A practice's staff structure is not an HR function — it is a valuation variable. The number of revenue-producing ODs, their compensation architecture, staff tenure, and clinical productivity metrics collectively determine whether your practice commands a 5.5x or an 8.5x multiple at exit.
Initialize Practice Equity AssessmentBuyers and their lenders underwrite practice acquisitions based on sustainable EBITDA — revenue that will persist after the selling OD departs. Lumina Medical Capital advises sellers to build staffing structures that separate practice revenue from the owner's personal clinical production, beginning at least 24 months before any planned exit.
The selling OD produces 80%+ of clinical revenue. No associate OD on staff. Support staff tenure under 2 years. Buyer's lender will apply a 15–25% revenue haircut to the underwriting model — directly compressing the achievable multiple.
Selling OD produces 50–65% of revenue with one associate handling the remainder. Support staff tenure averaging 3+ years. Buyer underwrites with confidence in revenue continuity — no haircut required. The associate reduces key-person risk from a lender's perspective.
Two or more associate ODs under employment agreements with 2+ years remaining. Selling OD produces ≤40% of revenue. Institutional-quality staffing documentation. Revenue is demonstrably not person-dependent — it is system-dependent. Maximum lender confidence; maximum multiple.
How you compensate associate ODs directly affects both your EBITDA margin and whether those associates are likely to remain through and after a transaction.
| Model | Structure | AZ Range (2025) | Valuation Impact |
|---|---|---|---|
| Pure Salary | Fixed annual compensation | $115K–$145K | Predictable EBITDA; easy to normalize |
| Salary + Production Bonus | Base + % of collections above threshold | $105K + variable | Aligns incentives; most common structure |
| Pure Production | 25–35% of net collections | $130K–$185K | Variable EBITDA; requires normalization in valuation |
| Equity Partnership Track | Salary + buy-in option at 3–5 years | $120K–$150K + option | Highest retention; reduces key-person risk premium |
Best-in-class optometry practices generate $180,000–$240,000 of revenue per full-time equivalent employee. Practices below $130,000 per FTE signal either overstaffing, underbilling, or scheduling inefficiency — all of which compress EBITDA margin and the resulting exit multiple. Document and benchmark this metric in the 24 months before any exit process.
Annual staff turnover above 25% is a yellow flag in acquisition due diligence. It signals management instability, cultural issues, or compensation misalignment — all of which create post-close operational risk that buyers price into their offers. Practices with ≤10% annual turnover and average staff tenure of 4+ years command measurable multiple premiums.
Practices operating at less than 70% of theoretical exam lane capacity have documented growth potential that a buyer can underwrite into the acquisition model — justifying a higher multiple for a currently smaller EBITDA. Document scheduling efficiency: the gap between available appointment slots and filled appointments is a capital expansion opportunity, not a valuation discount.
Revenue per comprehensive exam is the single most important practice productivity metric. Arizona medical optometry practices generating $280–$380 per comprehensive exam through bundled medical coding, optical sales, and ancillary diagnostics command a structural multiple premium over practices generating $140–$180 through vision plan billing alone.
Staffing optimization is one of twelve value drivers in the Lumina valuation framework. Explore the complete three-method valuation methodology and understand exactly what your practice is worth today — and what it could be worth with 24 months of intentional preparation.
Explore Valuation Services →The practice that commands an 8.5x multiple was built for it — deliberately, over years. Lumina helps practitioners engineer the staffing and operational infrastructure that institutional buyers pay premiums to acquire.
Initialize Practice Equity Assessment