Welcome to Optometrists Building Empires! Each week, host Ankit Patel, explores the journey of practice ownership and leadership in optometry with some of the top minds in his field. This show is sponsored by My Business Care Team: We help increase revenue, reduce costs, and reduce staffing headaches. Let's build your empire together!
Optometrists Building Empires
Claim This Podcastby Ankit Patel
5.0(6 reviews)
106 episodes
Updated Daily
Accepts GuestsHas SponsorsLocation 🇺🇸
70
Podcast Authority
BetaGoodBased on show quality, social media presence, reviews, charts, and more
Quality100
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YouTube68
Engagement32
Podcast Overview
Welcome to Optometrists Building Empires! Each week, host Ankit Patel, explores the journey of practice ownership and leadership in optometry with some of the top minds in his field. This show is sponsored by My Business Care Team: We help increase revenue, reduce costs, and reduce staffing headaches. Let's build your empire together!
Language
🇺🇲
Publishing Since
8/13/2024
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58 episodes over 1.1 years
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Recent Episodes
August 6, 2026
The 2:15 Problem: Missed Calls, Burnout, and the Half of Optometry That Is Running on Empty
## The short version Half of U.S. optometrists are burned out, and what separates the burned out half from the other half is not effort or love of patients. It is workflow. This episode uses one imaginary patient, Denise, to show how a practice can lose revenue and lose its doctor at the same time, from the same root cause: too much happening at once and no signal anyone can act on. ## The 2:15 problem Denise is not real, but she behaves like a lot of your patients. Tuesday afternoon, sitting in a parking lot, phone in hand, 15 minutes before her next meeting starts. That gap is the only reason she is calling today. Meanwhile your front desk is checking out the 1 o'clock exam and the rest of the team is working insurance. Nobody is slacking. Everybody is doing the job they were hired to do. The phone rings four times, five times, and she is gone. Out of 10 people like Denise, how many call back? Most owners guess six, seven, even eight. The research puts it closer to one and a half. About 85 percent never call again. ## Why it never gets fixed The number stings, but the bigger issue is that the call left no evidence. No voicemail. No note in the system. No report unless you go pull one from the phone system, assuming your phone system even lets you. Denise never appears anywhere. Three weeks later the schedule is soft and you spend a Sunday afternoon researching marketing companies in the OD groups. That was never the problem. You did not have a marketing problem, you had a 2:15 problem, and the 2:15 problem never generated a signal anyone could act on. ## The burnout numbers - A University of Colorado study of U.S. optometrists found 53.6 percent burned out, at varying levels. Roughly one in two doctors. - The entire distance between the most burned out doctors in the country and the least was four tenths of a clinical day, roughly three to four hours on a given day. - More clinic time correlated with more burnout. More patients correlated with more burnout. - Doctors using an EMR ran 17 percentage points higher on burnout. Treat that as correlation, not causation, though most of us feel intuitively that the software is sometimes served better than the provider is. - Doctors 30 years into practice showed much lower burnout. Some of that is survivorship bias, and some of it is that after 30 years they have run the experiments and found a working flow. ## The exercise: check your ratio Make a list of everything you do at work, including inside the exam room. Then ask one question: how much of this is work you were trained to do as a doctor, and how much is everything else? That ratio is a large part of the burnout story. Last week's guest, Dr. Fred Cho, did not notice he was burning out. His wife noticed and told him he did not look happy at work. What he changed was not his volume. He changed the ratio, moving away from admin and back toward practicing medicine. ## Two experiments you can run this week 1. **Get the phones off the exam floor.** Phones stop interrupting the exam, the flow improves, and the team stops splitting attention. Most optometry groups answer 75 to 80 percent of their calls. Aim for 90 percent. From that day forward, create the evidence Denise never left: a real process to call missed calls back and close the loop. 2. **Every exception that is not you gets an owner.** Credentialing, the one-off vendor issue, the odd insurance question. If it lands on your desk by default, name someone else who owns it. ## If you are considering more help Remote staff or additional in-office staff can work, but only if the financial decision is sound and the role is defined: clear deliverables, clear work instructions, a clear picture of what the person is supposed to do, and a clear definition of what success looks like for them. Defined properly, it takes weight off you. Defined vaguely, it adds to the pile. ## The takeaway Every other optometrist in the country is burned out right now, and it is probably not only the U.S. What separates the two halves is how the workflow is managed. Take inventory of where your time actually goes, then eat the elephant one bite at a time. Pick one process, automate it or hand it off, and watch what happens to both your schedule and your Sunday afternoons. ## Also mentioned - Last week's episode with Dr. Fred Cho on noticing burnout late and changing the practice model. - If you want help, book a conversation about what has worked for other offices, and we will send you a copy of the host's book.
July 31, 2026
From Burnout to Building a Team of Travel Optometrists with Dr. Fred Cho
Most guests on this show own practices. Dr. Fred Cho doesn't, and that's the reason to listen. Fred is a travel optometrist. He's licensed in Ontario, Manitoba, and Newfoundland, and he's built his career serving remote communities across Canada. University of Waterloo OD. He speaks on burnout, hosts the 20 Happy Podcast, and wrote a book called Redesigning Work. What he's building now is a team of travel optometrists. In his words, it's there "to address a multi-provincial doctor shortage in Canada." Honest status on that team: it isn't built yet. He's mid-build, still the doctor on the road himself, taking consulting work alongside it. I open every episode the same way. "What was the most important thing that helped you build your empire?" Fred didn't hesitate. Burnout. He said burnout is "forever linked" to his professional story, and that it "forced a change" onto him. He didn't choose the pivot. It chose him. My own read, and I said it to him on the episode: plenty of doctors who burn out are done. They move on to something else. Fred is the rarer case. He stayed and rebuilt the work around the thing that almost ended it. What an owner can take from this: 1. Coverage is a supply channel, not a favor. Fred's answer to a doctor shortage was to organize travel optometrists instead of waiting for one to move to town. If you've burned a quarter trying to staff a second location, that's a channel most owners have never priced out. 2. Burnout is a business risk, not a character flaw. Fred puts it at the center of his whole career story. If you wait until a doctor resigns to deal with it, you're treating the symptom. 3. The doctors you want to hire are comparing your job to a life, not to other jobs. That's what Fred speaks and writes about. Ownership is one route to a career that fits. Three provincial licenses and a mix of roles is another one, and it's competing with your posting. 4. Not every empire has walls. Fred doesn't own a chair. He's licensed in three provinces and building a team for communities on the wrong end of that shortage. Useful mirror if you've only ever counted growth in locations and chairs. About the guest: Dr. Fred H. Cho. Travel optometrist and consultant, speaker on burnout, host of the 20 Happy Podcast, author of Redesigning Work. Hosted by Ankit Patel on Optometrists Building Empires.
July 23, 2026
What Your Practice Is Actually Worth: EBITDA, the 50% Rule, and the 25% Benchmark
EBITDA explained: earnings before interest, taxes, depreciation, and amortization, and why it isn't the same as cash flow Cash vs. accrual P&Ls and how each changes the way you read your monthly numbers The 50% benchmark: cost of goods plus non-doctor payroll, including payroll taxes, at or below half of revenue Under 80% schedule fill points to a volume problem; at a full schedule, look at collections, per-patient average, staffing, and vendor contracts A strong practice lands around 25% all-in doctor take-home, roughly the efficiency private equity operates at Buyers typically look at a three-year P&L runway; a growing practice can earn a 5 to 7x multiple versus 3 to 4x for a flat or declining one Rule of thumb: average your last three years of EBITDA, then multiply by 4 on the low end and 6 to 7 on the high end Join the next iCareGrow event at iCareGrow.com; book a meeting with Ankit for a free copy of Optometry Redefined at meetings.hubspot.com/ankit98/optometry-redefined; connect at linkedin.com/in/ankitpatelcvc and mybcat.com
106 total episodes available
Recent guests on Optometrists Building Empires
Guests from recent episodes — sign up to see every guest that has ever appeared on this show.
Mike Herrera
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Bethany Fishbein
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Rupe Hansra
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Kerry Giedd
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Jason Klepfisz
Guest
Carlos Grandela
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Nathan Heilman
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Kyle Maxam
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Erika Morrow
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Alyssa Pack
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Justin Nguyen
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Rick Guinotte
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- What is Optometrists Building Empires?
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This podcast updates daily.
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