January 15, 2026 By Sherman Tung, OD, FAAO, FCCSO, FIAOMC, IACMM Hiring new staff for a myopia management program is exciting, but it also makes most practice owners nervous. Payroll rises immediately, while the return shows up later. Many of us try to stretch our existing team as long as possible, but if you wait until you are overwhelmed, patient experience declines and the program stalls. After developing my own myopia program, I realized that staffing decisions tend to follow predictable stages. When hiring is tied to clear signals instead of instinct, the process becomes more intentional and far less stressful. Before reaching any of these stages, however, there is an essential first step. Stage 0: Do Everything Yourself First This stage cannot be skipped. You cannot train someone effectively until you have gone through the entire process yourself. I block one weekend afternoon or one weekday afternoon and perform every part of the myopia consultation. I present options in the same order each time, beginning with orthokeratology, then soft multifocal or dual focus lenses, then anti-myopia glasses, and finally atropine. If the patient is moving forward with orthokeratology, I take the topography, guide insertion and removal training, and review the contract. If the patient is prescribed soft multifocals, I follow the same steps. When a child cannot manage contact lenses, I walk them to optical to select the right spectacles. If the patient is prescribed atropine only, I personally review side effects and expected results. A solo doctor does not need to do this entirely alone. Having a staff member sit in and document the visit is incredibly helpful. If they can record the flow accurately, they begin to understand it, and their questions often help refine your messaging. These notes can eventually become your training guide. You are ready to move to Stage 1 when your weekend block consistently fills or you are starting three to five new myopia patients per week.