A voice for independent doctors

Excerpted from page 34 of the Spring 2025 edition of AOA Focus. 

Aaron McNulty, O.D., was only looking for a summer optometry job. What he found was a door to independent practice and his career path.  

As he neared the end of his first year of optometry school in 2008, Dr. McNulty cold-called several optometry practices in the Louisville, Kentucky, area, looking for a summer optometry job to make a little money and gain experience. He and his fiancée, who was from Louisville, intended to put down roots there. He was offered a position with a practice owned by Elliott Rosengarten, O.D. What Dr. McNulty didn’t know at the time was that Dr.  

Rosengarten had been thinking about his retirement plans when the student appeared.  

“It turns out, when I walked into this office to drop off a résumé for a summer job, he was working on a succession plan and an exit strategy, and he had the pieces in place except for a buyer.”  

Without telling him, Dr. Rosengarten treated Dr. McNulty’s summer position as a prolonged interview process. The student passed, and the two later talked about employment and transitions. After graduation and residency, Dr. McNulty joined the practice as an associate in 2012 and bought it in 2015, renaming it the Louisville Eye Center. 

While it might sound serendipitous, Dr. McNulty believes there are more opportunities like this for new graduates.  

“I think there are a lot of senior docs out there who are starting to think about retirement, and they’re starting to think they’d like to have a partner, but they’re just not quite sure how to approach it.” A student displaying interest shows the optometrist owner their retirement possibilities—without being forced to close their practice, he says. 

Dr. McNulty believes that being an independent optometrist allows him to have a greater connection to the community he serves.  

“I’m passionate about being a small business in the community—where the doctor makes final decisions that are in the best interest, first for the patient, second for the office and third for the community. … I think that’s optimal for health care delivery and has been the most rewarding way for me to practice.” 

AOA launches the Center for Independent Practice 

To support today’s independent practice of contemporary optometry, the AOA launched its Center for Independent Practice (CIP) in 2022. Its mission is to fuel a passion for and create a foundational knowledge base to excel in the management of today’s independent practice. Independent practice does not only mean the traditional private practice model, says Rodney Peele, CIP executive director. Instead, it’s something that each clinician can define for themselves, as more types of practice models have become available. 

The CIP educates and connects doctors of optometry, as well as optometry students, in how to build a successful independent practice. Through the CIP, current and aspiring independent practitioners can develop strong partnerships, optimize practice resources, learn how to create a business and marketing strategy, and use the fundamentals of professional practice advocacy. 

“Practice ownership is not required for independent practice. As a doctor, we are responsible for making the decisions that are best for our patient. … Even if you are not a business owner, there are a lot of skills that independent practitioners need,” says Jacqueline “Jacquie” M. Bowen, O.D., AOA president-elect and CIP vice chair, who owns a practice in Greeley, Colorado. 

“Independent practice is about having the freedom and flexibility to make decisions for contemporary patient care, meaning using the full scope of treatment that’s available to us, and having the autonomy to access those treatments,” Dr. Bowen says. “We want the CIP to be the home for doctors to access independent decision-making, practice-building tools and treatment availability for patients across the range of eye disease.” 

The CIP is a one-stop hub for independent practice, distilling a wealth of professional expertise into tools and resources.  It connects users to EyeLearn, the AOA’s member-exclusive centralized education portal, which offers an expanding online catalog of educational modules, webinars and resources. Other tools and benefits are available through AOAExcel®, which provides financial planning tips and resources. In addition, AOAExcel’s partners provide information and discounts for several types of insurance. 

How AOA advocates for independent practitioners 

Having autonomy over the way she practices has been important to Tara DeRose, O.D., co-owner of Mountain Vista Eyecare and Dry Eye Center in Littleton, Colorado. Dr. DeRose has been an independent practitioner her entire career, since graduating from optometry school in 2005. After a few other optometry positions, she joined her current practice as an associate. After five years, she became a partner.  

“Independent practice allows you to be able to have the freedom to do what we think is best,” she says. “You have control in the decision-making, and that happens in all aspects of practice, not just in the clinical piece, but also with HR, with finance, operations, certain processes that we choose to do throughout the day to make our practice flow better for the doctors, the patients and the staff.” 

Growing up in a small town in South Dakota, Dr. DeRose remembers the local optometrists being a part of the community, attending high school football games and knowing everyone’s names. That was something she sought out after optometry school.  

“I love seeing patients at the grocery store, at the local sporting events,” she says. “I think that helps with patient connection to our practice. It helps with relationship-building and trust—when we recommend something, they trust us. I think that’s important. I love that aspect.” 

As an undergraduate, Dr. DeRose earned a business minor, but she says it wasn’t helpful when it came to running a practice. She thinks she only had one business class in optometry school. Nearly everything she learned about being an independent optometrist she learned from those who came before her. Learning from experts and successful case studies is one of the ways CIP is so helpful, she says.  

The AOA’s advocacy efforts also are a vital part of the CIP. A critical aspect of independent practice for many doctors of optometry is the ability to practice to the full scope, deciding for themselves what services and care they want to provide their patients. The AOA’s public policy team has long been committed to expanding licensure and scope of practice for doctors of optometry.  

“What we’re doing on Capitol Hill and in the statehouses is to give our members more rights, more protections, to be able to practice and see patients in the way that they want to,” Peele says.  

In addition, the public policy team—with help from AOA members—advocates to Congress, regulatory agencies and payers to reduce administrative and regulatory burdens that impede optometrists’ ability to best care for their patients, Peele says. 

Partnerships for the future 

Another important aspect of the CIP is its academic collaborations. As of January 2025, the AOA has five partner schools, with more being added soon. The current partners are the Southern College of Optometry, Northeastern State University Oklahoma College of Optometry, The Ohio State University College of Optometry, University of Pikeville Kentucky College of Optometry and Western University College of Optometry.  

The partner schools have committed 100% AOA membership among their faculty. In turn, the CIP provides special programming to the schools’ students about the potential for independent practice. Last year, the AOA’s CIP partnered with a practice management firm for independent eye care providers, to facilitate a series of in-person discussions at partner schools. Students learned about practice valuation, making a strategic business plan and cold starting an optometry practice.  

While some optometry schools are offering more courses on business management than seasoned optometrists received, students may not always be ready for the information—or know what questions to ask before running a practice. James Chung, a third-year optometry student at The Ohio State University College of Optometry, hopes to own a practice one day. He said the CIP directs students to a more “future-oriented mindset.”  

“When you’re in school, you’re just trying to pass boards, trying to pass classes and do well in clinic,” says Chung, who represents The Ohio State University College of Optometry as a trustee for the American Optometric Student Association. “But having the CIP as a resource and with so much information invested in it really puts everything into perspective that there’s so much more to school, and there’s a lot of good work to look forward to.” 

CIP programming can be helpful even for new graduates who don’t have their sights set on private practice. Webinars and other programs cover billing and coding, federal compliance, cybersecurity and more. Chung says he appreciates that the CIP is ready and waiting for him and fellow students as questions arise after graduation. Take billing and coding, for example. “The CIP has really specific details on how to do billing and coding,” he says. “As a student doctor, you kind of talk about billing and coding, but you’re not the one prescribing. You’re not the one dealing with all the intricacies of business. So, having that toolbox with you wherever you go as an AOA member can be really helpful in the future.”