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Should you finish in house or send your jobs to a lab?

Release Date: 07/22/2026

The simplest internal marketing idea you’re probably overlooking

The Optometry Success Podcast

What if one of the best marketing opportunities in your practice is sitting right in front of you—and you’re wasting it? In this episode of The Optometry Success Podcast, we answer a listener question about the best internal marketing strategy Chad has used to increase per-patient visits and promote products and services. His answer? A professionally produced video loop playing in the reception area of his practices. Adam’s initial reaction: That actually works? That skepticism leads us into a conversation about why this relatively simple $2,000–$2,500 investment has...

Some patients need to be fired

The Optometry Success Podcast

Not every patient relationship is worth preserving—and sometimes keeping the wrong patient creates more risk than letting them go. In this episode of The Optometry Success Podcast, we continue our conversation about managing difficult patient relationships by tackling three situations every practice owner will eventually encounter: the chronically noncompliant patient, the repeat no-show, and the patient who crosses the line with your team. We discuss when noncompliance moves beyond frustration and becomes a legitimate clinical and risk-management concern, why documentation and...

The patient isn't always right: How to handle difficult conversations

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...

Booked out doesn't mean you're ready for an associate OD

The Optometry Success Podcast

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...

Your partner wants profit. You want freedom. Now what?

The Optometry Success Podcast

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...

Before you hire your next CPA, ask these questions

The Optometry Success Podcast

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...

So you want to get rid of your front desk? Start here.

The Optometry Success Podcast

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...

How to Manipulate Yourself into Financial Happiness as a Practice Owner—and What It’s Really Costing You

The Optometry Success Podcast

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...

Why do you still have a front desk?

The Optometry Success Podcast

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...

Are You Overpaying for IT? The Hidden Technology Costs Draining Practice Profit

The Optometry Success Podcast

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...

More Episodes

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.

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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

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