Going from one location to two sounds exciting… until it’s not.
The truth is, scaling a practice brings on a completely different level of complexity than just more patients or an increase in revenue; it’s new operational pressure points, and a whole new set of problems that don’t show up until you’re already in motion.
In this listener-requested episode of Power Hour, host Eugene Shatsman speaks with two people who actually built and scaled multiple practices: Dr. Susan Lake (Optometrist at Eyecare Specialties) and Kevin Whaley-Stefany (Business Consultant at Autograph Eye LLC).
Dr. Lake and her husband grew from one location to six outside Kansas City. Kevin helped scale a practice from one location to nine in Florida through a mix of cold starts and acquisitions. They share the real-world lessons, mistakes, and “wish we did this sooner” insights that come from their multi-location journeys.
One of the biggest myths in optometry is that growth is linear. In reality, the jump from one location to two is often the moment where cracks begin to form (and you don’t always see them right away.)
In this conversation, Dr. Lake and Kevin break down what actually changes when you add a second location: communication becomes harder, accountability becomes fuzzier, and the owner often becomes the default solution to every problem. What used to be “manageable chaos” in a single practice can quickly become a system-wide bottleneck when you have multiple teams, multiple schedules, and multiple sets of expectations to align.
They also tackle one of the most common strategic decisions practice owners face: cold start vs. acquisition. Both paths can work, but the variables that matter most aren’t always the ones people focus on. The episode explores what you should be evaluating before making that decision, what makes a location scalable versus stressful, and how to avoid buying yourself a bigger job instead of buying a better business.
And then comes the stage where many owners feel the wheels start to fall off: the jump from two locations to four. Somewhere around that third or fourth location, you stop running a practice and start running an organization. That’s when leadership layers, management structure, and operational systems are no longer “nice to have,” they become the difference between sustainable growth and constant firefighting.
This episode digs into what those systems and leadership roles look like, how to prevent yourself from being the bottleneck, and how to build a structure that allows the business to grow without consuming the owner.
Key Takeaways
- What Breaks When You Add a Second Location: The hidden operational and leadership challenges that don’t show up until you’re already scaling.
- Cold Start vs. Acquisition Decisions: The key variables that matter most when choosing how to expand, and how to avoid expensive mistakes.
- How to Know If You’re Ready to Scale: The indicators that signal you’re ready for a second location (or not), and what needs to be in place first.
- Why the 2-to-4 Location Jump Feels So Different: The leadership shift that happens when you move from “practice owner” to “organizational leader.”
- How to Stop Being the Bottleneck: The management structure and systems that allow your team to run operations without everything flowing through you.
- Building Leadership Layers Before Growth Forces Them: What roles, accountability, and processes must exist before multi-location complexity starts stacking up.
In This Episode
- 00:00 | Introduction
- 02:41 | Meet Dr. Susan Lake & Kevin Whaley-Stefany
- 05:15 | The Reality of Opening Location #2
- 09:45 | Kevin’s Second Location Failure: What Went Wrong for 5 Years
- 11:15 | Cold Start vs Acquisition: How to Choose the Right Expansion Path
- 14:55 | How to Know if You’re Truly Ready to Scale
- 21:25 | Leadership Layers and Culture: Why Owners Become the Bottleneck
- 31:30 | Building Systems Before You Expand
- 46:35 | The 80/20 Rule
- 51:45 | Why the Wheels Fall Off From 2 to 4 Locations
- 56:55 | Final Scaling Advice
Contact Information
Connect with Dr. Susan Lake
Dr. Susan Lake is a veteran optometrist serving Missouri through Eyecare Specialties, where she practices in Lee’s Summit, Warrensburg, and surrounding locations.
She earned her Doctor of Optometry degree from Southern College of Optometry and is board certified in Vision Development and Vision Therapy. Her clinical focus includes pediatric vision care, myopia control (including orthokeratology), and vision therapy, while also treating adult ocular health needs.
She is known for her emphasis on patient education, clear communication (especially with parents of children), and tailoring care plans to individual needs.
- Website: https://eyecarespecialties.biz/
Connect with Kevin Whaley-Stefany
Kevin Whaley-Stefany is a business consultant and founder of Autograph Eye LLC, a consulting firm focused on providing custom, practice-specific solutions to improve eye care office efficiency, patient care, and new revenue streams for optometry practices.
Through Autograph Eye, Kevin works directly with practice owners to help refine operational workflows, enhance business systems, and support sustainable growth strategies tailored to the unique needs of independent practices.
Prior to his consulting role, Kevin gained hands-on experience in private practice growth, partnering with optometrists to help expand locations, teams, and operational capabilities. He also has managerial ties to eye care practices in Florida, where he supports leadership, practice development, and organizational scalability.
- Website: https://autographeye.com/
Connect with Eugene Shatsman (Managing Partner, NSG)
Website – https://www.eugeneshatsman.com/
LinkedIn – https://www.linkedin.com/in/eugeneshatsman