“Facts do not cease to exist because they are ignored.” – Aldous Huxley
IT SHOWS UP IN CONVERSATIONS with colleagues, in quiet trade show aisles, and in the uneasy sense that optometry’s center of gravity is moving. Over the last two decades, consolidation has reshaped the landscape of private practice at a pace many now refuse to accept. And with it, the traditional sales-force model — one built on handshakes, office visits, and long-standing personal relationships — is no longer where decisions are being made.
Not long ago, I met with a senior executive from a well-known company that has served private practices for generations. He shared that his sales teams were struggling to gain traction. “We’re doing the same things we’ve always done,” he said, “but the return isn’t the same. Decisions feel more remote.”
He wasn’t wrong. The profession has reorganized around larger entities — regional groups, national alliances, private equity networks — each with its own leadership structure, purchasing philosophy, and standardization goals. Influence over frames, lenses, contact lenses, and even diagnostics has been migrating upward. And once that happens, the field reps, trade shows, and product trainings that once held the ecosystem together lose their gravitational pull.
And yet, for all this change, I still prefer private practice. Not because it’s perfect, but because of what it represents.
My first optometry experience wasn’t in a corporate setting or a national network — it was in a small office with a doctor who knew every patient by name. He knew their kids. He knew their stories. That was where I learned that optometry is, at its core, a relationship profession. Not a volume profession.
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Not an algorithm profession. A human one.
Many of you have similar stories. Think of the family that followed you through three office relocations. Or the patient who brought her granddaughter to you because “you’ve always taken care of us.”
But nostalgia cannot be strategy.
Optometry is in the middle of transition. Some want to deny it. Others resent it. But the most successful will be the ones that face it head-on.
When I talked with that executive, I told him something that applies to us all: The companies that win will be the ones that design their strategy around where decisions are actually being made, not where they were made ten years ago. For many companies, that means shifting from territory management to strategic account management.
It means building relationships not just with doctors, but with the leadership teams of emerging groups. It means understanding that influence is no longer solely in the exam lane — it’s in a boardroom, a virtual meeting, a purchasing committee reviewing standardized SKUs.
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Private practice isn’t disappearing yet, but it is evolving. And those who continue to operate independently will need suppliers who understand their challenges, honor their autonomy, and support them with new kinds of value: business intelligence, patient-experience tools, digital engagement support, and data-driven insights that help them remain competitive.
I believe deeply in the soul of private practice. But I also believe in telling the truth: the profession is reorganizing, and those who adapt will lead the next era of optometry. This is an inflection point. The question for all of us is: Will we position ourselves where it’s going, or where it was?
Optometry is still a relationship profession. The relationships are just moving. Our opportunity is to move with them.
