Photo courtesy of Dr. Clayton Tyler Boyd, who is seen here with a patient using an OCT, one of his key investments, discussing exam findings.
Investments that transformed a rural practice
By Clayton Tyler Boyd, OD, FAAOMS
July 23, 2025
If you told me five years ago that a handful of carefully chosen investments would transform not just my practice, but my patients’ lives—and my own sense of professional fulfillment—I might have been skeptical.
Yet, in rural Oklahoma, where every mile matters and each patient’s trust is hard-earned, that’s exactly what happened.
I still remember the day a longtime patient called in tears. She’d been told she needed a simple YAG laser procedure, but the nearest specialist was three hours away. She didn’t drive, and her daughter couldn’t take off work.
That call was a turning point for me: I realized that investing in the right technology could mean the difference between accessible care and unnecessary hardship for my patients.
Here’s how three major investments—each made with a mix of hope, caution and plenty of number-crunching—reshaped my practice, improved care and delivered real returns.
YAG Laser System: Bringing Advanced Care Home
I invested in a refurbished YAG laser system for posterior capsulotomy and peripheral iridotomy procedures. Before this, I referred out 15 to 20 patients each month for treatments that took only minutes but required hours of travel.
The Numbers:
- Cost: $45,000 (refurbished; new units often exceed $85,000)
- Financing: Practice savings + small equipment loan (no ongoing lease)
- Break-even: 18 months
- Annual revenue: ~$35,000
The first time I performed a YAG procedure in my own office, my patient hugged me afterward, grateful she didn’t have to leave her community for care. That moment underscored the true value of this investment: it wasn’t just about revenue, but about trust, loyalty and access.
What I Wish I’d Known:
- Buy refurbished from reputable dealers—technology is reliable and cost-effective.
- Invest in training before your first case.
- Double-check your malpractice coverage.
- Start with straightforward cases to build confidence.
Editor’s Note: Scope-of-practice for ODs varies by state. In jurisdictions where state boards permit it—and when the practitioner has completed the requisite advanced training and certification—optometrists may perform Nd:YAG laser procedures (e.g., posterior capsulotomy). However, this privilege is not universal. Check with your state optometric board before making plans to invest in this technology.
Advanced OCT: Seeing More, Sooner
As diabetes and glaucoma rates climbed in my patient base, my old OCT just couldn’t keep up. I needed sharper imaging and anterior segment capabilities to catch disease earlier and support my expanded scope.
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The Numbers:
- Cost: $65,000 (refurbished; new can exceed $120,000)
- Financing: 5-year loan, ~$1,200/month
- Break-even: 14 months
- Annual revenue: ~$28,000
Within weeks, I diagnosed a subtle case of early glaucoma in a patient I might have missed before. The patient’s gratitude—and the ability to intervene early—reminded me that technology, when used thoughtfully, is an extension of our clinical judgment.
What I Wish I’d Known:
- Confirm insurance reimbursement rates and coding requirements before you buy.
- Staff training is crucial—good images mean better care and fewer headaches.
- Maintenance contracts are worth the extra cost for peace of mind.
Cloud-Based EHR: Streamlining for Patients and Staff
My old software was slow, unreliable and frustrating for everyone. Upgrading to a cloud-based EHR and practice management system felt daunting, but the inefficiencies were costing us time, money and patient goodwill.
The Numbers:
- Setup cost: $15,000
- Monthly fee: $800
- Break-even: 8 months
- Annual savings: ~$18,000 in admin costs and improved billing
After the initial learning curve, my staff was spending less time on paperwork and more time with patients. Automated reminders dropped our no-show rate by 30%. Patients loved the online portal, and my billing headaches disappeared.
What I Wish I’d Known:
- Expect a two- to three-month productivity dip during the transition.
- Involve your team in the selection process—they’ll spot issues you might miss.
- Invest in training and support up front.
- Data security is non-negotiable—choose a vendor with robust safeguards.
Looking Back: Lessons That Last
Each investment was a leap of faith, but the common thread was a willingness to listen—to my patients, my staff and my own instincts. The numbers matter, but so does the story behind them: the patient who can stay close to home, the staff member who finds joy in their work again, the practice that becomes a true community resource.
If you’re weighing a big investment:
- Don’t be afraid to buy refurbished, but do your homework.
- Let patient needs—not just technology trends—guide your decisions.
- Take your time, ask tough questions and trust that the right investment will pay dividends you can measure in both dollars and gratitude.
Read more practice investment success stories in Review of Optometric Business
Read more about successful practice investments in ROB sister publication Independent Strong
Clayton Tyler Boyd, OD, FAAOMS, is the owner of Clayton Boyd, OD in Perryton, Texas, and former associate at Guymon Vision Clinic, in Guymon, OK. To contact him: tboyd76@hotmail.com
