Photo courtesy of Dr. Jeff Klein, pictured here (far right as you look at photo) with his practice partner and wife, Dr. Ann Feidler-Klein, and the practice associate, Dr. Jason Kube. Dr. Klein says the team has been proactive about seeking practice growth opportunities.
The tipping point for achieving your target practice growth
By Jeff Klein, OD
June 25, 2025
The year 2020 will be remembered by many for the upheaval caused by the COVID-19 pandemic.
For our optometry practice, it was also a pivotal turning point—one defined not only by unprecedented global health challenges, but also by bold decisions that would lay the groundwork for the most significant period of growth in our history.
Plateauing at $1.5M: The Pre-2020 Status Quo
From 2012 to 2019, our practice hovered around $1.5 million in annual collections. There were modest fluctuations—some decline from 2012–2014, a small uptick in 2017 and another dip in 2019—but no meaningful breakthrough. We believed we were operating efficiently and delivering strong patient care, but we had clearly hit a ceiling.
Our schedule was booked out three to four weeks in advance, and we had literally maxed out every square inch of our 4,000 sq. ft. office. It was clear: we had outgrown our space. To grow further, we had to invest in a new facility and expand our clinical capacity.
A Leap of Faith Amid Uncertainty
Despite the chaos of 2020, we pressed forward. In July that year, we hired a new associate doctor, and by August, we had broken ground on our new office building. These two decisions—expanding our team and committing to a new, larger space—set the stage for transformational growth.
Looking back, these choices were the beginning of our transition from a $1.5 million practice to a $2–$5 million operation. But with rapid growth came growing pains, and we quickly learned that scaling a business involves much more than just seeing more patients.
Leadership: Letting Go to Level Up
As revenue and complexity increase, so must your leadership structure. Running a $2–$5 million practice isn’t just about patient volume—it requires a shift in mindset and operations. One person (especially a doctor actively seeing patients) simply cannot manage everything.
Before the move, we promoted one of our most trusted senior staff to office manager and created a leadership team that included:
- Office Manager
- Optical Manager
- Clinic Manager
- Front Desk/Bookkeeping Manager
These were seasoned professionals, each with over seven years of tenure, who helped carry the practice through the early pandemic when much of our team was furloughed. Together, they assumed control of daily operations so the doctors could focus on patient care and strategic planning.
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We implemented weekly departmental meetings, whole-office meetings and a monthly “Doctor Download” where the leadership team updates the doctors on departmental performance and long-term goals. Issues are now resolved through a clear chain of command—staff speak to their department manager first, then to the office manager. The doctor-owners are no longer burdened with day-to-day minutiae.
Staffing: Growing the Team and the Culture
Doubling our physical space (from 4,000 to 8,000 sq. ft.) meant we also needed to expand our team. In the months prior to the move, we added an optician and a scribe. Post-move, we brought on two front desk staff, another scribe and two more opticians—growing our staff to 16.
With a larger space, departments naturally became more segmented, so we’ve taken steps to preserve a sense of unity:
- Weekly Meetings: Departmental and whole-practice meetings to maintain alignment.
- Monthly Team Goals: We set 11 monthly goals. Hitting six earns a Sonic drink run; eight earns a $25 gift card; hitting all 11 gets the team lunch.
- Team Building Activities: Potlucks, holiday parties, community events and even golf tournaments help foster camaraderie.
This structured yet fun approach to culture has kept morale high and ensured the entire team feels like they’re part of a single mission.
Cash Flow: Planning, Adapting, and Running Lean
Expansion comes with risk, especially financial. Before committing to the new building, we estimated the mortgage payment and began setting aside that amount monthly into a money market account—almost two years before construction started. This “stress test” helped us build a financial cushion and confidence that we could manage the costs.
However, we underestimated our staffing needs and the post-pandemic surge in wages. The cost of goods also climbed, which created cash flow challenges in the first two years after the move.
Fortunately, we had already adopted the Great Game of Business framework, giving our team visibility into and ownership of financial performance. We also implemented a modified Profit First system, automatically diverting 15% of every deposit into separate accounts for taxes, payroll, emergency funds and equipment repairs. This taught us to operate efficiently on just 85% of our collections, while preparing for future contingencies.
Technology and Growth: Expanding Services and Capabilities
The growth of our physical space and provider team created room for exciting new clinical offerings. Since 2020, our gross charges have increased by over $2 million, and collections are up $1.2 million.
Much of this can be attributed to cash-pay technologies such as:
- Intense Pulsed Light (IPL) and Radio Frequency (RF) treatments for dry eye
- Neurolens for patients with eye misalignment symptoms
We now screen every patient for dry eye and perform a Neurolens test on all refracted patients. Our new building includes a dedicated dry eye suite and N3 Neurolens headsets in all eight exam rooms.
These innovations not only generate revenue but also enhance patient outcomes—solidifying our reputation for offering the most advanced care in the region.
Key Lessons from Our Transition
Moving from a $1.5M practice to a $2–$5M operation has been incredibly rewarding, but it required intention, resilience and a willingness to evolve. Here are the biggest takeaways from our journey:
- Build a Leadership Team Early
Empower others to manage operations so doctors can focus on growth, patient care and vision. - Plan Financially for Expansion
Test your ability to afford major investments before committing, and build reserve funds for future flexibility. - Invest in People and Culture
Growth means more staff—but don’t lose the team unity. Foster culture through communication, goals and shared wins. - Add Value Through Technology
Offer cutting-edge services that solve real patient problems—and differentiate your practice. - Go For It
Breaking through the million-dollar ceiling requires bold decisions. If you’re prepared and committed, take the leap. The growth, opportunities and impact you can create are worth it.
This journey has been one of tremendous change—but also tremendous reward. Growth isn’t just about seeing more patients. It’s about transforming your business into a smarter, stronger, more resilient version of itself. And with the right leadership, planning and technology, it’s absolutely possible.
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Jeff Klein, OD, is a partner with Feidler Eye Clinic in Norfolk, Neb. To contact him: jklein@feidlereyeclinic.com
