Advertise on podcast: The Optometry Success Podcast

The patient may always deserve empathy—but that doesn't mean the patient is always right.   Every optometry practice has difficult patient interactions: the patient who shows up for an appointment that isn't on the schedule, the person demanding an exception to a policy, or the patient expecting the practice to absorb the consequences of something that simply isn't its responsibility.   In this episode of The Optometry Success Podcast, we role-play two real-world situations and break down how practice owners and their teams can respond without becoming defensive, immediately giving in, or escalating the situation.   We discuss the importance of tactical empathy, giving patients choices, anchoring expectations, and empowering team members to make decisions without unnecessarily involving the doctor. Chad also explains why doctors may actually be the wrong people to handle these situations: our desire to solve the urgent problem in front of us can cause us to forget everyone else affected by that decision.   That leads us to the "tyranny of the urgent"—when the loudest, most immediate problem takes priority over everything else. Saying yes to one demanding patient might simultaneously mean saying no to the eight other patients on your schedule, your team, your profitability, and your own sanity.   And sometimes, even after doing everything right, the patient still won't accept the answer. We leave that question for our next conversation: What happens when empathy, flexibility, and reasonable solutions still aren't enough?   NBS (Next Best Step): Identify one common situation in your practice where your team feels pressured to make exceptions for patients. Define the boundary, decide who has the authority to handle it, and give your team a framework for responding with empathy—without automatically saying yes.   Have a question for us to address in a future episode? Submit it here!   Resources: The Optometry Success Podcast, Episode: Extended Warranty - Your Profits for Patient Peace of Mind Book: Never Split the Difference Learn more about Partners in Profit Download the Practice Owner's Financial Toolkit 20/20 Money Ultimate Financial Success Masterclass OD Mastermind Interest Form Check out Adam's new book: How to Buy an Optometry Practice   Subscribe on Apple Podcasts: https://shorturl.at/Fq1Ro  Subscribe on Spotify: https://shorturl.at/jCtsk

Being booked out for weeks might feel like proof that you need another doctor—but it could be giving you the wrong answer.   In this episode of The Optometry Success Podcast, we continue our conversation around associate ODs and tackle one of the biggest questions practice owners face: How do you actually know when it's time to hire another doctor?   We discuss why owners often hesitate to add an associate, the financial fear of giving up production and profit, and why adding another OD can actually create significant margin when much of the practice's overhead is already in place. We also get tactical about successfully integrating a new associate, including why established doctors need to intentionally move patients onto the new doctor's schedule rather than simply expecting the associate to build a patient base from scratch.   Most importantly, we challenge the commonly used benchmark of being "booked out" as the signal that it's time to hire. Two practices can both be booked out three weeks and have dramatically different levels of actual capacity.   Instead, we revisit schedule health and the numbers practice owners should be tracking: available appointment capacity, how much of that capacity is already scheduled a week in advance, and how many of those available slots ultimately turn into completed exams.   NBS (Next Best Step): Stop using "how far booked out are we?" as your primary measure of capacity. Calculate your schedule health using actual available appointment slots and completed exams. If you're consistently filling roughly 85% or more of available capacity in advance—and completed exams remain within about 10 percentage points of that number—you now have objective data to help determine whether it's time to seriously consider adding another OD.   Have a question for us to address in a future episode? Submit it here!   Resources: The Optometry Success Podcast, Episode: What is "schedule health" and why should practice owners be measuring it Learn more about Partners in Profit Download the Practice Owner's Financial Toolkit 20/20 Money Ultimate Financial Success Masterclass OD Mastermind Interest Form Check out Adam's new book: How to Buy an Optometry Practice   Subscribe on Apple Podcasts: https://shorturl.at/Fq1Ro  Subscribe on Spotify: https://shorturl.at/jCtsk

What if making less money actually made your practice—and your life—better?   In this episode of The Optometry Success Podcast, we explore a tension that can quietly create significant friction between practice partners: what happens when one owner wants to maximize profitability while another is willing to trade some of that profit for greater capacity, less stress, and a better quality of life?   We discuss why neither owner is necessarily wrong. Adding staff, scribes, technology, or other resources may reduce profitability if the additional capacity isn't converted into more production—but that doesn't automatically make it a bad business decision. The real question is whether everyone understands what they're receiving in exchange for the dollars they're giving up.   That becomes especially important in partnerships. When owners have different financial goals, work preferences, or definitions of success, seemingly simple decisions about staffing and expenses can quickly become much bigger conversations about fairness and compensation.   We also discuss the danger of trying to solve every difference through formulas, policies, and operating agreements. You can't legislate your way around poor communication. As we discuss in the episode, there's often a seamless transition between communication ending and resentment beginning—especially when money is involved.   Have a question for us to address in a future episode? Submit it here!   Resources: Book: Die With Zero Book: Crucial Confrontation Learn more about Partners in Profit Download the Practice Owner's Financial Toolkit 20/20 Money Ultimate Financial Success Masterclass OD Mastermind Interest Form Check out Adam's new book: How to Buy an Optometry Practice     Subscribe on Apple Podcasts: https://shorturl.at/Fq1Ro  Subscribe on Spotify: https://shorturl.at/jCtsk

The wrong CPA may file your tax return perfectly—and still be the wrong CPA for your practice.   This week on The Optometry Success Podcast, we're answering a listener question from a new 50% practice owner whose longtime CPA may soon be retiring: What should I be looking for when interviewing a new CPA, and what questions should I ask?   Before you start interviewing firms, though, there's an important distinction to make: What do you actually expect your CPA to do?   Do you need someone to prepare tax returns and make sure everything is filed correctly? Do you expect proactive tax planning throughout the year? Are they handling bookkeeping and financial reporting? Do you want them advising you on business decisions? And how does the CPA fit alongside the other professionals already sitting at your proverbial advisory roundtable?   We discuss why practice owners sometimes overestimate how much their CPA understands about the actual business of optometry. Knowing how to read a P&L and prepare a tax return isn't the same as understanding what healthy margins should look like inside an optometry practice or how an owner should operate the business.   From there, we get tactical with questions you can use when interviewing your next CPA. How many healthcare and optometry practices do they serve? What does their service model actually look like? How proactive is their tax planning? Do they have experience with the tax laws in your state? What technology do they use, and how accessible is your financial data? What mistakes do they commonly find when taking over optometry practices from other accounting firms?   We also discuss why your CPA probably shouldn't be the only person advising you on how to run your business. A strong practice owner builds a roundtable of professionals with different areas of expertise rather than expecting one advisor to know everything.   NBS (Next Best Step): Before interviewing another CPA, define the role you need them to fill. Then build your interview questions around that expectation. You're not simply looking for someone capable of filing a tax return—you're looking for the right person to occupy the CPA seat at your advisory roundtable.   Have a question for us to address in a future episode? Submit it here!   Resources: Learn more about Partners in Profit Download the Practice Owner's Financial Toolkit 20/20 Money Ultimate Financial Success Masterclass OD Mastermind Interest Form Check out Adam's new book: How to Buy an Optometry Practice     Subscribe on Apple Podcasts: https://shorturl.at/Fq1Ro  Subscribe on Spotify: https://shorturl.at/jCtsk

Getting rid of your front desk sounds great in theory—but what does it actually look like on Monday morning?   In a recent episode of The Optometry Success Podcast, "Why do you still have a front desk?", we challenged one of those assumptions in optometry that often goes unquestioned simply because "that's the way we've always done it." That conversation generated a listener question asking us to go one step further: How do you actually make this work?   So that's exactly what we're doing in this episode.   Chad walks through the self-check-in system he built and currently uses in his practices, including the physical kiosk setup, the simple technology behind it, the questions patients are asked when they arrive, and how that information gets communicated to the appropriate team members in real time.   We also talk about why eliminating the traditional front desk doesn't mean eliminating the patient experience—or even eliminating a team member. In fact, the better way to approach this may be to start running the new system while your existing front desk is still in place. Let patients learn the process. Let your team learn the workflow. Find the problems. Make adjustments. Then see whether the traditional front desk is still necessary.   This is a perfect example of Jim Collins' concept of firing bullets before cannonballs. You don't need a major remodel or an expensive technology investment to test the idea. A relatively inexpensive kiosk, an iPad, and a simple form can give you enough information to determine whether the concept works in your practice.   And if it does, the upside extends beyond payroll. You may create a more efficient check-in experience, reduce your dependence on a difficult-to-staff position, and even reclaim valuable square footage for more productive uses.   NBS (Next Best Step): Don't start by getting rid of your front desk. Start by making it unnecessary. Build a simple self-check-in process alongside your existing workflow, train patients and staff to use it, and see whether the system can gradually replace a task you've historically needed someone to perform.   Examples of a kiosk stand   Have a question for us to address in a future episode? Submit it here!   Resources: Learn more about Partners in Profit Download the Practice Owner's Financial Toolkit 20/20 Money Ultimate Financial Success Masterclass OD Mastermind Interest Form Check out Adam's new book: How to Buy an Optometry Practice   Subscribe on Apple Podcasts: https://shorturl.at/Fq1Ro  Subscribe on Spotify: https://shorturl.at/jCtsk

As a practice owner, it's possible to manipulate your financials in ways that make the business appear healthier than it really is, often without realizing you're doing it. On this episode, my co-host, Dr. Chad Fleming, and I discuss how decisions like paying yourself an artificially low salary or charging the practice below-market rent can inflate your reported profitability and create a false sense of financial happiness. We also discuss why practice owners need to normalize their financials, use consistent definitions when talking about profit margins, and understand the difference between profitability and cash flow. If the numbers don't reflect the true cost of operating the practice, you may be making decisions about equipment, hiring, debt, or expansion based on a financial reality that doesn't actually exist. Our next best step for you is to review your practice financials and ask whether they reflect fair owner compensation, realistic operating expenses, and the true financial health of the business. If you aren't confident in the answer, surround yourself with professionals who can help you establish accurate numbers before making your next major decision.   Have a question for us to address in a future episode? Submit it here!   Resources: Simple Numbers, Straight Talk, Big Profits! by Greg Crabtree Learn more about Partners in Profit Download the Practice Owner's Financial Toolkit 20/20 Money Ultimate Financial Success Masterclass OD Mastermind Interest Form Check out Adam's new book: How to Buy an Optometry Practice   Subscribe on Apple Podcasts: https://shorturl.at/Fq1Ro  Subscribe on Spotify: https://shorturl.at/jCtsk

In this episode of The Optometry Success Podcast, we challenge practice owners to reconsider whether they still need a traditional front desk. Chad shares how his practices use self-service check-in kiosks to address staffing challenges, reclaim office space and redirect payroll toward higher-impact roles. We also discuss how front-desk responsibilities can be reassigned or automated without sacrificing the patient experience. We're not suggesting every practice eliminate its front desk. Instead, we want owners to question long-standing assumptions and consider whether a kiosk could solve staffing, efficiency or space challenges.   Have a question for us to address in a future episode? Submit it here!   Resources: Learn more about Partners in Profit Download the Practice Owner's Financial Toolkit 20/20 Money Ultimate Financial Success Masterclass OD Mastermind Interest Form Check out Adam's new book: How to Buy an Optometry Practice   Subscribe on Apple Podcasts: https://shorturl.at/Fq1Ro  Subscribe on Spotify: https://shorturl.at/jCtsk

What if one of the biggest opportunities to improve your practice's profitability isn't seeing more patients—but simply questioning the technology bills you've accepted as "just the cost of doing business"? In this episode of The Optometry Success Podcast, Adam and Chad dive into one of the most overlooked expense categories on an optometric practice's P&L: IT and technology. From managed IT retainers to software subscriptions, networking fees, equipment warranties, and EMR integrations, they explore why so many practice owners assume these costs are fixed—and why that assumption may be costing them thousands of dollars every year. Drawing from Chad's hands-on experience building and managing technology infrastructure in a growing multi-location practice, the conversation focuses less on specific vendors and more on developing the mindset to thoughtfully evaluate every recurring expense. The goal isn't to cut costs at all costs—it's to ensure every dollar spent is delivering meaningful value to both the patient experience and the long-term health of the practice. In this episode, you'll learn: Why IT expenses deserve the same scrutiny as any other line item on your P&L. The trade-offs between managed IT services, subscriptions, and self-insuring certain technology costs. How convenience and automation can quietly inflate overhead. Why "everyone else does it" is rarely a good business strategy. Practical ways to begin evaluating whether your current technology spending aligns with your practice's goals.   Next Best Step (NBS): Ask your office manager or practice administrator to compile a complete list of every recurring technology-related expense—including IT retainers, software subscriptions, equipment support agreements, and integration fees. Don't make changes immediately. Simply review each item and ask one question: "Is this providing enough value to justify its ongoing cost?" Sometimes the greatest savings come not from eliminating technology, but from challenging long-held assumptions.   Have a question for us to address in a future episode? Submit it here!   Resources: Learn more about Partners in Profit Download the Practice Owner's Financial Toolkit 20/20 Money Ultimate Financial Success Masterclass OD Mastermind Interest Form Check out Adam's new book: How to Buy an Optometry Practice   Subscribe on Apple Podcasts: https://shorturl.at/Fq1Ro  Subscribe on Spotify: https://shorturl.at/jCtsk

In this episode, Chad and I build on our previous conversation about lab rebates by focusing on the next step: auditing the true cost of the optical jobs for which your practice pays the bill. We explain why comparing one discounted lens or rebate isn't enough and how analyzing the complete cost of your most frequently used lens-and-AR combinations can reveal what you're actually paying.   We also discuss how labs use loss leaders, when working with multiple labs may make financial sense, and why a buying group's preferred lab relationship doesn't automatically guarantee your practice the best pricing. We share how spreadsheets, AI tools, and insights from successful colleagues can help you compare your options, verify your current relationships, and protect your practice's profitability.   Have a question for us to address in a future episode? Submit it here!   Resources: Learn more about Partners in Profit Download the Practice Owner's Financial Toolkit 20/20 Money Ultimate Financial Success Masterclass OD Mastermind Interest Form Check out Adam's new book: How to Buy an Optometry Practice   Subscribe on Apple Podcasts: https://shorturl.at/Fq1Ro  Subscribe on Spotify: https://shorturl.at/jCtsk

In this episode, Chad and I continue our conversation about whether optometry practices should finish jobs in-house or send them to a lab. This time, we focus on the role managed vision care plans play in that decision, including state opt-out rules, required labs, reimbursements, and rebates.   We break lab analysis into two distinct lanes: when the managed vision care plan pays the lab bill and when the practice pays it directly. We also discuss why an attractive rebate does not always equal greater profitability and how I should evaluate the total net cost, product quality, turnaround time, and customer service before choosing a lab partner.   Have a question for us to address in a future episode? Submit it here!   Resources: Learn more about Partners in Profit The Optometry Success Podcast Episode: Should You Finish In House or Send Your Jobs to a Lab? Download the Practice Owner's Financial Toolkit 20/20 Money Ultimate Financial Success Masterclass OD Mastermind Interest Form Check out Adam's new book: How to Buy an Optometry Practice   Subscribe on Apple Podcasts: https://shorturl.at/Fq1Ro  Subscribe on Spotify: https://shorturl.at/jCtsk

Should your practice finish jobs in-house, or send them out to a lab? In this episode of The Optometry Success Podcast, we dig into a deceptively simple question that can have a major impact on profitability, efficiency, patient experience, and owner stress.   We talk through the decision matrix behind in-house finishing, including the obvious costs — lenses, equipment, and staffing — as well as the softer costs that are easy to overlook: square footage, utilities, training, quality control, staff turnover, and the operational risk of relying on one or two key people to keep the system running.   We also explore why this decision is not one-size-fits-all. For some practices, an in-house lab can be a profitable, high-quality, efficient part of the business. For others, outsourcing to a lab may reduce complexity, lower risk, and free the owner from one more system that has to be managed internally.   Have a question for us to address in a future episode? Submit it here!   Resources: Learn more about Partners in Profit 20/20 Money Episode: Edging In-House vs. Outsourcing: The Economics, Trade-offs, and Data an Optometric Practice Needs to Measure with Drs. Jennifer Stewart & Sam Hornberger Download the Practice Owner's Financial Toolkit 20/20 Money Ultimate Financial Success Masterclass OD Mastermind Interest Form Check out Adam's new book: How to Buy an Optometry Practice   Subscribe on Apple Podcasts: https://shorturl.at/Fq1Ro  Subscribe on Spotify: https://shorturl.at/jCtsk

In this episode, we talk through how optometric practice owners can think about debt more responsibly and avoid letting borrowed money quietly eat away at practice cash flow. Adam explains why a healthy P&L does not always mean there is money available in the bank, and why the statement of cash flow often reveals how much of a practice's earnings are being consumed by financing activities. We discuss how debt can be used to accelerate growth, but also how it can create pressure when the practice takes on more than its earnings can reasonably support.   We also explore how to evaluate new equipment purchases before signing the check. Rather than buying based on excitement, peer pressure, a conference-floor sales pitch, or the promise of a tax deduction, we talk about using your own patient data, referral patterns, and a clear business plan to determine whether the investment actually makes sense for your practice.   Chad shares the practical tension many ODs feel between wanting to provide the best possible patient care and needing to protect the financial health of the business.   From debt service coverage to cash flow, taxes, profitability, equipment decisions, and long-term ownership strategy, this conversation gives optometric practice owners practical ways to "count the cost" before taking on new debt. We also discuss why different seasons of practice ownership may call for different financial strategies, and why a strong team of advisors can help owners make better decisions for the practice, their team, their patients, and their future.   Have a question for us to address in a future episode? Submit it here!   Resources: Learn more about Partners in Profit Download the Practice Owner's Financial Toolkit 20/20 Money Ultimate Financial Success Masterclass OD Mastermind Interest Form Check out Adam's new book: How to Buy an Optometry Practice   Subscribe on Apple Podcasts: https://shorturl.at/Fq1Ro  Subscribe on Spotify: https://shorturl.at/jCtsk

In this episode, we respond to a listener question from a doctor preparing to open a cold start practice. The listener asks whether there is value in buying patient charts from a nearby retiring doctor, especially if doing so could help the doctor retire sooner and create an opportunity to reach out to those patients.   Adam and Chad discuss why charts alone usually have very little value unless there is a clear transition strategy behind them. They talk through what a collaborative handoff could look like, including the retiring doctor actively introducing patients, emphasizing continuity of care, and helping pre-appoint patients into the new practice.   They also discuss the second part of the listener's question: whether it makes sense to purchase the retiring doctor's frame inventory. Chad shares why he would be cautious about buying existing inventory, especially for a cold start, and why new practice owners need to be careful with early capital decisions. The conversation wraps with a broader reminder that cold start owners should measure carefully, ask good questions, and understand that the cost of a wrong decision is often much higher before consistent revenue is coming in.   Have a question for us to address in a future episode? Submit it here!   Resources: Learn more about Partners in Profit Download the Practice Owner's Financial Toolkit 20/20 Money Ultimate Financial Success Masterclass OD Mastermind Interest Form Check out Adam's new book: How to Buy an Optometry Practice   Subscribe on Apple Podcasts: https://shorturl.at/Fq1Ro  Subscribe on Spotify: https://shorturl.at/jCtsk

In this episode, we kick off a broader series on how optometry practice owners can make more intentional, profitable decisions in the optical. Adam and Chad start with cost of goods, discussing why "average" benchmarks should not automatically be accepted as the goal and why even small percentage-point improvements can have a meaningful impact on the bottom line.   They also talk through the difference between choosing what you personally like and choosing what is best for the business, especially when it comes to frames, ophthalmic lenses, vendor relationships, lab strategy, and contact lens rebates. This conversation sets the stage for future episodes on frame choices, lens strategy, private label, lab decisions, and helping patients understand their options between managed vision care and out-of-pocket choices.   Have a question for us to address in a future episode? Submit it here!   Resources: Learn more about Partners in Profit Download the Practice Owner's Financial Toolkit 20/20 Money Ultimate Financial Success Masterclass OD Mastermind Interest Form Check out Adam's new book: How to Buy an Optometry Practice   Subscribe on Apple Podcasts: https://shorturl.at/Fq1Ro  Subscribe on Spotify: https://shorturl.at/jCtsk

In this episode, we talk about why core values and core behaviors matter far beyond simply putting words on a wall. We discuss how clearly defined values can guide decisions around growth, team alignment, burnout, ownership, hiring, patient experience, and the overall direction of a practice. Chad also shares how his own leadership journey helped him better understand the role that personal and professional values play in creating a stronger, more intentional business.   We also walk through practical ways practice owners can begin defining and reinforcing these principles, even when it feels difficult to step away from patient care. From blocking a few hours with the leadership team to regularly revisiting values in staff meetings and connecting them to real-life behaviors, we make the case that a values-driven practice creates stronger culture, better consistency, and a more scalable foundation for growth.   Have a question for us to address in a future episode? Submit it here!   Resources: Learn more about Partners in Profit Download the Practice Owner's Financial Toolkit 20/20 Money Ultimate Financial Success Masterclass OD Mastermind Interest Form Check out Adam's new book: How to Buy an Optometry Practice   Subscribe on Apple Podcasts: https://shorturl.at/Fq1Ro  Subscribe on Spotify: https://shorturl.at/jCtsk