20/20 MONEY: The Business of Optometry

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: 1. How Ryan sees up to 16 pediatric Medicaid patients in just a few hours each morning 2. Why low overhead dramatically changes the Medicaid profitability equation 3. The logistics of scheduling, transportation, and dispensing glasses through the school system 4. The role school nurses and principals play in making this model successful 5. Why many children who "pass" school screenings still desperately need glasses 6. The hidden challenges of working with Medicaid reimbursement and bureaucracy 7. How this model creates remarkable work-life balance and flexibility 8. 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 [https://integratedpwm.as.me/schedule/bc0791cb/appointment/1713824/calendar/706316?appointmentTypeIds[]=1713824] Download the Practice Owner's Financial Toolkit [https://integratedpwm.com/toolkit] 20/20 Money Ultimate Financial Success Masterclass [https://www.2020membership.com/] OD Mastermind Interest Form [https://www.jotform.com/form/250467795073062] Check out Adam's new book: How to Buy an Optometry Practice [https://a.co/d/0wv5uLn] ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts [https://itunes.apple.com/us/podcast/the-dose-podcast/id1438352481?mt=2] Spotify [https://open.spotify.com/show/44jE3DxOjZQPok0H9D2jw3?si=7fhsalltRqGlwEbVqYnAQA] ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here! [https://integratedpwm.com/learningcenter/?cat=podcast] Check out Adam's other podcast! The Optometry Success Podcast Subscribe on Apple Podcasts: https://bit.ly/4tttng6 [https://bit.ly/4tttng6] Subscribe on Spotify: https://bit.ly/4tuf0YM [https://bit.ly/4tuf0YM]

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 [https://www.theeyecareboss.com/?utm_source=2020money&utm_medium=podcast_lp&utm_campaign=2020money] (Pre-order Eugene's book, The EyeCare Boss on their website!) Book a Triage call with Adam [https://integratedpwm.as.me/schedule/bc0791cb/appointment/1713824/calendar/706316?appointmentTypeIds[]=1713824] Download the Practice Owner's Financial Toolkit [https://integratedpwm.com/toolkit] 20/20 Money Ultimate Financial Success Masterclass [https://www.2020membership.com/] OD Mastermind Interest Form [https://www.jotform.com/form/250467795073062] Check out Adam's new book: How to Buy an Optometry Practice [https://a.co/d/0wv5uLn] ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts [https://itunes.apple.com/us/podcast/the-dose-podcast/id1438352481?mt=2] Spotify [https://open.spotify.com/show/44jE3DxOjZQPok0H9D2jw3?si=7fhsalltRqGlwEbVqYnAQA] ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here! [https://integratedpwm.com/learningcenter/?cat=podcast] Check out Adam's other podcast! The Optometry Success Podcast Subscribe on Apple Podcasts: https://bit.ly/4tttng6 [https://bit.ly/4tttng6] Subscribe on Spotify: https://bit.ly/4tuf0YM [https://bit.ly/4tuf0YM]

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: 1. Why more equipment does not automatically mean a more valuable practice 2. The hidden opportunity cost of continually reinvesting back into the business 3. How enterprise value is actually created in an optometry practice 4. The difference between spending, investing, and simply staying operational 5. Why patient flow and schedule utilization matter more than most owners realize 6. The role marketing can play in growing enterprise value versus buying more technology 7. How practice owners should think about free cash flow after taxes, debt service, and reserves 8. The dangerous feedback loop created by depreciation-driven purchasing decisions 9. 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 [https://integratedpwm.as.me/schedule/bc0791cb/appointment/1713824/calendar/706316?appointmentTypeIds[]=1713824] Download the Practice Owner's Financial Toolkit [https://integratedpwm.com/toolkit] 20/20 Money Ultimate Financial Success Masterclass [https://www.2020membership.com/] OD Mastermind Interest Form [https://www.jotform.com/form/250467795073062] Check out Adam's new book: How to Buy an Optometry Practice [https://a.co/d/0wv5uLn] Four Levers in Retirement [https://directory.libsyn.com/episode/index/id/10105897] IDOC [https://idoc.net/] Simple Numbers, Straight Talk, Big Profits! [https://www.amazon.com/Simple-Numbers-Straight-Talk-Profits/dp/1608320561] Simple Numbers, Straight Talk, Big Profits with Greg Crabtree [https://integratedpwm.com/197] ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts [https://itunes.apple.com/us/podcast/the-dose-podcast/id1438352481?mt=2] Spotify [https://open.spotify.com/show/44jE3DxOjZQPok0H9D2jw3?si=7fhsalltRqGlwEbVqYnAQA] ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here! [https://integratedpwm.com/learningcenter/?cat=podcast] Check out Adam's other podcast! The Optometry Success Podcast Subscribe on Apple Podcasts: https://bit.ly/4tttng6 [https://bit.ly/4tttng6] Subscribe on Spotify: https://bit.ly/4tuf0YM [https://bit.ly/4tuf0YM]

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 [https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2737840] "You will read this first" image [https://www.reddit.com/r/oddlysatisfying/comments/v64wmu/how_this_demonstration_of_graphic_design_rules/] Book a Triage call with Adam [https://integratedpwm.as.me/schedule/bc0791cb/appointment/1713824/calendar/706316?appointmentTypeIds[]=1713824] Download the Practice Owner's Financial Toolkit [https://integratedpwm.com/toolkit] 20/20 Money Ultimate Financial Success Masterclass [https://www.2020membership.com/] OD Mastermind Interest Form [https://www.jotform.com/form/250467795073062] Check out Adam's new book: How to Buy an Optometry Practice [https://a.co/d/0wv5uLn] Checkout all the benefits of becoming a Spexy Member at www.spexy.co [http://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 [https://itunes.apple.com/us/podcast/the-dose-podcast/id1438352481?mt=2] Spotify [https://open.spotify.com/show/44jE3DxOjZQPok0H9D2jw3?si=7fhsalltRqGlwEbVqYnAQA] ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here! [https://integratedpwm.com/learningcenter/?cat=podcast] Check out Adam's other podcast! The Optometry Success Podcast Subscribe on Apple Podcasts: https://bit.ly/4tttng6 [https://bit.ly/4tttng6] Subscribe on Spotify: https://bit.ly/4tuf0YM [https://bit.ly/4tuf0YM]

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 [https://integratedpwm.as.me/schedule/bc0791cb/appointment/1713824/calendar/706316?appointmentTypeIds[]=1713824] Download the Practice Owner's Financial Toolkit [https://integratedpwm.com/toolkit] 20/20 Money Ultimate Financial Success Masterclass [https://www.2020membership.com/] OD Mastermind Interest Form [https://www.jotform.com/form/250467795073062] Check out Adam's new book: How to Buy an Optometry Practice [https://a.co/d/0wv5uLn] ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts [https://itunes.apple.com/us/podcast/the-dose-podcast/id1438352481?mt=2] Spotify [https://open.spotify.com/show/44jE3DxOjZQPok0H9D2jw3?si=7fhsalltRqGlwEbVqYnAQA] ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here! [https://integratedpwm.com/learningcenter/?cat=podcast] Check out Adam's other podcast! The Optometry Success Podcast Subscribe on Apple Podcasts: https://bit.ly/4tttng6 [https://bit.ly/4tttng6] Subscribe on Spotify: https://bit.ly/4tuf0YM [https://bit.ly/4tuf0YM]