Issues in Optometry

What I Learned Over 20 Years About Pros & Cons of Having Multiple Practice Locations

An optometrist and his staff celebrate the opening of a new office with a ribbon cutting.

Ribbon cutting at one of Dr. Powell’s 12 locations. He says that, while there are substantial advantages to being the majority owner of multiple locations, there are certainly challenges that make managing multiple locations a career choice that is not for all ODs.

By Ryan Powell, OD

May 10, 2023

My second practice was added two years after my cold start. I now own the majority of the equity in 12 locations. I have learned many things since 2003 that allow us to run a strong organization today. Here are my top three pros and cons about being the founder and majority owner of a multi-location practice.

The Pros
Financial: My cash flow immediately improved when I went from one location to two. My two offices could share many of the administrative expenses and some of the diagnostic equipment. We continue to do the same today. With 12 locations, we are able to consolidate many of the administrative expenses that would otherwise be a burden on a solo-location practice. We also refer patients to centralized locations for advanced medical diagnostic tests.

Build a Regional Brand: We have been able to build a name for ourselves in our region. With a focus on differentiating our practice experience from the competition, and by being part of the larger Vision Source network, we are recognized as leaders in independently owned eyecare. Almost every week I see patients who chose our practice because they heard about us from someone who lives near one of our other locations and spoke positively about us.

Time & Practice Balance: As the practice owner, I have been able to find an enjoyable balance between seeing patients and managing the business. As we have grown, I have learned how to build a strong leadership team. I am now able to delegate projects and work alongside our leadership to continue our practice focus on constant improvement. It’s fun. I enjoy it. And the balance I have found is invaluable.

The Cons
The ability to get everyone together in one place at one time is much more challenging: We have had to create ways to be sure that we are communicating internally at a high level. We have a closed Facebook group that allows our team members to always feel connected. We have a monthly internal newsletter created by our vice-president of operations to draw attention and awareness to programs and processes. We hold weekly phone calls with employees of a specific division of the practice to engage with their colleagues at our other locations who are in the same job role. It is an ongoing challenge that we work on all the time.

Financial Risk: Acquiring practices puts debt on your books. Cold-starting a practice requires financial ramp up. You have to be a person who has an appetite for this. The stress that comes with the debt obligation is real. It’s not for everyone. I think there are many of us who would be successful and happy leading a strong one-location practice. I did not push to be a multi-location practice initially. It came to me and I accepted the challenge, but it has not been easy.

Building the Culture is More Challenging When Everyone is Spread Out. What I have found is that the culture I want in my offices only happens when I am 100 percent committed to it. I have to be present with my teams. I have to work alongside them and encourage them to be problem solvers. We hold an annual training and development event with all team members. We also hold several fun events throughout the year for them to get together. We make team t-shirts to show our organizational pride and pride for our city and communities. This has been challenging, and for many years we did not do a good job with our culture building. You have to be very committed to it.

Ryan Powell, OD, is the owner of Vision Source Eyecare, a 12-location practice in Missouri. To contact him:


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