Episode 76 - Do Hard Things: Dr. Tommy Pinkston Discusses The Importance Of Embracing Challenges

Working from an uncomfortable place is how we get better and stronger. Whether it is in our personal or professional life, embracing challenges is the path to success. In this episode, Dr. Harbir Sian teams up with Dr. Tommy Pinkston from the Haywood Family Eye Care to discuss mindset, improvement, and the entrepreneurial approach. Dr. Pinkston talks about what brought him to private practice, how he deals with staff, and why being uncomfortable and being ready to embrace difficulty leads to success. Tune in and learn more from great optometrists and their practices.

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Do Hard Things: Dr. Tommy Pinkston Discusses The Importance Of Embracing Challenges

Thank you so much for taking the time to join me again here to learn and grow. As always, I am truly grateful for all the support everybody has been giving me, whether you're reading, leaving reviews and comments and giving me shout-outs on social media. All of that stuff is incredible. I feel truly blessed. Thank you for that. As always, I always ask the favor right off the top. If you do find any value from any episode, and I know you will for sure out of this episode, please do share it. Take a screenshot, throw it up on your Instagram story, share a link on LinkedIn or whatever you can do.

I truly appreciate all of that. It has been a pleasure to get out there and connect with so many of our colleagues in the industry to share all the value that my amazing guests have. My amazing guest is Dr. Tommy, the Ironman, Pinkston from North Carolina, the Owner of Haywood Family Eye Care, the Young Optometrist of the Year in 2015 in Georgia and the 2020 Young Alumnus of the Year from UAB. He's truly a decorated young optometrist. Thank you for joining me. I appreciate it.

I'm super excited to be here. We have connected over social media. I listen to your stuff. You've got a long list of great guests. I'm excited to be a guest on this show. It's pretty awesome.

Thank you very much. I've been blessed to have some pretty incredible people and yourself included. It's incredible to have people who can share insights. I struggle with my words all the time here. We think because we're all optometrists, we all must think the same way or act the same way but we don't. We think so differently. There are a lot of people who are doing things that are outside the box or hard. We're going to talk specifically about that with you. Why don't you give us a little bit of a quick history of yourself, where you went to school, where you worked and how you ended up where you are?

I'm originally from Florida. I grew up in South Florida and went to school in Florida as an undergrad at the University of Florida. I'm a huge Gator football fan. That's another story for another time. We have had a rough couple of years here. I went to the UAB School of Optometry. I started in 2008, finished up in 2012 and then went to Woolfson Eye Institute to finish a year of residency in corneal disease and refractive surgery. After that, I started as an associate at a great private practice in the metro area.

I was there for about three years. I had some changes in my life. My father passed away and we had our first child. It made me start thinking about what I wanted to do with my life and put me in a perspective of pushing me to figure out, "What am I going to do? Am I going to do this? Am I going to wait around for something to be handed to me?" I decided, "I'm all in. All the chips are in black. Let's go. I'm going to figure this out or bust. We're going to do it."

That took a little while. It didn't happen over one thought process. I've got a business partner who graduated with me in 2012. We do rotations together. She randomly reached out, "Do you want to move to North Carolina?" At that time, I had no North Carolina license. Most people know that North Carolina for optometry is not one of the easier states to get. I was like, "I'm not a great test taker. I've never been the best student. This is going to be challenging but let's see what this is like."

I came up here and visited. My wife and I fell in love with the area. We were like, "Let's do it." We sold our house and I told my employer, "This is great but I'm out of here." Six months later, we went from living in Georgia and having a great and steady job, income and practice to starting over in a sense. The practice that I'm part of has been established since the '50s. It's not like we were going cold but it was a very smaller one-OD practice.

My partner did a great job of bringing it up to current standards and putting in new equipment and all the changes that you would have in a practice that needed some changes. I joined her. Over the years, we have seen tremendous growth in terms of seeing more patients and a lot of our internal changes in terms of how we develop staff and our leadership. We finished our new building and moved in October 2021.

That was a big upgrade. We went from about 2,000 square feet and four exam lanes running two doctors to now we have three ODs. It's myself, my partner and an associate. We have eight exam lanes and about 5,000 square feet. It was quite a big change. I had a chance to breathe in terms of being able to figure out what those changes look like logistically. That's the short story of where I'm at and how I've gotten here. I love private practice. I couldn't find a better way to practice.

There's a lot packed into that quick little story that you gave us. There are so many things that we could spend a lot of time talking about. It's the fact that you uprooted your family and moved to a new place. You didn't even have a license to practice yet. It's incredible that you had the courage to make that move.

We're all working very hard so that we can be comfortable at a certain age and retire. That's human nature to strive to be comfortable.

I can only imagine how tough it is with such a young family. You're already starting to plant your roots there and all of that kind of thing. That's incredible. That's part of what I wanted to talk about. As we were talking about before, one of the core things I want to talk about is the mindset. I've heard you say it before. One of your mantras is, "Do hard things."

You even share that with your family and talk to your kids about that. Part of the reason I started this show is to share these kinds of mindset things with my friends, colleagues and ultimately with the audience that reads. We can get clinical tips from a lot of different people to hear about the mindset that goes into changing your entire life, uprooting your family and doing all these things. It's so key. I want to dive into that. Let's start wherever you think is the right place to start. If you want to start with, "Do hard things," or what it took for you and your family to get comfortable with making a big leap, I would love for you to go with it.

There are a couple of things I could say there. The first thing is that I do not like change naturally, a part of all of us like comfort. We're all working very hard so that we can be comfortable at a certain age and retire. That's human nature to strive to be comfortable. It's a big dichotomy from being uncomfortable forcefully. That's hard. If you're in the eye care industry, whether you're an optometrist or whatever you're doing, you're probably doing it, so you have a better quality of life or improve some people's comfort level somewhere. That's naturally different than what we're forcing ourselves to do.

It took me a while to figure that out. Part of that whole thought process was when my father died. I had this newborn that was six weeks old. My wife and I were looking at each other, "Our world and whole process changed." We took on the idea, "I don't want to get to the end of the road, whatever that may be for me," and thought, "I should have or I could have." I had the talent but I was too scared to. We all have to face that eventually. Some people come to that sooner than others. Luckily, that was forced upon me. It has worked out.

I've taken some chances and gotten lucky on some chance or I could not have worked out and I wouldn't be sitting here talking to you. To some degree, you never know. It's important that you put yourselves in uncomfortable situations on a regular basis if you're not inherently risky. I'm doing endurance stuff. That's a great way to feel that stress physically. That's an important way to think about, "Am I not doing something because it feels uncomfortable and I don't like it? Am I not doing it because it's truly hard and I'm not going to be capable?" Most of the time, it's not that you're not capable. It's just you might be uncomfortable with the situation.

We spend most of our lives trying to create comfort. It's the opposite of what you're saying here as far as deliberately putting yourself in uncomfortable positions but that's how you're going to get stronger and better over time. One of the things that people talk about is this armchair or rocking chair philosophy. You and I were talking about a funeral analogy of putting yourself hopefully many years ahead in the future and then looking back. Tell me about how that plays in the decision-making that you have day-to-day.

I don't enjoy funerals, I'm going to be clear, but you can learn a lot from that. They're not fun by any means. Don't misread me. Weddings and funerals are big things where you get to stop and look around. It's a snapshot of somebody's life. You're an observer. Over the years, that's always a tough time, especially if you're close. On the flip side of that, it's a huge learning curve because you can look around and see, "I didn't know they touched this person's life. I had no clue about this whole aspect."

To some degree, those uncomfortable situations, and it's a tough situation to be in, help people find out where their goalposts are. Where do you want to be? That was my big turning point. I do think it's important to set yourself up to be challenged. I don't think it necessarily has to be something that you can't do. You alluded that I'm big into triathlons. By no means I am the fastest guy in the world but I like to do them because they're challenging. I don't think you have to set out and say, "I'm going to go do some crazy physical event." It doesn't have to be that. It's different for everybody.

My daughter and I completed a 5k. Three miles on little legs is not easy. Before the race, we sat down and I said, "Charlotte, it's going to be tough. You haven't trained for it." She wanted to do it. I said, "We're going to do it. We're not going to stop and take a break." I have other two kids I was pushing on it. She's like, "What if I get tired?" I said, "We will then rest but we're going to keep moving." In the first mile, she went out hot. I was trying to coach up the pacing overhead. At mile two, she started to burn out a little bit. When we got towards the end of mile two, she's like, "Can we get up here and rest?"

I said, "We can rest but we're not going to stop." We got to the end of the race and I could tell she was not happy with my answer. We got to the end of the race. She's like, "I'm so glad we pushed through it." You could see her little mind clicking. It was cool to be able to talk with her like, "That was uncomfortable. I didn't want to do it but I'm glad I did it because I would have stopped before I even knew I was capable." It's things like that. It's setting small examples and then building on them. For business, it's having those conversations that you don't want to have, like reaching out to that person.

We all have things that we're naturally gifted with. If you're outgoing, it's easy to be outgoing, working in the room and networking. That's great but if you're more introverted, that could be your challenge. If you don't want to have tough conversations and feel like you don't want to have some of that friction that naturally comes with the business, putting yourself in positions to slowly chip away and attacking those little problems are helpful because then it becomes easier the next time. I have enjoyed challenging myself.

I want to talk a bit about the triathlon stuff and then we're going to hopefully link that to work because there are a lot of parallels and a lot of connections there. You will agree. Let's talk about that. You've completed an Ironman Triathlon. Is it one or was there more than one? Even one is a feat in itself.

There are a couple of different versions of triathlons. There are sprints, Olympics, half distances and fulls. I've done one full, which is 140 miles. The one I did was 144.6 because of the way that the distance is set up.

You did more than an Ironman.

They're set up in a swim, bike and run. You always do it in that order for standard. In 2019, a buddy of mine said, "You should do a triathlon." I was like, "I'll do it. Let's try it." I signed up. There's a local one here in town and it's a half distance but there's a smaller distance. I'm assuming he thought I was going to sign up for the smaller distance, which I didn't do. I didn't realize how hard it was to swim or bike without knowing how to do that legitimately.

I swam as a kid but not competitively. I ride a bike but not competitively. I've finished that race and it kicked my tail. I finished it but I was talking to my maker at that point. It was a tough race. It's probably the toughest one ever done because I was not prepared. I just winged it and thought I was prepared. COVID started to come around and I was like, "That was a poor performance."

I didn't feel good about that. I couldn't sleep about it. I was like, "I'm going all in." I signed up for a full and then COVID hit. I was like, "I don't have anything else to do." You can't do anything. I live in the mountains, so there are great places to run, bike, get out and not to be in the big city of biking. I was like, "Let's do it." I did a full Ironman. It took me about two years to train for it. This was COVID. They kept canceling the race but finished it in September. Now I'm hooked.

I see why people get addicted to endurance events. It's like a business. You may not be the best at it. That's okay. It's not about being the fastest guy. You're never going to be the best. You're not going to be the Michael Jordan of it. That's okay but can you get a little bit better, shave off a little bit of time and go a little bit stronger. I love it. I would sign up for more if my wife left me but she told me, "There are no more fulls until our kids get a bit older."

That's fair enough. I can imagine it's a commitment because it's a full marathon that you're running and a crazy long bike. A couple of good friends of mine from undergrad were into that. A couple of them have done the Ironman. Back in undergrad, I would do some training with them. They had these t-shirts because they had the triathlon club back then. The slogan was, "Ain't no fun like swim, bike, run." That was there. I never got into the swimming part of it but I always enjoyed running. I got into biking years ago. Have you ever been out to Vancouver before?

No.

We did a ride from Vancouver up to Whistler Mountain, the ski resort. Speaking to your maker, that was me about three quarters of the way up that ride. I didn't look at my bike again for two years after that. It was too much for me. There are so many parallels and points. If I take that ride I did at Whistler, you go through so many stages of denial, grief and pains. It's like, "You can quit now. It's fine. Nobody is going to judge you," or other things that you're saying to yourself. You go to the point of, "One pedal at a time. One little step at a time." We were climbing a mountain. You're looking at this giant mountain you're trying to climb but if you do it one stride at a time, you will get there.

Do the small things and chip away at them. You can apply that to pretty much anything, whether it's personal relationships, business relationships, talking to your staff, which is where I want to take this, and building your team culture, which is something that I've watched you do on social media. You talk about how often you have meetings and the things that you do. You have a huge staff compared to our team here in Vancouver. I would love for you to tell me. A) Do you see those parallels that I'm talking about? B) How do you apply those to your work, staff and business?

Putting yourself in positions to slowly chip away and attacking the little problems are helpful because then it becomes easier the next time.

There are a lot of parallels between physical challenges and business or life. I don't think it's just triathlons. A lot of what you said is, "How do you talk to yourself in those tough moments?" When you're on your worst day, what do you tell yourself? It's real easy to get up in the morning when everything's going great. You've got a book full of patients. Everyone's going to come in and say how awesome you are. You're going to do all this stuff.

That's great and easy but how do you do it when somebody quits, you're understaffed and COVID hits? There are things that we have all had that we go, "I don't, I don't want to do this." Life is still going to move on. The sun is coming up. What are you telling yourself? How are you going through that? That's, for me, physical challenges at your toughest point in whatever race you've done or 5k or going to walk and get the mail. It doesn't matter what it is.

You don't want to do it but what are you going to tell yourself to get up and continue? That self-talk is huge. By no means I am a naturally positive person. I'm not that. It seems like that but it's not me naturally to go, "This is great. It's all perfect." I'm naturally more of a pessimist. I think of what's going to go wrong. It's very hard and uncomfortable for me to go, "I can do this. It might be awful. I don't like it and that's okay. Put that away. Let's move on and deal with it rationally as best I can."

I love that. That helps. The biggest translation for that was COVID. We bought our building about two weeks before COVID hit. We were excited. We have been looking for two years. We started looking in about 2017 for a building because we run out of space and found this building. We're in a small town. Commercial buildings don't come up very often. We found this and closed on it. We were super excited. We came back from Philadelphia trying to work with some people on some frame stuff and then COVID hits. It's like, "What are we going to do?"

I sat down with my wife a couple of days after we had to shut down and said, "We're going to be along for the ride." This was before we all knew what was going to happen. "We purchased a building. We can't see patients. We're going to liquidate and hang on as much as we can. It's over." That's naturally something where I went right to the negative side. You have to push through, think about how you're going to approach it step-by-step and take it one bite at a time as best you can.

We try to do that a lot with our staff. We've got a staff of about 17, which should be around 20. We're very understaffed. It's hard to find great staff. We try to focus hard on our staff. A lot of offices focus on patients first and how that goes. The patients are important. Don't misunderstand me but for me, it's focusing on your team and the people you have in your office every day because I cannot make every patient happy.

There's no possible way I can do that. I'm going to try my best to meet everybody's needs but I can't do it. I can't make twenty people happy either but I can try to make their lives a little bit easier by being the best employer I can be. By no means does that mean that I'm perfect but that does mean that I need to focus on that every day.

We do little things that are a little bit different in terms of trying to make sure that communication is a top priority, making sure that our staff feels appreciated every day, making sure that they come in and know how they're going to communicate with the owners and our leadership team and what their expectations are, and making sure that not only do we do that but that we continue to focus on that to try to improve a little bit every day in terms of getting some constructive feedback from them.

It's like, "We don't the way you are doing this." They go, "We have this problem." "I have to have some solution. Let me see if I can tweak it because you don't like it or I'm presenting it one way and it's not coming across that way." It's embracing that discomfort. That's hard to hear if you have an employer or employee that you like. They're like, "You sounded like a jerk when you said that." I'm like, "That's a good point."

At the same time, I value those employees so much that they're comfortable enough, brave enough or whatever it is to give you that feedback because a lot of people will keep it internal. The first thing I say is, "Thank you. I truly appreciate your transparency and openness to share that. It's so important."

We try to do that as best we can. It doesn't always work. Not everybody is a good fit for our office. Some people don't like that friction. Inherently, it's hard and challenging. As part of when we interview, I tell people, "How much do you like change?" Everybody goes, "I like it." It's an interview. Everybody tries to say something right. I said, "If you truly don't like change, you're not going to like it here. I don't like change either but know that's a pill you're going to have to swallow because if we can improve something, we're going to do it."

That may mean that we change it and feel very uncomfortable because we have done it for 2 years, 20 years or 30 years. It doesn't necessarily mean that we're going to continue to do it. We try to get everybody on the same page and continue to have those conversations to communicate. It's always a work in progress. By no means I am a guru on staff development. I try to be as best and knowledgeable as I can. I'm making sure that we can get all these team members to work together but by no means I am perfect. It's a work in progress.

That's amazing that you do all those things and you push the whole team to grow and change like that because that's difficult for the owner and the person who's coordinating all of that. That forces you to be in an uncomfortable position because the easiest thing for us to do is to let things slide, let things go the way they're going, ignore certain things and sweep them under the rug because you avoid the conflict that way. Most of us dislike conflict. There is seventeen staff. That's what you said. You feel like you're understaffed. That's more than double the staff that we have. I find coordinating 8 or 9 people difficult. Can you give me some tips on what works well for you?

My answer is I always find what doesn't work from personal experience. Everything I tell you that works, I've found only because I've made mistakes. There are a couple of things. We have three full-time ODs at our office, which is why we have so many staff members. We're in a small town. We have an in-house lab. We try to make this the one-stop-shop for anything eye care, whether it's exams, glasses and contacts. We try to do as much in-house and keep the patient in our office by providing them good care and services we can, which is why we can support so many staff.

I've found that the biggest thing is that one person can only successfully communicate or manage 3 or 4 people or maybe 5 to 7 if they're talented. At a certain point, it's like herding cats. Everybody has an opinion, which is great but then the opinions start to veer. It's hard to make sure we have everybody's vision on the same page. We try to break our team up into very manageable smaller teams. This is what will grow as our staff grows. We have it by department.

I have an optical team of about 3 to 4, a technician team of about 5 and our front desk team of about 3 to 4. Depending on how many people we have at a time, I can go to one person that has a leadership role. With that being said, we can come together as a staff, which we do every Monday, and talk about big issues. Those meetings are more general-based. We try to keep it topical where we can go over some numbers and metrics that deal with the business but also have some pressing issues and get to know each other. We try to do a question, "What is your favorite Easter candy?"

A lot of times, we will do, "Tell me one thing that happened to you great last week personally and tell me one thing we did as an office great." That gives them a chance to give some shout-outs to stuff that I don't see. If I'm in the back seeing patients and my front desk person handled up a spicy patient upfront and diffused a situation before I come up, that's awesome but I don't even know what happened. Having them be able to raise each other up is helpful.

We have those teams broken up. We have separate leadership roles. We have a team lead where if I have an issue and I have all my techs know something, I can either have a meeting, which may take me a week to do, or I can go to my team lead, Jennifer and say, "Jennifer, here's the deal. We need to adjust this. I need you to make sure that this is continually misspelled." She can talk with them on the fly a little bit easier. She's got 3 or 4 people she can manage.

We did that several years ago. It sounds very simple. I'm a simple person and it takes me a while to figure things out. Once we did that, it was much more helpful because then we could create a two-way communication system. I could have all my leaders meet and I could say, "What's the problem? Everybody is aggravated. We're understaffed. We're all stressed," versus the alternative. I would hear lots of whispers. It would feel like a bad culture. You're like, "You've learned to appreciate what we're doing." It's like, "That's not the case. They don't know how to approach you."

You have people that can candidly say, "We got to fix this." They can lay it all out there. Also, I'm more willing to listen too because I feel like I'm not being attacked. That's their job. It's not perfect. It's always a work in progress but for us, it has helped us make sure that we can capitalize on our growth and make people feel listened to, welcomed and valued. There's always room for improvement. We're trying to tweak it a little bit and make sure that we can have some little bells and whistles on it a little bit easier. That's essentially how we structure our team.

I've heard that from a few colleagues who have these bigger practices. Ours are both growing. I hope that we will be talking eventually in the near future numbers like yours as far as the number of staff and all that kind of thing as we have more doctors coming on daily. I don't mean this in a bad way. I mean this in a good way. It's like a corporate structure. You're the CEO and then you got your VPs. Your VPs are looking after it. I know that sometimes that seems a little cold. We don't like to be corporate.

It's amazing to implement that into an optometry practice because most of us as doctors think, "I'm going in to see patients. That's my job. I don't know how to deal with all the other things." You don't know how to because you don't have the structure to. It limits your growth. When you implement a structure like this, you can give yourself room to grow more smoothly.

People want to be a part of a bigger vision.

You learn these things from making mistakes. We all make the same mistakes. The question is whether you learn from it and implement these structures. I look at you as the CEO of this organization that you and your business partner have created. The other thing I find that's interesting is having that person who's the lead. You need that buffer sometimes. I always go to my staff and be like, "My door is open. Come see me. Come talk to me. Come straight to me," but they don't want to do that.

They're not comfortable as much as I try to be like this. I'm like this at work. It's the way I talk. I try to be very comfortable and open. Once you put someone in between who is the lead or the manager of that thing, all of a sudden, that person is like, "They're talking about all the things that they like and don't like." It opens a conversation way more. I don't know if that's how you feel as well.

It's myself and my business partner who owns the practice. I could say, "My door is open," and ask people. We have one-on-one meetings with them and they say, "Can we do anything better?" I'm like, "You're doing great." They will quit next week. You're like, "You don't feel listened to." Part of that is some things like in any relationship. I like simple analogies. When you think about your spouse, your spouse is going to communicate differently than I. My wife communicates very differently than I do.

Part of those first couple years of marriage is figuring out, "How do you communicate?" You step on a few hot button issues. You've got staff members who aren't any different than that. You're seeing them as much as you're seeing your spouse because you're here all day for eight hours. It's figuring out how you can get them to buy in but also make sure that they feel comfortable. It does help.

One of the things that I found most beneficial was when the light clicked for me. I forget who I got this idea from but people want to be a part of a bigger vision. We all are part of organizations, whether you're part of a church, religious organization, sports or a kids' group. Think of it when you're a kid. You're on a sports team. Part of the fun is being on a sports team but part of it is hanging out and being with my buds. We all want to be a part of that team and we all want that team to win.

Sometimes we're going to have some friction. We might not get along but we have to have a vision for our team. Having a clear, concise and repeatable vision that you can tell your staff no matter what type of business you're doing is helpful. I repeat our vision on a regular basis. I'll tell our staff, "We want to be the best practice in the state and eventually the country in terms of what we're going for." That's not a finish-line goal.

It's not like, "We're going to get to X value in terms of the receipts we do every day. That's our finish line." It's tangible but this is something that is an ever-unattainable goal in a sense. It's trying to get your staff involved in communication but also getting them pointed in the right direction of, "Why are we doing all this?" We're doing all this because this is the vision of the office and the vision that we're trying to drive towards. I find it helpful.

Do you know Justin Manning by any chance? Justin's a great guy. I did one at Vision Expo with a few different people. I did 10 to 12-minute conversations. One of them was with Justin. He's an amazing dude. Essentially what we're talking about is this whole building of culture and managing personalities. That's his role. He's at PECAA. He's the chief. He's going to hate me because I keep forgetting the name of his position. That's his job. He's helping ODs manage this type of stuff. He gave me the three things that he thought were key for business culture or team culture. The biggest thing was the vision.

It's exactly what you mentioned. It's 100% the way he described it. It's cool that you're already doing that yourself. These are things that I learned from Justin, honestly. I'm not giving my own ideas here. One is to have the vision and share it with your staff. Also, when you're giving feedback, if a staff member has done something well, you give positive feedback and then relate it to that vision. It's fantastic that you gave this patient this amazing service. It's going to help us get to our goal of the thing that we know that we're trying to achieve and bring it all together. That's so cool that you're already doing things that I'm learning and trying to implement in my office.

It sounds like you're on the right track. Moving from a 2,000-square foot place to a 5,000-square foot place with eight exam rooms and all the things is a sign that you're on the right track as well. I wanted to talk a little bit about that. Let's talk about the beautiful space that you have. I don't know if you want to try giving us a tour or if you just want to describe it to us. I've seen pictures on Instagram of the little things that you incorporate. First, tell me about anything design-wise or aesthetics-wise that you feel proud of. There are little things that you're doing too like the trays that you use and all these things.

Practicing with a partner is not what most ODs do. We divide and conquer. My talents and her talents play each other well. My talents are not in design. She was like, "Do you like this?" I was like, "Yep, because if I would pick it out, it would not look very good." She did an amazing job of making sure that it looked to the vision that she had in terms of what the practice was.

We used Optometric Architects, which is a good group in being able to help us with the logistics and figuring out little details that you don't think about in terms of things like plugs, how many outlets you're going to need and where they're going to be on the wall. It's little things like that which would end up costing money over time as you did changeovers or however you set up your contract.

That was super helpful. We tried to keep the history of our practice. Our practice was originally started in 1955 in downtown Waynesville, which is a small town. We have about 10,000 people in our town. It has been there. It has a cool little feel where I could walk outside, go across the street and get a coffee at the bakery that was there for a while or walks after work and get a beer if I want.

It's got this Mayberry feel where everybody knows everybody. It was a hard thing to feel like we were going to move this practice that has been so successful and ingrained in one of the longest-running businesses in our area off the main street. It felt like we were doing it wrong essentially. We wanted to make sure that we had the same unique feel but also brought it to the next stage of development with our office.

We have always had a boutique feel. Part of that was making sure that we had an independent look that looked like a practice that could not only be unique but you could find in any big city like Charlotte, New York, Miami, Vancouver or wherever that we could rival. We wanted to make sure that we had that good feeling. Part of it is the chandelier. It's quite impressive.

Every time I look, I'm like, "That thing is crazy." That was my partner's idea. It looks great and brings the room together. It's making sure that we have the visual displays that we need, whether you're getting a high-end, medium-end or a budget frame option, so that you feel comfortable in the space and that our staff is welcoming.

That chandelier draws a lot of attention but it's amazing. It's right in the center. It brings everything together. That's fantastic. What about those little design pieces like the trays that you use? Is that your partner or other?

My partner's husband helps with our team and some of our operations. That was his brainchild when he did all that. We're trying to make sure that we have all the little details. I like those little ideas that go above and beyond. You don't notice until you don't have it. When we give a pair of glasses, whether it costs $20 or $200, it needs to look unique and independent. We want to have that nice display. In our exam rooms, I've got screens in the corners. We try to keep our wait times very low but if you're a patient, you're a captive audience. I want to be able to have internal marketing.

A lot of the time, I have slides of our staff and we've got videos of our staff trying on glasses. I might have a glasses ad from a frame line and something about dry eye. I might go back to, "Did you know about eyeglasses?" The patient is sitting there and waiting for me on their phone or trying on their contacts. They're sitting there and looking at the screen there. They can say, "I didn't realize I could do daily contacts." You come back into the room and they're already in there. It has helped us fill that need where there's no time that the patient is not taken care of. At least, that's our goal. We want to make sure that each little step of the process is taken care of.

One of the things that felt uncomfortable, back to our uncomfortableness, is we had a traditional waiting room. Some offices already have this. This is not a new idea. It's not my idea. We toured offices to figure out, "What do we like? What don't we like?" There are a couple of offices that had minimal or no waiting room. That's a unique idea. The people that we talked to had built a building that had a waiting room. They said, "You can never do that because you've got to have a waiting space. You're going to have a wait time."

I was like, "If I don't, then I'm going to be forced to deal with it." If I have time for patients to wait, then magically, those chairs are going to fill out. We have crunched our waiting space with two nice chairs. The patient should be left there for less than five minutes. Our staff knows that if it takes them enough time to get a coffee, then we're not doing something right. Part of that has changed our whole conversation with our team, "The patient checks in. When they walk in the door, it's 20 feet from the door to the front desk."

"You should know exactly who's walking in, greet them by name and then offer them coffee. By that time, you should already let the tech know. The tech should be coming around the corner." They should almost feel rushed to their coffee, in a sense, which is the goal because we don't need those chairs filling up. Those chairs do not need to look worn because we should be on that type of rotation. That's back to those little details. How can I build an office space physically? How can I build a team mentally that can handle making sure that we go every mile with every patient to make them feel unique and special and suit their needs?

Doing what feels uncomfortable is important. That may look different depending on the phase of life you're in or the phase of your career you're in.

I've heard the arguments back and forth about having a waiting room or not having one. I get the idea of not having one. In both of our offices, the waiting area is quite small. There are only a few chairs. That was partly out of necessity to maximize the square footage but also deliberately in that we didn't want to have a giant waiting area. You want dollars per square foot. You want to make sure each square foot is being used the best way it can be.

That was one of the things but also because if you don't have the seats, it forces people to walk around, browse glasses and other things like that, which can be more productive. I lean more towards the way that you went. If we were to build another practice, I would do the same thing where I'm like, "It's minimal if there's any waiting area." Out of curiosity, do you have a kids' area or play space?

We don't. I have three kids. I love my kids and I'm not a paeds guy. I'll see the kids. Don't get me wrong. It's just not my forte. We're in a small town so we will see everything. I'll see kids from 2 to 100-year-old patients. I wish I could find somebody who loved paeds. It's not my thing. I don't mean that in the wrong way. You have to love it. We don't have a kids' area. Long-term, if we could find somebody if anybody reading wants to move to Western North Carolina, I'll build you a kid's area.

You can come and see all the paeds patients you want. That would be a great addition to the practice in terms of thinking about, "If I were to build a practice, then how do I make my space usable?" A waiting room doesn't make you any more cashflow. It makes patients comfortable but there's no cashflow that comes out of that. Is it going to add to your practice in terms of the field? That's utilizing those spaces as best you can.

For us, the biggest thought about the waiting room issue was if you walk into a doctor's office and there are ten people in there, it doesn't feel good. I don't like that feeling. It's different. If I go into a restaurant and there's a 30-minute wait, I'm like, "This must be good." It's the opposite. In a doctor's office, I don't want to see 30 people waiting because that already raises my blood pressure. If I walk in, I'm immediately greeted. There's no one sitting there and I see people but they're all browsing glasses. My initial reaction is like, "This is going to be a good feeling."

That immediate 30-second feeling for patients is very important. You have one chance to do that because if you walk in and your receptionist is mad and she's like, "Are you here for your exam?" It's immediately off to a bad start no matter how well you do. They're always going to be like, "I had a great eye exam but the receptionist was rude. I had to wait. It didn't feel right." It's that feeling and perception that becomes a reality for those patients.

Maya Angelou was like, "People will forget what you say to them but they will never forget how you made them feel." That's so valuable and important when you're trying to build something like this that's going to have staying power, especially in a small town but even in bigger cities. Word of mouth is still key. It's having people leave with that feeling. Going back to what you were saying before, it's focusing on your staff. The staff is the people who often will leave the patients with that feeling.

Starting by focusing on your staff is maybe more important than focusing on the patient. That all comes full circle. That's awesome. Before we get towards wrapping up, I want to go back to the do-hard-things thing. Are there any other thoughts you have on that? I want that to be the core of this. I want to encourage our friends and our colleagues out there to embrace challenges, venture into the unknown and go past the edge of their comfort zone and those types of things there. Is there anything else you want to share on that note that might be helpful?

That looks different for everybody. Doing what feels uncomfortable is important. That may look different depending on the phase of life you're in or the phase of your career you're in. The biggest takeaway is that when you're young in your career, it feels so overwhelming. I remember being in optometry school going, "There are tests that I can barely pass when I'm working my tail off." I wasn't the best student. That's fine. It's hard. I'm thinking, "I have this dream of owning a practice. How am I ever going to climb that mountain to be able to get out of optometry school after the first year?"

I got student loans I got to pay off. My wife wants to start a family when we get out of school. You start thinking about how far you have to go. It becomes paralysis by analysis. The only way that you can get over that is to figure out, "The hardest and most imperative challenge I have in front of me is this. I'm going to attack that with everything I have." Whether that's an optometry school test, you're in year one and it's your first optic test, do it. Do the best of your ability, whether you're at the top of the class or the bottom of the class, and continue to push yourself to do what is in front of you.

It's like what we were talking about with endurance stuff. That's the whole thing you have to do. You got to run the mile you're in. I get off the bike. I'm doing 112 miles. I'm like, "I've got to change my shoes in a few minutes and run 26." That first mile is awful. You feel great because you accomplished this huge feat. I swam and biked. Now I got to run a full marathon. You're like, "I don't feel like doing this." It's that same mentality. I'm passionate about private practice. There are a lot of students and entrepreneurs out there in optometry schools that are in that situation.

I know I would be if I was starting at optometry school. It's like, "I want to get in private practice but I feel overwhelmed. I have all this debt and the things I want to do in my life. I don't know how to prioritize that." My thought would be, "Go after it. Write yourself a little to-do note. Write it on your mirror in your apartment." You're saying, "I'm going to be a practice owner by 2030." It doesn't mean that you're going to do it. It doesn't mean you're not going to do it. They're silly. I'll write things down before I do it.

For two years, on my whiteboard in my house, I said, "Become an Ironman." I was going to do that. On days that I felt like not doing it, I go up there, slap the heck out of it and be like, "I'm going to do it." It's thinking about your goals and visualizing yourself going, "My practice is going to be so big. It's going to be this and look like this." When you're in your apartment in your first optometry school, that's helpful to embody that uncomfortableness because it's hard when you're in the thought of it and the thick of things going, "I don't want to study for this test." We all were there.

I wanted to give you space to keep going in case there was more. All of that is amazing. You touched on a couple of different things. Was there something else?

My concern for optometry is there's so much pressure on young ODs, young grads and ODs in general. There's a squeeze of student loans and stress from optometry school if you're in year 3 or 4. There are all kinds of changes in the market, private equity groups and all these things. You're getting squeezed in the middle. If you're at the beginning of your career going, "What am I supposed to do? I've got these things financially I've got to do. I've got things that are putting pressure and it feels like I can't find it," it's taking as many at bats as you can.

For me, I knew I wanted to own a practice eventually. I ended up doing a residency. I did a residency and I didn't even apply because I didn't realize I would back out of a job and then lock into a residency. I took an associateship knowing I wanted to do a job and then lucked into it. It's continually taking those at bats like, "I'm going to continue to put myself in situations where maybe this works out. Maybe it doesn't." Eventually, it will find you if you continue to push yourself.

I'm very passionate about it. If you're reading this and you're in private practice, I beg of you. Do it because you will not regret it. If you ultimately long-term, make yourself a promise that no matter what happens and no matter what life stresses, it's worth it in the end. Optometry wins, the more aggressive entrepreneurs we have, the better. Let's get optometry excited about private practice. There are a lot of people out there but don't be scared. It's tough but it's worth it.

How about that pep talk there? Let's get it. If you're not in private practice, I bet you're geared up now. I 100% would echo everything you said there about being aggressive and enthusiastic in private practice. We talk about how private practice is the backbone of optometry or the profession. We need to keep it there and keep growing even with all the other forces and things that are in there. It is easy for young ODs that are coming out now to feel a little pressure, confused or whatever it might be to take the job that's going to pay well so you can pay your loans off.

You're afraid you might get stuck in that forever but you don't have to be. You and I are examples. I pretty much only worked in sublease settings for the first few years of my career and eventually ended up with my private practice. Opportunities are always there. It's just a matter of being willing to take the leap. We need those aggressive-type entrepreneurs. We have a lot of them in our profession. In North America, there are a lot of people doing amazing things.

I love it because those are the types of people who are going to show us that there's so much more that we can do than spinning the dials or working for some big corporation. That's going to help us grow and move the profession forward. Thank you for that insight. Before we get to the last two questions that I'm going to ask you, I would love for you to share. Where can people find you and get in touch with you? How do you want people to find you online?

You can find me on LinkedIn and Instagram. I'm @Dr.TommyPinkston on Instagram. Feel free to reach out. I love getting to connect with people. I would talk about making sure that if you're interested in private practice, I won't sugarcoat it. There are tough times. It's not all sunshine and rainbows, by all means, but I will be candid with you in terms of what it could offer. If that's something that intrigues you, whether you're a student, a young OD or already in practice, by all means, feel free to reach out. I love talking about it. If you're in our area or want to make a trip to Western North Carolina, I will gladly show you our practice, what works, tips, tricks and things that didn't work that we wished we would've known too.

There's a lot to learn from people who have been through it. Let's put that back out there. If there are any ODs who want to practice in Western North Carolina, Dr. Pinkston is looking. Let's make this a classified ad here. I don't mind. Honestly, though, everybody is looking for a good place to work. Why not? If you're looking for that area, give Tommy a shout. Tommy, I came up with an idea. For your Instagram, you should change your handle to @TheEyeronman.

Be okay with striking out because something will come of it. It may not be good. You may not love it. It may not be what your goal was, but you can use that to make yourself better and learn from it essentially.

I like it. That's pretty classic.

I doubt there's anybody else who's got that handle. Let's scoop it up. Hang on to it, in case. Here are the last two questions that I ask every guest. I have changed this one. If you read previous episodes, which you did, the question I used to ask everybody is, "If you could go back in time to your younger self, what advice would you give yourself at that time?" I was in a meeting and there was a speaker. She's an accomplished entrepreneur.

She was like, "That's such a stupid question." She shut it down, not to me directly. She's like, "I hate when people ask me that question." On stage, she was saying that. I was like, "I'm not asking that anymore." I might bring it back but I like the other question that she was posing to us in the audience. That was, "What would your younger self say to you?" Let's say I like the idea of your undergrad or optometry student self. What would that person say to you?

My initial answer is, "I'm surprised you made it out of optometry school." It's funny that I was very much the class clown. We were at UAB. We were about 40 students. I was always playing practical jokes and that type of thing. My partner was our valedictorian. We have different personalities. That's the first thing that I would tell myself.

What would your younger self say to you? Let's say it's the first year of optometry school for Tommy Pinkston. What would he say to you now?

Is it a question or a statement?

Looking at you where you are now, what would he say? He's not looking for advice. He's just looking at you. How would he feel about where you are?

My answer is going to sound like I'm cocky.

I'm setting you up for that. That's the point of the question. It's one of those interview questions where you get to sound like you're bragging but not bragging.

My younger self would say, "I'm shocked you did as much with you did with as little talent as you had." That has come from taking a lot of bats, having lots of mistakes and continuing. The flip side is what I would tell my younger self, "Continue to embrace failure." One of the biggest regrets that I have is still feeling uncomfortable with failure. Most entrepreneurs get used to failing. That becomes part of the process. I still do not like that. Most eye care providers don't because we're very data-driven.

We want to get the refraction right and make sure everything is 20/20. That's how we measure our success. To have an unsuccessful venture and do things unsuccessfully feels uncomfortable. What I would tell myself years ago is, "Be okay with striking out because something will come of it. It may not be good. You may not love it. It may not be what your goal was but you can use that to make yourself better and learn from it essentially."

I apologize for putting you in the awkward position of having to pump your own tires but that's the point of that question. Take a second to see where and how far you've come. I wouldn't have known that was who you were back then. It is an accomplishment to come from being the class clown to being the accomplished optometrist and business person that you are. Here's the last question, which you've heard. I'm not changing this one because I still like this one. With everything you have accomplished now, like Young OD of the Year, Alumnus of the Year, business owner here of this beautiful practice and family man, how much of it is luck and hard work?

A lot of it is luck through hard work. To some degree, there's some randomness in life that you have you have no choice. I don't get to choose where I was born. That's part of it. I can only make with my hand what I can do. I got a hand in life and that hand may be better or worse. There may be things that are easier or harder for me but I've got to work that hand hard as best as I can and play it to its full potential.

For me, it's like, "I'm unlucky or lucky. It doesn't matter. Here's my hand. Let's move, take it in and have fun with it." That's part of what I like about being in private practice. I've got a hand. I may be able to make a better hand because I choose my fate or I could gamble and it could go bye-bye. It's different versus a steady hand. That's part of what I love about private practice.

You do essentially determine your fate for the most part when you're in that setting. I like that it's luck through hard work. That's a very philosophical answer. I'm all about that philosophical mindset. Are there any final words of wisdom you want to share with us before we wrap up?

I almost brought up the memento mori thing. I'm sure you're familiar with it.

Please, let's go talk about that. I'll talk about that all day. Memento mori makes sense.

You can get stickers made for your bike. You're on this bike when you're doing triathlons for six hours if you're doing a full. It's three hours if you're doing a half. Maybe it's two and a half if you have a good race. You're looking at this bike. Part of it is like, "What are you looking at?" You can look at the road and look up but when you look down, you look back up. In 2022, I'm going to have a little sticker made that either says, "Do hard things, memento mori or some version of that." I can look down and go, "This is what I signed up for," in those tough moments.

Memento mori is Latin. The point of the saying is, "It could all end at any moment. You got to live. Make the most of this moment. Otherwise, it could all be gone in the next moment." It's a way to make sure you give your fullest here in this moment, live your life to the fullest and all of that. It's a great philosophy to live by.

The translation is, "Remember, you must die," which is very morbid. The first time I heard it, I was like, "That's tough. I don't like that." I told my wife about that and she's like, "You're weird." I was like, "It's not meant in a morbid sense. It's meant in the sense that we all have a finite amount of time. What are you going to do with that?" Even in a professional sense, you got one time. This is it. What are you going to make of that? Remember that part of it is luck or unluck. Go for it.

I liked thinking, "Am I living that to the fullest?" Some days it's like, "No. I took that for granted. I got a short temper with my kids or whatever it may be. That's not who I want to be long-term." Putting a goal out there of enjoying your life is a better way to look at it in a positive sense. You enjoy your life because it's like carpe diem. Seize the day. It's the same type of mentality and idea.

Thanks for sharing that, Tommy. I appreciate it. Tommy, the Ironman, Pinkston, thank you for joining me. Thank you again for reading. We will be back with another episode. We will see you soon.

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About Dr. Tommy Pinkston

Dr. Pinkston is a native of Florida and attended the University of Florida for his undergraduate education. He received his Doctorate of Optometry from the University of Alabama at Birmingham. After graduation, he completed a residency in ocular disease and refractive surgery at Woolfson Eye Institute in Atlanta, Georgia, where he co-managed cataract, cornea and refractive surgery patients.

Dr. Pinkston relocated to Western North Carolina in 2016. Dr. Pinkston believes the key to great eye care is a continued focus on communication with each individual patient. When not in the office, Dr. Pinkston enjoys spending time with his wife and 3 children. He is currently training to complete an Ironman Triathlon in 2021.