For years, I’ve written, spoken, and advocated that practices need to have great systems in place. I’ve also said that when something isn’t going well, it’s usually the result of the lack of a system or of a system that needs fine-tuning. After all, when you have good reliable systems in place and things aren’t left to chance or personality, tasks are more likely to be completed consistently and properly. Think of what would happen if the airlines didn’t use checklists. Not only would your baggage be less likely to go where you’re going, but passenger safety would be put at risk.

In our practices, checklists and systems are essential to ensure good patient care. If you dispense lens X, your staff should know the proper way to instruct the patient to use lens care product Y. If your protocol for a scleral follow up is one week after dispensing, your front desk needs to know how to appoint that.

All of this said, there are some pitfalls to having systems in place.

Feeling Locked In

Creativity and the ability to improve things may suffer. With too many things scripted or pre-planned, the ability to move your practice forward may suffer or be slowed down. Employees may feel that their input to improve what appears to be a well-honed legacy process might not be welcome.

Tackle this head on by creating a culture of challenge. Let employees know that while a process is in place and appears to be working, that doesn’t mean that it can’t be modified. Rather, ask them to attempt to modify it. The only constant here should be that things must be modified in the context of your practice values and mission. So, if your practice foundation is built on providing exemplary clinical care, any changes to a system have to keep that as a hallmark. Everything from how, what time, and how often to check voicemail; when to order diagnostic lenses and how many to order; and where to order paper towels from or make a bank deposit counts!


Next, with lots of systems in place, boredom and the ensuing lack of energy is a genuine potential danger to your practice. Going back to the airlines, or remembering the last time you checked in at a hotel front desk, think about the robotic way in which the safety instructions were read or how you were greeted. In this case, autopilot doesn’t apply only to the person flying the plane!

The same thing can easily happen in our practices if we’re not alert and careful. This is especially challenging in a contact lens practice since, by design, the clinical nature of what we do is often repetitive. For example, when a patient asks, “So doc, what exactly is astigmatism?” recognize that you’re already formulating your response based on the last 26,000 times you were asked the same question. This doesn’t mean your response is bad. It simply means that if you’re not careful, it will be delivered by rote without the conscious realization that the person to whom you’re speaking might be hanging on your every word. Also, a mechanical response runs the risk of the patient focusing on your delivery rather than on your message.

To combat repetitiveness and its ability to drain energy, consider changing up systems (and make that a system!) every three months.

Recognizing that good systems and processes are essential to your practice, and doing something to ensure that they don’t ultimately damage your practice, is the hallmark of a great CEO. In fact, one system that a good CEO should institute is an intermittent review of current systems! CLS

Dr. Gerber is the president of the Power Practice, a company offering proven and comprehensive practice and profit building systems. You can reach him at and follow him on Twitter @PowerYourDream.