Should You Buy or Start an Ophthalmology Practice?
For an ophthalmologist who wants to become a practice owner, there are two main options: buy an established practice or start a new one. Both paths can lead to successful ownership, but they involve very different financial and operational considerations.
For physicians considering ophthalmology practice financing, comparing the two approaches can help determine which option best fits their goals.
Buying an Established Ophthalmology Practice
Purchasing an existing practice gives a physician an operating business from day one.
An established practice may already have a patient base, employees, equipment, referral relationships, established systems, and a recognizable reputation in the community.
The buyer can potentially begin generating revenue immediately rather than waiting for a new patient base to develop.
Starting a New Practice
Starting from scratch provides much more control over how the practice is built.
The physician can choose the location, facility design, equipment, technology, services, staffing structure, branding, and overall patient experience.
The challenge is that a startup begins without an established patient base or revenue history. Building the practice can take time while expenses begin immediately.
Which Requires More Money?
There isn’t a simple answer.
Buying an existing practice requires capital for the acquisition and potentially other expenses such as equipment, renovations, professional fees, and working capital.
A startup does not have an acquisition price, but the physician may need to pay for construction, equipment, technology, furniture, supplies, marketing, staffing, and other startup expenses.
The total investment depends heavily on the specific practice or startup plan.
Buying vs. Starting: Patient Base
This is one of the biggest differences between the two options.
An established practice may come with thousands of existing patient relationships, referral sources, and a history of patient volume.
A new practice must build those relationships over time.
For a physician who wants to begin with an established flow of patients, an acquisition may have an advantage.
Buying vs. Starting: Control
A startup generally provides greater control.
The physician can design the practice according to their own preferences without having to change systems inherited from a previous owner.
An acquisition provides less control initially, but the existing infrastructure can make the transition into ownership considerably easier.
What About Equipment?
An existing practice may already have much of the equipment needed to operate.
That can reduce the need for immediate purchases, but buyers should carefully inspect the equipment before completing the acquisition. Older equipment may need to be replaced sooner than expected.
A startup allows the physician to select equipment from the beginning, although purchasing everything new can significantly increase the initial investment.
Staffing Considerations
An established ophthalmology practice may already have experienced technicians, nurses, administrative employees, and other staff.
Keeping an existing team can help maintain continuity for patients and make the transition easier.
A startup physician has to recruit and train employees, but also has the opportunity to build the team around their preferred structure from the beginning.
Location Matters
When buying a practice, the physician generally takes over an existing location or lease arrangement.
That location may already be well known to patients and referral sources.
Starting a practice provides the freedom to select a location based on demographics, competition, accessibility, population growth, and long-term plans.
How Does Financing Differ?
An acquisition has an established business with historical financial information. Revenue, expenses, profitability, and cash flow can be analyzed as part of the financing process.
A startup does not have the same operating history. Financing may therefore rely more heavily on the physician’s financial position, professional experience, business plan, projections, available capital, and overall startup strategy.
Which Option Is Better?
There isn’t one answer that applies to every ophthalmologist.
Buying may make more sense for a physician who wants an established patient base, existing revenue, employees, equipment, and operating systems.
Starting may be more attractive to a physician who wants maximum control over the practice and has a specific vision for its location, services, technology, and design.
Look Beyond the Initial Cost
The least expensive option isn’t necessarily the better investment.
An acquisition with a higher purchase price may provide immediate revenue and an established patient base. Meanwhile, a startup with a lower initial purchase cost could require significant additional capital before it reaches sustainable revenue.
Physicians should evaluate the complete financial picture rather than comparing only the initial price.
Final Thought
Buying an established ophthalmology practice can provide immediate access to patients, revenue, employees, equipment, and established operations. Starting a new practice offers greater control but requires the physician to build the business from the ground up.
The right choice depends on the physician’s financial position, professional goals, desired location, available capital, and willingness to build or take over an existing business.
