Photo Credit: Getty Images. Drs. Licausi and Zilnicki share tips for planning for the new year early.
Planning for the new year in early fall
By Miki Lyn Zilnicki, OD, FCOVD,
and Jessica Licausi, OD, FAAO, FCOVD
Sept. 17, 2025
If there’s one belief that defines how we lead our vision therapy-focused practice, it is this: Proactive planning is essential for sustainable growth.
Over the past decade, we’ve learned that planning ahead is not just a good management tactic—it is the difference between thriving and just getting by.
Back to School, Back to Business: Why We Plan Early
Every summer, as our families shift into “back-to-school” mode, we treat that season as “back to business” for ourselves. Instead of waiting until December or the new year, we use early fall to check in on our practice’s overall health. This tradition started our very first year, since our opening coincided with the end of summer, and it has served us well ever since.
During this season, we check in with staff, perform annual reviews and reassess everyone’s role in the practice. By making these changes early, our team can grow into new responsibilities well before the January rush.
For example, after an early fall staff reshuffle, we saw a 14 percent increase in patient visits and a 9 percent jump in gross profitability the following spring.
The Metrics That Matter: Data Drives Our Decisions
Numbers tell the real story. Each summer, we run mid-year financials and review key performance indicators (KPIs) like profit and loss, gross versus net income, overhead and chair cost for the first half of the year. Tracking these metrics early allows us to project budget needs and confidently set next year’s goals while there’s still time to adjust strategy.
Capitalizing on Seasonal Trends
Back-to-school season offers more than chaos—it’s a huge opportunity for growth. We market our services heavily during this time, not only boosting annual recalls but attracting new patients as well.
The influx of school-age and pediatric patients gives us the profit baseline needed to reinvest in the practice for the coming year.
Strategic Investments: Technology With Purpose
As a vision therapy and rehabilitation-focused practice, staying ahead with technology matters. Right now, we’re exploring the Home Therapy Services VTS-4 Hololens, a virtual reality device that offers advanced programming for building vergence and stereopsis—but with greater flexibility than our old, stationary equipment.
Photo courtesy of Drs. Jessica Licausi and Miki Lyn Zilnicki, who are seen here with a young patient in a social media post. They share the actions they take to facilitate planning for the new year early.
On the primary care side, we’re considering an upgraded fundus camera and OCT unit to expand our medical optometry capabilities.
Investing in Team Growth
Continuing education is firmly back on our agenda. After a pandemic-era pivot to online courses, we’re encouraging more in-person meetings and team travel for workshops for our employees and ourselves. It costs more up front, but the benefits of real learning and strong team bonds always pay off in better and more innovative patient care.
Building Community, One Connection at a Time
Growth, for us, comes through community outreach. We regularly connect with local schools, pediatricians and professionals who share our patient base, like those in pediatrics and concussion care. This year, we formed a partnership with a local physical therapy office whose vestibular therapists now observe our vision therapy sessions—creating richer referrals in both directions.
We also offer and attend in-services with both current and potential referral partners to keep our network strong.
Budgeting and Forecasting (Without Fancy Software)
We keep things simple: Review our KPIs, make projections and talk frequently with our accountant, not just at tax time. Our mid-year profit and loss reports, plus updates about big expenses or income changes, help us avoid surprises and make sure we’re always prepared.
Solving for Staffing and Scheduling
Juggling two locations is our ongoing challenge. We analyze payroll trends against patient flow and look for ways to optimize staff hours between our main office and our now-busy satellite location. Sometimes this means considering expansion. Other times, it means shifting hours to make better use of our team.
Patient Feedback: The Heart of Lasting Progress
We know sharing patient successes is essential. After a recent staff meeting, we realized we weren’t consistently collecting and sharing patient testimonials and photos from completed vision therapy programs. We recommitted to making this part of our workflow, both to celebrate our patients and because these stories motivate others.
We also admit we need to get better at requesting Google Reviews. We plan to train our team so every happy patient gets gently reminded to share their story online and help us stay visible in the community.
Balancing Cash Flow and Future Investments
Planning for the future while meeting everyday expenses is no easy balancing act. We budget for major projects in a dedicated account, separate from daily cash flow, so we’re ready when it’s time for upgrades or renovations.
For example, we’re setting aside funds for a cosmetic office refresh to celebrate our 10-year anniversary.
Digital Innovation: Embracing What Works
Digital workflows make a difference. Our online system now handles confirmations, communication and billing. During the pandemic, we launched virtual vision therapy sessions—and we continue offering them for patient flexibility.
While artificial intelligence diagnostics aren’t core to our current patient base, we are eager to see how these innovations evolve and improve the field.
Eyes on the Future: Challenges and Plans
Our goals are big, just like they were when we first opened our doors. We want to expand our vision therapy technology and grow the reach of our satellite location. The biggest challenges? Staffing constraints, the rising cost of care and economic factors affecting our community.
Advice for Fellow ODs: Start Now, Not Later
If we could offer one piece of advice to fellow independent ODs, it’s this: Lay your groundwork early. Over the past 10 years, we’ve weathered unexpected challenges—pandemics, staffing changes, overlapping maternity leaves—but early, strategic planning helped us adjust and remain profitable through it all.
Regular communication with partners, associate doctors and staff about your systems and goals is key to keeping your practice on a growth track. If we had waited to plan until November or December, we would not have navigated those challenges nearly as well.
Don’t wait for the end-of-year rush. Start making next year’s plans now. Your future self—and your patients—will thank you.
Miki Lyn Zilnicki, OD, FCOVD, and Jessica
Licausi, OD, FAAO, FCOVD, are co-owners of Twin Forks Optometry and Vision Therapy in Riverhead, N.Y.
To contact Dr. Zilnicki: DrZilnicki@twinforksoptometry.com
To contact Dr. Licausi: DrLicausi@twinforksoptometry.com
