I'm Gregory Pappas, a fourth-year student at the Illinois College of Optometry serving as the 2020 class representative for the ICO Student Association and the 2020 class rep for student chapter of the Illinois Optometric Association. A first-generation optometrist, I was born and raised in a southwest suburb of Chicago, where I grew up in a household supported by a small family-owned business. I went to optometry school intending to graduate into private practice and eventually own an optometry practice, but like many optometry students with this dream, I'm concerned with the current state of optometry and what it means for the future of private practice.
Dear Future Private Practice Colleagues,
Please allow us to introduce ourselves. We are the future millennial caretakers of your legacy and the future of private practice. Much has been written about our intentions and desires following graduation, but few have directly asked us about our plans for our future and the future of the profession.
Many of us found inspiration in your chair. We chose to follow in your footsteps, hoping one day to provide the level of personalized care and individual interest that you once provided us. Most of you have even written us letters that gave us the opportunity to walk across the stage and step into this vocation. We have prepared our entire academic life for this: now we are ready to jump into our careers.
Many of us want this journey to end in private practice. Private Practice Club remains one of the most popular clubs at school. There is also constant demand for more opportunities to obtain private practice knowledge amongst students. Armed with the latest peer reviewed research and the most advanced clinical techniques, we hope to grow and diversify your practice and the profession. However, we need you to be there to welcome us, mentor us, and share your knowledge—in clinic and especially in business.
Yes, like many of you, we have student loan debt. You may be under the impression that it is excessive and restrictive. It’s not. Banks specializing in healthcare lending look at it as a worthwhile investment. You and those like you established a reputation of credit worthiness for our profession. Because of your fiscal responsibility, optometrists now have access to large amounts of capital provided by reputable lending sources that will allow us to take a financial stake in your practice—and for you to choose the terms of your retirement.
We hear story after story of practices closing, sold to private equity or simply closed as their original owners retire. However, we want the opportunity to own these practices—all we need is for you to wait for us to arrive. We have invested heavily in ourselves, and we are willing to invest in what you have worked so hard to create. Please keep the stool warm. We would love to call you “boss” and then one day “partner,” rather than share a drink with you at the employee holiday party. Show us the ropes. Provide us the honor of preserving your legacy, and give us the opportunity to inspire the next generation!
With Great Appreciation,
Gregory M. Pappas
Illinois College of Optometry
Class of 2020
What prompted this letter?
Externships during the fourth year of optometry school present an incredible opportunity to experience a variety of practice modalities while completing your education. Having recently gone through the site selection process, my classmates and I noticed popular, well-established private practice sites were disappearing or changing their name. For example, as class rep, I was made aware of a student that selected four diverse and challenging sites only to find out that six months later, half of her sites had been acquired by private equity and renamed. While I was aware of the recent aggressive consumption of private-owned practices, it now became personal, and I started to question why this was happening so quickly? To my surprise, I found out through my discussions with established practitioners and at seminars at national meetings that seasoned practitioners didn’t feel that “millennial" graduates and young optometrists were interested in purchasing or running a practice. I wanted to make a statement by saying that we are here and ready to continue their legacy rather than join them under a controlled, commercial umbrella.
New optometrists have some false impressions about private practice ownership
I feel that optometrists nearing retirement or considering a transition are under the impression that the new wave of optometrists are burdened by exorbitant debt. These same doctors are often confused as to the generalized ambitions of the “millennial” generation (to see what millennials actually want in a workplace, read this recent report). Maybe it is our fault for not expressing our intentions. I want to start a conversation and have a seat at the table instead of letting private equity create the narrative.
Many potential sellers focus on the sheer size of a new graduate’s student loan debt and compare that amount to their former student loans and current mortgages. What they don’t realize is that banks consider optometrists as a great investment. Financial institutions rarely penalize a new graduate for their high student loans, because they understand we are an excellent risk. We have a strong track record of paying our loans on time; for this we can thank those that have come before us. These are the same doctors we now need to believe in us. There is a large amount of capital available from institutions that specialize in health care lending for young optometrists to invest in private practice. We want to own. Mechanisms are in place to make this a reality. We are just asking for the opportunity.
My hopes for the profession
My hope for this letter is to stimulate conversation between all generations of optometrists and foster relationships that can preserve the optometric private sector now and into the future. Private practice is the backbone of optometry. The rights and privileges we have today were championed by private practitioners. We hope to stand on their shoulders to bring the profession to new heights. Only together can we move the profession forward to benefit of our patients and future generations.