Photo courtesy of Dr. Matthew Ward, who is seen here (right as you look at photo) with his practice partner, Dr. Erik Kyler. Dr. Ward shares a new approach to financial management.
A different way to approach practice financial management
By Matthew Ward, OD
Sept. 3, 2025
I’ve always tried to stay on top of practice finances, but the constant stream of advice and new ideas can be overwhelming.
I started hearing the term “Profit First,” and my curiosity was peaked. I realized I needed to learn more about this approach and see what all the buzz was about.
What Is Profit First?
If you haven’t heard of it, the Profit First system, outlined in the book, “Profit First: Transform Your Business from a Cash-Eating Monster to a Money-Making Machine,” flips the traditional financial management approach on its head. The idea is to take out profit, taxes and payroll up front—instead of just hoping there’s something left over after the bills are paid. It’s a simple change, but it forces you to look more closely at your practice finances.
I decided to dive in, using both the book and a specialized optometry-focused Profit First course by Mick Kling, OD, that breaks the system into manageable steps. There’s an online module from Dr. Kling with 15 lessons, recordings, Excel spreadsheets and a 40-page PDF. What really made it work for me is the clear breakdown and optometry-specific examples.
Six Bank Accounts: The Heart of the System
The first major change for me was setting up six separate bank accounts. This single move gave me far more clarity about every dollar in my practice.
Here’s how I structured it:
- Profit: I take 1% out of income every week and put it here.
- Tax: Protecting myself from getting blindsided when tax season hits.
- Operating Expenses
- Doctor Pay
- Income: Where all money comes in.
- Rainy Day Savings: I set this up outside my regular bank, in a high-yield savings account to make it harder to pull money out on impulse.
Using the Profit First system, I transfer funds every week (call it Transfer Tuesday), allocating specific percentages to each account. Starting with just 1% toward profit might not seem like much, but it quickly adds up. The goal over time is to raise that to 10%, but even small, steady growth makes a difference.
How the Numbers Changed for Me
After just four months, here’s what I’ve seen:
- Operating expenses down by 3 to 4 percent: The biggest and most immediate impact came from renegotiating contracts with five different vendors—including patient communication software, HIPAA compliance, phone service and internet. By shopping around and showing vendors that I’d done my research, I was able to cut costs without sacrificing quality.
- An extra $200 a week in profit: While my practice has had solid months, seeing those weekly transfers into the profit account gave me peace of mind. Two hundred dollars might not sound like a windfall, but over time, especially as the practice grows and the system matures, that number compounds.
- Greater financial clarity: With money clearly separated into accounts, I always know exactly what’s available to pay bills, cover payroll and reserve for taxes. No more last-minute worries about whether a surprise expense is going to throw everything off.
Vendor Negotiation: A Systematic Approach
Before Profit First, I hadn’t focused as much on actively negotiating with vendors. After setting up the accounts and seeing up front how expenses affected profit, I made appointments, gathered competitive quotes and went back to my current vendors, asking for better rates. Every single company was willing to work with me.
If you’re hesitant or negotiation isn’t your style, this is a great task to delegate to an experienced office manager. The key is being persistent and not taking the first offer.
Building a Safety Net and Tackling Debt
One of the most reassuring parts of the Profit First plan is the emphasis on building a rainy day fund before you increase your own income. By setting up a high-yield savings account outside my main bank, I made it harder for myself to dip into these reserves for minor issues. I’m earning more interest and feeling more secure.
When it comes to debt, the system encourages you to allocate a percentage of profit directly toward repaying loans. There’s satisfaction in watching balances actually shrink, and the guidance helps keep me from jumping straight to personal draws before I’ve secured the long-term health of the practice.
Implementation: Easier Than I Expected
Setting this up wasn’t complicated. With a little help from my banker, I arranged the new accounts and automated the core weekly transfers. It only took a few weeks to get comfortable. The spreadsheet and workflow templates from the course helped me maintain momentum.
This isn’t a passive system, but it isn’t overwhelming either. If you’re already busy (and we all are), the ritual of transferring funds becomes second nature—and each week, I get another reminder that my business is becoming more intentional and resilient.
You Can Start Seeing Results Fast
I’m only a few months in, but the changes are already significant:
- Lower operating expenses
- More profit actually set aside
- Less stress about bills and taxes
- Increased negotiating power with vendors
If you’re thinking about adopting a Profit First approach, my advice is to give it a try. Set up those dedicated accounts and start moving just a small percent each week into profit. Negotiate everything you can. If you stick with it, the improvements show up quickly—and they last.
Read more about practice financial management here.
Matthew Ward, OD, is the owner of Valley Eye Clinic in West Des Moines, Iowa. To contact him: eyedocward@gmail.com
