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How optometric practice owners can turn strategy into execution
By Thanh Mai, OD
Feb. 18, 2026
By the time most optometric practices reach $1+ million in revenue, the problem is no longer clinical skill or patient demand. It’s vision and execution. Most decent optometrists should be able to grow a million dollar practice with so-so leadership and management skills. Past that, great ideas pile up. Meetings feel busy but unproductive. The owner becomes the bottleneck.
This is where I believe that the Entrepreneurial Operating System (EOS®) can help.
If you’ve already read “Traction: Get a Grip on Your Business” by Gino Wickman or implemented Level 10 meetings, the next major inflection point is your first EOS full-day session with your leadership team. Done correctly, this single day can create more clarity and momentum than months of scattered meetings.
Done poorly, it becomes an expensive, exhausting retreat with no follow-through.
Here’s how to conduct your first EOS full day in a way that actually moves the needle in an optometric practice.
Step 1: Understand the Purpose of the EOS Full Day
This is not a team-building retreat. It’s not a vision-casting monologue by the owner. And it’s definitely not a clinical CE day.
The purpose of your first EOS full day is to:
- Create clarity around where the practice is going
- Identify the real constraints holding growth back
- Establish accountability at the leadership level
- Reduce owner dependency
In optometry, this often means shifting from:
“I carry everything in my head” to “The business runs on a system.”
Step 2: Invite the Right People (Fewer Is Better)
Your EOS leadership team should be small and role-based, not title-based. Hint: being an “owner” is not a role, nor does it prove you have the merit to be a leader. The ideal size is three to seven people.
If you’re tempted to invite “everyone,” you’re not ready for EOS yet.
In most optometric practices, this includes:
- Practice Strategist (a visionary, usually the practice owner but not necessarily)
- Integrator (often office manager or COO-type role) the one who executes the plan
- Lead optician
- Lead technician or clinical manager if applicable
- Billing/finance lead (if applicable)
- Marketing or growth lead (internal or external)
Step 3: Prepare Before the Day (This Is Where Most Practices Fail)
Your full day will only be as good as your preparation.
At least one week before, send attendees:
- A simple agenda
- Current scorecard (even if it’s imperfect)
- A request to come prepared with:
- Top three issues holding the practice back
- One win from the past quarter
- One frustration they haven’t voiced yet
If you’re using an EOS Implementer, a special facilitator for this system, they will guide this.
Step 4: Structure the Day (Sample Optometric EOS Full-Day Agenda)
1. Check-In (15 minutes)
Each leader answers:
- Personal best from the last 90 days
Professional win
This matters more than it sounds. Optometric leaders often wear multiple hats; clearing mental clutter early improves decision-making.
2. Review the Vision (60 minutes)
Use the Vision/Traction Organizer (V/TO) framework:
- 10-Year Target
- 3-Year Picture
- 1-Year Plan
- Quarterly Rocks
For optometry, this is where clarity emerges:
- Are you building a lifestyle practice or a sellable asset?
- Is specialty care core—or optional?
- Are additional locations a goal or a distraction?
Alignment here prevents years of misallocated capital and effort.
3. Scorecard Reality Check (45 minutes)
This is often uncomfortable the first time and that’s a good sign.
Focus on:
- Five to 15 weekly numbers
- Lag measures (results)
- Lead measures (behaviors)
Examples in optometric practices:
- New patient count
- Revenue per patient
- Optical capture rate
- Specialty consults booked
- Show rate
- AR days
The goal is not perfection. The goal is visibility. I would review the P&L and discuss budget once a year.
4. Identify the Real Issues (IDS Session – 2–3 hours)
This is the heart of the day.
Using EOS’s IDS (Identify, Discuss, Solve) framework:
- List every issue
- Prioritize the top three to five
- Solve only those
Common “real issues” in optometry:
- Owner is still the main salesperson/doctor
- Poor follow-through with specialty leads
- Middle managers unclear on authority
- Meetings without accountability
- High staff effort, low output
Most practices discover they don’t have a “marketing problem” or a “staff problem”—they have a clarity and ownership problem.
5. Set Rocks (45 minutes)
Each leader leaves with one to three quarterly Rocks, which are goals with the steps to achieve them. They should be:
- Specific
- Measurable
- Owner-assigned
Examples:
- Implement dry eye consult workflow
- Improve recall process
- Increase myopia enrollments to X/month
- Document front desk SOPs
If everything is a priority, nothing is.
6. Close Strong (15 minutes)
End by rating the day (1–10). Anything below an eight becomes an issue to solve next time.
This reinforces a culture of continuous improvement—not politeness.
Step 5: The Most Important Part, What Happens After
Your first EOS full day fails if:
- Rocks are forgotten
- Meetings revert to old habits
- Accountability fades
Success requires:
- Weekly leadership meetings
- Public scorecard review
- Ownership, not consensus
- Willingness to address underperformance early
EOS is not about being nice. It’s about being clear.
Common Mistakes Optometric Practices Make
Set yourself up for success. Try to avoid these roadblocks:
- Treating EOS like a project instead of a system
- Skipping difficult conversations
- Letting the owner remain the integrator responsible for getting everything done
- Overloading Rocks
- Expecting culture change without behavior change
EOS exposes issues—it doesn’t magically fix them.
Let the System Lead to Success
Most optometric practices don’t fail because they lack vision. They fail because execution depends on one person.
Your first EOS full day is the moment you decide: “This practice will run on a system—or it will always run on me.”
If done correctly, it’s not just a meeting. It’s the beginning of a very different kind of practice.
Read more insights from Dr. Mai here.
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Thanh Mai, OD, is an owner of Insight Vision Center Optometry, a Vision Source practice in Costa Mesa, California; Optometry Corner, a Vision Source practice in Irvine, California; and Eyecon Optometry, a Vision Source practice in Reseda, California. In addition, Dr. Mai owns Project Eyecare, a Vision Source practice in Mission Viejo, California. To contact him: tmai@visionsource.com |
