Is Your Overhead Eating Your Practice's Profits?
Is Your Overhead Eating Your Profits? How One Optometrist Found Hidden Cash—Without Adding Patients or Staff
Running a healthcare practice can feel like walking a tightrope: you’re focused on great patient care and steady growth, yet the numbers in your bank account don’t always reflect the effort you pour in each day. If that sounds familiar, you’re not alone.
Recently, I worked with an optometrist—let’s call him Dr. Sam—who was experiencing this exact frustration. His books told a different story than his bustling reception area. Here’s how we uncovered (and fixed) the disconnect—and how you can, too.
Watch the Video Overview
The Symptom: Healthy Practice, Anemic Paycheck
Dr. Sam’s practice checked all the “success” boxes:
Reliable Patient Flow – A loyal base plus healthy new-patient referrals
Solid Capture Rate – Patients bought eyewear in-house at a respectable clip
Active Optical Shop – Inventory was moving, and displays looked full
Yet every month his take-home pay lagged behind his expectations. A quick Profit & Loss review didn’t raise any red flags at first glance, so we dug deeper.
The Diagnosis: Overhead Built for a Practice 40% Bigger
Using our framework, we examined six pivotal cash metrics. One number jumped off the page:
Operating-Expense Margin – the share of collections consumed by overhead.
Dr. Sam’s overhead was consistent with a $1 million practice, but his collections were only ≈ $600 k per year. In other words, he had hired, equipped, and leased space as if revenue were 40 percent higher than reality.
Unless that gap closed, profit would remain stuck—no matter how busy the schedule felt.
The Prescriptions: Four Proven Levers
We brainstormed four options—ranked from least to most disruptive:
Increase Average Value per Patient (AVP)
Revisit fees and insurance schedules
Train team to bundle premium lenses, coatings, or second-pair packages
Introduce high-margin products patients already want (dry-eye kits, nutraceuticals, etc.)
Tighten Pricing Strategy in the Optical
Audit frame markup consistency
Ensure lab costs aren’t creeping up unseen
Scrap “race-to-the-bottom” discounts that don’t convert
Accelerate Receivables
Identify aged insurance claims hiding on the books
Implement same-day payment prompts and auto-reminders
Reduce Operating Expenses
Renegotiate vendor terms
Trim under-utilized subscriptions
Right-size staffing or hours (often the last resort)
The Action Plan: Focus on AVP First
Dr. Sam chose to tackle Average Value per Patient before slashing costs or adding hours.
Together we:
Set a Baseline – Calculated current AVP for routine vs. medical visits.
Created Quick-Win Bundles – Anti-reflective coating became default, second-pair discounts were positioned properly, and staff practiced confident scripting.
Tracked Results Weekly – Tiny adjustments prompted instant feedback.
Within three months his AVP climbed by $100+ per patient—all without:
Extending clinic hours
Hiring more staff
Compromising patient satisfaction
That uptick alone recaptured a six-figure chunk of “missing” cash and instantly realigned overhead with revenue.
Could Your Practice Hide the Same Opportunity?
Most owners assume only two solutions exist for cash-flow headaches: see more patients or slash expenses.
Dr. Sam’s story proves there’s often a third path—discovering and unlocking hidden cash that’s already in motion.
Warning Signs Your Overhead Is Out of Sync
Take-home pay flat or shrinking
Collections growing but margins stagnant
Frequent cash crunch despite “busy” days
If these resonate, you might be spending like a million-dollar practice while collecting far less.
Next Step: Map Your Hidden Cash
Want to see exactly where money is hiding in your practice—and which lever will free it fastest?
I’ll build your personalized in a complimentary 30-minute session. You’ll walk away with:
Your six core cash metrics
Dollar-for-dollar estimates of unrealized profit
A prioritized, no-fluff action list
👉 Grab your spot here: prowisefinancial.com/hidden-cash
No sales pitch. Just clarity and a concrete roadmap to stronger profitability.
To your abundant practice.
