From Our Editors

The $1,000+ Clinical Hour: It’s Not Magic

With consistency, a strong team and a few other factors, you can reach this $1000+ per clinical hour benchmark, too! Photo credit: Dr. Sorrenson

Try these practical steps to move from the $600s to $1,000+ per doctor clinical hour

By Laurie Sorrenson, OD, FAAO

May 29, 2026

I had assumed that hitting $1,000+ per doctor clinical hour was reserved for unicorn practices—those perfect combinations of location, payer mix and patient demographics. The reality? I think it is doable for most practices.

It is hard to find what the average is for this metric but it appears to be about $600-$650 per clinical doctor hour. That’s not bad. But it’s also not the ceiling.

At our practice, we averaged over $1,100 per doctor clinical hour in 2025. We have nine doctors, and all but our newest associate was above $920 per hour—one is over $1,200. And no, we are not a super high-end optical!

Looking at Exams/Hour

Most practices can’t reach $1,000 per hour scheduling one exam per hour. There are exceptions. Super high-end opticals selling $1000+ frames with a high capture rate or offices doing aesthetics with multiple aesthetic technicians doing the procedures could achieve this.

However, most practices that break this threshold are scheduling three to four patients per hour. We schedule at three per hour, and that’s been a sweet spot for maintaining both efficiency and experience.

We try hard to do several things with our schedule.

Try to get as many of those appointments to be comprehensive exams (I will explain this more later).
Try to keep the appointment booked each day as much as possible, although we don’t like being fully booked for more than a few days out. (Here is an article about why.)

Delegate, Delegate, Delegate (Empower your Staff!)

If the doctor is doing tasks that someone else could do, maybe not quite as well or quite as efficiently but still with 80–90% effectiveness, you’re capping your own production.

In our office, we’ve aggressively delegated:

most contact lens follow-ups to our technicians
myopia management consultations (We have one main MM counselor but have 2 others that can do them, too.)
dry eye workups and therapies (Almost every technician can do all our dry eye procedures including IPL, LLLT, RF, LipiFlow, Blephex, Manual MG expression along with taking MG images.)

That way all of the doctors can focus on diagnosis, decision-making, recommendations and seeing more annual exams.

Protect the Schedule from Low-Value Visits

This is a bit controversial. I don’t want anyone to think we don’t take care of our patients with medical issues, because we do! We have lots of glaucoma, AMD, dry eye, amniotic membranes, ortho-k and even neurovisual exams. But one of the biggest killers of doctor productivity is a schedule filled with low-producing encounters.

So we try to prioritize our doctors’ schedules to be open for “full” exams. How do we do that?

Our online schedule is available for full exams. Emergency visits are placed on a separate schedule and worked into the doctor’s schedule. Our doctors are very aggressive about moving patients to the “side schedule” when they know the visit will be short so that they can keep their schedule available for the full exam.

For example, if a glaucoma patient is coming in for their 6 month eval and they have been coming in for years and they are stable, they might get moved over to the side schedule because this visit will most likely be very short. Or if it is a follow-up to an abrasion and the doctor feels it will be quick, that appointment can be moved over.

Improve Your Optical Capture Rate

When we track the metrics of each of our doctors and compare, we notice which of the other metrics makes the most difference with the metric “revenue per clinical hour”. We have found that optical capture rate is one of the most important metrics that affects “revenue per clinical hour”.

You can do a perfect exam and still underperform financially if the handoff to optical is weak.

We work hard at our optical handoff. We use Cqueue to call the optician to the exam room. The goal is for it to happen in the exam room but the backup plan is to see in Cqueue which optician has “acknowledged” the patient and then meet the optician in the optical (or hallway sometimes).

Introducing the optician to the patient, complimenting the optician’s skills out loud and then repeating the recommendations from the Four Rs that were done at the end of the exam is essential.

Keep recommendations simple and straightforward.

Keeping best sellers on the board is also important. If you are still ordering frames for your board when the rep shows up, I promise you are losing sales! Having a static inventory system, or ordering 1-2x a week or even daily, can help you keep your best-selling frames on the board.

Market to Keep the Schedule Full

It is hard to produce $1,000+ per hour with a lot of holes in your schedule.

Marketing well is HARD! I definitely do not think I am an expert, but I do try!

We invest in:

SEO
social media
internal recall systems (probably the most important)
patient experience that drives referrals (well, maybe this is the most important!)

The bottom line is that an empty chair is the most expensive thing in your practice.

Embrace High-Value Clinical Care

So even though I believe filling your schedule with mostly full exams is essential, also having technology and practicing at the highest level is important too.

We do a lot of:

amniotic membranes
light-based therapies (IPL, LLLT, RF)
scleral lenses
myopia management, including ortho-k
EyePrintPRO and other specialty lenses
ERG, VF, OCT, ocular response analyzer, meibography, Pentacam, Optos Silverstone & Monaco, Specular Microscope, B-scan, etc.

We do a lot of medical, and we can be successful because we train and delegate our staff to help.

Consistency is Tough!

With nine doctors, consistency is so important and so hard to achieve.

We’ve worked hard to align on:

scheduling
workflows
patient communication
handoff language

We meet weekly to discuss these things and more.

That’s how you get one doctor at $1,200+/hour and everyone else not far behind.

Be Intentional

Crossing $1,000 per doctor clinical hour isn’t about one big change. It’s about stacking a series of intentional decisions:

See enough patients
Delegate aggressively
Protect your schedule (mostly full exams)
Nail the optical handoff
Keep the schedule full
Offer high-value care
Build a consistent team

None of these are revolutionary on their own. But together? They’re powerful.

If you’re sitting at $650 per hour today, the path to $1,000+ per hour is very possible. Really!

Read another column by Dr. Sorrenson here.

Laurie Sorrenson, OD, FAAO, ABO, is president of Lakeline Vision Source in Cedar Park, Texas, CEO of ODs Care working with Half Helen, Director of Practice Management and Austin Administrator of Vision Source and the Professional Editor of R eview of Optometric Business (ROB). To contact her: lsorrenson@gmail.com