Article Date: 11/1/2009

Dream Practice, Nightmare Economy
Patient's Perspective

Dream Practice, Nightmare Economy

Learn how we started a practice in tough economic times more than 25 years ago.

By Susan G. Quinn, OD, FAAO, and Thomas G. Quinn, OD, MS, FAAO

We're in the midst of a recession. Unemployment is 9.7%. It's an intimidating environment for new practitioners.

We started our practice in this climate — not in the current "economic downturn," but in the last big economic recession in the early 1980s. Granted, student loans were smaller in 1982. But our business loan had a painful 13.5% interest rate, and like any new practice, ours took a few years to become self-sufficient.

Twenty-seven years later, we own a 3,100-square-foot facility with four exam rooms, a pretest area, two associates and a staff of ten. We made it thanks to enthusiasm and hard work, things that aren't affected by the economy.

Deciding Where to Live and Work

We dreamed of having a practice of our own, with total autonomy, offering the best care and no patient quotas. But where?

To make this important decision, we listed characteristics of our dream town, and then we listed towns that fit the profile. We looked at each towns' eye care situation, including population density, competing providers and OD-to-patient ratios.

In the end, we chose Athens, Ohio, a mid-sized college town and well-traveled county seat that could support a new practice with two ODs. We also wanted to live in Athens, because of its abundance of amenities and park space. Plus, we'd loved the location for nearly three decades.

We laid out our market research in a business plan for the bank. A month-by-month budget showed business expenses such as physical plant needs, utilities and a receptionist. We showed how the loan and our second jobs would cover living expenses, and a timetable displayed how our dependence on the loan would decline as the practice grew.

At first, patients were scarce, but we didn't let them know that! To provide the illusion of a busy practice, we scheduled patients back-to-back and once asked Tom's parents to sit in the waiting room and read magazines. To help maintain a positive vibe, we made a pact that even when patients were rare, we would always tell people we were doing great. Meanwhile, we lived modestly, following a steady pattern of growth:

■ Year 1: The startup loan helped cover business and personal expenses. Tom cultivated referrals from a local ophthalmology practice by capitalizing on his cornea and contact lens residency.

■ Year 2: Our second jobs and the practice paid all of our expenses. Susan visited case managers who helped the visually impaired in our county. This was the first step to offering a low-vision subspecialty that now draws patients from the whole region.

■ Year 3: We could start taking money out of the practice. We bought a house. Susan, who was expecting our second child, quit her second job, and Tom soon followed.

■ Year 4: Our accountant helped set up a loan from family, which we used to furnish a second exam room. We also took our first vacation!

■ Year 5: We paid back our bank loan. We were now a twodoctor practice with a steady flow of patients.

Taking the time to do our research and make a strong business plan paid off, since the real-life schedule of growth and repayment matched the plan.

You Can Do It

With no entrepreneurial experience, building our practice has felt like a pioneering journey. But even in a tough economy, our preliminary research and planning worked. We were willing to work hard and be rewarded gradually as the practice prospered. If you have that kind of passion and drive, then we suggest you go for it, too! nOD

The Quinns are founders of Quinn, Quinn and Associates in Athens, Ohio (

Optometric Management, Issue: November 2009