Dr. Lillie displays visual representations of his office culture for himself and his staff. Photos courtesy of Dr. Lillie.
Define your culture, develop your competitive advantage
By Nick Lillie, OD
March 3, 2026
I believe you need a solid foundation to run your practice and have a thriving business. You have to have a clear vision for where you want to go, set up systems to scale and, most importantly, define your culture. The vision is the north star that guides all decisions. Systems allow you to run smoothly and efficiently and not be dependent on a single person. Instead, it sets up the business to operate as staff turnover inevitably occurs. In my opinion, culture is the most important piece of this puzzle.
Culture may be the most overlooked aspect of your business. I believe this is because it is hard to define and there are no specific KPIs that directly measure it. It is a feeling that radiates from every interaction for patients and staff. Staff turnover and doctor burnout can be traced back to a culture problem.
A SMALL CHANGE WITH BIG RESULTS
In Charles Duhigg’s book, “The Power of Habit,” he outlines the downstream effects of a great culture. Duhigg shares an example of how Paul O’Neill, the newly appointed CEO of Alcoa, one of the world’s largest manufacturers of aluminum. O’Neill set the cultural mindset to be the safest workplace in America. As a publicly traded company, focusing on workplace safety was quite contrarian at the time. Most new CEOs would talk about growth, optimizing the sales process or strategy to take the company to the next level.
Despite his critics, O’Neill made workplace safety priority number one. Every injury had to be reported within 24 hours with an action plan and communication lines were established so employees could report issues without fear of retribution. Managers were forced to directly address the concerns in a timely manner.
This may seem great for the employees, but was it going to actually help the business? In fact, Alcoa’s profits skyrocketed. The business was one of the safest in the world. His critics were turned into huge supporters as shareholders made impressive returns!
I know what you are thinking. How could an emphasis on safety have those effects? This new approach had downstream effects:
- improved communication
- streamlined processes for more efficient and effective operations and manufacturing processes
- reduced errors
- built trust among staff and leadership
As a result, this translated directly into higher productivity, better quality and lower costs.
All of this because of a change in culture. This principle can directly be applied to our optometric practices.
CULTURE AND MY OFFICE
During my first year in practice, we had six or seven staff members turnover. In the past year, we also had a fair share of growing pains as I doubled the physical size of my office, doubled my staff and added an associate. We now have nine full time staff members, so this has been a considerable change. A few of these did not last more than a week, but some had been with the office for a couple of years.
In the same spirit of O’Neill, we made a huge commitment to core values and set that as the standard to work in the office. Care and empathy for fellow co-workers and bringing positive, fun and friendly energy every day are not your typical KPIs for a practice. However, I believe they are a driving factor behind why we are up 30% for the year.
We committed to these and have hired a team that believes in what we do. It was a little rocky at the start, but I would not change the commitment we made to our culture. Our staff is operating at its highest level I have ever seen, and we are providing amazing patient care as a result. If you want to have a culture that matters, it is going to take 100% buy in. One bad apple will spoil the bunch. A few hard conversations may be necessary, but the practice you want is on the other side of them. You and your patients deserve it!
STEPS TO ESTABLISH CULTURE
These three steps will help you establish your office culture.
STEP 1: DO NOT FIGHT WHO YOU ARE OR WHO YOU WANT TO BE
As practice owners, we set the culture. We ultimately get to decide who we work with and how we practice. You have to make sure you operate in the way you want, not what you think you are supposed to be doing. I have a Type A personality who likes being on schedule, I love adding new technology and optimizing how we practice and I like being busy. This is just who I am and it sets the tone for our office.
In my early years, I would hire who was available. We were small enough that my personality and presence would make up for less than total buy-in. Yet this will not last, so you need to take stock and figure out 5-7 core values that you firmly believe in. Consider what makes you tick, and you will be surprised at how you will see the correlation with what type of optometry that you enjoy. Sometimes you will feel the energy, and other times, you are drained. The former usually aligns with your passion.
STEP 2: DEFINE YOUR CORE VALUES
Once you figure this direction, gather your leadership team: maybe your office manager and a key staff member. Ask them to share the values they believe define your practice. I displayed these on a white board. Once we had exhausted our lists, we combined our similar themes. For example, commitment to excellence and quality were focused on the same goal. We then ranked them from 1-7, and ultimately, we settled on five core values.
We listed about 3-4 sentences about each that defined the behaviors that represented those values. The key to involving your leadership team is that they are signing off on the values. Therefore, they can be held to that standard. This is crucial because they are in charge of making sure the rest of the team follows through on your core values when you are not around.
Staff members earn pins for their positive representation of the defined office culture.
STEP 3: PRACTICE WHAT YOU PREACH
Once you define your core values, start shouting them from the rooftops! I use these to start every office meeting. We shout out exemplary conduct citing the core value it illustrates. I make sure every potential hire gets the rundown of our values and what it means to carry them out in our office culture.
Read my practice’s core values below. They are front and center on our website. When we do performance reviews, talk about changes we are making or get patient reviews, our core values are always considered. We talk about them often, and it has made a huge difference in our office culture. Our staff and patients have commented about the noticeable change since we started emphasizing them in all that we do.
We give each staff member a special pin every Monday if they are shouted out for a core value. This has helped reinforce behavior amongst peers. I hear staff using this language in their day-to-day conversations and feel a little bit of pride because they mean so much to me. I truly believe that emphasizing these small behaviors has had a downstream effect of improving our business as a whole.
Our Core Values
Here are the values we live and work by at Family Vision Optical and Rejuvenation Dry Eye Center.
CARE: Genuine Care for People as a Whole
Sees each patient’s encounter as an opportunity to use the knowledge, tools and resources available to educate and optimize their vision and give them hope for a better tomorrow
Listens and shows empathy and compassion for the patients and co-workers
Actively communicates positive and negative feedback, sets proper expectations in a productive and professional manner to improve themselves and the patient care experience
QUALITY and CONSISTENCY: Accurate attention to detail
Performs their duties accurately and consistently on a daily basis to serve patients and represent the business
Takes pride in providing patients with accurate answers to their questions and solve any issues involving their eye care needs
Committed to training, protocols, and standards set in place to keep their skills and knowledge up to date and provide patients with the best possible experience and take initiative to understand and communicate what is not completely understood
EXPERTISE: Lifetime Learner
Understands the three areas of focus that set us apart in eye care and what their role is in these areas
Knows the ins and outs of their role (insurance, scheduling, optical options, etc.) and uses them to give the patient the best experience possible
Committed to learning and are open and willing to staying cutting edge in the science and optometric technology we offer
TIMELINESS: Prioritize and Follow Through With What Is Most Important
Physically and mentally here to serve our patients effectively and efficiently
Knows their role in the business process, gives their best effort and keeps everything moving forward
Serves not only the patients in the office, but our future and past patients with their questions, concerns and requests in the most efficient means possible
T.E.A.M. MENTALITY: More Than the Minimum
Adaptable and flexible – Asks “Where do you need me?” and does what is needed to get the job done
Positive, fun and friendly – Brings positive energy to the office on a daily basis
Goes above and beyond – Routinely does more than the minimum to solve problems or provide answers to coworkers and patients
Read part 2 of the CEO Mindset series from Dr. Lillie here.
Read more on professional development 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. |
