by William K. Vincett, O.D.
It’s easy to view hiring an associate as an expense risk, but that mindset is exactly what keeps practices from growing.
With the right structure in place, an associate doesn’t cost money—they pay for themselves by creating growth and a practice revenue stream that doesn’t rely on you being in the exam room.
When I hired my first associate, that decision changed everything. One associate became several, one location became multiple, and my practice grew to become 47th in the country in gross revenue. But the real takeaway isn’t the ranking—it’s the associate growth model I created behind it, and how I now help other owners implement it.
With an intentional plan in place, independent private practice can absolutely match or exceed corporate optometry compensation and compete for top-tier talent.
For associate ODs, it means you don’t have to default to corporate mandates and compromise your clinical autonomy to achieve your financial goals. You will also have the opportunity to craft your own practice identity and subspecialities.
But there’s a key reality on both sides—first, the associate has to pay for themselves.
That only works when the owner and associate are aligned. Owners must build a model and system that empowers associates to build their practice within a practice, and associates must step into the role as practice builders—not employees.
Here’s are the five steps to focus on:
1) Build a “practice within the practice” model.
Instead of limiting associates like in corporate optometry, give ownership over their growth. The owner handles overhead, operations, and marketing support, while the associate focuses on building their patient base, clinical interests, and revenue stream in a practice-aligned direction.
2) Create compensation that supports stability and growth.
A well-structured contract offers a solid base salary so associates can comfortably meet obligations such as student loans and living expenses, then layers in performance-based incentives that are achievable and transparently measured.
For associates, the major advantage is the opportunity to increase earnings without taking on the financial responsibilities of equipment purchases, staff salaries, rent, and other overhead costs. For owners, the benefit is reduced financial risk as the associate contributes to a growing secondary revenue stream for the practice.
3) Track performance with clear, meaningful metrics.
Use dashboards and production reports to give associates visibility into their progress. Key metrics might include total production, exam volume, average revenue per patient, contact lens fittings, and product capture rates—allowing doctors to self-manage and improve.
4) Drive growth by addressing unmet patient needs—pivot from “selling” to “solving.”
Increase revenue per patient by identifying unmet needs and offering solutions (e.g., computer glasses, polarized lenses, dry eye therapies, migraine glasses …). This shifts care from basic vision correction to overall vision wellness, improving patient outcomes while naturally increasing practice revenue.
5) Set achievable goals and align incentives with outcomes.
Let associates help define their own production benchmarks and tie bonuses to realistic, behavior-driven targets—not just volume. Regular and transparent reporting keeps performance measurement objective, removes the need for difficult evaluation conversations, and ensures that as the associate’s practice grows, so does their compensation.
Need a proven roadmap to create your “practice within a practice” model for your next associate?
Request a no-obligation consult at: https://vincett.com/contact/
