128 - 4-Day Workweeks? Why That Mindset Could Kill Your Medical Practice Before It Starts

Can an optometrist build a thriving, multi-location medical practice without corporate backing — or is burnout inevitable?

Many physicians today are searching for autonomy, flexibility, and meaning — but feel trapped between overwork and under-compensation. In this episode, you'll hear what it really takes to stay independent in medicine (particularly in an optometry practice) while avoiding burnout, and building something that lasts.

• Discover the real cost — and payoff — of building your own medical practice from the ground up.
• Learn why “work-life balance” might be killing your momentum more than saving your sanity.
• Get a behind-the-scenes look at how to scale without selling out to private equity or large hospital systems.

Listen now to learn how to beat burnout and build a profitable, resilient medical practice that you actually love.

Discover how medical graduates, junior doctors, and young physicians can navigate residency training programs, surgical residency, and locum tenens to increase income, enjoy independent practice, decrease stress, achieve financial freedom, and retire early, while maintaining patient satisfaction and exploring physician side gigs to tackle medical school loans.

Transcript

Coach JPMD (00:00)
By the end of this episode, you're going to learn how an independent optometrist grew his practice from zero locations to six locations during COVID-19. Welcome back to another episode where I help younger physicians decrease stress and increase income by transitioning from corporate to independent practices, even without any business experience. In this episode, you're going to learn the most important trait for surviving solo practices.

You'll also learn the difference between optometrists and opticians that I didn't know before this episode and how subleasing space can be the key to you growing your practice quickly.

Welcome to the independent physicians blueprint where we help physicians decrease stress and generate wealth in this crazy world we're living in. And today we're joined with or by Christopher Tumolo, who is an optometrist in the area that I had the privilege of meeting several, several weeks ago, maybe a couple months ago, actually, ⁓ in another project that I've been working on. And, you know, I came home saying to my wife, after I met you, I said, this guy kind of feels like me. He's like really, he's a cool dude.

And ⁓ you're doing some pretty neat things in the Tampa area setting up and competing with the big boys in the optometry world. So tell us about what you do and and who you are.

Christopher Tumolo, OD (01:23)
Yes. Yes. So I'm an independent optometrist. My wife is also an optometrist and we created the on 2020 vision specialists, probably the LLC, probably the end of 2019. We started in the end of 2020 and here we are in 2025. We started with one associate, one sublease, and now we have six offices. So four subleases and two private practices.

Coach JPMD (01:48)
That's Yeah, that's that's during COVID.

Christopher Tumolo, OD (01:51)
It was all during COVID. Yeah. We, we, we ramped up during, yeah. So we, we started during COVID. Yeah, exactly.

Coach JPMD (01:57)
I remember that that time timeframe and and to start a business around that time and to see the amount of locations you have is pretty impressive and I think you know what I want our audience to take away from this is that number one is possible and number two ⁓ It's it's also possible to stay independent. Yes of the of the big boys I like to say and so, you know before we get into the details of the business, what do you do for fun? Because I know that you've got some boxing videos online

So that was pretty intriguing.

Christopher Tumolo, OD (02:30)
Yeah, I do Muay Thai kickboxing at PAYAC, which is an authentic Muay Thai school in Newport Ritchie under Crew Scott. And then I do Brazilian Jiu Jitsu with Juan Tavares, which is in Odessa. So Tavares Martial Arts. Kind of on and off with both kind of my whole life. I've always been into martial arts and you know how it is with school. It's demanding. So there's usually... ⁓

There's usually some give. So I was like studying and working and trying to balance Brazilian Jiu Jitsu and kickboxing and they compound. So you can, you really need to be consistent in order to get really good. So I finally got to a point in my life where I have the time to be more consistent. So not as consistent as I need to be, but more consistent. So that's a little bit of what I do for my stress relief and I do a little workout too with the gym, but.

Coach JPMD (03:21)
Yeah,

so, you know, that's pretty impressive. Because I know that running a business and doing the things that you're doing, it can be challenging and opening up in 2020, 2021, 2019, like you said, multiple locations, when do you have time to do this stuff?

Christopher Tumolo, OD (03:36)
Yeah. ⁓ there was a point where I was working seven days a week, seeing patients. ⁓ we had a sublease initially that was a seven day sublease and, it was tough to find doctors during that time. ⁓ people were confused with COVID and they didn't know exactly what was happening, what the virus was. They didn't want to necessarily go out. So I did a lot myself. ⁓

My thought process back then was I'm young, I'm healthy, if this thing's gonna kill me, it's gonna kill 99.9 % of the people on the planet. So I felt pretty confident. I don't typically get sick. eat right, I work out, so I was pretty confident. So yeah, was like six months where I did seven days in a row on top of opening the business, sourcing product, doing a lot of research. I did more business when I was younger and I did like the optometry stuff later in life.

So my business acumen was pretty good starting out, which is a little bit flipped from what you would get traditionally with medical school students. The traditional path is undergrad straight into medical school and then your discipline. And then you come out with little to no business experience.

Coach JPMD (04:43)
So maybe I didn't know that. Maybe I didn't ask, but what did you do before optometrical?

Christopher Tumolo, OD (04:48)
So before optometry

school, was an optician. My dad was an optician. That's how I got into it. So I had an atypical traditional, or an atypical path. My high school resume wasn't spectacular. Well, so in high school I was a little bit wild and I liked to have fun with my friends. I wasn't really buckled down. guess back then.

Coach JPMD (05:03)
What does that mean?

Christopher Tumolo, OD (05:13)
there was no ADHD diagnosis per se or maybe there was, but it was really less commonly known. So looking back, I probably had that. I couldn't stay focused. was like, just my attention was always everywhere instead of where it should have been. So, you know, I got out of high school and I, you know, kind of slid through and then, ⁓ I want, you know, it took a couple of years off and, and partied and hang out with friends. And, ⁓ yeah. And my dad was a, he was an optician and he was,

trying to get me on the straight and narrow, was like, listen, you gotta do something. You gotta do something with your life. So he said, let's take a class together in Hillsborough Community College. It's a refracting class. It's something he wanted to do at the time. And ⁓ I was like, okay, as cool as you can do with my dad. So was like, 19 years old, was like, let me try this. So we did it together and that kind of was the...

what spawned me to get into this kind of profession. So I got a job with a physician who worked with my father and really liked it.

And then I just started to do more and more within that. And then I said, okay, listen, like I need to go back to school. Now I'm in my early twenties and I need to go back to school and to do more. So I tried to apply to do pre-med and they laughed at me because my high school transcripts were really bad. And ⁓ so I had to start from scratch. So I had to start pretty much like two years of community college with, and then none of that really counted.

So it was a lot because I had to work. My parents didn't have any money, so I had to work my way through school and do it all from kind of the beginning.

Coach JPMD (06:51)
So when you say optometrist, if you can help me understand, an optometrist ⁓ does what exactly versus

Christopher Tumolo, OD (07:01)
Optician. Yeah, that's a good question. So optician is like the pharmacist. They dispense the eyewear. That's a two year degree. And then the optometrist is the eye doctor, non-surgical. So we fit you with contacts, eyeglasses. We can do medical exams. just can't, in the state of Florida, can't cut into the eye.

Anything superficial we can do though, like we got a metal foreign body in your cornea, we can take it out, we can do oriolums, we can prescribe antibiotics, we just can't do surgery.

Coach JPMD (07:32)
Okay,

so you don't do injections in the eyes.

Christopher Tumolo, OD (07:34)
Correct, the ophthalmologist

does the injections. And then the ophthalmologist is just the, that's like when it breaks into the surgical realm, then the ophthalmologist takes over. So anything non-surgical we do.

Coach JPMD (07:44)
And so what you know, it's almost as if you see a vision works or lens crafters, Warby Parker in every corner of a major city. Correct. You know, is it that lucrative for them to be out there?

Christopher Tumolo, OD (07:57)
It is. ⁓ mean for the entity or for the doctor? For the entity. Yeah, for the entity it is. because they saw a lot of materials. So they contact lenses, they eyeglasses, they did the eye exams. yeah, like, loxotica is the biggest.

Coach JPMD (07:59)
Division with.

Christopher Tumolo, OD (08:13)
multi-billion dollar company. They own ⁓ some pearls, some are franchised, some they own. They own Target, Lenscrafters, Escelor. So it's a very big, big company and ⁓ it's homed in Italy. And it's a multi-billion dollar company. there is a lot of money in optometry or the eyewear industry.

Coach JPMD (08:37)
So what made you go into that versus being independent versus joining them or starting a franchise? lot of physicians are looking to start their own practices. They can join a big practice or they can join a hospital system, but some want to be independent. So what drove that decision?

Christopher Tumolo, OD (08:55)
seeing things done incorrectly and patients being treated poorly. That was the biggest driver. So coming out of school, working for other doctors, would walk into an exam room and talk to my patients and the patient might say, you know, I had a great exam but the girl at the front desk wasn't very pleasant. Or sometimes they would start with that. I introduce myself, hey, how you doing? know, smiling. They're like, the girl at the front or the guy at the front was rude.

And sometimes I would be fixing other doctors' mistakes. Sometimes I would be ⁓ filling in when other doctors weren't there. And after just a few months out of school, I said, I can do this better. Not to mention that I had been in the field before. So I already knew kind of the recipe that I needed in order to do this well, or at least as close to perfect as it could be.

So that was the driver. said, okay, I need to work for myself because I'm going to create a company that's going to be five stars across the board. And we're 4.9. Five stars is really tough. I lost sleep. I didn't sleep for three nights when we went from five to four, nine. my wife laughs at me because I was literally up all night trying to figure out what I could do to get back to the five. But you know, that's just me.

Coach JPMD (09:57)
Unacceptable.

So you decided to do that. What does it take to open up a optometry ⁓ business? You know, you hear physicians having to open up offices, and the clinic licenses and equipment and, know, full disclosure, I actually went to your office and had an eye exam and I have to say your equipment is pretty nice. Yeah. And I can only imagine how much it costs.

Christopher Tumolo, OD (10:38)
Yeah, so we

allocate all the money to the equipment. So everything that you see in the office while it's nice we we've really ⁓ Like bifurcated it down to like the most simplistic look so it's it looks nice and clean but it's like there's no you're not gonna find like the waterfalls and like the ivory and all the like the really fancy stuff but we we really put all the money into the technology and also into the equipment so that's part of like the recipe for success because

You can get an eye exam and use a manual foropter or you can get an eye exam and use an OPD and use an automatic foropter and the results can be much more efficient with the ladder and also much more accurate with the ladder and also the patient's psychosomatic experience with the better equipment. Sometimes they just see the better equipment and think like this is going to be better.

Coach JPMD (11:23)
Yeah, you just said some words I had no idea what you're talking about. can you tell us what you

Christopher Tumolo, OD (11:28)
Of

course, yeah. So the FROPter is the machine that you put in front of the patient's face and they look through it and you typically say like, what's better, one or two? Okay, yeah. So we don't have to necessarily get into the deep details of the one or two with the automatic because the automatic and the pre-testing equipment that's really, really efficient and accurate gets us to your subjective prescription, probably 95 or upwards percent of the way, meaning that the objective stuff

from the beginning gets us so close to what your answers would be subjectively that we don't have to do a lot of like one or two. And sometimes that confuses the patient and it gives the patient anxiety because they say, I feel like I'm going to get this test wrong and I'm going to get the wrong prescription. So it's really important to have the best equipment on the market in order to make the patient feel like they're getting the best exam, but also to actually give them the best results. yeah, the, think your question was, you know, how does it, how did you do all this?

Coach JPMD (12:20)
.

Yeah,

well, yeah, I was gonna ask you a follow-up question because sounds like the equipment that's gonna cost a lot of money and so yeah You take out loans you lease them. Do you like? ⁓

Christopher Tumolo, OD (12:36)
We purchase

everything we don't lease. purchase it all. Initially what I did is I took a sublease out inside of a Costco. I started practicing in a Costco and that was a sublease. I subleased the space and started to build my reputation there. And when we do the sublease, we don't pay anything. They provide you with the equipment and you just, you're the doctor. You keep your fees for the medical side of it. And then the

classes are purchased through Costco and that's where they make their money. So it's like a mutualistic relationship between the two. That helped fund my account so I could start my private practice.

Coach JPMD (13:16)
OK, so how do you get into a Costco? Because that sounds like a

Christopher Tumolo, OD (13:18)
It's really really

difficult so ⁓ There were a lot of doctors who applied and I actually wasn't the first choice I was the second choice the first choice decided against it because at the time she was getting married and had a newborn on the way and the commitment that they wanted was too Aggressive for her. So she decided to say she said like listen. I'm just gonna do something closer to home I've got a baby coming. I want to be more close to my family. So I was the second option. So Yeah, so sure

Coach JPMD (13:48)
Love that, right?

Christopher Tumolo, OD (13:49)
That was great to hear, it? I'm like, man, this is not good.

Coach JPMD (13:52)
So

you're at Costco. Well, you apply to Costco. You don't have much experience because you don't have a clinic, right? Correct. have. How? Why would they pick you over someone else?

Christopher Tumolo, OD (14:03)
They wanted us to give them five days of coverage. And I told them I'm gonna give them seven days of coverage. So they really liked that. And said, we want you to see.

two patients an hour, so I'm gonna see four patients an hour. So they really like that. And I had a plan because I'm very efficient with what I do and I also know how to, I was gonna fill the other days with other doctors. So had a ⁓ business plan and ⁓ that was one of the differentiators between myself and the first applicant. The first applicant was gonna just give them the five days. I don't know the exact reasons why she was chosen over me, but they did say afterwards that it was nice that I was gonna offer seven days coverage and see more patients because the more patients, the more days, the more volume, the more volume, the more people that are gonna buy glasses.

is the better Costco does. So initially, they were very low in the region. And then after a year that we were there, they went from like the 25th percentile in the region up to the 75th percentile of the region. And then by the end of our second year there, they were like at the 99th percentile, they were like top in the region. then they started to move the metric for like the entire like, so the region is like several stores. Then they started to move the metric for like the geographical region of the US like Southeast region.

Coach JPMD (15:08)
because

Christopher Tumolo, OD (15:08)
because of the

coverage you're Yeah, because of the coverage. At that point, had like 500, sorry, had 355 five-star reviews. So had great reviews. We put a billboard in front of Costco. That was a very difficult thing to get approved by them. They don't like ⁓ marketing within the brand. We marketed ourselves, but also we had to say where we are, right? They didn't quite like that, so it was difficult to get those things approved, but I put a billboard directly in front of the location.

So yeah, we did really well. We built it up and it was like thriving and going in and then I would, use that to fund the private practice.

Coach JPMD (15:44)
That's that's it's pretty neat. Yeah, so You mentioned the clinic days seven days a week and I did some research on burnout and because you know we try to help physicians decrease stress and decrease per not yeah, and you know one of the things I found was that there was a increase in burnout amongst optometrists versus ophthalmologists with men burning out about 40 % and women 60 % so and it sounds like it's correlated to how many days they work. Yeah, so how do

you decrease your chance of burning out when you're working seven days a week? Because you have physicians now coming out wanting to work four day week, four day, four day work weeks. They want to do weekends, they want to do call, but they want to make a lot of money. So how does that work for you? How do you decrease your chances?

Christopher Tumolo, OD (16:35)
Yeah, so so there are the new the new doctors that are coming out of school you're 100 % correct like scaling the business beyond where we're out today work that's the ⁓ that's kind of a weak link in the chain or the area that we're like We're we're hitting that bottleneck because the newer doctors like you just said they don't want to work weekends They don't want to work past four they want they want the most money and give the kind of the least amount of work and that you know Haven't quote quote unquote paid their dues yet ⁓ it's it's off right now because ⁓

There's a lot of leverage for the new grads and there's a lot of leverage for the employees and not the employers. The landscape sort of flipped. But for me personally, I'm very goal-oriented and I am very disciplined.

So for example, in school, I never took a day off. I studied seven days a week. Even Sundays, I was at the library studying. And then when boards came around at the end of school, I didn't have a lot of time to study for boards because I had to take a summer class and I passed on my boards immediately, first time with high scores because of the work I put in prior. But I've always had a strong work ethic. My parents got me working when I was 14. And by the time I was 15, I had two jobs.

And I had two jobs pretty much my entire life. Even when I was making good money, had a second job, always had a second job. So I have really I'm really resilient and I have a lot of discipline and it goes back to even like the martial arts like we talked about in the BJJ like I'm 46 now and I really haven't slowed down. I don't tend to slow down and and.

Coach JPMD (18:12)
But

you have young guy you have young physicians optometrists optologist listening to this podcast right now and saying yeah, you're 46 I'm not doing that now I don't have to because I can go to Lenscraft or I can go to Warby Parker and make X amount of dollars and very happy. Yep. Why should I

Christopher Tumolo, OD (18:27)
I also have a very internal drive to be the best and a very internal drive to be not necessarily better than others but better than myself yesterday and the day before. I don't want to let myself down. I don't want to my friends and family down. Everything I do is like concentric rings. So like my immediate family is the most important. So I work hard so they don't have to. And I feel

It's probably going to get a little off topic, but I feel like there's a lack of the responsibility for men today where they feel like they can just give into their emotional state. ⁓ I don't necessarily agree with that. I kind of push my emotions aside and don't succumb to them because you've got to be, there's got to be something

to be tethered to. And I feel like in my family, that's me. Like I'm the immovable object. you know, I make sure that everyone's taken care of and you know, you can't do that by, you know, giving into feeling like, hey, I'm kind of tired today. I'm not going to go into work, you know, or I don't feel like working today. So a lot of that's very ⁓ much ingrained in me from the way I was raised.

Coach JPMD (19:45)
Yeah, you know that brings up some things in my brain, you know, because I means a lot things open your brain, but But I had a conversation with two women older women in the practice Who were struggling struggling with not knowing how to manage their diet? Not knowing how to manage what they're eating what they're doing and they were both single

And they had no direction. ⁓ And what I find is a lot of older, our senior population that lose their husbands or lose, you know, their loved ones don't have direction. And what you're saying is that if you can provide, you can work hard now, provide for your family, be that tether. ⁓ That's what's going to help them long term. So if they're not around, you at least have something that they can fall back on. And because men do live.

shorter than women. So women are outliving us. Yes. And so I think, I don't think it's off topic. I think it's pertinent to the overall societal changes that we're seeing. So when we come out of residency saying, I only work four days a week, how do you grow a practice working four days a week? Because patients are not going to come to you if you're not available.

Christopher Tumolo, OD (20:56)
You can't end.

Correct. When we first opened, I ⁓ had my cell phone number on ⁓ our auto attend and I also had my cell phone number on our website. And patients would contact me all hours of the night. remember, ⁓ if you look at our reviews, there's a review from years back and... ⁓

and he says, I contacted Dr. Tumolo at like 9 p.m. on a Saturday and he replied within a minute and ⁓ I said, yeah, we'll see you tomorrow and he opened the office on, I have opened the office on closed days for ocular emergencies. I would take calls, I'd be having dinner with my family, I would take a call.

You have to understand that there's always gonna be compromise in life. And in order to be successful in business, you do have to compromise some of that work-life balance, which is a term that I'm not fond of, very particularly fond of, but it's very common right now. But you can give to work and you can give to life and still be successful at both, but it does come with a balance. And in the beginning, you are gonna be...

putting more of the percentage of your time and effort into probably the business, but that will pay dividends as you get the momentum going, because once the momentum starts, just like in physics, it's a lot easier to keep it going than it is from a dead stop. So you will push harder in the beginning, but then you'll get the momentum and then you can take a couple steps back and let the company kind of run, and then you can focus more on the family. People want...

People want everything and they want it now and it doesn't work like that.

Coach JPMD (22:34)
Yeah, yeah, and coming from with your experience and what you've done, I think it's, it's obvious that these are some of the traits that a physician needs to have. You talk about resilience, you talk about, you know, work ethic, seven days a week. That's what I'm, that's what I'm used to. And ⁓ it's not for everyone. You know, we're not saying that everyone should do it. Correct. But I think everyone, people should understand that, you know, if you don't do it, you're not going to get the same rewards or same benefits as, as

So I think I know the answer to this. So what would be the one advice that you'd give to a new doc, a new optologist, ophthalmologist coming out today?

Christopher Tumolo, OD (23:04)
you do.

You are lucky to be in a country where you can work hard and they can pay off. you are in the 1 % already because you're a doctor. And that's due to hard work. Like you worked hard to get there. And you truly can make a difference. So I try to make a difference in every one of my patients' lives. So I mean take, I take.

Ownership and I take interest in my patients beyond the level of their eyes, you know, I know about their families I know about their general health history. We talked about that It's it's a great thing. It's a great career to be a doctor in the US and it's ⁓ You know, you should just you should enjoy it and relish in it and get to know your patients like I talked to my patients my patients they asked me about

my wife, about my dogs, about where I move. I enjoy what I do. mean, to truly enjoy what you do, it really doesn't make it feel like work. It makes it feel like just a good part of your day. And we try to template that with all our doctors. We try to create an environment where, from the top down, it cascades so that at the bottom, we start at the top with the owners and then the doctors and then the technicians and then the patients. And we want...

the environment to be just the best. We want patients to walk in and see people laughing and smiling, having a great time. We don't want them to walk in and see an angry secretary behind the desk who's like, you know, looking down and say, give me your license. Like that's just not the, you're not gonna see that at our office.

Coach JPMD (24:55)
They don't last either. I think if you create a culture where people are happy and they're working hard, that person that's the lazy link ⁓ won't be there long. Correct. Because they'll be uncomfortable.

Christopher Tumolo, OD (25:06)
Yep, they don't fit in and ⁓ you know, where don't fit in, you typically don't stay.

Coach JPMD (25:11)
So one last question. What's your superpower? What would you be your you say that your wife maybe even yourself would say your is your superpower?

Christopher Tumolo, OD (25:20)
Yeah, probably everybody that knows me knows me well. It would be the internal discipline internal drive. Like I just don't stop. I just don't stop I've had a lot of struggles in my life a lot of struggles and there have been a lot of difficult times But ⁓ like I just just don't stop. I never stop. Yeah

Coach JPMD (25:38)
And I think that's what I saw in you. Yeah, this guy's this guy's going places.

Christopher Tumolo, OD (25:44)
Yeah, there's just nothing. When I was in school, there was a lot of obstacles and there were lot of people who didn't want me to succeed and there's just nothing they could do could have or would have stopped me. So yeah, would say internal drive, discipline, perseverance. Those are the traits that, and I think again, a lot of that goes back to foundationally the way I was raised. Yeah.

Coach JPMD (26:10)
It's been a great conversation. Thank you so much for coming into the studio. We don't do this as often. I want to do it more. Really appreciate the conversation. All right. Thank you so much for listening to the podcast. If you'd to hear more, subscribe, follow your favorite podcast app so you'll never miss an episode.

Christopher Tumolo, OD (26:16)
Yeah, that's Terrific. Thank you so much. Thank you.