5 Things I Wish I Had Known Before Opening My Optometry Practice Cold

Jun 18, 2014
6 min read

I wish I had known about […so much…] before I opened my optometry practice cold

There is so much to consider when opening an optometry practice cold that despite months of preparation, you will still feel unprepared. When I started my practice one year ago, there was a lot of unknowns. A year in, there’s still a lot I don’t know, but I hope these recommendations and ideas will provide new graduate entrepreneurs with knowledge that may be of benefit when opening cold.


1. Lens Technologies

When it came to optics class as a student, I couldn’t have been any less interested. When I opened my optometry practice cold, I soon realized that I needed to stay current on lens technologies. I need to be able to clearly articulate to my patients about our advanced technology and why competitors’ offerings are not equal.

I’ve tried two different lens companies since opening to better understand for myself the differences. As new grads, we are not progressive lens wearers so we must rely on patient feedback. I would recommend new graduates visit the optiboard for specific information on progressive lens types.

At graduation, most of my colleagues and I would not have been able to explain molded vs. free-form technologies. There is not a huge emphasis placed on prescribing from the chair in optometry school, however, this is vital to optical production.

Your labs as well as your sales representatives can be very helpful on specific lens information.  A subscription to the Lens Guru is helpful for more specific information.

Here’s a brief summary of the differences:

Free Form Technologies:

  • created when a computer digitally surfaces the back of a lens blanks
  • less peripheral distortion and customization of the lens for the patient and frame selected
  • a lab’s inventory costs decline so the price we pay for lenses goes directly towards an investment in technology

Molded Technologies:

  • made from a mold
  • mold was originally created digitally, but the lenses themselves are duplicated from a mold
  • considered conventional progressive lenses
  • labs have a much higher inventory of stock lenses increasing both their cost and the retailer’s cost

2. Optical Dispensing and Adjustments

At SCO, we received the book, System for Ophthalmic Dispensing  during our third year.  I never opened the book until  last year. Even if you hire an optician, you will have to perform many optical duties yourself and in school we didn’t spend much time on heating horn frames or on semi-rimless repair. Opening an optometry practice cold? Well then pay attention to this part!

  • New graduates should spend extra time with an optician.
  • Flatter them by asking them to demo their craft.
  • Ask them if they have any recommendations on adjustments, working with certain frames, labs they prefer, and progressive lens preferences.
  • If all else fails, wipe the dust off your book. Read it from cover to cover before you open. You will save yourself a melted frame, a meltdown or both.

I spoke with a colleague who opened a practice recently, and he said he wished he had bought deeper within frame lines and selected fewer frame lines. With this model, you cut down on time spent with reps, shipping charges, and you receive large quantities discounts. This is tricky obviously with a start-up because you don’t know your patient base and what will sell. Local demographics only go so far.

I wish that I didn’t have any name brands. When you open, reps will tell you there are certain name brand lines that you must have or patients will walk – not true. If patients ask for a certain line you must be prepared to explain why you don’t sell that line. I have the number one selling frame line in America and I can’t move it because I bought it because I “had to have it.” Buy what you love because you will sell it! Stick to your gut instinct! Be different! You don’t want your patients to go down the street to another optometry practice for the same frame at a cheaper cost.

3. Marketing

Spending lots of money on marketing is easy to do as marketers hound new business owners, especially optometry practices.

You will find doctors who have had success with Groupon, health fairs or direct mail outs, but overall insurance and word-of-mouth are most successful. The median annual marketing expenditure of independent ODs is just 1.2 percent of gross revenue per the Management and Business Academy sponsored by NGO’s friends at Essilor.

Optometrists are looking for a quick fix. We want something fast with big results.  It just doesn’t happen that way.

The best marketing is encouraging patients to send their friends and family.  Word-of-mouth is slow, but free. After each exam, be sure to let patients know you are also able to treat their allergies and “pink eye.”

4. Insurance and Coding

When it comes to coding and billing, the rules seem to always change.

I can’t stress the importance enough of meeting with an OD well versed in insurance to learn about the filing process. I don’t believe it is enough to hire someone to file your insurance, it is an OD’s responsibility to know how to maximize benefits with insurance companies.

The minute you put the practice’s accounts receivable in someone else’s hands, you’re asking for trouble!

  • Do whatever it takes to make sure you know how to collect the required co-pays and check on deductibles.  If you don’t collect at the time of service, chances are you won’t ever collect. Many doctors have thousands and thousands of dollars out in accounts receivable that if not followed up on will be left uncollected.
  • Don’t be the doctor who sees patients for free.  Each and every dollar is important to cash flow.
  • Read each insurance contract you sign as well as each provider manual.
  • Check each EOB, make sure balances were collected correctly.
  • Read Chuck Brownlow’s AOA column on billing, attend coding seminars, participate in webinars offered by experts. Join the AOA for more information.

5. Hiring

When you start interviewing, frustration occurs quickly. Here’s my advice:

  • Make sure your job descriptions accurately reflect the position you’re hiring for.
  • Take your time with the interview process. You will interview many frogs before you find a prince.
  • Each interview conducted and each employee hired will prep you as an employer to be better equipped for the next interview.
  • Start the hiring process early so you have plenty of training time.
  • Make each decision on hiring slowly and carefully because it is hard to eliminate someone.
  • Give each employee a 90-day trial period in case the dynamic just does not work.
  • Do your research beforehand on what questions you are legally allowed to ask

We are not just doctors, we are human resources.

About Courtney Dryer, OD

Courtney Dryer is a 2011 graduate of SCO. She opened 4 Eyes Optometry in her hometown of Charlotte, NC in February of 2013. After 5 years, the practice name was changed to Autarchic Spec Shop to renew the practice's commitment …

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