Staff Management

4 Ways I Established Trust With Staff to Build a $1 Million+ Practice

By Ken Krivacic, OD, MBA

Nov. 3, 2021

A relationship of trust between practice owner and staff goes a long way toward enabling you to provide a high level of care and profitability.

I took the building of staff trust seriously in my practice. Staying conscious of management’s relationship with staff allowed us to build a practice with $1 million+ annual revenues. Here is what I have learned about the importance of trust in staff management, and how I applied those principles in my own practice.

An Empire (or Practice) Built on Trust
I recently read the book, “Sapiens: A Brief History of Humankind” by Yuval Noah Harari.1 In the book, Harari, a history professor, discusses the evolution of mankind from 100,000 years ago until today and discusses how our thinking as humans has shaped not just us, but the world around us. One particular discussion in the book–on behavior related to trust–got me to thinking about how we interact as practice leaders with our employees, and how that interaction affects the success or failure of the practice.

In the chapter on capitalism, Harari reviewed the history of how in the mid-1500s the Dutch revolted against Spain, which at the time was the most powerful state in Europe and controlled commerce throughout much of the world with bases as far away as Africa and Asia.

Within 80 years, the Dutch not only secured their independence from Spain, but they also replaced Spain as the masters of commerce in the world and became the richest state in Europe. So, how did they do that? Harari contends the Dutch did this by being able to repay loans to their creditors on time, investing profits back into building their trade and commerce and using the rules of law to protect investors.

Meanwhile, the king of Spain developed a reputation for not always paying back loans, and because he was king, had a tendency to ignore private property laws and seize money and property when he needed to. Ultimately, trading partners could trust the Dutch and not the king of Spain.

This is a nice history lessons in dealing with others in business, but what does this have to do with running an optometric practice? In one word: TRUST.

A world empire is not the only place where trust is required. To have a smoothly running and successful practice there needs to be trust between the practice owner and the staff. Too often, practice owners talk about not being able to trust staff, but how often have we considered whether our staff can trust us?

Trust works both ways. Let’s talk about ways we can build trust between practice owners and staff.

In an article in Harvard Business Review,2 Carolyn O’Hara presents several principles that can help business owners build trust with their employees. Here is how I applied those principles to my practice.

Make a Connection
Making a personal connection with your staff is one of the best ways to get them to follow you and the goals you set for them. This can be as simple as asking what they did over the weekend or discussing a topic you have in common such as travel or photography. It took me a while to figure this out.

When I first started our practice, I viewed myself as the boss and the employees as employees. My perception was that I did not want to make much of a connection because if we got too close, they would not listen to me. It took me years to understand that this was not the case. As part of our yearly bonuses over the years we took staff on a long-weekend getaway as a reward for a good year. Remarkably, the ones who went the most often on these getaways stayed with our practice the longest. Long-term employees require less management and reduce the economic cost of replacing an employee.

Be Transparent & Truthful
O’Hara recommends sharing as much as you can about the current health and future goals of the company. In our office, we used an open-book management system. Our bonus system was based on income and expenses. We constantly tracked those numbers and shared them with staff at a weekly meeting.

Everyone knew what came into the office every month in revenue and what went out in expenses. If you are uncomfortable with this, you can lump all salaries into one bucket so as not to single out anyone – that’s what we did. You also need to explain to staff that out of the net, the owner will take a portion of that. Once you get everything out in the open, it is easier to manage a bonus system and employees can then see where all the expenses go. Too often without being transparent, employees feel that the owner is just raking in the profits.

Encourage Rather than Command
Jim Dougherty, a senior lecturer at MIT Sloan School of Management, says, “You don’t succeed in the long run by telling people what to do, you have to motivate them to do it.”

If you can align the goals of your company with the goals of your employees, they will work harder for you. In our case, we accomplished this with our bonus program. Revenue goals were set for the practice, and if met, the employees would share in the profits. A win for the practice was also a win for the employee.

Be sure to give your employees autonomy to make decisions without constantly having to run it by you as the practice owner. “People will trust you if you trust them,” says Dougherty.

Take Blame, But Give Credit
Make sure you give employees credit when the office does well. After all, could your office generate the income it does without the employees? Giving credit also reinforces the fact that everyone is working toward a shared goal.

On the other hand, if things don’t go as planned–let’s say you failed to make bonus one month–be careful not to cast blame on the staff. It would be much better to say that the company and your leadership need to do a better job in the future.

Bottom Line: Trust is a Two-Way Street
If you want your practice to do well, and want less stress in dealing with your employees, follow the above four principles. There needs to be a leap in faith as you delegate more to your employees and empower them to make decisions on their own. You need to be able to trust them.

And employees need to be able to trust you. This can be accomplished by making sure your leadership style encourages connections, and is truthful and encouraging.

Trust is a two-way street. Use it and speed your way to a more successful practice and a staff that is more enjoyable to work with.

1. “Sapiens: A Brief History of Humankind” by Yuval Noah Harari
2. “Proven Ways to Earn Your Employee’s Trust” – Carolyn O’Hara – Harvard Business Review June 27, 2014

Ken Krivacic, OD, MBA, practices at Las Colinas Vision Center in Irving, Texas. To contact him:




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