Optometry Practice Management: Build a Strong Foundation Before You Grow

Growing an optometry practice starts with understanding what happens inside it every day. On the Play Chess Not Checkers podcast, Dr. Adam Ramsey shares how an unexpected conversation with a transportation company owner challenged him to reconsider his approach to leadership, patient experience and business operations. He was traveling to Orlando to deliver a talk, but the lesson began before he reached the stage: Sustainable growth depends on the systems, people and service already in place.

The driver who picked Ramsey up was the transportation company’s owner. After noticing that a previously frequent client was booking fewer rides, he had traveled from Los Angeles to reconnect personally and ask whether the service needed improvement. That attention prompted Ramsey to examine his own involvement in everyday practice operations.

When had he last answered the office phone, performed a patient workup or completed an optical transaction? He recalled using the front desk computer years earlier and discovering how slowly it operated. Although the machine had received IT servicing, its age still made routine tasks frustrating. He purchased a replacement that day. The experience illustrated a leadership blind spot: Problems become easier to understand when the owner encounters them firsthand.

The conversation also raised questions about the difference between the service a practice intends to provide and what patients actually experience. The transportation owner described booking rides through his own company to assess drivers’ professionalism, greetings and vehicle cleanliness. When drivers would recognize him, he asked someone else to evaluate the service.

Applying that approach to optometry, Ramsey encourages owners to examine whether calls are answered, promised callbacks happen and patients receive updates when glasses are delayed. He reviews recorded calls and message exchanges in his own practice, looking for gaps in communication. Positive reviews, he cautions, do not capture every disappointing interaction. Personal outreach to longtime patients who have stopped returning can also reveal circumstances that automated reminders never explain.

When Ramsey asked how the owner had grown his transportation business nationally, the response supplied the episode’s central idea: “I worked on my foundation before I ever worked on my ceiling.” Procedures and supporting technology came before expansion, while existing clients helped identify demand in additional cities. For optometry practice growth, Ramsey draws a similar connection between opportunity and preparation. Before choosing another location, owners should consider where their patients already live and seek services. They should also assess whether their current practice functions reliably during their absence. Unfinished orders, neglected returns and incomplete tasks can signal that the operational foundation needs attention before the business grows further.

That foundation depends as much on people as on procedures. The transportation owner sought experienced professionals with managerial qualities who could follow established systems and work independently. Within an eyecare practice, Ramsey connects that independence to staff training and clearly defined authority. Employees need written guidance on returns, exchanges and resolving patient concerns, including any spending limits. When every decision requires the doctor’s approval, repeated interruptions reflect the process leadership created. Giving staff the tools and permission to act makes those expectations more workable.

Ramsey’s closing challenge is to examine the practice at ground level: Listen to calls, test equipment and experience the pressures employees face. Stronger optometry practice management begins with leaders understanding those daily realities and building a foundation that can support the growth they want.