Practice Management

How I Specialized Quickly After Cold-Starting & Crushed My 5-Year Goals in 3 Years

Dr. Markowski performing an intense pulsed light (IPL) procedure on a patient. Dr. Markowski says specializing quickly after cold-starting was good for patients and helped speed her new practice to profitability.

How soon is too soon to specialize?

By Allise Markowski, OD

Feb. 7, 2024

Some believe that a cold-start must not specialize too quickly. However, I found success by doing just that. Here’s how I did it.

The Practice Launch

I opened my practice as a cold start in January 2020 in my hometown of Suffield, Conn. I have been heavily involved in my community for the past 10 years, so I was able to build my practice around my reputation.

I offer routine eyecare in addition to specialized services, but from the beginning, I opened with a high-end boutique optical. I only carry independent frame lines.

I also brought in the Neurolens technology from the start, and recently invested in the OptiLIGHT intense pulsed light system from Lumenis, so I am beginning to increase my dry eye specialist clinic too!

How Much Did It Cost to Specialize Early?

I had had all three versions of the Neurolens device, so I invested over $50,000 in that technology, but my return on investment has made that decision a no-brainer

My OptiLIGHT investment was about $100,000. I had the opportunity to expand my office’s square footage in the past year, which allowed me to dedicate an entire room as a treatment “spa” in our office

The cost of the boutique optical was the price of the frames, and I slowly have built up the optical displays. Many of my displays were complimentary from frame lines such as Etnia Barcelona, Maui Jim, Silhouette and Arbor. Etnias displays are amazing! I am currently working with the Salt design team to get a display wall built in the office too!

How Long to Profit from the Investment?

Everything new that you introduce into the office takes time to feel comfortable with. For Neurolens, as soon as I got the “lingo” down on how to explain the misalignment, my confidence was boosted. I role-played with my optician for an easy hand off to make sure we were explaining the benefits the same way, without using all of the exact same words, so it came off as authentic and not rehearsed.

I also felt supported by my Neurolens rep. He wanted me to do well with the technology, and was a great coach/cheerleader during implantation.

My protocol and confidence level for the IPL has been a more bumpy road. This is a newer technology and a completely different realm of eyecare for me. Switching gears from the medical to the aesthetic side of optometry has been more of a learning curve.

So far the most successful thing we have done is have each staff member get IPL treatments, so they can talk about it based on their own experiences. I am also starting to use a dry eye questionnaire asked during pre-testing to identify patients who are symptomatic.

We do really well recommending and selling OPTASE products from our office. Their Dry Eye Kit makes for a great presentation, and people like the guidance and ease it provides with the step-by-step process for lid hygiene.

Building on a Strong Start

I want to maximize the services I offer. I am trying to increase my capture rate in the optical. I also want to keep expanding our frame lines and selection, so that it’s always new and fresh and people can always find that perfect new pair!

I will be working on finishing my spa room. I need a spa chair, and may add a device that warms up the meibomian glands for better expression post-IPL.

I also really want my associate to add a few more days, and make sure she is offering all specialized services to patients that she feels they could benefit from.

How Did You Get the Word Out About Your Specialties?

I take time with each patient to educate them about their eyes and ways we can not only improve their vision, but also their quality of life, whether that’s with a therapeutic lens, a dry eye treatment, or the best quality glasses and lenses possible. I have done a few Instagram posts, and I am working on updating my website to make it more user friendly.

I have seen an increase in my word-of-mouth referrals. Patients who have a great experience because of my modern office, with its “spa-like” feel, brag to their friends. I can tell who has been talking to their neighbors, because shortly after, all the new patients calling in will be from the same neighborhood. I am proud of the reputation I have in my community.

I love being the community eye doctor. I like seeing kids as young as six months old, and my grandmother’s friends in their 90’s and 100’s. I make sure to hand out my business card to every mechanic, landscaper and farmer so that I can feel like the hero if they get a piece of metal in their eye.

I sponsor the little league teams, and soccer teams, and make sure the Girl Scouts stop by so we can buy cookies. If I have a staff outing, it’s to a workshop at a local florist to make a seasonal arrangement, or a local brewery to support others in the community.

Being authentic and truly caring for the patients and the community sets you apart from the big-box stores and private equity. You will get a quality experience when you come to my office. I will care for you, educate you and provide the best service.

Because I knew the culture that I wanted to build in my office, and I stuck to that, I have crushed my five-year goals in three years. I have expanded my office space twice, hired an associate and taken more time off each year. I love my practice, and I don’t want to experience burnout. I want to stay passionate and love what I do each day!

Allise Markowski, OD, is the owner of Connecticut Vision Associates in Suffield, Conn. To contact her:



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