When success quietly creates too much risk
20/20 MONEY: The Business of Optometry
Release Date: 09/07/2026
20/20 MONEY: The Business of Optometry
AI might save you hours every week—but if you simply fill that time with more work, have you actually gained anything? In this episode, Dr. Steve Vargo joins me to discuss his new book, Human-Centered AI, and why the biggest opportunity AI presents to practice owners isn’t necessarily the technology itself—it’s what we choose to do with the time it gives back. We discuss using AI as a strategic thought partner rather than a decision-maker, why asking AI to interview you can lead to better thinking, and where human judgment, context, and connection remain irreplaceable....
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Optometrists earn good incomes—so why does the profession’s median net worth tell a very different story? In this episode of 20/20 Money: The Business of Optometry, I’m joined again by Dr. Chris Lopez to unpack findings from the latest ODs on Finance financial survey, which gathered responses from nearly 2,000 optometrists. We dig into the numbers behind OD income, student loan debt, net worth, and practice ownership—and, more importantly, what those numbers actually mean for the financial decisions optometrists make throughout their careers. Chris and I discuss...
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Welcome to this episode of 20/20 Money! My guest on today’s show is . Hayley is the and predominately focuses her time and expertise on bookkeeping services for IDOC clients. Hayley joins the show to talk about the importance of bookkeeping in practices and how to properly ensure that your books are accurate. We spend a lot of time talking about items that are reported on the balance sheet and specifically talk about why it’s important to understand the relationship of your retained earnings and your net income. As a reminder, you can get all the information discussed in today’s...
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Welcome to this episode of 20/20 Money! My guest on today’s show is . Greg is the author of two of my favorite books about running a business and using the numbers of your business to make informed decisions ( and ). He’s also the Partner in Charge in the Huntsville, AL office of Carr, Riggs, and Ingram and I was excited to chat with him about the concepts he talks about in his book. We talk about cash reserves in your business, the 4 forces on cash flow and the importance of starting with profitability, the lies that business owners tell themselves through their financials, why...
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In this episode of 20/20 Money: The Business of Optometry, I’m joined by Nathan Hayes of Books & Benchmarks to go over their recently updated benchmarks analysis and unpack what the latest optometry practice data says about growth, overhead, and profitability. We discuss why a benchmark is a starting point, not a verdict on your practice, and why rising expense ratios may call for a closer look at revenue rather than an immediate round of cuts. We also talk about the difference between profit and cash you can take home, how equipment purchases affect the balance sheet, and what...
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The most expensive professional service may not be the one with the highest price—it may be the one you mistakenly thought was a great deal. In this episode of 20/20 Money: The Business of Optometry, I explore the familiar idea of “good, fast, and cheap: pick two” and applies it to the professional services optometric practice owners rely on every day. It’s easy to compare prices. It’s much harder to compare value—especially when you’re hiring an attorney, financial advisor, consultant, accountant, IT provider, or other professional precisely because they possess...
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What does it really take to build and lead a successful multi-location optometry practice? In this episode of 20/20 Money, I’m joined by Dr. Andy Yaryan, Dr. Jeni Kohn, and Dr. Patrick Curran, three experienced practice owners who offer an honest look at what is happening beneath the surface of a growing practice. We discuss the challenges that remain even after achieving visible success, including rising expenses, staffing and culture, shrinking margins, associate recruitment, and the danger of becoming complacent. We also explore how each owner evaluates investments in the practice,...
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The most expensive mistake in your practice might be solving a problem you never proved existed. Dr. Jen Stewart joins me back on the show for a conversation about making better decisions before writing the check. Inspired by we explore why practice owners should test assumptions, gather evidence, and understand what success actually looks like before committing significant money or resources to a decision. One idea kept resurfacing throughout our conversation: more isn’t better; better is better. Before you hire another employee, buy another piece of equipment, or sign...
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The investments you own may be perfectly reasonable—and still be completely wrong for you. In this episode of 20/20 Money: The Business of Optometry, I’m joined again by Peter Lazaroff, Chief Investment Officer at Plancorp and author of , for a conversation about what actually makes an investment portfolio “perfect.” We discuss why portfolio construction has to begin with the investor rather than the investments, why simplicity is valuable but shouldn’t become an ideology, and how to evaluate whether added complexity is actually solving an important problem. Peter...
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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, . That doesn’t make the S&P 500 a bad...
info_outlineYou 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.
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Resources:
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Podcast: Are you building wealth, or just feeding the machine
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Check out Adam's book: How to Buy an Optometry Practice
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