20/20 MONEY: The Business of Optometry

Adam Cmejla
  • 4.9 (85)
  • Business
  • Updated Weekly

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/

  1. 6d ago

    When success quietly creates too much risk

    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 than they have historically. That doesn't make the S&P 500 a bad investment, but it does challenge the idea that simply owning VOO means you've built a complete, diversified portfolio. "VOO and chill" is an implementation strategy. It isn't an investment philosophy. The same phenomenon can happen with a successful optometry practice. You may never intentionally decide to put the majority of your net worth into one business. You simply grow a great practice. But over time, your income, distributions, enterprise value, and perhaps even your real estate can all become dependent on the same economic engine. Having a high net worth isn't necessarily the same thing as having diversified wealth. The solution isn't to stop growing the practice or abandon the S&P 500. It's to broaden the sources of your wealth. That means consistently harvesting excess cash flow from the practice and investing it outside the business while building a portfolio that captures more than just one segment of the market. We also discuss why this matters enormously when it comes time to sell your practice. The more financial independence you've created outside of the business, the less dependent you become on receiving a specific number or specific terms from the eventual sale—and the more optionality you have when navigating that transition. The Next Best Step: look underneath both sides of your balance sheet. Ask yourself how diversified your investment portfolio really is, what percentage of your family's net worth depends on the success of your practice, and whether you're intentionally becoming more diversified over time—or simply becoming more concentrated in whatever has worked recently.   Have a podcast-related question? Contact our team here!   Resources: Podcast: Are you building wealth, or just feeding the machine 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 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!

  2. Aug 31

    Does your optometry practice even need a front desk anymore?

    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 Podcast is the show I co-host with Dr. Chad Fleming, partner at Wichita Optometry. Each week, we combine my perspective from working with optometric practice owners across the country with Chad's boots-on-the-ground experience as a practicing OD, owner, and operator. The goal is simple: short, actionable conversations about ideas you can actually implement to build a more successful practice.   And today's conversation is a great example.   We tackle a deceptively simple question: Does an optometry practice even need a traditional front desk anymore?   As technology changes the way patients schedule, check in, communicate, complete paperwork, and interact with your team, it's worth questioning whether the front desk should continue functioning the way it always has—or whether those valuable team members and payroll dollars could be deployed differently.   This conversation is also timely because a follow-up to this discussion is coming Wednesday on The Optometry Success Podcast. If you enjoy today's episode, subscribe there as well so you can catch part two.   Have a podcast-related question? Contact our team here!   Calls to Action: Interested in the OD Ski Trip? Message us!! Learn more about OD Masterminds The Optometry Success Podcast   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 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!

  3. Aug 24

    The 401(k) rules have changed. Has your retirement plan?

    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 reduced much of the administrative burden historically associated with 401(k) plans, and why payroll integration should be one of the most important considerations when evaluating a provider. We also unpack some of the planning opportunities created by recent retirement-plan legislation, including startup and auto-enrollment tax credits, increased contribution opportunities, plan-design flexibility, and the ability to use profit-sharing contributions as part of a broader tax and cash-flow strategy. Jared and I also dig into an increasingly popular strategy: the mega backdoor Roth. While it can be valuable in the right circumstances, we explain why after-tax contributions aren't automatically available—or advantageous—for every practice owner and how required nondiscrimination testing can quickly change the math. This episode isn't about convincing every practice owner that they need a 401(k). It's about understanding the options available today so you can make an educated and informed decision about whether your current retirement plan is still the right tool for your practice, your employees, and your own financial independence.   Some of the topics we cover include: Why SIMPLE IRAs can become limiting as a practice grows How modern 401(k)s differ from the plans many owners remember from years ago Payroll integration and what "360-degree integration" actually means Auto-enrollment requirements and recent retirement-plan legislation Tax credits that may offset the cost of establishing and operating a plan Matching versus safe-harbor non-elective contributions Using profit sharing as part of a practice owner's tax strategy Why plan design should begin with the end in mind Roth 401(k)s, after-tax contributions, and the mega backdoor Roth The testing requirements that can derail an after-tax contribution strategy   NBS (Next Best Step): Pull out the details of your current retirement plan and ask your advisor to evaluate it based on today's rules—not the assumptions that were true when the plan was originally established. Specifically, review your contribution limits, employer contribution structure, payroll integration, investment flexibility, administrative costs, available tax credits, and whether profit sharing could improve your overall tax and retirement strategy.   Have a podcast-related question? Contact our team here!   Resources: 401GO Link: 5 reasons why I hate the SIMPLE IRA 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 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!

  4. Aug 17

    Why your optometry marketing isn't working with Jeremy Bono from IDOC Marketing

    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't enough to differentiate a practice, how storytelling can make your marketing more memorable, and why practice owners need clarity around their ideal patient before deciding where to spend marketing dollars. We then get much more tactical. Jeremy explains why Google Ads can be one of the fastest ways to generate new patient demand, how practice owners should think about marketing as an investment rather than simply another expense, and why measuring leads without tracking how many actually become patients can create a misleading picture of ROI. We also discuss some of the seemingly small things that can quietly sabotage otherwise good marketing: making patients call instead of allowing online scheduling, forcing them to interact with your practice the way you prefer rather than the way they prefer, ignoring existing patients while constantly chasing new ones, and failing to maintain the digital presence that Google increasingly uses to determine which practices deserve visibility. The larger lesson is that marketing isn't one campaign, one social post, or one advertising budget. It's the entire journey from someone discovering your practice to deciding you're the right place for them—and then making it incredibly easy for them to become a patient and stay one. NBS: Set aside an hour this week and define your ideal patient avatar—your "IPA." Write down who they are, what they value, what problems they're trying to solve, how they search for care, and how they prefer to interact with a business. Then look at your current marketing through their eyes and identify one point of friction you can eliminate.   Have a podcast-related question? Contact our team here!   Resources: IDOC Marketing Service 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 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!

  5. Aug 10

    Is optometry too focused on specialty services? A discussion with Dr. Kyle Klute

    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 to manage a broad range of their patients' eye and vision needs through comprehensive primary eye care. They also discuss why the patient and the clinical protocol should come before the equipment purchase. Rather than buying an expensive device and hoping to create demand, practice owners should first establish consistent diagnostic triggers, treatment protocols, follow-up systems, and a proven flow of patients who would benefit from the technology. The conversation ultimately moves beyond specialty services and into a deeper question: Who are you professionally, and what role do you want to play in your patients' lives?   In this episode: Why Kyle believes specialization in optometry may be overrated The difference between comprehensive care and a specialty-service mindset How equipment FOMO can create expensive "doorstops" in a practice Why protocols and patient demand should come before purchasing technology The unique value optometrists provide that other eye care professionals may not How professional identity and confidence influence clinical and business decisions Why understanding your personal strengths can improve leadership and practice culture   Next Best Step: Become clear, confident, and capable in your professional identity. Define the role you want to play in your patients' lives before deciding which services, systems, or equipment belong in your practice.   Link to Chris Wolfe Episode Optometry Simplified: Kyle's newsletter Review of Optometric Business Article (Specialization is Overrated) The Optometry Success Podcast Enneagram Link to Six Types of Working Genius assessment   Have a podcast-related question? Contact our team here!   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!

  6. Aug 3

    How successful practice owners actually become wealthy

    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 practice, diversifying into multiple income-producing assets, maintaining adequate liquidity, and increasing their investments before expanding their lifestyle.   He also addresses one of the biggest financial risks facing practice owners: relying on the eventual sale of the practice as the primary retirement plan. Buyer availability, health changes, burnout, market conditions, taxes, outstanding liabilities, and unrealistic valuation expectations can all disrupt a transition.   The wealthiest owners Adam has worked with did not become wealthy when they sold their practices. They became wealthier. The practice sale simply converted one asset into another—it was the whipped cream and cherry on top of the financial sundae, not the sundae itself.   In this episode: Why generating cash and deploying cash require different skill sets How excess cash in the practice can create significant opportunity costs The importance of building wealth outside the practice Why net worth and liquidity are not the same thing How lifestyle creep can reduce flexibility inside the business Why practice owners should build income-producing assets The risks of making the practice sale your retirement plan How personal financial pressure can derail practice-sale negotiations Why financial independence should be built before closing day   Next Best Step: Ask yourself this question: If your practice were worth 30% less than you expect—or you had to retire five years earlier because of your health—would your financial plan still work?   If the answer is no, your practice is not merely part of your retirement plan. It is your retirement plan—and that may be the greatest financial risk you are carrying.   Referenced episodes: Are you building wealth...or just feeding the machine?? 3 financial lessons learned from my grandpa and grandma   Have a podcast-related question? Contact our team here!   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

  7. Jul 27

    Understanding and setting pricing in your practice that are fair and profitable with Dr. Chris Wolfe, OD (Rewind)

    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 practice, and how practice owners can think about setting their fees in relationship to the different 3rd party payors. And with that introduction, I hope you enjoy my conversation with Dr. Chris Wolfe, OD.   Resources: Book a Triage call with Adam CodeSafePlus EyeCode Education EyeCode Media Podcast Adam's in-flight conversation with Chris Download the Practice Owner's Financial Toolkit 20/20 Money Ultimate Financial Success Masterclass OD Mastermind Interest Form Check out Adam's 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

  8. Jul 20

    What every seller needs to know before selling their practice

    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 can derail even the most promising transition.   Along the way, I'll also tackle one of the most misunderstood metrics in business valuation—EBITDA—and explain why practice owners should be cautious about relying on it when estimating what their practice is worth.   Have a podcast-related question? Contact our team here!   Resources: Berkshire YouTube clip: Every time you hear EBITDA, substitute it with "bull***" earnings 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 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

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About

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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