Managing Multiple Practices

Thursday, May 7 2026 | 08 h 06 min | Optik Magazine, Practice Management

By Dr. Diana M. Monea, OD, FAAO, MHRM

Developing, growing, and sustaining three optometric practices, one in Regina, Saskatchewan and two in Calgary, Alberta, Canada, was not easy. As a wife, mother, and early woman entrepreneur, I faced the demands of raising a family, which significantly complicated practice management. Life–work balance is an ever-changing dynamic.

It requires a clear vision of what you want, with great personal sacrifice. Even with that, the daily roles of motherhood and business constantly overlapped and changed with the pressures of staff issues, finances, regulatory changes, technical updates, and family demands. Creeping doubts of loneliness and insecurity made it challenging to exist and thrive while straddling the balancing act of work and life.

Mentorship with Practices

Assisting colleagues across provinces presented unique challenges due to regional differences and practice dynamics. The consistent goal was to maintain high-quality patient care and customer service, ensuring that patients were satisfied, returned for follow up care, and referred others. The objective was to build sustainable practices rooted in patient retention. To support this effort, the approach relied on proactive, well-defined communication, clear objectives, and ongoing mentorship. Achieving this required strong relationships built on trust and close collaboration with key leaders at each practice location.

Financial and Operational Issues

Continual surveillance of finances and operational challenges for each practice involved ongoing review and decision-making, with the most urgent issues receiving priority. Ways to incorporate new revenue streams are imperative and ever-changing as the scope of optometry expands. Equipment repairs, compliance issues, cybersecurity, insurance changes, and privacy issues all trump daily operations with heightened concern. Technological transformations are constantly in flux. New accounting and EMR systems, with updates, require significant capital outlay with careful planning. New practice modalities to generate alternative income are necessary as the scope of practice constantly evolves, requiring ongoing review with new capital outlay. Facing these day-to-day challenges requires experience and even trial and error when making decisions amid the stress of balancing costs with exceptional patient care.

Decision Regarding Provincial Jurisdictions

Jurisdictions vary between Alberta and Saskatchewan with respect to licensure, billing, and scope-of-practice requirements. Continually monitoring, updated education requirements, and communication with regulatory bodies are crucial for protecting patients, staff, and practice quality.

Addressing Family Needs

Work-life balance is constantly in flux. Sick children and unexpected life tragedies can catastrophically erode and destroy even the best-developed plans. Unpredictability is every entrepreneur’s worst nightmare, but a reality that must be carefully considered. Managing multiple practices can create chaos, especially during emergencies. These situations require flexibility, support networks, and delegation within a closely webbed network.

Dealing with Imposter Syndrome

When referring to all forms of social media, from Instagram to LinkedIn, it is easy to be overwhelmed with feelings of inadequacy. Entrepreneurs may question their ability by comparing themselves to others. It is imperative to remember that confidence grows through reflection, discussion with mentors, and taking time to celebrate progress and all achievements.

Methods for Surviving Challenges

It is critical to have a solid structure with trusted people whom you can delegate to. Prioritization is a vital tool for weighing the urgency of what needs to be done versus what can be delayed, depending on circumstances. Urgent tasks trump day-to-day routine. It is only by building strong, supportive teams and fostering genuine care among dedicated, long-term staff that a manageable work life balance can be facilitated. Entrepreneurs must acknowledge feelings of needing assistance without seeing it as a weakness. This help is often readily available from mentors, colleagues, or family. Vulnerability and the acceptance of its limitations are necessary survival skills. Even more important is setting aside intentional time for reflection, exercise, or simply embracing family moments to create everlasting memories, experiences that really matter. Long term well-being is essential, and it matters most when managing a business during these current unsettled times.

Takeaway of What Really Matters

The key takeaways: Success is measured by practice culture, dedicated staff, loyal patients, and individual fulfillment. Challenges will always be there; running any business requires careful balancing of a well-thought-out perspective and cautious preparation. Perseverance, in difficult times, involves “one foot in front of the other” with strategizing and reformatting, and a clear conscience to “never give up”! Entrepreneurs must remember that perfection does not exist. Life throws unexpected, disruptive curveballs. Only resilience, coupled with adaptability, will build a legacy in a career rooted in strong family values and traditions.

Finally, building one or multiple practices involves giving your best effort with a firm commitment to self-awareness, while asking for support on a journey to create a dynamic practice that stands the “test” of time.

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