When Monica Miller, OD, graduated from the New England College of Optometry in the spring of 2020, she entered the profession at a historic moment. The COVID-19 pandemic was reshaping nearly every aspect of health care, and for new graduates, that meant finding footing in a profession that suddenly looked very different from what they had trained for.
What Dr. Miller didn’t anticipate was how quickly that footing would turn into momentum—or that within five years, she would own four optometry practices while still in her early 30s.
A ROUGH START
After graduation, Dr. Miller worked briefly at a private practice before taking her first step into ownership through a LensCrafters sublease inside a Macy’s. It wasn’t a glamorous start, she says.
“It was a location no one wanted, in a department store off the freeway, next to the intimates section. But it was all I could afford.”
Motivated to make it work, Dr. Miller focused on what she could control—cleaning up the space, building systems and growing a patient base from scratch. At first, she handled nearly everything herself.
“I was horrified by the task of dealing with the hiring process or payroll,” she says. “I did the check-in, insurance, exam, post-op care and optical sales.”
She hired her first technician about four months in, but much of the responsibility stayed with her. While she felt the day-to-day operations were becoming more manageable, she also realized she wanted more variety.
“I was doing the same thing every day,” she says. “I was getting bored.”
That desire for challenge pushed her forward quickly. Six months after opening her doors inside Macy’s, Dr. Miller acquired a second location, and a third just a few months after that—all on the Connecticut/Massachusetts line.
“It was a huge jump—pandemic or not,” she says.
The timing, however, came with one unexpected advantage. With federal student loan payments paused during the pandemic, Dr. Miller was able to save more aggressively and reinvest in her business sooner than she otherwise would have. That financial breathing room helped fuel her early growth.
BECOMING BUSINESS-MINDED
Within a year of opening her first practice, Dr. Miller had built a team of about 15 employees. While she was confident in her clinical abilities, business ownership and leadership required an entirely different skill set.
“School teaches you how to be a doctor,” she says. “It doesn’t teach you how to lead people, manage a team or communicate in real-life situations.”
Letting go of control was one of the hardest lessons, she says. Hiring felt risky, and trusting others with what she describes as “my baby” didn’t come naturally—especially as a perfectionist.
Early on, stress often showed up in how she led. Over time, Dr. Miller began to recognize that growth required a different approach—one rooted in patience, communication and trust.
“I had this need to be in total control. There’s a lot I wouldn’t do again,” Dr. Miller says. “I quickly learned that the more the practices grew, the more I had to pass tasks along.”
A major turning point came when she hired a senior operations manager to oversee all four locations. The two met years earlier while working as technicians and had joked about working together again someday. Now, that relationship anchors Dr. Miller’s ability to step back without losing control.
“I didn’t want to hire a glorified babysitter,” Dr. Miller says. “I wanted a leader—someone who brings ideas to the table and motivates the team.”
Today, Dr. Miller no longer needs to be physically present for her practices to function smoothly. Managers handle operations, staff members are encouraged to think independently and administrative work is largely delegated, including to virtual assistants.
“When I go into a location now, my team doesn’t really need me there,” she says. “They know I’m available if they need anything, but they have it under control.”
She also focuses on helping employees work at the top of their skill sets.
“It’s helpful to understand the financial side,” Dr. Miller says. “You shouldn’t have someone making $25 an hour doing a $10-an-hour task. Let people reach their full potential, and growth becomes their priority, too.”
Dr. Miller’s role has evolved from managing every detail to carrying what she calls “the weight of the decisions,” rather than the repetition of daily tasks.
“There’s this misconception that owning your own practice automatically means more work,” she says. “I thought the more locations I had, the busier I’d be. But as the business grew, my workload actually became less.”
Her advice for others considering ownership or expansion centers on shifting mindset.
“Get away from the ‘if you want it done right, do it yourself’ mentality,’” Dr. Miller says. “Growth isn’t always about doing more or packing your schedule. It’s about building something that can grow without you.”
