In this episode, Dr. Steve Vargo welcomes back optometrist and practice owner Dr. Kristina Pusz for a deeper conversation about the one thing most growing practices are missing: structure that actually sticks.

Steve and Christina explore what happens when a practice is growing on the outside but quietly unraveling on the inside — staff turnover, things slipping through the cracks, and a leader waking up in the middle of the night unable to turn her mind off. Christina shares how shifting from sporadic, one-sided staff meetings to a structured, accountability-driven leadership system changed not just her practice, but her life.

This conversation goes beyond meeting agendas and to-do lists. It's about psychological safety, the courage to let go of control, and why the practices that run the most efficiently are often the ones with the fewest people — not the most. Christina opens up about her own struggle with micromanagement, what her team finally said to her that forced her to change, and why the doctors who say they don't have time for this kind of structure are often the ones who need it most.

If your team goes quiet when you ask for feedback, if accountability keeps slipping, or if you're carrying more than you should be — this one is for you.

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