20/20 MONEY: The Business of Optometry

AI might save you hours every week—but if you simply fill that time with more work, have you actually gained anything?

In this episode, Dr. Steve Vargo joins me to discuss his new book, Human-Centered AI, and why the biggest opportunity AI presents to practice owners isn't necessarily the technology itself—it's what we choose to do with the time it gives back.

We discuss using AI as a strategic thought partner rather than a decision-maker, why asking AI to interview you can lead to better thinking, and where human judg...

Optometrists earn good incomes—so why does the profession's median net worth tell a very different story?

In this episode of 20/20 Money: The Business of Optometry, I'm joined again by Dr. Chris Lopez to unpack findings from the latest ODs on Finance financial survey, which gathered responses from nearly 2,000 optometrists.

We dig into the numbers behind OD income, student loan debt, net worth, and practice ownership—and, more importantly, what those numbers actually mean for the financial decisions optometrists make throughout their careers.

Chris and I discuss why...

Welcome to this episode of 20/20 Money! My guest on today's show is Hayley Stewart. Hayley is the Financial Services Manager for IDOC and predominately focuses her time and expertise on bookkeeping services for IDOC clients. Hayley joins the show to talk about the importance of bookkeeping in practices and how to properly ensure that your books are accurate. We spend a lot of time talking about items that are reported on the balance sheet and specifically talk about why it's important to understand the relationship of your retained earnings and your net income.

As a...

Welcome to this episode of 20/20 Money! My guest on today's show is Greg Crabtree, CPA.

Greg is the author of two of my favorite books about running a business and using the numbers of your business to make informed decisions (Simple Numbers, Straight Talk, Big Profits and Simple Numbers 2.0: Rules for Smart Scaling). He's also the Partner in Charge in the Huntsville, AL office of Carr, Riggs, and Ingram and I was excited to chat with him about the concepts he talks about in his book. We talk about cash reserves in your business, the 4...

In this episode of 20/20 Money: The Business of Optometry, I'm joined by Nathan Hayes of Books & Benchmarks to go over their recently updated benchmarks analysis and unpack what the latest optometry practice data says about growth, overhead, and profitability. We discuss why a benchmark is a starting point, not a verdict on your practice, and why rising expense ratios may call for a closer look at revenue rather than an immediate round of cuts.

We also talk about the difference between profit and cash you can take home, how equipment purchases affect the balance sheet, a...

The most expensive professional service may not be the one with the highest price—it may be the one you mistakenly thought was a great deal.

In this episode of 20/20 Money: The Business of Optometry, I explore the familiar idea of "good, fast, and cheap: pick two" and applies it to the professional services optometric practice owners rely on every day.

It's easy to compare prices. It's much harder to compare value—especially when you're hiring an attorney, financial advisor, consultant, accountant, IT provider, or other professional precisely because they possess expert...

What does it really take to build and lead a successful multi-location optometry practice? In this episode of 20/20 Money, I'm joined by Dr. Andy Yaryan, Dr. Jeni Kohn, and Dr. Patrick Curran, three experienced practice owners who offer an honest look at what is happening beneath the surface of a growing practice. We discuss the challenges that remain even after achieving visible success, including rising expenses, staffing and culture, shrinking margins, associate recruitment, and the danger of becoming complacent.

We also explore how each owner evaluates investments in the practice, why the desired return is...

The most expensive mistake in your practice might be solving a problem you never proved existed.

Dr. Jen Stewart joins me back on the show for a conversation about making better decisions before writing the check. Inspired by Jim Collins' concept of "firing bullets, then cannonballs," we explore why practice owners should test assumptions, gather evidence, and understand what success actually looks like before committing significant money or resources to a decision.

One idea kept resurfacing throughout our conversation: more isn't better; better is better.

Before you...

The investments you own may be perfectly reasonable—and still be completely wrong for you.

In this episode of 20/20 Money: The Business of Optometry, I'm joined again by Peter Lazaroff, Chief Investment Officer at Plancorp and author of The Perfect Portfolio: A Proven Guide to Smart Investing for Long-Term Success, for a conversation about what actually makes an investment portfolio "perfect."

We discuss why portfolio construction has to begin with the investor rather than the investments, why simplicity is valuable but shouldn't become an ideology, and how to evaluate whether added co...

You may feel diversified while quietly becoming more dependent on the exact same sources of wealth.

In this episode of 20/20 Money: The Business of Optometry, I explore concentration risk from two angles that practice owners often don't connect: what's happening inside an investment portfolio and what's happening on their personal balance sheet as their practice becomes more valuable.

We start with the S&P 500. Because the index is market-cap weighted, the companies that perform best naturally become larger portions of the index. Today, the largest companies represent a significantly greater share of the S&P 500...

What if one of the most familiar parts of your optometry practice is also one of the things most overdue for a rethink?

This week's episode of 20/20 Money: The Business of Optometry is a little different. After a few updates on what's ahead for the podcast—including upcoming guests, a potential optometry-owner ski meetup at Copper Mountain before IDOC Connection 2027, and an opening in the OD Masterminds Founders Club—I'm sharing an episode from another project that some listeners may not yet have discovered: The Optometry Success Podcast.

The Optometry Success Podc...

If your practice has been using the same retirement plan for years simply because "it works," you may be leaving valuable planning opportunities on the table.

On this episode of 20/20 Money: The Business of Optometry, I'm joined by Jared Porter, co-founder of 401GO, for a practical conversation about how much the qualified retirement plan landscape has changed—and why optometric practice owners should periodically reevaluate whether their current plan still fits their business.

We discuss why SIMPLE IRAs may no longer be as "simple" or advantageous as many owners assume, how technology has re...

Your next patient may already be looking for an optometrist—and choosing someone else before you ever know they existed.

On this episode of 20/20 Money: The Business of Optometry, I'm joined by Jeremy Bono, Director of Optometry Marketing Services at IDOC, for a wide-ranging conversation about what effective marketing actually looks like inside an optometry practice.

We start with a bigger question: does the public really understand what an optometrist does—and, more importantly, why they should regularly see one? From there, Jeremy and I explore why simply saying that you provide "exceptional eye care" isn...

What if the pressure to add specialty services is distracting you from the value already sitting inside your practice?

In this episode of 20/20 Money: The Business of Optometry, Adam is joined by Dr. Kyle Klute for a thought-provoking conversation about specialization, comprehensive eye care, and the growing pressure practice owners may feel to purchase new technology or build a niche service line.

Kyle explains why labeling dry eye, myopia management, glaucoma, and other areas as "specialties" can unintentionally allow optometrists to treat them as optional. Instead, he argues that ODs are uniquely trained and positioned...

A profitable practice can create tremendous cash flow—but it does not automatically create personal wealth.

In this episode of 20/20 Money: The Business of Optometry, Adam bridges the gap between running a successful optometry practice and using that success to build lasting financial independence. Drawing on nearly 20 years of working with business owners, he explains why practice size, income, and personal net worth are related—but far less correlated than many owners assume.

Adam shares several patterns consistently demonstrated by financially independent practice owners, including intentionally moving excess cash out of the...

Welcome to this REWIND episode of 20/20 Money! My guest on today's show is Dr. Chris Wolfe, OD. Chris joins me on the show to share in a conversation about how ODs can think about pricing the different services provided in the practice and how to frame that conversation with your patients, how ODs can think about researching their pricing on medical procedures, how to think about scheduling in your practice to be as efficient with OD hours as possible, 4 questions to consider asking every pt as it relates to dry eye, the 5 steps needed to introduce change in your...

A practice sale that should have been the easiest transition imaginable ended before negotiations even began—and the lessons could save you from making the same costly mistake.

In this episode, I shares the story of an anonymized internal succession plan that unraveled despite all the ingredients for success: a trusted associate, established patient relationships, and a seller committed to staying through the transition. So what went wrong?

Using this real-world case study, I'll share the psychology of selling a practice, why valuations are opinions—not verdicts—and how misunderstanding business value ca...

What if the next level of your practice requires less time in the lane — not more? In this episode of 20/20 Money: The Business of Optometry, I'm joined again by Nathan Hayes for a wide-ranging conversation about how practice owners should think more intentionally about their most limited resource: time.

We pick up where our last conversation left off and explore what it really means to work on the business, not just in it. Nathan and I discuss why growth is not always linear, why some seasons of ownership are meant for building while others are mea...

AI can feel overwhelming, overhyped, and impossible to keep up with — especially when every conversation seems to swing between "this changes everything" and "this is all just noise." In this episode of 20/20 Money, I'm joined once again by Dr. Mick Kling for a practical conversation about where AI is actually useful for practice owners right now — without the doom-and-gloom, hype, or technical jargon.

Mick shares how he's been thoughtfully experimenting with AI inside his own workflows to improve efficiency, analyze practice financials, model business decisions, and simplify strategic planning. More importantly, we discuss how practice owne...

What if the biggest reason patients aren't buying glasses from your practice… is the experience you've unintentionally created around optical? In this episode of 20/20 Money, I'm joined once again by Dr. Jennifer Stewart for a candid and energetic conversation around the subtle — and sometimes overlooked — ways practice owners can dramatically improve optical sales without feeling "salesy."

Jen shares how she's intentionally built an optical-forward patient experience that turns eyewear into something patients genuinely get excited about, why most practices unknowingly make optical feel transactional and overwhelming, and how small shifts in attention, storytelling, and intentionality can co...

What if the biggest mistake practice owners make with dry eye isn't buying the wrong technology… but building their entire strategy around the technology itself? In this episode of 20/20 Money, I'm joined once again by Dr. Chris Wolfe for a fascinating conversation around dry eye, specialty services, patient communication, and the dangerous trap of becoming "device-centric" instead of patient-centric.

Chris shares a candid behind-the-scenes perspective on what he's observed from practices across the country when it comes to implementing dry eye services and expensive treatment technologies. We discuss why so many practices buy devices that ul...

What if serving Medicaid patients wasn't a drain on your practice… but one of the most efficient and fulfilling business models in optometry? In this episode of 20/20 Money, I'm joined by Dr. Ryan Hansen to discuss a truly unique model he's built inside a public school district that provides eye care exclusively to children on Medicaid — while still creating a financially viable and highly efficient practice structure.

Ryan shares how he operates a school-based satellite clinic inside the Rockford public school system, why the traditional "either/or" mindset around Medicaid and profitability may be flawed, and...

Why do so many optometric practices hit a ceiling in their practice? We know it's not because the owner isn't working hard enough, so what is it? It's because the business was never designed to scale in the first place. Eugene Shatsman joins me back on the show to talk about the ceiling practice owners inevitably hit in their practice—and a system he's created to help owners break through it. In our conversation, we discuss the systems and frameworks behind building a more intentional, scalable practice, including the five operational pillars Eugene believes every successful practice must manage we...

What if one of the biggest financial mistakes practice owners make is confusing "spending money in the practice" with actually investing in it? In this episode, I'm joined once again by Nathan Hayes for a thoughtful and nuanced conversation around reinvesting in your practice, opportunity cost, and the hidden tradeoffs owners often overlook when deciding what to do with excess cash flow.

We explore the mindset many owners have that every dollar spent on equipment, technology, or expansion automatically creates enterprise value — and why that assumption can quietly create long-term financial consequences if it's never ch...

Most optometric practice owners have no idea how much money they're quietly losing in their optical simply because of merchandising, layout, and the conversations happening—or not happening—between staff and patients.

Welcome to this episode of 20/20 Money: The Business of Optometry. My guest on today's show is Kayla Ashlee. Kayla joins me on the show to talk about the subtle but incredibly powerful levers that influence buying behavior inside the dispensary and why the difference between a thriving optical and an average one often has less to do with pricing and more to do with...

Thinking about buying or expanding a practice, but nervous about debt, banks, or making an expensive mistake?

In today's episode, I'm joined by Mike Smith of Bank of America to demystify the lending process for optometrists. We break down what banks actually look for in a borrower, how student loans and cash reserves really factor in, why tax returns matter more than stories, and the common traps buyers and sellers fall into when financing a deal. If utilizing OPM, other peoples' money like a bank's, is on your radar (now or in the future), this c...

What if the biggest threat to your practice isn't reimbursement, competition, or overhead—but the way you hire, lead, and retain people?

In today's episode, I'm joined by Mike Dixon, president of Hoops, for a conversation every practice owner needs to hear. We unpack why staffing issues feel so hard, why most owners were never trained to lead, and how the right systems can turn your team from your biggest headache into your greatest competitive advantage. If you've ever said, "I just can't find good people," this episode may challenge the way you think about the...

The financial decisions you make early in your career can shape the next several decades—and most people don't realize it until much later. On this episode, I'm sharing a presentation I recently gave to students at the Indiana University School of Optometry on the timeless financial and business lessons every optometrist should understand. I discuss the power of compounding, how to think about saving priorities, student loans, disability and life insurance, and why your income is your greatest wealth-building tool. I also cover important concepts on the business side of optometry, including ownership, practice valuation, buying in, cold st...

Ever wonder if, when, or how to build stronger operations within your practice? In this episode, I sit down with Tom Restivo to unpack EOS and what it looks like to build a stronger operational foundation inside an optometric practice. Tom shares his experience leading a rapidly growing eye care organization through expansion, complexity, and the pressures that eventually exposed where systems were missing. We talk about why growth without structure creates avoidable friction, how core values shape hiring and leadership decisions, and why vision has to be more than a vague idea if you want your team aligned.<...

In this episode I sit down with Dr. Steve Vargo to unpack a mindset that many practice owners quietly wrestle with: the belief that there is no longer money to be made in the basics of optometry. We start with a real question from a practice owner who feels discouraged by stagnant reimbursements and declining capture rates, and use it as a springboard to discuss the deeper issue underneath it all: communication.

Steve explains why successful practices are not necessarily dependent on adding new cash pay services, but instead on improving how doctors listen, communicate, a...

In this episode I sit down with John Marvin to explore a challenging but important idea for private practice owners: the difference between independence and isolation. We unpack John's perspective on why fierce independence can sometimes limit growth when it prevents doctors from learning from others or leveraging the resources already available to them.

Our conversation touches on mindset, the importance of personal growth as a business owner, and why building something bigger than yourself often requires becoming comfortable with discomfort. If you are thinking about the long term future of your practice and how t...

Most optometrists think growth comes from better marketing or more patients—but the real advantage often starts somewhere much less obvious: your team and your culture.

In this episode of 20/20 Money, Dr. Kurt Steele joins me back on the show to discuss the leadership philosophy and operational frameworks that helped him build a thriving multi-million-dollar optometry practice while developing future leaders inside the organization.

The conversation explores why the strongest practices aren't simply focused on production or patient volume, but instead invest heavily in building engaged teams, creating ownership opportunities, and desi...

Health insurance is one of the most confusing and frustrating decisions practice owners face. In this episode I sit down with Matt Allen, founder of Iconic Insurance, to break down the real options available to optometric practice owners and their teams. We walk through the three primary approaches to offering coverage including fully funded plans, self funded plans, and reimbursement strategies. Matt explains how each structure works, when they make sense, and why understanding the risk profile of your team can dramatically impact cost and plan design.

We also spend time discussing a second scenario m...

Many optometrists are either leaving money on the table with their tax strategy—or unknowingly pushing the boundaries of tax law.

Today's episode is my guest appearance on Dr. Steve Vargo's Eye Own a Business Podcast. Steve invited me onto his show to talk about tax planning for optometrists—specifically the strategies practice owners should be embracing right now, the ones they should avoid, and where costly mistakes often show up on tax returns.

In our conversation, we walk through several examples of where optometric practice owners tend to be either too co...

In this episode I sit down with Dr. Vicki Weiss, president of VOSH International, to talk about how optometrists can use their clinical skills to create impact far beyond their own practices. We discuss how VOSH has evolved from the traditional short term clinic model into a global organization focused on education, partnership, and strengthening optometric care in low and middle income countries. Dr. Weiss shares how she became involved, what the organization looks like today, and the many ways ODs can contribute through time, talent, and treasure. If you have ever wondered how your work as an optometrist...

Recording live from IDOC Connection in Orlando, I sit down with Dr. Todd Cohan, Sadie Blair, and Polly Stearns from Forsight Vision and Midwest Dry Eye Center to talk about the relationship between vision and execution inside a growing private practice. We go into the dynamic between the owner (visionary) and the operations lead (integrator), and why that chemistry matters more than most doctors realize.

We discuss leadership cadence, how they structure weekly meetings, how goals are set and tracked, and what it looks like to invest in developing internal talent. We also unpack the r...

In this episode, we share how to confidently give patients clear choices in the exam lane without creating confusion or pushback around vision and medical care. We explain how setting expectations early and taking ownership of clear communication builds trust and increases acceptance of follow up visits. We also touch on how to structure your schedule to support shorter, more frequent visits and why giving patients ownership of their decisions improves both the patient experience and practice profitability.

Hosted By Adam Cmejla, CFP and Chad Fleming, OD, FAAO

Have a question? Submit i...

Eugene joins me to talk about how artificial intelligence is showing up in optometry and why there's a growing gap between how patients use AI in their daily lives and how most practices are adopting it.

We discuss how this shift is changing patient expectations, what it means for the patient journey, and where practices can use AI to improve engagement, communication, and efficiency—without losing the human element of care. We wrap up with a look at where AI in healthcare is headed and how practice owners can use it intentionally to enhance both pat...

In this episode, we dive into the critical concept of schedule health and how it drives strategic growth, especially when adding associates. We explore how data-driven insights help us make confident, informed decisions that support sustainable scaling for our practices.

Hosted By Adam Cmejla, CFP and Chad Fleming, OD, FAAO

Have a question? Submit it here

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The Optometry Success Podcast, hosted by Adam Cmejla, CFP and Chad Fleming, OD, FA...

Ever feel like you're stuck in the "messy middle" and on the operations "hamster wheel" in your practice? If so, this one's for you. Mandy Brown joins me to talk about operational efficiency and what it really takes to run a well-functioning optometry practice.

We discuss the challenges practice owners face with delegation, the importance of hiring the right people, and developing an operational mindset that supports long-term success. Mandy also shares how virtual assistants can play a meaningful role in freeing up time, improving focus, and helping owners work more intentionally on their business r...