Welcome to Optometry Simplified.
In this weekly newsletter, I've curated the best resources to help you grow personally and professionally.
My mission is to find what's best for my patients and my practice.
Here's what I've found...
Links I Liked
AI doomsday predictions: a needed perspective.
It may be that Cal's measured perspective on AI and the economy just soothes my anxiety, or he may be on to something. Hopefully, the latter. Listen to or watch Cal Newport, an MIT-trained computer scientist and technology critic, provide a solid critique of the recent "AI will destroy the economy" predictions. Cal Newport
Which myopia management options have the highest dropout rates?
This review of 57 trials and over 7000 participants might surprise you: Orthokeratology did not have the highest dropout rate, as is often assumed. You can read the full paper here at Contact Lens and Anterior Eye or get a great summary from Myopia Profile.
Research I'm Reading
Sometimes it's the simplest, cheapest "tech" that helps your patients the most.
I admit, I often forget to recommend an Amsler Grid for my AMD patients to take home and test themselves. In the age of OCT and OCTA; a piece of paper with lines on it to help detect disease progression? Seems too ancient to bother with. A 2026 review wants to change my mind (and possibly yours) on the role of Amsler grid testing in everyday practice. Clinical Ophthalmology
Deep Thoughts
One of the most common objections I hear during our workshops on chronic disease management — glaucoma, OSD, myopia, AMD — is some version of:
"I don't have time for that." Or its cousin: "I make more money selling glasses or a year supply of contacts."
I get it. Most practices are built and optimized around optical. The exam feeds the sale, the sale hits the books that afternoon, and adding disease management appointments feels like it disrupts that well-worn path.
But I don't think the math holds up. What usually underlies that pushback are three assumptions worth examining.
Assumption #1: You have to spend a lot of time with every patient.
I love talking to my patients. It's one of the real joys of this work. But I've had to be honest with myself: I think we value that time more than our patients actually do.
I think most of us are people pleasers. We connect time to feeling cared for.
But research doesn't fully support that. A JAMA Internal Medicine study of nearly 1,500 ambulatory visits found that 69% of patients expected to spend 20 minutes or less with their doctor, and satisfaction was identical regardless of whether the physician felt rushed. What mattered was whether patients felt they got more time than expected, not the absolute amount.
What drives successful care isn't duration. It's precision, good listening, and clear communication that signals: I see your problem, and I'm solving it.
A focused, organized visit where the doctor is clearly in command often feels more competent and more caring than a longer, scattered one. Warmth and efficiency aren't opposed.
Assumption #2: The annual exam has to be "comprehensive."
Unless you're running a boutique or insurance-free practice, this mindset is quietly costing you and your patients more than you realize.
Know exactly what your managed vision care plan requires for an annual wellness visit and do precisely that. Anything beyond that should be acknowledged and communicated in 30 seconds or less and rescheduled as a separate medical appointment. Not ignored. Not crammed in. Rescheduled.
That handoff, done well, is better care. Chris Wolfe, OD, and I have worked with hundreds of practices on how to script this conversation.
Contact us if you want help building it into yours. Or reply to this email with the subject: "Help me stop managing disease under vision plans." We have an incredible program to train you and your team.
The "comprehensive" mindset anchored at the annual exam too often leads to OSD getting merely a sample and a "see you next year," and where glaucoma suspect and diabetic care gets tucked under MVC.
Breaking that habit is the single biggest lever most practices have available right now.
Assumption #3: Revenue per exam is the metric that matters most.
Revenue per exam is still useful. I'm not throwing it out. But as your primary performance metric, it becomes misleading as you build out medical care.
Here's why: as you add chronic disease services and in-office procedures, revenue per refraction climbs. Not because you're more efficient, but because you're doing fewer refractions relative to your total revenue. The number looks great, but it doesn't tell you anything real about how you're using your clinical time.
When I ask a room of ODs how many track revenue per OD hour monthly or quarterly, fewer than 10% of hands go up. Every time.
For long-time readers, you've heard me say it: revenue per OD hour is the one metric to rule them all.
On average, an annual routine exam with an optical sale runs ~$500/OD hour. If you follow the glaucoma guidelines and perform the necessary tests at each evaluation using about 15 minutes of your time, the typical revenue per hour is over $700/hour. A well-built OSD protocol with in-office treatments can exceed $1,000/OD hour.
So what do you do with this?
Ask yourself which assumption is running your schedule.
Do your patients actually demand as much time as you're giving them, or have you built that expectation?
Pull out your MVC contracts. What are your actual obligations for an annual wellness visit?
And run the math: calculate your current revenue per OD hour, then project what happens if you add just three focused OSD or glaucoma visits to your day.
Most doctors who do this exercise for the first time are genuinely surprised. The appointments they thought were "extra" turn out to be the most productive hours in their day.
Practice Performance Partners Pick
Afraid of audits? You should be, says Chris, Wolfe OD.
His recent podcast episode breaks down where the real financial risk lives: improper documentation, unsigned charts, and insufficient test interpretations.
If audit anxiety is sitting in the back of your mind, this is worth an hour of your time.
Can you do me a favor? If you found any of these resources helpful, share this newsletter with one of our colleagues!
See you next week!
--Kyle Klute, OD, FAAO