The Optometry Success Podcast

The Optometry Success Podcast helps private-practice optometrists build profitable, sustainable businesses with clarity and confidence. Hosted by Adam Cmejla, CFP—a financial planner and CFO to ODs nationwide—and Chad Fleming, OD, FAAO—a multi-location practice owner with decades of hands-on experience—each 20-minute episode delivers practical strategies and actionable insights you can apply right away. From leadership and financials to team culture, operations, and growth, this is your weekly dose of real-world advice for real-world practice owners. New episodes every Wednesday.

The simplest internal marketing idea you’re probably overlooking 10/14/2026

The simplest internal marketing idea you’re probably overlooking 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 been so effective. Rather than treating the reception area as dead time, Chad uses it to educate patients about specialty services, products, providers, eye health, and other opportunities they may never hear about during a busy exam. We discuss how this content plants the seed before the patient ever reaches the exam room, allows patients to self-select into conversations they’re interested in, and makes education—not selling—the starting point for additional services and products. We also talk about why internal marketing doesn’t have to require a massive investment. Before firing a $50,000 cannonball, practice owners can test smaller “bullets” like this one and measure the impact. NBS (Next Best Step): Identify who on your team can own this project. Find a local video professional, determine which services and products you want patients to better understand, and ask your vendors for educational content you can incorporate. Start small, put it in front of patients, and see what questions they begin asking. And if you’d like to support an organization important to Chad, check out , a nonprofit helping provide kids with opportunities to participate in sports and be positively influenced by coaches and mentors. Have a question for us to address in a future episode? Submit it ! Resources: Learn more about Check out Adam's new book: Subscribe on Apple Podcasts: Subscribe on Spotify: /episode/index/show/b8846a06-cd6c-43f8-bcd6-1015f24b042a/id/43282678

Some patients need to be fired 10/07/2026

Some patients need to be fired 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 clear communication matter, and how Chad approaches patients who repeatedly ignore treatment recommendations. We also explore the important distinction between a routine vision-care patient who repeatedly no-shows and a medical patient whose failure to return could have serious consequences. Finally, we tackle one of the most important responsibilities of practice ownership: protecting your team. Chad shares why practice owners need to establish clear boundaries around harassment, belittling, and inappropriate behavior—and why being willing to fire a patient can build tremendous relationship capital with your staff. The goal isn’t to look for reasons to get rid of patients. It’s to recognize when continuing the relationship is no longer serving the patient, the provider, or the practice. NBS (Next Best Step): Ask yourself whether your team knows—with absolute confidence—that they can come to you when a patient crosses a line. Make that expectation explicit, establish how those situations should be escalated, and make sure your team knows you’ll have their back when it matters. Have a question for us to address in a future episode? Submit it ! Resources: Learn more about Subscribe on Apple Podcasts: Subscribe on Spotify: /episode/index/show/b8846a06-cd6c-43f8-bcd6-1015f24b042a/id/43202218

The patient isn't always right: How to handle difficult conversations 09/30/2026

The patient isn't always right: How to handle difficult conversations 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 giving in, or escalating the situation. We discuss the importance of tactical empathy, giving patients choices, anchoring expectations, and empowering team members to make decisions without unnecessarily involving the doctor. Chad also explains why doctors may actually be the wrong people to handle these situations: our desire to solve the urgent problem in front of us can cause us to forget everyone else affected by that decision. That leads us to the “tyranny of the urgent”—when the loudest, most immediate problem takes priority over everything else. Saying yes to one demanding patient might simultaneously mean saying no to the eight other patients on your schedule, your team, your profitability, and your own sanity. And sometimes, even after doing everything right, the patient still won’t accept the answer. We leave that question for our next conversation: What happens when empathy, flexibility, and reasonable solutions still aren’t enough? NBS (Next Best Step): Identify one common situation in your practice where your team feels pressured to make exceptions for patients. Define the boundary, decide who has the authority to handle it, and give your team a framework for responding with empathy—without automatically saying yes. Have a question for us to address in a future episode? Submit it ! Resources: Book: Learn more about Check out Adam's new book: Subscribe on Apple Podcasts: Subscribe on Spotify: /episode/index/show/b8846a06-cd6c-43f8-bcd6-1015f24b042a/id/43062303

Booked out doesn't mean you're ready for an associate OD 09/23/2026

Booked out doesn't mean you're ready for an associate OD 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 place. We also get tactical about successfully integrating a new associate, including why established doctors need to intentionally move patients onto the new doctor’s schedule rather than simply expecting the associate to build a patient base from scratch. Most importantly, we challenge the commonly used benchmark of being “booked out” as the signal that it’s time to hire. Two practices can both be booked out three weeks and have dramatically different levels of actual capacity. Instead, we revisit schedule health and the numbers practice owners should be tracking: available appointment capacity, how much of that capacity is already scheduled a week in advance, and how many of those available slots ultimately turn into completed exams. NBS (Next Best Step): Stop using “how far booked out are we?” as your primary measure of capacity. Calculate your schedule health using actual available appointment slots and completed exams. If you’re consistently filling roughly 85% or more of available capacity in advance—and completed exams remain within about 10 percentage points of that number—you now have objective data to help determine whether it’s time to seriously consider adding another OD. Have a question for us to address in a future episode? Submit it ! Resources: Learn more about Check out Adam's new book: Subscribe on Apple Podcasts: Subscribe on Spotify: /episode/index/show/b8846a06-cd6c-43f8-bcd6-1015f24b042a/id/42978728

Your partner wants profit. You want freedom. Now what? 09/16/2026

Before you hire your next CPA, ask these questions 09/09/2026

Before you hire your next CPA, ask these questions 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 proactive tax planning throughout the year? Are they handling bookkeeping and financial reporting? Do you want them advising you on business decisions? And how does the CPA fit alongside the other professionals already sitting at your proverbial advisory roundtable? We discuss why practice owners sometimes overestimate how much their CPA understands about the actual business of optometry. Knowing how to read a P&L and prepare a tax return isn’t the same as understanding what healthy margins should look like inside an optometry practice or how an owner should operate the business. From there, we get tactical with questions you can use when interviewing your next CPA. How many healthcare and optometry practices do they serve? What does their service model actually look like? How proactive is their tax planning? Do they have experience with the tax laws in your state? What technology do they use, and how accessible is your financial data? What mistakes do they commonly find when taking over optometry practices from other accounting firms? We also discuss why your CPA probably shouldn’t be the only person advising you on how to run your business. A strong practice owner builds a roundtable of professionals with different areas of expertise rather than expecting one advisor to know everything. NBS (Next Best Step): Before interviewing another CPA, define the role you need them to fill. Then build your interview questions around that expectation. You’re not simply looking for someone capable of filing a tax return—you’re looking for the right person to occupy the CPA seat at your advisory roundtable. Have a question for us to address in a future episode? Submit it ! Resources: Learn more about Check out Adam's new book: Subscribe on Apple Podcasts: Subscribe on Spotify: /episode/index/show/b8846a06-cd6c-43f8-bcd6-1015f24b042a/id/42787350

So you want to get rid of your front desk? Start here. 09/02/2026

So you want to get rid of your front desk? Start here. 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 and currently uses in his practices, including the physical kiosk setup, the simple technology behind it, the questions patients are asked when they arrive, and how that information gets communicated to the appropriate team members in real time. We also talk about why eliminating the traditional front desk doesn’t mean eliminating the patient experience—or even eliminating a team member. In fact, the better way to approach this may be to start running the new system while your existing front desk is still in place. Let patients learn the process. Let your team learn the workflow. Find the problems. Make adjustments. Then see whether the traditional front desk is still necessary. This is a perfect example of Jim Collins’ concept of firing bullets before cannonballs. You don’t need a major remodel or an expensive technology investment to test the idea. A relatively inexpensive kiosk, an iPad, and a simple form can give you enough information to determine whether the concept works in your practice. And if it does, the upside extends beyond payroll. You may create a more efficient check-in experience, reduce your dependence on a difficult-to-staff position, and even reclaim valuable square footage for more productive uses. NBS (Next Best Step): Don’t start by getting rid of your front desk. Start by making it unnecessary. Build a simple self-check-in process alongside your existing workflow, train patients and staff to use it, and see whether the system can gradually replace a task you’ve historically needed someone to perform. Have a question for us to address in a future episode? Submit it ! Resources: Learn more about Check out Adam's new book: Subscribe on Apple Podcasts: Subscribe on Spotify: /episode/index/show/b8846a06-cd6c-43f8-bcd6-1015f24b042a/id/42628640

How to Manipulate Yourself into Financial Happiness as a Practice Owner—and What It’s Really Costing You 08/26/2026

Why do you still have a front desk? 08/19/2026

Are You Overpaying for IT? The Hidden Technology Costs Draining Practice Profit 08/12/2026

Are You Overpaying for IT? The Hidden Technology Costs Draining Practice Profit 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 assumption may be costing them thousands of dollars every year. Drawing from Chad’s hands-on experience building and managing technology infrastructure in a growing multi-location practice, the conversation focuses less on specific vendors and more on developing the mindset to thoughtfully evaluate every recurring expense. The goal isn’t to cut costs at all costs—it’s to ensure every dollar spent is delivering meaningful value to both the patient experience and the long-term health of the practice. In this episode, you’ll learn: Why IT expenses deserve the same scrutiny as any other line item on your P&L. The trade-offs between managed IT services, subscriptions, and self-insuring certain technology costs. How convenience and automation can quietly inflate overhead. Why “everyone else does it” is rarely a good business strategy. Practical ways to begin evaluating whether your current technology spending aligns with your practice’s goals. Next Best Step (NBS): Ask your office manager or practice administrator to compile a complete list of every recurring technology-related expense—including IT retainers, software subscriptions, equipment support agreements, and integration fees. Don’t make changes immediately. Simply review each item and ask one question: “Is this providing enough value to justify its ongoing cost?” Sometimes the greatest savings come not from eliminating technology, but from challenging long-held assumptions. Have a question for us to address in a future episode? Submit it ! Resources: Learn more about Check out Adam's new book: Subscribe on Apple Podcasts: Subscribe on Spotify: /episode/index/show/b8846a06-cd6c-43f8-bcd6-1015f24b042a/id/42365620