Photo courtesy of Dr. Julie Helmus
Creating a practice you can step away from
By Julie Helmus, OD
August 6, 2025
How long would you be willing to step away from your practice? How long could it function without your physical presence? The answers will reveal whether you own a business or the business owns you.
Part of the allure of private practice ownership is the autonomy it can offer — over time, place and pace. I prize my freedom; it’s been hard-fought.
I told my parents I was going out of state for the whole summer. “You should have been a teacher,” Dad replied. Escape for a season as a private practice owner? No way. They would know; both are retired optometrists who together ran a successful clinic for 30 years.
Earning My Exit: What It Took to Step Away
I believe the hardest working private practice optometrists are the solo ODs seeing patients four to four and a half days a week and squeezing practice management into the margins. Kudos to all of you out there, truly. That’s how my parents ran their clinic for 20 years before hiring their first associate.
Growth in private practice demands strategy, time, luck and above all, investment (read: risk). But the payoff is worth it. Once your practice reaches a certain size, you can build redundancy into your staffing and outsource both clinical and administrative roles. That’s how I’ve been able to step away from my practice for nine weeks each of the past three summers. (For a great read on this mindset, I recommend “10X Is Easier Than 2X”).
From 2015 to 2020, I gradually purchased 100 percent of the shares in our California-based multi-doctor family practice, ultimately paying $1.49 million — a note I’ll be carrying until 2035.
It was a big price for a big practice: more staff, more legacy systems, more problems. For years, that’s exactly how it felt. But once we hit a critical mass — revenue, headcount, a core team I could trust —and I’d reinvested in major upgrades—I could finally step back.
When the Water Is Still: Leadership Lessons from Stepping Away
A good way to test your systems is to let them operate without you. How does your team respond to an unhappy patient, broken equipment, emergency referral, pushy unscheduled rep or integration failure without you?
What about capture rate and revenue per patient? Revenue per patient on average drops from $595 to $550 when I’m gone, but my associates are on production and incentivized to prescribe to the standards of care of our clinic and trained in the art of the handoff.
Opticians receive bonuses based on capture rate and multiple-pair sales. We don’t have any zero-dollar managed care frames and our go-to lenses are all Category D PALs, high index with AR, UV and Transitions. The systems are in place.
Throughout the weeks away from my practice, I can feel my attention span lengthening. I realize that few things are urgent. I can make better decisions when I’m not bombarded by a million requests at once. Big decisions are best made with a quiet mind.
There’s a beautiful Zen proverb: “To see the moon clearly, the water must be still.”
The Practice Isn’t You — And That’s a Good Thing
A little separation is good; I realize it is just a business. Helmus Optometry is not my child nor my identity. It’s a separate, dynamic, independent entity. It will likely exist with or without me and hopefully outlast me. Practice ownership is an infinite game.
Heaven forbid some family crisis arose, I have confidence that the office can run in my absence. And my team shares that same confidence. That’s peace of mind for all of us.
Absence has made the heart grow fonder. I miss the smiling faces of my team, hustling from exam room to exam room and the connection with my patients.
Taking a meaningful break from the day-to-day preserves my commitment to remaining independent. Every year I dodge buyer inquiries. “My practice is not for sale,” I respond. Each year I stay on as owner is worth several years working as an associate.
But even that reward is not enough for many of my OD friends; private practice has high rates of burnout and everyone has a price.
Another quote I like: “When you are tired, learn to rest instead of quit.”
By checking out for the summer, I hope to maintain ownership long term.
How I Leave My Practice Every Summer
Here’s how I’ve done it: I own a second home in Washington state, north of Seattle close to the Canadian border. I am a proud Pacific University College of Optometry alum and I love the nature, moody weather and coffee culture of the Pacific Northwest.
The craftsman-style home I purchased in 2022 was affordable by California standards but still a stretch financially. It is zoned for short-term rentals, a strategic decision and managed by a professional property manager who takes 25 percent. Even though it rents frequently, the house is still in the red and therefore in my liability column. Investing in index funds would have been smarter.
However, I believe in its long-term financial potential and it’s my excuse to escape every summer. I rent my primary California residence to local families through Facebook or Airbnb while I’m in Washington.
So, what do I do up here? This is not a vacation. My two kids attend camp all summer. I’m a single mom and while they are playing in the woods with their campmates I do chores, exercise and work.
Every morning I check the company bank account, credit card accounts and the patient schedule. I monitor outstanding charts from my four providers and their patient satisfaction surveys. I review RPP, special testing, LLLT and preappointment rates by provider.
Every Monday morning I send out a weekly staff memo, as I do throughout the year. I schedule reps and trainings, respond to online reviews and monitor monthly numbers for no-show rates, open rates and warranty capture rate.
We have two new initiatives running for qualifying patients: meibography and BioAge reporting. Implementing these new procedures required scripts, a communication plan, dedicated staff trainings, EHR edits and follow-through.
It’s easy to connect with my leadership team, bookkeeper, CPA and marketing firm remotely. Every two weeks I meet with my three office managers for a four-hour leadership meeting via Zoom; we have a long-running agenda. I might be more connected with my office managers while I’m away than when I’m in office behind an exam room door.
Freedom and a Trail with Cell Service
My favorite place to field calls is from the trail. I have several loops with reliable cell service. I call my managers and colleagues. The conversations are deeper, I’m more at ease, less distracted.
I try to replace as many Zoom or Teams meetings with phone calls. I listen more and talk less (especially when I’m going uphill). I also listen to industry podcasts (my favorites are 20/20 Money and The Power Practice).
When the high-priority work is complete, I tame my inbox, complete some CE, go over notes from conferences I attended the past year and follow up on leads. I read articles on leadership and culture and share the highlights with my team.
The Practice Isn’t You — And That’s a Good Thing
I don’t take this time away for granted. If I lose a key associate or manager, I could be tethered once again to the office, just as I was when my father retired from practice, or when I dismissed my former business partner or during the pandemic. We do whatever it takes, don’t we?
Stepping away allows me to catch my breath and mellow out my nervous system. Starting next week, when I return to the office, I’ll be hustling nonstop until February. Scarcity creates value in the eyes of my patients.
Recharged, I plan to make it rain like the Washington skies.
Read another article by Dr. Helmus
Julie Helmus, OD, is a second-generation optometrist and owner of Helmus Optometry in Davis, Calif. To contact her: dr.julie.helmus@helmusoptometry.com
