Optometrists Building Empires

E116 · Republish. The full original E028 conversation with Nathan Hayes, director of financial services at IDOC. First aired February 20, 2025. 41:34.

The short version

Nathan Hayes works on practice financials with independent optometry owners. He also helps run Books and Benchmarks, a bookkeeping and benchmarking service from IDOC.

When an owner tells him they want a second location, his first question is always "why?"

This is the full conversation, back in the feed: what multi-location owners do well, who controls each line of the P&L, the cost targets he watches, EBITDA, what buyers pay, and why stepping back can make a practice grow faster.

If you are thinking about location two, start here.

The named problem

A second location adds complexity, stress, and risk. Many owners plan the lease and the equipment. Fewer plan who runs the first office when they are not there.

Nathan sees the same gap again and again. The title "manager" goes to the most senior person. Nobody writes the job description first.

The hidden mechanism

Your first office has to run without you before you open the second. Your attention moves to the new location. The first office has to manage itself.

Nathan wants three things in place first:

The convincer

Nathan puts practice money into buckets. One bucket is cost of goods plus non-OD staff. His historical target for that bucket: about 50% of collected revenue. Then he shows how far inflation has pushed that number.

He also explains EBITDA in plain words. Then he walks through what an individual doctor pays for a practice, what private equity pays, and why.

Numbers take the fear out

Most owners know what their practice needs. The fear shows up when it is time to spend money: the next hire, a bigger space, another doctor.

"It can take the fear out and the risk out and help people make better decisions."

And the line on why to grow at all:

"You're doing it because you want to and not because you're scared."

What to do this week

If you want help running the numbers on your next location, book time with Ankit below.

Chapters (ASR stamps, approximate)

Connect

Ankit Patel (host)

Nathan Hayes (guest; copied from the live E028 page)

Original E028 page, "Financial Insight": https://buildingempires.live/episodes/financial-insight-nathan-hayes-optometrists-building-empires-episode-028

Listen

https://share.transistor.fm/s/edbeb65d

E115 · Republish. The full original E041 conversation with Dr. Brian Samartino and Tyler Mills, co-founders of Premier Eye Associates. First aired May 22, 2025. 42:09.

What does it take to grow a cold-start practice into a thriving multi-location empire? On this week’s episode of Optometrists Building Empires, host Ankit Patel sat down with Dr. Brian Samartino and Tyler Mills, co-founders of Premier Eye Associates, to uncover their journey from opening their first doors in 2014 to running three successful locations. From overcoming early cash flow challenges to building a strong culture that attracts top talent, Brian and Tyler share candid lessons learned, including both wins and failures, like a bold neuro lens trial that didn’t pan out. Whether you're thinking about scaling your practice or refining your operations, this episode is packed with practical wisdom. 

Takeaways:

• Start thinking like a big practice early. Even if you're just getting started, approach decisions with a growth mindset. Negotiate like a larger business and build scalable systems from day one.
• Don’t grow without a solid foundation. Before expanding, make sure you have clear SOPs, strong leadership, and the infrastructure to support multiple locations. Growth without structure leads to burnout.
• Invest in your culture. Define your core values and live them. A strong culture isn’t just good for morale, it helps attract and retain top-tier talent who believe in your mission.
• Define roles and stick to them. Use tools like EOS to clearly assign responsibilities and decision-making authority. It’ll minimize conflict and help your team move faster with confidence.
• Pilot everything before going wide. Whether it's a new treatment, software, or process, test it in one location first. Learn from the rollout, refine it, and scale only what works.
• Don’t be afraid to fail. Innovation comes with risk. Embrace failure as part of the growth process.

Quote of the Show:

• “ We want to develop leaders, we want to develop people who can be better interpersonally and at work.” 

Links:

• Brian’s LinkedIn: https://www.linkedin.com/in/brian-samartino-36ba221b7/  
• Tyler’s LinkedIn: https://www.linkedin.com/in/tyler-mills-864389a0/  
• Company website: https://www.premiereyedoctors.com/  
• Brian’s Email: [email protected] 
• Tyler’s email: [email protected] 
• Simple Numbers, Straight Talk, Big Profits!: https://www.amazon.com/Simple-Numbers-Straight-Talk-Profits/dp/1608320561 

Ways to Tune In:

• Spotify: https://open.spotify.com/show/5w1H9BBwRXvBSSkexePYxG 
• Apple Podcasts: https://podcasts.apple.com/us/podcast/optometrists-building-empires/id1762685070 
• Amazon Music: https://music.amazon.com/podcasts/689a039b-54ce-4f04-b641-66d8640d93d0 
• Podchaser: https://www.podchaser.com/podcasts/optometrists-building-empires-5812208 

E114 · Republish. The full original E089 conversation with Dr. Kyle Maxam, owner of EyeDocs Family Eye Care. First aired April 16, 2026. 30:57.

The short version

Dr. Kyle Maxam started college as a business major. A talk about eye exams on mission trips to Haiti moved him into optometry.

Today he owns two locations in the Dayton, Ohio area with three associates. This is the full conversation, back in the feed: mentors, a slow two-year handoff, when to add a doctor, opening a second office, and hiring for culture.

If you own a practice and the culture feels like something that happens to you, start here.

The named problem

Most owners can see the culture problem. One teammate drags the room down. Hiring feels like a gamble. The team does not follow the change you know is right.

Kyle names the difference early: leading a team is not the same as dragging it along with you.

The hidden mechanism

Culture starts before day one. Kyle picked his first practice for the doctor who wanted to teach, not for the best numbers on paper. He learned the P&L, payroll, and the team from the inside before he took over.

He planned his second office the same way. Staff and leadership were in place and cross-trained before the doors opened. Same systems. Same equipment. Day one felt seamless.

And he hires slow. He waits for people who work hard, work well with a team, and are there to help patients.

When a hire does not fit, he does not wait it out forever. His words: "It's our job to fix that."

The convincer

Kyle treats a full book as a signal, not a badge of honor. When the schedule runs about two weeks out, he adds doctor time. Patients who wait too long go somewhere else.

Ownership is the control

He watched practices and surgeons he referred to get bought by private equity. Now he sees owners coming back to private practice. His line on it:

"We don't want someone telling us how to take care of our patients."

And the line he closes on:

"We being practice owners, we're creating the culture in the workplace. So if we don't like it, it's our own fault."

What to do this week

If you want help thinking through hiring or culture, book time with Ankit below.

Chapters (ASR stamps, approximate)

Connect

Ankit Patel (host)

Dr. Kyle Maxam (guest; copied from the live E089 page)

Original E089 page, "Creating the Culture": https://buildingempires.live/episodes/creating-the-culture-kyle-maxam-optometrists-building-empires-episode-089

Are you ready to scale your optometry practice and embrace bold career moves? On this week’s episode of Optometrists Building Empires, host Ankit Patel sits down with Dr. Harbir Sian, award-winning optometrist, practice owner, and host of The 2020 Podcast. Dr. Sian shares how he expanded from one to three clinics, navigated staffing challenges, and leveraged public education to build a strong professional brand. If you're looking for insights on growth, resilience, and thinking big in optometry, this episode is for you!

Takeaways:

• Success doesn’t happen in isolation, so surround yourself with people who provide honest feedback, even when it’s tough to hear. A reliable network of mentors, peers, and business partners can help refine your ideas and keep you grounded.  
• In a challenging labor market, bringing candidates in for trial periods allows you to quickly assess their fit within your team. This approach ensures you find dedicated employees who align with your practice's culture and values.  
• Growth requires stepping outside your comfort zone and embracing challenges that may seem intimidating at first. The biggest opportunities often come from pushing beyond what feels safe and trying new approaches.  
• Success in optometry isn’t just about clinical skills; it’s about adjusting to industry changes and patient needs. Staying flexible and willing to pivot your business strategy ensures long-term stability and growth.  
• Public education is more than just a way to give back—it’s a powerful tool for establishing authority and trust in your field. Creating content and sharing insights helps expand your reach and strengthen your professional brand.  
• Scaling a practice isn’t just about opening more locations; it requires thoughtful evaluation of community needs and long-term sustainability. Strategic growth ensures your expansion benefits both your patients and your business.

Quote of the Show:

• “ I wouldn't be where I am without the support that I've gotten from friends and family.” - Harbir Sian

Links:

• LinkedIn: https://www.linkedin.com/in/harbirsianod/  
• Clarity Eye Care: https://clarityeyecare.ca/our-practice/  
• High Street Eye Care: https://highstreeteyecare.ca/our-practice/  
•  Instagram: https://www.instagram.com/harbirsian.od/?hl=en  
• 2020 Podcast: https://www.the2020podcast.com 

Ways to Tune In:

• Spotify: https://open.spotify.com/show/5w1H9BBwRXvBSSkexePYxG 
• Apple Podcasts: https://podcasts.apple.com/us/podcast/optometrists-building-empires/id1762685070 
• Amazon Music: https://music.amazon.com/podcasts/689a039b-54ce-4f04-b641-66d8640d93d0 
• Podchaser: https://www.podchaser.com/podcasts/optometrists-building-empires-5812208