Issue 6

In this
Issue
Rethinking
Optometry
KPIs
Disagreeing
With Your
Boss
Master Your
Practice
EBITDA
Twenty most read Blog posts from August
2021 with Instagram Story Answers
Bonus
Article
Support us: Hy.page/opticalforum
August is
Children’s
Eye
Health/
Safety
Month
Optical Forum 6
August
2021
Making an
Impact
ISSUE
Blog Flipbook

Optical Forum
Blog flipbook
Making an Impact
Disagreeing With Your Boss - Page 10
Rethinking Optometry KPIs -
Page 6
Master Your Practice EBITDA - Page 13
2

News and editor’s
perspective
ugust is children’s safety month. Injury is among the eye
problems that hit children and can be prevented by the use of
proper safety equipment during sports. Sunburns can be prevented
by wearing sunglasses. Other problems include infection and
nearsightedness that is increasing due to prolonged screen usage.
As eye care providers we are all committed to providing the latest
information to parents and children to ensure proper eye sight
development and to prevent problems that can lead to blindness.
At Optical Forum and during August we continued to post new
original content on daily basis and we invited readers to frequently
participate and engage by commenting on posts and through the
“Answer & Insights” section in Instagram stories. This month’s
topics revolved around Eye Health, Technology, Practice
Management, Motivation, emotional intelligence, along with other
topics of entrepreneurship, leadership, marketing, etc…
As is the case in every issue, we thank and salute every scholar
and professional who volunteered to review the content of this
issue. At the same time we invite every one of you to share his or
her story with Optical Forum. Share your insights become an author
and get heard. By doing so you contribute and help advance the
boundaries of knowledge. You are all invited to accompany us in
this journey so feel free to submit your articles and comments to
feedback@opticalforum.space or by filling the form at
https://opticalforum.space/contribute/
A big “Thank you” for all our followers and colleagues who trust us
and believe that we can make an impact, and are supporting us
through donations no matter how small at hy.page/opticalforum
Gilbert Nacouzi, BSc, MBA, DBA, EIC
3
B y G i l b e r t N a c o u z i , B S c , M B A , D B A , E I C
A
Gilbert Nacouzi

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amet, consectetur
adipiscing elit. Lorem
ipsum dolor sit amet,
consectetur adipiscing
elit.
Sports Eye Safety
4
Enjoy reading our insights
related to the Eye Care
Business
This Blog is like the “Agora” in
Ancient Greek which means
“To Gather Together”. Like
Homer, we characterize a
community without an Agora
as such as that of the
Cyclopes, as lawless
Optical Forum Blog
Contact The Editor:
Dr. Gilbert Nacouzi
admin@opticalforum.space
Issue 6 Reviewer:
Dr. Rasha Faraj
Article Reviewers:
Joyce Abdo
Mira Fazah
Samir Msalm
Support us:
Hy.page/opticalforum
6
August
2021
ISSUE

Contents
Master Your Practice
EBITDA
The Scientific
Way to Do it
Disagreeing
With Your Boss
6 What Makes
Them useful and
indicative
Rethinking
Optometry KPIs
1
0
1
3
5
Intrinsic Motivation of Employees
28
Employment Offerings Based on
Motivation Theories
30
Is Your Practice Set For
Intrapreneurship? 32
Optometry Product Productivity
33
More on Motivating Optometry
Employees 35
Understanding and Shaping your
Practice Culture
37
Practice Organizational
Structure 8
Grow Leaders in Your Optometry
Practice
14
Pitfalls of Transformational
Leadership in Optometry 16
How Good is Your Practice Value
Innovation?
17
Participative Leadership in
Optometry 19
Keys to Delivering Value
Innovation in your Practice
21
Time Management Tips:
Organizing emails
22
Time
Management in
Optometry
2
6
Beyond Valuation

Rethinking
Optometry KPIs
Answer & Insights
OPTOMETRY KPIS SHOULD BE
True
False
Easy to understand, easy to
measure, easy to interpret
Complex, to reflect complex data

Rethinking Optometry KPIs
After writing one post
about Optometry Practice
Expenses and one post
about Optometry Practice Revenue, I
thought it would make a good post to
write about few key performance
indicators (KPIs) in Optometry that
we might look at on daily basis and
get insights about the success of the
business.
KPIs deliver quick reports to
Optometrists and practice owners
that they can use to make data-driven
decision instead of purely relying on
instinct and coincidence. Even though
we sometimes get driven to
producing complex KPIs based on
complex data and delivering complex
interpretations, however, the purpose
of KPI is make it simple to the
decision-maker to understand,
measure, be able to compare to other
KPIs, and easily interpret it and its
implications to the business.
The most common KPIs we find in
every small business include: Gross
Profit, Return on Investment ROI, Net
Income. Those are KPIs that provide
indications about the business itself
and how it’s doing.
Other KPIs provide information
aboutemployees and they include:
Revenue per hour paid, labor cost per
employee, ROI on total labor cost,
etc.
Depending on whether we look at the
top or bottom line we can think of
those KPIs in terms of revenue
(revenue per hour paid, gross
revenue), profit (labor cost per
employee, gross profit), and net
income (ROI on total labor cost, net
income). More complex KPIs provide
insights on price (how well am I
charging for my services), employees
rewarding (optimizing rewards to
improve hiring), cash flow compared
to receivables (shows how well is my
collection), new patients, fee-for-
sevice and other forms, recalls,
referrals, etc.
My most preferred KPIs are related to
the Optometrist and employees
performance and practice strategy for
growth. I may not find revenue per
employee, profit per employee, and
average task completion rate as the
ultimate KPIs in this category.
However, the KPIs that I find very
attractive include:
Overtime hours per employee,
provides insights on both the need to
increase workforce or to reduce or
sometimes completely eliminate
activities or services.
Sales per labor hour and Income per
labor hour along with Overtime hours
per employee, they provide us with a
lot of valuable insights about growth
strategy. If we want to build a
disruptive, sustainable, and efficient
practice at the same time we should
constantly think of a system that
constantly creates jobs, constantly
creates products, and constantly does
more with less. Those three KPIs
provides all it takes to make this
system.
They provide information about who
is the optometrist or the staff bringing
the highest sales per labour
hour. Moreover what jobs is he
performing? Discovering those jobs,
helps us organize the practice around
providing more of those jobs thus
specializing to sustain consistent
delivery, hiring new recruits
accordingly, and eliminating old and
obsolete services.
7

Optometry Practice
Organizational
Structure
Optometry Practice
Organizational Structure
If you see yourself jumping from
refracting a patient to contact lens
fitting and then to doing something
else this is a clear indicator that
your practice does not have an
organizational structure. Your
practice may not need an
organizational chart if you practice
solo and don’t have any plans to
grow your business. However, if
you plan to grow your business,
then unless your practice has a
well-developed organizational
structure, growth will not happen.
Growth is a strategic decision.
Therefore, being clear on the
growth intentions helps set the
stage for organizational
developments.
As your practice grows new
opportunities emerge and your
system should be ready to put
those opportunities into boxes that
develop into an organizational
chart. Any organizational chart is
composed of boxes put in a
hierarchical, matrix or clustered
way. The boxes in the
organizational structure do not
consist of Dr. X, employee Y, or
Staff member Z. They consist of
roles,

9
departments, and jobs.
The design of the organization could be hierarchical, clusters, or a
matrix. The Optometrists may become the CEO of the practice but if
we structure the organization hierarchically we get confused about
where the Optometrist should be. Is he at the CEO post or the
frontline? What’s most suitable for optometry practices is an
innovative collaborative team-based organizational structure.
Each box in the organizational chart will correspond to a department,
role, or function. Each department in the structure will cover specific
processes and enable people with new capabilities to deliver new
products. No matter what you do, as the practice grows and new
design criteria become imposed because of the development and
emergence of new capabilities, the need to connect those silos
becomes greater. Therefore, you need to find the points of
intersection, where staff should collaborate and find out who needs
to collaborate across functional boundaries, products, services, or
customers to plan, measure, monitor and make adjustments to the
work. As the work gets adjusted and the practice now has new
capabilities, a new system of compensation to employees should be
put in place to suit this new environment.
Answer & Insights
YOUR PRACTICE MAY NOT NEED AN
ORGANIZATIONAL CHART
True
False
if you practice solo and don’t have
any plans to grow your business
if you hire an office
manager

Disagreeing With Your Boss
In a previous post, we emphasized
how to succeed with working with an
Optometrist who has poor leadership.
It consists of answering a set of
questions before deciding whether to
stay or move on with another job.
Answering the first question should
eliminate the possibility that you are
the root cause of the problem, then
you should answer that you have
enough influence and credibility with
the leader, you deal with the issue
privately with the leader and never
talk to coworkers about the issue.
According to Amy Gallo, author of
HBR Guide to Dealing with Conflict, it
seems there is a scientifically proven
way you can employ when you
disagree with your boss. It helps you
decide on what to do when you
disagree with your boss, how do you
know if it’s worth speaking up, and
what to say if you decide you should
speak.
The natural human reaction of every
employee when disagreeing with their
boss is to shy away and avoid facing
their superior. The reason for that is
that employees think it’s going to
leave the boss with a bad impression
about them and will negatively affect
the relationship in the future.
Nevertheless, the following brings a
way how to disagree with someone
superior or more powerful than you.
The first thing to do is to be realistic
about the risks and try not to inflate
them when you speak up. 10
Having realistically assessed the risk
you should have enough information
whether to wait and hold off on
speaking up or going right away.
Before you speak up and share your
thoughts, identify what your boss
cares about and try to present a
shared goal when you speak and
articulate every argument. When you
have to disagree, try to provide a sort
of safety and control by asking
permission to disagree in the way you
address them.
One very important point is to stay
calm and demonstrate confidence
and assertiveness while addressing
your boss. Stay humble, don’t make
judgments, and always acknowledge
their authority as they are the person
to makes the final decision.
Disagreeing With Your
Boss

Disagreein
g With
Your Boss
THE NATURAL HUMAN REACTION
OF EVERY EMPLOYEE WHEN
DISAGREEING WITH THEIR BOSS
Good
Bad
is to shy away and avoid
facing their superior
is to ruthlessly face their
superior

August is Children’s
Eye Health and Safety
Month
“Children are susceptible to a host of vision and eye
problems such as injury, infection and increased
nearsightedness. In support of Children’s Eye Health
and Safety Month in August, the American Academy of
Ophthalmology provides information to the public that
can help protect and preserve a child’s eye health for
life.” https://www.aao.org/newsroom/observances

Master Your Practice
EBITDA By Dr. Gilbert Nacouzi
They had everyone
on EBITDA
Master your Practice EBITDA
The term EBITDA consists of the
acronyms earnings before interests,
taxes, depreciation, and
amortization. EBITDA along with
EBITDA multiples are considered by
many the most important numbers in
the valuation of practice. Because the
valuation is the product of EBITDA
and a range of multiples, every dollar
of EBITDA increase increases
shareholders’ value by the EBITDA
multiple times that dollar. Mastering
EBITDA ensures that the practice
owner is making everything possible
to add value to shareholders by
increasing the overall practice
valuation.
Multiples assigned to EBITDA tend to
differ among industries and they are
mainly a function of environment and
market factors that include conditions
in the stock market, interest rate
levels, economic conditions, industry
conditions, etc. EBITDA multiples are
not controlled by company managers
and Optometry practice owners,
however, the practice EBITDA can
largely be affected by the practice
manager or owner.
How EBITDA is determined as well as
any increase or decrease in it on the
financial statement are impacted by
the practice operating expenses
(Opex) and the practice capital
expenses (Capex). Changes in Opex
and Capex impacting EBITDA can
occur in different ways. An increase in
Opex decreases EBITDA whereas an
increase in Capex does not decrease
EBITDA.
Increasing revenue increases
EBITDA. This can be achieved by
increasing sales of products and
services to existing patients or selling
existing products and services to new
markets. Discontinue and eliminate
products and services that lose or are
the least that generate money.
Reducing and minimizing the cost of
goods sold by improving the practice
processes of delivery of products and
services, increasing efficiency, and
improving purchasing pricing.
Reducing Opex by reducing personal
costs whenever possible, eliminating
redundant expenses, use efficient
marketing channels and means,
adopt new technologies that help
better organize and improve
efficiency.
Making shift or trade between Opex
to Capex. A good example is to buy
the practice equipment, office
furniture, vehicle, and real estate
instead of employing operating
leases. Another example of Opex is
employees’ wages that can be shifted
to Capex by hiring more consultants
on a one-time-only engagement
whenever possible.

14
into finding and developing leaders?
The most common answer to this
question is that the case for inclusion
and diversity in executive teams still
matter and is very strong according to
a 2020 Mckinsey & Company report.
Not only the business case persists in
being strong but also the relationship
between diversity on executive teams
and the probability of outperformance
at the financial level is intensified. So
the success in developing leaders is
highly rewarding in terms of
outperforming the competition but
also in changing the world as Maxwell
points to.
Recognizing that developing leaders
is
HIRING MORE CONSULTANTS ON A
ONE-TIME-ONLY ENGAGEMENT
Increases Capex
Increases Opex
Grow Leaders in Your
Optometry Practice
Grow Leaders in your Optometry
Practice
To John Maxwell, author of many
books on leadership, “everything rises
and falls on leadership”. He asserts
that maximizing our potential and
pushing to make a difference makes
us better leaders. Nevertheless, if we
want to make an impact on the world
we must develop and grow leadership
within others. Leaders are hard to
recruit, hard to tutor, and hard to keep
and maintain. Once they form their
wings you can not keep them from
flying and exploring their skies and
spaces. But why would organizations
in general and Optometry practices,
in particular, want to spend efforts,
time, and money

rewarding towards outperforming the
competition is not a real challenge as
to be able to find and attract good
Optometrists and good people who
have strong leadership potential upon
whom your success depends. Two
main criteria largely affect your ability
to succeed in the quest of finding
potential leaders. The first criterion is
related to how you search and the
second criterion is related to what you
search.
When it comes to how you search,
you should enable an incubator
practice and develop the culture that
promotes and cultivates leaders very
early. You should challenge potential
leaders in different tasks and gather
data that provide you insights on
talents and how
15
they interact, network, and work with
existing leaders and staff. As the
potential leader rotates through
different technical, administrative, and
conflict resolution tasks you should
collect enough data that uncover
potential leadership capabilities.
When it comes to what you search:
using the gathered data, you will need
to identify and find who emerges from
the different tasks as a catalyst, an
influencer, a relationship builder, a
value-adding person, an opportunist,
a gatherer, and a finisher. Potential
leaders easily reveal any of those
traits, the hardest thing is to spend
your time trying to help people without
the potential to lead.
TWO MAIN CRITERIA LARGELY
AFFECT YOUR ABILITY TO
SUCCEED IN THE QUEST OF
FINDING POTENTIAL LEADERS
How you search and What
you Search
What tasks to perform and
how to perform them

Pitfalls of
Transformational
Leadership in Optometry
By Dr. Gilbert Nacouzi
16
leaders who motivate and inspire
followers, earn the respect of their
team and carefully form and develop
every subordinate in the team under
their leadership. Although this trait
can be effective in reaching
objectives easily without commotions,
this may lead to narcissistic leader
behaviors when the leader makes not
well-thought decisions that can
negatively affect the purpose that the
practice should have in serving
patients.
Transformational leaders are
charismatic, innovators, creators, and
very helpful, therefore they are
admired by their followers. The charm
that leaders impose on their followers
may enable them to make decisions
that are not in the best interests of the
majority
Leaders who are
transformational
achieve their goals as
they see the vision of
their followers aligned
with their vision…
Pitfalls of Transformational
Leadership in Optometry
Transformational leadership style has
its benefits in healthcare systems and
Optometry as we see it working in
most organizations. Leaders who are
transformational achieve their goals
as they see the vision of their
followers aligned with their vision. In
this way, transformational leadership
in Optometry works well when it
entails the relationship between the
Optometrists and other staff members
whose role is a supporting role
nonetheless for the optometrist. This
type of leadership helps Optometrists
bring out the best in staff and
motivate them toward a common goal
that benefits the organization.
Especially as it has been claimed by
many that transactional leadership in
Optometry can cause resentment
among staff members and employees
and potential setbacks in the delivery
of quality eye care.
Despite its relevant advantages,
transformational leadership has its
shortcomings that we cannot ignore if
we want to build a practice its primary
focus is to create opportunities to
improve the quality of eye care.
Transformational leadership pertains
to

leading to negative outcomes.
Followers under transformational
leaders follow their leaders because
they feel valued and respected.
Those leaders have the means to
incline their followers to share the
same enthusiasm and think for the
common good rather than the
individual benefit. Under
transformational leadership,
employees
17
perform better and push to maximize
their potential as they grow this
feeling of being part of the team. This
may have a negative impact if the
leader starts to take advantage of
employees, exploiting their potential,
and make them work long hours
going beyond what they are
supposed to perform to achieve the
organization’s objectives.
obtained value is the
difference between the benefit of the
product/service and the price he
pays. The value for the practice is the
difference between the price and the
cost of the product/service.
In Value Innovation, practitioners
seek to increase both the value
created to the patient and the value
created to the practice. Professor
Green emphasized the importance of
the Value
TRANSFORMATIONAL LEADERS
have no power over their followers
and cannot drive their decisions
Have the mean to incline their
followers to think of the common good
How Good is Your
Practice Value Innovation?
How Good is your Practice Value
Innovation?
Value Innovation makes one part of
University of Maryland Professor
James Green Opportunity Analysis
Canvas that pertains to developing
the entrepreneurial idea. Value
Innovation consists of simultaneously
pursuing differentiation and low cost
generating added value to both the
patient and the practice. The patient’s

Curve which is a diagram that
contains
a comparison of all possible factors of
products and services. Those factors
are sorted in the diagram on a relative
scale of low to high. Examples of
products and services factors include
features, benefits, price, etc.
Kim and Mauborgne developed and
employed the Value Curve to draw
the practice’s strategic profile
showing how it invests and how it will
invest in factors of competition. In a
nutshell, the strategy canvas works
by adding all competitors and factors
to the diagram. A relatively low
position in the diagram indicates that
the competitor invests less (or asks
less in price in case of a price
diagram) in that factor. Connecting
the dots across all factors for each
competitor reveals the practice’s
strategic profile, its competitors’
profile, and its main alternative
(optician, ophthalmologist, perimetrist,
…). By comparing the factors of all
competitors you can identify common
and differing factor levels with
competitors.
A typical diagram would include
factors
18
from your optometry practice,
competitors’ optometry practices, and
alternatives like opticians,
ophthalmologists, etc. A good drawn
strategy should reveal more dots in
common with alternatives than
competing optometry practices. A
winning and effective strategy should
reveal three complementary qualities
that include focus, divergence, and a
compelling tag line.
The practice diagram should reveal a
clear and distinct focus on factors that
are apart from other competitors.
Divergence in the factors the practice
focuses on should reveal factors that
the practice is investing or should be
investing in. The compelling tag line
should deliver a clear message of a
truthful offer or package that other
competitors don’t have.
Value innovation is directly related to
the value curve. By changing different
factors and features and assessing
the negative and positive tradeoffs
and effect of this arrangement, we
can know what new features to
create, and we can change the value
proposition.
VALUE INNOVATION IS DIRECTLY
RELATED TO THE VALUE CURVE OF
FACTORS OF COMPETITION
Yes
No

Participative
Leadership in
Optometry By Dr. Gilbert Nacouzi
19
importance in healthcare settings is to
help managers maximize efficiency
and reach the goals of the
organization. Participative leadership
also called democratic leadership, is a
style that entices input from
employees and every team member
on all organizational decisions. What
participative leadership does is
engage employees in the decision-
making process, commit them to a
common goal, and motivate them to
work and try to achieve this goal.
Participative leadership is employed
in hospitals and pharmaceutical firms
where leaders facilitate the idea to the
followers rather than command the
idea to followers. Enabling them to
take on top of individual
responsibilities,
Optometrists, like most
healthcare providers
exhibit leadership
styles that include
transformational,
transactional,
autocratic,
participative, etc.
Participative Leadership in
Optometry
We constantly remind and emphasize
the role of team spirit and shared
commitment in the Optometry
practice. As team leaders,
Optometrists, like most healthcare
providers exhibit leadership styles
that include transformational,
transactional, autocratic, participative,
etc.
In current Optometry atmospheres,
the leadership styles that prevail in
the practice, ensure high-quality eye
care that provides consistent safe and
efficient eye care products and
services. Recognizing and identifying
the leadership styles that ensure this
job will be done, not only helps
everyone in the practice develop his
skills, but also improves how every
employee interacts with colleagues
and gives a perspective
of the employee as a leader in the
field he works in.
Leadership influences others to
understand what needs to be done
and how to do it for the common good
and the collective benefit.
Leadership’s

leadership positions, or leading a
team over time. The Optometrist
should make it clear during staff
meetings that a participative
approach is being adopted to making
decisions. Everyone is invited and
encouraged to input and discuss how
a given situation that is being
discussed should be handled.
The Optometrist should appreciate
his employee’s ideas and input and
synthesize opinions to come out with
a
20
strategy to dealing with such a
situation in the future. There is no
better way an Optometrist can
employ to boost the morale of
employees and everyone in the team.
Implementing the decision and
strategy can undergo enhancements,
but the most important thing is that all
employees and staff members will
participate in deciding as well as in
implementing.
PARTICIPATIVE LEADERSHIP
engages employees in the
decision-making process
limits leadership decisions to top
executives
"The single biggest way to impact an
organization is to focus on leadership
development. There is almost no limit to the
potential of an organization that recruits good
people, raises them up as leaders and
continually develops them."
-John Maxwell
“Leadership should be more participative than
directive, more enabling than performing.”

Keys to Delivering
Value Innovation in Your
Practice By Dr. Gilbert Nacouzi
21
eliminating them the practice can
provide faster and more efficient
services through investing in factors
that add value.
Are there any products and services
factors on the value curve that can be
reduced without reducing the value
delivered to the patient?
Reducing the focus on certain factors
will provide the opportunity to focus
on more essential factors that deliver
high value.
What factors of products and services
can be raised with minimum to no
cost and that will raise the value
delivered to the patient?
The idea is to be able to identify the
Reducing the focus on
certain factors will
provide the opportunity
to focus on more
essential factors that
deliver high value
Keys to Delivering Value
Innovation in your Practice
the importance of value
innovation and how it is related to
the value curve. By changing different
factors and features of the products
and services the practice delivers,
and by assessing the negative and
positive tradeoffs and effects of every
arrangement, we can know what new
features to create, and we can
change the value proposition. In
considering so, the keys to
delivering value innovation according
to Professor Green would require the
practice manager to focus on
answering four questions that align
with what factors to eliminate, reduce,
raise, and create within the venture.
Are there specific factors to eliminate
that are of no real value to the
patient?
The idea is to be able to identify the
factors that are common with other
competitors’ products and services,
deliver the least value, and that by

factors that really matter to provide
exceptional service, exceed the
patient’s needs, and lead to more
differentiation from competitors
increasing the practice’s competitive
advantage while minimizing costs and
increasing revenues to the practice.
What factors can be created with
22
minimum to no cost that can create
and increase value to the patient?
Even if you have to create and
introduce entire new factors of
products and services, you should not
hesitate as long as those new factors
and features make you unique in this
way and provide your patients with
added value.
CREATING ENTIRE NEW FACTORS OF
PRODUCTS AND SERVICES THAT MAKE
YOUR BUSINESS UNIQUE INCREASE
VALUE INNOVATION
True
False
Time Management
Tips: Organizing emails
Everyone has his own way to
personalize his inbox as everyone
employs a different system (Outlook,
Gmail, Yahoo, Yandex, Hotmail, etc).
Rachael Doyle in Organize your
Business: Organize your life
describes seventeen ideas on how to
organize your inbox emails like a pro
no matter what system you currently
use. The following ideas are the ones
that I use combined
Time Management Tips:
Organizing emails
It’s the terrifying thought when you
open your phone, desktop, tablet, or
laptop and you have hundreds of
unread emails in your inbox. Some
are spam, some are related to work,
and others are related to friends and
relatives. Technology should help
make our lives better by saving us
time.

With many ideas from Rachael Doyle.
Idea 1: Don’t become terrified by the
thought of a full inbox. Check your
email daily, the first thing in the
morning, and organize it every day.
Idea 2: Create Multiple email
accounts but consolidate them in one
system: I find creating multiple email
accounts to be especially beneficial
when you want to separate among
subscriptions to list mails and digests
from work and personal email.
Idea 3: Archive emails quarterly. This
way you keep your inbox clean
without having to delete emails that
are not useful anymore.
Idea 4: Have a category take some
time to create all categories related to
your work, subscriptions, family,
friends, business, and others. Then
create subfolders of each category.
ex: projects, travels, website,…
Idea 5: keep, delete, or
complete after you finish reading an
email. Those are the three actions
that you should consider immediately
after you finish reading an email.
Always try to avoid snoozing emails
for later.
Idea 6: Color code to reduce the
load based
23
on who sent the mail. For example,
you can choose a “green” color code
for emails coming from your superior,
a “blue” color code for CC emails,
“red” color code for emails sent to you
directly.
Idea 7: Draw the line is another way
to differentiate emails from their
subject by making sure that your
subject line is as specific as possible.
Also, make sure to change incoming
and responding emails subject to one
you can easily track.
Idea 8: Negate notifications to avoid
getting notifications about social
media posts that you commented on
(Facebook, LinkedIn, Pinterest, or
Twitter). Each time you comment on
a post, Facebook keeps sending you
emails about who else has just
commented. This can be avoided by
visiting the social media platform and
turning off the notification function.
Idea 9: Create rules and filters to help
sort incoming emails but also create
default responses to common
questions (like using the function
Quick Parts in Microsoft Outlook).
Idea 10: Always unsubscribe from
your unwanted email lists.
True
False
EVERYONE HAS HIS OWN WAY TO
PERSONALIZE HIS EMAIL INBOX

Assemble a Diverse
Optometry Team By Dr. Gilbert Nacouzi
24
entrepreneurs that are identified
among employees within the
organization and they create business
solutions to their organizations that
were never possible unless the
company would acquire or merge with
another company.
Among the six corporate strategies
identified by Ernst & Young that
underlie the most successful
intrapreneurship efforts is to
“assemble and unleash a diverse
workforce”. Statistically, diverse
viewpoints resulted in better ideas
and better products. Higher levels of
innovation correlate with higher levels
of cultural diversity. Teams made by
people with different specialties
worked more
As the practice
starts growing and
the number of
employees starts to
increase, it is
important to foster a
culture of
Intrapreneurship…
Assemble a Diverse Optometry
Team
Diverse divisions and teams typically
outperform homogeneous groups.
This has been shown by many pieces
of research and studies at Stanford
University and Cornell University. At
the University of Michigan, Professor
Scott Page emphasized that even a
group made of the most capable
members cannot outperform a
diverse group.
In a previous post, we
emphasized the importance of
encouraging intrapreneurship in
Optometry practices. As the practice
starts growing and the number of
employees starts to increase, it is
important to foster a
culture of intrapreneurship providing
associates and employees with the
opportunity to discover gaps in the
organization and come up with
solutions to overcome problems and
close that gap. Intrapreneurs are the

effectively with other teams in the
organization and exhibited a higher
rate of innovation.
Two kinds of diversity should be
evaluated and taken into
consideration in a practice that wants
to benefit from diverse viewpoints to
create innovative solutions.
First, Inherent diversity, pertains to
traits people are born with like
gender, ethnicity, and sexual
orientation. Second, Acquired
diversity, pertains to traits people
acquire through experience, like
working in another country helping
people appreciate being culturally
different. Experiences a male
salesman can acquire by selling to
women or vice versa. Indeed
researchers found that employees of
firms with at least three
25
inherent and three acquired diversity
traits are 45% likelier to report a
growth in market share over the
previous year. Moreover, those firms
are 70% likelier to report they
captured a new market.
To increase innovation practice
managers should create teams with
equal proportion of men and women,
diverse cultural background, different
nationalities, different age levels, etc.
At the same time acquired diversity
should be taken into consideration
building multidisciplinary teams. This
strategy will benefit from the most
diverse pool of viewpoints and
perspectives that lead to exceptional
creative thinking that may not happen
otherwise.
DIVERSITY IN OPTOMETRY PRACTICES
INCREASES INNOVATION
True
False
“It is time for parents to teach young people early
on that in diversity, there is beauty, and there is
strength.”
~ Maya Angelou

Time Management
in Optometry By Dr. Gilbert Nacouzi
26
Some people think that multitasking
and time management are must-
haves in entrepreneurial behavior.
However, in the Optometry
profession, both Optometrists
entrepreneurs and Optometrists
employees are required to master
time management. Optometry
entrepreneurship is no doubt a highly
rewarding road. However, specialized
employed Optometrists are highly
paid and have significant financial
independence in many practices
where they get a percentage on the
job they perform. To be able to
specialize they are required “Strategic
time management”.
According to Brian Tracy, if you want
to get the best results from everything
you do, you need to adopt a different
approach to time management to
each activity and responsibility you
take.
Some people think that
multitasking and time
management are
must-haves in
entrepreneurial
behavior…
Time Management in Optometry
Let’s face it we are as successful as
our ability to manage time effectively.
I started my MBA program by
studying time management; it was the
first lesson. The first word was
“Procrastination”. Benjamin Franklin
in Poor Richard’s Almanack,
1746 wrote “Dost thou love life? Then
do not squander Time; for that’s the
Stuff Life is made of” and “Lost Time
is never found again”. It has been
proved that top achievers are not
more intelligent but they manage time
more intelligently and effectively. The
advancement of technology
transforms life and everything around
into a high-speed changing
environment.
There is a lot we wish we can do but
there is not enough time. Optometry
is a profession that is highly exposed
to technology changes and the tasks
that an Optometrist performs are
becoming uncountable.

You need one approach to time
management planning, decision-
making, and setting goals and
another time management approach
to deal with your personal life at
home, and another type to dealing
with your community, etc. Types of
time management are like water and
oil they never mix well together.
“Strategic time management” starts
with asking four basic sets of
questions that aim to identify your
current state or position, how you got
into your current state, where do you
want to get in the future, and how are
you going to do it? The essence is to
be able to set goals and work to
achieve them. There is a goal-
achieving formula that consists of
seven steps:
Step1: consists of deciding exactly
what you want to accomplish, where
you want to go, and what you want to
become.
Step 2: consists of writing down all
that has come out of step 1. Plans
and goals aren’t plans and goals until
they are put on a piece of paper, in a
document, or recorded on a device.
27
Step 3: consists of setting a list of
deadlines for the different tasks and
goals you are looking to accomplish.
Step 4: consists of thinking of
everything you can do, and writing
down all lists of processes and
requirements to get to where you
want and achieve your goals and
tasks.
Step 5: consists of organizing those
lists by sequence, creating checklists,
ordering them to indicate what should
be done first, second, third, … and so
on to accomplish your goals.
Step 6: consists of taking action to
your plan and getting into the first
step. The first step is the most difficult
one and requires the most effort, but
once done you will get feedback that
will help you deciding on the second
step and you will gain confidence.
Step 7: consists of doing small steps
every day that move you to your most
important goal. Do something big or
no matter how small, every day, 365
days a year, that helps you get closer
to your goal.
“Time is free, but it’s priceless. You can’t own it,
but you can use it. You can’t keep it, but you can
spend it. Once you’ve lost it you can never get it
back.” ~ Harvey Mackay

Intrinsic Motivation
of Employees By Dr. Gilbert
Nacouzi
28
ourselves and consists of the drive
and needs for fulfillment, growth,
reaching full potential, making our
own choices, and finding the purpose
and meaning of our lives.
According to Professor Sam
Glucksberg, motivation plays a
different role in every type of task. In
easy to perform tasks motivation does
improve performance, drives staff to
act more quickly, and more
purposefully. However, in hard tasks
that need more logic and critical
thinking, motivation keeps you
working hard for the wrong reason
and the wrong purpose. Professor
Sam Glucksberg often refers to the
“Candle Experiment” by German
Psychologist Karl Duncker to
demonstrate hard tasks that require
mental restructuring rather than
simple extrinsic motivation. Daniel
Pink emphasizes that what
psychologists call Controlling
Contingent Reward or “if-then
rewards” (if you do this you get that
reward) is extraordinarily effective
Intrinsic Motivation of Employees
Deci and Ryan (2008) Self
Determination Theory (SDT) of
motivation that relies on both intrinsic
and extrinsic motivation. Moreover,
we added that most actual Optometry
Practice Management textbooks rely
on Maslow’s hierarchy of needs to
teach Optometrists how to motivate
employees. However, Maslow’s
hierarchy consists of extrinsic
motivation and undermines intrinsic
motivation. In his bestselling book
“Drive”, author Daniel Pink divided his
understanding of motivation into three
stages. Pink thinking on motivation
heavily relies on the work of Deci and
Ryan on SDT.
In Pink’s concept, the first stage, or
Stage 1.0 is all about fundamental
biological needs, the need for safety,
security, and economic wellbeing.
Those needs are very much similar to
the base level of Maslow’s hierarchy
of needs.
Pink’s Stage 2.0 is all about the
extrinsic motivation that comes from
outside and consists of the promise of
reward or the threat of punishment
(carrot and the stick analogy). Stage
2.0 is fundamentally about promises
and threats or something we often
refer to as “if-then reward”.
Pink’s Stage 3.0 is all about the
intrinsic motivation that comes from
within
…most actual
Optometry Practice
Management
textbooks rely on
Maslow’s hierarchy of
needs to teach
Optometrists how to
motivate employees…

for simple short-term tasks. However,
“if-then rewards” get us to focus too
narrowly, don’t allow us to look
extensively at things, and exhaust our
motivational energy; thus are not very
effective for more complex, creative
work with long-term projects. Offering
extrinsic motivation to employees to
perform hard tasks diminishes their
performance levels, creativity,
autonomy, and ability to be in control
of things and drives them to focus
solely on the “carrot and stick” or
control and reward. Moreover,
offering extrinsic motivation for hard
tasks discourages good behavior and
encourages shortcuts and unethical
behaviors, and drives short-term
thinking.
Based on the SDT, Daniel Pink
pinpoints three constituents of
intrinsic
29
motivation:
Autonomy is the ability to make our
own choices in life, a sense of self-
direction, and a sense of control over
what they do when they do and how
they do things;
Mastery is the ability to learn and
increase our skill level of knowledge,
understanding, and confidence in
doing whatever we choose to do. It’s
the sense of getting better at
something that matters, getting
feedback that is important, and
making progress;
Purpose is the sense of meaning, a
good reason, a higher call, and
purpose that motivate us. It is about
knowing how to do a task but also
most importantly why it is being done
in the first place. What impact does it
make? How it is changing or affecting
someone’s life?
THE THREE CONSTITUENTS OF INTRINSIC
MOTIVATION ARE
Autonomy, Mastery, and Purpose
Resilience, Thrift, and Confidence

Employment
Offerings Based on
Motivation Theories
30
Theory. A third theory that is based
on extrinsic motivation and is very
useful and practical to day-to-day
management tasks is David
McClelland’s three needs theory also
known as “the needs theory of
motivation”. The three needs
theory argues each of us has three
needs that include:
The need for achievement is relevant
with employees who are motivated by
achieving, being promoted, have a
strong desire to accomplish difficult
and complex jobs, set records, and
prefer to do new things no one did
before. Employees with low
achievement needs avoid failure
whereas employees with high
achievement needs fight to win at
Theories that
emphasize extrinsic
motivation are content-
based, explain what
motivates employees,
and are solely useful
to accomplish simple
jobs and tasks
Employment Offerings based on
Motivation Theories
In this series of posts, we
emphasized the role of motivation in
managing the Optometry practice. So
far, we have defined different theories
and most importantly we have
described the role of intrinsic and
extrinsic motivation and how theories
fall into one of these two categories.
Theories that emphasize extrinsic
motivation are content-based, explain
what motivates employees, and are
solely useful to accomplish simple
jobs and tasks. Whereas theories that
emphasize intrinsic motivation are
based on processes, explain how
employees are motivated and are
useful to solve complex problems and
jobs that
require creativity and autonomy.
Needs-based theories are based on
extrinsic motivation and ultimately on
“what” motivates employees. Among
those theories are Maslow’s
Hierarchy of Needs and Herzberg’s
Two Factors

any cost.
The need for affiliation means building
relations, collaborating with others,
the need to be part of a group, and
the need for relationships. Employees
with low affiliation needs are loners
whereas employees with high
affiliation needs tend to be more
intolerant of disagreement.
The need for power is relevant with
employees who want to be in charge,
prefer competition over collaboration,
are discipline-oriented, and put a lot
of emphasis on status. Employees
with low power needs are dependent
and subordinate whereas employees
with high power needs tend to
overemphasize their potential and
ability to do things.
Optometrists and managers can use
the three needs theory to set
motivational targets tailored to each
of their team members. How often do
we struggle to identify whose staff
member is best for sales, office
administration, reception, etc…?
Some practices receive many interns
and cannot choose who to offer a job,
a partnership, or ask to join as an
associate.
31
For managers working with teams,
the theory of needs allows them to
select which aspects of the role will
appeal to each of the team members.
By knowing which needs motivate
employees most, managers can
select what opportunity to present,
how they present the opportunity, and
which elements of the presented
opportunity they have to emphasize.
Understand the motives of the team
members to reward them in a way
that motivates them. For example,
you offer an opportunity for a partner
or an associate to an optometrist with
high power needs and high
achievement needs. You identify a
low power needs person to be a good
employee at performing day-to-day
routine tasks. A sales opportunity is
offered to a high achievement needs
employee. The more he sells, the
more he achieves, the more he
satisfies his need. New higher targets
are constantly updated for a sales
person to keep achieving. A
partnership opportunity is offered to a
person with high affiliation and power
needs.
THE THREE NEEDS THEORY ARGUES
EACH ONE OF US HAS THREE NEEDS
The need for Achievement,
Affiliation, and Power
The need for Food, Health, and
Esteem

Is Your Practice Set
for
Intrapreneurship?By Dr. Gilbert Nacouzi
32
resources and capabilities from day
one just at the inception of their idea.
The greatest examples of successful
intrapreneurship stories come from
giant companies like Google, 3M,
Sony, and Corning Incorporated. All
those gigantic companies have put in
place a corporate setting that fostered
creativity and rewarded innovation.
Businesses don’t need to be huge to
foster creativity. These settings and
spirit can be enabled in any
Optometry practice. Associate
optometrists and staff can pursue
their projects that help them become
innovators and intrapreneurs who
explore ideas, risks, and rewards
within the established Optometry
practice structure.
employees can come
up with ideas to solve
a problem or relief
from a constraint that
the business is having
and that is preventing
it from profiting and
growing
…
Is Your Practice Set for
Intrapreneurship?
The term Intrapreneurship refers to
the employee’s initiative and ability to
behave and act as an entrepreneur
within the company. It is based on the
propensity that employees have to
innovate and come up with new
creative solutions that can close a
gap, create a solution, or discover
and seize the opportunity to benefit
and grow. Moreover, employees can
come up with ideas to solve a
problem or relief from a constraint
that the business is having and that is
preventing it from profiting and
growing. Some scholars and
entrepreneurs argue that
intrapreneurs are self-motivated. This
is partly true, intrapreneurship
enables the employee to innovate but
needs to be effected and enabled by
the employer. Even though
sometimes intrapreneurs may be
under
a lot of pressure by the company to
achieve and come up with winning
solutions. However, unlike
entrepreneurs, they rarely face
outsized risks that entrepreneurs
face. Moreover, they have access to
the company’s

To enable and encourage
intrapreneurship within Optometry
practices, practice owners
themselves, need to first encourage
and support the spirit of creativity.
Second, they need to reassure that
the failure of an idea will not sentence
or stigmatize the associate
optometrist or the staff member
responsible for the idea.
Ernest & Young pointed out six
corporate strategies that are behind
the most triumphant intrapreneurship
efforts:
33
Set up a formal structure for
intrapreneurship;
Ask for Ideas from employees;
Assemble and Unleash a Diverse
Workforce;
Design a Career Path for your
intrapreneurs;
Explore government programs and
incentives;
Prepare for the pitfalls of
intrapreneurship.
Optometry Product
Productivity
Optometry Product Productivity
An Optometry practice provides
different products and services.
Based on product productivity, one
would consider performing the
profitable products and services and
eliminating none profitable ones. The
decision to eliminate a product is not
that easy because an
underperforming product
has to be judged on the performance
of at least five years and not one
year. Besides, sometimes the
decision of eliminating an
underperforming product or service
may not improve the performance of
the business and that is because part
of the cost of performing the product
still exists after eliminating it: That is
indirect fixed costs.
INTRAPRENEURSHIP IS BASED ON THE
PROPENSITY THAT EMPLOYEES HAVE
to innovate and come up with
new creative solutions
to get other employees perform
extra tasks

When I ask Optometrists why they
outsource lens edging and they reply:
because it’s a labor-intensive activity.
I immediately conclude that their
costing method is based on labor
hours pushing their practice to
become more efficient by performing
easy tasks and outsourcing labor-
intensive activities to reduce their
overheads. Labor and staff are direct
fixed costs, by eliminating them we
fail to eliminate indirect fixed costs
like administrative costs, marketing
costs, practice insurance, and
security costs, etc.
To be able to calculate the full cost of
a product or service, two types of
costs need to be understood. The
variable costs and the fixed costs.
Variable costs are proportional to the
volume provided such as using lab
consumables with edged lenses.
Fixed costs that don’t change with
volumes especially in the short term
since volume changes are
34
insignificant. Indirect fixed costs is a
third element, added to those two
types of costs, adds more complexity
in calculating them.
If lens edging would be considered a
service provided, one way to allocate
costs would be the number of hours
of staff time spent edging lenses.
However, this method of allocating
costs does not take into consideration
that the same time is spent edging
two different lenses that have
different prices. It would not be the
right way to allocate the same fixed
price to both lenses that have
different prices.
The calculation of the cost of the
product helps determine whether the
market of laboring in lens edging labs
is profitable and worth competing in.
The basis of allocating cost can be a
tricky operation since it has to take
into consideration variable costs and
direct and indirect fixed costs.
TO CALCULATE THE FULL COST OF
PRODUCT TWO TYPES OF COSTS NEED
TO BE UNDERSTOOD
Fixed costs and Variable costs
Marketing costs and Security costs

More On Motivating
Optometry
Employees By Dr. Gilbert Nacouzi
35
The worker is not asked whether he
likes his job or not. The only way to
do the job the right way is to be
motivated by good pay. Moreover,
projects should be divided into small
jobs that can be easily controlled and
monitored. Training prepared workers
to perform these small jobs in a well-
defined and standardized way. This
way employee’s performance is
measured on how many of the same
jobs they can perform, eliminating
autonomy and limiting their ability to
develop skills that solve complex
tasks.
Another theory that is concerned
about
While Maslow’s needs
theory focused on
“what” motivates
people Taylor’s
scientific management
focused on “how”
people are motivated
More on Motivating Optometry
Employees
Perhaps the most recognized theory
in the workplace besides Maslow’s
hierarchy of needs is Taylor’s
“scientific management”. While
Maslow’s needs theory focused on
“what” motivates people Taylor’s
scientific management focuses on
“how” people are motivated. “How”
employees are motivated, is basically
a process that can be adjusted to get
different results. Taylor’s theory is
probably among the first theories of
motivation and it mainly focused on
money as a motivator of employees.
Taylor’s point of view has been
praised
by management experts as the first
and among the most influential
theories in management. Not taking
into consideration the humane aspect
of the work, Taylor studied
management as if there was only one
way to doing each given job, and
employees either would do it as
required by management or not.

“what” motivates people is Herzberg’s
two-factor theory, in which he argues
that there are two factors that are
essential to motivate employees:
motivators and hygiene factors.
Motivators, if present, encourage you
to work harder. Having an interesting
job is a motivator. Hygiene factors, if
not present, cause you to become
unmotivated. So for example having
poor working conditions or having
poor pay will make you unmotivated.
Herzberg’s theory on management
36
focused on the common worker and
argued against Taylor’s theory that
focused on money as a motivator.
Herzberg emphasized that workers
are motivated by achievement,
praise, responsibility, and
advancement. Those are intrinsic
factors that employers would have to
cater to in order to get the best out of
employees. Moreover, employers
should work on eliminating hygiene
factors thus eliminating the feel of
being unmotivated.
MOTIVATORS IF PRESENT
ENCOURAGE EMPLOYEES TO WORK
HARD
True
False
“When you change your thoughts,
remember to also change your
world.”—Norman Vincent Peale

Understanding and Shaping
your Practice Culture
By Dr. Gilbert Nacouzi
37
cultural values, beliefs, and
fundamental assumptions.
Organizations are made out of staff
who share common values, norms,
beliefs, and practices that make the
culture of those organizations unique.
Those persistent and common
values, characteristics, and practices
explain the behavior of the individuals
and provide a frame of reference that
explains all events and actions
occurring in the organization.
To be able to understand how the
culture of the organization is
developing
…as soon as other
optometrists and
staff begin to join
the practice they all
will be filtered in a
way that goes with
the founder’s
culture...
Understanding and Shaping your
Practice Culture
Managing your practice as it grows in
size and staff should be planned and
developed with the same vigilance
you plan and develop your patient
base. The organizational culture that
builds over time is the result of the
culture that started with the founding
optometrist and the culture that
developed as new staff members
joined the practice. The optometrist
as a leader will have an important role
in shaping the organization’s culture.
Indeed at the organization’s inception,
the
optometrist implements his values,
beliefs, and fundamental assumptions
in the practice and as soon as other
optometrists and staff begin to join
the practice they all will be filtered in
a way that goes with the founder’s
culture. Moreover, if an optometrist
acquires a practice with its staff he
should be able to identify certain
dimensions of culture that help him
cope and slowly instill his

Geert Hoftede has developed a
model of organizational culture with
six dimensions that include:
Dimension 1: process oriented vs
result oriented explains why and how
certain organizations are more
bureaucratic and technical whereas
other organizations are result
oriented focusing on achieving
desired results and outcomes to
reach the organization’s goals and
objectives.
Dimension 2: employee oriented vs
job oriented explains why and how
certain organizations are more people
oriented to solving the staff problems
and putting employees well-being first
whereas other organizations put a lot
of emphasis and pressure to
complete the job and create this
culture that is only interested in work.
Dimension 3: parochial vs
professional explains why and how
staff in professional organizations
identify themselves by their
profession whereas in parochial
organizations staff feel that the same
norms cover their behavior at both
work and personal life.
Dimension 4: open system vs closed
38
system explains why in open systems
members consider both the
organization and it’s people open to
outsiders and newcomers whereas in
closed systems members are closed
even to each other.
Dimension 5: loose control vs tight
control explains why and how in loose
control organizations staff members
can operate in perfect autonomy
whereas in tight control organizations
the structure dictates that supervisors
know, monitor, and control everything
employees do.
Dimension 6: normative vs
pragmatic depends on the
organization relation to it’s
environment. In normative
organizations people are bound to
norms, rules, processes, and
procedures whereas in pragmatic
organizations people are bound to
results and meeting customers
needs.
The model of organizational culture
developed by Geert Hofstede helps
optometrists understand the culture in
any practice and identify new factors
affecting it.
GEERT HOFTEDE USED THE SAME
NATIONAL CULTURE MODEL TO
ORGANIZATIONAL CULTURE
True
False

Remote Optometry
Challenges By Dr. Gilbert Nacouzi
39
Away from precautionary, disease
containment, and business
technology adjustments one
important element that strongly
impacts the aspect of the relationship
between the patient and the
practitioner as we move from face to
face to remote is Trust. Trust is the
result of four elements: competence,
logic, empathy, and reliability. Each
of those four elements that are
central to building and maintaining
trust in the patient-practitioner
relationship has changed in a
particular way as we shifted from
face-to-face to remote consultation.
When building and maintaining
competence Optometrists always
consider the image and the setting
that communicate professionalism
and
Optometrists
are making practice
management and
business adjustments
that mainly focus on
transitioning to remote
work…
Remote Optometry Challenges
COVID-19 has forced Optometrists
and created an urgency to adopt
telehealth and telemedicine. Some
strategies and measures are a direct
response and therefore temporary in
terms of the precautions that should
be taken during the pandemic and
relate to how practitioners should deal
with preventing the spread of the
disease, whereas others are rather
more long-term strategies that can
spam well beyond the time of the
pandemic. Optometrists are making
practice management and business
adjustments that mainly focus on
transitioning to
remote work. The business
adjustments include introducing or
upgrading existing hardware and
software solutions to keep patients
recurring visits and referral of new
patients ensuring a sustainable
business and steady growth.

convey the guaranteed message
about the practitioner’s eligibility and
credibility. Logic is a very important
element in building and maintaining
trust since Optometrists need to
prove to the patient that remote
working provides comparable quality
of care as an on-site visit. Many
practitioners share their screen with
the patients in a way to add logic to
the consultation and show the patient
that his record history is at the basis
of the decision-making
40
process. Empathy is significantly hard
to convey in telemedicine, the more
your telecommunication technology is
subject to glitches and errors the
more difficult will be to comfort the
patient and show empathy.
Optometrists should be able to
provide reliable services and any
question that arises after the
teleconsultation. Therefore, patients
should be given many options to call
the office or the practitioner whenever
they want to inquire about an issue.
EMPATHY IS SIGNIFICANTLY HARD
TO CONVEY IN TELEMEDICINE
True
False
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Reciprocal
Concessions in
Offerings By Dr. Gilbert Nacouzi
41
Reciprocity equally applies to the
workplace, where you are prone to
help your colleagues when they need
help because they helped you when
you were covered up with work. If you
are a practice owner, you may let
your employees sometimes leave
early if there is nothing left to do, and
in the same way, they may
reciprocate and offer to stay overtime
when they see you are alone and
need help.
the principle of
reciprocity is one of
the most effective and
powerful principles in
influence, persuasion,
and negotiation…
Reciprocal Concessions in
Offerings
Reciprocity is the notion that if a
person does something for you or
offers you a gift you owe him
something of the same value and you
often can’t wait for the first
opportunity to return the gift.
According to Professor Robert
Cialdini, the principle of reciprocity is
one of the most effective and
powerful principles in influence,
persuasion, and negotiation. This
notion of reciprocity is also often used
in sales, marketing, and employment.
Following the reciprocity principle,
human beings are inclined to pay
back gifts that they consider to be
debt or obligation or in another way to
treat others the same way they were
treated.
Take for example an Optometrist who
offers free screening or one day per
month free complete comprehensive
eye examination. Patients who come
and subscribe for this event will feel
obliged to return this gift by perhaps
buying eyeglasses or even
sunglasses when they have no
ametropia. In the same way, consider
offering a free contact lens trial for
one month for new contact lens
wearers. Patients are apt to reorder a
supply of the same lens they tried.
Reciprocity in this way persuades
patients and increases sales.

Reciprocity is relevant in blogging and
social media too. Following
someone’s weblog will push him
towards following your weblog in
return.
In a nutshell reciprocating pertains to
being able to give back to someone
the same behavior that has been
received by this person. In terms of
leadership
42
and wanting to influence people, the
first thing a would be leader is ready
to offer his help and the gift to
addressing people’s problems.
Now given the examples we
presented above, can you describe a
reciprocating situation you have faced
in your optometry practice? How did
you solve it?
RECIPROCITY IS RELEVANT IN
SOCIAL MEDIA
True
False
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Lincoln

Scarcity a Key to
Persuasion By Dr. Gilbert Nacouzi
43
influence patient’s decisions. What
the flight company does to me every
time it employs the scarcity principle
is first shows my conscience that it
can create the shortcut I need to feel
with the search of the best deal which
seems to be a hard work. Second,
with the scarcity principle, it limits the
number of opportunities I have thus
limiting my freedom to chose.
The ways we can employ this
principle
People value
opportunities more
when they know that
they are rare. Robert
Cialdini calls it the
scarcity principle..
Scarcity a Key to Persuasion
People value opportunities more
when they know that they are rare.
Robert Cialdini calls it the scarcity
principle. I experience the scarcity
principle every time I register for an
international event like the Academy
of management, Interdisciplinary
Social Sciences, Vision Expo, mido,
or silmo. That is when I look to book a
flight or more frequently when I
reserve a hotel room. The two
messages that pop up and put me in
a scarcity mindset are “last three
seats available on this flight”, “visitors
booked more than 30 rooms during
the last 24 hours”,” this hotel is in high
demand”, or “last room”. This
information has a direct effect on your
decision pushing you voluntarily to
stop
further search and book immediately.
Scarcity principle is employed in
almost every business and we
experience it in every walk of life.
Bitcoin is a scarce currency that gives
you the impression that it is value is
higher than other currencies. Last
week my blog hosting company sent
me a one time only hosting offer for
three years paid upfront at a price of
thirteen months paid monthly.
The scarcity principle is a powerful
tool that Optometrists, Opticians, and
practice managers can employ to

in eye care include:
Create and promote one time offers.
Staff should always prepare and
communicate with every practice
visitor the current one time offers.
Another way is to highlight and
emphasize “limited edition” versions
of products in the show room. You
can do this for products ranging from
designer sunglasses to engraved and
customized eyeglasses cases, again
increasing scarcity by limiting
availability.
44
Another way is scheduling on
weekdays and being selective on
fridays, week ends, and late after
noon appointments, increasing
scarcity around your own availability,
and leading to an increase in desire
for meeting with you if you surely
have something special they need.
If you are not the only one to provide
the service you should be aware that
scarcity of availability makes you
inefficient. So be careful and alert
when you choose to employ this
principle.
IS SCARCITY A DANGEROUS WAY
OF PERSUASION
True
False
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