As an optometrist, you wear many hats: clinician, manager, mentor. But sustainable growth begins when you embrace the fourth hat: CEO.
This first post in The 20/20 CFO Series shows you how to see your practice through the lens of financial leadership, so you can make confident, data-driven decisions that drive profit and financial freedom.
The Shift from Practitioner to CEO
Most ODs start their practice to help people see clearly, not to stare at P&Ls. Yet the most successful owners realize that clear financial vision is what keeps a practice healthy.
Making the CEO shift means learning to:
- Think in Systems, Not Tasks: Design processes that let the business run smoothly without your constant presence.
- Lead by Numbers, Not Instinct: Base decisions on metrics, not gut feeling.
- Empower Your Team: Share the “why” behind goals so staff drive performance with you, not for you.
The Three Core Responsibilities of an OD CEO
1. Vision – Define Where You’re Going
Every thriving practice starts with a destination:
- Boutique, family, medical, or multi-location – what’s your identity?
- How do you want patients and staff to describe you?
- What’s your 3-year revenue or lifestyle goal?
Document it and revisit at least quarterly. A clear vision keeps you and your entire team aligned.
2. Financial Oversight – Know Your Numbers
You don’t need to become your own accountant, but you must know what your numbers say.
Track these optometry practice KPIs:
| KPI | Why It Matters |
| Revenue per Exam | Measures productivity and fee structure. |
| Cost of Goods Sold % | Reveals optical margin health. |
| Payroll % of Revenue | Gauges team efficiency. |
| Net Profit Margin | Shows overall business strength. |
When you review your P&L, ask: What story are these numbers telling me?
3. Leadership – Build an Aligned Team
Leadership means turning financial goals into collective purpose. Hold quick team huddles, share progress toward KPIs, celebrate wins, and coach through challenges. Practices with engaged, informed teams outperform competitors by double-digit margins.
According to Review of Optometric Business, practices that review KPIs monthly can increase profitability by up to 20%.
Your First Action Step
Block one uninterrupted hour this week to step out of the exam room and look at your business from above. Ask yourself:
“If I were hired today as the CEO of this practice, what would I change first?”
That single question can redefine how you lead…and how fast you grow.
