Finances

Ready to Open a Second Office? Assess Finances and Logistics

By Monica Allison, OD, FOAA

Opening a second office by purchasing a practice can provide additional space and offer access to new patients, but you must first assess whether the time is right financially and logistically.

From my early days of optometry I knew I wanted to be a practice owner. I felt like buying an established office would be best, but I wasn’t opposed to opening cold. After moving to San Antonio, Texas, I began to scope out areas of town that I wanted to establish myself in. After two years of searching and making my intentions known to other ODs in town, I was given a tip about a practice that was coming up for sale. I completed this purchase and steadily grew that office for the next seven years. After we underwent an expansion and had no more room available to grow into, I began looking for other opportunities, specifically a satellite office. My second office has been open just over a year. Here is how I knew the timing was right for a second office and the lessons I learned along the way.

Before: The optical dispensary at Stone Oak Vision Source’s second office in San Antonio, Texas, which opened last year, before a major remodeling effort that transformed the space.

Project How Long to Profitability

The practice I purchased to open our second location was 28 years old. Within one year we have grown 282 percent from the previous year’s gross.

I was looking for a practice I could quickly make profitable and had an affordable asking price. I looked at current doctor coverage of the practices I was interested in purchasing versus the office hours of the locations. I also looked at billing practices of the practices I was interested in to see if they were billing medical eyecare versus vision plans only. I found that many were not maximizing billing nor doctor coverage and these factors exhibited potential to become profitable quickly by an easy change in practice habits.

Customer service has been our emphasis at my primary location, and I evaluated the level of service at the offices I looked at by visiting them and also reviewing online surveys. Poor reviews did not discourage me because I felt that changing to a customer friendly office could ultimately change the office. My theory was that if you make just these few changes and put successful systems in place, the direction of the practice could change in a dramatic way.


After: The remodeled optical dispensary at Stone Oak Vision Source’s second office in San Antonio, Texas, which opened last year.

Gain Support from Optometric Alliance to Keep Branding Consistent

I am a Vision Source doctor, so I converted the new office to Vision Source to match our primary location. Doing so enabled us to have consistent branding at both offices. Plus, people in the community surrounding the new office were glad to have a Vision Source practice in their neighborhood. I feel Vision Source’s good standing in our community contributed to our success.

Need for Primary Office Financial Health and Staff Flexibility

Make sure your original practice is financially healthy because initially the main office may have to support the new practice during its early transition. There were three doctors working at my original location so I knew we could also cover any needed days at the new office if it took a while to find an interested doctor to work there. Staff flexibility in that regard is important. It may take a while to find the right team at the new location, so ODs and support staff may need to work some days at the new office instead of, or in addition to, the primary office. Having flexible staff to cover both locations helped me tremendously in the early stages. I was only inheriting two staff members from the practice I purchased, and I needed more team members there to get the office up and running. Fortunately, I was able to send team leaders from my primary office to the new location in the beginning to get our systems and customer service standards initiated successfully.

Having supportive staff members who are up to the challenges of the new office was critical. I was able to transition a current staff member to manager at the new location, and she was able to help implement our systems quickly and got all the new team members on board.

Before: The contact lens room at Stone Oak Vision Source’s second office in San Antonio, Texas, which opened last year, before a major remodeling effort that transformed the space.

Almost every piece of equipment had to be replaced at the new office, and we had unexpected repairs on a poorly maintained air conditioning unit that came up within our first week there. This is why having a financially healthy primary office that can aid in keeping both offices afloat for the first few months of what I call the “discovery period” was extremely important and a key element to our success. I didn’t have to take out a large loan for the purchase because my primary office had good cash flow. I was able to take out only a minimal loan to allow for additional frame and contact lens inventory purchases and also to cover any unexpected surprises. The loan was small enough that the new office could cover its expense right away.

Lean on Associates During New Office Opening

My schedule at my primary office already had me seeing patients just three days per week with my associates covering the other days. The extra time in my schedule allowed me to serve initially as doctor at the new location while I searched for the associate who would be there full-time, and it also allowed time to oversee contractors, meet with vendors, and supervise the new staff and get the right mix of inventory started at the new office. Even getting the EHR set up at the new office took a lot of time, but we needed to start things out the right way so we would be on track for success. I was split 50/50 at first between the two offices, and after a few months, I was able to go to the second office one to two half days per week to do administrative tasks, as the doctor coverage is handled by my new associate there. Anticipate being at the new office every moment you can initially.

After: The remodeled contact lens room at Stone Oak Vision Source’s second office in San Antonio, Texas, which opened last year.

Get New Office Credentialed to Accept Insurance

The staff at my primary office worked tirelessly getting the second office credentialed, and we were up and running with medical plans immediately upon opening. Maximizing patient encounters with proper billing contributed to our success.

Renew Office Environment in New Office

After the purchase, we closed the new office for a week and remodeled with painting, covered the noisy painted concrete floors with industrial linoleum tiles and replaced the dated frame displays with solid oak cabinets. The total remodel cost less than $5,000 because I got the oak frame cabinets relatively inexpensively from another colleague who was remodeling her office. I wanted the current patients to visually notice a dramatic change, and have them feel that they were coming into a new and improved office. We also added computers in all of the exam rooms and added OfficeMate practice management software as it was previously a paper-based office. We invested in a billboard across from the office announcing our new look and new ownership and we sent letters to all of the current patients announcing the changes. We emphasized that there was new ownership and that the new owners were committed to quality patient service.

Related ROB Articles

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Open Cold or Buy? Weigh the Pros and Cons

Monica Allison, OD, FOAA, is owner of Stone Oak Vision Source, with two offices in San Antonio, Texas. To contact her: drmonicaallison@yahoo.com

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