How to go from your first million to 10 million in refractive surgery practice

Not everything that got you 1 million will get you to 10, but a lot of it will. The most efficient way to get your practice from 1 million to 10 million in revenue is to sell a second product to another avatar and expand into different acquisition channels (because now, you’ll be able to afford that).

As you acquire these new customers, you can now reinvest that revenue to serve them. You must sweat the assets along the way, expand your marketing channels, and install a scalable practice operating system that enables the practice to navigate growth challenges.

By the way, this is a follow-on post to my previous post where I shared how to get from 0 to 1 million pounds in your refractive surgery practice. If you’re not at 1 million pounds yet, read that. Second, know that this isn’t easy.

Statistically, only four per cent of business owners ever reach the $1m mark, and only 10 per cent of those (that’s 0.4 per cent of all business owners) ever reach the $10m mark.

Scaling the practice 10X

The $1-$10 million/year stage involves consistently spinning the 1 million a year flywheel that you established in that stage of the business. Then, expanding to avatars, multiple services, increasing utilisation, expanding into different marketing channels, and installing a scalable practice operating system to help your people do productive work within a system.

In this article, I’ll cover

Expanding to serve multiple patient avatars

If the practice got to 1 million selling laser vision correction, it could now expand into lens based surgery, or vice versa. By providing a comprehensive package of services, the practice can increase customer satisfaction and attract new patients from different demographics.

This could include diversifying into related areas such as added-value post-operative care (i.e. lifetime offers on a subscription basis) and specialized consultations and treatment options for edge cases (ICLs, PresbyLASIK).

  • Geographic Expansion: If the practice operates in a limited area, considering expansion to new locations can unlock growth potential. Opening satellite clinics or establishing partnerships with healthcare facilities in different regions can increase accessibility and attract a larger patient base.
  • Targeting a Broader Market: Instead of relying solely on the initial service line, the practice can aim to reach a wider customer base. This may involve exploring different patient demographics. By expanding the target market, the practice can tap into new sources of revenue and achieve higher sales volumes.

Expanding Your Service Lines

Scaling from $1 to $10 million per year involves expanding beyond a single service. Many entrepreneurs introduce cross-selling and upselling strategies to create a value ladder.

By identifying additional products or services that complement the initial offering, vision correction entrepreneurs can increase customer lifetime value (LTV) and revenue. This stage requires strategic thinking about what customers will naturally desire after purchasing the initial product.

For a one-and-done vision correction medical practice that cannot easily upsell products and services, the approach to scaling from $1 to $10 million per year would require alternative strategies. Here are some options to consider:

  • Investing in technology and infrastructure. To serve multiple avatars, you’ll need to invest in either a laser suite (if you started with lens-based surgery) or an operating theatre set-up (if you started with a laser suite). You may be able to do both in your facility (if you planned to scale in advance). Alternatively, you could begin by leveraging an external facility until you prove the new flywheel works and then invest in another facility for your other service line.
  • Enhancing Customer Experience: Focusing on providing an exceptional customer experience can help drive growth. This involves investing in patient satisfaction, improving facilities, and ensuring top-notch customer service. Satisfied customers are more likely to refer others to the practice, leading to increased word-of-mouth marketing and a larger customer base.
  • Diversifying Revenue Streams: If upselling is not a viable option, the practice can explore alternative revenue streams. This could include offering additional services or products that complement the vision correction procedure, such as specialised eye care products, post-operative recovery aids, or related educational resources.

Sweating the assets

“Sweating its assets” refers to maximising the utilisation and value of its existing resources. Here are some ways a practice can do this:

  • Increase Appointment Capacity: Evaluate the practice’s current appointment scheduling and workflow to identify areas for efficiency improvements. This may involve optimising appointment durations, reducing wait times, and implementing effective patient flow management strategies. By maximising the number of surgical patients seen per day without compromising quality, the practice can generate more revenue from its existing infrastructure.
  • Utilise Equipment and Facilities: Ensure that expensive medical equipment, such as lasers or imaging devices, are fully utilised throughout the day. Minimise downtime by scheduling appointments efficiently and considering options like extending working hours or operating on weekends. Additionally, explore opportunities to lease or rent out equipment during idle periods to generate additional income.
  • Leverage Staff Expertise: The practice’s medical professionals and staff have valuable knowledge and skills. Find ways to leverage their expertise to generate revenue. This could involve offering specialised consultations, training programs for other medical professionals, or speaking engagements at conferences or events. By monetising their expertise beyond the core service, the practice can tap into additional revenue streams.
  • Explore Telemedicine Options: Investigate the feasibility of offering telemedicine consultations or follow-up appointments for certain cases. This can help expand the practice’s reach beyond its physical location, allowing for more patient interactions and potentially increasing revenue.
  • Continuous Professional Development: Encourage ongoing education and training for the practice’s medical professionals and staff. This ensures that they stay updated with the latest advancements in the field and can provide specialised services or offer additional expertise. By staying at the forefront of the industry, the practice can maintain a competitive edge and attract more patients.

By “sweating its assets” and maximising the value of its existing resources, a one-and-done vision correction practice can generate additional revenue and drive growth despite limitations in upselling opportunities. Through operational efficiencies, strategic expansions, and innovative service offerings, the practice can optimise its potential for success.

Expanding marketing channels

If you’ve consistently proven that you can sell surgical treatment using one marketing channel, you’ve proven that your offer works.

You’ve also proven that you’ve addressed some issues that plague practices that keep them performing under a million (e.g. failing to excite customers, failing to convert them, having a flimsy or broken funnel from awareness to engagement to subscription). When you know all of this works, it’s time to expand your marketing tactics:

  • Expand into alternative marketing channels: You’ve probably done this already (most impatient surgeons do), but now is the time I recommend to invest energy and resources into alternate channels. For example, if you built your practice on pay-per-click advertising, now you may want to start doing SEO. You may want to expand more heavily into a chosen social media channel. It might be time to start doing direct outreach to optometrists for referrals. It might be time to start running webinars, patient evenings, get on the radio, start the PR machine, do community events, and spend money on print or environmental advertising (also known as “outdoor”).
  • Optimise Marketing and Referral Tactics: Review the practice’s marketing efforts and referral networks. Ensure that marketing campaigns are targeted effectively to reach potential patients who may benefit from the vision correction procedure. Strengthen relationships with existing patients and encourage referrals by offering incentives or referral programs. By maximising patient acquisition and retention, the practice can generate more revenue without relying solely on upselling.
  • Building a Referral Network: Establishing strong relationships with optometrists, general practitioners, and other medical professionals can generate a consistent stream of patient referrals. Providing educational materials, conducting seminars, or offering professional training can help build trust and credibility within the healthcare community.
  • Developing Partnerships: Collaborating with other health care providers or professionals in complementary fields can open up opportunities for growth. Partnering with optometrists, ophthalmologists, or other medical practices can create referral networks and expand the reach of the vision correction practice. These partnerships can also lead to joint marketing efforts and shared resources, contributing to overall growth.

By adopting these alternative marketing tactics, a one-and-done vision correction medical practice can navigate the stage of scaling from $1 to $10 million per year, despite the limitations on upselling. The key is to identify opportunities for expansion, enhance the customer experience, and explore new avenues for revenue generation.

Installing a professional operating system

Many of the above practices will get your top line to $10 million. We can’t forget, however, that the purpose of business is to make a profit, not to simply enjoy a larger top revenue line.

So, well in advance of reaching $10 million, you’ll likely need to start implementing an operating system for your business (usually, the best time to start this is at $1 million a year revenue, but you can get started at after that because it’s better late than never).

Every business has an operating system. Most operating systems are owner-dependent (YOU are the operating system).

What I’m talking about here is upgrading your operating system to one that helps you and your people level up your business so you can 2X your take-home profit, build your board, expand with M&A and hit your number. Over this period, you have the option to exit aspects of your business.


Beyond you, this level is about surrounding yourself with talented people (A-Players) who can help you devise strategies and implement tactics to reach your goal. This is trusting talented people to do the job you hired them to do and getting out of their way. This is about enabling your people to become those 80/20 producers because you have built a system in which they can do their best work and create the most value for customers and your company.

Diving deep into the nuts and bolts of a professional operating system is beyond the scope of this blog post. I can assure you, however, that the growth from $1M to $10M will bring a lot of chaos and pain. Those with a scalable practice operating system have the tools to organise the chaos and in may cases prevent the pain.

Can you have a $10 million practice?

In summary, scaling a one-and-done vision correction medical practice from $1 million to $10 million per year requires strategic initiatives and alternative strategies.

Expanding to serve multiple patient avatars, diversifying service lines, and exploring geographic expansion and broader markets can unlock growth potential.

Sweating the assets by maximising appointment capacity, utilising equipment and staff expertise, exploring telemedicine options, and continuous professional development can generate additional revenue.

Expanding marketing channels, optimising marketing tactics, building referral networks, and developing partnerships can attract a larger patient base.

Finally, installing a professional operating system enables the people in the practice to navigate growth challenges and improve profitability.

By implementing these strategies, the practice can successfully scale and achieve its revenue and profit goals.

NOTE: The best way to answer that nagging question about practice growth or marketing or patient volume in the back of your mind is to book a free 15-minute compatibility call. Get some options and go away with a clear idea of what’s possible.

About the author

Rod Solar
Founder & Fractional CMO

Rod co-founded LiveseySolar and acts as a Fractional CMO for our customers. He’s on a mission to help transform the lives of 10,000 people through vision correction surgery by 2024. To achieve that, he inspires his customers to make confident decisions that will help 50,000 people take the first step towards vision correction.

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Meet our Founders

We’re passionate about helping leaders of high-quality, growth-minded practice owners double their practice revenue

Rod Solar

Founder & Scalable Business Advisor

Rod co-founded LiveseySolar and acts as a Fractional CMO and Scalable Business Advisor for our customers. He’s on a mission to help transform the lives of 10,000 people with vision correction surgery by 2024. To achieve that, he inspires his customers to make confident decisions that will help 50,000 people take the first step towards vision correction.

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LiveseySolar completely transformed the way we were approaching this… We’ve gone from having just the dream of having a practice to having a practice up and running with people making inquiries and booking for procedures… It’s extremely pleasing. We feel lucky we connected with LiveseySolar.

— Dr Matthew Russell, MBChB, FRANZCO, specialist ophthalmic surgeon and founder of VSON and OKKO

Laura Livesey

Founder & CEO

Laura Livesey is the co-founder & CEO of LiveseySolar. She has developed powerful refractive surgery marketing systems that increase patient volumes and profits for doctors, clinics, and hospitals, since 1997.

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Rod and Laura know as much about marketing surgery to patients as I know about performing it. They are an expert in the field of laser eye surgery marketing. They know this industry inside out. I believe that they could help many companies in a variety of areas including marketing materials, sales training and marketing support for doctors.

— Prof. Dan Reinstein, MD MA FRSC DABO, founder of the London Vision Clinic, UK