Starting your own optometry practice is a significant undertaking, one that requires dedication, vision, and a strong entrepreneurial spirit. In this article, we delve into the experience of an optometrist who embarked on the journey of cold-starting their practice after gaining valuable experience in various clinical settings.
Driven by the desire for change and a fresh approach to eye care, I had the chance to interview ODs on Finance member Dr. Ashley Szalkowski of Guild Eyewear Studio. She shares insights into the process of establishing a thriving practice from the ground up.
What was the drive behind cold starting your own practice?
After graduating from The New England College of Optometry in 2018, I spent the first few years of my career working in an MD/OD setting. When COVID hit, I decided it was time for a change and pivoted to private practice. I split my time among five different practices. It didn't take long for me to see a trend. There were the same problems and complaints at all these offices. There were the same frames, the same displays, the same everything. I was a young OD and I didn't want to spend the rest of my career feeling stuck in the same rut.
Walk us through the initial process: choosing a location, understanding the market and putting together a blueprint for your practice
Choosing a location and understanding the market really came from my early work experience. After graduating from optometry school I moved back to Buffalo, NY and started practicing in a busy OD/MD practice. I then started working in OD owned and optician owned practices around the area.
I was very eager to learn and was constantly talking with reps, attending meetings, and getting a feel for the local optometric community. Western New York is home to me, so I already had a good lay of the land. Combining my hometown knowledge with my work experience, I was able to piece together where there was a need for a new office and what type of niche I could fill.
Financing - how did you do it? Any surprises?
I worked with Bank of America Health Practice Startup Loan. The first few stages of the loan were relatively easy, however, the buildout phase was more difficult than I would have liked. If I had some prior experience with business loans I may have felt differently. However, as a first time business owner I was completely overwhelmed by the process. It's cliche to say, but I didn't know what I didn't know. I don't believe there's anything that could have prepared me for it other than to go through it and learn from the process.
The biggest surprise to me was how difficult acquiring a business loan is compared to a student loan..... essentially the same amount of funding is requested. A student loan requested at the young age of 21 with absolutely no plan in place, approved with no questions asked. A business loan requested as a practicing doctor having spent hours of research and planning, and it's like pulling teeth.
It’s a good thing ODs on Finance has leveraged relationships with all the major practice financing institutions (including Bank of America) for up to $500,000 in cold start financing (up from $200,000), all at low conventional rates, without the need for the high interest SBA rates. This is a game changer for ODs, reducing the financial obstacles to open cold.
Take a look at current rates and get in contact with our leadership connections here.
Leasing/Purchasing - how did you negotiate a lease or purchase of the space you are in?
I knew exactly what area I wanted to be in and the type of location I was looking for. I didn't want a strip mall or medical office building. During the time I was looking for a space to rent, I would walk up and down the main streets of the area I was focused on. Whenever a for rent sign would go up, I would call and set up a viewing.
The right building came up at the right time. Neither the owner nor I worked with real estate agents. This probably isn't the most business savvy, but there were no lease negotiations, it seems like a fair contract to me and I signed.
Did you use any sort of consulting service, and if you did, was it worth it?
At the very early stages of planning I interviewed several different consulting companies. I had a very strong vision of what I wanted the office to be, part of that vision was taking a concierge approach and not participating with vision plans. Some of the consulting services I interviewed did not believe in this approach, and I knew immediately they would not be a good fit.
What were surprises you encountered in the cold start journey and how did you deal with them?
- 1) Not enough working capital. This goes deep into the difficulty I had with my business loan and not having the right support staff to help me with my loan stages. I found myself signing up for a 0% APR credit card and used that as a line of credit in the early stages. Learn from my mistakes, request more working capital!
- 2) No one in this industry is talking about a proper marketing budget! especially if taking an OON approach. The copy-paste eye care marketing programs are not going to be in your best interest and can often be very expensive.
Our partner’s Roya and Done4You Marketing come into the picture here. From website, to print & digital marketing, they offer customized marketing plans for your budgets so that you can start building your patient base immediately.
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How did you hire your initial staff?
Having worked at several offices in the area, I had a network of opticians and support staff I was familiar with. I tapped into that network when it was time to hire. As a cold start, there is so much uncertainty and newness, to bring in a staff member that I already knew was such a sense of comfort. I was fortunate that the timing of hire worked out with a staff transition at another office.
Walk us through creating operations for billing, the optical, inventory, etc.
Ask those who've done it before! No, in all honesty I've been leaning on my optician who has much more optical experience than I do. She's helped to implement systems within optical, ordering and inventory.
For the clinical side, I lean on my own experiences to create and implement systems. For the business side... well that's learn as you go! There's going to be many systems that you're adjusting and learning from as you grow. When you can lean on previous experiences, whether it be personal experiences or that of your staff, it's always beneficial. But be open to adjusting systems and learning from mistakes, because there will be plenty with a new business.
What have been some of the biggest hardships both past and ongoing?
Cash Flow! My loan had initially planned for $25,000 in working capital. However, I ran into some unforeseen delays and ate up most of my working capital before even opening the doors. Cash flow, overhead expenses, start up costs, and learning how to run a successful business have made the first year financials especially nerve wracking.
Author’s Note & Financial Tips
✅ Imagine paying one of those flat fee “cold start consultants” $20-25K. Then there would be no working capital and nothing to show for it. Even though Dr. S ran into cash flow issues, she was savvy enough to avoid that pitfall!
✅ Working capital can be obtained as a piece of a practice loan or separately as a Line of Credit. Avoid using a credit card as a substitute for traditional working capital means - when it’s time to pay the bill and an interest rate of 20-30% kicks in…you’ll be feeling the pain!
✅ Always aim for a higher than expected working capital number. Ensure that you have enough to keep the lights on and payroll moving. Note that your operating expenses will be dependent on your area. Running lean in terms of operating expenses will help you immensely in keeping initial costs down.
What makes your practice unique? How do you differentiate yourself amongst a sea of competitors?
Branding and Design In the very early stages when I envisioned the type of office I wanted to have, I knew I wanted a very cohesive brand and office design. In my prior experience, most offices lacked identity. (It felt like the frame companies owned the office rather than the office owning the frames, if you know what I mean).
- I worked with a local interior design firm and branding agency to develop a brand and office design that felt incredibly unique. I stayed away from optometry design groups as I felt these could be repetitive and wouldn't be able to achieve the unique look I was going for. Without a doubt our branding and design is the most unique aspect, and it's what sets the tone for everything else.
Transparency One of my biggest frustrations with the eyecare industry is the lack of price transparency when it comes to purchasing glasses. Copays, discounts, upgrades, chargebacks, the list goes on. The reason for this confusion and complexity boils down to the many different types of insurance plans.
- By taking an out-of-network approach, I was able to rewrite the script. Being an out-of-network provider, I felt it was very important to be transparent about how we work and what our pricing is like. I wanted the patient to know what to expect before even walking in the door, and that transparency has helped to cultivate a very positive experience from start to finish. It also helps to eliminate the patients that might not be suited to our office.
- We have a set "menu" - it lists the prices of each lens type and gives a brief description. We've gone against a "good - better -best " model when it comes to lenses. We have one type of progressive and one type of single vision. The theory behind this is, we've picked the best product(s) for the patient because it's what we believe in. We make the process easy to understand and the pricing extremely transparent. It's been very well received by our patients. Here is the online service price list for patients to see
Personality With the rise of social media, we now have a behind-the-scenes look of various businesses, organizations and people. It creates a personal connection with something or someone that we may not have had otherwise. As the times change, it's important we evolve with them. When it comes to healthcare, it's important to maintain professionalism but we must realize our patients also want a personal connection. And it's a connection that no longer happens just in the office, it must be maintained online.
- As a millennial I know the importance of social media. I always knew Guild would have a good online presence, and it has evolved a lot in the last year. Learning what works, what patients respond to, what's appropriate and what's not. I will say our online presence and personality is something that certainly makes us unique. Cultivating an online presence will make you unique no matter what, but giving it a personality is what will make you really stand out. People don't want to see generic posts, they want to see you! They want to get to know you and the personality behind the office.
Local Partnerships We've done many collabs with local business, but the most notable are our lab partners. We use two labs, one located in Orchard Park, NY, a short 15 minute drive from the office. The other lab is located in Rochester, NY just an hour away from the office. Patients LOVE when they find out their lenses are made locally.
What are your plans for the future?
First, pay myself (LOL).... On a professional note, I would love to become an authority on cold starts and building an OON practice. I think we're going to see a trend in that direction over the next few years. On a business note, I would like to grow our frame lines into more niche and exclusive offerings. I would also like to build out a full dry eye/ocular aesthetic clinic.
Author’s Note & Final Thoughts
Thank you to Dr. Ashley Szalkowski for sharing her experience. It was a joy to read and I really enjoyed the transparency in your online pricing menu and sharing all the mistakes/obstacles that you made so future doctors can learn!
If you’re a successful cold start and want to share your journey for the 25,000+ ODs on ODs on Finance - please email us: firstname.lastname@example.org
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