Author Archives: Holly Fisher

Prepare for the New Year

Prepare for the New Year

Where does the time go? It is time to ask yourselves these questions. Where is my practice today? What is my vision for the future? Am I set for the end of year with tax planning? What are my goals for 2024? Am I prepared to grow in 2024? Is my staff ready, willing, and trained to deliver the care and service necessary to be as efficient and knowledgeable as possible to educate my patients about the lifestyle products and services we provide or plan to add in the New Year?

Those are a lot of questions to answer, but they need to be asked and you need to begin planning. We all know this is a great time to look for new instruments not only to enhance the practice, but also for tax benefits. We all know it is time to do a thorough inventory of frames, contact lenses, accessories, and other items you have inventoried for your dry eye spas and more. Remember, it is time to look at the eyewear, both contact lenses and eyeglasses waiting for patients to come pick up those orders. If they have balances owed, now is the time to collect that money and dispense the product.

Evaluate those frames in your optical. Have they turned over two and one half to three times in the past twelve months? If the answer is some brands are and some are not, now is the time to create a plan to sell those brands down and bring a new fresh independent frame brand into your office. Be different, offer your patients a product they don’t see in every chain location or other practices.

How many more years are left on your lease? Does the space you are in accommodate the business growth you are experiencing and into the future? Do you need to start to renegotiate your lease? This needs to be started eighteen to twenty-four months before the lease expires. If you wait too long the landlord knows you cannot move out overnight, plan it so you have time to negotiate and have options to consider. Do you plan to add an associate in the coming six to twenty-four months? Should you consider buying your own building? What would it cost, and can you afford such an investment? As you look at the current space, if you plan to stay, is it time to refurbish your practice? Does it need a fresh coat of paint and new flooring? Do you need a full remodel with new fixtures, lighting, and all? Investing in your space or relocating will help you grow your practice. Don’t put it off too long. If you are considering the addition of another doctor, a dry eye spa, a call center or other, I encourage you to explore these options. The investments you make in your practice will add value for yourself and your team. It will make your office more marketable to the new associate or partner and/or new owner when it is time for your exit strategy.

Speaking of exit strategy… Have you completed your estate planning in the event something unplanned occurs? You need to and must do this, not for yourself but for the wellbeing of your spouse, children, and the practice. Should you have a valuation completed for your office? Remember a valuation is based on the previous three years. The New Year, 2024 now means we will not have the challenges and adjustments to make in the calculations of the valuation because of the challenges the pandemic in 2020 brought us. All these items are your legacy, and you need to protect them, and yourself.

Many of you Acquios Alliance members are also part of other groups and organizations. I see many of our members active in as many as two to five different organizations. I say this all the time, each one may bring different values to different practices. It is time to review each of them. You need to measure what the Return on Investment is for the vendors you pay. Are you seeing any ROI in the vendors you are associated with and work with? From buying groups to businesses where you purchase accessory items, they all need to be reviewed. The organizations and vendors you order contact lenses, frames, labs for your ophthalmic lenses, office supplies, and all. You need to divide these vendors among your staff and assign them to review the prices you are paying now and look at other vendors to consider changing. Just because you have done business with one company for the past years does not mean you should not look for something different and new. Make this an action plan for and with your team. You won’t be disappointed.

Do not overlook yourself. Yes you, your professional fees. Do you need to increase the fees? Is it time to evaluate the third party plans you accept? What is the ROI on the plans paying you for the time you are with your patients. If you never analyze them, you will never know. Look at them, question them and ask yourself, does this plan benefit or hurt me or my practice and cause unnecessary chaos for my team? Act and you will be happy!

What about those annual tools we all need to review and in all honesty are not exciting or fun.; HIPAA acknowledgement forms and compliance. Your employee handbook manual, when was the last time you read your manual? Have you revised it to be current with the times? Do you make sure your staff has signed off on it this year? Start the new year out with everyone reading it once you have it updated by December 1, 2023 to know and understand the policies you have in place for the coming year. Dress code, attendance, the definition of a workday, vacation and bonus structures are just a few items you need to review and update. Make it happen! As I said it is not exciting, but it will make the new year easier and better for all. Policies and rules are necessary for a successful business. Again, in the words of Nike, Just Do It!

As you look at your year-to-date numbers and see where your top line growth is today, begin to ask yourself where you want to be next month and at the end of the year. Begin to look at the number of days you are working in the clinic. Are you looking to work less and make more money? Are you going to add another doctor to help with the patient’s demands and increase your practice. What will you need to add another doctor? Will it be an additional exam lane? Will you add a “specialty” to the practice? What will the out-of-pocket expense look like and what will the investment generate? Be conservative on the projections.

Never overlook your most important assets which are your employees, your work family, and your team. Do you have enough hours staffed and scheduled to care for your patients to exceed the expectations outlined in your practice mission statement, your core values and to meet your personal expectations? Do they know your why? Do they know why you became an Optometrist? Do they know why you started your own practice? Do they think it is because you wanted to make larger amounts of money for yourself? If the answer to that is maybe or yes, you need to share with them your why! Did you open your practice because you did not want to be told how and when to care for your patients? Are you in a better place because you can select and make all sorts of decisions and recommendations on how you run your independent business and clinic? You need to educate your employees about you and how the organization you came from operated. Many of your employees have no idea about the benefits of an independent practice. It is not easy at all! You could be employed in a large organization, arrive at work, see patients, and leave. None of the other items listed before now would you have to be concerned about, and we know there is more. You operate a private practice for your patients to deliver better care, you do this for your staff, so they have a fun place to come to each day and build relationships with their fellow team members, you do this because it is fun. Here at Acquios Alliance and Advisors we are thrilled to be a part of every practice we are associated with.

As you read through your edition of this newsletter, please consider the vendors within and throughout as all of them have been carefully vetted and are only added when we know with certainty that they are on your side. They are here to help you make your practice more efficient and better with you tomorrow and beyond!

Thank you all and here is to productive close to the 2023 fiscal year to each and every one of you. Whether you are an owner, an associate OD, Optometric Technician, Optician/Apprentice/Frame stylist, receptionist billing and coding specialist or other, you are all appreciated. Remember the patient you helped who never wore glasses and you dispensed the glasses with a -2.00 OU and the smile on his or her face. That is why you do what you do. Never forget it. You make a difference in each of your patients’ lives.


Rick Guinotte


Social Media Empowering Confidence

People are braver today than ever. They are confident when there is not a face in front of them and they don’t have to worry about an immediate response from others when they are asking a question, making a statement, or asking for guidance. The number of platforms available for people to share their questions, thoughts, concerns, praises, complaints, and ideas are expanding and growing every month. From Neighborhood, industry specific, review sites such as Google, Yelp, and other apps is exponentially increasing. People are sharing, and willing to share, from an electronic device from the comfort of their own homes. They share at any time of the day or night. Possibly when they have had a bad day or a little too much fun after a long week. Today, in this article, I want to focus on information shared on Optometrist specific sites.

You might ask yourself, what is Rick talking about? I will be the first to say, I participate in many of the ODs on……. Pages. There are many times I need to stop myself from responding because the nature of the question or questions being asked requires more information from the person asking to give proper directions. We have said since January of 2015, here at Acquios Advisors, every client’s office is unique and there is no one answer for all offices. Don’t get me wrong, I think these platforms are a great   resource for people to learn but we need to be careful of expecting to get each answer we need to make the right impact on your office. What is right for one office is going to be different than what is right for another. As the newest round of ODs completing their education and passing their board exams enter the market for hire, I see numerous questions about what a fair compensation for an Optometrist in an office generating a specific amount of money. I love the collaboration and thoughts being shared. It is great to see the community coming together to help guide one and all to be better. But I will say, there are a few factors to consider when looking at what is necessary in a compensation package for an associate in a practice.

I see repeatedly, on sites, the going rate for an OD is $600.00 per day. I am not saying that is not accurate in some states, but does it work for every office? The per diem will vary in areas of the US and Canada. Before making such a bold statement, does the office offer other benefits? Is there a bonus, reimbursement for CE, vacation days, PTO, cell phone service, retirement plan, maternity leave and more? How many patients will the office expect the associate to see per day, per hour? What is the office’s break-even point per OD day? How many patients does the associate need to care for to achieve and exceed the break-even? All items the owners know about their office or should know about their office. If you do not, please let us know. We have a tool for that.

New grads are asking for larger than ever guarantees to start their new career and what a great career they have selected to be a part of. We must make sure we are looking at your situation and not because we see the post on this group or that group stating we need to pay this or that amount of money to hire an associate.

To you younger ODs and new grads, ask more questions as you interview with various private practices, commercial companies, chains and more. Learn what will be expected of you in the practice. How many patients are you expecting me to see per hour and per day? Will I be required to deliver care using new technology such as Tele optometric lanes? Are you comfortable doing this? Can you deliver full scope optometric care in this practice? Can you prescribe specialty contact lenses? Offer Myopia management to patients who would benefit?  How about Dry eye treatments and such?

The compensation package being presented will always be tied to expectations. Again, no two offices are identical and can offer the same compensation packages. The offices hiring need to share what they offer for quality care and what makes this office special and different from others. Remember, fixed expenses in California will be and are higher than most every other state in the US. Rent in Brooklyn NY will be higher than what we see people negotiating in Wyoming. The cost of doing business per square foot is going to vary, therefore the compensation packages will fluctuate as well. Social media posts FAIL to be 100% accurate because one never knows. Bonus structures are there to bring balance to the owner and the employee.

Social media is making people braver, and, in many cases, I have seen new grads be too demanding asking far too much for their initial contracts or even at renewal time. Be careful as some of these organizations offering very handsome packages are going to force you to make sacrifices in how you practice. I am not saying they will compromise your quality, but they will more than likely narrow your scope of practice. You invested four plus years in your professional education and deserve to be happy. Take time to learn more and understand the practice you are considering for employment. Be careful. You cannot teach the same trading emails or texts. Schedule time to be face to face and conduct a healthy conversation.

Another fact to consider is the plan for the existing OD or ODs in the office. He or she may be close to exiting the practice. Don’t just look at the here and now! Look three years forward and see where the office will be and what opportunities will you be presented? All owners reading this will nod their heads as you read this next sentence. When I started this practice, I did not get a vacation day for a period, I did not get a paycheck until X months after opening or acquiring my practice.

I am not suggesting any doctor works without pay but there needs to be growth, commitment to network oneself in the community and prescribe what is best for the patients’ needs and lifestyle. This is where the bonus piece comes in. The bonus is an equalizer. This is the tool to reward the associate for their contribution to the success of the practice. For those of you I worked with associate agreements, you know I am all for taking care of those that take care of you.

Not only is social media encouraging people to ask for higher compensation, better retirement plans and more, but it is also some of the guidance being given by the Optometric Schools. Advice being given by the schools by people unaware of the rising costs of doing business. It is up to each and every one of us to help educate students and newer grads on just how great your practice is for the patients, your team, and how great it will be for them as a professional. We have a tool to teach people to budget their personal finances. Please request it from us. Email us at for this tool. It will help people to see just how good they can live on $100K per year with their student loans and other monthly expenses. It is all about teaching people to live within their means.

Yes, I focused on associate compensation in this article. The same questions and direction apply to your other team members. It is interesting. The other day I was reading an article about why a company generating $18 Million dollars per year should pay significant fines to improve the safety of the industry it is in. Well, just because a business generates 18 million dollars per year does not mean it has large amounts of money to pay to invest more in the safety of that industry. They have their Cost of Goods, fixed, staff and variable expenses, just like you. Top line dollars don’t tell the whole story, neither do social media posts. Do your homework and be aware of the opportunity you can present. Be confident and be proud. Choose the right office for yourself as a professional. Hire the right professional for your office and your opportunity. The right position is out there, and the right professionals will be there for you.


Thank you all,

Rick Guinotte

Living Our Mission

Our Mission Statement: We listen with Compassion and Collaboratively work to Develop and Implement a plan to help You and Your Team!

We are seeing and hearing great things from across the country. More of you are staffed to the levels you need, training is being worked on, and more people are sharing their resumes for work in offices. I have said it many times and will continue to repeat this; your staff is your most important asset. For this reason, over the past months Scott Cline along with others on our team collaborated to develop our new Executive Management Program. We are excited to share the first days of the event that took place on June 2nd and June 3rd. Thank you to those that attended and are currently working through this 6-month development program.

Yes, you read that correctly. This event started over two days and will have over a total time of 45 hours for the attendees. We are guiding the management/leadership of offices to become better leaders for the practice owners, the team, and of course themselves. Over my years of Advising, I have seen some very good managers. I have seen many that needed some mentoring as well. We now have the tool to help your office grow and help the manager to learn from us as well as the other 19 people in their class. We have limited the number of attendees per class to 20. Why limit attendees? We want to let voices be heard, questions to be asked, and experiences shared. The sessions are interactive and informative. The first month was about the attendees personal Mission statement, what they expect to deliver as the business leader, being in control of the day as opposed to the day controlling them, delegating, follow through, and how to navigate challenging times. This next month we will conduct a ZOOM meeting to discuss questions and implementation of the actions discussed in early June. We will be moving into HR management along with motivating staff, accountability, budgeting, managing the trends of the business, and more.

I am thrilled to share the next session is open for registration. It will begin on September 15th and 16th here in Omaha Nebraska for the next class to join and participate. Sign up fast as this truly is an amazing program!

We Deliver Insight that Inspires.



Rick Guinotte,

President Acquios Alliance and Advisors INC.


What is new in 2023

As Acquios Advisors enters our ninth year in business and the Acquios Alliance continues to grow and add more vendors, we are excited to be able to challenge you to review the list of businesses now associated with the Acquios Alliance and see how they can help you to run a better more independent practice.

We have some new vendors to mention; Optical Vantage, an independent lab with an amazing owner/operator, Review Wave and HIPAAmate. Believe it or not, it makes HIPAA fun. Ask us more, we will get you introduced. New frame vendors are coming on soon as well.

From the operations side, not only do we offer you a great option for a team retreat to a great city, Nashville, Tennessee will be host to the second Living your Mission event. We look forward to seeing doctors and staff in person to energize your team to deliver an amazing patient experience while building appreciation of each and every one of your team members and the roles they play! This is a new year, and the past is behind. Please join us in Nashville for this event on April 14th and 15th. It is going to be invaluable.

You spoke, we listened and have acted. We are launching our Leadership workshop in the coming weeks. This program is going to guide managers and owners on how to manage your practices. This multi month program will be interactive, insightful, and full of valuable knowledge. Learn to manage and guide your team to be the best in your business’s history.  Stay tuned on our FB pages for more details to register and join the program.

2023 is going to be filled with success for all. Choose to be successful, write down your goals, track your progress, and be the catalyst you want, and your team needs. We are here to support and drive each and every one of you.

Make it the year you want; utilize the resources you see here within this newsletter. Together we will succeed!



Rick Guinotte, CEO and Co-Founder


A Story Goes a Long Way

Times have been interesting for us all. I am not sure there is any business owner or manager today that will not say staffing and HR management have not been a challenge this year. It is important to step back from time to time and reflect on what makes the optometric industry unique and rewarding while offering a secure place for people to work. As I go through each of these items, you will think to yourself, yes, my practice reflects that thought and other times you may say, I don’t see it here, I need to improve on this area or share more with my team to help them see the whole picture.

When I started in this industry many years back, I was in a position to make a difference in a young girl’s life. She was only seven and had never had glasses but needed them badly. When the doctor had completed the exam, he made his recommendations for her first pair of glasses. She had a -2.50 in one eye and a -3.50 in the other with some astigmatism in each eye. I was the optician to assist with her frame selection and lens order. She selected a pink Disney frame with cable temples. A week or so later, the eyeglasses were back from the lab and ready for her to pick them up. She came to the office, so I grabbed her glasses, and we sat down by the window. I placed the glasses on her face and the smile she had was priceless. She looked out the window and asked her mother if those were leaves, followed by, is that a bird? I realized at that moment this industry was amazing. I was hooked. I have been in many offices when an optometrist makes life-saving discoveries or saves a patient’s vision. What starts out as what the patient thought was a “routine” exam, the doctor discovers a retinal detachment, glaucoma, a brain tumor, signs of Multiple Sclerosis, and more.

How many other businesses can help care for patients’ whole-body health with the technology available in your practices today while offering products to improve your patient/customers’ quality of life? Asked a different way, what online service, or commercial owned and operated clinics have the technology you offer?  I can’t think of many. This is a unique industry with opportunities for people to grow and carry forward in it. To make your passion infectious in your office, you need to share your diagnoses and experiences with each and every one of your team members. Make your team proud of the services you deliver patient in and patient out.

The technicians, receptionists, and opticians have numerous patient interactions daily. The receptionist makes it possible for the clinic to have patients to care for. There should be conversations between the receptionist and others in the office about patients coming in and what their needs are. Communication between the team members builds unity on the team and respect for one another. This results in staff retention. Why? The more they share information to make their patient interactions more personable and effective, the more they begin to care for one another.  The same will be said about communication between the optometric technicians to the optical staff. The staff represents you and your brand. The patient experience is not just one area of the practice but the whole. The whole team must be working in unison to make certain your mission and your core values are being represented every minute of every day.

It starts with the doctor, the visionary of the practice. Challenge yourself to share your experiences about those unique patients you have. What was the diagnosis? How did you and your team make a difference in your patients’ lives?  Furthermore, ask your receptionist to share information with the team about the patient she/he has made appointments for. Ask your technicians to share stories about some of their patients and how they adjusted to help a patient to have the best interaction in your practice as possible. Let the opticians share stories about the patients who recently picked up their first pair of glasses. What were the patients’ facial expressions? Were they excited, appreciative, and grateful for the service and the product the team delivered? Every employee needs to share and hear how they all helped your patient in your practice and the care that your team was able to provide. That is the lasting impact that your brand has on the community.

Make time for team meetings and spotlight the highlights of individuals in your practice but most importantly, recognize your team for their contribution to making you and your practice successful. Remember, every person matters. Every employee makes a difference. Every team member represents the whole practice. Each person is a piece of the puzzle and without them, you couldn’t achieve what you set out to do. Acknowledge the positive experiences and learn from the areas the individual and the team need to improve. Tell patients on social media about the great performers in the practice. They need to know they have their best interest in their heart. The result will be increased appreciation for the work the team does, increased collaboration within the team, and increased employee retention. Look at me, one patient about six months into my career, and I still talk about it today.


Rick Guinotte, CEO and Co-Founder

Draw your line in the concrete

This will not come as a surprise to any of you. Every office we work with has office hours. You have the hours posted on your website, your front door, in your employee handbook, on business cards, and possibly many other places as well.  You have your employees’ hours to be worked on a schedule. The schedule is written to be efficient for your practice. It is also created and produced to make certain you have the right people in the office at the times you need them to deliver amazing service to each and every one of your patients. Whether it is the first appointment in the door in the morning, the person coming in to pick up their new eyeglasses, an adjustment, a repair, or the last appointment of the day, your patients expect the best service on every visit they make to your office.

Remember you have both external customers as well as your internal customers. I have just outlined what you do to care for your external customer. But your internal customer, the people you met, interviewed, and discussed an agreement for them to provide a service to your practice and your patients in return for a product, their paycheck. They agreed in the interview to work with you and your fellow team members to deliver excellent patient care throughout the entire patient production cycle and their visits when necessary. The internal customer made the commitment to work collaboratively with others employed to deliver this patient care during their scheduled hours and when necessary, additional hours.

Over the past few years, because of the pandemic, we had to become extremely relaxed and flexible to accommodate people when not feeling well. If a person they cared for, a relative, their child, or other, wasn’t feeling well, the person needed to be out of the office for an extended period of time to care for themselves and those around them. This left offices short-staffed, and in some cases, they had to close their doors.  We saw high school students, mid-way through their senior years, told to stay home. Proms were canceled, their composite photos were not taken to display in their high schools, graduations canceled or held virtually, and classes were recorded and accessed when it was convenient for them to watch and attend. College students saw much of the same as high school students. Schedules became optional. Study and take your tests when you want but have it done by a specific date and time for your grade. For three years this went on. My daughter who is a junior in college did not have her first in-person college class until the Spring semester of 2022. From midway through her senior year of high school, to the early start of her junior year in college, classes were online and recorded. Imagine those who were in their junior years of college and finished their education in 2022.

These are your future internal customers, your future team members. It is imperative to set the tone and expectations with your current team and future employees and make certain they understand what and who you and your practice is about.  You need to tell the story about what made your practice successful. You need to reignite the fire and culture you had in your practice pre-pandemic. Share the history of your practice, where it was and where it is today! Share with your team the vision you have for your future. Remind them they are the most important asset in the practice. Without them, your practice would not and will not be the success for your patients as it is.  Share with them the fact you need them in the office at their scheduled hours. They need to respect the vacation and PTO policies you have in your practice and not to exceed the planned days off.  We need them in the office to support one another, to care for the patients scheduled, coming to pick up products, adjustments, repairs, or just stopping in to learn about your services to make your practice successful.

It is time to set the tone for the new year, 2023 is here. Now is the time to review all that has been said in this article. Set the tone for 2023. Help them to see you want them here, but we need them here for the hours per year they agreed to work. You don’t want to say these words in 2023, “They’re a great employee when they’re here.”

It is time to draw the line in the concrete. As of January 1, 2023. You must follow through and be accountable to your employee handbook attendance policy. Everyone has been very lenient and patient with each employee through the pandemic. We work in a profession where flex schedules are NOT effective for our patients or fellow team members. They need to be here when scheduled and you must work that schedule to maintain full-time status and retain benefits. Your team is here to care for patients and one another on your team and you cannot continue to have people out of the office for days beyond what we have planned in the employee handbook.  It puts unnecessary stress and work on your team members when people go beyond the days allowed. It is not about the paid or unpaid days off, it is about managing and caring for each one of you to make certain your workload is where it should be. You do not want to burn out or overwork your employees, so enforce the policies. Set a standard. If a person is tardy X times, they are ineligible for a bonus. Coach, counsel, and guide them to improve. Set the standard you want in 2023 now while we are in 2022. Help them to know now the line is drawn and you are going to expect the best from your team. Reteach those that had to be educated during challenging times. Make 2023 the turning point we all want to see. Know not every employee will make the change. The good news is, we are seeing more and more offices collecting more quality resumes over the past 2 months. There are people that want to work. And why not work in what I see as the greatest industry out there. Combine that with your practice and who would not be prouder than to say they work with you and all on your team?

Happy Holidays and Happy New Year!


Rick Guinotte, CEO and Co-Founder