Practice Management
Spring 2026
by Tonya LaRue and Chase Rabourn
As ophthalmologists approach retirement, the question “What next?” becomes increasingly urgent. Succession planning is not just about finding a replacement surgeon—it’s about preserving the legacy, culture, and operational integrity of a practice built over time. For aging ophthalmologists, a well-structured succession plan ensures continuity of care, financial stability, and peace of mind.
Today’s succession planning must also contend with a new and pressing challenge: a national shortage of both ophthalmologists and optometrists. This workforce shortage adds urgency and complexity to the transition process, making early and strategic planning critical.
Eyecare workforce shortage
The U.S. is experiencing a widening gap between the demand for eyecare and the available provider workforce. This shortfall is driven by a combination of professional and demographic shifts: The influx of new eyecare professionals is largely offset by a rising rate of retirement, preventing the workforce from expanding at the rate necessary to serve a growing population.
This pressure is most visible in the rapid expansion of the population aged 65 and older, which carries a higher clinical burden. The sheer volume of required surgical interventions could outpace the throughput of current training pipelines. Consequently, as supply begins declining, clinical demand is spiking. This imbalance creates a provider gap that disproportionately affects rural areas, where underserved populations face the greatest barriers to access. Addressing this requires a focus on proactive succession planning within private practices to ensure continuity of care.
Why succession planning matters more than ever
Succession planning is not just the best practice, it’s a necessity. Without a clear plan, practices risk: extended patient wait times; loss of referral networks; burnout among remaining staff; decreased practice valuation; and interrupted continuity of care. For aging ophthalmologists, the stakes are high. A thoughtful succession plan ensures patients continue to receive high-quality care, staff remain supported, and the practice retains its value and reputation.
Key components
A robust succession plan should include: 1)clinical succession, 2) administrative continuity, 3) financial planning, 4) legal and regulatory compliance, and 5) communication strategy.
Let’s explore each of these, with a focus on how the workforce shortage and administrative leadership intersect.
Clinical succession
Finding a qualified successor is increasingly difficult. The shortage of ophthalmologists means competition for new graduates is fierce, and many are drawn to urban centers or corporate employment models. To address this:
- Start early: Begin recruitment 5–10 years before retirement.
- Offer mentorship: A phased transition with mentorship can attract younger physicians.
- Consider optometric partnerships: In areas with severe shortages, expanding the role of optometrists in co-management may help bridge gaps.
- Explore virtual consultations: Virtual consultations can extend reach and reduce strain on in-person services.
Administrative continuity
While clinical succession is critical, the administrative team ensures the practice continues to function smoothly. In a strained workforce environment, their role becomes even more vital.
Practice administrator:
- Manage recruitment and onboarding
- Maintain morale during transitions
- Ensure compliance and accreditation
- Coordinate external partners and vendors
ASC nurse manager:
- Staffing and scheduling in a competitive nursing market
- Maintain infection control and safety standards
- Support new surgeons during onboarding
Chief financial officer (CFO):
- Practice valuation and buy-in structuring
- Navigate private equity interest
- Manage cash flow during transition
- Forecast future financial performance
Financial planning
The shortage of providers has increased the value of well-run practices—but only if they are positioned correctly. Key steps include:
- Valuation: Engage a healthcare valuation expert.
- Buy-sell agreements: Define clear terms for ownership transfer, even consider early buy-ins.
- Private equity: Evaluate offers carefully; some may offer short-term gains but long-term loss of control.
- Retirement planning: Align personal financial goals with practice needs.
Legal and regulatory compliance
Succession involves complex legal and regulatory considerations:
- Credentialing: Ensure new providers are properly credentialed.
- Contract updates: Review leases, employment agreements, vendor contracts, and payer contracts.
- HIPAA compliance: Maintain data security during transitions.
- ASC accreditation: Notify accrediting bodies of leadership changes.
Communication strategy
Transparent communication is essential:
- Staff: Keep employees informed and engaged.
- Patients: Introduce new providers early to build trust.
- Referral networks: Reassure partners about continuity of care.
- Community: Use communication tools, including social media, to share the transition story.
Making succession planning a living process
Succession planning should not be a one-time event. Given the evolving challenges in healthcare, including workforce shortages, regulatory changes, and shifting patient demographics, your plan must be dynamic and regularly reviewed. Incorporate succession planning as a standing agenda item during annual or biannual owners’ meetings. These reviews should include:
- Progress updates on recruitment or mentorship efforts;
- Evaluation of key administrative roles and potential successors;
- Financial performance and valuation trends;
- Regulatory or compliance updates;
- Contingency planning for unexpected departures or health issues.
By revisiting the plan at least once a year, you ensure that it remains aligned with your practice’s goals, market conditions, and personal retirement timeline.
A model transition amid workforce challenges
A cataract and glaucoma specialist begins planning a transition in their late 50s to early 60s. Aware of the workforce shortage, they:
- Partner with a local residency or fellowship program to identify candidates;
- Structure a 2- to 3-year mentorship and buy-in plan;
- Retain the key administrative stakeholders for the practice and surgery center to ensure continuity;
- Communicate the transition to staff and patients clearly.
Despite the challenging environment, this transition plan allows the practice to continue thriving.
Planning for a future with fewer providers
The shortage of ophthalmologists and optometrists is reshaping the landscape of eyecare. For aging ophthalmologists, this makes succession planning not just important but urgent. By involving consultants, recruiters, and key administrative leaders and planning strategically, practices can navigate this transition successfully, ensuring that patients, staff, and communities continue to benefit from high-quality care.
The time to act is now. Your legacy—and the future of eyecare—depends on it.
About the authors
Tonya LaRue
Consultant
Medical Consulting Group
Springfield, Missouri
Chase Rabourn
Client Business Manager
Medical Consulting Group
Springfield, Missouri
Contact
LaRue: tlarue@medcgroup.com
Rabourn: crabourn@medcgroup.com
