The Real Cost of Doing Nothing: What Staying the Course Is Actually Costing Your Practice

There’s a response I hear more than any other when I talk to independent ODs about their practice operations.

“We’re doing fine.”

And I believe them. I’m not here to tell you your practice is failing. But “fine” is a dangerous place to park, because fine has a cost — and most owner ODs have never stopped to calculate it.

The decision not to change anything is still a decision. It just doesn’t feel like one. And that’s exactly what makes it so expensive.

Inaction Has a Price Tag

Let me put some numbers around this. The national average COGS for independent optometry practices runs between 27% and 35%. Crazy right? Who wants to work forever? Practice owners that do it differently have fully adopted a modern optical model — no-cost frame inventory, integrated lab partnerships, strategic vendor pricing — regularly run COGS at 18% to 22%.

If your practice generates $1 million in gross revenue and you’re running COGS at 30%, you’re spending $300,000 on goods. Drop that to 20% and you’re spending $200,000. That’s $100,000 — not in new revenue, not in more patients, not in longer hours. Just in running a more optimized system.

That’s what staying the course costs. Not in some abstract sense. In real dollars, every single year.

The Comfort of Familiarity

I understand the pull toward the status quo. I’ve felt it myself. When you’ve built something that works — that pays the bills, supports your staff, and serves your patients — there’s a rational instinct to protect it by not disrupting it.

But the market doesn’t stand still while you do. Insurance reimbursements continue to compress. Overhead costs keep rising. Corporate groups keep expanding. The practice that felt stable three years ago is often running measurably thinner margins today, even if nothing visible has changed.

Staying the course isn’t neutral. It’s a slow drift in the wrong direction.

What “Fine” Is Really Telling You

In my experience, when an owner OD tells me their practice is doing fine, what they often mean is: things are manageable, I’m not in crisis, and I don’t have the bandwidth to evaluate what I don’t know I’m missing.

That last part is the real issue. Not resistance to change — most ODs I talk to are open-minded, motivated people. The barrier is usually a lack of clear, quantified information about what the alternative actually looks like.

So let me make it concrete. If you’ve never run a no-cost frame board model, you’re funding your entire frame inventory upfront and carrying all the risk. If you’ve never reconciled your vendor invoices against your price list, there’s a meaningful chance you’ve been overcharged for months or years. If you’ve never benchmarked your COGS against what’s achievable — not just against the industry average — you don’t have a complete picture of your practice’s potential.

None of that means you’re doing something wrong. It means there are questions worth asking.

Curiosity Is the First Step

I’ve said it before: complacency is not a destination. The most profitable independent practices I know aren’t the ones with the most patients or the longest hours — they’re the ones with owners who stayed curious, asked better questions, and were willing to examine what they’d always done.

You don’t have to overhaul your practice overnight. But you do have to be willing to look honestly at the numbers — the real ones, not just the ones that confirm you’re doing fine.

The cost of doing nothing is real. It just doesn’t show up on an invoice. It shows up in the gap between what your practice earns and what it could.

If you’re ready to close that gap, let’s start with a conversation.