As a part of my interview series with prominent medical professionals about “How To Grow Your Private Practice” I had the pleasure of interviewing Dr. Larry E. Patterson, M.D., founder and medical director of Eye Centers of Tennessee, is a nationally known leader in the field of cataract and refractive surgery.

Thank you so much for joining us! Can you tell our readers a bit about your ‘backstory”?

I founded Eye Centers of Tennessee (ECOTN) over 30 years ago in Crossville, Tennessee, as a one-doctor “mom and pop”-style practice with only two supporting office staff. Since then, we’ve grown the practice immensely. Today, we have eight doctors treating patients across an entire region with four locations — soon to be eight! — and a support staff well over 100 strong.

What made you want to start your own practice?

While still in residency, 32 years ago, I was looking for a place I’d like to eventually practice. Growing up, my dad was a preacher and we lived all over the country, so I felt comfortable moving just about anywhere. I’d narrowed my list of ideal locations down to about five places, but after visiting Crossville and seeing its beauty, I knew that’s where I wanted to be.

In addition to the gorgeous surroundings, there was only one ophthalmologist in the area, so there was a substantial need for a new eye care provider. That said, the other ophthalmologist didn’t want to take any other practitioners on board, so I was faced with the option of starting my own practice. And even though that would require a massive amount of work, I liked the idea of starting a new business from scratch; building it the way I wanted to.

Managing being a provider and a business owner can often be exhausting. Can you elaborate on how you manage both roles?

When ECOTN was smaller, I did everything. As the practice grew, though, I had to become more comfortable turning over business operations to other people. Eventually, I hired an office manager, and later a practice administrator. Now, we have a a huge front office staff including a CEO and COO.

A doctor’s truest value is being a physician, a healthcare provider. Seeing patients and being the healer I’ve been trained to be is the most important role for me. Now, I rely much more on having weekly and quarterly staff meetings and getting updates from the great professionals we’ve hired to manage ECOTN.

If I were doing it all over, I’d do it exactly the same way. When you’re just starting out, you have time during the day — at nights and on the weekends too — to do paperwork and scheduling and all the other important business details. You have time to wear all the hats. But as you get busier, you just can’t do it all, and you have to make choices about where to invest your time and what needs to be handed off to other people.

I’m a doctor. That’s what I focus on, and I trust the people we’ve hired to manage the business.

As a business owner, how do you know when to stop working IN your business (maybe see a full patient load) and shift to working ON your business?

20 years ago, when I hired Ray Mays, who is now ECOTN’s CEO, one of the things he said to me was, “We need to get you to a place where you never do anything that someone else can do.”

That was a great piece of advice.

It doesn’t come from a sense of arrogance, or a spirit of, “Hey, I’m a doctor and all this other work is beneath me.” Rather, if someone else can schedule a follow-up appointment with a patient, or make coffee — or a whole host of other to-do items — the more patients I can see and the more time I have to spend with each of them.

From completing your degree to opening a clinic and becoming a business owner, the path was obviously full of many hurdles. How did you build up resilience to rebound from failures? Is there a specific hurdle that sticks out to you?

It’s a fact: You’re going to experience failures. You’ll try things that don’t work, but the key is to let those experience build a sense of resilience in you and to learn from those missteps.

Not every “failure” has to be a catastrophic moment. Actually, few of them are. Thomas Edison failed many times, but he had a mindset of, “Well that’s one more way it doesn’t work.” I love that and have adopted that spirit.

We’ve spent money on elaborate marketing campaigns that turned out to be big busts. But in life and business, there are always ups and downs, home runs and strikeouts. The key is to try and learn from everything you do and refine your efforts based on what works and what doesn’t.

What are your “5 Things You Need To Know To Grow Your Private Practice” and why?

  1. Consider locating your practice in an area where there’s a clear need for your services. Many people love the idea of working in big cities like New York, Atlanta, Dallas, or San Francisco. While those are great metros, the concentration of doctors in those areas is so high you might have a hard time carving out a niche. Then there’s the reality of having to spend so much time and effort getting to and from work every day or spending a large amount of capital on things like marketing. We have an extraordinarily low marketing budget. Part of that is because we work in a place where we don’t have to beg people to come to see us.
  2. When you start, be sure to adhere to the “3 A’s”: availability, availability, availability. Day or night, on the weekends, it doesn’t matter. Never be too busy to see someone in an urgent situation. It will help you build your patient roster, strengthen relationships with referring physicians, and establish you as a trusted and reliable presence in the healthcare landscape.
  3. Surround yourself with THE BEST people. Equipment and facilities are important. But far more important than those things are happy, capable people. In our experience, personality is so much more important than skills. You can teach skills. Personality, though, is almost impossible to teach. If I hear something like, “You’ll really like them when you get to know them” about a potential employee, then that’s somebody I’m not going to hire.
  4. Don’t hesitate to delegate. When you first start a practice, sure, be willing to wear as many hats as you need to. That said, if I were still spending time doing patient billing on the weekends, ECOTN wouldn’t have grown to its current size and I would not be able to treat as many patients as I do.
  5. Never be scared to ask questions. As a doctor, it is easy to trick yourself into thinking you’ve always got to have all the answers. However, smart doctors are always seeking out new medical information, and the same should be true when it comes to figuring out how to scale your business. You won’t be the first person to ever start and grow your own medical practice. Ask questions of those who’ve done it before you, or are doing a great job of it now.

Many healthcare providers struggle with the idea of “monetization”. How did you overcome that mental block?

At the core of what doctors do is helping people. That’s our calling. I want to help people see better, whether that’s with glasses or contacts, or through LASIK or some other type of surgery.

The hard, cold, truth is if you can’t turn a profit, you can’t help people. That’s the bottom line. So then the question becomes: Are you going to make a profit just enough to get by, or are you going to make a bigger profit?

There’s no rule that says you can’t truly help people, keeping people’s needs first, and still make a healthy profit. You can absolutely meet both goals. If you’re efficient enough, profits will go up.

What do you do when you feel unfocused or overwhelmed?

It hardly ever impacts me, and maybe it’s because I can only do one thing at a time. If I have 60 patients to see in a day, I see them one at a time. If I find we’re running a little low on time, I might cut back on the chit-chat, but I still just see them one at a time.

If you feel overwhelmed regularly, maybe you’ve taken on a little too much or could delegate responsibilities a little more efficiently. I see people who have amazingly successful practices but are working six days a week and never taking any personal time.

You’ve got to be better to yourself.

In the office, when I walk out of a patient room, I’m done with that patient for the time being. When I’m with them, they get all my attention and care. Then, with my staff, we figure out codes and charges, any letters that need to be drafted — and we do it all on the spot. From there, I see my next patient, and when I’m with them, they have all my attention.

I’m a huge fan of mentorship throughout one’s career — None of us are able to achieve success without some help along the way. Who has been your biggest mentor? What was the most valuable lesson you learned from them?

I never had that one mentor who’d guide me through every tricky situation. Instead, I’ve compiled a network of dozens of people I can use as sounding boards along my professional journey. When I have a problem, I think of someone I know of who could help me solve that specific matter.

“Who’s been through this before?,” I think. And then I give them a call.

An important lesson I’ve learned along the way is that many doctors are happy to share their insights, so it’s never a good idea to put a ton of pressure on yourself to figure it out on your own. We’ve all been in those moments where we need to be pointed in the right direction or to simply have someone verify our plan of action. There’s no shame in seeking guidance.

What resources did you use (Blogs, webinars, conferences, coaching, etc.) that helped jumpstart you in the beginning of your business?

One of the things I’m glad I did was hire a practice management consultant. There is no way you have any business trying to launch your own practice all on your own. You’re going to have to get someone with a lot of expertise to help you. That advice was true 30 years ago for me and is still good today.

What’s the worst piece of advice or recommendation you’ve ever received? Can you share a story about that?

Fortunately, I don’t have too many bad stories. The only thing that comes to mind was when we were approached with a TV show idea to help promote our refractive surgery capabilities. It cost a lot of money to produce and was filmed in a fancy studio. The whole thing didn’t get us more than maybe one or two extra clients. The concept appealed to our vanity, being able to see ourselves on a television screen and all. We learned, though. We haven’t produced a television show since.

Please recommend one book that’s made the biggest impact on you?

I have two recommendations. The first is “The Goal” by Eliyahu M. Goldratt. It’s been around awhile, but Goldratt’s novel (yes, it’s a work of fiction) is a management manifesto that provides universally relevant scenarios that apply to all organizational professionals.

As for my second, I’m a pilot in my spare time, and the surgical world has started learning many valuable lessons from airlines. It’s unbelievable, when you think about it, how low the accident rate is in the airline industry. A large part of that is the prominence of checklists in air travel. That’s why I love and recommend “The Checklist Manifesto” by Atul Gawande. He explains how becoming a checklist expert can make you an incredibly successful professional.

Where can our readers follow you on social media?


ECOTN Website:

For other incredible interviews, please check out our podcast: Healthcare Heroes.

A special thanks to Dr. Patterson again! The purpose of this interview series is to highlight the entrepreneurs, innovators, advocates, and providers inside Healthcare. Our hope is to inspire future healthcare providers on the incredible careers that are possible!

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