Why Your Revenue Per Patient Is Stuck — and How One OD Nearly Tripled His

In this episode, Dr. Steve Vargo sits down with Dr. Zach Holland, owner of the Cornea and Contact Lens Institute of Minnesota, to unpack how a specialty practice grew its revenue per exam from roughly $562 to more than $1,500 — and why there was never a step-by-step playbook behind it.

Steve and Zach talk through how Zach layered specialty pillars one at a time — scleral lenses, myopia control, dry eye, clinical trials, and in-office corneal cross-linking — using the profit from each to fund the next. They get into why he stopped referring cross-linking out, why he doesn't schedule separate consultations, and the one simple question that opens the myopia control conversation without a sales pitch.

This conversation goes beyond adding services. It's about building a practice patients choose on purpose: pricing specialty care reasonably, protecting referral relationships by sending patients back to their primary doctor, and framing price and risk so patients feel informed rather than pressured. Zach shares why he's willing to accept a slightly lower capture rate today to build a practice that's full of patients who want to be there five to ten years from now.

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