To Buy or Not to Buy?

Must-read, expert advice for new optometry grads that may well answer this perennial question

whether buying into an existing practice or opening a new practice from the ground up, new graduates who want to own their own practices are eventually going to need to learn the ropes of running an optometric business. But what’s the best path to knowledge and success?

It may seem that only a bold few new optometrists would dart out on their own right after graduation. In the first year of private practice, the task of learning how to be a doctor is daunting enough without the added pressure of learning how to manage a business.

But, in fact, many young O.D.s have opened practices right after graduation and have gone on to thrive.

Alternately, many new doctors who have the end goal of practice ownership may choose to start a partnership path within an existing practice, honing their own style under the tutelage of a more experienced optometrist. Deterred by student loan debt, high start-up costs, or the uncertainty of flying solo, these young optometrists adopt an existing and (hopefully) proven approach to running a practice in hopes of achieving an invitation to ownership over time.

Which scenario is right for you?

Step #1: Know Thyself

Both approaches to practice ownership have pros and cons, but the bottom line is that it takes an entrepreneurial temperament and certain level of risk aversion to open a practice cold or buy into an existing practice. The approach you choose should be based on your ideal environment for ultimate success.

Do you thrive as a group learner and collaborator? Do you work best in established systems and find stability in structure? Or, do you shine when you break away from the pack, innovate, deconstruct, and then create your own systems?

This is where the advice “Know Thyself” is apropos. No one path is superior to the other for a young doctor seeking to be a business owner.

Option #1:
Join or Buy Into an Existing Practice


Working as an associate for an experienced doctor is a great way to gain knowledge and possibly secure a path to partnership or full ownership of the practice.

If you are interested in a specialty area and want to gain expertise, there is no better way to do so than to practice with an expert in your field of interest. If you are looking for a boutique-style practice or want to take over a practice that has a proven record of success, these are both great reasons to join an existing practice.

of 3rd-year optometry students say they prefer to start their careers through private practice ownership (only 15% became an independent practice owner in their first year)
Source: VSP Vision Care Survey

There is no nobility in reinventing the wheel if your ideal practice has opened its doors to you. Other advantages of joining a practice include having access to an existing revenue stream and patient base.

Pro Tip: The new associate who plans to become a partner should be considering how to take the practice to its next level of success, whether that means broadening services, updating equipment, or implementing new efficiencies to increase cash flow.


We learn our practice habits from the culture of the practice where we begin. If the practice style of the owners leaves something to be desired, the new doctor might find himself or herself without a mentor, or even worse, he or she might learn habits that are not conducive to long-term success.

Vetting your future employer is as important as his or her vetting you, because ultimately their reputation will impact your own.

Pro Tip: Be sure to make it well-known to your potential employer that your end goal is to buy into the practice. Ask about the timeline for partnership with the practice and ask about whether the owner has a succession plan.

Some new associates worry that such questions may make them seem overly ambitious, but, trust me—these are the conversations that engage and excite employers who are serious about one day adding you as a partner.

Option #2:
Opening a New Practice


None of us is born an expert in our practice areas or with the acumen that is required to flawlessly run a business. The good news is that you don’t have to be. There are a multitude of resources for a new O.D. who wants a path to ownership.

Pro Tip: Create a marketing plan to target the demographic you wish to serve. Patients won’t come to you if they don’t know where you are or what you do.

Of utmost importance is balancing your gross revenue with the expenses and cash flow to ensure that you can service debt, pay staff, and maintain a level of professionalism. Purchase accounting software and learn basic accounting as it pertains to payroll, taxes, and creating profit and loss statements. You may one day hand this task over to an office manager, but you must also personally know how to measure the health of your practice.


While flying solo may feel exhilarating, remember what happens to the antelope that strays too far from the pack—it gets eaten by a lion. You will need startup money, commercial space, equipment, practice management software, and a lot of help from other doctors.

Pro Tip: Find a mentor (or a community of mentors) who can advise you on the day-to-day operations of running a practice. In addition to seeking out mentors, consider hiring a consulting firm to provide you with ongoing support and education. A mentor or consulting service is essential to learning the habits of success, avoiding costly mistakes, and maximizing the first impression you make on the community in which you open your practice.

—Susan M. Napolitano