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4 steps to opening a practice cold


I started my own practice on January 4 -finally-after six years in practice. This decision was hardly a hasty one because I dreamed of having my own practice since the first day of OD school. Like most ODs fresh out of school, however, I was saddled by debt and fear of the unknown.

The views expressed here belong to the author. They do not necessarily represent the views of Optometry Times or UBM Medica.

I started my own practice on January 4 -finally-after six years in practice. This decision was hardly a hasty one because I dreamed of having my own practice since the first day of OD school. Like most ODs fresh out of school, however, I was saddled by debt and fear of the unknown. In an earlier blog, I wrote about obtaining an MBA  which was a great introduction to the business world, yet in some ways, it still could never have prepared me for owning my own practice.

Related: The ROI of an MBA for an OD

When I began to seriously plan the opening of my own practice, I found that there were very few resources to help with the process. There are a thousand different ways to design your dream practice; you may be dreaming of a heavily medical setup or heavily optical. Maybe you’re dreaming of a specialty contact lens practice or one with a pediatric specialty. No matter your situation, I believe that there is a general sequence of events that must occur before the grand opening.

Step 1: Commit (variable timeline)

OK, yes, this might sound ridiculous. But if you’re gonna do this, you’re gonna have to want it. Bad. When I read advice like this, I shrugged it off as silly. It’s not silly. Starting cold is tough. There are many moments of, “What am I doing?!” and you must know that it is the only path for you. If you’re like me, you’ll read this and say, “Yeah, obviously.” If so, continue on!

More blogs: Riding out conjunctivitis like a bad storm

Step 2: Get it together. (A couple of months)

Your personal stuff, I mean. Take an honest look at your life and the way you’re living it. I’m referencing your liabilities-including debts-but also personal spending habits. Starting cold is a big goal, and it may take rearranging your other priorities to make it work. I personally revamped my spending habits a full year before starting cold, re-appropriating what would have been clothing or eating-out money to savings.

Also, figure out any obligations you have to finish. I personally had to get my MBA degree finished up before taking on another large project. I also knew I’d have to move to start up in my target area, so moving and buying a house was on this list for me, too. From personal experience, I know that having made these little changes early on in the process made it easier once I started actually checking off boxes.

Next: Step 3


Step 3: Prepare. (6 months-ish)

The preparatory/research phase was the very longest one for me. I researched everything in regard to opening a practice. Here are a few things you will want to know more about:

State business laws and regulations: There is quite a bit of paperwork to be done. Start figuring out what’s necessary in your state. Some examples: incorporating/group formation, getting a state business license, preparing corporate bylaws, registering for sales tax, registering for unemployment ID number, getting a group national provider identifier (NPI), obtaining a federal and/or state tax ID number.

Loans: Types, timelines, requirements, etc. Get all the details. I talked to four banks, which gave me a better understanding of how the process worked and prevented surprises once I started spending their money.

More blogs: Does your practice have a culture of can't?

Demographics: It’s important to have a clear understanding of the area in which you will practice. Look at the census reports, but spend time there, too. A town that looks to be middle-of-the-road in economic indicators may actually have pockets where economic status varies. You have to walk the streets, talk to locals, ask other business owners why they chose their location, etc.

Obtain business insurance: You may already carry malpractice insurance, but you’ll also want to have property insurance, general liability, and potentially disability and life insurance, too.

Facilities planning/real estate: Are you going to rent or buy? It may depend on where you’re setting up shop. Is there adequate parking? Will the office layout work for patient flow, reception, and other use of space? Will you have to complete a build-out? If so, research contractors and architects in your area.

Clinical objectives: Think long and hard about the type of practice you’re opening.

Equipment and supplies


• EHR systems

• Financial management

• Credentialing

More blogs: Why 'Made in Italy' is often a lie

Step 4: Do it!

All the stuff you researched? Now’s the time to put into action the best options you’ve found. In my next blog, I will break down how I approached some of the aforementioned details of starting cold.

Click here to check out more Optometry Times blogs

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