What does it actually mean to be the CEO of your practice?

For many practice owners, that question does not become real until growth starts creating pressure.

The practice gets busier. The team needs more direction. Associates need more training. Patients still expect the owner’s touch. And suddenly, the thing that once felt like a successful business starts feeling like a very well-paying job.

That is what makes this episode of Power Hour with Dr. Nick Lillie so valuable.

In this week’s episode of Power Hour, Eugene speaks with Dr. Nick Lillie, Owner of Family Vision Optical and Rejuvenation Dry Eye Center, who has spent the last two years intentionally moving from doctor-owner to true practice CEO. And the results are not theoretical.

His practice has continued to produce double-digit growth, even in a market where many practices are starting to feel pressure. But the real story is not just the growth, it is the machine he is building underneath it.

The Shift From Job to Business

Dr. Lillie started his practice cold after graduating in 2011.

For years, he was doing what many successful owners do: seeing patients, solving problems, making decisions, and carrying much of the practice’s tribal knowledge in his own head.

The business was working,  but it was also dependent on him.

Instead of continuing to optimize only around his own production, Dr. Lillie began asking a different question: How do you build a practice that can grow because of systems, not just because of the owner?

As his life changed and his family grew, he started to recognize a harder truth: If he was not seeing patients, the practice was not producing the way he wanted it to. That realization forced a major shift.

Why Systems Changed the Growth Curve

One of the most important parts of Dr. Lillie’s journey came when he hired his first associate.

At first, he thought the solution was simple: Clone himself. But that did not work.

The associate did not have his tribal knowledge, his instincts, his on-the-fly adjustments, or his years of experience inside the practice. That forced him to step back and start documenting the business more intentionally.

Phone calls, patient scheduling, exam flow, dry eye conversations, handoffs, exam-only reduction; the list goes on. 

Each piece became part of a larger operating system designed to make the practice less dependent on one person and more capable of scaling consistently.

The CEO Role Is Not Just About Seeing Fewer Patients

One of the strongest themes in the episode is that becoming CEO is not simply about getting out of the exam room.

It is about using that time differently.

Dr. Lillie talks through the trade-off every owner eventually faces:

Is your time best spent producing revenue directly, or is your time better spent building the systems, people, and accountability that allow everyone else to perform at a higher level?

That distinction matters because the CEO role requires management capacity.

It requires training, reviewing numbers, listening to calls, and coaching associates and staff.

It requires building the feedback loops that make systems stick instead of becoming another “idea of the week.”

That is where the real transformation begins.

How Dr. Lillie Makes Systems Stick

Many practices create a script, checklist, or process once, then assume the team will keep following it.

Dr. Lillie’s approach is different.

He and his team define the desired behavior, document it, measure it, observe whether it is happening, and then provide consistent feedback.

For example, his practice tracks phone performance, farming, exam-only behavior, optical performance, and other core KPIs through regular scorecards and meetings.

The result is a practice where the team knows what matters. They know what is being measured. They understand how their work connects to the bigger goals. And over time, they begin to self-correct, support each other, and take more ownership of the outcome.

That is what separates a documented process from a true operating system.

The Next Stage of Leadership

In the second half of the episode, Eugene shifts the conversation from Nick’s current progress to the next stage of his CEO journey.

That part of the conversation becomes especially useful for any owner trying to scale beyond themselves.

They look at where Nick has already made major strides: building systems, creating meeting rhythms, tracking KPIs, developing associates, and giving his team more structure.

But they also explore the next challenge:

How does Nick continue removing himself as the bottleneck?

But they also explore where he may still be the bottleneck.

The next level is not just about Dr. Lillie identifying the problems and creating the solutions.

It is about developing leaders who can bring him the ideas, prioritize issues, solve problems, and run parts of the business without waiting for him to direct every step.

That is the next evolution from doctor-owner to CEO.

And it is the work required to build a practice that can continue optimizing and scaling over time.

This episode is ultimately about what happens when a practice owner stops trying to personally carry the business and starts building the structure that allows the business to grow beyond them.

Eyecare BOSS Live Summit

If you’ve been to conferences before, you’ve probably left with many great ideas and intentions, and then when you get back to your practice, nothing actually changes.

Eyecare BOSS Live is designed specifically with that in mind so you can not only know what to do to reach your goals, but also have the tools, strategies, and plans to implement lasting changes once you’re back. to change that.

This is a 2 and a half-day, invitation-only event (September 16–18 in Cleveland) designed specifically for practice owners who want execution, not just inspiration.

Inside the room:

• 200 growth-focused operators
• Peer-level masterminds
• Real conversations around revenue, staffing, leadership, AI, and specialty growth

And everything is built around one outcome:

You leave with a 90-day plan you can actually implement.

If you want to be considered, click the link below:

• CEO Thinking Requires a Different Role | Learn why moving from doctor-owner to CEO means shifting from personal production to building systems, people, and accountability.
• Systems Scale Better Than Tribal Knowledge | Discover how Dr. Lillie moved from relying on instinct to documenting repeatable processes his team and associates can follow.
• Associate Training Needs Structure | See why “just do what I do” rarely works, and how better guardrails help new doctors grow faster.
• Feedback Loops Make Systems Stick | Understand why scorecards, call reviews, meetings, and consistent coaching are what keep initiatives from fading.
• The Owner Can Still Be the Bottleneck | Explore the next stage of CEO growth: developing leaders who bring solutions, manage issues, and help the business scale beyond the owner.

• Connect with Dr. Nick Lillie

  Dr. Nick Lillie is the Owner of Family Vision Optical and Rejuvenation Dry Eye Center in Grand Rapids, Michigan. He has built a growth-focused practice model centered on dry eye, patient experience, associate development, team accountability, and systems-driven execution.

  • Website: https://therdec.com/ 
  • LinkedIn: https://www.linkedin.com/in/nicholaslillie/ 

Connect with Eugene Shatsman

Eugene Shatsman is Host of Power Hour, Managing Partner of National Strategic Group, Co-Creator of The Eyecare BOSS, and a TEDx Speaker. A growth strategist and consultant to hundreds of optometric practices nationwide, Eugene specializes in scaling independent eye care businesses through structured strategy, marketing science, and operational clarity.

• LinkedIn: https://www.linkedin.com/in/eugeneshatsman/
• Website: https://eyecareboss.com/