Independence vs Isolation in Private Practice with John Marvin

Adam Cmejla:
Welcome back to another episode of 20/20 Money, The Business of Optometry. Joining me back on the show today is John Marvin. John, it is good to see you, my friend. Thank you for taking the time out of your schedule to be with us here today.

John Marvin:
Thanks for the invitation. I enjoyed our last conversation and I’m looking forward to the one today.

Adam Cmejla:
Absolutely. I have no doubt we’ll exchange some thought provoking ideas, opinions, and forecasts. My hope is that listeners walk away with their next best step based on our conversation. What that step will be, we’ll see where the conversation goes.

Where I want to begin is with a column you wrote on EnvisionMag.com titled Why Fierce Independence Is Weakening Private Practice. I mentioned before we hit record that I’m in violent agreement with what you wrote. I think it connects the dots on a lot of what is happening behind the scenes.

Where I’m interested in picking up is how you finished the article. The final line reads: Will you protect your independence at all costs, or will you use it to build something bigger?

Before we started recording you said there’s a difference between independence and private practice, and I stopped you mid sentence because I wanted to capture that here. What do you mean by that?

John Marvin:
Private practice is fundamentally a small business. It is typically led by a doctor who is entrepreneurial and prefers caring for patients without the constraints of a corporate employer.

Some doctors are comfortable in a corporate structure where decisions are made for them, where someone else hires the staff and dictates the structure of the practice. Others prefer the freedom to practice in a way they believe best serves their patients.

Private practice simply means the practice is privately owned and decisions are made internally.

Independence, however, can come from a different place. Sometimes it is rooted in insecurity. When someone feels uncertain about what to do, independence can become a defense mechanism. It becomes a stubborn refusal to listen to advice or consider change.

For example, a consultant might walk into a practice and say, “Your optical displays should probably be reorganized.” The response might be, “I’ve done it this way for five years and I’m not changing.”
It becomes this mindset of “I’m going to do it my way.”

Adam Cmejla:
Sounds like a kid.

John Marvin:
Exactly. That stubbornness often comes from insecurity. The question is whether you’re willing to move through the discomfort of trusting advice from others or whether you stay in that mindset of refusing help.

Unfortunately, if you stay stubborn long enough, the business eventually forces the decision for you. If the practice starts failing, you may not have the luxury of independence anymore. That would be tragic because it is completely unnecessary.

Adam Cmejla:
The timing of this conversation is interesting because I recently spoke with Dr. Kurt Steele about building a practice that is bigger than the owner.

One of the ideas he shared is that the more important you are to your business, the less valuable the business becomes to you. The inverse is also true. If you build a business that can operate without you, it becomes far more valuable.

If a doctor never builds something valuable enough for someone else to buy, they may eventually be forced to close the doors or sell under terms they don’t like.

So when you wrote “build something bigger,” what did you mean?

John Marvin:
I didn’t mean bigger in the sense of opening more locations. I meant building alliances.

In the 60s and 70s there was an organization called the Independent Grocers Association. Individual grocery store owners joined together to gain collective purchasing power and share best practices.

Optometry has pieces of that idea. Buying groups and organizations like Vision Source exist, but many doctors still choose not to fully participate.
Even when these organizations offer tools, marketing support, or operational guidance, some doctors still say, “I want to do things my way.”

My point was that the resources already exist. Doctors simply need to use them more effectively.

If you belong to a group like iDoc or another alliance, maximize it. Take advantage of the marketing help, operational guidance, and strategic support available.

If you walk into a buffet, you should probably take advantage of everything available.

Adam Cmejla:
That reminds me of a scene from the movie Jerry Maguire where Tom Cruise says, “Help me help you.”

Maybe part of the challenge is humility. Recognizing you don’t have to know everything and allowing others to help solve problems.

I often encourage business owners to evaluate their practice through three lenses: challenges, opportunities, and strengths. Once you identify those areas, bring them to your advisors or organizations and ask for help.

Does that resonate?

John Marvin:
Absolutely. But the biggest obstacle isn’t tactics. It’s mindset.
There is often a lack of trust toward anyone outside the profession. At conferences and educational events, most speakers discussing business are optometrists themselves.

Many doctors will listen to other optometrists talk about practice management but won’t listen to someone like Jeff Bezos or Elon Musk because they think, “What do they know about optometry?”
That reluctance to learn from broader business leaders limits growth.
The most successful doctors I know openly admit they don’t know everything. They constantly seek knowledge and challenge themselves to grow.

You have to be comfortable being uncomfortable.

Adam Cmejla:
I think that’s an important clarification. It’s not an either-or conversation. It’s an and conversation.

You can learn operational ideas from colleagues in optometry while also learning strategic thinking from successful entrepreneurs outside the profession.

For example, I enjoy listening to the podcast Founders because it explores how great business leaders built their companies.
There are lessons there that apply to any business, including optometry.

John Marvin:
Exactly. And another issue is that many private practice owners operate more like sole proprietors than true business owners.

Using Robert Kiyosaki’s Cashflow Quadrant, most optometrists fall into the self employed category. They own a job rather than a business.
A true business owner builds systems and teams that allow the organization to function without them being present every hour.
That shift requires personal growth and learning.

Adam Cmejla:
There’s an interesting dynamic happening in the profession. Competition is increasing, but at the same time access to knowledge and connection has never been greater.

Between online communities, buying groups, masterminds, and podcasts, there are more ways than ever for doctors to learn from each other.

Yet many still feel isolated.

John Marvin:
And part of that comes down to culture within the profession.
Over time there has been a shift toward emphasizing the clinical identity of optometry while distancing from the retail side of the business.

But the reality is that a private practice optometrist still operates within a retail environment. Ignoring that reality doesn’t help.

Successful practices tend to be run by people who enjoy relationships and community engagement.

Those human connections have always been one of the most powerful aspects of private practice.

Adam Cmejla:
As we wrap up, I want to come back to the idea of a next best step for listeners.

Many people want better results, but the difference between wanting and willing is action.
If you want something you’ve never had before, you’re going to have to do things you’ve never done before.

No problem can be solved with the same level of thinking that created it.
The good news is that whatever challenge you’re facing in your practice, someone else has already faced it and solved it.

You don’t have to solve these problems alone.
John Marvin:
Exactly. And if anyone wants to talk through their situation, I’m happy to help.

I’m not in the consulting business, so there’s no fee involved. If someone wants to have a conversation about their practice, they can reach out and I’ll respond.

Out of a hundred optometrists, maybe ten or twenty are ready to pursue that level of growth. If I can help those doctors in any way, I’d be honored to do it.

Adam Cmejla:
That’s incredibly generous. We’ll include your contact information in the show notes.

John, thank you for the conversation. I always enjoy these discussions with you and I appreciate you sharing your perspective with the profession.

John Marvin:
Thank you. Anytime.

Adam Cmejla:
And we’ll catch everyone on the next episode of 20/20 Money, The Business of Optometry.