Podcast Ep. 126 – Lessons from Expansion: Growth, Hiring, and Refocusing the Practice with Dr. Nick Lillie

[00:00:04] Intro

[00:00:04] Evon: Hey everybody, welcome back to the Optometry Money Podcast, where we’re helping ODs all over the country make better and better decisions around their money, their careers, and their practices. I am your host, Evon Mendrin, Certified Financial Planner(TM) Practitioner, and owner of Optometry Wealth Advisors.

[00:00:22] An independent financial planning firm just for optometrists nationwide. And thank you so much for listening today. Really appreciate your time and your attention. And on today’s podcast, I am excited to bring back to the podcast, Dr. Nick Lilly and Dr. Lilly and I dive into lessons he’s learned as he’s moved from one location to another expanded larger location, we talk about his approach to onboarding an associate optometrist. we talk about his approach to planning for the new year. And although we’re already in February, I think there’s a lot to learn and a lot to gain from hearing his approach to having a renewed focus on the practice financials and profitability to having a renewed focus in the practice on their core competencies, the core services they wanted to provide to patients.

[00:01:15] And then finally, his renewed focus on building his business to be in service of his ideal lifestyle and his personal values. And I’ll put all of Dr. Lilly’s contact information in the show notes, which you can find by just scrolling down in whichever app you’re using, or at the education hub at my website, www.optometrywealth.Com.

[00:01:38] And you’re there, check out all the other articles, blog posts, episodes we’ve done. And if you’re curious about what it’s like to work with a optometry specific financial planning firm, feel free to schedule a no commitment introductory call.

[00:01:53] We can talk about what’s on your mind financially and how I help optometrists navigate those same questions, those same topic and issues. nationwide. And without further ado, here is my conversation with Dr. Nick Lilly.   

[00:02:08] Start of Interview with Dr. Nick Lillie

[00:02:12] Evon: welcome back to the Optometry Money Podcast. I am your host, Evon Mendrin, and I am excited to welcome back to the podcast once again, Dr. Nick Lilley.

[00:02:21] Dr. Lilley, thanks for coming back on.

[00:02:23] Nick: Thanks for having me, man. It’s been, I think about two, three years. It’s crazy. You were just starting. I was like getting ready to go to the next level. I

[00:02:31] think we’re both, we both get to re regroup and see where we’re at, how we did.

[00:02:36] Evon: That’s right. Yeah. I was looking back. You were episode nine and we’re over a hundred episodes beyond that. So that, that early appearance on my podcast didn’t tank your career. So it looks

[00:02:46] like we ended up. Okay. Yeah.

[00:02:48] Nick: Right, how funny is it though? Cause I started my podcast in about 2020. If you look back at some of those early episodes, it’s like, oh man. What was I thinking? Right. But with like

[00:03:00] everything, it’s the reps, it’s the consistency, and I’m sure you have a different flow and feel, and you can just do this in your sleep.

[00:03:08] Now that’s, that’s how I at least feel. It’s, it’s awesome to see that the work pays off.

[00:03:12] Evon: Yes, yeah, I cringe a little bit at my, at how I handle those early episodes, but you know what? You learn, you get better, and that’s all a part of it, right? Those reps are a big part of anything. I mean, you talk about maybe an optometrist getting the reps of working with patients for the first time coming out of college, you know, those the reps in anything new are super important.

[00:03:29] And I think we’re afraid of that a lot of times, right? We don’t want to put ourselves out there. We don’t want to make mistakes, but you learn from those mistakes. You, you get through that. So, and I see you’re, you’re doing not only your own podcast, the Ultimate OD Podcast, you’re doing YouTube videos now.

[00:03:43] So you’re really putting yourself out there too, right? In all these different ways.

[00:03:47] Nick: Absolutely. It’s, it’s one of the things that I looked at is that, that’s the evolution of what I’ve seen influencers or people do. So it was like pulling teeth to get me to do the podcast and then be in front of the camera. I talk for a living. I mean, that’s literally what I do. But when you’re in front of a camera, you just kind of freeze up.

[00:04:09] It’s different. But because I do that, on a weekly basis now, I can have a conversation with anyone. When I, when you look at my outlines, I used to outline like pages. Now it’s like five words and I know where to take it. And it’s made me not only better with speaking, but I’m better at communicating with my patients.

[00:04:28] That’s one of the coolest things about this is I, I take what I, what I, I want to know and I put it in a podcast or I put it in a YouTube video and now I have it Simplified down and that’s my conversation. My talking points with my patients. It’s really really cool. It’s been beneficial in that sense

[00:04:45] Evon: So that’s interesting. I’ve noticed the same thing in that the things I talk about, things related to my work with optometrists, you have to, you have to think, how am I going to explain this in a podcast? And that experience of learning more and boiling it down, translates to the work that I do with clients and I can explain it a lot clearer as I’m going through that with real people in real time.

[00:05:07] sometimes I go way too far or way too long in the podcast and I learned from that too, because I know when I’m talking to someone in real time, I shouldn’t do that. So, so you learn from, from everything you’re doing here with all these bits of content, but, let’s talk about some changes and updates that you’ve seen in your own practice.

[00:05:24] I know last time we talked, You were thinking about, you had goals of adding an associate, you had goals of expanding. Talk to us about where your practice is at right now.

[00:05:33] Where Dr. Lillie’s Practice is At Right Now

[00:05:33] Nick: Excellent, yeah when we talked last I was in the original place I started we had about 1,600 square feet one exam room, workup room. And that was, that was the extent. And I had like six or seven staff in that small of a space. And it was crowded. We were on top of each other. And, thankfully through just sheer persistence, I’m like, we have to grow. And I just started calling everyone I could, knocking on doors. And it was quite the adventure. because what you realize is, just because you think you have a successful thriving business, when you go to a location looking to lease a space. They have a different idea of what they want, what they’re looking for. And, I, I missed out on a couple of spots and I thought I was competitive. I’m, I’m, I was shocked that they didn’t want a stable business to be there like my own, but it was the square footage that I needed. And when you do an optometry practice, you can’t just go into like a medical office. And use their rooms.

[00:06:34] We are really unique in what you need. So that fell through and I called one of my, colleagues that I’ve worked with on looking at different real estate and he was a developer and we, we had a deal fall through about two years ago. I’m like, Hey, is that still open? And we just hashed it out, made it work and. a 3,500 square foot new build, which is awesome because when we built the building, I got to design the spot. It wasn’t even built. So usually you have to conform your business to the space that’s there. I got to design my space and he built the building around that. So

[00:07:08] it’s like starting your own practice. Clean slate, it was, it

[00:07:12] was awesome. So we have that, we have 3, 500 square feet. So we have six exam lanes, two of them are dedicated dry eye. we have eight full time staff members and I added an associate doctor, which is, that was the biggest, am I ready to delegate? Am I ready to have another doctor in there?

[00:07:30] Because I operated for 13 years answering to no one but myself. So that was a, that was a big jump, but it’s been, been awesome.

[00:07:37] Evon: yeah. Fascinating. So you, what did you look for as you looked for new spaces? What were some of the criteria that you were looking for?

[00:07:47] Nick: Yep, number one I wanted to be in a heavy traffic area. I wanted high visibility. The spot I was in now, I was there for 13 years and I’d say people that would come in and be like we didn’t even know you were here and That’s the most frustrating thing you can hear as a business owner. You’re putting stuff out on social media You’re marketing in the community You’re trying to be active and present and people still don’t know that you’re there.

[00:08:11] That was that was just frustrating to me so we got Thankfully, we’re not on our busiest street, but we are busy A stones throw away, from the, one of the busiest intersections in Allendale, Michigan, and there’s Walgreens right on the corner. So I’m right next to a Walgreens. If you know anything about real estate, Walgreens knows where to pick a location.

[00:08:32] So that made me feel good. And then the two, high schools and middle schools are. Literally right down the street. So it’s very busy in the morning. We got street frontage and we lit up our signs so people can see us from the road. And one of the things we did, we used to be Allendale Family Vision. We renamed ourself to Family Vision Optical because Allendale Family Vision, one, was geo specific, it was specific to a location, and then if you hear that, you’re not sure, are they selling glasses, is it family planning, what is that? So by putting the optical in there, we changed our logo to have a pair of glasses, they know what we do. So if you see us from the street, that’s an eye care office. So we did that and, It’s really been good. People are like, oh, how long have you been here? Well, actually we’ve been here for a while, but it’s it’s new.

[00:09:21] and then as we grow and look to scale We’re building a brand that’s not centered around a location So that was one of the things that we did to help and I wanted that high traffic area. I also wanted That was in a professional setting nothing against these other businesses, but we were next to a restaurant.

[00:09:41] There was some smoke shops roofing like Okay, it just was a bunch of hodgepodge of things and it wasn’t necessarily helping us build each other up. I wanted to have more of a medical field. As I look at the landscape where I think optometry is going, I think we’re going to more of a medical model. So I want to be around more professionals, whether it’s an insurance agent or, you know, other doctors, other professionals in that sense.

[00:10:06] That’s the clientele I’m trying to, trying to be around and serve.

[00:10:10] How Dr. Lillie Split the Patient Schedule with the New Associate Optometrist

[00:10:10] Evon: Gotcha. And you, you, that’s interesting. You, you were looking for the traffic. You obviously had plenty of space that you wanted to fill what you, where you felt your practice was going. you mentioned six lanes. So are you and your associate both working full doctor days? How, how is that scheduled divvied up?

[00:10:26] Nick: Yeah. So, and that is one of the biggest things that I’ve really had to ask myself is what do I want? Right? I was working four and a half days. So Monday, Tuesday, Wednesday, and we work nine to noon on Fridays and I heard everyone tell you if you hear anyone Talking about private practice is you have to work on your business not in your business get out of the exam lane and that’s when you really grow and My thought was, well, what am I going to do with that time? And the, the advisors, the people I’ve talked to said, you just set that time aside and you will find a way to fill it. And I was like, okay, that sounds good. So the goal was that the new doctor that came on, she did not want to work full time. So she works Tuesday, Wednesday, Thursday, full days. And then she works the night and noon on Fridays. I started off Monday, Tuesday, Wednesday, and nothing on Thursday and Friday. And after about three weeks, it just, I didn’t like how it felt. if I’m in the office and I’m going to show up, I want, I want to see patients. That’s just kind of how, how I did it. So what I’ve done now, and this has took some time, I work nine to six on Mondays and I have full days.

[00:11:34] I mean, I booked myself out. I see about 25 comprehensives. Tuesday, Wednesday, and Thursday, I work nine to three. So a school day and then I get out and I saw patients and I get out and I get to be with my family. I saw a graphic that, the time you’re going to spend with your kids as they get to a certain age, it just drops off.

[00:11:54] So

[00:11:54] I’m trying to take full advantage of that and still see patients. So it’s been, it’s been one of the most fulfilling things is I get in, I get to see patients and then I get to go home and spend time with family. And that one day on Friday with no patients, and no other obligations is enough for me to work on the practice.

[00:12:10] So it’s been really a great balance, to have that. And

[00:12:13] another thing I noticed was when you have an established practice and you bring on someone new, my patients were loyal to me. I tried to block off that time. So they scheduled with her. They were just scheduling weeks out and I have higher overhead.

[00:12:29] I have a higher staff. I have a doctor that has to get paid. I’m like, I need to see patients. So we had to figure out a happy medium in that sense, because they weren’t, I was just going to work less and not have the revenue that I needed to be able to see patients and still have that cashflow coming in.

[00:12:45] Lessons Learned From Moving the Practice to Another Location

[00:12:45] Evon: Gotcha. Going through that expansion phase now, and especially going through the build out, designing the new location. Are there any lessons that you learned that you can share with the audience around, around building out the location, designing it, moving into it, marketing it? Like what, what lessons have you learned that maybe you didn’t know when you first started that would be helpful to share?

[00:13:07] Nick: Yeah, absolutely. Two, two things stand out right away. Number one, Optometry is a unique profession. Work with optometric professionals. So I actually had a second office. I opened in 2011. Okay. 2014 I opened a second office and I designed this on my own and I didn’t maximize my space and then I had a couple of opportunities where I was gonna have another office and Went through the design process with their people the people that represented the the space and it just it didn’t flow It didn’t feel right So when I did this, I worked with Optometric Architects and iDesigns, two well known people in the industry, and I got amazing results.

[00:13:50] I, I wrote up my plan on a,piece of graph paper, sent it to iDesigns, and what they did, or not iDesigns, Optometric Architects, and they made it fit, they made the flow so much better, and I’m like, this is amazing. They maximized the rooms, maximized the flow, thought it all through, how doors open, where you’re going to put chairs, and it wasn’t, it just made sense.

[00:14:12] And then in terms of design, iDesigns is amazing at optical. I, I knew that they were going to be more expensive. but I wanted to invest in something that provides 60 percent of my revenue. So going with them was, I think was awesome. Like

[00:14:28] that, that really helped make it pop. It gave me the feel that I wanted and I had a vision. I was able to express that to them and they made it a reality. So working with professionals that know your business, kind of like when you’re working with an, a CPA like yourself, I now have so much more value in people that know what I do.

[00:14:47] that understand optometry as a whole, it makes a huge difference.

[00:14:50] Evon: Yeah. Even like you said, you knew it was more expensive going in, but you knew the results. Was probably gonna be higher quality. It was gonna meet, it was gonna fit your business better because they knew optometry. Right? They knew your, your business even better. Yeah.

[00:15:03] Nick: hundred percent. And,

[00:15:04] and, and the second thing that I would say, if I, if I add on is I knew that, we were moving in, in October, whenever you do anything like that, you want your marketing, you want everything set and planned. So starting in March, I work with a company called National Strategic who knows again, optometry.

[00:15:23] I said, Hey, we’re moving here. Where are my blind spots? And then also we need to fill this up as soon as we get in there. So we had a, PPC. So paper, like Google ads,

[00:15:33] Evon: mm-hmm

[00:15:35] Nick: plan set in place. We had a marketing plan. We got in there and it wasn’t like, okay, now what are we going to do? And it’s going to take three months to get it.

[00:15:43] We had a plan in place for, we’re going to move in this day. These are all the boxes we’re going to check off and let’s market and build this out as quick as we possibly can. And we’ve seen a great amount of growth. Right away because of having that plan in place.

[00:15:56] Dr. Lillie’s Approach to Strategic Planning for the New Year

[00:15:56] Evon: Very cool. Very cool. going back to spending more time working on the practice versus in it. I, I want to talk to you about how you’ve approached, you know, cause I’ve heard recent podcast episodes that you’ve done on your podcast. You have a lot of great episodes about mentality and a goal setting and preparation.

[00:16:14] And I want to ask you a little bit about how you prepare for the new year. We’re in January, 2025. So we’ve already gone through the New Year’s Eve. It’s already 2025, but how did you approach looking at this new year and reviewing your business? asking yourself questions, areas of improvement. How did you approach that as you went into the new year?

[00:16:38] Nick: Great question. And that, that’s something that also has evolved over the past two years. two years ago when I said we’re gonna put this, this in motion to get to where I’m at right now. Profit First by Mike Michalowicz.

[00:16:51] I read that book and I thought that was amazing. And I said, if I want to do this, I need to start focusing on the business side of things.

[00:16:58] We need to make money. So I was looking at all my revenue, like what am I doing in Optical? What am I doing for my exam fees? And I revamped all that and said, if I’m going to do this, I’m going to make money. Like, let’s get in there and get that. And. What happened was my business grew. We were more efficient.

[00:17:19] It’s that pumpkin principle like 80 percent of your growth is from 20 percent or you you know the the

[00:17:26] saying of that But so we we got rid of the outliers We stopped trying to be the Cheesecake Factory and have everything and we were gonna be Ruth’s Chris. We have a great steak We don’t have a kid’s menu. We we do what we do when we do it. Well, and we’ve we focused our our goals on dry eye, ocular health and wellness, and then our optical. Anything outside of that was not in our, in our, in our realm. And then when it got to this year, I spent the past, you know, 13 years trying to be the practice that I think everyone else would admire.

[00:18:01] You know, I want to do this much revenue, I want to do the high end optical, I want to do the medical stuff. And it was great, it gave me a goal But at the end of the day, I wasn’t necessarily making myself happy. I’m like, I’m checking out these boxes. I’ve got them and I still am not overly fulfilled, right?

[00:18:19] I have this hunger. There’s something missing. So this year it was really different. I really sat back and said, where do I want to go? What do I want out of the next decade of my life? And how do I want to practice? What kind of patients do I want to see? Do I want to grow and expand? And that’s I kind of came to the conclusion of what I said to you is I like seeing patients, but I like being home with my family.

[00:18:46] I

[00:18:46] found a happy medium, a doctor that works the hours that I don’t. So by having an associate, I’ve opened up my time. And then the whole thought of growing and expanding, that’s kind of my, how much of a headache do I want? If I do it, it’s going to be merely because it gives me joy, not because I’m chasing a monetary goal.

[00:19:04] And everything else previously used to be based on money. And you have to make a living. You have to be profitable, but what does your lifestyle mean? What does that look like? And, I’ve gotten really good at looking at my personal finances, what I want to accomplish with my wife, with my kids. And now I’m building my life around that versus. building my life around the practice that I’m running. It’s, it’s kind of reversed in that sense, but I really sat down and thought, what do I want that gives me joy? What makes me happy? When do I come home and I had an amazing day? How do I repeat that over and over again? So it was more of a looking at what I wanted out of life versus what I wanted the practice to do and reverse engineering that.

[00:19:46] Does that, does that make sense?

[00:19:47] Evon: Yeah. So to, to kind of break that down a little bit, number one is you had a better focus on the financials of the business, especially profit.

[00:19:56] And what’s great about that Profit First book and sort of mentality is that even if, even if you don’t go the full lengths and dealing with the way that the accounts are set up and, and all of that, the gist of the, of what it should be giving you is that you shouldn’t be a slave to your business.

[00:20:14] You should be. Drawing an income from your business. Your business should be profitable. You should be enjoying the fruits of your labor. you know, that’s one of the major takeaways of the book is to focus on profit because you should be enjoying the The fruits of your labor. And, and so it sounds like you had a renewed focus on that.

[00:20:31] What’s happening in the business. Are we profitable? Let’s maintain that. second thing it sounds like is that you focused on your, your best key core competencies. Like what do we want to be the very best at because they are the most impactful. And for you, it was dry eye. It was,

[00:20:48] what

[00:20:48] Nick: I could help

[00:20:48] Evon: was dry eye. and then what was the third?

[00:20:51] Nick: Optical.

[00:20:52] Evon: Optical. Okay.

[00:20:53] Yes, that’s right. Yes. The optical. So you, you honed in on these other things on these, on these key things. What were some of the other things that you felt like were taking resources from the business or time or energy? Like what, what were some of those other things that you trimmed down?

[00:21:09] Nick: Yeah, two, two of the big things. One was, scleral lenses. I love the impact it had on patients. However, when I look at it, the amount of time it took to fit a patient, their satisfaction was high initially, but once they saw what they saw, they just wanted that again and again, and they weren’t necessarily willing to pay for it.

[00:21:32] They, they, they got it, and if you’re good at what you do when it comes to sclerals. They just expect it to be that easy every time.

[00:21:38] And it’s an art. It really takes up a lot of chair time, but in addition, it takes up a lot of staff time. And what I was seeing is my staff only had so much bandwidth. I couldn’t have dry eye, optical, them knowing about macular degeneration and the supplements we want to do, and know about sclerals. So where was our, where was my passion and where was our focus,and what moved the needle in terms of the business? So, that’s why we kind of cut sclerals. In addition, one of the hardest things that we have in our office is hiring new opticians. Because it’s a whole new language, it’s a whole new, dealing with vision insurances. We cut down our options in what we offer. So we have basically three options. This is what we offer in terms of lenses. And if you don’t like that, great. You don’t have to get it from us. We’re just not the office for you. We deal in high end stuff. If you want cheap, totally fine. You have to do what’s best for you and your family.

[00:22:35] We’re just not the office for you. So we, we raised our prices, but I said if we’re gonna do that, we’re gonna give them value. They’re gonna get the best quality they can and we’re gonna own it and we had a couple patients that didn’t like it They they they said this is too expensive We don’t see the value in it and I just told my staff we’re not the office for them trust Trust me We’re gonna find a group of people that love what we do and they’re gonna be our loyal followers And that’s what that’s what we’ve done and it’s really worked well for us

[00:23:10] Evon: Yeah, that’s fascinating. You, you focused in on who do we serve best and what do we do for them and, and those highest impact activities and focused in on that.

[00:23:19] How Dr. Lille Realigned His Practice to Fit His Personal Lifestyle and Values

[00:23:19] Evon: And then lastly, you, you talked about, reviewing sort of what the business means to your family, right? And sort of reviewing your personal values and what you, what you want your business to do for you rather than are you a slave to your business and became more intentional about building your business around that.

[00:23:40] And has that been something that you’ve struggled with before? Have you felt like you were spending too much time in the business. Like your whole life was led by the business instead of these other things that you felt like value were more valuable to you. Like, how did that suddenly come up over the last year?

[00:23:57] what, how have you, how have you planned around that?

[00:24:00] Nick: One of the biggest things that I really thought about was I had a really good job, but if I wasn’t there, we weren’t making money.

[00:24:09] And that’s a great job, but it’s not a business. One of the things I wanted to do was be able to be, go on vacation with my, my kids and family because I only have a lot of fixed time with them. I’m going to take the vacation regardless, but I hated that I’d leave and my patients weren’t being served. There’d be a red eye or there’d be something where they needed help, and I wasn’t there. My staff, again, depends on me, and if I’m not there to drive revenue, we’re, we’re paying them money and they’re sitting there and doing nothing, right? so I wanted to have a way that we, we could have a business in that sense. So that I, I just really focused on how do I I practice the way I want but also have it provide income when I’m not there and it really just came down to how do I want to spend my time in the office and out and outside the office I know That when my kids are playing sports, they’re going to do things I can always be there and it was it’s fine It’s a sacrifice my wife understands the kids get it dad has to take care of the business That’s what he does, but it was killing me inside that I’d missed a an opportunity to be there that’s not going to always be there.

[00:25:22] I can work for the rest of my life, but my time with my kids, is fleeting. How do I get so I can see them? And it initially was, well, I’ll just, we’ll, we’ll lower our lifestyle. We’ll get less money. But when I talked to other doctors, other people that have done what I want to do, they found a way to do both.

[00:25:41] I’m like, I, I just got to change my mindset, practice how I want to practice, but set up. the infrastructure to have an actual business. And that’s kind of what’s evolved is, EOS, the entrepreneurial operating system.

[00:25:54] it is something that I’m really going deep and hard into. I’m hoping to implement in the next, the first six months, the first two quarters of the year. And what I found there is systems scale. Having systems will allow me to be out of the office and not be the sole reason that we’re, we’re successful. Now, granted, I’m My managers, the other doctors, they’re probably going to be not quite as good as I am, but there’ll be 80 percent of it, and that’s good enough.

[00:26:22] And I had to just accept that my patients will still show up, they’ll still come, even if they were about 80 percent as good. And that was a really, me letting my ego aside, right? Letting things go and teaching and training them to handle those, those things that I couldn’t.

[00:26:39] Evon: Yeah. And so it took you to really sit down and say, okay, what’s most important to me in my life and let me adjust my business around it. And there are.there are a few different motivations for hiring an associate. One of them is capacity constraints. So you want to get through the next revenue band or, or whatever it is, meet that increasing patient demand.

[00:26:59] Part of it is wanting more time freedom and allowing yourself to step out of the practice, knowing that patients can still be seen if you’re not there, allowing you to do other things that you want to do in your life. And it sounds like you’ve done a little bit of both.

[00:27:12] You found ways to improve the business as well as to buy yourself some time, right? Which is, which is interesting. Sometimes those goals can compete against one another. And it sounds like you found a way to do a little bit of both.

[00:27:26] Nick: Yeah, absolutely, and the beauty of it is, it’s given me more juice, because the doctor that I brought in, loved her to death, she’s absolutely amazing, and one of the biggest things that we connected on was, we believe in practicing the same way. We believe in the dry eye aspect, the ocular health and wellness. I can see her patients, she can see mine, and we know we’re not going in different directions. We’re rowing in the same direction. That’s been awesome, but throughout this process, I realized that a lot of what I do, I just took it as like every doctor does this, and I, I’ve developed some skills and abilities over the past decade that aren’t just common sense, which I, which I thought they were, and I’ve been able to help and mentor her a little bit to just, see herself as a business. How does this make sense? And I love that aspect. I really look forward to, eventually getting big enough where either we can have externs or residents come if we grow and expand. I do like the idea of mentoring other doctors. It’s kind of what we do in our podcast is we have information that we love to share.

[00:28:36] I like applying it and helping, helping the, Other doctors be better than they think they can be or operate in a way that they’re still profitable. They’re still operating at a high level, but they’re better than they thought they could be. It’s really been fulfilling in that sense. So I gave myself another tool.

[00:28:54] It’s not just in the office or business owner. There’s a mentorship aspect that I really, really enjoy.

[00:29:01] How Dr. Lillie Onboarded a New Associate Optometrist Into His Practice

[00:29:01] Evon: That’s, that’s really cool because I feel like I hear a lot where associate doctors want that mentorship, especially when you compare it to higher, much higher paying, potentially much higher paying corporate jobs. The contrast is that in, in many private practice settings are able to get more of that mentorship from, from the owning doctor or other, other doctors there.

[00:29:22] And I feel like that would be a, go a long way in terms of Getting that associate onboarded and making that transition really successful is giving them that mentorship that they need. But it also sounds like you found a really good like culture fit. Like you found someone that sees the way you practice or sees optometry very similar to the way that you practice.

[00:29:44] Was that a result of hiring? Was that a result of training? Like how, how did that come about?

[00:29:49] Nick: Yeah, so the Hardest part about this whole expansion thing has been finding a doctor. I’ve had opportunities to buy and acquire practices, but I can’t find a doctor to go there. So it’s really hard to grow and expand. So my mentality has been, I’d rather have it all under one roof because if Things get real.

[00:30:10] And we had an instance where she was sick for a couple days and I was able, because we’re so early, to absorb her schedule. And again, I was a little busy on certain areas, but I could still handle it all, right? Again, probably doing more than I should, but I like it all under one roof so I can have my hands in it kind of guide. And what we did was, we just had tons of conversations of, this is what we believe in. This is how we practice. This is what we do. And we just jived. The thing I liked about her was outside of optometry or whatnot, I could have a conversation. We could go out to dinner and talk about the same things. We have a similar liking in nutrition.

[00:30:51] We like the You know, medical side of dry eye, not the aesthetic side. So we’re on the same page there. And we could just riff off each other for hours. And it felt like I was really just talking to a friend. Whereas when I talked to some of the young doctors coming straight out of school, it was a little rough.

[00:31:09] It was a little of like, they are really, really fresh. I couldn’t trust them to just handle their own schedule without me really babysitting. Now again, that’s not every doctor. Some doctors are going to be a little better than others, but then you have to figure out, do they want to work for what you’re willing to pay?

[00:31:28] Do they like the area that you’re at? There’s a lot more variables, so the fact that we jived, she had three years of experience working in other practices, I could trust her to be a good doctor. I’ve never once questioned her, performance. Patient Care Aspect, there’s just been some flow and efficiency things that she’s had to learn.

[00:31:46] And part of that is because when you’re a private practice doctor you always try to do things at the least expensive way possible. So that means

[00:31:55] you put a lot of it on your plate.

[00:31:57] Well when she came in she was used to having amazing techs, amazing opticians, where she could just kind of show up, do her doctor thing, and all the business side would be taken care of. Where I have just put it all on my shoulders. I, I sell from the chair. I talk about the procedures. I’m not afraid to talk about the cost of everything. Where she can have those conversations, but she’s not used to having them.

[00:32:20] Kind of like we were talking about, when I talk about the podcast or, the YouTube videos, I’m having these conversations. She’s not used to doing it at that capacity, so kind of, I I literally, what we do once a week, we have a one on one. We have lunch together and I’ll just go through my schedule. This is my patient. This is what I did. This is how I approached it and let her ask me questions and I go, what is your mindset?

[00:32:43] What are you thinking? All right, this is what I was thinking and let her bounce things off my head and I go, I’m not the only way, but at least see what I do and have perspective. And that’s been a game changer. She’s now like seeing things from a different light and I’ve helped focus her in on what can get you bogged down in an exam and what, what’s going to make you more efficient. And now she’s more efficient, but still providing that amazing patient care and still being authentic and true to herself. So it’s,

[00:33:12] it’s been a work, but meeting weekly and just talking about what we do has been very helpful as well.

[00:33:19] Evon: weekly meetings. Yeah, it sounds like it’s a, it’s a mix of, the hiring process, but it sounds like you definitely have a good, a good regular cadence of, of mentorship, like you talked about of meeting and coaching through, learning new skills.

[00:33:33] Right. As you would expect, I guess, anytime any professional moves to a new setting, there’s going to be some new skills, new procedures, new systems to learn.

[00:33:42] And so going back to that sort of an original conversation of, How do we plan for the new year? You talked about reviewing and getting more focused on the financials, especially profitability. you talked about getting a renewed focus on your business and what are the most impactful things that you do for patients that you really want to focus in on.

[00:34:01] You talked about a renewed focus on building your business around your, the most important things in your life and making sure that your business is serving those things. What else should the listener think about in terms of how you approach planning for a new year?

[00:34:18] Nick: Yeah. I think the biggest thing, I guess two things about that is, You get, this is your business. This is your life. You have complete control and that comes with a lot of responsibility. You have to own everything that you do, but that also means you can practice how you want.

[00:34:38] And one of the things that I, I, I always equate everything to like sports. And what you’ll see is a new coach gets hired and You know, he’s initially has this mindset, this is what he’s going to do. And if he’s not quite as successful as he wants initially, he’ll start listening to the outside noise and like changing his way of doing, running an offense and doing it to try to cater to make people happy. And at the day, he’s going to get fired either way. If you’re going to do this, do it the way that you want, because your passion, your authenticity cannot be duplicated. Right, I don’t care how many people listen to my podcast, if they are not passionate about dry eye, ocular health and wellness, they don’t have my energy, you can’t duplicate it. And that’s what patients feed off of. My

[00:35:24] patients that come in love that aspect. So be true to yourself and practice the way you want to. I know you, when you first start out, it’s really easy to say, I just want people on the schedule. What do you want? I’ll make it happen. And that’s how I started, but I was just finding that I was. Busy, but unfulfilled, not happy with what I was doing. But now that I put the people on the schedule that I like to see, I’m a better doctor. I’m, I’m more energetic and it’s, it’s fun, right? And that comes down to having a vision. You know, what do you want to do? What’s your goals for your business? And that’s where the EOS system has that, the VTO vision, traction organizer,

[00:36:07] and you have your mission. What’s your, your, your. your niche within that, your five year plan, your 10 year targets, and that’s amazing because when I had to sit down and really think about that, you know, what do you wanna do in three words or three to five words? You really are thinking about what, what gives you energy? And my, my thing is I like to give people hope. I like to give guidance and offer solutions, right? And if you hear what I talk about, that’s what I like about having the associate like hope for a better way of practicing. You know, I like to guide and mentor. And then if she has a issues, I like to give her solutions. It applies to my patients. It’s who I am as person and that’s how I’m running my business, how I live my life. And our, our goal as a practice is to optimize vision. If we do anything, if we’re not optimizing vision, it’s not what we do in art. My staff knows this. We talk about it every meeting. So just being true and knowing what you want.

[00:37:06] And that that’s a really big. you know, existential question,

[00:37:11] but if you can narrow it down and it can change over the seasons, it’s not going to be forever, but what do you really want out of life and how do you live it? And that VTO should, in my opinion, apply to everything you do, right? Inside and outside.

[00:37:24] If I’m providing guidance, you know, mentorship, giving people hope, I’m happy. So

[00:37:30] it’s kind of applying that to your business and life. It’s really cool.

[00:37:34] Evon: Yeah. I, especially when so many people So often, the reason ODs are going to go into private practice ownership is, is, that freedom, freedom of choice around how they practice, around the patient experience, scope of care, freedom and flexibility around their time eventually, to be able to, like you mentioned, build a business around their life, rather than the other way around.

[00:37:56] If you’re not doing that, if you’re not building towards that, then you’ll find what you mentioned earlier. You have a really busy, you know, high paying job essentially,

[00:38:05] right? And that’s not a fulfilling way to own a business. that’s probably the fast track to burnout, right? It’s probably a lot of the times where you hear doctors are really unfulfilled as practice owners.

[00:38:15] it might be where they accidentally got into practice ownership, really didn’t have a clear vision around what they wanted, or at least didn’t build towards that vision. They were building towards something else. And so if you’re going to go and take on the work and stress and, and the work that goes into private practice ownership, you might as well build towards something that you want to build towards, something that’s fulfilling to you.

[00:38:37] And, in one of the questions you’ve asked in some of your episodes recently is, are you willing to put in the work when you’re, you’re not guaranteed the outcome? Right. And that’s, we don’t know. I mean, we can’t control the outcome. We can’t control patient decisions. We can’t control. There’s a lot of the future in business ownership we can’t control.

[00:38:53] Are we willing to put in the work and get the right process in place and do what needs to be done knowing that there’s that uncertainty there. Right. And, and all of those consistent actions go a long way to, to at least improving the probability of the outcome you want.

[00:39:09] So I thought that was a really, really, compelling question.

[00:39:12] Nick: Yeah, it’s, it’s really fun, and at that point, you’ll figure out, are you a process driven person or are you an outcome driven person? Because the process driven person loves the steps, loves the off season, if you will, the planning that goes into, what it takes to get that goal. Where if someone just wants the outcome, they don’t care how they get there. It’s hard to find fulfillment along the way, but that’s that’s why I like that. That question is I’m willing to put in the work because I like the journey,

[00:39:43] you know, I like that, but I’ve set up my, my environment to be enjoyable. Like the people I work with, how I run my office, the way we practice. If I was doing someone else’s dream and practicing in a way that I didn’t find joy in. I don’t think, like, I don’t think it’d be fun. I’d have to leave. I’d rather make less money, but be going my own way. It’s just, that’s, that’s how I am. And knowing what you find joy in is really crucial to finding happiness in this profession.

[00:40:16] Evon: Yeah. And any last thoughts in terms of planning for the year, business planning for the year, personal side? what other things would you like to leave or do you have in mind in terms of reviewing your own planning and your practice for the new year?

[00:40:31] Nick: Yeah, I think one of the most important things is Once you set out a goal, you have to have metrics, KPIs, something to evaluate if you’re making progress. Because that’s the hardest thing that we come from an environment where we get constant feedback as students. You did a good job, you get an A. You do a bad job, you don’t pass the practical, right? You get in a private practice and you’re like, I showed up, I saw patients, I don’t know if I did a good job, right? You’re really left wondering. So, we’ve set up a lot of metrics where, The exam onlys, the, our pre appointment rate, frame capture rate, lens capture rate, and, just a couple, like, metrics that we track on a weekly basis, we’re constantly looking at that, and having that constant feedback lets us know if we’re going in the right direction. I think it’s great to have a vision, it’s great to have goals, but if you don’t have a way to get feedback on a, at least a weekly basis You’re going to be going in the wrong direction and not realize it until it’s too late and you’re never going to get there. It’s going to take you twice as long. So put guardrails in place and they don’t have to be like huge, but just look at it.

[00:41:43] And if the data, if you look at data and you don’t change because of it or keep doing something because of it, if you just look at it, it’s a number. It’s not a good metric.

[00:41:53] You have to be able to look at data and say, based on this, I’m going to keep doing what I’m doing, or I’m going to make a change. You have to have KPIs that can move the needle.

[00:42:02] A lot of people love to collect data, but they don’t do anything with it. If this information doesn’t change what you’re going to do, I don’t think it’s a good metric. Right? At least for you. So, find metrics that match your goals. And, like I said, the pre appointment rate is important. is one of the big things that will help us grow.

[00:42:19] We’re spending so much time in marketing. We’re spending so much time in building this practice. You get that patient, you want to keep them coming. They’re your bloodlines, right? So we went from, I think we’re at 30 to 35 percent pre appointment rate. Well, we started tracking, we’re at over 75 percent now. And it’s because we’ve been looking at it. I was asking my opticians, what is your pain point? Why is this not working? Talk to the other doctor. Why are we not getting this happen? And we’ve, I don’t know how, but we’ve honed our craft and now we got down to a science and it’s helped us in all other aspects of what we’re doing. How do we do the handoff to get a better frame capture rate? How do we do the handoff to get more of our supplements to get them to follow the doctor’s plan of action? And it’s all because we had metrics that moved the needle that made us Understand whether or not we’re moving towards our goal for the for this year So have metrics that give you input that you can adjust your business based on

[00:43:15] Evon: Hmm. Interesting. If anyone’s listening has read the book Atomic Habits by James Clear, what he writes in that book is that you don’t rise to the, you don’t rise to the level of your goals, you fall to the level of your systems. And he even speculates you don’t even need goals because if you’re, if you’re doing the processes and the habits, if you’re doing the actions on a consistent basis, you’re going to eventually get to where you need to go.

[00:43:40] And, and those metrics, like you mentioned, are the scorecard for those systems. I mean, those metrics are the scorecard. Hey, are we doing the actions we need to be doing? And are they working? Or if not, let’s adjust our actions. Let’s adjust the inputs. And, I like the way you focus on these key metrics. These are the things that you identified that are most impactful in your business. And we are going to, we’re going to keep a heavy focus on these and, the EOS operating system is really good at that too,

[00:44:07] because it, it starts you, you know, 10 years down and it brings you into shorter and shorter periods of goals.

[00:44:14] But the meat of it is it breaks that down into shorter actions. Like what do you need to do on, I think it’s like a quarterly basis, right?

[00:44:22] The quarterly rocks. Again, it really breaks that down into smaller chunks of actions and it really brings that focus into, okay, what are you accountable for? What are the things you need to be doing on a quarter, a quarter, or a week to week basis in order to move things along?

[00:44:37] So, love the focus in there on KPIs. Any final thoughts?

[00:44:42] Nick: No, I mean just this is one of the most amazing professions if you practice the way you want and I hear a lot of doctors that are burned out or just not finding fulfillment and I challenge them to Really look and see if they’re practicing the way they want to. And if their, their goals line up with their wants.

[00:45:03] You know what I mean? Like, I have a goal to do this, but I want to have more time. It doesn’t, doesn’t line up. Get those in alignment. You should feel joy. You shouldn’t have the Sunday scaries where you’re like, Oh, no. Gotta go in on Monday.

[00:45:17] I’m excited to go in on Monday. Mondays are my favorite days, which is ridiculous because they’re our busiest, but I’m practicing, I get so much juice from that.

[00:45:25] So. It can be the most fulfilling profession, but you have to take ownership of that. Make this your dream. Like, whatever that looks like to you, you have that ability. If you’re in private practice, even if you’re practicing for someone else, find a way to make it enjoyable because you have that power. We have the most amazing profession in the world.

[00:45:46] What excites him the most about the future of optometry?

[00:45:46] Evon: When you think about the future of optometry, what excites you the most?

[00:45:51] Nick: I think the most exciting thing for me is the way I see us owning primary care. I see the baby boomers getting older, there’s not enough ophthalmologists coming into practice to be able to handle all the surgical consults, all the surgeries needed, we’re in a prime position and honestly when I talk to the younger doctors, the younger generation, they don’t want to own the practice, they don’t want that responsibility per se, so people, old dogs like me that want to run businesses, that want to mentor. I am like a kid in the candy store. There’s an abundance of patients coming in and there’s abundance of doctors looking for the environment. I want to give them the best environment that they can have to work in and provide the best patient care. I think it’s going to be amazing because it’s just, like you said, putting in the effort, the opportunities are there.

[00:46:46] So that has me very excited for the future of optometry.

[00:46:49] Evon: Well, I, I love that, love that answer. And I, I really appreciate your time here today. for, for anyone listening, wanting to get in contact with you, wanting to follow and learn more about what you’re doing, where can people find, follow and, and learn about you?

[00:47:02] Nick: Absolutely. we’re at Dr. lilly@theultimateod.com. That’s, for our podcast. You can find Optometry: The Ultimate OD podcast on all your, you know, iTunes, apple, Facebook, YouTube page. We have stuff going out, so just hit me up. I love to talk. I talk to doctors all the time. Send me a message, send me an email, whatever it takes, and I’ll, I’ll, I’ll talk optometry for hours, Evon.

[00:47:25] Evon: Well, we will put links to all that in the show notes again, Dr. Lilly, really appreciate your time. For the listener, appreciate your time and attention today. We will catch you on the next episode. In the meantime, take care.

[00:47:37] ​