By Dr. Trevor Miranda. 

Dr. Miranda will be regularly contributing his thoughts and perspectives on the topic of Independent Eye Care Practice in Eye Care Business Canada.

In life and at work, we can often think it is easier not to think of something to avoid having to use the scarce resources of time and energy to properly deal with the task at hand.

For me, it’s organizing my closet or cleaning the garage. I cope by putting it off but every time I open my drawers I am reminded that it needs my attention (I finally did tidy the garage and I feel so much better!).

My stress could be reduced by just stopping the avoidance of these tasks!

Multi-tasking Owners are Challenged

Independent optometric owners have to juggle many responsibilities. Marketing, human resources, inventory management, cash flow, financial statements, scheduling, tax planning, budgeting, equipment purchasing and maintenance, product information, staff training, patient experience, E-Commerce and many other duties can easily overwhelm the minds of optometric owners.

Beyond that, the responsibilities of continuous learning on glaucoma, macular degeneration, vision therapy, low vision, myopia management and primary eye care further compete for optometrists’ time and energy.

Wearing all these hats is very challenging and often leads to avoidance coping.

Avoidance coping is a maladaptive form of coping in which a person changes their behaviour to avoid thinking about, feeling, or doing difficult things.

Stress Management versus Stress Avoidance

Avoiding stress might seem like a great way to become less stressed, but this isn’t necessarily the case.

More often than not, confronting a problem or dealing with a stressor is the only way to effectively reduce the stress it causes.

We strive for “stress management” rather than “stress avoidance”. Usually, procrastination or trying not to think of the stresses leads to further stress and increased frustrations. Actively managing stress is a more healthy and productive strategy.

Ways to Manage Stress

Delegate (don’t abdicate):
Delegation of duties is an effective way to distribute responsibility and accountability.

Effective delegation requires structure and training. It is important that there is oversight of delegated tasks.

This means using “SMART” goals: Specific, Measurable, Attainable, Realistic, Timelines.

As an owner, it is important to be briefed regularly on the status of a particular portfolio. For instance, delegation of marketing in your practice should include a regularly updated budget and a yearly marketing plan with regular reviews at predetermined intervals.

There are task management applications that can assist in overseeing these delegated tasks; examples include and Trello.

Delegation of tasks can be divided among the entire team rather than residing as the responsibility of the office manager. For instance, one staffer can be in charge of outstanding accounts; another in charge of ordering supplies.

We utilize Slack to assign tasks that combine communication to both assignee and assignor until task competition. The management of outstanding tasks allows compartmentalization of these potential stresses and combats avoidance.

Cultivation of empowerment in each team member to be part of the solution is important to stress reductions and better office functioning.

The culture of not passing the buck or saying “that’s not my job” is crucial to a shared responsibility and accountability. This helps reduce the burden and decrease potential stress.

Leaders guide their businesses in a directional way. Avoiding micromanaging will reduce stress.

It is important to quickly address large issues but avoid managing each and every mistake. Resist the urge to point out every mistake as this can be demotivating and depressing while adding stress on both sides.

If something is particularly bothersome, ensure you are not actively frustrated and address the issue in private with the appropriate compassion and honesty. Collaborate on ways to improve with training and feedback. Getting buy-in is crucial.

Avoiding difficult conversations will only add to stress levels. It is better to act like the CEO of your optometric business. Guide the ship through small directional maneuvers rather than being stuck in reflexive reactions in day-to-day events.

Another way to help manage the myriad of responsibilities is to outsource to experts.

Companies offer marketing, human resources, accounting, and even optical dispensary management where experts take on the responsibility and reduce the owner’s stress load.

Don’t avoid the necessary time it takes to manage these areas properly. Use outsourced experts that are accountable for results and preset timelines.

I remember when I started my first clinic. I answered the phones, did the accounting, cleaned the office and helped in frame selection.

All of these duties are currently not my direct responsibility. It is important that you change as you grow.

Learning the business by doing it yourself is great if you’re capable, enjoy that aspect of business and have the time to do it.

As your business grows your management techniques need to adapt. With five clinics and a growing team, I know that I must adapt to actively manage stresses rather than avoid them.



Dr. Miranda is a partner in a multi-doctor, five-location practice on Vancouver Island.

He is a strong advocate for true Independent Optometry.

As a serial entrepreneur, Trevor is constantly testing different patient care and business models at his various locations. Many of these have turned out to be quite successful, to the point where many of his colleagues have adopted them into their own practices.


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When the decision to sell is made, one is thinking from the logical, left-brain side of the mind. There are numerous practicalities to take care of and the owner knows that selling will help achieve personal goals. However, deciding to sell can be difficult and many cannot imagine things could become any more difficult. But they can. Selling a practice is fraught with a myriad of emotions.

The Emotional Peaks
We know selling a practice is always emotional. We do remind our clients though, that there are two particularly challenging periods once the listing agreement is signed. The first is while we wait for offers to come in and the second is while we wait for conditions to be waived.

During the initial stage of waiting for an offer, one cannot help but feel exposed. After all, potential buyers are reviewing your information and deciding if this is a good opportunity for them.

A vendor cannot help but feel as if he/she is being judged. When an offer does not come quickly, the owner asks, “why is my clinic not good enough”. Of course, it is good enough. In fact, it is a good option, but it must be the right option for a particular buyer.

Any time in life when we are waiting on someone else to make a decision that affects us, it is very difficult, it makes us doubt ourselves and why our practice has not been chosen. As a vendor, it is critical you remember that you cannot appeal to everyone. And that is truly okay.

Offer Anxiety
There is always the right buyer for your office, and it is impossible to appeal to all. It may take time, but the key is not to second guess everything that is or is not happening. Your practice is unique, and the right buyer will have their own unique set of circumstances that make them the right fit.

For many owners, the first emotions experienced around the offer for the practice will be excitement, exhilaration, and pride.

The fact that there is a buyer for your office validates that you have created something of value and your clinic is wanted. As such, once an offer has been placed, many start to celebrate. We encourage owners to simply wait.

It’s Not Over Until It’s Over
Even with an offer being accepted, there are still hurdles that the purchaser must over come.

The toughest two are financing and assigning of the lease. Financing is certainly more difficult during this pandemic. Largely because bankers are scrutinizing the purchasers far more than pre-COVID days. They want to ensure when they grant a loan that they have confidence in the buyer.

The assignment of the lease can be challenging for many reasons – for example if an owner has had a difficult relationship with the landlord over the years, the landlord may not be willing to be so co-operative. Perhaps during the assignment of the lease, the purchaser may use this opportunity to ask for things that may not be granted.

Should any condition not be met, unfortunately, the offer becomes void, and deposit is returned. This is difficult for the vendor as now things start over.

This does happen but it does not mean your practice will not sell. You just need to be patient. The right buyer will be motivated and never stray from the motivation that drew them to your practice initially.

Transition Stress
Another stress a vendor may not be prepared for is the actual transition once all the conditions have been removed and the closing date is in sight.

It is normal to start to question the initial decision to sell. Is it right for your staff and patients? How will things run once it is in new hands? How will the owner really fill their time after the sale?

A sale brings up strong emotions particularly when an owner has been owning and operating for many years. If the vendor stays on, the realization that new management is now in place and that a say in the day-to-day decision making is no longer part of their responsibility.

Many do not realize how a large part of the vendor’s identity is tied to the clinic.

Rest assured that these thoughts and feelings are normal. Preparing ahead of time is the best way to handle the emotions connected to selling your practice.

While some doubts and fears are normal, preparation and planning for what life will look like post sale, will help an owner navigate the transaction as smoothly as possible.

Jackie Joachim, COO ROI Corp


Jackie Joachim is Chief Operating Officer of ROI Corporation. Please contact her at or 1-844-764-2020.


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