Practice Management

Solutions to Independent Optometry’s Biggest Challenges = 85% Eyewear Capture Rate

Dr. Mena with his practice team. Dr. Mena says it's important to keep both doctor and practice team well-being in mind as you serve patients and grow your practice.

Dr. Mena with his practice team. Dr. Mena says it’s important to keep both doctor and practice team well-being in mind as you serve patients and grow your practice.

Ways to lessen the burden of three major challenges in optometry.

By Vittorio Mena, OD, MS

Dec. 13, 2023

Independent optometry comes with many rewards, including giving the owner the ability to create exactly the practice they have in mind, but it also comes with daunting challenges. Here are a few challenges I am confronting, along with the solutions I found.

Doctor & Support Team Burnout

There has been a tremendous increase in mental health issues, such as depression and anxiety, in our society, including in many OD practices. This affects not only the person dealing with those particular issues, whether it’s support staff or the optometrist themselves, but patient care as well.

According to the American Medical Association (AMA), physician burnout is “a long-term stress reaction which can include the following: emotional exhaustion, depersonalization (lack of empathy for or negative attitudes towards patients) or a feeling of decreased personal achievement.”

The AMA states that the “U.S. health care system is in an epidemic with 63 percent of physicians reporting signs of burnout.” The problem comes down to the systems in which a practice operates, which will ultimately determine the outcome of burnout. Whether it is a private practice, commercial or a hospital setting, these factors play a role in burnout: the number of patients you see in an hour or total in a day, time during lunch breaks, staffing, human resources support and whether an optometrist is frequently on call.

For example, let’s say an optometrist never leaves work on time because of charting or because of low staff in the office, or brings work home. The OD is then not able to fully focus on spending time with family and doing other things they enjoy. Having a long commute and being on call for emergencies during the night can also zap a doctor’s energy. Along with causing burnout, these things can lead to physical health problems later in life.

Reduced reimbursements from insurance companies, and practices having to schedule more patients in the office to recoup “lost” wages, can take a toll on the support staff and the practice as a whole.  This can lead to staff turnover. A high staff turnover rate typically leads to a loss in revenue requiring the practice owner to continuously train new employees. A constant stream of new employees also can interrupt the quality of care and service patients receive.

Solution: Doctor burnout can sometimes be alleviated by spending more time with patients in the exam room, focusing on quality rather than quantity. Too little doctor-patient relationship time in the exam room chair can lead to misdiagnosis, malpractice or not being able to educate the patient sufficiently. You may not have time to educate them about beneficial eyewear upgrades and other important purchases, such as two pairs of glasses, a separate pair of sunglasses or an eye supplement that could improve the quality of their vision.

It’s also important to remember to hire appropriately. In addition, keep in mind that an employee needs to be passionate about whatever they are working on since mundane tasks can get boring or repetitive. Incentivize your team if they hit certain goals or tasks every month or quarterly to keep them mentally in the game. When they have something to strive for, both they and the practice wins.

Many of our staff members are either college students or young people who are taking time out from college, but plan to go back. That results in employees who may stay with us for as little as 1-2 years. To offset the stress of that turnover, we have an office culture in which the out-going employees are expected to help train the new people coming in. Our older staff members stay with our office five years, or more, on average.

Competing with Online Glasses & Contact-Lens Retailers

Patients are still frequently asking for their prescriptions, or their pupillary distances, so they can purchase elsewhere.


When it becomes difficult to match the prices from online contact-lens sellers, then the next best step is to raise your fees for your contact-lens evaluations and fitting fees. Since contact lenses are a class 2-A medical device, they need to be renewed on a yearly basis. Some practices charge more for toric fits versus spherical fits and even more if it is a multifocal fit.

Having a discussion with every patient about the advantages of having an alternative to glasses, and also giving them the chance to wear contact lenses if they have not worn them before, can potentially keep patients buying from you. If a patient were to buy both glasses and contact lenses in your practice, the practice will create happier patients while generating more revenue.

When patients do not wear contact lenses at all, we must sell them prescription sunglasses, which they can wear while driving or while soaking up the sun at the beach, reading a book.

Selling multiple pairs of glasses, or even bundling the glasses with a contact-lens package, can lead to a sale you didn’t think was possible.

Our eyewear capture rate is about 85 percent and our contact-lens capture rate is about 70 percent. We offer lower-cost options on glasses than most other ECPs in our area, so this helps us capture sales. Having a lab on the premises also helps us sustain our capture rate.

Private Equity

For many years now, private equity-backed investors have been buying stakes in eyecare practices, taking over practices nationwide, and making it increasingly difficult to compete as an independent.

It’s no mystery why PE is so interested in eyecare. The profession is almost recession proof since people will always need eyeglasses or contact lenses as well as medical eyecare. Optometric and ophthalmology services will always be needed, and the growth in the eyewear retail sector is a billion-dollar industry.

For an independent practice owner, who is on the verge of retirement, selling to PE often seems like an easy and profitable exit strategy. The downside is that the practice owner would typically have to stay on for another three years and essentially become an employee of that practice. After being a business owner all those years, it can be difficult not calling the shots anymore and having to follow someone else’s rules.

The new investors can also change how the practice flows, the days/times the practice is open and how many patients are seen within the hour. The prices of services also can change because under PE. This can potentially compromise patient care.

Solution: In life there will always be challenges, and trends continuously come and go, including PE. If you market yourself and your practice the right way, and deliver excellent patient care, you should never have to worry about the competition.

In addition to our brick-and-mortar office, we have a mobile “office” we use to travel to schools and worksites to perform eye examinations. This is a service that stands out among all of competitors, including large PE-owned optical chains.

Bottom Line

You will go far as an independent practice if you focus on maintaining an energetic, upbeat staff, offer competitive deals on eyewear and find service offerings your largest competitors have overlooked.

Vittorio Mena OD, MS, is the sports vision director with Optical Academy. To contact him:


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