Are You Flexing the Four Freedoms of Independent Practice Ownership?

Achieving success starts with defining what success actually means. One of my favorite rubrics of success is Dan Sullivan’s Four Freedoms of Entrepreneurship. Sullivan, founder of the entrepreneurial coaching firm Strategic Coach, outlines four key freedoms that help entrepreneurs measure and achieve meaningful success:

1. Time
2. Money
3. People (Relationships)
4. Purpose

Let’s consider how all four apply to independent optometry.

TIME

The first and most important freedom to figure out is time. Show me an owner who makes more than they need yet feels chained to their practice, and I’ll show you an owner with low professional satisfaction.

As your independent practice grows, gaining control of your time requires a shift from being self-employed to becoming a business owner.

A self-employed OD is responsible for both patient care and daily operations. A business owner hires the right doctors and staff, implements systems and processes and creates accountability so the practice thrives with or without them.

Here are four tips to gain control over your time:

1. Scale matters. Most practices need to gross $1.2M or more to afford the associate OD needed to free the owner from daily patient care.
2. Delegation is an iterative process. Expect your early efforts to go poorly. Fail fast, learn lessons and delegate again. Rinse and repeat!
3. Protect strategic time. Build in a four- to eight-hour uninterrupted block each week to measure results, communicate expectations and think strategically.
4. Test operational independence. The best way to build a practice that runs without you is to step away from it. Take a vacation, block calls from your office and learn from what breaks down.

MONEY

In theory, owning an independent practice means unlimited income potential. While few owners aspire to grow to a multi-multi-million-dollar practice, higher income yields greater freedom to spend time where you want, partner with the people choose and pursue what matters most to you.

Here are four principles I see practice owners overlook in their quest to grow income:

1. Patients are everything. The surest, most reliable way to boost revenue, profit and cash flow is to grow your patient base. Simple principle. Hard to execute.
2. Cost-cutting has limited upside. Few practices have meaningful expenses that can actually be cut. Growth is more often achieved by investing more, not spending less.
3. Capacity follows demand. If you have holes in your schedule, increase your marketing budget to fill them. If you have a backlog, consider whether spending more on staff, ODs or space will get patients in sooner and/or deliver better care.
4. Revenue comes down to two core drivers, with one important sub-driver.
   • 1) Number of patients seen (comprehensive exams)
   • 2) Revenue per patient (collected revenue per comprehensive exam)
   • 2.5) Billing and collection efficiency with third-party payers (a subset of revenue per exam)

PEOPLE

The third freedom is people, though relationships may be a more accurate term. Of all relationships in a practice, employees are the ones an owner can most directly shape. If you want to enjoy independent practice ownership, this is a freedom you must flex.

You may see your reps once a quarter and your patients once a year, but your staff are with you—and your patients—every day. That proximity is what makes this freedom so powerful, and so important to get right.

Exercising it starts with clarity and consistency. Evaluate your team regularly, set clear and consistent expectations and define your minimum acceptable standards. If someone isn’t meeting them, have the courage to move on.

This freedom also shows up in how you allocate resources. Circling back to income, you can trade higher payroll for higher performance—using above-market compensation to attract A-players into critical roles like manager or optician.

And don’t forget that the freedom of people (relationships) goes beyond your in-office team.

PATIENTS

It may seem like your patient population is limited by geography, but you can still shape who chooses your practice through your services and specialties—and, just as importantly, who doesn’t.

Don’t like managing glaucoma? Consider pediatrics specialties like myopia management or vision therapy. 

Kids drive you crazy? Focus on dry eye, couture eyewear or glaucoma.

You get the idea…

PARTNERS

You also have control over who you do business with. While the internet is full of opinions on which vendors are “good” or “bad” for independent optometry, the decision is ultimately yours.

As the owner, it’s your practice and your choice.

PURPOSE

I’ll keep this one short because helping people see is reason enough to show up to work each morning.

But you can and should be intentional about why you do what you do. Maybe it’s to innovate the profession, to create income and opportunity for your team, to support a family or to spend time on missions bringing eyecare to underserved communities.

WHAT FREEDOM DO YOU NEED TO FLEX?

The point of owning your independent practice is control—ideally across all four freedoms. The next time you make time to sit down and think, assess each one. Which feels the least free?

Choose one action step, set a deadline and start flexing these freedoms in your practice so you can enjoy all the benefits of independent ownership.

Read more on professional development here.