Power Hour Optometry

Episode: 12 Month Case Study to Scale Smarter – Growing Revenue and Culture with Dr. Nick Lillie

Host: Eugene Shatsman (A)
Guest: Dr. Nick Lillie (B)
Date: August 27, 2025

Episode Overview

This episode showcases Dr. Nick Lillie's transformative journey as he scaled his optometric practice in Allendale, Michigan over the last year. Host Eugene Shatsman leads an in-depth discussion on how Nick 5x'ed dry eye treatment acceptance rates, halved his "exam only" rate, nearly doubled revenue per patient, and expanded his team—including adding an associate—while actually seeing fewer patients himself. The conversation is packed with actionable insights on metrics-driven management, culture-building, patient communication strategies, and leveraging authentic video content to drive growth.

Practice Background & Expansion: Setting the Stage

[03:07–04:29] Dr. Nick Lillie:

Practice in Allendale, MI, near Grand Valley State University.
In 2022, grew from a 1600 sq ft location to 3500 sq ft: 4 exam lanes, 2 dry eye suites, associate OD added.
Focused on three core areas: dry eye/ocular surface disease, ocular health (macular degeneration, glaucoma, wellness), and optical—even as future focus shifts more to medical care.

Key Quote ([04:00]):

“We try to focus on three things ... but my passion is the anterior segment, dry eye, and growing that practice.” — Dr. Lillie

The Growth Metrics: Dramatic Results

[04:29–08:01] Eugene Shatsman & Dr. Lillie:

Expansion of physical space and team—yet metrics improved, contrary to typical trends.
Notable performance advances in 12 months:
- Exam only rate dropped from 59.7% to 33%.
- Revenue per patient rose from mid $300s to $500–$600+.
- Dry eye treatment acceptance soared from 10% to 47%.

Key Quote ([04:29]):

“To go from a 59.7 exam only rate … to a 33% exam only rate this year. I mean, a 10 point move in a year is insane.” — Eugene

Metrics-Driven Management: The Weekly Scorecard

[08:01–12:36] Dr. Lillie:

Relentless measurement is central: “What gets measured gets managed.”
Weekly scorecard tracks: exam only rates, pre-appointments, frame/lens capture, dry eye evaluations, advanced therapy signups, family appointment ‘farming,’ and individual contributions (e.g., chart preparation).
Staff reviews and owns numbers, discusses at Monday morning meetings. Culture of praise, not just criticism.

Key Quote ([09:36]):

“My staff … know when they’re starting to get your messaging through is when they start repeating what you’re saying.” — Dr. Lillie

Building a Culture of Accountability & Team Success

[12:36–15:37] Dr. Lillie:

Culture shifted via deliberate one-on-one meetings, focus on individual and team metrics.
Best practices and successes shared peer-to-peer, not just top-down.
Progress seen as staff took pride and supported each other; competition avoided, team rewarded together.

Key Quote ([14:37]):

“If there’s a reward, everyone wins … We rise and fall together.” — Dr. Lillie

Incentives and Staff Engagement

[15:37–18:01] Dr. Lillie:

Call-outs and physical symbols (pins, tie clips) for achievements, worn as badges of honor.
Non-monetary and monetary rewards: team lunches, comfort food, cash bonuses if sales tiers hit—and tiers escalate to continually raise the bar.

Key Quote ([17:14]):

“The bigger things that move the needle, I try to give a bigger incentive for.” — Dr. Lillie

Changing Behaviors: Behind the Numbers

[18:01–21:30] Dr. Lillie:

Major lessons from tracking exam onlys: focus on what happens in the handoff from doctor to optician.
Shifted from “Would you like to look at frames today?” to assuming the purchase: “What color do you want? Metal or plastic?”
Upselling and framing always positioned from a patient-benefit viewpoint (e.g., “If your frame breaks, you’ll have a backup.”)
Empowered non-industry staff with scripts and strategies.

The Dry Eye Center: Branding and Operations

[21:30–25:26] Dr. Lillie:

Created “Rejuvenation Dry Eye Center” as a DBA—distinct branding encouraged referrals from local ODs skeptical of referring to a ‘competitor’.
Authentic commitment to dry eye care sets the practice apart.
Every staff member can talk about dry eye treatments.

Key Quote ([24:32]):

“When they go to most offices, there’s like one person they can talk to. Every single one of my staff members knows the commitment, knows the value.” — Dr. Lillie

Referral Program & Content Strategy

[25:26–29:20] Dr. Lillie:

Most referrals currently come from strong SEO and educational video content—no paid marketing yet.
Weekly short-form videos (under 1 min) filmed in 90-minute batches, inspired by real patient questions and casual brainstorming.
Authenticity and expertise improve Google rankings; videos link back to local search listings.

Key Quote ([26:46]):

“What it'll do is … you get cited a lot when somebody searches ‘dry eye doctor’ … because we can link all of that authentic content that you create.” — Eugene

Video Content Workflow (Process & Tips)

[29:20–33:01] Dr. Lillie:

Content topics sourced from patient questions (“just jot one down”), not high production, and practiced weekly.
Authentic delivery trumps polish; content grows easier with time.

Key Quote ([31:19]):

“It doesn’t have to be rocket science. It’s the same things your patients are asking every single day. Just answer that in a video.” — Dr. Lillie

Authenticity, Passion & Motivating the Team

[33:01–35:01] Dr. Lillie:

Associates thrive when encouraged to lean into authentic passions—even if personalities differ.
Letting introverted staff “own” a subject area raises engagement; being a nerd for your specialty is a strength!

Key Quote ([33:29]):

“Do what you love and no one can compete with you. You’re an N of one at that point.” — Dr. Lillie

Dry Eye Treatment Acceptance: The 47% Playbook

[36:22–45:30] Dr. Lillie:

Separate, visible dry eye suite with open doors—sparks patient questions and curiosity.
Clinical process: My biography done for every patient over 18. “If there’s any gland dropout … it’s like glaucoma. There’s no question about this.”
Communication refocus: Link treatment to what patients care about most—cosmetics, red eyes, tiredness, etc. (“Everyone wants to buy the painkiller, not vitamins.”)
Cosmetic improvements (lashes, baggy lids, facial redness) as entry points to start conversations, then segue to ocular health benefits.
Stopped discounting packages: Now charge per treatment for more flexibility and lower buy-in threshold (leveraging the ‘$500 rule’ for approval without spouse consultation).
“White glove” tiered bonus treatments (e.g., free lid cleaning or zest) used to incentivize second/third treatments and drive full package completion.

Key Quotes:

([40:54]) “No one wants to buy vitamins. Everyone wants the painkiller.” — Dr. Lillie
([45:07]) “We have our base treatment … then we come up, I want them to get LLT and a zest treatment, include that in their treatment. … We’re going to do the IPLs, giving these other things as free. Again, they see value.” — Dr. Lillie

Hiring & Training Associates for High Performance

[46:24–54:38] Dr. Lillie:

Hired ODs aligned with the practice vision and authentic interest in dry eye, even if personalities vary.
Weekly one-on-ones, shadowing, role-play: clinicians observe and learn from each other openly.
Associates encouraged to fail safely and grow—build confidence, focus on process over immediate results.
Friendly competition: Key metrics tracked at individual doctor level, fostering excellence.

Key Quotes:

([47:58]) “I give them my vision. I ask them, what do they want? … If they jive with me, this is what we’re going to make.” — Dr. Lillie
([53:29]) “We make each other better. … Small secret here—when I wasn’t doing it, and then she started converting that, you start to question, do I still have it?” — Dr. Lillie

Staying Energized: Purpose & Learning

[55:30–56:41] Dr. Lillie:

Personal north stars: give hope, educate, and advise—applied in every setting from patient care to coaching youth football.
Relies on constant learning (podcasts, study groups, reading) to fuel new ideas and share with staff/team.

Key Quote ([55:30]):

“Three things I do in everything … I want to give people hope. I want to educate and I want to advise.” — Dr. Lillie

Community & Strategic Vision

[56:41–60:33] Dr. Lillie & Eugene:

Participating in masterminds/study groups exposes broader perspectives, lifts ambitions, and shifts from short-term thinking to strategic, 10-year vision.
Strategy is about knowing what to say no to—avoiding shiny objects, sticking with fundamentals, and playing the long game.
Daily/weekly scorecards serve as the “bridge” between tactics and the ultimate goal.

Key Quotes:

([57:46]) “What’s the definition of strategy, Eugene? … It’s knowing what to say no to.” — Dr. Lillie
([60:00]) “It’s not our goals that drive us crazy. It’s our timelines.” — Dr. Lillie

Memorable Moments

“Badge of honor”: Staff wear physical symbols for achievements, explaining them proudly to patients and peers. ([16:11])
Patient-centric positioning: “Everyone wants to buy the painkiller, not vitamins” reframes how to present treatments for genuine buy-in. ([40:54])
Role reversals: Associates sometimes outperform Nick, driving him to improve as well—“iron sharpens iron.” ([53:50])
Scorecard as culture: Weekly tracking and open discussions make metrics and improvement a lived, team value. ([12:36–15:37])

Quick Reference – Notable Quotes & Timestamps

“What you measure, gets managed.” – Dr. Lillie ([09:36])
“If there’s a reward, everyone wins. … We rise and fall together.” – Dr. Lillie ([14:37])
“Assume they’re going to get the frame … It’s more of the assumption.” – Dr. Lillie ([20:26])
“Every single one of my staff members knows the commitment, knows the value.” – Dr. Lillie ([24:32])
“No one wants to buy vitamins. Everyone wants the painkiller.” – Dr. Lillie ([40:54])
“It’s not our goals that drive us crazy. It’s our timelines.” – Dr. Lillie ([60:00])
“Strategy … is knowing what to say no to.” – Dr. Lillie ([57:46])

Timestamps – Key Segments

00:00–03:07 – Introduction & main theme
03:07–04:29 – Dr. Lillie’s practice background
04:29–08:01 – Overview of growth metrics
08:01–14:37 – Weekly scorecard & culture shift
15:37–18:01 – Incentives & reinforcing great behaviors
18:01–21:30 – Behavior change at the exam & optical level
21:30–25:26 – Building a dry eye center and brand
25:26–29:20 – Referral and content marketing via video
29:20–33:01 – Video workflow and authenticity
33:01–35:01 – Passion as a differentiator
36:22–45:30 – Dry eye acceptance, presentation, and pricing
46:24–54:38 – Hiring/training associates, collaborative growth
55:30–60:33 – Energizers, vision, and study group lessons

Key Takeaways for Practice Owners & Managers

Relentless measurement and discussion of the right metrics fosters ownership and improvement.
Culture is built by positive reinforcement, friendly competition, peer sharing, and shared rewards.
Assuming the sale, scripting, and lowering real or perceived barriers dramatically improve sales acceptance.
Authentic, patient-focused video content supports both SEO and in-office conversion.
Hiring for passion and shared vision is even more important than pedigree or personality.
Long-term strategic thinking, not short-term wins or distractions, builds sustainability and growth.

For more information, visit Power Practice or contact the host via eugene@shotsman.com.

Power Hour Optometry

Episode: 12 Month Case Study to Scale Smarter – Growing Revenue and Culture with Dr. Nick Lillie

Host: Eugene Shatsman (A)
Guest: Dr. Nick Lillie (B)
Date: August 27, 2025

Episode Overview

Practice Background & Expansion: Setting the Stage

[03:07–04:29] Dr. Nick Lillie:

Practice in Allendale, MI, near Grand Valley State University.
In 2022, grew from a 1600 sq ft location to 3500 sq ft: 4 exam lanes, 2 dry eye suites, associate OD added.
Focused on three core areas: dry eye/ocular surface disease, ocular health (macular degeneration, glaucoma, wellness), and optical—even as future focus shifts more to medical care.

Key Quote ([04:00]):

“We try to focus on three things ... but my passion is the anterior segment, dry eye, and growing that practice.” — Dr. Lillie

The Growth Metrics: Dramatic Results

[04:29–08:01] Eugene Shatsman & Dr. Lillie:

Expansion of physical space and team—yet metrics improved, contrary to typical trends.
Notable performance advances in 12 months:
- Exam only rate dropped from 59.7% to 33%.
- Revenue per patient rose from mid $300s to $500–$600+.
- Dry eye treatment acceptance soared from 10% to 47%.

Key Quote ([04:29]):

“To go from a 59.7 exam only rate … to a 33% exam only rate this year. I mean, a 10 point move in a year is insane.” — Eugene

Metrics-Driven Management: The Weekly Scorecard

[08:01–12:36] Dr. Lillie:

Relentless measurement is central: “What gets measured gets managed.”
Weekly scorecard tracks: exam only rates, pre-appointments, frame/lens capture, dry eye evaluations, advanced therapy signups, family appointment ‘farming,’ and individual contributions (e.g., chart preparation).
Staff reviews and owns numbers, discusses at Monday morning meetings. Culture of praise, not just criticism.

Key Quote ([09:36]):

“My staff … know when they’re starting to get your messaging through is when they start repeating what you’re saying.” — Dr. Lillie

Building a Culture of Accountability & Team Success

[12:36–15:37] Dr. Lillie:

Culture shifted via deliberate one-on-one meetings, focus on individual and team metrics.
Best practices and successes shared peer-to-peer, not just top-down.
Progress seen as staff took pride and supported each other; competition avoided, team rewarded together.

Key Quote ([14:37]):

“If there’s a reward, everyone wins … We rise and fall together.” — Dr. Lillie

Incentives and Staff Engagement

[15:37–18:01] Dr. Lillie:

Call-outs and physical symbols (pins, tie clips) for achievements, worn as badges of honor.
Non-monetary and monetary rewards: team lunches, comfort food, cash bonuses if sales tiers hit—and tiers escalate to continually raise the bar.

Key Quote ([17:14]):

“The bigger things that move the needle, I try to give a bigger incentive for.” — Dr. Lillie

Changing Behaviors: Behind the Numbers

[18:01–21:30] Dr. Lillie:

Major lessons from tracking exam onlys: focus on what happens in the handoff from doctor to optician.
Shifted from “Would you like to look at frames today?” to assuming the purchase: “What color do you want? Metal or plastic?”
Upselling and framing always positioned from a patient-benefit viewpoint (e.g., “If your frame breaks, you’ll have a backup.”)
Empowered non-industry staff with scripts and strategies.

The Dry Eye Center: Branding and Operations

[21:30–25:26] Dr. Lillie:

Created “Rejuvenation Dry Eye Center” as a DBA—distinct branding encouraged referrals from local ODs skeptical of referring to a ‘competitor’.
Authentic commitment to dry eye care sets the practice apart.
Every staff member can talk about dry eye treatments.

Key Quote ([24:32]):

“When they go to most offices, there’s like one person they can talk to. Every single one of my staff members knows the commitment, knows the value.” — Dr. Lillie

Referral Program & Content Strategy

[25:26–29:20] Dr. Lillie:

Most referrals currently come from strong SEO and educational video content—no paid marketing yet.
Weekly short-form videos (under 1 min) filmed in 90-minute batches, inspired by real patient questions and casual brainstorming.
Authenticity and expertise improve Google rankings; videos link back to local search listings.

Key Quote ([26:46]):

“What it'll do is … you get cited a lot when somebody searches ‘dry eye doctor’ … because we can link all of that authentic content that you create.” — Eugene

Video Content Workflow (Process & Tips)

[29:20–33:01] Dr. Lillie:

Content topics sourced from patient questions (“just jot one down”), not high production, and practiced weekly.
Authentic delivery trumps polish; content grows easier with time.

Key Quote ([31:19]):

“It doesn’t have to be rocket science. It’s the same things your patients are asking every single day. Just answer that in a video.” — Dr. Lillie

Authenticity, Passion & Motivating the Team

[33:01–35:01] Dr. Lillie:

Associates thrive when encouraged to lean into authentic passions—even if personalities differ.
Letting introverted staff “own” a subject area raises engagement; being a nerd for your specialty is a strength!

Key Quote ([33:29]):

“Do what you love and no one can compete with you. You’re an N of one at that point.” — Dr. Lillie

Dry Eye Treatment Acceptance: The 47% Playbook

[36:22–45:30] Dr. Lillie:

Separate, visible dry eye suite with open doors—sparks patient questions and curiosity.
Clinical process: My biography done for every patient over 18. “If there’s any gland dropout … it’s like glaucoma. There’s no question about this.”
Communication refocus: Link treatment to what patients care about most—cosmetics, red eyes, tiredness, etc. (“Everyone wants to buy the painkiller, not vitamins.”)
Cosmetic improvements (lashes, baggy lids, facial redness) as entry points to start conversations, then segue to ocular health benefits.
Stopped discounting packages: Now charge per treatment for more flexibility and lower buy-in threshold (leveraging the ‘$500 rule’ for approval without spouse consultation).
“White glove” tiered bonus treatments (e.g., free lid cleaning or zest) used to incentivize second/third treatments and drive full package completion.

Key Quotes:

([40:54]) “No one wants to buy vitamins. Everyone wants the painkiller.” — Dr. Lillie
([45:07]) “We have our base treatment … then we come up, I want them to get LLT and a zest treatment, include that in their treatment. … We’re going to do the IPLs, giving these other things as free. Again, they see value.” — Dr. Lillie

Hiring & Training Associates for High Performance

[46:24–54:38] Dr. Lillie:

Hired ODs aligned with the practice vision and authentic interest in dry eye, even if personalities vary.
Weekly one-on-ones, shadowing, role-play: clinicians observe and learn from each other openly.
Associates encouraged to fail safely and grow—build confidence, focus on process over immediate results.
Friendly competition: Key metrics tracked at individual doctor level, fostering excellence.

Key Quotes:

([47:58]) “I give them my vision. I ask them, what do they want? … If they jive with me, this is what we’re going to make.” — Dr. Lillie
([53:29]) “We make each other better. … Small secret here—when I wasn’t doing it, and then she started converting that, you start to question, do I still have it?” — Dr. Lillie

Staying Energized: Purpose & Learning

[55:30–56:41] Dr. Lillie:

Personal north stars: give hope, educate, and advise—applied in every setting from patient care to coaching youth football.
Relies on constant learning (podcasts, study groups, reading) to fuel new ideas and share with staff/team.

Key Quote ([55:30]):

“Three things I do in everything … I want to give people hope. I want to educate and I want to advise.” — Dr. Lillie

Community & Strategic Vision

[56:41–60:33] Dr. Lillie & Eugene:

Participating in masterminds/study groups exposes broader perspectives, lifts ambitions, and shifts from short-term thinking to strategic, 10-year vision.
Strategy is about knowing what to say no to—avoiding shiny objects, sticking with fundamentals, and playing the long game.
Daily/weekly scorecards serve as the “bridge” between tactics and the ultimate goal.

Key Quotes:

([57:46]) “What’s the definition of strategy, Eugene? … It’s knowing what to say no to.” — Dr. Lillie
([60:00]) “It’s not our goals that drive us crazy. It’s our timelines.” — Dr. Lillie

Memorable Moments

“Badge of honor”: Staff wear physical symbols for achievements, explaining them proudly to patients and peers. ([16:11])
Patient-centric positioning: “Everyone wants to buy the painkiller, not vitamins” reframes how to present treatments for genuine buy-in. ([40:54])
Role reversals: Associates sometimes outperform Nick, driving him to improve as well—“iron sharpens iron.” ([53:50])
Scorecard as culture: Weekly tracking and open discussions make metrics and improvement a lived, team value. ([12:36–15:37])

Quick Reference – Notable Quotes & Timestamps

“What you measure, gets managed.” – Dr. Lillie ([09:36])
“If there’s a reward, everyone wins. … We rise and fall together.” – Dr. Lillie ([14:37])
“Assume they’re going to get the frame … It’s more of the assumption.” – Dr. Lillie ([20:26])
“Every single one of my staff members knows the commitment, knows the value.” – Dr. Lillie ([24:32])
“No one wants to buy vitamins. Everyone wants the painkiller.” – Dr. Lillie ([40:54])
“It’s not our goals that drive us crazy. It’s our timelines.” – Dr. Lillie ([60:00])
“Strategy … is knowing what to say no to.” – Dr. Lillie ([57:46])

Timestamps – Key Segments

00:00–03:07 – Introduction & main theme
03:07–04:29 – Dr. Lillie’s practice background
04:29–08:01 – Overview of growth metrics
08:01–14:37 – Weekly scorecard & culture shift
15:37–18:01 – Incentives & reinforcing great behaviors
18:01–21:30 – Behavior change at the exam & optical level
21:30–25:26 – Building a dry eye center and brand
25:26–29:20 – Referral and content marketing via video
29:20–33:01 – Video workflow and authenticity
33:01–35:01 – Passion as a differentiator
36:22–45:30 – Dry eye acceptance, presentation, and pricing
46:24–54:38 – Hiring/training associates, collaborative growth
55:30–60:33 – Energizers, vision, and study group lessons

Key Takeaways for Practice Owners & Managers

Relentless measurement and discussion of the right metrics fosters ownership and improvement.
Culture is built by positive reinforcement, friendly competition, peer sharing, and shared rewards.
Assuming the sale, scripting, and lowering real or perceived barriers dramatically improve sales acceptance.
Authentic, patient-focused video content supports both SEO and in-office conversion.
Hiring for passion and shared vision is even more important than pedigree or personality.
Long-term strategic thinking, not short-term wins or distractions, builds sustainability and growth.

For more information, visit Power Practice or contact the host via eugene@shotsman.com.

12 Month Case Study to Scale Smarter: Growing Revenue and Culture with Dr. Nick Lillie

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Summary

Power Hour Optometry

Episode: 12 Month Case Study to Scale Smarter – Growing Revenue and Culture with Dr. Nick Lillie

Episode Overview

Practice Background & Expansion: Setting the Stage

The Growth Metrics: Dramatic Results

Metrics-Driven Management: The Weekly Scorecard

Building a Culture of Accountability & Team Success

Incentives and Staff Engagement

Changing Behaviors: Behind the Numbers

The Dry Eye Center: Branding and Operations

Referral Program & Content Strategy

Video Content Workflow (Process & Tips)

Authenticity, Passion & Motivating the Team

Dry Eye Treatment Acceptance: The 47% Playbook

Hiring & Training Associates for High Performance

Staying Energized: Purpose & Learning

Community & Strategic Vision

Memorable Moments

Quick Reference – Notable Quotes & Timestamps

Timestamps – Key Segments

Key Takeaways for Practice Owners & Managers

Summary

Power Hour Optometry

Episode: 12 Month Case Study to Scale Smarter – Growing Revenue and Culture with Dr. Nick Lillie

Episode Overview

Practice Background & Expansion: Setting the Stage

The Growth Metrics: Dramatic Results

Metrics-Driven Management: The Weekly Scorecard

Building a Culture of Accountability & Team Success

Incentives and Staff Engagement

Changing Behaviors: Behind the Numbers

The Dry Eye Center: Branding and Operations

Referral Program & Content Strategy

Video Content Workflow (Process & Tips)

Authenticity, Passion & Motivating the Team

Dry Eye Treatment Acceptance: The 47% Playbook

Hiring & Training Associates for High Performance

Staying Energized: Purpose & Learning

Community & Strategic Vision

Memorable Moments

Quick Reference – Notable Quotes & Timestamps

Timestamps – Key Segments

Key Takeaways for Practice Owners & Managers