With proper systems in place, staff can be more confident and efficient. All photos courtesy of Dr. Lillie.
Empower your staff when you delegate with efficient systems
By Nick Lillie, OD
Dec. 22, 2025
I have worn many different hats over the years in my office. When I started, it was just me and one other staff member. We did everything! There were times when I was the only person in the office, so I did the workup, my exam, answered phone calls and then helped the same patient pick out glasses and lenses.
Fourteen years later, I now have 10 full time staff members and an associate doctor. I plan on adding a second associate within the next year. The way we used to operate is no longer practical nor is it scalable.
Don’t Do It All Yourself
As I talk to other doctors just starting out or doctors who are just starting to grow, I’ve noticed this is a common theme. It can be one of the biggest challenges to growing your office into a thriving business instead of just being focused on doing a really good job every day. A good business makes money and runs when you are not there. However, most doctors are essential to day-to-day operations, and the office does not make money when you are not in the exam room.
In this second part of a three-part series on growing your CEO Mindset, I’ll explore how doctors of varying experience levels can put the right pieces in place to scale and function the office routine to run smoothly even if they are not there. You can have a thriving business and be the CEO of your office.
Develop Your CEO Mindset With Systems
Earlier on, even as my office team grew, I still found myself relying on one or two people to do things the right way. If they were to leave, we would be in trouble from an operations and training standpoint. Does this sound familiar to you?
If it does, let’s talk about how to get past the dependency on one person and raise the ability level of everyone working in your office. The key is to put standardized systems in place. As you grow, these systems scale and make your business function based on proven procedures–without dependence on a single person.
Create Systems That Scale
Here are the steps I recommend to put proper systems in place.
Step 1: Define Your Key Operations To Replicate
I suggest working on the most important aspects of the practice first. For example, how to make an appointment is a great place to start. Then, look at the way your team works up a patient for a specific type of exam, exam protocol for different needs, how to do a proper handoff and picking out glasses.
These are just a few examples, but you can and should apply this methodology to every aspect of your office. Remember to focus on your core business If your practice concentrates on dry eye services like mine, make sure to outline signups and scheduling.
Step 2: Get Staff Input In Outlining Processes
Start simple and ask for their help. Have each staff member outline all the steps in making an appointment. This will save yourself time. Instead of starting from scratch, you can refine their notes.
With a bigger staff, you may see more deviations in the process. This is exactly what you need to examine the process closely, asking everyone for input. If you do it as a team, instead of individually, the lead staff may take over the conversation before you have a chance to evaluate each staff member. This is invaluable from a training perspective.
Step 3: Create Your System From Outline and Procedures
After you have each person’s step-by-step process, you or your office manager can finalize the official process. Then it’s time to provide education to get everyone up to speed.
Review the official step to the system together as a team and get everyone to sign off on the process. Once you have set the standard and they all have had input, you can hold them to this level of accountability going forward.
Step 4: Create Educational Resources to Support Your Systems
Once the standard operating procedure (SOP) is set, I suggest making videos and storing them to a database. Existing staff can refer back to this training archive, and new hires can learn from it, too. It also assures the information that could be lost when a key employee leaves stays with the company for years to come.
When making videos, do not worry about quality. Just make sure you capture all of the basics and steps. I like using Loom, which allows me to record my screen while doing a task. Or I can film a step-by-step process for a routine such as checking in glasses.
Having this information in a central, easily accessible location is crucial to allow your office to scale past a single doctor and small staff.
A dry eye treatment room
How Systems Helped My Practice
So how does this work in practice? We have seen a drastic improvement in 3 specific areas since implementing this process. Our onboarding is quicker and more efficient, our virtual assistants can handle a larger and more complex workload, and our dry eye clinic has taken off.
Onboarding
This is the obvious and low hanging fruit. New staff members learn with a uniform system and process that is written out as well as complemented with visual references to aid their training. Without the systems in place, new staff members would hear numerous ways to do a task causing confusion. They were less effective at their jobs. Our training time has been cut in half, and I’m seeing a higher level of performance with more job satisfaction.
Virtual Assistants
Our two virtual assistants (VAs) have become an invaluable part of our staff. One of the biggest issues in finding success with VAs was in learning how to train someone who was not in the office. By applying implementing systems in our optical department, we now have the VAs accurately trained to send in all patient lens orders, order frames and call on patient jobs. They do the same thing for prior authorization and insurances questions. By streamlining how we operate and having accompanying videos, they now allow us to focus on patient care while they handle the details.
Dry Eye Clinic
The third, and probably most impactful area of improvement, has been in our dry eye clinic. Before we expanded, everything ran through me. I was the person who did the majority of the patient education. We had one or two staff members that could sign a patient up for treatments; many offices refer to these staff members as champions.
This routine worked until we moved to the new office. We doubled the staff and added an associate doctor, as well as new treatments (Tixel and RF to our IPL technology). This caused disruption, as we were having trouble properly educating patients and getting them to buy into our treatment plans.
Our team worked together to break down every step of the process and rebuilt our dry eye evaluation protocol from the ground up. As a result, everything was streamlined and every staff member was able to be a champion for our therapies. All doctors also operate in the same protocol in regards to a dry eye evaluation and how we transition them to treatment.
With everyone rowing in the same direction, patients are now being properly educated and accepting our treatments. This has led to better patient care, and our staff loves being an integral part of the process. Everyone wins!
Dr. Lillie saw an increase in his dry eye signs up after he implemented systems to get the entire team on board.
Always Adapting
It is our goal as business owners to make our processes as replicable as possible and not dependent solely on any one person, including ourselves. Having refined SOPs is the first step in this process.
With these systems in place, you will have the freedom to choose what you want to use your time, effort and energy on.
Remember: nothing is forever. You will need to take the time to adapt and adjust when needed. These updates are much easier to make with a starting point. Having a proper system in place is far better than having everyone follow their own routines.
Check back for part three of this series, focused on defining your office culture.
Read part 1 of this series by Dr. Lillie here.
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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. |
