Building to Stay Independent in the Modern Ophthalmology Landscape

Clinical Report: Building to Stay Independent in Ophthalmology

Overview

In an AAO 2026 presentation, health care attorney Isabelle Bibet-Kalinyak and physician and finance colleagues discussed ways ophthalmology practices may pursue scalable growth while remaining independent of private equity. The presentation emphasized succession planning, physician recruitment and partnership, governance, and evaluating options such as surgery-center ownership, practice consolidation, and adding service lines in light of local circumstances.

Background

The article describes rising practice costs, industry consolidation, and succession challenges as pressures on independent ophthalmology practices. It reports that at least 35% of ophthalmologists are age 65 years or older, raising the importance of planning for leadership and ownership transitions. The speaker notes that private equity-backed practice models are not suitable for every physician and that some senior physicians have brought junior partners into their practices. The related articles address early-career surgical practice development and the changing ownership landscape in retina practices.

Data Highlights

Topic	Source detail
Ophthalmologist age	At least 35% of ophthalmologists are reported to be age 65 years or older.
Practice pressures	Rising costs, consolidation, and succession challenges are identified as pressures on independent practices.
Growth options discussed	Surgery-center ownership or shared ownership, consolidation, and adding practice lines or subspecialties are presented as options whose suitability depends on the practice and geographic area.

Key Findings

The AAO 2026 presentation focused on maintaining independence while building a scalable ophthalmology practice without private equity.
The speaker identifies succession planning as a priority, citing that at least 35% of ophthalmologists are age 65 years or older.
Attracting and retaining future physician partners may require updated corporate governance and clear communication about the financial commitment and potential investment involved in partnership.
The presentation states that practice leaders on both administrative and clinical sides need some understanding of practice business and finances.
Potential growth approaches include owning or co-owning an ambulatory surgery center, consolidating, and adding practice lines or subspecialties; the speaker says suitability depends on individual facts and geographic circumstances.
A related 2025 article describes the transition to independent vitreoretinal surgery as an opportunity to develop surgical confidence, skill, and judgment and to build a referral base in a new community.

Clinical Implications

For ophthalmology practice leaders considering continued independence, the presentation supports evaluating succession, governance, recruitment, and financial planning alongside possible growth options. The speaker cautions that options such as surgery-center ownership, consolidation, or adding subspecialties should be assessed according to the practice's circumstances and geography.

Conclusion

The presentation frames independent practice as a possible path amid rising costs and consolidation, while emphasizing advance planning for succession, physician partnership, and sustainable growth. It does not identify a single growth model as appropriate for all practices.