Photo Credit: solar22/Getty Images
By Nick Lillie, OD
Sept. 11, 2026
I recently got an email from a listener to my podcast asking how much of the CEO mindset can be learned and how much is already ingrained. The emailer went on to describe that although he wanted to have a strong successful business, CEO things feel more like work than fun. He also felt that no amount of books, podcasts or consultants could really change that. He also suspected that I was probably always gung ho and laser focused about those things.
I loved this email and readily admit that I genuinely find joy in exploring growth, strategy, systems and developing people. I probably have higher ambitions than the average practice owner on where I want to bring my business. However, this is merely my expression of the CEO mindset. It’s not the definition of it. You do not have to want what I want to think like a CEO.
We Have Made “CEO” Too Complicated
When I speak to other practice owners about being the CEO of their practices, they instantly start thinking about boardrooms and spreadsheets. What KPIs do they need to track? Is the goal multiple locations and aggressive growth?
I have to get them to take a step back and explain that none of these things define the mindset. It comes down to having a vision for your practice and a vision for your life and intentionally working towards those things. For example:
A solo OD who wants one excellent location, four clinical days, a great team and a wonderful life can be every bit as great a CEO as someone building multiple locations and having an organizational chart of over 50 people simply by being intentional. Ambition does not always mean bigger.
Having a CEO mindset begins with one question: What do I actually want my practice to be?
The Real Difference Is Intention Versus Reaction
The problem I lived with for the first 10 years of my private practice life was a lack of clear vision. I was reactive to the moment rather than intentionally building towards the practice and life I wanted.
The vicious cycle was:
- A staff member complained. I would change.
- A patient got upset. I would change.
- The month was slow. I would panic.
- A new initiative received resistance. I would abandon it.
I know I am not alone, and I talk to owners that are still stuck in this cycle. Eventually, the practice is being shaped by whatever happened most recently. Having a CEO mindset means having a vision and allowing that vision—not today’s mood—to guide decisions. Don’t get me wrong, feedback still matters. Circumstances still matter. But neither should automatically determine direction.
A CEO Mindset Happens in Ordinary Moments
When the CEO mindset is viewed as merely practicing with a definitive purpose, it becomes easy to think like a CEO. Let me give you some simple examples:
Going to CE
- I learn something I believe will improve care.
- I bring it home.
- I train the staff.
- I change the process.
- I make sure it actually gets implemented.
That is a CEO mindset.
Training a new employee
- I don’t simply teach which buttons to push.
- I explain how we care for patients, how we communicate and why their role matters.
That is systems, culture and leadership.
Creating a great patient experience
- I intentionally think about what happens from the phone call all the way through the exam, handoff and optical experience.
I am designing an experience instead of just hoping one happens.
CEO Mindset Is Also About the People Around You
Now, if the ordinary moments don’t speak to you, remember that one of the most important aspects of being a CEO is your people. Maybe your vision is simply to create an office where your staff loves working. A nice side effect of a happy staff with a great environment is you also work in that environment.
If that is your vision, build that environment with intention:
- Give people the tools to succeed.
- Train them.
- Recognize them.
- Hold standards.
- Explain why their work matters.
If you have an associate, a CEO mindset doesn’t have to mean maximizing every dollar of their production. I went to AOA this year and one of the lectures was how to avoid burnout. I love what I do, but more than anything, I want my office to be a place where doctors want to work, where they become the best versions of themselves, the place that allows them to live the lives they want. If you have this same desire, having a CEO mindset looks like:
- Helping them become clinically excellent.
- Finding what they love about optometry.
- Building confidence.
- Giving them autonomy.
- Creating a career they enjoy.
How Much of It Can Actually Be Learned?
I agree that some traits probably are hardwired or personality-driven:
- Appetite for growth
- Competitiveness
- Risk tolerance
- Love of numbers
- Comfort with change
- Desire to build
Books and consultants may never make someone love expansion—and they shouldn’t have to. One of the clinical pearls recently told my newest associate was to find the intersection between optometry and what he scrolls through at night.
For example, aside from reading about CEO business and systems, I love working out and sports. Two of my favorite podcasts, “Mind Pump” and “The Herd with Colin Cowherd,” have nothing to do with optometry. However, I routinely gain insights on how to be a better doctor and leader.
“Mind Pump” has three personal trainers that constantly have to find ways to motivate people to workout and remain consistent. This translates directly to my dry eye clinic. How do I get people to do home therapies?
On “The Herd,” I could not care less about fantasy draft tips, but I love hearing how coaches and executives motivate incredibly talented athletes to work as a team and improve. Think of this as an opportunity to make talented doctors even better at what they do.
This is where I believe the important CEO behaviors can be developed:
- Setting direction
- Making deliberate decisions
- Communicating expectations
- Developing people
- Following through
- Building systems
- Protecting culture
- Looking beyond today’s problem
- Evaluating whether something worked
- Adjusting when evidence says you should
You may not be able to learn my appetite for growth. You absolutely can learn to lead your practice with intention.
You Get to Define “Enough”
At the end of the day, a CEO mindset does not tell you what you should want. It helps you build the practice (life) that you want. Intentional leadership may actually tell you not to grow. Maybe your ideal practice is one location with a small, excellent team. Or you want to provide only four clinical days per week. Perhaps the goal is providing exceptional patient care while still preserving time with your family.
If this is the case, use a CEO mindset to build that deliberately. Growth for the sake of growth is not using a CEO Mindset. Building a practice that serves the life, patients and people you care about is.
Practice on Purpose
All of us are the CEOs of our lives, and a special group of us get to be CEOs of our practices. In both cases, I encourage you to ask yourself the following questions:
- What kind of doctor do I want to be?
- What experience do I want my patients to have?
- What kind of workplace do I want to create?
- If I have associates, what kind of doctors do I want them to become?
- What kind of life do I want this practice to provide?
- Then start making decisions intentionally toward those answers.
A CEO mindset isn’t about building the biggest practice or becoming someone you’re not. It’s about building the practice you actually want—on purpose.
Catch up on Dr. Lillie’s CEO Mindset series
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, Michigan. He is also the host of the weekly podcast, “Optometry: The Ultimate O.D.” To contact him: drlillie@therdec.com. |
