With 49% of respondents in the Eyes On Eyecare 2023 Optometrists Report working in private practice, this setting continues to be popular among optometrists. Advice on the pros and cons of private practice would have been invaluable early in my career.
In this spirit, this article covers my personal experience working in private practice and offers hard-won, practical advice on navigating the challenges of practice ownership.
The American Medical Association defines private practice as being “wholly owned by physicians rather than a hospital, health system or other entity.”1 It further quotes survey results showing 49.1% of US physicians as working in such practices.1
4 top benefits of private practice
The road to owning a private practice is varied. While many practitioners are driven to achieve this as their end goal, even before applying to optometry school, others may choose this option for the clinical freedom and other benefits it offers. Below, I’ve listed the top four rewards of private practice, in my opinion.
1. Identifying and implementing the core values of your practice
Prior to owning my own practice, the nature of my work was bound by the vision and goals of my employer. While these often matched my own goals, I could clearly see the benefit that my employer enjoyed in deciding on the core values of their practice.
Harvard Business Review reminds us that core values are deeply ingrained principles that should form the basis for every decision the company takes.2 They are owner-established values that define the practice’s mission and set clear expectations for team members to adhere to.3 Choosing these values yourself allows you to set the tone for your practice as a private practitioner and business owner.
Pearls for achieving your core values:
- Carefully consider and choose authentic core values for your practice. Examples may include clinical excellence and attentive, patient-centered customer service.
- Authenticity, as opposed to hollow generic phrases, should be key in defining core values (which differ from aspirational values, which a company still needs to work towards).2
- Choose team members who align with your practice’s core values.3 Model these values yourself and reinforce them with ongoing training and group discussion.3
2. Having independence and autonomous decision-making
Private optometry practice allows for independence in various aspects of our work.1
This may include:
- Clinical freedom in structuring the schedule and choosing the focus of your work.
- Financial autonomy in terms of pricing and decision-making without the additional overhead of royalties or franchise fees.
- Choosing and developing customized daily systems to suit your practice (e.g., electronic health record [EHR] software, optical stock, workflows, and business model).
- Independently choosing colleagues with complementary talents who share the same overall philosophy and goals.
- The additional personal career satisfaction that entrepreneurship gives, for those who enjoy it.1
Pearls for success:
- Listen to others’ ideas and learn from their experience, but enjoy the satisfaction of building and sustaining a practice based on your own well-founded decisions.
- Choose a clinical focus that you enjoy and decide on systems that work for you.
3. Driving your own career growth within your practice.
Employees place a high value on learning opportunities, highlighting its positive effect on work engagement, productivity, staff collaboration, and employee retention.4 Professional development is a valuable tool for optometric practices.
In private practice, you possess the freedom to direct and drive the development of both your and your employees’ chosen skills. Improved job satisfaction is a valuable result of this career growth, and such career development may be in clinical, optical, or business management skills.4
Pearls for offering professional development:
- Set your practice up for success with ongoing career development for you and your colleagues. This may be done through virtual or in-person conferences as well as in-office training with optical, pharmaceutical, or equipment reps.
- Continued professional development is mandatory in many countries. Maximize its benefit by choosing areas of study that are of interest to each individual as well as core practice values, for improved job satisfaction.4
4. Developing community and enjoying continuity
Continuity of care includes both a patient’s continuous caring relationship with a specific healthcare professional, their satisfaction with the care received, and its coordination with other care providers.5
While certainly a part of other practice modalities, my private optometry practice has allowed me to offer individualized care for all generations in families, and contribute to my community over an extended period of time. This has been a privilege and a great loyalty builder.
Pearl for building patient trust:
- For patients to choose to see you over an extended period, one needs to earn their trust and provide for their eye health and visual requirements consistently and effectively over time. Hold yourself to high standards to earn this trust.
3 top challenges of private practice
While the pandemic presented exceptional clinical and financial challenges to all practice owners, running a practice can be demanding even in more normal times.
Below are three of the most significant challenges specific to private optometry practice that I have experienced.
1. Building a business framework
Corporate practices would often have well-established business frameworks, systems, and marketing in place.
Such systems may include:
- In-house stock-keeping and billing software
- Group buying power of optical inventory
- Established HR and other business services
- The support of marketing departments with established campaigns
As a private practitioner, the development of such systems adds to your responsibilities.1
Navigating this challenge:
Research solutions that work for you and have these systems in place from day one:
- Develop a marketing plan that you are comfortable with and pay attention to developing your professional reputation.1
- Embrace modern software-based solutions for routine daily tasks, and consider outsourcing marketing and other aspects of your practice if they do not fall within your skill set or daily schedule.
- Keep a clear focus on the financial aspects of your practice, working with professionals to best advise you.
2. Having a lack of clinical support from colleagues
Private practice can, at times, feel lonely without a senior colleague in the practice. Routine discussion of the best management of difficult cases is certainly a benefit that I missed before colleagues joined my practice.
Navigating this challenge:
- Find a clinical mentor. Be humble and reach out when you need clinical guidance. Former professors and preceptors can be a great source of knowledge and support.
- Attend conferences or join discussion groups (whether in person or online).
- As your practice grows, you may choose to bring in professional colleagues to work with you.
3. Learning the basics of practice management while on the job
Certain aspects of running a practice may not be your forte. Balancing the clinical and business-related demands of the work can be a challenge, one which I believe deserves focused attention.
Navigating this challenge:
Apply yourself to studying best practices in practice management. Eyes on Eyecare has a wealth of such information in articles and interviews.
- Consider finding a business mentor or work with a colleague in your practice, whose skills overlap with your own.
- Consider outsourcing certain aspects of the work with a practice management consultant.
- Align with professional organizations that can guide you on legislation and other responsibilities as an employer and practice owner.
Valuable qualities for success:
- A clear vision for your practice and consistency in working towards it.
- Dogged determination to sustain your momentum during challenging times.
- Healthy doses of enthusiasm, resilience, and adaptability.
In conclusion
Despite the challenges of private practice, it allows for a multi-faceted and rewarding career for new grads and seasoned ODs alike. There are certainly obstacles to overcome and red flags to avoid when entering private practice.
New grad optometrists are encouraged to take a balanced view of the challenges that lie ahead so they can take the leap into this exciting practice modality with both eyes open.
