6 Steps to Opening Your Ophthalmology Practice

Opening an ophthalmology practice requires careful planning, strategic decision-making, and a deep understanding of the healthcare industry. There are numerous steps involved in establishing a successful practice. Find below an overview of the key steps to consider when launching your ophthalmology practice.

1. Establish a corporate entity

Typically, your legal and accounting team can advise you on how to set up an LLC vs. S/C Corp. You will need to get an EIN/Tax ID as well.

2. Establish a budget

This can be tricky because we are typically not given the tools to understand pro formas and other accounting reports.

A pro forma is an excel document that anticipates your expected costs and revenue monthly and yearly. It is a great way to project costs, and you will eventually need it to secure a loan.

Some costs you will want to anticipate for your new ophthalmology practice:

  • Rent
  • Utilities
  • Equipment (covered later)
  • Office supplies
  • Medical supplies
  • EMR/technology costs
  • Data storage facility cost
  • Postage
  • Janitorial costs
  • Phone
  • Fax (key in referral and co-management)
  • High-speed internet
  • License renewals (medical, state drug and substance, DEA)
  • Malpractice insurance
  • Business insurance
  • Website development and maintenance
  • Consulting fees
I recommend speaking with other colleagues who started their practice. I had some wonderful resources who shared their pro forma with me.

3. Find a space

Location is key!

When finding the ideal location for your practice, consider the following:

  • Geography
  • Patient payer population: What does the payer mix look like in this area? Does it offer a mix of commercial, Medicare, and Medicaid?
  • Competition: Are there other ophthalmologists, optometrists, or specialists like yourself in this area? What does the referral landscape look like? Is it already saturated with ophthalmologists? Is there the potential for built-in referrals close by?
  • Physical space: For a solo practice, you may only need 1,200 to 2,000 square feet, but for multiple providers, you may need more exam rooms and space. Ideally, you would find a medical space (compared to retail spaces) for the following reasons.
  • Medical spaces: Make sure that medical spaces offer built-in sinks in the exam rooms and provide easy patient access (consider elevator/stair access and parking considerations). Oftentimes medical spaces have good visibility, with other medical practices close by.

4. Secure a loan

The financial considerations when opening a practice are tremendous. Typically, it will take $300K to $500K+ to open a new practice, given how expensive ophthalmic equipment can be.

Finding alternative sources of income for financial stability, such as doing locum tenens or moonlighting, can make the financials seem less daunting.

5. Choose communication carriers

Once you have a location, set up your email, phone, and fax. You will want to find a HIPAA-compliant email platform (ex., Outlook or Google Workspace). Voiceover internet protocol (VoIP) phone lines are more popular today (ex., Spruce or Ring Central). Doximity offers free faxing capabilities for physicians.

6. Buy equipment

Find refurbished pre-owned equipment when possible. Consider working with local ophthalmic equipment suppliers, such as Premier Ophthalmic Services or Walman Optical.

Prioritizing your equipment needs

Make a wish list, and then prioritize. For example, as a retina specialist, having a solid optical coherence tomography (OCT) machine was important to me. I also wanted to offer in-office laser treatments, so I prioritized my favorite imaging systems and laser equipment. Will you be performing in-office LASIK? Cataract surgery? Minor procedures? Consider the equipment and tools needed for each.
Consider splurging on items that will help with the efficiency of your practice for both you and your patients. I decided to splurge on ultra-widefield (UWF) photography which is one of the most important tools for a retina specialist, as it captures the retina via image capture montages and angiography.

This not only helps me, as the doctor, understand the patient’s disease state but also helps educate the patient with photos and, lastly, also to document.

Here is a list of equipment to get you started at your new ophthalmology practice:

Lane Equipment:
  • Slit lamp ($7000 to $15,000)
  • Tonometer ($1000 to $1500)
  • Chair ($5000 to $10,000)
  • Stand ($4000 to $7000)
  • Phoropter ($3000+, $8,000 to 10,000 for digital versions)
  • Visual acuity chart ($1200+)
  • Muscle light ($300)
  • Retinoscope ($300)
  • Wireless indirect ($3,000 to $4,000)
  • Computer/monitor ($1000+)
Testing Equipment:
  • Autorefractor ($6,000 to $10,000)
  • Autolensometer ($2,000 to $4,000)
  • Biometry ($40,000 to $70,000)
  • Topography ($8,000 to $12,000)
  • Optical coherence tomography ($40,000 to $70,000)
  • Visual field ($8,000 to $10,000, consider the virtual field option $200/month)
  • Fundus photography ($40,000+)
  • Fluorescein angiography ($60 to $120,000, typically includes fundus photography as well)
  • Pachymeter ($2,500 to $3,000)
  • Tonopen ($2,500 to $5,000)
  • B-scan ultrasound ($2,000 to $6,000)

6. Select an electronic medical record (EMR) provider

EMR is a huge consideration as well; when starting, I recommend going as lean as possible and avoiding signing lengthy contracts with expensive EMRs. These programs can help make your day more efficient with charting, uploading photos, and faxing letters to referrals.
The more these bells and whistles an EMR offers, the more expensive it can be. I have used Nextech in the past and loved that it combined functionality with efficiency.
For my new practice, I couldn’t justify the cost of an expensive EMR, nor did I want to sign a 3-year contract. I chose to use Office Ally for now based on recommendations from other ophthalmology colleagues. It is basic, gets the job done regarding charting, and is only $40/month without a contract. I also use Doximity since it is free with a physician profile for faxing chart notes to other ophthalmology providers and my optometric referral network.

Ready to open your dream ophthalmology practice? Browse our selection of reliable and durable eye examination equipment and services. If you have questions, call us at 855-410-7999 and join our IG here.

Reference: [https://eyesoneyecare.com/resources/lessons-in-opening-an-ophthalmology-practice-with-checklist/]