KPIs, Profit Loss Plinko, Generational Human Capital Management, and Buying or Selling in Today’s Market with Dr. Solomon Gould, OD MBA

December 1, 2023

Adam: Welcome, Solomon Gold to 2020 Money. Thank you so much for being here. I appreciate it.

Dr. Gould: Hey, thank you so much, Adam, for having me. It’s an honor. I’ve been following your platform for a number of years now, and you are a true pioneer and legend in the industry. Thank you for all that you do. And again, a true honor and pleasure to be here.

Adam: Legend? I don’t know that I’ve ever had that word associated with my name, so that made me really uncomfortable. But, hey, I’ll take it. Likewise, man. I appreciate the work that you’ve been putting out there. When I prepare for these interviews and for these conversations, I always wonder, how hard is it going to be for me to understand the guests that I’m going to have on? How far am I going to have to dig? With you, I didn’t have to dig very far because you are very generous with the content you put out. You’re very transparent, and you certainly let your personality shine, showcasing the passion you have for optometry and this profession. So having you on the show and doing my own due diligence was candidly pretty easy. Thanks so much for that and making my job as a host here easy.

Adam: I likewise have been following the work that you’re doing and am excited for this conversation that we’re going to have here today.

Adam: So, where I thought we would begin is understanding that optometry, in and of itself, is a business. The goal of 2020 Money here is to help optometric practice owners understand how to leverage the business as a vehicle to provide for what’s important to them in their personal life. As I’ve mentioned on the show in the past, KPIs, or key performance indicators, are crucial. What you measure gets managed, and what you manage gets improved. 

You’re a multi-generation practice owner. In the experience that you’ve had, in the multiple different lenses that you wear and facets that you show up in the profession of optometry, what do you think are the top three to four KPIs that practice owners should be focusing on in their practice?

Dr. Gould: Yeah, good question, Adam. I’ll start with just a preface of one thing I always teach my cohorts. Whether it’s a client, a friend, an audience member, whether you’re an associate working for someone, or whether you’re the practice owner, whether you’re a W-2 employee working for a corporation, the worst thing you could do is not at least learn the business of optometry. 

For a lot of reasons. I always like to say it’s good to have your PhD in Business Optometry 101. If you’re an associate, it’s good to know what they’re looking at from an operational standpoint. How can I compare myself to what their expectations are, but also concomitantly to that if you’re a W-2 employee, am I being compensated fairly? What should my bonus incentive be based on my performance? Now, if you’re a practice owner, as you know, on the same day, you will love and hate your life every five minutes.

But being a practice owner and watching the KPIs, because to your point, Adam, KPIs are the life of your practice. It’s like the heart rhythm for us, for we humans. And if your heart rhythm is healthy, you’re going to have a wonderful, healthy, long life. If your KPIs are fluid and within a healthy industry standard range, then you’re going to have a very successful and long-term, sustainable, long-term practice. 

So to get to your question, I see a lot of practice owners, to your point, they get lost in some of the, let’s just say, less important KPIs. In my humble opinion, Adam, I think the most important KPIs, if I were to give you the top four, would be the net profit ratio or margin KPI. A lot of practice owners focus on the gross profit margin ratio and they forget you can have a gross profit margin of 30-40%.

But if your net profit margin ratio is only in that five or lower percentage, then that’s tough to sustain cash flow with. So for those of you who are unfamiliar with that margin, that’s essentially what collections are coming in that are yielding a net revenue. 

And so that’s number one. Adam, number two, I would say, would be without a doubt your cost of goods ratio and your cost of goods sold. For those of you who are wondering, that’s the supplies, professional performance, and watching that KPI is really important because they are driving the majority of the revenue the OD is. But at the same time, you really want to know how efficient you are with your non-professional personnel and their efficiency. So if I could give you the top four, that would be it.

Adam: Let’s peel back the layer of that onion. Let’s kind of double click and zoom in on that a little bit. So those are the qualifications or the definition of them. Do you have some bandwidth or not? Bandwidth? Excuse me. Guardrails, wrong metaphor there, as to how you think of that from a percentage standpoint? Right? I’ve used the metaphor on the show a number of times and I’ve used it in conversations with clients.

It’s that a practice, when you look at it from a financial statement, is like a game of Plinko, right. For every dollar of revenue that you bring in, every line item on that profit loss, whether it’s in your cost of goods, which is a cost of doing business, right? That cost of goods sold, your COGS.

That’s one big whack off the top end, right? And then you have your gross profit margin, and then you go into your operating expenses, your OpEx of the practice, and then you end up with your net operating income at the bottom. But every single line item, if practice owners print out their P&L, their profit/loss statement and they look at all those items, every single one of those is a knock on a dollar of revenue that comes in that game of Plinko. So that what you have at the bottom is what is left and that is what you pay taxes on and live on, etc.

Then you have decisions on where and to what extent you invest that back into the business.

So traditionally we’ve seen, okay, cost of goods should be 25% or maybe 28%, maybe a little bit higher if you’re a heavy contact lens practice, non-OD staff equivalent was what that 25% range? Maybe plus or minus a little bit. Any thoughts on what you’ve seen with those metrics from a percentage standpoint? And I guess equally, if not more.

Importantly, have you seen those shifts in recent history as technology changes and patient demands and patient experience and journeys change?

Dr. Gould: Yeah, fantastic question. I’ll start with giving you kind of that point and click and zoom in on the KPIs. Starting with collections for full-time equivalent OD and utilizing what we refer to as a mean database of over hundreds of thousands of practices, what we take is the range and then we zoom in on the average. So with collections per full-time equivalent, what we like to see as being healthy is somewhere between 500 and $800,000. And that’s per a full-time equivalent OD. Adam, as you know, many practices have part-time equivalents and therefore you want to adjust those figures accordingly. So if they’re half-time, it’s 0.5. If they’re three-quarter time, obviously you get the deal there. Then if we talk about cost of goods ratio, again, highest expense for most practices you’re looking between on average 25 and 40% is considered healthy.

Now, I’ll come back to each of these and make sure we talk about has this changed? And certainly they have. And it’s great that you thought of that when it comes to the staff themselves or collections for full-time equivalent. So generally what we like to see is a range of 115,000 to roughly 150,000. And that’s for the non-professional staff, also our staff. And then you get into this whole gross or net profit margin. Gross profit margin is a lot easier to assess from a healthy range than the net profit margin. As you know, in the gross range, you want to be at least above 10% considered healthy. When you get into the net. What I see personally, I see everything from as low as 3% scarily enough to 20, 30%. You want to try to be in my opinion, I like to say the magical numbers above 8%.

Dr. Gould: That’s kind of like that bottom dollar. Now, to answer the latter part of your question, Adam, I think a lot has shifted. We’re seeing a combination of market consolidation, corporatization, decreased insurance reimbursements and so all of these KPIs are becoming ever more difficult to achieve. And then you combine for those reasons, but then you combine the human factor at them and that is hard to find good employees or to sustain employees and then it’s really difficult to perform at the peak or at even healthy standards. So I’ve seen in my clients who I would be consistently above in the upper 99th percentile now they’re not there and they’re struggling just to get into the healthy range. So yes, brilliant observation on your point. I’ve seen more difficult challenges for them to achieve and I’m seeing as a result a lot of optometry practices vertically integrating into other revenue streams and other sources just to sustain their practices.

Adam: It’s interesting that you bring that up, Solomon, because one of our relationships, and I know she listens to the show, so kudos to you, has introduced holistic omega-3s and dietary supplements. This diversified yet related stream of income into the practice is just a way, for lack of a better word, to hedge and diversify the streams of income in the practice. I see it from multiple different angles. On one hand, it’s a very cognizant, proactive, and anticipatory business decision. 

But on the other hand, she wholeheartedly believes that by offering that to her patients, and the data she’s read, every OD can agree that there are certain dietary supplements and actions that directly impact one’s ocular health. I don’t want us to dive down that rabbit hole too deep, but that’s demonstrative of the mindset that practice owners have to have right now in this shift and flux. Maybe I don’t think I’m being too hyperbolic or speaking in hyperbole about what’s happening in the practice model right now. 

I do want to come back to the cost of goods. You said like 25% to 40%, and I immediately thought, “Oh my gosh, forty cents of every dollar going to the cost of goods. What can we do there?” There are conversations to be had on the power of your buying group and renegotiating your rates and services. You can either reduce cost or increase the top line to affect that margin. 

We have a client that is not an optometrist, and they own a specialty compounding pharmacy. Their cost of goods is 82%. Drugs are really expensive to buy, even at cost, even at wholesale prices. So they did 3.52 million in top line revenue last year, and their cost of goods was 2.913. So it’s all relative. We have to look at the business.

Dr. Gould: Exactly right.

Adam: And what you said, if we take that game of Plinko all the way down, at the very bottom, this is why I don’t care what gross revenue is of a practice. I don’t care what you make; I care what you keep. When you see a practice that has a 5% profit margin, and to clarify for the listeners, the unspoken assumption that you and I are both making here is that we are assuming the owner is part of that OD full equivalent to some extent. If the practice is a ten-doctor day practice, we’re assuming that they’re going to be one of those two full equivalents in the practice. So we’re looking at the profitability of the practice after the doctor’s compensation. As an owner, you should get paid in two ways: the work that you’re doing in the business as a clinician, providing patient care to your patients, and then on the business. And that “on the business” is what you’re referencing, correct?

Dr. Gould: Yes, thanks for clarifying, Adam. That’s important for the listeners, for sure.

Adam: So let’s flip that coin then. Are there wrong KPIs that you see practice owners focus on? I feel like there’s a poem or a metaphor out there that is relevant. They spend so much time climbing up the ladder only to realize it’s leaning against the wrong house. Are there areas of a practice that you have seen practice owners focus on? Is there a common denominator where they focus so much on a handful of these items in their practice when in actuality, do they matter? Maybe. But is it the best return on time, energy, and effort they could be having in their practice?

Dr. Gould: Yeah, for sure. Now that’s a good one. I’d say more on the micro scale, Adam. A lot of owners focus on staff productivity per hour. That’s an apples-to-oranges mistake, in my humble opinion. Two practices are very different from one another. If you’re vision therapy versus a full-fledged medical practice, glaucoma surgical management, focusing solely on staff productivity per hour is getting lost in the weeds. Another one would be the whole net income ratio. It’s good to know compensation efficiency, but if they’re so focused on these big macro KPIs, like how much revenue are we making, you’re focusing almost too large. And if you’re focusing too much on those staff productivity per hour, you’re almost too small. I like to focus on the heart and soul of the practice. I like your analogy with the game. I think that’s much more informative for monitoring practice performance.

Adam: Now, I’ve been using that metaphor for a while. In my mind, I’ve always thought, how can I gamify this? Can we create a board game for optometry? Maybe it’s not Plinko, but something like Connect Four. Can we create a Plinko board game that would be fun to fund? 

I’m just rambling here, but gamification is a very real thing. Companies have made billions off the gamification of everything from fitness to investing to cooking and even true gaming. The gamification of sports betting, everything has been turned into some type of game that works really well for our psyche. Not to digress too far, but I think of the HR and the team aspect, whether we’re talking about ODs or non-OD, human capital inside of a practice. 

In the conversations we’ve been having, I think human capital is going to be one of the main topics at the various optometry gatherings and conferences this year. A lot of practice owners are struggling with not only how to attract but also how to maintain the team they have. Show me a practice that has good margins, a happy OD practice owner, and a growing practice, and I’ll likely show you a practice that has a tenured staff. 

If they have a tenured staff, they’re not paying them or themselves in the 50th percentile of wages. They’re investing in the right people and making that proactive investment into their practice. The question is, with every dollar, it’s a finite resource. Unless you’re going into debt to maintain the practice, which is a bigger problem, where can a doctor owner wanting to allocate more capital in the business towards human capital find the funds? Last time I checked, it could come from their profit margin, but let’s be honest, they’d look for every other place first. So, any thoughts?

Dr. Gould: Certainly, Adam. Thank you. I’m personally waiting for Amazon to come out with robotic employees, just kidding. One common mistake I see is the belief that increasing dollars will bring in talent. That’s an old-school way of thinking. The new generations now operate differently. For example, the baby boomers, 64% of them are still working part-time, and they’re over ten years into retirement age. 

They do this for various reasons, including staying active and the rising cost of healthcare. There’s an abundance of good people out there, but many employers use antiquated tactics. It’s more expensive to hire than to retain. So, focus on reconnecting with your team. Find out their engagement level. If they’re a good employee, retain them. If not, I personally pay them to leave my practice to avoid a toxic environment. Different generations operate differently. 

Gen Zers love providing a quality experience but don’t like to work many days a week. Incentivize them with work-life balance. Millennials want to contribute and need empowerment. Gen Xers are loyal and just need job security and validation.

Dr. Gould: They really like structure, clarity, and communication. Communication is their biggest language. And then the boomers, they’re at that stage where they can just work part-time and have fun. But I guess that was a long answer, Adam, on a simple question. Don’t go for the monetary reward. Go for understanding what makes them tick. There are many resources out there. Jason Dorsey is the number one expert on generational differences. If you don’t know Jason Dorsey, check him out.

Adam: That’s a good tip. We’ll put links to that in the show notes. Has he written a book or is it all published online?

Dr. Gould: This guy is the Yoda of generational differences. I’ve attended many of his lectures and conferences. He has his own firm out of Austin, Texas, and lectures globally for big companies.

Adam: As you’re talking about that, you’re spot on in knowing that money only goes so far. Jim Rohn said, “money is not everything, but it’s right up there with oxygen.” But there should be an asterisk next to that because it’s only to a point. The paycheck doesn’t wear out, but it’s not all that people care about. I was reminded of a quote from “Remember the Titans” with Denzel Washington: “Attitude reflects leadership.” That phrase is very applicable in practices. Culture can either be a blessing or a cancer in an organization. Your team members look to you for leadership, guidance, and direction. Great leaders are judged more by the questions they ask than the orders they give. As a leader, ask what will make them happy. This isn’t about giving up control but giving them a sense of purpose in your practice. If you find yourself constantly hiring, it’s much more expensive in multiple ways than paying more. Don’t just think that giving a raise will solve HR problems. Understand what motivates and drives your team members. Reflect on that. It matters for everyone, not just for specific job descriptions. I’m passionate about human capital because it’s an expensive line item in your business.

Dr. Gould: I couldn’t agree more. Many doctor owners are burnt out, both clinically and as practice owners. A lot of it can be avoided by checks and balances on themselves. Ignorance is not bliss in practice ownership. If you avoid the pain and delegate everything to a practice manager, it’s the worst thing you can do. Preserve yourself along the way and ensure that what you’re doing is what you’re passionate about. If you’re not doing what you love, find someone who is passionate to take over. If the leader at the top isn’t in a good place, turn it over to someone who is. Take care of yourself. We’re seeing a lot of burnout in the industry. Practice owners are unhappy. You don’t have to continue being unhappy. Do what you love and preserve yourself along the way.

Adam: I want to bring us up for air here and come back to ideating around the economic numbers we’re seeing right now. Unless you’ve been living under a rock and haven’t bought anything in the last three to six months, you know things are getting expensive. Inflation is here. Now, I’m not going to go on a whole inflation tangent, but it’s important to note that your team members are cognizant of it. So, we have to start thinking about to what extent compensation plays a role in retaining and attracting top talent. Money in a practice is a finite resource. So, are there areas in the practice that are ripe for disruption that can have a bottom-line impact? Is that rethinking a marketing plan or looking at other areas where we can reduce costs without sacrificing quality?

Dr. Gould: A lot of sense, man. I live and breathe it every day. We’ll start first and foremost with COGS, right? COGS is the one area where you can most easily adjust things. Buying groups, through sheer economies of scale, can really bring down the COGS for you. This comes with some stipulations, like vendor loyalty and volume. But most people already have brand loyalty. Another thing people often overlook is refinancing. Rates are at their lowest, and many barriers have been dropped. Whether you’re financing for the first time or refinancing an existing practice, now is a great time. By refinancing, you can increase your cash flow cushion. Another thing to consider is what practice specialties are net positive. Do a revenue analysis on your specializations and trim the fat where necessary.

Adam: Right, and to your point, every business owner eventually realizes that time is more valuable than money. With more time, you can make more money, but with more money, you cannot make more time. This ties back to the refinancing option, which is a great option right now. Yes, you might have a little more interest expense, but the next iteration is to think about what you can do with that freestanding cash flow. If you’re going to spend it on non-revenue-producing depreciating assets, that’s a bad choice. But if you can redeploy that capital either back into the practice or take it home to live your life on purpose, that’s a good choice. Yes, you have an interest expense, but what is the financial and quality of life implication of making the responsible decision with that money? It’s a subjective analysis, but a valid one at that.

Dr. Gould: Absolutely. And back to the specialty improvement, if you’re doing specialty contact lens fittings and it’s chewing up your chair time, that’s taking up a comp exam slot that could be driving revenue to the practice. If you do that a handful of times per month at $350 industry average comp exam fee, we’re talking about thousands of dollars per month. That’s a soft dollar benefit. It didn’t cost you any more money to capture that additional revenue. You’re just being more cognizant and intentional with the time and management of the time that you have in the practice.

Dr. Gould: Adam, you’re absolutely spot on.

Adam: I’m debating if we want to pivot towards marketing because I know that’s a passion of yours as well. Let’s do it. Let’s dive into it because it’s something both of us have a passion for. This ties into another question I have about building enterprise value in the practice. The enterprise value of a business is determined by the extent to which someone in the future can have confidence in the predictability of the future cash flow of that practice. If I’m a buyer looking to buy a business years in the future, I want to know where that revenue is going to come from and how confident I can be that it will repeat itself. Every practice has some attrition on an annual basis, whether that be through relocations, expanding cities, or new competition. I don’t like the phrase, “if you’re not growing, you’re dying.” But I think you do have to be aware of your surroundings when you think about marketing. So, what excites you about marketing in practices in today’s environment?

Dr. Gould: Honestly, Adam, the last two years have been an eye-opener for the marketing aspect of eye care and healthcare at large. In 2020, there was a 46% average increase in social media usage by practices. Consumers are craving more communication from the brands they’re loyal to. Many practices have embraced direct text messaging through their CRM platforms. People are relying on marketing not just to find you but to build a relationship. They expect regular and consistent postings and also social responsibility. Marketing is no longer just a way to attract potential customers; it’s a way to retain and engage them. If you’re not active, you can’t just have a website anymore. You need to deploy direct messaging, online appointment scheduling, and more. Everyone lives on their cell phone now.

Adam: I view it, at least in our profession, that if you don’t have online scheduling, I will immediately knock you down a peg. Are we at the point where online scheduling is basically the expectation, the status quo? How close do you think we are to being there?

Dr. Gould: We’re beyond there, Adam. Those in more rural settings get a bit of a buffer, especially if they’ve been practicing for a while. But the majority of practices nowadays need online scheduling. The largest generation is the Gen Zers, followed closely by the millennials. They want online scheduling. If you don’t have it, almost 100% will move on to a brand that does. If your website has a phone number and it doesn’t auto-dial for them when clicked, they’ll move to a brand that does. It’s all about convenience and experience.

Adam: It’s about creating a frictionless experience with your brand. We live in an era of instant gratification, or maybe it’s more about wanting instant progress. If setting an appointment with my optometrist requires me to fill out an online form and then wait for someone to call me back, some might say, “That’s how we do it, and it works.” But, quoting Wayne Gretzky, the best players go where the puck is going to be, not where it is. 

When we implemented online scheduling, we were concerned about its adoption, especially among our older clients. But then we realized that the biggest users of Facebook are those individuals, and they’re doing it from their phones. If they can upload videos and photos of their grandchildren on Facebook, they can surely click on a link in an email. 

There’s often a disconnect between what we think the patient wants and what they actually want. Inertia is a powerful force in practice ownership. But it’s the responsibility of the practice owner to change the script and the experience. You never get a second chance to make a first impression. I had another point, but I can’t recall it now. Maybe you can bridge the gap if you have any thoughts.

Dr. Gould: I’d love to. One of the best things practice owners can do is customize their approach. In my St. Paul practice, which I use as a testing ground, everything was technology-driven. But some patients from the silent generation didn’t like automated reminders. So, we learned to customize based on individual preferences. To your point about anticipating future needs, what if you could be significantly more profitable by implementing something that a majority of people want? We’re well beyond that now.

Adam: It’s funny when you mentioned St. Paul as your testing ground, it reminded me of my microbiology days and gram staining petri dishes. But back to our main topic, for some listeners, they might be young associates planning to buy, while others might be owners looking to exit. What excites you more right now, being a buyer or a seller?

Dr. Gould: It’s a bit like the housing market. Both buying and selling are exciting for different reasons. Right now, you can probably sell your practice for more than its fair market value. But if you’re purchasing, there are many undervalued practices out there. The future of optometry is promising, and brick-and-mortar practices are becoming more important. 

When it comes to private equity, there are pros and cons. Some people prefer to focus on being a great doctor without the headaches of business ownership. However, there are long-term implications to consider. Now is an exciting time to buy or sell for many reasons. Financing options have become more favorable, and there’s more support available than ever before.

Dr. Gould: Honestly, it’s a bit like the housing market. Every morning, I read that we’re currently experiencing the highest rate of home sales in the past 15 years. This means many people are buying. So, both macroeconomically and micro economically speaking, for both short-term and long-term reasons, both buying and selling are equally exciting. Right now, you can probably sell your practice for maybe 20% to 30% above its fair market value. We’re in the era of private equity. Whether it’s through private equity or a private sale, you’re likely to achieve that margin. On the buying side, there are many undervalued practices out there. There’s so much more to a practice than just its financial statements.

Considering the direction of optometry’s scope of practice and the generational shifts, with Gen Zers emphasizing brick-and-mortar healthcare, it’s an exciting time on both sides of the fence. When it comes to private equity, many have strong opinions, either positive or negative. But there are genuine benefits to it. It’s challenging to provide quality healthcare when you’re a small entity due to the margins. And as you’ve pointed out, the situation isn’t improving. If someone wants to focus on being an excellent doctor without the business headaches, partnering with private equity isn’t a bad route.

However, there are long-term implications, as you know, Adam. Many think short-term, focusing on immediate gains, but they overlook the long-term opportunity cost of selling and the equity they might miss out on. But truly, now is an exciting time to either buy or sell. Many financial barriers are being lowered. You can enter the market with 0% down and a favorable interest rate. If you’re looking to partner up, whether with a buying group or another entity, there’s more support available now than ever. This level of assistance wasn’t something we saw 5-10 years ago. It’s a new era; previously, you either could secure the help, or you couldn’t.

Adam: I joked with you during our show prep that this is kind of a loaded question, right? Because, yes, it’s a great time right now to be both a buyer and a seller. And I guess the two things I’d highlight from what you said are: First, private equity has been a major topic in the optometric profession lately. But the mistake that practice owners can make is thinking that private equity will buy every practice. In reality, private equity is only interested in, let’s say, 15 to 20% of the practices out there. Some private equity firms are trying to target practices that fall below their ideal revenue amount. We’ll see how that plays out. But that still leaves 80 to 85% of practices that will need some type of succession plan, whether the owner realizes it or not. You will leave your practice at some point, guaranteed. It’s just a matter of whether it’s on your terms or someone else’s. If you’re planning for succession, don’t assume private equity will be interested in every practice. Finding a private buyer might be your only option. Look at rural practices, for instance. We did an episode with Dr. Matt Mitchell about the benefits of practicing rural optometry. And lastly, on the topic of overpaying: practices are selling at a premium right now. If you’re a young practitioner concerned about high valuations, you might pay more than you would have a couple of years ago. But in the grand scheme of things, the future cash flow of that practice will make up for it. The net worth you can create with that asset, combined with proper planning, will outweigh that 15 to 20% premium. Don’t let that stop you from making a significant life decision. Any final thoughts on that?

Dr. Gould: Absolutely. You’re spot-on about the buying aspect. And on the selling side, if you’re in retirement strategy mode and just want to exit, that’s one thing. But if you’re in private practice and are tempted by a large offer, consider the long-term implications. If you plan to practice for another 20 years or more, think about the taxes and amortization. Before deciding to sell based on a large offer, consult with experts like you, Adam, to get a clear picture. There’s more to it than meets the eye.

Dr. Gould: There’s more than just the tip of the iceberg that you need to know before making that decision.

Adam: Very well said. Okay, two final questions. The first one’s easy. We’re doing this on video right now, though listeners are only hearing this on the podcast. What does your Snellen chart say behind you? I can make out some of it, but what’s the rest?

Dr. Gould: This was given to me by my grandfather, who was an optometrist from the 50s. It says, “If you work really hard…”

Adam: How’s your acuity? Can you read it? I’d guess you’re maybe at 20/40 best corrected.

Dr. Gould: I should be better at this since I’m wearing my contacts. It says, “If you work really hard and you’re kind, amazing things will happen.” That took a while.

Adam: “If you work really hard and you’re kind, amazing things will happen.” Nice. Sorry, I didn’t mean to put you on the spot there.

Dr. Gould: It’s a good test for me. Now I’ll have it memorized if I ever get asked again.

Adam: Right. Last question. This is 2020 Money, a show to help optometrists and practice owners make educated and informed decisions about their money, life, and practice. Dr. Solomon Gould, what’s the biggest financial lesson you’d teach your younger self?

Dr. Gould: When I was young, I focused too much on industry averages for collections per exam. I didn’t account for chair time or that the revenue per exam isn’t what you take home. You need to understand the cost of everything you do. It’s not about gross revenue, but net income. I made the mistake of spending too much when cash flowed in, but then hit a cash flow issue. Always maintain a cash buffer above what you think you need.

Adam: Dr. Solomon Gould, thank you for being here. If people want to learn more about your work, where can they find you?

Dr. Gould: Thank you, Adam. It’s been an honor. I’m on social media – Facebook, LinkedIn, Instagram. My email is [email protected]. I’m here to help, not to accrue clients. If you have a question, I’m here to assist.

Adam: We’ll link to all of that in the show notes. Solomon, this conversation lived up to my expectations. I think this won’t be our last conversation on 2020 Money. Thanks for being here, and we’ll catch everyone on the next episode of 2020 Money.

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