Photo courtesy of Dr. Madison Barnes, who is pictured here (center) with her office manager, Elise (right as you look at photo) and her technician, Maha. Dr. Barnes says Akrinos gave her the know-how she needed to successfully launch her cold-start practice.
Launching a cold-start practice
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By Madison Barnes, OD
June 4, 2025
A few years ago, I had a pivotal realization while working at a private practice as an employed optometrist. I wanted to work in a practice of my own, with everything fine-tuned to my exact specifications.
The challenge: I didn’t know a thing about launching a cold-start practice. As luck would have it, however, I found just the solution I needed to get going in this pursuit: Akrinos and its Practice Launchpad.
The First Steps: Finding the Right Guidance
Once I had the epiphany that I wanted to open my own practice, I dove into research to determine my next steps. I began looking into consulting firms and eventually connected with Erich Mattei, the president and chief vision officer of Akrinos, who I felt a strong rapport with.
Our first phone call was in April 2022, and by August of that year, my planning with Erich and Akrinos was in full swing. We spent about two years planning and developing before I officially launched my practice in December 2024.
Creating a Roadmap for Success
Akrinos helped me create a detailed roadmap, guiding me through the process. The team constructed my business plan and financial pro forma, set up meetings with banks, assisted in finding a location and optimizing a buildout, and provided direction on what to do every step of the way. Alongside Erich and Akrinos, I collaborated with other advisors and partners they introduced me to including optical consultants, attorneys and other specialized professionals.
The Importance of Location
Finding the right location was a significant challenge that took six months. I wanted a spot with high foot traffic and good visibility in an affluent area of Atlanta, which Akrinos’ analyses and advisory delivered! Once I narrowed down my options, I had to consider size and rental costs. I didn’t want a space that was too large, so we laid out the financials and geo-spatial analyses to understand what I needed to bring in to break even and how we would make it happen in that market.
Our practice is located in Sandy Springs, just outside of Atlanta, and we’re attracting patients from all over the city thanks to our presence on Zocdoc. This affluent area tends to have patients who are willing to spend more, so it’s a great fit for my practice vision.
A Boutique Experience
Ultimately, I aim to create a high-end boutique-style optical practice.
However, as I work toward that goal, I am supplementing our offerings with brands that cater to patients reliant on insurance, such as Eyemed and VSP. Akrinos got me credentialed in a timely manner and established fees and pricing for my practice based on analytics form my local market.
Akrinos advised me that while vision insurance can be a helpful tool, it shouldn’t dictate my business model. Instead, I should use it to attract patients and then focus on secondary sales.
My goal is to eventually drop insurance plans, which would allow me to lower prices since insurance companies typically take a 40% cut into an OD’s profit. I plan to communicate to patients that by dropping insurance, I can offer them better prices without compromising quality. Akrinos has provided the analytics and strategic plan to make this possible for my practice, along with the marketing mix and strategy to grow my practice in accordance with my vision.
Progress: A Steady Climb
The journey has been a gradual one—some days my office is bustling with activity, while other days are quieter. However, considering that I am just starting out, I feel fairly content with our progress.
I continue to work with Akrinos, and nearly six months after our opening date, we continue to sit down monthly to review statistics in the Practice Pulse. In this monthly coaching session, we compare our performance to national averages and explore ways to refine different aspects of the practice and business plan, increasing the likelihood of a successful first year. Akrinos provides me with the guidance, business goals and accountability to grow with confidence.
Expanding the Team
Akrinos has set my practice up for success as we grow, providing everything I need for human resources— organizational chart, job descriptions and standard operating procedures; employee handbook, code of conduct and management tools; localized compensation and employee benefits; staff on-boarding guidance, training and development tools, and more.
Currently, I have an office manager and a technician, with the office manager also performing optician duties. As we grow, I recognize the need for additional staff—a full-time optician and technician. I’ve been reviewing resumes and analyzing national averages for salaries to determine what makes sense based on my projected income.
Future Aspirations: Expanding Services
I would love to add an associate in a few years. I have an empty exam lane that I plan to use for aesthetic services, such as optometrist-approved lash extensions. Akrinos provided me with the financial forecasting tools and guidance on how to make this happen in a few years’ time.
I’m also exploring partnerships with ophthalmologists to offer Botox and fillers in an additional exam lane. We have a 10-year lease on our office space, and I envision renting out the room to specialists.
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Focusing on Quality Over Quantity
My focus is on growing our current offerings while moving into aesthetics, IPL and high-end optical services. I want to create a tailored experience for our patients, emphasizing quality over quantity, and Akrinos is helping me do that.
It’s essential to reflect on what I love about optometry and why I pursued this path in the first place, independent of financial motivations. This vision will guide my practice’s growth.
Genuine Connections Matter
Throughout this process, I’ve spoken with various firms, but what stood out to me about Akrinos was Erich’s genuine excitement for my vision. He wasn’t just looking to close a business deal; his enthusiasm felt authentic. This connection to Erich and Akrinos has been invaluable as I work to bring my dream practice to life.
Madison Barnes, OD, is the owner of See and Be Seen in Sandy Spring, Georgia. To contact her: mbarnesOD@gmail.com
