Photo courtesy of Dr. Thanh Mai, seen here with his team at his first location as they celebrate that office’s 10-year anniversary. Dr. Mai shares the easy-to-overlook points that you must consider to efficiently add more locations. Front row on the ground, left to right as you look at photo: Nathan Schramm and Nhi Nguyen and back row left to right: Dr. Thanh Mai, Valerie Lam and Ariel Chen.
How to efficiently add more locations
By Thanh Mai, OD
August 20, 2025
Friend: “Thanh, I’m thinking about opening another office or buying one. Any advice?”
Me: “Imagine you take a three-month vacation from your first location. Would it keep making money or collapse like a Jenga tower in an earthquake?
For most owners the honest answer is “I can’t even take a long weekend.” Some would be lucky to survive 30 days before the business flat-lines. That’s my first test before expansion. If your current location can’t run without you, opening another is like riding two bikes while juggling chainsaws.
If you’re already skipping workouts, losing sleep or grabbing dinner from a vending machine, adding another office won’t fix it. It’ll just add more vending machines.
To build a multi-location powerhouse—five, 10 or even more than 100 offices—you need more than ambition and caffeine. You need a scalable architecture that works without duct tape, unicorn employees or daily miracles.
Duplication: Same Headache, More Addresses
Most people mistake duplication for scaling. Here’s the old playbook for adding an office
- Hire an office manager and/or associate OD
- Train them to handle billing, scheduling, optical, human resources, marketing crisis management and therapy sessions
- Cross your fingers and hope it all runs smoothly
At first it works. Soon cracks appear. Each location becomes its own little island with its own rules. Staff turnover becomes a crisis. Growth slows because each new office takes as much effort to stabilize as the last one. That’s duplication, not scaling. It’s like opening a second restaurant with the same chef, same menu and the same kitchen—except the chef lives in the first restaurant.
Scaling: One Engine, Many Rooms
Now picture this. You don’t run 10 separate offices. You run one big optometric business with exam rooms on different streets. That’s the mindset shift. In a scaled model:
• One central billing team handles all claims
• One scheduling team books across locations
• One procurement team orders inventory for everyone
• Training, hiring and systems are standardized
• Team leads in optical, tech and front desk own their lanes across every location
The result? Every new office you open plugs into the same high-functioning engine instead of rebuilding the car each time.
The Myth of the Unicorn Manager
Stop hunting for magical creatures. In the old model an office manager must be good at finance, human resources, optical sales, conflict resolution, scheduling, therapy sessions and somehow everything else. Those people are unicorns—rare, expensive and when they leave, your office collapses like a soufflé.
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In a scaled model, each leader masters one function. You promote from within building deep expertise. Burnout drops, retention rises and hiring gets easier. You don’t need superheroes; you need team members plugged into a strong system. Break the manager’s job into parts anyone can master, hire for those roles and keep your empire running on process, not luck.
What Scaling Looks Like in Real Life
Three to five locations (about $4 million to $10 million in revenue)
• Central billing scheduling and marketing
• Optical tech and front-desk leads across all offices
• One integrator or operations manager running quarterly goals
Five to 10 locations
• Chief medical officer managing all optometrists
• Directors for optical, patient experience and human resources
• Call center and billing hub
• Fractional chief financial officer and a full-time chief operating officer
• Same technology stack, same key performance indicators, same training everywhere
Key principles
1. Every lead owns one lane—they don’t float
2. Shared services let you grow without duplicating overhead
3. Promote from within whenever possible
4. Think of your business as one big clinic with streets between rooms
5. Use the Entrepreneurial Operating System early to keep meeting goals and key performance indicators on track
Follow these principles and you won’t just grow—you’ll grow calmly
Final word: You Need a Management System That Can Growth With You
To scale to 100 offices you can’t rely on duct-taped management superhero managers or burnout-fueled miracles. You need a system that grows smarter as it grows larger.
Centralize what matters, specialize your team build once and grow forever. Because the goal isn’t to run more offices—it’s to run one business that happens to have a few more front doors.
Thanh Mai, OD, is an owner of Insight Vision Center Optometry, a Vision Source practice in Costa Mesa, California, Optometry Corner, a Vision Source practice in Irvine, California and Eyecon Optometry, a Vision Source practice in in Reseda, California. In addition, Dr. Mai owns Project Eyecare, a Vision Source practice, in Mission Viejo, California. To contact him: tmai@visionsource.com
