Once you see the signals that you’ve reached a capacity ceiling or you’re in a similar situation as either Doctor Six or Doctor Seven, the next question becomes when to act. Should you hire once you’re fully booked or bring someone on proactively?

Waiting until you’re booked solid feels safe. You know the demand is there, but the tradeoff is steep because it’s the reactive approach. It’s the classic “too busy to grow” trap that can impact patient loyalty and opportunities, like we’ve touched on a few times in this series so far.

The proactive approach is hiring ahead of demand. It feels riskier, but it’s often smarter in the long term. Yes, it adds short-term expense and potential cash flow strain, but it gives you time to build into the new capacity through marketing, referrals, and recall campaigns while keeping service quality high. Doctors have breathing room to connect, educate, and build trust with patients. You’re not just buying doctor time—you’re buying time for your business to scale smoothly.

If you have strong cash flow and an underutilized exam lane, being proactive is worth serious consideration, but you do not have to go all-in to max capacity right away. Start with one more doctor day per week. That alone can boost your exam capacity by 10% to 20% without increasing your rent or square footage. Plus, every additional doctor day creates roughly 14 to 20 new exam slots per week. At an average of $400 per exam, that is $5,000 to $8,000 per week in potential, or more than $300,000 per year, per doctor day, once filled.

Let’s quantify what this can actually mean for your practice: If you know your revenue per exam, your cost of goods (COG%), and your incremental staffing cost of the OD and staff (if needed), you can calculate your break-even patient volume. Most other costs, such as rent, utilities, and software, are fixed. Every exam beyond that breakeven number is pure gross profit. That’s the math that turns risk into strategy.

In our conclusion next week, we’ll review the steps you can take to reduce risk, maximize return, and take the plunge into bringing on another doctor in your practice.

Evan Kestenbaum is a lifelong entrepreneur and data geek who has cofounded and led several successful businesses within eye care. His latest project provides resources and advocacy for people who stutter. Evan enjoys spending time with his wife, Paula, in their most fulfilling role: parents to three adventurous daughters. For questions or comments about this article, please contact ekconsulting@gmail.com.

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