric for success, then identify what your list of tools is that could potentially solve the problem. Pick one, pick.

one tool, one solution, one something, assign a champion in your office to really see that through, to really go through the whole process, through the whole, I didn’t just pay the credit card fee, or I didn’t just pay the fee and hope that it works, like we went through the whole process of getting this thing built, unboarded, whatever, set up in our practice. And in some solutions that will take time, in some solutions that’s almost turnkey but you still need some inputs, and then measure again. At the right time, just measure again and see if it’s a positive impact on the original number, or if it’s not a positive impact, try to figure out what you learned. Try to write down all of your issues that you may have identified and give it a fair shot. Keep it going with those issues being addressed.

my opinion, it takes more than just paying the fee to the technology tool to get in the same way that doctors buy very expensive diagnostic devices and then say, well, that doesn’t cash flow. Well, it doesn’t cash flow because it’s sitting in the closet like 90 % of the time. And you didn’t have a team-focused implementation, nor did you put a metric around it, nor did you give it a fair shot to be able to ROI for you. So that’s where I say point three, four months later, you can look at the metric that you were supposed to, that’s supposed to improve. And maybe, you know, if it was patient volume, maybe you went from, I don’t know, 60 % fill rate to 70 % fill rate. And it feels like it’s not working because your schedule isn’t 100 % full, but maybe it is working. You just need to now add a second tool to help solve the second part of that problem because it’s working better, but it still needs a little bit more help. So this is where I think about integrating technology.

integrating new services, integrating anything that helps any of those three problems, staffing, patient volume, or revenue per patient. AI solutions exist today to solve all of those problems in some capacity. You just have to be able to figure out what’s the right flavor for you to integrate into your practice.

Adam Cmejla (53:11.2)
There’s another door that I want to crack, but we don’t have time to discuss it today. So let me, let me selfishly corner you and put you on the spot and say, in a future conversation on the show, what I would be curious to explore is…

Eugene Shatsman (53:24.961)
Let’s do it.

Adam Cmejla (53:33.344)
The concept of having four different agents, like I like what you had said there about not overwhelming things and or not overwhelming these agents as they sit right now, juxtaposed against some of the all-in-one solutions that are seemingly cropping up in the profession. Again, I want to keep this as objective as possible and I don’t want to name any names right now.

but there are a handful of solutions out there that are an all in one. And I always want to give the benefit of the doubt. And I say that purely and truly, genuinely from a position of like, I want them to succeed. I hope that these are like amazing platforms. I’m curious to know from your experience or, and maybe that’s a subject, maybe it’s not, but I do.

Again, that’s what was coming to mind when you were talking about the individual agents and outsourcing, for lack of a better word, more and more of these tasks and what that eventually means for an all-in-one platform. And then, what do we do with the team members that we had in place in the practice? And this opens up the whole can of worms of…

dare I say, for lack of better word, the humanitarian aspect of what AI means and how we reconcile the implementation of this technology against the very real disruption to human lives, to human livelihoods, I guess I will say, to the livelihoods of team members in our practice, in other companies.

Eugene Shatsman (54:59.137)
yeah.

Adam Cmejla (55:20.648)
Again, that’s a whole deeper conversation that will candidly be harder to maybe keep just within the confines of practices. that would be, I’d be curious to explore that further with you.

Eugene Shatsman (55:31.629)
You really did open a great great freaking door here Adam, so I’ll put it this way I’m gonna I’m gonna make it as simple as possible, but I do want to I mean there’s so so there’s such a great question so much in there, but I’ll Maybe I’ll leave you with this and it’ll be the teaser for our next episode is that AI can’t bring a patient coffee But we both know both from human psychology and data within offices. We both know that if you walked into that awesome office that you were just describing because Chat GPT told you and you walked into that office and you sat down and the person at the front desk without even asking knew how you liked your coffee and brought it to you, you would be impressed enough where the reciprocity principle kicks in. And when they start making recommendations,

of six or seven hundred dollar frames and lens packages maybe. All of sudden you’re like well you know but they did make me a great coffee so I’m definitely going to stick around and hear the pitch and maybe look around. my gosh and this one’s got a great warranty and you know what I do. I do spend a lot of time in front of the computer and I spend time in the airplane so like I do need different glasses. And these people really know their stuff and that coffee was really great. So if you think about the human asked

of like if you could just free up the humans to make the connection.

If you could get your humans, whether it’s the doctor, whether it’s the tech, whether it’s the optician, whether anybody in the practice to spend time really making an amazing human connection with you and your patients, that’s the massive differentiator. And just automate the crap out of everything else so that it’s seamless. It’s easy. It doesn’t feel arduous. It doesn’t it doesn’t feel like a bunch of friction for the patient. It is truly an enjoyable visit where I feel like I’m

that I’m truly taken care of. And that’s what a better patient experience for less money that drives more revenue is enabled by AI. That’s what an AI enabled practice looks like in my mind.

Eugene Shatsman (57:48.233)
It’s not a practice where you walk in and the doctor zooms in via camera and never talks to the patient. I’m sure there’s an operating model for that. That’s just not the model I’m advocating for. I think right now, where we have the greatest opportunity to maximize the experience, because we as humans, we still want experiences. And there is a category of consumer, and I say it’s definitely in the majority, that appreciates a good experience enough to reward that with their wallet. And if you can use the technology to enable you to provide that experience, if your staff isn’t distracted answering the phone and filling out this paperwork and doing all this crap, but instead can bring me my favorite cup of coffee and the way that I like it because they already have that information that’s possibly been provided by AI to them before you even walked in the door.

That would be the wow component of that experience that makes you buy more and drives revenue into that practice.

Adam Cmejla (58:49.182)
That is a great pin to put in an awesome follow-up conversation, Eugene. So I appreciate that tease and that tee up for our next dialogue because I do think it is worth exploring because I don’t want to be opaque and callous to the fact that everything that we’re talking about right now has been somebody’s responsibility in a practice. Whether they’ve done it right or wrong or maybe right or wrong is the wrong way to say it. Whether they have done it…

Eugene Shatsman (58:54.615)
Fantastic.

Adam Cmejla (59:16.348)
efficiently or not, we’re still talking about another human being and a livelihood that is attached to that human being and people that are dependent upon them in some way, shape or form. And so I don’t, again, want to be dismissive to that. And I think it’s important to continue that dialogue and conversation to understand the causal effect of what this, I’ll go back to the word I use, what this revolution means. yeah, that’ll be fun. I’m looking forward to exploring that with you further.

Eugene Shatsman (59:45.907)
Absolutely.

Adam Cmejla (59:45.912)
I wrote down a couple of other notes that I, again, in the spirit of time, will wrap up this conversation, but I did jot down a couple of other things that I’m excited to explore with you tangentially to that. So Eugene, as always, it was a pleasure. Thank you so much. We will put links again for, I know we talked about a lot here. We’ll put links to your company, your profile, some of the resources that you’ve been putting out there for those that want to find out more about the work that Eugene is doing, or if you want to see where he’s speaking next, you can.

Again, links to his platform will be in the show notes of this episode or on our website at integratedpwm.com. So Eugene, thank you so much for the engaging and eye opening conversation, pun intended, I guess. And we’ll catch everybody on the next episode of 20/20 Money, the Business of Optometry.

Eugene Shatsman (01:00:33.237)
Always a pleasure, Adam. Thank you very much.