20/20 MONEY: The Business of Optometry

Hosted by Adam Cmejla

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397

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Jun 2026

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About the show

20/20 Money is the top podcast for optometrists, private practice owners, and ODs who want to master optometry practice management, financial planning, and long-term business strategy. Hosted by Adam Cmejla, CFP®, the show delivers practical guidance on everything that affects the profitability, growth, and value of your optometry practice. Episodes cover: • Optometry practice management & operations • Financial planning for optometrists • Practice growth strategies & profitability tips • Selling your practice & OD exit planning • Private equity deals in optometry • Hiring, leadership, and team development • Tax planning, cash flow, and retirement readiness • Student loan strategies for ODs • Cold starts, acquisitions, and multi-location scaling With expert interviews, case studies, and step-by-step breakdowns, you'll learn how to make smarter business decisions, build personal wealth, and create a thriving career inside and outside the exam room. If you're an OD serious about elevating your practice and improving your financial future, 20/20 Money is your competitive advantage. For more information on the show and on Adam, please visit https://www.integratedpwm.com/

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June 15, 2026Episode 39743 min

Implementing a profitable Medicaid practice into your local school district: a convo with Dr. Ryan Hansen

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 how he's leveraged simplicity, delegation, and strategic partnerships to create a practice that serves an incredible need in his community. We also unpack the emotional realities of caring for underserved populations, the operational logistics of working within a school district, and the surprising economics behind a model many ODs assume can't work. We also discuss: How Ryan sees up to 16 pediatric Medicaid patients in just a few hours each morning Why low overhead dramatically changes the Medicaid profitability equation The logistics of scheduling, transportation, and dispensing glasses through the school system The role school nurses and principals play in making this model successful Why many children who "pass" school screenings still desperately need glasses The hidden challenges of working with Medicaid reimbursement and bureaucracy How this model creates remarkable work-life balance and flexibility What optometrists should consider if they want to explore a similar partnership in their own communities As always, we close the conversation with practical NBSs (Next Best Steps) for listeners who may want to explore opportunities like this in their own school districts and communities. Resources: Book a Triage call with Adam 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 ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here! Check out Adam's other podcast! The Optometry Success Podcast Subscribe on Apple Podcasts: https://bit.ly/4tttng6 Subscribe on Spotify: https://bit.ly/4tuf0YM

June 8, 2026Episode 39652 min

A blueprint for scaling your practice (while having a life in the process): unpacking Eyecare B.O.S.S. with Eugene Shatsman

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 well. We also talk about the hidden KPIs that quietly hurt profitability, how to create stronger accountability within your team, and why elevating the patient experience from transactional to consultative can dramatically improve both growth and practice value. Resources: Eyecare BOSS (Pre-order Eugene's book, The EyeCare Boss on their website!) Book a Triage call with Adam 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 ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here! Check out Adam's other podcast! The Optometry Success Podcast Subscribe on Apple Podcasts: https://bit.ly/4tttng6 Subscribe on Spotify: https://bit.ly/4tuf0YM

June 1, 2026Episode 39555 min

Are you building wealth...or just feeding the machine?? A conversation with Nathan Hayes on investing capital in your practice

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 challenged. Nathan and I unpack the difference between true investment versus simply adding expense, how owners should think about ROI inside the practice compared to investing outside the practice, and why many of the highest-value drivers in a business have nothing to do with buying another piece of equipment. We also discuss: Why more equipment does not automatically mean a more valuable practice The hidden opportunity cost of continually reinvesting back into the business How enterprise value is actually created in an optometry practice The difference between spending, investing, and simply staying operational Why patient flow and schedule utilization matter more than most owners realize The role marketing can play in growing enterprise value versus buying more technology How practice owners should think about free cash flow after taxes, debt service, and reserves The dangerous feedback loop created by depreciation-driven purchasing decisions Why many owners underestimate the value of investing outside the practice As always, we close the conversation with practical NBSs (Next Best Steps) to help owners think more intentionally about capital allocation decisions both inside and outside their practice. Resources: Book a Triage call with Adam 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 Four Levers in Retirement IDOC Simple Numbers, Straight Talk, Big Profits! Simple Numbers, Straight Talk, Big Profits with Greg Crabtree ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here! Check out Adam's other podcast! The Optometry Success Podcast Subscribe on Apple Podcasts: https://bit.ly/4tttng6 Subscribe on Spotify: https://bit.ly/4tuf0YM

May 25, 2026Episode 3941 hr 2 min

Making These Merchandising Mistakes is Costing You Tens of Thousands of Dollars: An Optical Conversation with Kayla Ashlee

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 psychology, presentation, and process. In our conversation, we discuss the difference between optician-led versus patient-led frame selections, why many owners underestimate the power of suggestion in the optical, and how practices may be unintentionally leaving revenue on the table simply through the way eyeware is presented.. We also talk about practical merchandising strategies that can materially influence capture rate and optical performance without adding more patients to the schedule. Resources: MassGeneral cafeteria experiment "You will read this first" image Book a Triage call with Adam 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 Checkout all the benefits of becoming a Spexy Member at www.spexy.co Use code 2020money to get your first month of Spexy+ Premium for $1 at checkout. ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here! Check out Adam's other podcast! The Optometry Success Podcast Subscribe on Apple Podcasts: https://bit.ly/4tttng6 Subscribe on Spotify: https://bit.ly/4tuf0YM

May 18, 2026Episode 3931 hr 3 min

Practice financing decoded: what owners need to know now about how banks think about deals

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 conversation can save you time, money, and unnecessary stress. Resources: Book a Triage call with Adam 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 ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here! Check out Adam's other podcast! The Optometry Success Podcast Subscribe on Apple Podcasts: https://bit.ly/4tttng6 Subscribe on Spotify: https://bit.ly/4tuf0YM

May 11, 2026Episode 39246 min

How great practice owners build teams that stay and perform

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 real problem—and the real opportunity. Resources: FEAR Setting Exercise from Tim Ferriss HoopsHr.com Book a Triage call with Adam 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 ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here! Check out Adam's other podcast! The Optometry Success Podcast Subscribe on Apple Podcasts: https://bit.ly/4tttng6 Subscribe on Spotify: https://bit.ly/4tuf0YM

May 4, 2026Episode 3911 hr 29 min

Don't make these financial and business mistakes! (the talk I give at every optometry school's private practice club)

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 starts, and why some of the best opportunities in the profession are often overlooked because of geography. Whether you're a student, recent grad, or experienced provider, this episode is about making intentional decisions with your money so you can create more confidence, options, and freedom over time. Resources: Book a Triage call with Adam 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 ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here! Check out Adam's other podcast! The Optometry Success Podcast Subscribe on Apple Podcasts: https://bit.ly/4tttng6 Subscribe on Spotify: https://bit.ly/4tuf0YM

April 27, 2026Episode 39054 min

Using EOS to Create Clarity and Traction in Your Practice with Tom Restivo

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. We also get practical about how EOS actually works inside a practice. Tom breaks down the six key components of the system, the role of the Vision Traction Organizer, how Rocks help teams focus on the right priorities, and why Level 10 Meetings can transform communication and accountability. If you are feeling like the business is starting to run you instead of the other way around, this conversation offers a useful framework for creating more clarity, consistency, and traction in your practice. Resources: Book a Triage call with Adam 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 Tom Restivo's LinkedIn EOS Worldwide Traction: Get a Grip on Your Business by Gino Wickman ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here! Check out Adam's other podcast! The Optometry Success Podcast Subscribe on Apple Podcasts: https://bit.ly/4tttng6 Subscribe on Spotify: https://bit.ly/4tuf0YM

April 20, 202653 min

How a Limiting Mindset Can Cost Practice Owners More Than They Realize with Dr. Steve Vargo

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, and guide patients toward solutions that solve real problems. If you have ever felt frustrated by patients walking with their prescriptions or wondered whether the future of your practice depends on adding the next new service, this conversation will challenge that assumption and give you practical ideas to improve both patient outcomes and the financial performance of your practice. Resources: Book a Triage call with Adam 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 Connect with Dr. Steve Vargo on LinkedIn ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here! Check out Adam's other podcast! The Optometry Success Podcast Subscribe on Apple Podcasts: https://bit.ly/4tttng6 Subscribe on Spotify: https://bit.ly/4tuf0YM

April 13, 2026Episode 38853 min

Independence vs Isolation in Private Practice with John Marvin

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 to strengthen private practice in an evolving profession, this discussion will challenge the way you think about leadership, collaboration, and the role you play in the success of your business. On a personal note, I really enjoy my conversations with John. I usually get a number of pieces of feedback from listeners when I have him on the show. He's been around the profession and business of optometry for decades, and I certainly appreciate his candor, perspective, and opinions. I trust you as a listener do as well. Resources: Book a Triage call with Adam Download the Practice Owner's Financial Toolkit 20/20 Money Ultimate Financial Success Masterclass OD Mastermind Interest Form Private Practice Was Not Defeated by Corporate, It Surrendered Connect with John Marvin on LinkedIn ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here! Check out Adam's other podcast! The Optometry Success Podcast Subscribe on Apple Podcasts: https://bit.ly/4tttng6 Subscribe on Spotify: https://bit.ly/4tuf0YM