Dr. Monica Miller and her team cutting the ribbon on a new practice location. All photos courtesy of Dr. Miller.
By Monica Miller, OD
March 20, 2026
When I graduated from the New England College of Optometry in the spring of 2020, I entered the profession at a historical moment. The COVID-19 pandemic was reshaping nearly every aspect of health care, and for new graduates, that meant finding footing a profession that suddenly looked very different from what they had trained for.
What I didn’t anticipate was how quickly that footing would turn into momentum—or that within five years, I would own four optometry practices.
A ROUGH START
After graduation, I briefly worked at a private practice before taking my first step into ownership through a LensCrafters sublease inside a Macy’s. It wasn’t a glamorous start, but it was all I could afford.
Motivated to make it work, I focused on what I could control by cleaning the space, building systems and growing a patient base from scratch. At first, I handled nearly everything myself—from check-in and insurance to exam and post-op care—but hiring and payroll quickly felt overwhelming.
I hired my first technician about four months in, but much of the responsibility stayed with me. While I felt the day-to-day operations were becoming more manageable, the routine was increasingly monotonous. I needed variety.
That desire for a challenge pushed me forward quickly. Six months after opening the doors inside Macy’s, I acquired a second location, and then a third just a few months after that. It was a huge jump, pandemic or not.
The timing, however, came with one unexpected advantage. With federal student loan payments paused during the pandemic, I could save more aggressively and reinvest in my business sooner than I otherwise would have. That financial breathing room helped fuel that early growth.
BECOMING BUSINESS-MINDED
Within a year of opening my first practice, I had built a team of around 15 employees. While I was confident in my clinical abilities, business ownership and leadership required an entirely different skill set. School teaches you how to be a doctor, not how to lead people, manage a team or communicate in real-life situations.
Letting go was one of the hardest lessons. Hiring felt risky, and trusting others with what I’ve worked so hard to create did not come naturally—especially as a perfectionist.
Early on, stress often showed up in how I led my team. But over time, I began to recognize that growth required a different approach—one rooted in patience, communication and trust. I had this incessant need to be in total control until I learned that the more my practices grew, the more I had to pass tasks along.
A major turning point came when I hired a senior operations manager to oversee all four locations. I met her two years earlier when we were both technicians and joked about working together again someday. I wasn’t looking to hire a glorified babysitter. I wanted a leader who could bring ideas to the table and motivate the team. Now, that relationship anchors my ability to step back without losing control.
GROWTH THAT LETS YOU STEP BACK
Today, I no longer need to be physically present for any of my practices to function smoothly. Managers handle operations, staff members are encouraged to think independently and administrative work is largely delegated, including to virtual assistants. My team knows I’m available if they need anything, but they have it under control.
There’s this misconception that owning a practice means more work. I thought the more locations I had, the busier I’d be. But as the business grew, my workload actually lightened. But before you do any of this, you need to shift your mindset. Get away from the “if you want it done right, do it yourself” mentality and invest in the right people and systems. Growth, I’ve learned, isn’t always about doing more or packing your schedule. It’s about building something that can grow without you.
Read more on expanding your practice here.
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Monica Miller, OD, is the owner of City Eye Optometry, a four-location practice in Massachusetts and Connecticut. |
