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Private practice ownership in optometry is both rewarding and daunting. In this episode of the Play Chess Not Checkers Podcast, Dr. Adam Ramsey sits down with Dr. Chris Smiley to unpack the grit, setbacks, and leadership lessons that shaped his journey from central Ohio student to multi location private practice owner, clinical professor, and mentor.
The discussion explores what it takes to succeed in private practice optometry, how to navigate externs and residents, when to invest in new equipment, and why communication, not just clinical skill, defines success in the exam lane. For eye care professionals seeking inspiration and tactical guidance, this episode delivers.
From File Clerk to Practice Owner
Dr. Smiley’s journey began humbly, filing charts for his childhood eye doctor. That role grew into lab work, cutting lenses, and eventually, optometry school. But just before his third year, the mentor who promised him a job revealed he wanted to stay solo.
The blow was devastating. Everything he worked for to be a private practitioner seemed out of reach. Yet the setback became the catalyst for independence. The lesson, grit matters more than guarantees.
Grit and Growth, The Early Struggles
In 2001, he acquired a struggling two location practice grossing under 450,000 combined. Financing was difficult, with banks demanding 20 percent down. Smiley negotiated seller financing for the gap, stepping into ownership just months before September 11 stalled patient visits.
By 2002, growth returned, proving that timing plus resilience is essential in optometry business. His advice, if ownership is your dream, prepare for curveballs, and never stop moving forward.
Hobbies, Balance, and Mental Reset
Optometry demands energy, but longevity requires rest. For Dr. Smiley, evenings on the lake or scrolling classic car auctions provide a mental reset.
I need that time to unplug, time for thought, time for thinking. The reminder for professionals, better leaders unplug regularly.
Miami to Ohio State, The Education Curveball
Originally eyeing Duke or UNC, Smiley enrolled at Miami University in Ohio before transferring to Ohio State. Twice waitlisted for optometry school, he received his acceptance call the night before classes started.
The takeaway for students, persistence pays off. As Dr. Ramsey notes, the goal is just to get in. How you get in is not how you end.
Teaching and Training the Next Generation
For 15 years, Dr. Smiley trained fourth year externs and now oversees a contact lens resident one day per week through Ohio State.
Externships can initially slow efficiency. But patients value doctors who develop the future of the profession. With the right systems, scribes, cross trained staff, and oversight, externs become assets, not obstacles.
The Resident Advantage, Private Practice Exposure
Residency programs often emphasize clinical work while neglecting private practice realities like billing and patient pay. Smiley’s residency track fills that gap, unless you learn how to help a patient say yes and how to document and bill correctly, the model will not work.
This balance of clinical rigor and financial reality prepares residents for sustainable careers.
Mastering Doctor Patient Communication
Clinical skill alone is not enough. Smiley stresses that early in his career, he studied how to say things to patients.
You can refract all day, but if you tell a patient it only changed a little, you did your whole exam a disservice.
Communication builds trust, frames value, and helps patients say yes to treatment. For optometrists, refining words is as critical as refining prescriptions.
Specialty Lenses and the Art of Differentiation
From scleral to hybrid lenses, Smiley emphasizes that niche expertise sets doctors apart. His team driven efficiency, technicians mastering insertion and removal and running diagnostics, frees him to focus on analysis and decision making.
For young doctors, the advice is clear, pick a passion niche and own it. Patients will seek you out for what only you can deliver.
Staffing, Training, and Cross Training Lessons
Turnover is inevitable, but continuity ensures growth. Smiley credits cross training as the key. We would love to have a super tech that can do everything. In today’s market, train teams so no one role becomes a bottleneck.
For practices aiming to scale, investing in people is as vital as investing in technology.
Deciding on Equipment, Needs vs Noise
Exhibit halls are full of distractions. Smiley’s rule, never buy at the show. Instead, listen to trusted colleagues, trial technology, and only invest in tools that align with your vision.
If you have to come to me, the answer is no, he says of pushy sales reps. His warning, be careful with very expensive devices that have no ongoing supplies. Some reps vanish once the sale is closed.
Navigating Vision Plans and Pay Parity
With most of his patient base on vision plans, Smiley approaches the system differently. He advocates for coordination of benefits to bridge vision and medical insurance, enabling optometrists to provide holistic care.
The challenge is not only reimbursement. It is also that some optometrists accept contracts that are too low. You have to draw a line and hold it.
Building Beyond One Location, Ownership Stories
From his first acquisition in 2001 to subsequent growth, Smiley focused on communities with momentum, patient centric service, and strong leadership. He reminds buyers to network with reps and colleagues, ask often, and be ready to move when timing aligns. Banks may say no, but creative structures such as partial seller notes can open doors.
For multi location owners, cash flow modeling must include associate compensation. A single owner operator may be able to pay more for a practice where they supply clinical labor, while a group buyer must pay another doctor and still make the numbers work.
Giving Back and Leadership Beyond the Lane
Smiley invests in students, residents, and his community. He also supports peers through teaching and speaking. In person meetings remain his favorite medium for learning and sharing, thanks to live dialogue, peer exchange, and practical takeaways.
He encourages colleagues to attend major meetings such as Academy, SECO, AOA, and Vision Expo to recharge and connect.
Looking Ahead, Succession and the Future of Practice
Over the next decade, Smiley aims to refine leadership, empower teams, and continue building in central Ohio. Succession matters, and he hopes to keep ownership local through committed associates and possibly family. The larger charge, protect private practice by planning ahead, mentoring successors, and modeling cultures that make the profession look fulfilling to the next generation.
The conversation with Dr. Chris Smiley is a master class in grit, communication, and strategic growth. Private practice optometry thrives when leaders pair excellent clinical care with clear patient communication, disciplined purchasing, thoughtful training, and firm boundaries with payers. The call to action, choose a niche, refine your words, invest in people, and plan your path to ownership with intention.
