The Communication Mistakes Holding Practices Back—and What to Do Instead

In more than a decade of working with optometry practices as a business consultant, I’ve seen one recurring challenge that consistently rises to the surface: communication. In my experience, nearly 90% of staff-management problems stem from communication breakdowns that undermine accountability and morale.

Here are the seven most common communication mistakes I see in optometry practices—and what practice owners should do instead.

MISTAKE NO. 1: TREATING COMMUNICATION AS OPTIONAL

One of the biggest gaps I see is simply insufficient communication. Many practices don’t make it a priority. There are no regular team meetings, no one-on-ones and sometimes no real communication at all. And when communication does happen, it’s often vague.

Staff members are left unsure of what’s expected of them day to day. Owners and managers frequently tell me, “We don’t have time for meetings,” which is ironic because the lack of communication often creates more problems that take even more time to fix later.

When communication takes a back seat, assumption tends to fill the gap. A practice owner hires someone who’s “done this before” and assumes they can do the job exactly the same way in a new environment. But every practice is different, and assuming alignment without clarity almost always leads to frustration on both sides.

What to do instead:

Make communication nonnegotiable. Set meetings. Invite questions from your team. Even short, consistent touchpoints create alignment and prevent misunderstandings before they snowball.

MISTAKE NO. 2: GIVING VAGUE OR NO INSTRUCTION, THEN GETTING MAD

When instructions aren’t clear, staff members are put in a no-win situation. They either do the wrong thing because the doctor had something specific in mind but never communicated it, or they default to doing the bare minimum because they don’t want to make a mistake.

I learned this lesson early on in optometry school while working the front desk at a practice. Two patients arrived at the same time, one early and one late. I didn’t know who should go back first, so I froze. I didn’t want to make the wrong decision. The doctor was frustrated that I didn’t take initiative, but the expectation had never been communicated. That moment would have been an ideal opportunity for my supervisor to clarify expectations for similar situations in the future.

What to do instead:

Spell out expectations clearly and proactively. When something goes wrong, explain what you want done next time.

MISTAKE NO. 3: SKIPPING THE “WHY” BEHIND CHANGES

Few aspects of communication matter more than explaining the “why” behind changes, yet it is routinely overlooked in team settings. Change management is hard, and without context, staff resistance is almost inevitable.

Research shows the top reasons new hires don’t work out are simple: They don’t know what to do, they don’t know how to do it or they don’t know why they’re doing it. When staff members ask, “What was wrong with the old way?” it’s usually a request for clarity, not an act of defiance.

What to do instead:

Take the time to walk your team through the reasoning behind changes. Explain why the old method isn’t effective, how the new process helps and what you expect from everyone. When people understand the “why,” they’re far more likely to embrace the change.

MISTAKE NO. 4: ASSUMING ONE CONVERSATION IS ENOUGH

One of the most frustrating things I hear from leaders is, “I told them once, and they keep making the same mistake.” The problem isn’t the staff—it’s the expectation that one conversation is enough. Repeating key expectations is how teams learn and internalize priorities. Former LinkedIn CEO Jeff Weiner once said, “When you are tired of saying it, people are starting to hear it.” Repetition signals priority.

I once worked with an OD facing a customer service crisis and poor online reviews. He thought he needed to have a team meeting to solve the problem. I asked when he had last talked about customer service with his team. Silence. That conversation needs to be ongoing, not reactive.

What to do instead:

Reinforce expectations consistently and proactively. Feedback should be continuous, not episodic.

MISTAKE NO. 5: AVOIDING TOUGH CONVERSATIONS

Avoiding difficult conversations at work is no different than avoiding them in personal life—the problem doesn’t get better on its own. Accountability is everything, even if it’s uncomfortable.

Many leaders struggle with confrontation, but accountability doesn’t have to feel confrontational. If you’re proactive and set regular meetings where team members report progress, you shift the dynamic. Instead of chasing problems, you’re reviewing outcomes together.

What to do instead:

Create systems where accountability happens naturally through structure and routine.

MISTAKE NO. 6: DELIVERING FEEDBACK THE WRONG WAY

Common feedback missteps include being too vague, overly critical or poorly timed. Giving group feedback to a room of 10 people can result in 10 different interpretations and waiting until annual reviews to unload a list of complaints helps no one.

At the same time, many ODs only speak up when something goes wrong, missing opportunities to celebrate wins. Public recognition during meetings builds morale, loyalty and trust—but it has to be genuine.

What to do instead:

Give timely, specific feedback in private. Balance constructive criticism with recognition of what’s going well. Call out good work when you see it, and don’t oversystemize appreciation.

MISTAKE NO. 7: LEADING WITH CONTROL INSTEAD OF COLLABORATION

A command-and-control leadership style is often rooted in the belief that the doctor is the smartest person in the room. But curiosity is one of the most powerful leadership traits.

Chris Voss, former FBI hostage negotiator and author of “Never Split the Difference” once said, “Negotiation is often described as the art of letting the other side have your way.” The same principle applies to leadership: set the goal, but don’t dictate every step of the process. Your team often sees things you don’t and giving them ownership encourages engagement and accountability.

What to do instead:

Ask more questions. Invite input. Share ownership of outcomes.

BUILD A CULTURE THAT COMMUNICATES

There’s no shortcut to strong communication. It starts with structure—regular meetings, ongoing conversations and consistent follow-through. Accountability grows when teams know that expectations and progress will be revisited.

If your team knows they’re meeting with you next week, they’ll show up prepared. But that kind of alignment only happens through effective communication. It’s more than a “nice skill to have.” It’s foundational to a successful practice and a healthy team culture. And when everyone gets it right, everything gets easier.

Read another article by Dr. Steve Vargo here.

Read more on staffing here.