Episode 120 – The Man Behind The Mug – Dr. David Kading

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TTTP 120 | Myopia Management


Dr. David Kading is one of the most well-known and renowned personalities in eye care. He is the owner of a multi-location specialty practice in Seattle, he has authored hundreds of articles and research papers, and he is the co-founder of Optometric Insights and the host of The Myopia Podcast. One of the more interesting things that Dr. Kading has become famous for is his collection of coffee mugs.


In this episode, Dr. Dave dives into the importance of myopia management, what must be done to make real progress in this space, and how he created the career he has today. He also presents valuable advice for optometry students and fresh graduates.


See what Dr. Kading is up to:

LinkedIn: https://www.linkedin.com/in/davekading/

Optometric Insights:https://optometricinsights.com/

The Myopia Podcast: https://podcasts.apple.com/us/podcast/the-myopia-podcast/id1606064102

Watch the episode here


Listen to the podcast here


The Man Behind The Mug – Dr. David Kading

Thank you so much for taking the time to join me here to learn to grow. As always, I am truly grateful for you taking the time out of your busy schedule to join me. I’m going to ask you a favor right off the top. If you could please leave a review and leave a rating. Unfortunately, we lost a lot of our ratings due to some glitch in Apple Podcasts. If you wouldn’t mind taking the moment to do that. That will help us show up more and we can share these amazing conversations with our colleagues.

This is going to be an amazing conversation because I have on a superstar, an all-star, and a legend in the eye care space, Dr. David Kading. Dr. David Kading was recognized as one of the top 50 influencers of all time in eye care, and one of the top 250 innovators in eye care. Also, his practice is listed as one of the top ten best practices and eye care. He has three practices in the Seattle area, focusing on dry eye, specialty lenses, and myopia management. He has written thousands of papers and articles. He sits on multiple boards. He is one of the most recognizable faces in the eye care space. Thank you very much for joining me here, Dr. Kading. I appreciate it.

I’m stoked to get to hang out with you.

My pleasure. It’s been a long time coming. I’ve been excited about this opportunity to sit and chat. You’re in Chicago. Thank you for joining me. Normally, we’re in the same time zone but you travel so much. I get to catch you when you’re out of town.

We have to be thousands of miles apart rather than hundreds of miles apart.

That’s funny how that happens. It’s happened to me with other people as well who live in Vancouver. For example, Sheena Taff is an optician out here. I often will see her at conferences and rarely ever see her in Vancouver even though we live so close. I did say one of the most recognizable faces in eye care but often your face is hidden behind the mug. I was going to label this The Man Behind The Mug. Tell me about the mugs. If people follow you on social media, they know you a little bit in that regard. They will know because you do post weekly or even more regularly a picture of a mug, and there’s always a story behind it. I love that.

I’m not the brightest guy. I realized that I needed to have a bigger social media presence along with my podcast which has been going to The Myopia Podcast. I was thinking, “What can I do that is consistent, has a little story to it, is funny, and also a little gimmicky? I just started taking pictures of these cute mugs that I had and people gave me. Lo and behold, it has become these little cult phenomena with optometry. I go places and people are handing me mugs all the time. People are commenting on the mug, “I didn’t recognize you without a mug.”

It’s pretty funny. I go to conferences and I was joking with you ahead of time that I should have started The $100 Bill Club. It would have been a little more profitable for me. Now, I’m getting tons of mugs. It’s a little way for me to get into a story of encouraging people either in business or in life. We talk about calmly, whether it’s politics, religion, or business management, something in these little mugs, comments that we have, and trying to stir a conversation with people to get them started.

They’re usually posted on Monday morning as you’re starting your week. It’s something that’s a little cutesy thing that we do. It has helped me get more social media posts that are out there in a simple way, where that’s not just optometry-related and people have gotten to know me a little bit better. I’ve known people for 15 or 20 years in optometry. They’re like, “I never knew that you were a Christian or that you like to shoot guns.” It has allowed people to get to know me a little bit better.

That’s such a great way to do it. You could post a picture of yourself and write something but guarantee that maybe the first few times you do it, it might get some traction. Eventually, people are going to say, “It’s just another picture of Dave.” I’d be happy to see pictures of you, Dave, but I’m just saying the way the algorithm works. The mug thing though is interesting because it’s a different mug and a different design, and whatever you want to see. What does that design look like and what’s the story behind that? It pulls you in. The mug that you have here is very fitting for what we’re doing right now. Make sure you go and check this out.

I’m at the Vision by Design meeting, which is the Orthokeratology Myopia Management meeting. I’m podcasting in the exhibit hall. I have a booth for my Myopia Podcast. I brought so many mugs. I’m going to have to throw some of them away because there are so many of them. I’m giving them out 2 or 3 at a time to every attendee that’s here. I’ve never had this mug before this meeting. It’s pretty cool.

That’s so perfect. You have a mug because now you’ve become known for coffee mugs. You have a mug with your logo on it, a podcast, a microphone, headphones, and The Myopia Podcast. That’s a perfect blend of handing them out. I wish I was there. I’d like to have one.

I’ll have to get you one.

If you don’t mind. I’ll grab one from you there. That must make your bags pretty heavy and check that in.

We had to ship them. It was going to be weight. I brought 200 mugs.

Fair enough. To be honest with you, Dave, I don’t do a lot of clinical conversations on the show. We have so many other things we can talk about entrepreneurial-wise. We can talk about the impact you’re making in the industry. Since you talk a lot about myopia, I talk quite a bit about myopia as well. I know I’m not at the same level but my conversations are often encouraging colleagues to get into the space. Let’s talk a little bit about myopia management. I feel like I would be remiss to not bring that up a little bit with such an expert. Where do you think our profession is at? I know this might be a tough question, but you’re out there talking to people. What percentage of our colleagues are doing some form of myopia management? Is it low? Is it 50%? What do you think?

It’s probably in the 5% to 10% region. You have to ask the question, “What does it mean to be doing myopia management?” If you do 1, 2, or 3 a month, does that count? The reality is that’s a huge myopia management practice in the United States and Canada. The reality is unfortunately, there are very few people who are doing 25 or more a month, and that would be a great number. Within North America with over 30 million myopic children, 10,000 of us, it would need to be doing 300 a year to even scratch the surface.

I don’t believe 30 million is the accurate number. I think it’s a lot higher than that. We’re far away from even being able to say that we do myopia management in North America with the fact of probably not even a million children being treated with myopia management where we are. Where are we? Nowhere near where we need to be.

TTTP 120 | Myopia Management
Myopia Management: Myopia management in North America is nowhere near where it needs to be.


Very early stages it sounds like. That sounds consistent with what they are saying when I talk to people in the industry. I got into myopia management by accident. Unintentionally, I started doing it 6 or 7 years ago. I can’t remember how long ago it was because it was so unintentional. I started prescribing low-dose atropine. I’d read Lamp One or something like that, or maybe before that even. I was like, “I guess this could work. Let’s start.” I started seeing good results. I got more kids on it.

Eventually, we started doing soft contact lenses and we started doing spectacle. We don’t do ortho-k, but I refer patients out for that. Now between the two offices, I thought I was just dabbling, but it sounds like I’m doing it quite a bit more than most people. I had lots of conferences where I talked about it to colleagues and tried to encourage them. It seemed like it was easy enough to get into for me, and there are so many patients who can be helped by it.

There are two things with regards to why it hasn’t caught despite the fact that everybody would agree that slowing down the progression of myopia is something that we need to do. The number one reason is because we don’t believe that it is a disease, and it truly is. We have staggering statistics to show that myopia leads to vision loss in the vast majority of people to some degree. Even low amounts of myopia are highly associated with macular disease. We can’t just say that a minus 1, 2, 3, and 4 is immune from these conditions as they get to age. I’m a minus 1 and my risk over an emmetrope of getting glaucoma is about two times higher.


We don’t believe that myopia is a disease, even though statistics show that it leads to vision loss in the vast majority of people.


Nobody would celebrate me having a two times higher risk of any disease, let alone a visually threatening disease. We know that as axial length increases, which is the best predictor and measure of us being able to know what’s going to happen, our risk factors go substantially up when we get over 26 millimeters for an axial length. By the time you get over 29 millimeters in your axial length, 9 out of 10 people will have some sort of visual impairment of 20/40 or less.

The thing is these growth charts are relatively accurate. If we look at somebody that’s 5, 6, or 7, for the most part, we know where they’re going to be. By not doing anything, it’s allowing it to progress because we don’t believe that it is a disease or there is a problem. We shouldn’t be celebrating any refractive error in the myopic category because of its additional risk factor. One diopter increases your risk of maculopathy by 40%, from a 1 to a 2, or a 2 to a 3.

The second reason why we’re not getting into myopia management to a degree is because so many people think that it is complicated. To your point, it isn’t. When we start seeing axial length in our practice on a daily basis, we will become bigger believers. I was not an early adopter of axial length because the way I practice and the way I teach optometrists by and large is, can 90% of people do this? Let’s teach that. That’s what we should do.

Until innovation is at that point, I don’t say everybody should do this with a lack of accessibility. We didn’t have axial length devices that could be purchased by a large group of eye care providers until recently. All we had for the most part were surgical devices that we were using for cataract surgery. Now, in North America, both Canada and the US, we have devices that become autorefractors as well or keratomers or they pattern also with a topographer. Maybe you’re doing myopia management on 5 to 10 kids a month, and now your autorefactor dies. When you buy a new autorefactor, buy one with a biometer in it.

We don’t have room in our offices anymore to buy all this extra stuff. We have to be adding it in. You may not be ready for a biometer right now, but when you do need a new topographer, get one with a biometer in it, and now you’re going to be exploding in your myopia management because you’ll do biometry on every single patient. You’ll be like, “This is a signal that this parent has a high axial length. Do they have any kids?” You start that conversation with everybody.

The two reasons are our lack of calling a disease, and the innovation and technology haven’t been there yet to drive it. We have the treatments. We have the data saying that it works. It’s not that. It’s the innovation that is now coming into our practices. Hopefully, 5 and 10 years from now, we will be at a point where most people are buying those equipment and those things, and then they’re ready to move forward.

Those are two great points. It reminded me of a saying that’s totally out of context. It’s used for something very different. The saying is, “The only thing evil needs to triumph is for good people to do nothing.” I feel like myopia here is the evil. If you sit around and don’t do anything, it’s going to continue to progress and cause the visual issues that it will. It’s certainly something that I encourage all our colleagues to get into a little bit. A good point you made earlier is what you consider myopia management.

An older doctor came up to me and was like, “I’ve been doing myopia management for 30 years.” I was like, “Can you tell me what that entails?” He was like, “I’ve been encouraging patients to spend more time outdoors. Isn’t that myopia management?” I said, “You’re not wrong.” How do we classify myopia management? In this case, we’re talking about initiating some form of treatment. What’s the threshold? How many are you doing in a month? Ultimately, we just get started. Do one and see how it feels.

When you get to the point where you are close to that and you can’t handle somebody not doing myopia management in your practice, it would be like watching a glaucoma patient continuing to progress because they’re not doing the treatment. I’m black and white in a lot of things in my life, and this is one of them. My patients either move forward with myopia management eventually or leave my practice. That sounds rather harsh. What I mean by that is if you don’t start myopia management right now, no problem. I’ll see you in three months. We’ll track the progress. If you’re not going to start it in three months, no problem. We’ll see you in three months. We’ll track your axial length and your refraction.

TTTP 120 | Myopia Management
Myopia Management: When you get to the point where you can’t handle somebody not doing myopia management, it would be like watching a glaucoma patient continuing to progress because they’re not doing treatment.


The patients will either get sick of coming in because I’m passionate about it, or they’ll see that, “My kid is progressing. The doctor was right. This is a problem. Johnny is now gone from a minus 50 and now he’s one and a quarter. The growth curve shows that he’s going to continue up. Over these last six months, the data points continue to show that he is going up. Maybe there’s something to this.” We see patients back for free consultations until they move forward or they quit. They’re out. They’re like, “We’re going to go see somebody who’s going to passively watch this.”

You bring them back for free. They’ll keep coming back and doing the axle length measurements until they either decide to move forward with something or see you later we’re not coming back anymore. It’s funny you say that black and white. You might know this guy. I had Mile Brujic on. Before we did the interview, he was like, “If you ever talk to David Kading, you’re going to learn. He’s very black-and-white about stuff. I got to see the gray area and stuff. Dave though is black and white.” I thought that would be interesting to dive into. Tell me about the black and white and how that plays into other things that you do. Is it truly like that? Are you an on-and-off guy or you’re either in or out?

In large part, I always teach black and white. I am very like that in the clinic. I try to find ways that we can be most effective at what we do. I like to hack things in life. How can I get the vast majority of an impact out of the reaction and the action that I do? If I want every patient doing myopia management that I encounter, who’s a myope, what do I have to do to make that happen? I’ve seen enough people progress in their myopia before I was like this. It was just I had to be that way. I’m like that with dry eye as well. I’m like that with specialty lenses for the most part, not all the way.

That’s my personality. It’s like let’s find the best way to be the most reactive. It doesn’t mean I force people away from me. I probably am better about that than I used to be. This is the way I see things and I’m going to do my best to share with you why I think my opinion matters. That doesn’t mean that it is the only way. I’d love to hear your perspective on things, but I will share with you why the data that I have at my disposal shows that this is a good way to go. I’m a futurist, so I tend to see the future well. How do we get the maximum outcome five years from now by making the most impact right now?

That’s the way I get it. In the teaching that I have, the realization is I’m not going to move 100% of an audience where I need them to be, but helping by being black and white will draw more of them halfway than if I was in the middle and I only get 25% of people to go. I want to move those people in that direction by being very matter-of-fact. This is how I see it and this is where we need to be in the future. Mile and I balance each other out in that way. That’s why our relationship has worked so well over the years.

It’s very cool to hear how you guys speak about each other and about the things that you do together. I want to ask you about that a little bit more in a moment. One of the questions I wanted to ask you is a question I get asked. People will ask me like, “How do you do all the things that you do, clinic, family, podcast, and conference?” I’ll say, “Have you seen what Dave Kading or Mile Brujic does?” Other people are doing a lot more. I take it as a compliment, but I appreciate that. I wonder to myself, “How does Dave do all of that?” Dave, how do you do all the things that you do?

I asked that question about some of my friends and colleagues too. How do they do what they’re doing? The reality is you have to find a balance. If I’m at a conference, I do my darnedest to get on a plane on Friday so I’m home for Saturday and Sunday with my family. That’s important for me. I’ve reduced my clinic time over the years because I was working way more hours. I’ve semi-retired. One of my other optometry friends has taught me that. I semi-retired. Instead of working 80 hours a week, I try to keep it at to about 50 to 60. That has reduced my workload.

It’s surrounding yourself with good people. As I said, my clinic load is a little bit less than it used to be. Surround yourselves with people who can support you in the things that you’re not good at. I have an incredible assistant. She helps take care of a lot of the mundane things that I used to spend a lot of time doing. She’s better and faster at it. I get better flights and better hotels. I get incredible scheduling for the things that I do so that it maximizes my time.

Having done this not a good way for a long time, I’m trying to hack it to the best that I can. I’ve found that I am good at writing when I am on a plane. It’s uninterrupted time and I’m already writing some of my 2024 articles and things that I’m doing. It’s finding where am I going to be best about doing that and finding how to fit that in. I used to write everything the night before. It drove me nuts and it raised my stress level.

I’m not perfect. My wife and I talk all the time about what ball are we going to drop as we’re juggling all of these different things. The reality is I don’t want to drop very many of them. If somebody can make each of those things that I’m doing lighter, then it allows me to do what I’m good at. I’m a futurist. I induce action. I love ideating with people about what to do. That has led to some new roles where I’ve become a medical advisor with companies. This draws me into where my mission in life is. That is to enrich people’s lives so they can succeed to their greatest potential. Once that mission for life came about, it taught me where I’m best suited to do the things that I do.

With patients, that’s usually in specialty care. Primary care, doing glasses and contact lenses, while I love the relationship with the patient, they may be as good or better suited by another doctor who’s doing eye exams every day, all day. When it comes to a specialty dry eye patient who was referred to me, whose life is miserable, if I’m enriching their life, then I feel better about myself. Those are the types of patients that I try to see. When I’m teaching other doctors or working with the industry about how to make patients’ and doctors’ lives better, I know I am more successful and I’m more enriched. It’s driving me towards what are the things that I love to do, how I do more of those things better, and having to surround myself with a team of people who can support me in that. It’s that team that makes me look like I’m doing everything.

That’s great to hear. I would echo that on my end. I’m not doing as much as you. I was telling you before we started this. I look at what you and Mile are doing. I aspire to those things. You guys are doing such great things. It sets an example for others like myself to reach a certain direction to a certain level.

When I answer that question, if somebody asks me, my number one answer is that I’m lucky to have a lot of support. As in my wife who encourages me or supports me in all these endeavors, but obviously taking care of things at home, and then business partner, and all these other things taken care of that allows me to explore these other opportunities and find the things that I love as well.

I feel what you’re saying about specialty care because that’s something that I’m starting to lean into more. I’m finding the fulfillment that I get from that is very different than primary care. While I still love my interaction with my patients, specialty care gives you a very different level of satisfaction.

That’s the beautiful thing about our profession. There are other people who would be driven nuts doing specialty care every day. What they are on this earth to do is form meaningful connections and relationships. For them, they do that every day by encountering 15 or 20 eye exam patients. They see those patients grow up and they meet the family. That is what they’re put on this earth to do. Our profession allows us to have variability in how we do things. If it wasn’t for doctors like that, I wouldn’t be referred to patients that I get to see every day. I’m grateful for partnering with them. Those doctors that are down the streets are not in competition with me. I’m not in competition with them. I’m here to support them.


Other people would be driven nuts doing specialty care every day, but what they are on this earth to do is to form meaningful connections and relationships.


Because my mission is to enrich people’s lives so they can succeed to their greatest potential, if they call me up and they’re like, “I have this patient that has this problem. I was thinking about doing this. What do you think?” That’s not just an opportunity for me to get a patient. It’s how I enrich that doctor’s life by teaching them or helping them or guiding them through some of the things that I’ve learned so that they can do it with their patient and they don’t even have to be referred to me.

That’s the beauty of primary care providers and I love them. They have the hardest job in eye care. It’s not easy being a primary care doctor. By no means do I think somebody should feel like they’re not excelling in the profession. It’s the hardest thing. Being a primary PCP in healthcare is also the hardest job out there. There are so many things you have to think about.

That’s very true. You have to know at least a little about everything versus just knowing a lot about 1 or 2 things. Let’s switch gears a little bit from practicing doctors to future doctors. I know with Optometric Insights, you and Mile spend a lot of time talking to and teaching students. If you could share a little bit about what that is and what Optometric Insights is, then we’ll lead into that. I want to see if we can share some good tangible insights for students and new grads as well.

The genesis of Optometric Insights is also a fun story. In the early days, Mile and I got connected on almost like a blind date. Somebody set us up to have dinner together with someone in the industry. They’re like, “You guys need to know each other.” It was love at first sight and we connected. He was doing something an incredible amount on the East Coast and I was doing on the West Coast. I was like, “This is a great partnership.”

We were always talking with each other about things that we loved to do. Both of us love going in and teaching young grads, or in teaching optometry students. In different industries, people would support us. I’d go and do this program for an insurance company. He’d go and do this program for a pharmaceutical company or whatever it was. We were doing these one-off little optometry school programs.

We were in Alaska and we were driving to a continuing education that we were doing. It was 2:00 in the morning and bright out as it could be because it was in the summer. We were having this dazed and confused conversation of what if. What if we started this company and partnered with all these companies that were doing these one-off things and see if they would support us to go in and teach a message of how do you accelerate success as you’re in optometry school? I don’t know about you, but I had no idea about what I was going to do when I graduated. I didn’t even think about it until I walked across the stage. It was like, “What am I going to do?”

I did have a residency so I did know what I was going to do. I knew that but I didn’t think about my future a whole lot. It hindered me. It has not kept me from studying. It just would have been cool to have done that. He and I formed Optometric Insights. We initially started in the optometry schools, but we’ve certainly reached outside the optometry schools. Our audience is negative four from graduation to plus ten. That’s where we focus. How do we get you to be what you consider to be successful faster? If you were thinking 10 years, how come we can do it in 5? If you were thinking 5, how do we get you to 3?

In the Optometric Insights program, we go to optometry schools and we share with them the best tips and practices that they should be thinking about in order for them to reach that height of what is success for them. Sometimes it’s freedom to be able to travel. Sometimes it’s a financial goal. Sometimes it’s, “I want my practice to look like this.” Some pretty fun things that we do. That was about 10 or 12 years ago that this all started.

That’s amazing. I imagine there are a lot of students who have benefited from those conversations because one of the biggest things that you’ll hear from most ODs is we got zero business training in school. I feel like if you have a chance to sit down with yourself and Mile teaching these types of things, it’s going to help you think a bit more about the business and the marketing and whatever else you might need to do to accelerate your career like you’re saying. That’s great. Let’s say three things for students. We’ll do three things for recent grads. What are the three things that you would say are important pieces of advice you’d give to current students right now?

We wrote a book and it’s released on our website. It’s free. If you go to OptometricInsights.com. You can download the Pathways to Success book. It’s for students and recent grads. Mile and I both would agree that our number one is that you need to know where you’re going to live. We encourage people to set the state or province that they want to be when they graduate. If you can narrow it down to a region or a couple of towns or cities, and if you can narrow it down to a city, even better. The reason is some people do it, but it’s very difficult to reach the goals that you have when you’re moving from location to location and practice to practice.

You may be able to be in one city and be able to move up the scale of the practices that you want to be in, but that’s because people in that city know you. If you are going from state to state or province to province, and you’re jumping from one practice to another, not very often that they know you by your reputation. You’re not going to reach those objectives as quickly. We encourage you to figure out where you want to go so that you can start making connections.

Number two is to start realizing what is your purpose and what is it that’s going to help you feel fulfilled. It’s not just paying off your student loans and all that’s a very important thing, but it’s getting to the point where I say, “This is why I went into this profession and this is what I’ve set to accomplish.” For me, that’s enriching people’s lives so they can succeed to their greatest potential. Every day when I get up, I can say, “This is what I’m striving to do.” We recommend reading the book Start With Why, by Simon Sinek. That’s a great way to get to your why.

TTTP 120 | Myopia Management
Start with Why: How Great Leaders Inspire Everyone to Take Action

I would say, in many things, the next thing to do is start making connections with strategic people. Those people could be at state or provincial meetings. Those people could be at, “I’m interested in dry eye.” You go to the Dry Eye Summit out in Toronto, or you go to the Vision by Design because I want to do myopia management. Start becoming the person that you want people to see you. That’s because you’re already making those inroads. Those are three of the early things for students that we think they should start doing. It doesn’t have to be a lot of conferences or moving around, but just connecting with people, knowing where you’re going to go, and realizing what would success look like for you internally, not just externally time-off type of practice and finances.

Where do you want to practice? What’s your why? Networking and connecting with people in the area. Those are at least three of the many things you said that you think are important. That’s for students. People who are in school right now, take the time to think about those things and start connecting. Those are amazing pieces of advice. I got lucky with the where. I knew I was coming back to Vancouver. That was never a question for me. It allowed me to start to connect with people right away. I planned my last clinical rotation in Vancouver. It was a little bit of a headstart.

The networking part to me is super important. I feel most of the things that have happened for me in my career have come around because I got to know other people who could support me and provide or present the opportunity. A lot of that came through our provincial association. I always encourage students and new grads to get involved in your association, your state or provincial association, or society and start to meet people. You never know what opportunities are going to come up through those conversations. Let’s move on to new graduates. What advice do we have for maybe brand new grads or recent grads that you think will help them accelerate their career at this stage?

First of all is realizing what it is about optometry that you’re finding you’re most passionate about. I do realize that in the optometry world that my grandfather practiced in from the year 1950 to 2000, those 50 years of practice were about building a foundation for what optometry is. My grandfather anticipated that the next 50 years would be years of innovation for eyecare. He wrote me a letter in optometry school. He is like, “I learned pharmaceuticals. You’re going to learn technology.” He was dead on in saying that.

Find the areas that you are passionate about. I do believe that the vast majority of us will be leaning in the direction of a specialty of some sort. Because we are going so deep in glaucoma, macular disease, low vision, vision therapy, myopia, dry eye, and specialty contact lenses, that aspect of your practice will help drive you financially. It will also help drive your practice to set itself apart. Find out what that is that you’re passionate about.

The likelihood that the practice that you are in right now is going to be your final practice is 50/50. I thought the first practice I joined was going to be my final practice. Lo and behold, it wasn’t. They fired me because they knew it wasn’t the best fit for them and it wasn’t the best fit for me. They saw my future and knew that I was going to be better suited, not in a primary care practice, seeing exams all day long, but I was going to be better suited doing specialty care. Realizing where you’re at will help you get there quicker.

This is a controversial one. I do not recommend putting every spare dollar that you get from your paycheck toward your student loan. That’s controversial. I recommend putting a portion of it into optometry-specified savings. The reason is that five years from now, if you have done that, you will have incredible leverage to buy a practice, to put a down payment on something, to do whatever it may be, or if you’ve been aggressive at it, you could pay off your student loans just like that. You’ll be five years down the road. Having that little bit of knowledge of what you want to do with the rest of your career will help set you apart from some of the other colleagues who don’t have cash right at hand.

TTTP 120 | Myopia Management
Myopia Management: Instead of putting every spare dollar you get from your paycheck toward student loan, put a portion of it into optometry-specified savings.


That’s controversial because I’m one of the most anti-debt people that are out there. I still think you should be paying down your debt, but you’re putting that extra large amount of money away in savings so that you have the opportunity when it presents itself. If five years down the road, you’re in the practice of your dreams and you’re doing what you want to do, you’ll have a huge cash layout that you could then drop your debt. You’ll have paid a little bit for it in interest. That is a small cost to pay should you decide that you want to be able to do something. Right now you can get CDs for 5%. That’s close to what our interest rate is. Not quite, but pretty close to 6% or 7% interest rates for students.

Right now savings rates or saving interest rates are pretty high. Are you saying just drop it in a savings account or are you saying invest it in something? Put it in an index fund or something that might grow.

Somewhat liquid if you can. A low-risk place. An index fund is a good place as long as you’re not going to see a huge drop in the market that’s going to drop you. A safe place is to do some sort of a money market or a high-interest CD, which right now CDs are running about 5%. That’s huge. We haven’t seen that. I don’t think that’s a good place to have all of your investment for the future. Is that a 5%? When you’re looking at your money being accessible within a set time period and it’s a low risk, that’s an okay place to be.

There’s controversy and we could argue back and forth about how that fits in, but I love having opportunity with cash when an opportunity presents itself. When my most recent practice came for sale, I had the leverage of my other practice and the leverage of cash to be able to buy the practice where other recent grads had put offers in, but couldn’t get it because they didn’t have enough of a down payment. They couldn’t make the bank feel good enough about the offer where I could. I’ve been out for a lot longer, but I had cash accessible to me to be able to do that. Those opportunities may not be available to you if you don’t have them. We could go off on that.

The third thing is starting to connect with all of your colleagues. You said it. Networking is key. Getting to know all the doctors in the area, and that’s going and having lunch once a week with a new doctor, making sure you’re part of your association, and your state of provincial meetings. Going to those and making sure that you are known and that you make yourself known to those people so that you can best refer your patients when you’re not comfortable with something. Other people can learn, “You just got back from such and such a conference and you learned a whole bunch about whatever it was that you’re passionate about. I want to refer my patients to you.”

Great advice. Thank you very much. Dave, before we wrap up, there are always two questions I like to ask every guest at the end of every episode. Before we get to that, I’d like to ask, how can people find you and learn more about you or Optometric Insights, The Myopia Podcast? What contact info would you like to share?

We are launching and depending on when we are going to be launching this, I’m partnering with Marketing4ECPs as you do so well. We’re launching the Myopia website. That’s where The Myopia Podcast is going to be living. You can search for anything myopia, as well as the myopia newsletter through that contact information. You can reach me on social @DaveKading with all of the social handles. OptometricInsights.com is a great place for us to learn more about the resources and the things that we’re coming out of within the student arena.

Shout out to Marketing4ECPs. I’m glad that you’re working with them. They’re a great team, so that’s good. Dave, last two questions. The first one is if we could hop in a time machine and go back to a time when younger Dave was struggling with something. You’re welcome to share the moment or experience if you’d like, but more importantly, what advice would you give to younger Dave at that time?

That’s all about juggling and looking at the big picture. When younger Dave has been focused on the weeds, younger Dave hasn’t been happy. Like I said, I’m a futurist and I’m a big-picture person. I do not do well with details and how to accomplish every single step. I would encourage younger Dave to get himself affiliated with other people who can crush it in those areas far better than he can and to start looking at where his strengths lie.

That’s what we need to do with this. It’s knowing our mission and vision, and then being able to surround ourselves with the people who fill in all of the areas that we are very poor at. You said it yourself, surrounding yourself with people like your wife, who is the best advocate for you. My wife is the same thing. She’s my business partner. She’s an optometrist in our practice. She and I have done what we’ve done to be able to grow the practice and advocate for me to get out. She’s also good about helping me, not in a bad way, but realizing where other people can help support me. That would be where I would go talk to younger Dave.

TTTP 120 | Myopia Management
Myopia Management: Know your mission and vision, then surround yourself with people who can fill in all the areas you are poor at.


That’s great advice. It’s very important to have somebody who can point out your flaws or your weak spots and encourage you to fill those in, whether it’s a supporting cast or other things that can help you. I always find that one of the most valuable things is when people can give me very direct and frank feedback. If it means, “Sorry, that was really bad,” that’s what I want to hear. I’m lucky that my wife is not afraid to give me that feedback, and a couple of my good friends. Thankfully those are my friends and that’s who they happen to be, but they will give me feedback like, “What are you doing there?” It helps me grow. That’s good advice to younger Dave to surround yourself with those people.

The final question. Everything that you’ve accomplished to this point, and there was a long list of them that we named, not even all of them at the top of the show, but all of the things that you’ve accomplished and continue to accomplish, how much of that is due to luck and how much is due to hard work?

I’m sure other people in your show have answered this question similar to what I have, but Thomas Jefferson said, “The harder I work, the luckier I get.” I am a fan of that. A major value in my family is hard work. There is no substitute for hard work. My children do not get praised for their accomplishments. They get praised for the work that they put into achieving those accomplishments. I’m happy to take any luck that is coming my way. I am going to put in every effort that I can make to achieve the things that I set out to do. I’m pretty happy with the fact that I’m a very hard worker when it comes to accomplishing the things that I want to do. The achieving of things is probably a lot of luck, but I’m going to work hard to put myself in the places where those successes are available to me.

That’s amazing. That’s a great answer. Thank you very much, Dave. This has been awesome. Given the limitation of time, we didn’t get to cover all the things I would loved to talk to you about. I’d love to have you back again some other time and learn more about you and the impact that you’re having on the industry. Thank you for everything that you do. Any final words that you want to share with the audience before we wrap up?

I love what you do in your show. You combine life wisdom, knowledge of the industry in the eye care space, as well as some occasional clinical stuff. You do a good job of balancing that. I’m grateful for your show in our industry. I know so many other people are. As a podcaster myself, I have to say to your audience that those reviews that you leave mean the world. He’s asking for them. I would encourage you, if you like the show, to leave why you like the show and to leave those reviews.

As far as the aspects of life, it’s the ability for us to live. The quote is out there that a man is born twice. The day he comes out of his mother’s womb and the second one is when a man or a woman is realizing what they’re put on this planet to accomplish. Those have been things in the last 5 to 7 years that have come to me. That helps you achieve a much more fulfilled life. A lot of us are looking for success outside of ourselves in other people and their accolades towards us.

If you know what you’re supposed to be doing, it guides the work that you do and it reframes success. That’s the key thing that we need to be doing and looking for in our quiet times, in those moments when we are reflecting on our own lives. That’s what I would encourage people to do. Take that time to find out what were you put on this planet to accomplish and chase after that.


Take the time to find what was put on this planet to accomplish and chase after that.


I love that. That’s a great insight. Thank you. Great wisdom. Thank you so much, Dave. I appreciate it. I’m grateful for everything that you’re doing. Thank you for sharing all that insight on the show. Thank you to everybody who’s tuning in. Don’t forget to leave a review. I’ll see you guys in the next episode.


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About Dave Kading

TTTP 120 | Myopia ManagementDave Kading has been recognized as one of the top 50 optometry influencers of all time, as one of the top 250 innovators, and listed as one of the top 10 best practice in eyecare. His three practices in the Seattle focuses on Dry Eye, Specialty Lenses and Myopia Management. He Co-Owns Optometric Insights which is changing the way students and doctors perceive practice. He performs research as part of the post-graduate Residency program that he hosts in Seattle. He lectures internationally and has written thousands of papers and articles. Dr. Kading’s teaching style brings about innovation and simplified perspectives to longstanding conditions. His podcasts: The OI Show and The Myopia Podcasts are released weekly and downloaded by practitioners worldwide. Dr. Kading sits on several boards of both medical and charity organizations. Most of all, Dr. Kading loves spending time with his three daughters and optometrist wife, Kristi Kading, OD, FAAO, FCOVD.

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