Optometrists Building Empires

Original solo with Ankit Patel. No guest. The short version The next big purchase for your practice is probably already on your list. A device. A new service line. A dry eye room. This episode gives you three questions to answer on one page before you sign anything. If you are about to take a demo call, start here. The expensive shelf The device shows up. The room gets set up. The team gets trained for an afternoon. Six months later it sits on a shelf. The device was fine. The order was wrong. The check came before the plan. Why it never feels like a mistake The buying process is built to move fast. Three pushes do the work: fear of missing out, social proof from forums and colleagues, and a vendor ROI sheet that looks like a plan but is a sales tool. None of the three tells you if your patients want it, who on your team will run it, or how it gets sold in your office. Those are your questions. Nobody else will ask them for you. The three questions Who is the patient, and how do they find you? Not "everyone with dry eye." Which patients already in your chairs need this, and where will new ones hear about you? Your own schedule and records hold the answer. Who owns it? One name. Who books it, runs it, follows up, and notices when it slips. A service with no owner becomes everyone's side job, and side jobs drop first on a busy Tuesday. How does it get sold? The chair script, the phone script, the price question at the front desk, and the follow-up call. Then the outside path: website, local, referral partners. Under IRS rules, eye exams, prescription glasses, and contact lenses count as medical expenses for HSA and FSA dollars. Cosmetic work does not. Check your specific service and the patient's plan before you promise it. What to do this week Pick the next purchase on your list. Fill in the one-page plan before your next demo call: the patient, how they find you, the owner, the chair script, the phone script, the marketing path, the smallest first step, and the 90-day go or no-go check. Ask the vendor one question: "What is the smallest version of this I can start with?" If you can't fill in all eight, the answer is not no. It is not yet. Connect Optometrists Building Empires: https://buildingempires.live iCare Grow: https://icaregrow.com MyBCAT: https://mybcat.com LinkedIn: https://www.linkedin.com/in/ankitpatelcvc/ Book time: https://mybcat.com/book/discovery Listen https://share.transistor.fm/s/6b564c4a

E116 · Republish. The full original E028 conversation with Nathan Hayes, director of financial services at IDOC. First aired February 20, 2025. 41:34. The short version Nathan Hayes works on practice financials with independent optometry owners. He also helps run Books and Benchmarks, a bookkeeping and benchmarking service from IDOC. When an owner tells him they want a second location, his first question is always "why?" This is the full conversation, back in the feed: what multi-location owners do well, who controls each line of the P&L, the cost targets he watches, EBITDA, what buyers pay, and why stepping back can make a practice grow faster. If you are thinking about location two, start here. The named problem A second location adds complexity, stress, and risk. Many owners plan the lease and the equipment. Fewer plan who runs the first office when they are not there. Nathan sees the same gap again and again. The title "manager" goes to the most senior person. Nobody writes the job description first. The hidden mechanism Your first office has to run without you before you open the second. Your attention moves to the new location. The first office has to manage itself. Nathan wants three things in place first: A team that does not depend on the owner for every decision. A real manager who can lead and hold people accountable. Enough cash flow to take a hit to your income in year one. The convincer Nathan puts practice money into buckets. One bucket is cost of goods plus non-OD staff. His historical target for that bucket: about 50% of collected revenue. Then he shows how far inflation has pushed that number. He also explains EBITDA in plain words. Then he walks through what an individual doctor pays for a practice, what private equity pays, and why. Numbers take the fear out Most owners know what their practice needs. The fear shows up when it is time to spend money: the next hire, a bigger space, another doctor. "It can take the fear out and the risk out and help people make better decisions." And the line on why to grow at all: "You're doing it because you want to and not because you're scared." What to do this week Write down why you want location two. Name the goal: income, free time, challenge, or impact. Add up cost of goods and non-OD staff for the last 12 months. Divide by collected revenue. Compare it to Nathan's numbers in the episode. Name the person who runs your first office when you are not there. Write their job description this week. If you want help running the numbers on your next location, book time with Ankit below. Chapters (ASR stamps, approximate) 00:00 Show intro 00:27 Meet Nathan Hayes 01:23 What successful multi-location owners have in common 03:30 Same model or a new model at each location 06:05 The common pitfall: the manager bench 08:16 Who controls what on the P&L 11:10 Scale means fighting complexity 12:49 What to hit before you expand 13:43 Three buckets and the 50% target 15:30 Why fees cannot keep up with costs 16:23 EBITDA explained 17:38 How multiple sites change the exit 20:28 Multiples: individual buyers vs private equity 21:37 Run the practice for the income it pays now 22:22 Grow because you want to, not because you are scared 25:08 Stepping back makes the practice grow faster 25:56 The two-week vacation test 28:35 Fixed overhead at scale 30:12 Doctor pay plus EBITDA as a benchmark 31:03 How to manage rising labor costs 33:16 Nathan's story 35:39 Why Books and Benchmarks exists 38:15 Where to find Nathan Connect Ankit Patel (host) - Optometrists Building Empires: https://buildingempires.live - iCare Grow: https://icaregrow.com - MyBCAT: https://mybcat.com - LinkedIn: https://www.linkedin.com/in/ankitpatelcvc/ - Book time: https://mybcat.com/book/discovery Nathan Hayes (guest; copied from the live E028 page) - LinkedIn: https://www.linkedin.com/in/nathan-d-hayes/ - Company website: https://idoc.net/ - Books & Benchmarks: https://booksandbenchmarks.com/author/nathan-hayes/ Original E028 page, "Financial Insight": https://buildingempires.live/episodes/financial-insight-nathan-hayes-optometrists-building-empires-episode-028 Listen https://share.transistor.fm/s/edbeb65d

E115 · Republish. The full original E041 conversation with Dr. Brian Samartino and Tyler Mills, co-founders of Premier Eye Associates. First aired May 22, 2025. 42:09. What does it take to grow a cold-start practice into a thriving multi-location empire? On this week’s episode of Optometrists Building Empires, host Ankit Patel sat down with Dr. Brian Samartino and Tyler Mills, co-founders of Premier Eye Associates, to uncover their journey from opening their first doors in 2014 to running three successful locations. From overcoming early cash flow challenges to building a strong culture that attracts top talent, Brian and Tyler share candid lessons learned, including both wins and failures, like a bold neuro lens trial that didn’t pan out. Whether you're thinking about scaling your practice or refining your operations, this episode is packed with practical wisdom.  Takeaways:Start thinking like a big practice early. Even if you're just getting started, approach decisions with a growth mindset. Negotiate like a larger business and build scalable systems from day one.Don’t grow without a solid foundation. Before expanding, make sure you have clear SOPs, strong leadership, and the infrastructure to support multiple locations. Growth without structure leads to burnout.Invest in your culture. Define your core values and live them. A strong culture isn’t just good for morale, it helps attract and retain top-tier talent who believe in your mission.Define roles and stick to them. Use tools like EOS to clearly assign responsibilities and decision-making authority. It’ll minimize conflict and help your team move faster with confidence.Pilot everything before going wide. Whether it's a new treatment, software, or process, test it in one location first. Learn from the rollout, refine it, and scale only what works.Don’t be afraid to fail. Innovation comes with risk. Embrace failure as part of the growth process.Quote of the Show:“ We want to develop leaders, we want to develop people who can be better interpersonally and at work.” Links:Brian’s LinkedIn: https://www.linkedin.com/in/brian-samartino-36ba221b7/  Tyler’s LinkedIn: https://www.linkedin.com/in/tyler-mills-864389a0/  Company website: https://www.premiereyedoctors.com/  Brian’s Email: [email protected] Tyler’s email: [email protected] Simple Numbers, Straight Talk, Big Profits!: https://www.amazon.com/Simple-Numbers-Straight-Talk-Profits/dp/1608320561 Ways to Tune In:Spotify: https://open.spotify.com/show/5w1H9BBwRXvBSSkexePYxG Apple Podcasts: https://podcasts.apple.com/us/podcast/optometrists-building-empires/id1762685070 Amazon Music: https://music.amazon.com/podcasts/689a039b-54ce-4f04-b641-66d8640d93d0 Podchaser: https://www.podchaser.com/podcasts/optometrists-building-empires-5812208 

E114 · Republish. The full original E089 conversation with Dr. Kyle Maxam, owner of EyeDocs Family Eye Care. First aired April 16, 2026. 30:57. The short version Dr. Kyle Maxam started college as a business major. A talk about eye exams on mission trips to Haiti moved him into optometry. Today he owns two locations in the Dayton, Ohio area with three associates. This is the full conversation, back in the feed: mentors, a slow two-year handoff, when to add a doctor, opening a second office, and hiring for culture. If you own a practice and the culture feels like something that happens to you, start here. The named problem Most owners can see the culture problem. One teammate drags the room down. Hiring feels like a gamble. The team does not follow the change you know is right. Kyle names the difference early: leading a team is not the same as dragging it along with you. The hidden mechanism Culture starts before day one. Kyle picked his first practice for the doctor who wanted to teach, not for the best numbers on paper. He learned the P&L, payroll, and the team from the inside before he took over. He planned his second office the same way. Staff and leadership were in place and cross-trained before the doors opened. Same systems. Same equipment. Day one felt seamless. And he hires slow. He waits for people who work hard, work well with a team, and are there to help patients. When a hire does not fit, he does not wait it out forever. His words: "It's our job to fix that." The convincer Kyle treats a full book as a signal, not a badge of honor. When the schedule runs about two weeks out, he adds doctor time. Patients who wait too long go somewhere else. Ownership is the control He watched practices and surgeons he referred to get bought by private equity. Now he sees owners coming back to private practice. His line on it: "We don't want someone telling us how to take care of our patients." And the line he closes on: "We being practice owners, we're creating the culture in the workplace. So if we don't like it, it's our own fault." What to do this week Write one sentence on why you became an optometrist. Read it at your next team huddle. Check how far out your schedule runs today. If it is two weeks or more, plan the next doctor day. Name one thing in your office that makes it hard for your team to take care of patients. Decide who owns fixing it this month. If you want help thinking through hiring or culture, book time with Ankit below. Chapters (ASR stamps, approximate) 00:00 Cold open 00:22 Show intro 01:28 Mentors and picking a first practice 04:06 The two-year handoff, and leading vs dragging the team 05:24 Taking over in 2018 and finding a coach 08:14 When to add an associate 10:25 Stepping back to work on the business 12:02 Going from one location to two 15:39 Staffing across two offices 16:40 Hiring slow for culture fit 18:16 When a hire does not fit 20:04 Private equity and "enough is enough" 22:18 From business major to Haiti 26:25 Advice to his younger self 27:36 Shout-outs 28:57 Where to find Kyle Connect Ankit Patel (host) - Optometrists Building Empires: https://buildingempires.live - iCare Grow: https://icaregrow.com - MyBCAT: https://mybcat.com - LinkedIn: https://www.linkedin.com/in/ankitpatelcvc/ - Book time: https://mybcat.com/book/discovery Dr. Kyle Maxam (guest; copied from the live E089 page) - LinkedIn: https://www.linkedin.com/in/kyle-maxam-24b10290/ - Facebook: https://www.facebook.com/kyle.maxam.1 - Company website: https://www.eyedocsbrookville.com/index.html - Email: [email protected] Original E089 page, "Creating the Culture": https://buildingempires.live/episodes/creating-the-culture-kyle-maxam-optometrists-building-empires-episode-089

Dr. Thanh Mai of Insight Vision Center Optometry (Costa Mesa, Irvine, Las Vegas) returns for a tactical second conversation. We get specific about what it takes to turn an underperforming practice around: why the effort from zero to one location matches the effort from one to three, where hiring and team systems create real pull, and the one part of the New Business Road Test framework that goes against common logic. He also explains why a named person still beats automation for patient attention. Episode 113 of Optometrists Building Empires.

Every practice owner has an instant answer for why their best person quit: money, a better offer, kids these days. The data and the owners who fixed it say something else. Healthcare front-line tenure averages 18 months. Some practices keep their people. The difference is system and culture, not personality. This solo episode opens with a question you have to answer out loud, then tells Nico's projection-booth story before the number lands. Real clips from Dr. Nick Lillie, Dr. Gina Wesley, and Dr. Fred Cho show what it looks like when the system owns the failure, not the person. Episode 112 of Optometrists Building Empires.

Dr. Alex Martin: Curiosity, Grit, and the Future of Eye Care Dr. Alex Martin joins Ankit Patel to discuss access to eye care, remote diagnostic technology, and the role clinicians should play in shaping new tools. He shares his perspective that remote tools cannot displace full eye exams when patients need them. He also shares how a high-school biology experiment taught him persistence and why he is learning to recognize when saying yes has become overcommitment. This episode reflects Alex's views and experiences from the August 28, 2026 recording. It makes no product-performance or clinical-efficacy claim. CHAPTERS 00:00 Optometrists Building Empires 00:27 Meet Dr. Alex Martin 02:48 A career across clinical care and technology 12:16 The access gap in eye care 17:25 Remote diagnostics and access 24:02 Clinicians shaping new tools 28:02 Learning persistence 33:27 Connect with Alex CONNECT WITH ALEX LinkedIn: https://www.linkedin.com/in/alexander-martin-od-faao-2a609ab0 ABOUT OPTOMETRISTS BUILDING EMPIRES https://buildingempires.live BOOK WITH ANKIT https://meetings.hubspot.com/ankit98/optometry-redefined

Dr. Nadia Afkhami: Start Before You Feel Ready Dr. Nadia Afkhami started sharing her experience online as an optometry student. Those connections later helped her find mentors, meet her podcast co-hosts and connect with an associate for her practice. In this conversation with Ankit Patel, she talks about starting optometry school at 29, buying into an existing practice and choosing a work schedule that fits her family. She also shares why taking the first step matters, how she asked her podcast network for help pursuing a Vision Expo speaking opportunity, and what she would tell her younger self about noticing progress. In this episode: - How sharing her own experience helped Nadia build a professional community. - Why her practice, social media and podcast belong to the same story. - What practice ownership means to her beyond adding locations. - How she approaches opportunities when she feels uncertain. - Why she values the path that brought her to optometry. Chapters 00:00 Opening 00:27 Meet Dr. Nadia Afkhami 02:05 Building an optometry community online 05:18 Saying yes before you feel ready 08:09 Starting optometry school at 29 09:25 Practice ownership on her own terms 11:20 How the practice, podcast and social media connect 12:40 Take the first step and ask for help 15:08 Her hopes for the profession 18:39 Family support and a first-generation journey 20:02 Advice to her younger self 22:28 The opportunities behind a change of plans 24:26 Connect with Nadia 27:35 Closing and Optometry Redefined Connect with Dr. Nadia Afkhami Instagram: https://www.instagram.com/eyeamdrnadia/ LinkedIn: https://www.linkedin.com/in/drnadiaafkhami/ The Depth Perception Podcast: https://defocusmediagroup.com/the-depth-perception-podcast/ Connect with Ankit Book a conversation with Ankit and ask about Optometry Redefined: https://meetings.hubspot.com/ankit98/optometry-redefined Optometrists Building Empires https://buildingempires.live

How many more hours a week does an owner spend on patient care than the associate they employ? Most owners say ten. The best national numbers put it at about two. This episode takes apart the belief behind every first-associate hire that did not work out: busyness is not demand, an associate multiplies demand but does not create it, and the number that decides the hire never shows up on a report. With real cut-ins from Dr. Carlos Grandela (Episode 092) on hiring before the patients existed versus hiring off a documented 8-to-12-week wait, and Dr. Kyle Maxam (Episode 089) on using your own patient base to fill a new doctor's column. Plus the 1962 Tusko story on scaling by the wrong input. By the numbers: owner vs employee patient-care hours 1,828 vs 1,731 (AOA 2017). Net income $172,016 vs $101,457 (AOA 2017). Seven years later $243,650 vs $156,819 (Review of Optometry 2024, n=422). Widest ownership gap: doctors 4 to 6 years in practice, $59,716 apart. One thing to count: every Monday for four weeks, write down how many days out your third open exam slot is. Under two weeks is a demand question, not a doctor shortage.

From the Optometrists Building Empires catalog. This is the Harbir Sian conversation on avoiding stagnation, first published as episode 34. Are you ready to scale your optometry practice and embrace bold career moves? On this week’s episode of Optometrists Building Empires, host Ankit Patel sits down with Dr. Harbir Sian, award-winning optometrist, practice owner, and host of The 2020 Podcast. Dr. Sian shares how he expanded from one to three clinics, navigated staffing challenges, and leveraged public education to build a strong professional brand. If you're looking for insights on growth, resilience, and thinking big in optometry, this episode is for you! Takeaways:Success doesn’t happen in isolation, so surround yourself with people who provide honest feedback, even when it’s tough to hear. A reliable network of mentors, peers, and business partners can help refine your ideas and keep you grounded.  In a challenging labor market, bringing candidates in for trial periods allows you to quickly assess their fit within your team. This approach ensures you find dedicated employees who align with your practice's culture and values.  Growth requires stepping outside your comfort zone and embracing challenges that may seem intimidating at first. The biggest opportunities often come from pushing beyond what feels safe and trying new approaches.  Success in optometry isn’t just about clinical skills; it’s about adjusting to industry changes and patient needs. Staying flexible and willing to pivot your business strategy ensures long-term stability and growth.  Public education is more than just a way to give back—it’s a powerful tool for establishing authority and trust in your field. Creating content and sharing insights helps expand your reach and strengthen your professional brand.  Scaling a practice isn’t just about opening more locations; it requires thoughtful evaluation of community needs and long-term sustainability. Strategic growth ensures your expansion benefits both your patients and your business.Quote of the Show:“ I wouldn't be where I am without the support that I've gotten from friends and family.” - Harbir SianLinks:LinkedIn: https://www.linkedin.com/in/harbirsianod/  Clarity Eye Care: https://clarityeyecare.ca/our-practice/  High Street Eye Care: https://highstreeteyecare.ca/our-practice/   Instagram: https://www.instagram.com/harbirsian.od/?hl=en  2020 Podcast: https://www.the2020podcast.com Ways to Tune In:Spotify: https://open.spotify.com/show/5w1H9BBwRXvBSSkexePYxG Apple Podcasts: https://podcasts.apple.com/us/podcast/optometrists-building-empires/id1762685070 Amazon Music: https://music.amazon.com/podcasts/689a039b-54ce-4f04-b641-66d8640d93d0 Podchaser: https://www.podchaser.com/podcasts/optometrists-building-empires-5812208