Power Hour Optometry Podcast Summary

Episode: Multi-Location Optometry Growth: Systems, Leadership Layers & Cold Start vs Acquisition

Host: Eugene Shatsman, The Power Practice
Guests: Dr. Susie Lake, Kevin Whaley
Date: January 16, 2026

EPISODE OVERVIEW

This episode dives into the complexities, pitfalls, and strategies of growing an optometry business from a single location to multiple sites. Guests Dr. Susie Lake and Kevin Whaley share vivid, hard-earned lessons from expanding their own practices—Lake from one to six locations near Kansas City and Whaley from one to nine in Florida, using both cold starts and acquisitions. They discuss systems, leadership, bottlenecks, and how to recognize when you're truly ready to scale. The conversation is rich with practical advice, honest reflections, and memorable anecdotes about what breaks as you grow, and what to put in place so your "wheels don’t fall off" as you hit that three-to-four location mark.

GUEST BACKGROUNDS ([03:25]–[04:39])

Dr. Susie Lake

• Co-owner of a six-location primary care practice outside Kansas City, MO. Also runs a specialty vision therapy office.
• Responsible for operations, HR, and systems during expansion.
• Took about 15 years to grow from one to six locations.

Kevin Whaley

• Master optician, business-side leader, partnered with an optometrist in 2010.
• Expanded from one location with three employees to nine locations (a mix of cold starts and acquisitions), mostly since 2020.
• Location and team culture varied; significant growth occurred within a few years.

“We learned along the way as we attempted to do that second location... a lot of learnings happened in those first locations.” — Kevin [05:31]

GOING FROM ONE TO TWO LOCATIONS: LESSONS AND MISTAKES

Motivations and Early Challenges

• For both guests, a combination of opportunity and necessity drove their second location—with less strategic planning than they’d now recommend. ([06:28]–[07:27])

Cultural & Team Considerations

• Satellite vs. Primary Location:

  “Do not call them satellites. Those are other locations within your practice. You cannot focus on one as your primary. If for no other reason, the staff absolutely go crazy... They hate feeling like stepchildren.” — Dr. Lake [08:28]

• Staff Morale: Attention must be paid to language, culture, and parity between locations.

System Failure and Learning the Hard Way

• Kevin’s first expansion attempt resulted in a five-year financial failure due to poor location, lack of systems, and misunderstanding the required support and resources. Success didn’t materialize until they acquired and merged with a retiring local optometrist's practice. ([09:44]–[11:13])

COLD START VS. ACQUISITION ([12:10]–[14:47])

“Stick with what you know.”

• Kevin: Cold starts let you build culture but are risky. Acquisitions offer predictability if you verify financials and understand the seller’s intentions.
• Susie: Success depends on the departing owner’s role and expectations.

  “Are they prepared for the psychological changes that happen when you are not the owner...?” ([14:07])

KNOWING YOU’RE READY TO EXPAND

The “Why” Matters Most ([15:11]–[17:03])

• Mindset: Don’t expand just for the sake of growth.
• True Bottleneck: Expansion should only solve a real business restraint, like a capped patient base or revenue ceiling.
• Leadership Structure: You need at least one management layer before scaling, or burnout is inevitable.

“In my opinion, you need at least one layer of management in place before you can scale... Without that, you’re just going to have some level of burnout.” — Kevin [17:08]

MANAGEMENT AND SYSTEM STRUCTURE ([17:55]–[23:53])

When to Hire Management

• Management structure typically includes a dedicated manager before opening a new location—often sourced from within ([19:47]–[21:25]).
• Expanding teams sometimes means moving top players from the flagship location to new sites, especially to install systems and culture.

“We always... took someone from our most successful practice and moved them over to lead that additional practice.” — Dr. Lake [21:25]

Culture, Turnover, and Integration

• Acquisitions often see rapid turnover of existing staff; integration hinges on having your own “culture carrier” present ([22:21]–[23:37]).

SYSTEMS AND PROCESSES: THE REAL GROWTH CHALLENGE ([23:53]–[29:32])

Two Locations: Manageable, but Cautious Optimism

• 1 → 2 locations is a leap, but not as seismic as 3 → 4, where complexity “stacks up.”
• Advocates for rigorous bottleneck analysis before signing leases and taking on overhead.
• Use data and marketing experimentation to exhaust growth potential in a single location first.

KEY METRICS & FINANCIAL READINESS ([29:32]–[34:43])

Profitability & Staff Stability

• Crucial Metric: EBITDA must be in double digits before expansion—the pain of low profits multiplies with more locations.
• Solid Staff: Low turnover and flexibility essential, as staff movement between locations is almost inevitable; have compensation plans for split teams (e.g., extra $2/hr for cross-location work, per Dr. Lake [31:26]).

ROLES, TRAINING, AND OWNER’S MINDSET ([34:43]–[40:57])

Manager–Operator Balance

• Debate around whether managers can/should remain in clinical roles or need protected management time.
• Consensus: At some scale, managers must step back from daily clinical duties to focus on systems, observation, and coaching.

SOPs and Owner Bottleneck

“If your team is relying upon one person... to get [every] question answered, then that’s your bottleneck.” — Kevin [26:30]

Leadership Evolution

• Owners must transition from being star clinicians to genuine business leaders—a move many resist, to their own detriment.
• Key Reflection: “Do you want this job?” (i.e., building a business, not just practicing) ([38:33])

COMMON GROWTH PITFALLS

Promotions & the Peter Principle ([41:35]–[44:33])

• Promoting star performers (e.g., best optician) too quickly often results in failure.

  “You promote someone to the level of their incompetence. I have done that more times than I care to say.” — Dr. Lake [42:10]

• Require staff to train their replacement before they can be promoted.

Managing Diverse Doctor Preferences ([44:33]–[47:41])

• Allow some autonomy in pace and style, but require adherence to core business values and systems.
• 80/20 rule: 80% standardized, 20% individualized for creativity and care.

THE DREADED 3-4 LOCATION “WHEELS FALL OFF” MOMENT ([51:38]–[56:09])

• Going from 2 to 4 locations exposes every missing protocol and weakness.
• Fires at every location, staff confusion, and constant crisis-management are the norm until deep systems (SOPs, handbooks, training, recall protocols) are institutionalized.

“As soon as we put out a fire in one location, we were putting out another fire in another location... All you're doing is trying to get from day to day by putting out, you know, one fire after another.” — Dr. Lake [53:36]

• You no longer “know by feel”; structure must replace intuition.

FINAL ADVICE ROUND ([56:40]–[58:42])

Kevin:

• Take your time:

  “Beta testing marketing in a given location is much less expensive than buying another location... Make sure you are fully committed.” [56:56]

Dr. Lake:

• Invest in formal leadership training for management.
• Accept that with more locations, changes and new systems will take longer—the “big ship turns slowly.” ([57:42])

HIGHLIGHTED QUOTES

• “Do not call them satellites... Those are other locations within your practice.” — Dr. Susie Lake [08:28]
• “If your team is relying upon one person... then that's your bottleneck.” — Kevin Whaley [26:30]
• “You promote someone to the level of their incompetence. I have done that more times than I care to say.” — Dr. Susie Lake [42:10]
• “Beta testing marketing... is much less expensive than buying another location.” — Kevin Whaley [56:56]

TIMESTAMPED KEY SEGMENTS

• [03:25] – Guest introductions and practice backgrounds
• [08:28] – Cultural pitfalls: “Satellite” offices & staff morale
• [09:44]/[11:13] – Stories of failed and successful second locations
• [12:10] – Cold start vs. acquisition: pros, cons, decision factors
• [14:07] – Pain points of acquiring practices with lingering owners
• [15:11]-[17:03] – Knowing if you’re truly ready to expand
• [17:08] – Management structures needed before adding locations
• [21:25] – Best practice: move top staff from flagship to new location
• [23:53] – Why 3-4 locations is the real breaking point
• [42:10] – Leadership and promotion pitfalls
• [53:36] – “Wheels fall off” moment explained
• [56:56] – Final advice: take your time; leadership investment

SUMMARY TAKEAWAYS

• Multi-location growth is far more complex than duplicating a successful single practice; leadership, true systems, and SOPs are non-negotiable.
• Embrace a business owner mindset—or realize you may be happier (and more profitable) as a “super single.”
• Fumbling your way through expansion is survivable at two sites, but chaos prevails by the fourth location if structure, culture, and documentation are missing.
• Promotions and management must be deliberate, not just rewards for past clinical performance.
• Growth for growth’s sake is misery; expand only to solve a real bottleneck or serve new patients you can’t otherwise reach.

This episode is a must-listen for any optometrist considering geographic or operational expansion. The stories, warnings, and blueprints from Dr. Lake and Kevin Whaley will save years of pain and potentially hundreds of thousands of dollars in missteps.