Dr. Nick Lillie. All photos courtesy of Dr. Lillie.
Surpass your fears and take action to see business growth
By Nick Lillie, OD
Oct. 8, 2025
Upon graduation in 2011, I made the educated decision to start an office cold in a 1,600 square foot office space. I say educated slightly tongue in cheek, because I quickly found out that running an office takes constant focus and effort. I may have been naive to the energy it would take. However, I felt I could practice optometry beyond what I had experienced in school and in my fourth-year rotations.
Fast forward 14 years—I have a brand new 3,500 square foot office with three dry eye treatment rooms, three primary care rooms, two workup rooms and one room for special testing. To this day, I take pride in practicing at a higher level of clinical care.
There are countless lessons I would share. The one that resonates the most is to take big shots and not let fear keep you from taking action. It is the piece of advice I give to fellow ODs, optometry students and preoptometry students alike.
It is very easy to get comfortable and complacent, but to do big things you need to be willing to take big chances and change the status quo.
In the past two years, these three big chances have paid the biggest dividends.
Invest in a New Office and Associate
We were doing great and had a very well-functioning business. I was comfortable but starting to feel bored with very little room to grow. Although our schedule was full, I did a poor job of pre-appointing and tracking key performance indicators (KPIs), so I had trouble justifying the need to move to a bigger location.
By not having a good feel for my metrics, I had trouble projecting what more space would do other than add to my expenses. I saw an increased overhead and no real plan for increasing topline revenue. In addition, the cost of building out a new space, adding more to my monthly rent and adding additional staff made the thought of adding a new doctor overwhelming.
The mistake I made was looking at merely the increased cost and not factoring in the increased revenue that more space and a new provider would allow. An unforeseen benefit was it allowed me to step back and spend time outside of the exam room which allowed me to optimize the operations of our office. By working on my business, we were not only more efficient and profitable, but the business was not solely dependent on my production. This has helped tremendously for my mental health and quality of life.
Add New Equipment, Schedule Longer Exams
I made some big purchases to go with the new office. I have added Tixel i and Tixel C, InMode Forma-i RF and 2 Essilor instrument sl650+ slit lamps with the dry eye suite to grow our dry eye clinic. These instruments are in addition to our Lumenis Optilight IPL. In order to provide the best possible dry eye outcomes, you need to have the equipment to manage every unique situation.
Now this may seem counterintuitive, but to maximize this equipment, I actually cut down the scheduled number of exams I saw in a day. I went from 24 comprehensive spots to 12. Here’s what happened:
- First, it allowed me to have more time to educate patients on their eyes and the conditions affecting their eyes which has allowed for more dry eye treatment conversions.
- Additionally, it allowed more time to perform these advanced therapy treatments. As a result, we have seen a $200 to $250 increase in our revenue per patient!
Say “No” More Often
In the early days of a cold start, I would say yes to just about any request a patient made. I had the time and I wanted to make a positive impression. As I have grown, I realized I needed to become more focused. If you try to be everything to everyone, you will end up being nothing to everyone.
By becoming more specialized, we are better able to care for patients that value what we offer. In the past two to three years, we have been refining the services we offer and the lens options available in our optical.
It has grown our dry eye clinic as well as made it easier for the staff to increase their knowledge in the products and services we offer. Everyone in the office knows the ins and outs of what we do and that allows for surround sound education from everyone in the office.
We also stopped making exceptions in regards to our schedule. Now, we have a templated schedule that spaces medical and comprehensive exams for maximum efficiency. In the early days, we would see anyone at any time, regardless of exam type. This created bottlenecks that would degrade the patient experience. Now, aside from true emergencies, we follow the template we have created. Staff and doctors are more efficient with a strict scheduling protocol. Patients do not wait to get into their exams, and staff scheduling has been more productive. There are a handful of people that have gone to other offices because of availability. But overall, we have gained more than we lost and our quality of care has increased.
It’s Time to Take a Chance
These three chances may have gone against the status quo and did have their fair share of growing pains, but we are a better office for it. Had I stayed in my comfort zone and not taken bigger shots, I would have remained a small one-man operation wanting more and on a one-way track to burnout. So, accept the challenge, and take big shots. I promise after the initial shock of change, you will be better for it.
Read more Practice Management articles on Review of Optometric Business 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. He can be best reached at drlillie@therdec.com. |
