Too Old To Start Cold? I Think Not!

In the eleventh installment of the Cold Start Series, Dr. Stewart shares the benefits of cold-starting at any age.

One of the biggest comments I hear from doctors who are interested in opening their own practice is, “That sounds great, but I am TOO OLD!” If you have been following along for the past year, I have detailed my journey through cold starting my practice, Look New Canaan, in February 2024. I did this at…drumroll please….age 43! While I joke that this was not something I had on my early 40s bingo card, I couldn’t imagine doing it successfully at a different time or a younger age.  

While cold starting is daunting at any age or career stage, I feel there is so much value that comes from experience. As a new or newer practitioner, we are so consumed by clinical care and becoming good doctors. We are constantly learning new techniques and skills, fine tuning our diagnostic abilities, and becoming more efficient. We are fine tuning our communication and messaging, and we are becoming better at what questions we ask our patients and what to do with that information. While it takes time to become a good doctor, it also takes time and growth to become a good business person as well.

When I think back to myself as a new doctor and compare myself to the person I am now, there are definitely some ways that age and wisdom are on my side. Here are my top three:

  1. Confidence. One of the biggest skills we learn as practitioners is the confidence to make decisions and stick with them. As students, we have our preceptors to ask for help, and they are ultimately the decision makers when it comes to clinical care. As we go along in our careers, we gain the necessary skills to filter information well and make a clinical decision based on our experience.

    As a business owner, this happens to us as well. It can be so easy to second guess every decision you make in a cold start — and there are lots of them! We are fortunate to have so much information at our fingertips, in online journals, publications, and social media groups, but it can be overwhelming at times and lead to decision paralysis. Here is where age and experience can be a HUGE benefit in a cold start. The longer we have been in practice, the more varied our roles have been and the more we have been exposed to. We can take that information and filter out what we think is important, and then we can use that to make better, smarter decisions. Without the experience I had had as a clinician and business owner, cold starting would have been much more difficult. I am more confident in the decisions I have made, and now with a year under my belt in a cold start, those decisions continue to get easier.
  1. Know What You Like and Build a Business Around That! One of the parts of optometry I love the most is the wide, varied careers we can have. How lucky are we that there are so many opportunities we have to work with patients — different practice modalities, specialties, products, and solutions. After being in practice for 17 years, there are definitely aspects of optometry I enjoy more than others, and in cold starting, I had the opportunity to design and build a practice around that. It can be very hard to do that without the experience of figuring that out. There can also often be FOMO (“fear of missing out”) in practice, and many of us feel that because we CAN offer a service to our patients, we NEED or HAVE to, or else we are somehow failing them or failing ourselves. I’m here to tell you that having the wisdom to finetune what you enjoy doing and building your practice around that is a much more enjoyable route — instead of feeling like you are fitting a round peg into a square hole. Other benefits? Patients immediately can sense when you enjoy what you are doing, which is a huge practice builder (especially for new practices!).

    It also becomes easier again to make decisions (sensing a theme yet?) when you are true and honest about the type of practice you want to create. Do I need that piece of equipment? Instead of thinking about the revenue it MAY bring in, or the lost opportunity of something, I first ask myself, does this support the type of patient care and practice I am creating? If not, then I make the decision to move on — no second guessing needed! Being deliberate and specific is incredibly freeing. But I needed all these years in practice to get me to this point!
  1. Family/Work Life Balance. This may be the most important, personal reason doctors have for either wanting to cold start or hesitating based on life timing. I have spoken to many practitioners who cite this as one of their biggest question marks with starting a practice — is it possible to balance family life and a new business?

    I am the mom of two young boys (12 and 9) and this weighed heavily on me as well. I sold my former practice in 2022 to free up time to do consulting and speaking, but also spend time with my family. I enjoyed being a “room mom” and taking them to sporting events, going to their concerts, and being home on their days off. I, like many of you, was concerned how that would all change once I opened my new practice. Would my “new baby” take all the time away from my family, and how could I manage that all, especially at the ages they are now?

    As someone who had previously bought into a busy, successful practice, I had no experience with the schedule of a cold start. One of the unintended benefits of a slower schedule is that I don’t have to choose between my family and my practice — I can actually choose both. I have fully embraced slower days in our first year. Instead of panicking, I took the opportunity to leave the office a bit early and take my son to swim practice. I am also able to block out the schedule in advance for things I don’t want to miss because there are no pre-appointed patients (this year!). One of the main reasons I have been a business owner for almost my whole career is that I have always prioritized flexibility. While I don’t mind working extremely hard, I also value my time away from the office, and find that self-employment has been key to this. It also has become more important to me in this stage of my career (and family!).

    While it can be difficult to separate work from home, I put some strict rules in place for myself. Unless something is urgent, I try and leave my computer in my bag for the weekend and not work on anything practice related. I use all the spare moments I have during the day between patients while I’m in the office to get as much done as possible so I can be present with my family when I am home. 

    However, one of the fun benefits that comes with a family-owned business is that my boys are extremely interested in what happens at Look! They love to find out what frames we sold that day and are extremely proud of the business. They came on site visits and contractor meetings and watched the construction process, so they also feel a sense of ownership and pride in what we have created. There is always worry that our practice will take away from our family life, but there are ways that it can enhance it as well.

As I enter my 18th year (!) of practicing optometry at the age of 44, I am incredibly proud of what I have accomplished. It can be very daunting to take a huge career leap at any age, but especially at a time that many of us have gotten comfortable in our situations. While cold starting involves a lot of time, effort, and work, there is no right or wrong time to start a business. I even argue that the time when many feel they are “too old to open cold” is actually the best time of all.

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