20/20 MONEY: The Business of Optometry

In this engaging discussion, Peter Lazaroff, Chief Investment Officer at Plancorp and author of Making Money Simple, dives into the fascinating world of direct indexing. He explains how this investment strategy can significantly minimize tax liabilities, especially during the sale of a practice. Peter emphasizes the importance of due diligence when selecting direct indexing firms, and highlights the benefits of customizing portfolios for tax efficiency. The conversation also touches on integrating ESG concerns and maximizing returns through smart tax strategies.

Welcome to the first episode of 2025! In this episode, I take a bit of a trip down memory lane as I recently came across a list that I wrote 10+ years ago. Re-reading it, I thought it would be a great way to kick off the new year and give optometrists & practice owners some principles and habits that can guide and shape how they plan & live their life, on purpose. As a reminder, you can get all the information discussed in today's conversation by visiting our website at integratedpwm.com and clicking on the Learning Center. While there, be sure to subscribe to our monthly "planning life on purpose" newsletter that's filled with tips and ideas to help you plan your best life, on purpose. You can also set up a Triage conversation to learn a little bit more about how we serve in the capacity of a personal and professional CFO: helping OD practice owners around the country reduce their tax bill, proactively manage cash flow, and make prudent investment decisions both in and out of their practice to ultimately help them live their best life on purpose. Lastly, if you're interested in learning more about the 20/20 Money Financial Success Masterclass, a course & platform that we created to help ODs become "brilliant at the financial basics," please check out the link in the show notes of this episode to learn more. Resources: Plan Your Year: An Introduction to Free, Focus, and Buffer Days 20/20 Money Membership Information ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify Google Podcasts Stitcher ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here!

As we set up for the beginning of yet another year, I wanted to bring back an episode that I released earlier in the year. I think the timing of replaying this episode is good as it's being released during a very busy time of year and also while you're likely thinking through how you want to set yourself up for success in 2025. All the best to you and your family during the holiday season! In the spirit of managing information overload, I wanted to take a week to pause on new information and rather share a process or organizing and prioritizing your thoughts, goals, and actions that can often stem from listening to shows like 20/20 Money and the consumption of other content. Resources: 20/20 Money Membership Information reMarkable 2 Tablet ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify Google Podcasts Stitcher ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here!

Welcome to this episode rewind of 20/20 Money! In keeping with tradition, I'm bringing back this episode again, just like I did last year, for one of the last episodes of 2024!! Given that this is the last episode of the year, this is usually when we are thinking about goal setting, and everyone's schedule is anything but normal being the day after Christmas, I wanted to bring back the conversation that I had with my friend, business collaborator, and advisor coach Stephanie Bogan from early 2022. I'll share some info about Steph here shortly in the intro and then close out this introduction with some personal thoughts and reflections. While Stephanie has built and sold a number of businesses in her career, most recently she is the founder of Limitless Adviser, a coaching program where she empowers financial advisors to create and build wildly successful practices and a life that they love. This was a special conversation for me as I'm also privileged to be involved in that program—first as an advisor that was being coached by Stephanie and now currently serving as an advisor coach, where I help coach and empower other advisors to work intentionally on their practices by applying the mindset and methods that Stephanie teaches in the curriculum and that I've learned over the years as well. In this conversation we talk about something that tends to be popular around this time of year: goal setting. However, we talk about it from a bit of a different angle, which is first spending time focusing on your purpose and intention for building what you're building and how money plays a role in that plan. We talk about it from two angles: the first being the practice owner that's at the tail end of their career and facing an inevitable transition from their practice and also from the lens of a younger practice owner that has many years in front of them. We talk about some of the "sacred cows" that exist in practice ownership, why some of them should be questioned, and how to think about solving those problems. We wrap up with Stephanie's very powerful answer to the one question that I ask every first-time guest on 20/20 Money. As a reminder, you can get all the information discussed in today's conversation by visiting our website at integratedpwm.com and clicking on the Learning Center. While there, be sure to subscribe to our monthly "planning life on purpose" newsletter that's filled with tips and ideas to help you plan your life on purpose. You can also set up a Triage conversation to learn a little bit more about how we serve in the capacity of a personal and professional CFO: helping OD practice owners around the country reduce their tax bill, proactively manage cash flow, and make prudent investment decisions both in and out of their practice to ultimately help them live their best life on purpose. You can also check out any number of additional free resources like our eBooks, blog posts, and on-demand webinars. Lastly, if you're interested in learning more about the 20/20 Money Ultimate Financial Masterclass, a course that we created to help ODs become "brilliant at the financial basics," please check out the link in the show notes of this episode to learn more. Now over 300 episodes into 20/20 Money, this show has continued to grow and develop into something bigger than I thought it would have and I'm eternally grateful for everyone that's been involved in the show. To all my guests that have given their time to come on the show and share their perspective, experience, and expertise—thank you. To my producer Kyle— yet another thank you for all your help with the show. From getting it initially set up in 2018 to handling everything with the show after I've finished recording an episode…I appreciate all that you do for the show. And lastly, to you, the listener of the show. Whether this is your first episode, or you've listened to dozens (or even hundreds!) of them, I'm sincerely grateful for the intimate, albeit asynchronous relationship that we've been able to have. My goal is to have positive impact at scale in the optometric community and help practice owners make educated and informed decisions with their money and this podcast has allowed me to have a platform to share not only my knowledge and experience but also the experience of the guests that I've had on the show. I have always tried to keep the show as objective and unbiased as possible. I've never taking a dollar of sponsorship money, no guest has ever paid to be on the show, nor have I ever paid a guest to be on the show. This podcast is organic and authentic, and your continued support through listening and sharing the show is something that I'm both humbled and grateful for and I look forward to another great year in 2025!! Resources: OD Masterminds Application 20/20 Money Membership Information ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify Google Podcasts Stitcher ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here!

Welcome back to another episode of 20/20 Money. My guest on today's show is JR Armstrong, CPA and a partner at May & Co, a CPA firm dedicated to serving optometric practice owners nationwide. JR joins me back on the show for a year-end tax planning episode. We talk about the importance of taking a multi-year approach when evaluating your depreciation strategy on equipment, how inventory influences year-end tax planning, how to "penalty proof" your personal tax return, and other important tax concepts practice owners should be thinking about and discussing with their advisory team. As a reminder, you can get all the information discussed in today's conversation by visiting our website at integratedpwm.com and clicking on the Learning Center. While there, be sure to subscribe to our monthly "planning life on purpose" newsletter that's filled with tips and ideas to help you plan your best life, on purpose. You can also set up a Triage conversation to learn a little bit more about how we serve in the capacity of a personal and professional CFO: helping OD practice owners around the country reduce their tax bill, proactively manage cash flow, and make prudent investment decisions both in and out of their practice to ultimately help them live their best life on purpose. If you're interested in learning more about the 20/20 Money Financial Success Masterclass, a course & platform that we created to help ODs become "brilliant at the financial basics," please check out the link in the show notes of this episode to learn more. Resources: OD Masterminds Application 20/20 Money Membership Information ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify Google Podcasts Stitcher ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here!

Today's episode talks about how I think about Dave Ramsey's baby steps towards financial independence as it pertains to optometrists. I share where I think the baby steps are great to follow and I also share some iterations on the baby steps that I believe are more relevant and applicable to ODs, specifically with regards to the journey as a practice owner. As a reminder, you can get all the information discussed in today's conversation by visiting our website at integratedpwm.com and clicking on the Learning Center. While there, be sure to subscribe to our monthly "planning life on purpose" newsletter that's filled with tips and ideas to help you plan your best life, on purpose. You can also set up a Triage conversation to learn a little bit more about how we serve in the capacity of a personal and professional CFO: helping OD practice owners around the country reduce their tax bill, proactively manage cash flow, and make prudent investment decisions both in and out of their practice to ultimately help them live their best life on purpose. Lastly, if you're interested in learning more about the 20/20 Money Membership, a platform that we created to help ODs become "brilliant at the financial basics," please check out the link in the show notes of this episode to learn more. Links & Resources: 20/20 Money Membership Information Dave Ramsey's Baby Steps Holland Student Loan Debt Episode #1 Holland Student Loan Debt Episode #2 (Re) thinking your investment asset allocation as a practice owner ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify Google Podcasts Stitcher ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here!

Welcome to this episode of 20/20 Money! My guest on today's show is my friend Ashby Daniels, CFP® and we have what I think is a very engaging and revealing conversation about the emotional and mental journey a business owner goes through when considering a sale of their business. We talk about getting over the fear of selling, how to think about regrets, the alternatives to selling, the importance of having something to retire to, and the surprising truth about what it feels like when the check from the sale of your business hits your bank account. I really enjoyed this conversation and I trust you will as well, especially if you are a practice owner that has considered selling (or know, deep down, that you should be thinking about selling, if for no other reason than you'd like to enjoy the next chapter of life post-practice ownership). As a reminder, you can get all the information discussed in today's conversation by visiting our website at integratedpwm.com and clicking on the Learning Center. While there, be sure to subscribe to our monthly "planning life on purpose" newsletter that's filled with tips and ideas to help you plan your best life, on purpose. You can also set up a Triage conversation to learn a little bit more about how we serve in the capacity of a personal and professional CFO: helping OD practice owners around the country reduce their tax bill, proactively manage cash flow, and make prudent investment decisions both in and out of their practice to ultimately help them live their best life on purpose. Lastly, if you're interested in learning more about the 20/20 Money Membership, a platform that we created to help ODs become "brilliant at the financial basics," please check out the link in the show notes of this episode to learn more. And with that introduction, I hope you enjoy my conversation with Ashby Daniels. Resources: 20/20 Money Membership Information 20/20 Money Episode #284 – Dr. Jennifer Stewart's "tepid" start optometry practice: the power of vision & intentionality, the importance of an ideal patient avatar, and reconciling business risk with a conservative personality My first conversation with Ashby Tim Ferriss Fear Setting Exercise Inside the Contrarian Mind of Sam Zell ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify Google Podcasts Stitcher ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here!

Welcome to this episode of 20/20 Money! My guest on today's show is Dr. Chris Wolfe, host of The Chris Wolfe Podcast, founder of the online billing & coding LMS EyeCode Education, and a partner in Exclusively Eye Care, a private practice in Omaha, NE. This is part 2 of my conversation with Chris and I'd really encourage you to check out Part 1 of our conversation over on Chris's podcast The Chris Wolfe Podcast (links in the show notes of this episode). Part 1 will really give some context behind the mindset that's required to embrace some of the strategies and concepts that Chris talks about during this conversation. As a reminder, you can get all the information discussed in today's conversation by visiting our website at integratedpwm.com and clicking on the Learning Center. While there, be sure to subscribe to our monthly "planning life on purpose" newsletter that's filled with tips and ideas to help you plan your best life, on purpose. You can also set up a Triage conversation to learn a little bit more about how we serve in the capacity of a personal and professional CFO: helping OD practice owners around the country reduce their tax bill, proactively manage cash flow, and make prudent investment decisions both in and out of their practice to ultimately help them live their best life on purpose. Lastly, if you're interested in learning more about the 20/20 Money Masterclass, a platform that we created to help ODs become "brilliant at the financial basics," please check out the link in the show notes of this episode to learn more. And with that introduction, I hope you enjoy my conversation with Dr. Chris Wolfe, OD. Listen to part 1 on Apple Podcasts Listen to part 1 on Spotify Resources: 20/20 Money Membership Information ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify Google Podcasts Stitcher ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here!

Welcome to this episode of 20/20 Money! My guests on today's show are Drs. Jeremy Ciano & Jennifer Stewart. This is another 20/20 Money takeover, so while I usually will spend the introduction giving you a glimpse into what we talk about on the show, your guess is as good as mine about what this episode is about…since I just gave them the platform to talk about whatever was top of mind for them around the topic of cold starting & satellite expansion. Enjoy!! As a reminder, you can get all the information discussed in today's conversation by visiting our website at integratedpwm.com and clicking on the Learning Center, and we have a link to that site right here in the show notes of this episode. While visiting the website, be sure to subscribe to our monthly "planning life on purpose" newsletter that's filled with tips and ideas to help you plan your best life, on purpose. You can also set up a Triage conversation to learn a little bit more about how we serve in the capacity of a personal and professional CFO: helping OD practice owners around the country reduce their tax bill, proactively manage cash flow, and make prudent investment decisions both in and out of their practice to ultimately help them live their best life on purpose. Lastly, if you're interested in learning more about the 20/20 Money Membership, a platform that we created to help ODs become "brilliant at the financial basics," please check out the link in the show notes of this episode to learn more. And with that introduction, I hope you enjoy the show takeover conversation with Drs. Jeremy Ciano & Jennifer Stewart!! Resources: 20/20 Money Membership Information ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify Google Podcasts Stitcher ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here!

Welcome to this episode of 20/20 Money! My guest on today's show is Dr. Bethany Fishbein, OD, consultant and executive coach with Leaders of Vision. Bethany has been on the show many times in the past and today she joins us to talk about a topic that is admittedly harder and more distressing to talk about: embezzlement in optometry practices. In Bethany's experience as a consultant having worked with many practices over the years, she's unfortunately been privy to instances where embezzlement was happening. We talk about who's likely to do it, what they're likely to do, and small ways you can cross check the systems in your practice to ensure that you're running a tight business. As a reminder, you can get all the information discussed in today's conversation by visiting our website at integratedpwm.com and clicking on the Learning Center. While there, be sure to subscribe to our monthly "planning life on purpose" newsletter that's filled with tips and ideas to help you plan your best life, on purpose. You can also set up a Triage conversation to learn a little bit more about how we serve in the capacity of a personal and professional CFO: helping OD practice owners around the country reduce their tax bill, proactively manage cash flow, and make prudent investment decisions both in and out of their practice to ultimately help them live their best life on purpose. Lastly, if you're interested in learning more about the 20/20 Money Membership, a platform that we created to help ODs become "brilliant at the financial basics," please check out the link in the show notes of this episode to learn more. And with that introduction, I hope you enjoy my conversation with Dr. Bethany Fishbein, OD. Resources: 20/20 Money Membership Information ————————————————————————————— Please rate and subscribe to 20/20 Money on these platforms Apple Podcasts Spotify Google Podcasts Stitcher ————————————————————————————— For past episodes of 20/20 Money with full companion show notes, please check out our episode archive here! ChatGPT Prompt/Answer Embezzlement in an optometry practice (or any healthcare setting) can occur in several ways due to the complex nature of transactions, including patient billing, insurance claims, and cash handling. Below are some realistic examples of how an employee might embezzle funds in an optometry practice: ### 1. **Billing Fraud:** - **Overcharging Insurance:** An employee could submit inflated insurance claims by increasing the cost of services or adding services that were never provided. They would then pocket the difference between the amount paid by the insurance company and the actual cost. - **Phantom Patients:** Creating fake patient records and submitting claims for services or products (like glasses or contacts) that were never provided, then diverting the insurance reimbursement to themselves. ### 2. **Skimming Cash Payments:** - **Cash Payments Not Recorded:** If a patient pays in cash, an employee might record the visit as "invoiced" or "to be billed later" rather than marking it as paid. The employee then takes the cash and destroys or alters any record of the payment. - **Under-reporting Receipts:** An employee could under-report the total cash collected at the end of the day, skimming small amounts regularly to avoid detection. ### 3. **Inventory Theft:** - **Selling Optical Inventory:** Employees could steal optical products (like glasses, contacts, frames, etc.) and resell them privately. Since optical products are high-margin items, this could go unnoticed if inventory management is lax. - **Ordering Extra Supplies:** Over-ordering contact lenses, frames, or other supplies and then selling the excess or returning items to vendors for cash or personal store credits. ### 4. **Falsifying Refunds or Discounts:** - **Fake Refunds:** An employee could process fake refunds for products or services and divert the refunded amount to their personal account or as cash. - **Unauthorized Discounts:** An employee might give unauthorized discounts to friends or family and accept a bribe or kickback in return. ### 5. **Manipulating Payroll or Expenses:** - **Payroll Padding:** The employee could inflate their working hours or add fake employees to payroll, then collect their salaries or wages. - **Expense Reimbursement Fraud:** An employee might submit inflated or completely fake expense reimbursement claims, such as fake mileage for business travel or falsified invoices for office supplies or services. ### 6. **Misappropriating Patient Deposits:** - **Misusing Prepayments:** In cases where patients prepay for services or products (e.g., contact lenses ordered in advance), an employee could misappropriate these funds, not recording the prepayment in the system. ### 7. **Altering Financial Records:** - **Adjusting Daily Ledgers:** An employee responsible for managing the daily financial ledger could adjust entries to match up with the cash they skimmed or misappropriated, making it appear as though the totals balance. - **Reconciling Bank Deposits:** Employees responsible for reconciling bank deposits might under-report the actual cash received, depositing a portion into their own account or taking some before it is deposited. ### 8. **Vendor Fraud:** - **Fake Vendor Invoices:** An employee could create a fake vendor, submit invoices for non-existent goods or services, and then approve payments to the fake vendor (which is actually the employee's personal account). - **Colluding with Suppliers:** An employee could collude with a real supplier to submit inflated invoices for services or products, splitting the overpayment with the vendor. ### Safeguards to Prevent Embezzlement: While this experiment is theoretical, it's crucial to implement safeguards to minimize the risk of embezzlement. These may include: - **Segregation of Duties:** Ensuring that no single employee has control over multiple aspects of financial transactions (e.g., someone handling cash should not be responsible for reconciling the ledger). - **Regular Audits:** Conducting surprise audits and thorough annual reviews to catch discrepancies early. - **Inventory Management:** Using automated systems to track inventory and spot unusual fluctuations in stock levels. - **Bank Reconciliation:** Assigning bank reconciliation duties to someone outside of the person handling deposits. - **Transparent Payroll:** Having a separate, trusted party regularly review payroll and expense reports. Testing your practice's internal controls without actually attempting fraud can help you spot weaknesses before they become a real problem. Would you like to explore specific ways to strengthen the financial controls in your practice?