Eyeworld

48 | EYEWORLD | WINTER 2026 ATARACT C by Ellen Stodola Editorial Co-Director About the physicians Nicole Fram, MD Advanced Vision Care Los Angeles, California Vance Thompson, MD Vance Thompson Vision Sioux Falls, South Dakota William Trattler, MD Director of Cornea Center for Excellence in Eye Care Miami, Florida YES CONNECT "As a result, we don't think about business strategy, contractual relationships, building a team culture, patient experience, marketing, social media, and patient education. … We don't think about all the forms and materials, referral development, and visiting doctors who you hope will consider adding you to their list of options to refer patients for surgery. We don't think about how to develop doctor education programs so that the people who you work with are functioning at the level that you hope they function at. We don't think about compliance, billing, coding. … I could go on and on." However, Dr. Thompson said that one of the keys is to realize that in modern-day medicine, the business of medicine is extremely import- ant. "Yes, we want to keep our skills up," he said. "We want to be great clinicians. We want to have all the technology needed to make the best diagnoses and to rule people in and out for surgery, and of course, deliver great surgery and keep up with advancements. We all want to do what's the safest, most precise, most accurate thing we can do for our patients." This involves keeping up with innovation, which is a big job. When you want to be a good doctor, you have to hire people to be great businesspeople, he said. While doctors can also be good at busi- ness, it can be tough in modern-day practice. At first, Dr. Thompson tried to handle everything on the business side, clinical side, and surgical side of his practice, but eventually, he realized that he needed to hire others to help. That involved working with optometrists who were able to help in the clinic. While he focused on final clinical decisions and taking care of irregu- larities, they would handle workups and routine patients. "Working with great optometrists extended me, and working with great business- people also extended me," he said. "Those were things that I had in place prior to any partners, and as a result, it attracted partners." That's another important decision to make: Do you want to be in a solo practice? Do you want to be part of a big group? Dr. Thompson wanted to be able to keep up with progress, but as his practice grew, he needed more help, and this was when he started to add partners. He said that it's important to have partners who complement you. What they don't teach you about building an ophthalmology practice Some of the hardest parts of building a prac- tice are the things we barely talk about during training. We spend years preparing to take care of patients and become good surgeons. We get much less preparation for leading a team, building re- ferral relationships, or figuring out what we want our practice to look like. One of the best parts of building a practice is that you don't have to do it alone. When I think about who I'd call with a practice question, Vance Thompson, MD, Nicole Fram, MD, and William Trattler, MD, are at the top of that list. I'm grateful to each of them for sharing their experiences here and being so open about what they've learned along the way. I hope this article gives young ophthalmolo- gists a starting point for conversations we should be having more often. There's a lot to figure out early in practice, and hearing how others have approached it can make that process a little less daunting. —Alexander Knezevic, MD, YES Connect Guest Editor T hree established ophthalmologists spoke to EyeWorld about lessons they've learned in practice building, common mistakes they see, handling referrals and reputation, important business and leadership skills for success, and their advice for surgeons just starting out in practice. Vance Thompson, MD Discussing the most important lesson about practice building that training never taught him, Dr. Thompson said it gets down to the philos- ophy of what you want in life. While he noted that he didn't consider this as much in training, once he got into practice, it was important to make a decision about what practice life would look like. It helps to understand how entrepreneur- ial you are, how much risk you're willing to take, and how much security, or lack of risk, that you want, he said. "So often, people come out of training thinking it's about being a great clinician and being a great surgeon, and we're just not taught business," Dr. Thompson said.

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