CEO Mindset Part 1: Define Your Vision

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Define your vision: the first step in developing a CEO mindset

By Nick Lillie, OD

Nov. 3, 2025

COLD START TO CEO

I graduated in May of 2011 and opened my office cold in October of the same year. I cannot believe it has been 14 years since that milestone. There have been many changes along the way but none more important than separating myself from the business and acting like an actual CEO.

It is a huge mindset shift that has allowed me to grow with a purpose and much more efficiently than my early years. I was ready to start down this new pathway in 2023, after about 12 years in business.

There are three key components to acting like a CEO: having a clear vision for the office, creating systems that scale and establishing a culture that defines your brand.

In this first part of exploring the CEO mindset, we will take a look at the importance of having a vision for your business. Consider where you are today and where you want to be in the near and not-so-near future.

SURVIVE AND ADVANCE

Success starts with a clear vision for the office. I like to call this my north star. It is absolutely crucial to consistent growth and allows you to make decisions for the business much more decisively and confidently. For example, when I first opened the office, my goal was simple: survive and advance to another day. This was admittedly pretty shortsighted, but it was all I had the capacity for at the time.

One day, my office did not exist. The next day, we were a functioning office–sort of. We created policies and procedures on the fly. It seemed that with every patient we learned some new nuance and implemented new policies each day. When it came to patient care, there were the basics (slit lamp, phoropter, etc.) but there were also so many other options. My purchases were driven more by the next shiny object than by what my patient base would support. I was rudderless as I tried to serve everyone. I did not have a defined vision for the office!

DEFINE YOUR VISION

I had to go through a process to define my vision and mission at the office. This will be your roadmap. It gives you clear direction for how you operate and make decisions at your office. Let it guide you through every purchase, hire and strategic move you make going forward.

To do this, we are assuming you have a defined culture: you know what you’re passionate about, and you have clearly defined core values. Without these two things, your vision for the future will be much harder to achieve. (I will discuss defining your office culture in part 3 of this CEO Mindset series.)

These three steps can help you fine-tune your vision for your practice.

Step 1: Your BHAG (10-Year Goal)

Jim Collins, in his book “Good to Great,” coined the term Big Hairy Audacious Goal (BHAG). Benjamin Hardy would call this an impossible goal in the recent book, “The Science of Scaling.” Both are referring to setting huge goals. Collins was more practical in his approach. He encouraged the goal to be something really big yet more attainable than pushing the limits of reality.

Regardless of the route you take, the point is to have the end in mind. Some key questions to ask yourself are: What patients give you the most joy? When you go to an optometry conference, what lectures do you like to listen to/find yourself attending?

In my experience, you need to find a way to create a practice that allows you to see the patients that give you joy and consume the information you enjoy. Once you answer these questions, you can set a 10-year goal based on what you want out of your career.

In my practice, we have been intentional with treating dry eye and ocular surface disease (OSD). My goal is to create a standalone, tertiary care referral center for dry eye and OSD.

To provide context, let’s look back at where I started. Remember how I mentioned that when I started I was seeing patients of all ages and just wanted to get to the next day with money left in the bank? I focused on primary care, glasses and contact lenses. The office didn’t have a visual field or OCT. I would refer out for anything medical other than red eyes.

Step 2: Your Vivid Vision (5-7 Year Goal)

Once you have the 10-year goal in mind, you need to work backwards. In order to be there in 10 years, where do you have to be in five to seven years? This is the vivid vision. 10 years is a long time and does not create a sense of urgency. It merely acts as the north star. It’s a guide that helps you gauge if you are veering off the path. In five years, you need to be a little more intentional.

Before last year, I was in a 1,600-square-foot office with one exam room, one special testing/treatment room and one workup room. I was capped at my ability to see patients or add doctors and staff. I could not foresee a future in which that spot would allow me to reach my 10-year goal. As a result, I started the process of finding a new location that could support my goal.

In five years, I wanted to have a second doctor, at least two rooms dedicated to dry eye and room to grow my dry eye services. Right now, we are two years into the five-year plan. We are ahead of schedule!

Step 3: Your Plan (1-3 Year Goal)

After you set your vivid vision, you need to get to work. In the next one to three years, what do you need to do that will allow you to be at your five-year check point?

In my case, I want to be a referral center for dry eye and OSD. This has focused my efforts like a laser. I read as much as I can about dry eye/OSD. The technologies I have brought into my office are all focused on this type of care, including Tixel, RF by Inmode, IPL by Lumenis and  SL 650+ slit lamps by Essilor. The way I train and hire staff has all been influenced by my 10-year goal.

It is a lot easier to make a decision in a sea of options when you know where you want to go and how you want to practice.

Since I’ve shifted to a CEO mindset, the numbers show how the practice has grown.

In the past 12 months, we have seen an 11% increase in comprehensive exams (3,210 to 3,569), yet we have grown top line revenue 25% (from $1.4 million to about $1.77 million). The outsized increase is attributed to focusing on growing our dry eye clinic.

BONUS: Supercharge Growth (Ben Hardy’s Method)

Hardy used the following example in his book. There was a high school tennis player who wanted to play in college. His father sat him down and asked him if he thought he was doing enough to get there. His son replied that he thought so. The father then asked his son, if his goal was to play professionally, was he doing enough? His son, without hesitation, said no.

At this point, the father asked his son what would he change if he wanted to play professionally? His son detailed where he would train, what he would cut out and how much more focused he would become. The astute father suggested that if his son did that now, he would have an advantage for an even better position to play in college.

When you look at your 10-year goal, it may seem daunting. It also can seem so far into the future that we tend to get distracted. We may not put in the same effort as if it was going to happen in one year. If you were going to accomplish your 10-year plan in one year, what would you do differently?

In my scenario, I would stop spending money on frames and marketing for primary care exams. I would get as much information out as possible about my dry eye center and new services. I would convert primary care exam lanes into additional treatment rooms, and I would hire more staff to support the advanced treatment and dry eye services we offer.

EFFORTS PAY OFF

I focused my efforts on developing my BHAG and vivid vision in July 2025. We have experienced more growth in this six-month time frame than any other time period. When I gave myself an impossible timeline to get things done, I jumpstarted my plan into motion.

What is your 10-year goal? What steps will you put in place to work towards accomplishing as much as you can in one year?

Come back for parts 2 and 3 of this series where I will explore creating systems and defining culture and how they relate to the CEO Mindset.

Read another article by Dr. Lillie here.

Read more on professional development from ROB here.

Nick Lillie, OD, is the owner and founder of Family Vision Optical and Rejuvenation Dry Eye Center in Allendale, Mich. He is also the host of the weekly podcast, “Optometry: The Ultimate O.D.” To contact him: drlillie@therdec.com.