Why Independents Can Lead the Way...

WRITER Shaina Zheng

In the current environment, many established independent optometry practices are being acquired by corporate models; however we’re also seeing the blossoming of greenfield independent practices, often being set up by younger eye care professionals.

Within this changing environment, optometrist Shaina Zheng has undertaken research that has revealed the cultural strengths shaping independent practices, resulting in staff happiness and stability, and improved patient outcomes.

When I think about culture, I don’t think of abstract theories. I think of people and the moments that stay with you. Early in my career, while working regionally as a locum optometrist, I met a manager who completely reshaped how I saw leadership.

He had this calm, supportive way about him. When team members were going through difficult times, he didn’t ignore or criticise them. He gave them space, encouragement, and the help they needed.

I remember one dispenser, in particular, who was struggling with lens measurements, leading to repeated remakes. Some of us had stopped handing jobs to her because we didn’t trust the outcome. Instead of sidelining her, the manager sat down one-on-one, coached her, and gave her the tools to improve. From that day forward, she didn’t make the same mistake again. More importantly, the team’s trust and respect for her returned.

That moment was a turning point for me. I realised that mistakes, when met with compassion, can transform both people and culture.

And the experience stayed with me. It showed me that leadership isn’t about hierarchy, it’s about creating safety and growth.

Years later, when I began hearing from colleagues who felt unsupported at work, I wanted to understand more about how leadership shapes individual experiences and the success of practices.

What makes a successful leader? How does leadership influence practice culture? And how does that contribute to success? What could others in the profession learn from practices that have an established positive culture?

As part of my Master of Business Administration degree, I undertook a study into workplace culture, focussing solely on independent optometry. It explored perspectives from every role within the practice – optometrists, dispensers, receptionists, managers, and owners – because culture isn’t lived by one group alone, it’s built and experienced by everyone.

What I found was encouraging, and in some ways surprising. Across 10 domains of culture, every one scored positively at a statistically significant level. In workplace research, where results usually reveal a mix of highs and lows, this is rare.

The message is clear: the independent practices I surveyed are not just holding their ground in a rapidly consolidating industry; they are doing it with cultural strengths that directly support resilience. These successful independents are showing us what a sustainable future for optometry could look like if culture becomes our foundation.

WHY CULTURE MATTERS NOW

It’s easy to believe that the future of optometry will be secured by new technology, advanced treatments, or better funding models. These are all important but, in my experience, none of them will matter if we don’t also address something more fundamental: how people feel at work.

Culture is the invisible thread that ties everything together. When it is strong, staff feel supported and valued. They stay longer, grow into their potential, and deliver care with pride. Patients sense this and benefit from the consistency and compassion that follows. When culture is weak, even talented people burn out, disengage, or leave – and patients feel that too.

I often come back to the idea of psychological safety, because it is the foundation of high-performing teams.1 One story from healthcare always resonates with me: a nurse who spotted a dosage error hesitated to speak up because the last time she had raised a concern, she was shouted down by a doctor. That silence put patients at risk. By contrast, in high-performing teams, mistakes are surfaced, owned, and treated as learning opportunities. Everyone makes errors. The difference is whether a culture punishes them or learns from them.

We see echoes of this in optometry. I have spoken with many colleagues who feel disengaged from their workplaces, and in some cases, from the industry itself. A few have already left the profession or are planning to. This isn’t because they lack skill or passion, it’s because the culture around them doesn’t support their growth.

The evidence backs this up. Studies have shown that when people are happy and engaged at work, they are more productive, more creative, and deliver better outcomes.2 In some industries, this even translates into higher sales. In healthcare, the benefit is even clearer: better engagement leads directly to safer, higher quality patient care.3

A NEW CONVERSATION FOR OPTOMETRY

For decades, we’ve carefully measured clinical outcomes in optometry, but rarely cultural ones. It’s time we did.

Hospitals once treated hand hygiene as a matter of goodwill, until evidence showed that consistency saved lives. In the same way, culture deserves attention and investment, not as a ‘nice to have’, but as an essential part of how care is delivered.

Many practices already demonstrate what strong culture looks and feels like. The next step for our profession is to find ways to support and resource it.

Culture is not soft; it is the infrastructure of resilience. And in today’s healthcare environment, resilience is what will determine whether practices and the people within them, thrive or struggle.

My Study of Independent Optometry Workplaces

Unlike many surveys that focus solely on optometrists, my study gathered insights from entire teams. Ten cultural domains were assessed, from teamwork and leadership to innovation and recognition.

This research was based on a national anonymous survey conducted over five weeks, distributed through professional and industry networks to those working within independent optometry practices across Australia.

A total of 117 participants responded, with 96 complete surveys included in the final analysis. Respondents represented a cross-section of roles; optometrists (69.78%), optical dispensers and retail staff (15.63%), practice leaders (9.38%), optometry assistants (2.08%), and reception/administration (3.13%), providing a holistic view of independent practice environments.

The study adhered to ethical research standards, with informed consent, confidentiality, and ethics approval obtained.

Using a mixed-methods approach, it combined quantitative and qualitative insights.

• Quantitative data assessed 10 workplace culture domains: leadership, teamwork and collaboration, psychological safety, innovation, growth mindset, recognition of contributions, inclusion, patient-focussed care, financial and staffing resources, and favourable workplace culture compared to the industry.

• Qualitative data from open-ended questions captured personal reflections and experiences, which were thematically analysed to identify common strengths and challenges.

Data were analysed using descriptive statistics, correlation analysis, and regression modelling to explore the key drivers of positive workplace culture.

The findings offer the first evidence-based view of workplace culture within independent optometry in Australia, providing valuable insight into the conditions that drive engagement, wellbeing, and resilience across the sector.

THE RESULTS

• All 10 domains scored positively.

• Teamwork, recognition, and patient focus came through as strong differentiators.

• Innovation, growth mindset, and resourcing showed potential, but were often squeezed out by pressures of time and funding.

This shows that independent practices are already strong, however to remain resilient, they must keep strengthening the conditions that allow innovation and growth.

THE SIX DRIVERS OF CULTURAL RESILIENCE

Teamwork and Collaboration

What I found: Successful independent practices thrive on teamwork. Many described their environment as ‘family-like’, where people genuinely look out for each other.

Why it matters: In small teams, collaboration allows practices to flex, adapt, and keep going when pressures mount.

As one participant shared, “We show our colleagues respect and try to help each other as much as possible. When one person is unwell or cannot work, we try to work a bit harder so that they can rest and recover well.”

That’s culture at work. Leaders can:

• Create daily or weekly huddles so everyone is aligned,

• Design rosters that protect collaboration, and

• Celebrate group wins, not just individual ones. Team members can:

• Step in for a colleague during busy periods, and

• Share knowledge openly.

Patient-Focussed Care

What I found: Staff across independents said they valued being able to put patients first. Many linked their motivation directly to this freedom. But there were also frustrations when systems or resources didn’t allow them to give the care they wanted.

Why it matters: Patient-first care is only sustainable when workplaces are people-first. When staff feel supported, patients feel cared for.

Leaders can:

• Align appointment structures with care goals,

• Act on feedback when staff flag barriers to care, and

• Let patient-first values guide both clinical and business decisions.

Team members can:

• Speak up when processes undermine patient outcomes,

• Suggest small workflow improvements, and

• Encourage each other to keep care compassionate.

Recognition of Contributions

What I found: Recognition is one of the strongest motivators. People don’t need grand gestures, they just need to know their efforts are seen.

Why it matters: When recognition flows, people feel valued and give more. When absent, even high performers disengage.

As one participant shared, “The aspect that I find most supportive is the recognition of individual performance or even little things that they do to help the practice. It makes me feel appreciated and motivated to keep working hard and to give the patients the best care possible.”

Leaders can:

• Build in simple rituals like monthly ‘shoutout’ rounds,

• Give timely feedback, and

• Model gratitude openly. Team members can:

• Recognise a peer daily (out loud),

• Give credit in front of others, not just privately, and

• Make appreciation part of everyday culture.

Innovation

What I found: The appetite for innovation was strong. Only 6% resisted change, but time and workload often got in the way.

Why it matters: Innovation allows practices to adapt and thrive. Without it, resilience stalls.

One participant admitted, “We want to innovate, but we’re just too busy most of the time. Still, it doesn’t take long if we want to implement something new.”

Leaders can:

• Protect time for reflection, even 30 minutes a week,

• Reframe mistakes as learning opportunities, and

• Encourage small ‘test and learn’ experiments. Team members can:

• Suggest manageable ideas,

• Share learnings from both wins and setbacks, and

• Encourage peers who try new things.

Financial and Staffing Resources

What I found: Resource pressures were a major barrier. Staff weren’t against innovation, they just lacked the time, money, or people to make it happen.

Why it matters: Resources are cultural signals. Under-resourcing communicates that wellbeing is secondary.

Leaders can:

• Be transparent about financial realities,

• Invest where culture and care align, and

• Explore partnerships or networks to share resources.

Team members can:

• Flag workload challenges honestly,

• Offer efficiency ideas, and

• Share solutions across roles.

Growth Mindset

What I found: Staff thrived in environments where mistakes were treated as learning.

Why it matters: A growth mindset is what keeps people engaged, learning, and contributing.

Leaders can:

• Share their own learning moments,

• Normalise regular feedback, and

• Provide small, ongoing development opportunities.

Team members can:

• Ask for feedback proactively,

• Share their own lessons, and

• Encourage peers who try new approaches.

Together, these findings show that successful independent practices have built something special, a culture that supports both care and connection. Their strength lies not only in what they do well, but in their willingness to keep learning and adapting, even under pressure.

This brings me to one of the clearest lessons from the study: patient-first care depends on people-first workplaces.

FROM PATIENT-FIRST TO PEOPLE-FIRST

When staff feel supported, patients experience continuity, compassion, and quality. But when that support is missing, care inevitably suffers.

The independent practices that participated in my survey already model this link consistently. But to keep leading, they must invest in the systems and resources that sustain it.

THE LEADERSHIP IMPERATIVE

Culture is shaped by leadership every day. And leadership isn’t just about owners or managers, it’s visible in how every role sets the tone, supports peers, and treats patients.

The challenge for leaders is to turn values into daily practice. Model openness when things go wrong, show that feedback is safe, and make learning part of the routine conversation.

It’s not enough to just say culture matters, it must show in decisions. Treat culture as a strategic asset, not an afterthought.

If hospitals can measure hand hygiene as a key performance indicator (KPI), optometry can begin measuring culture too. Not because numbers are the goal, but because what we measure, we prioritise.

The independent optometry workplaces that contributed to my research are already showing what good culture looks like day to day. Now it’s time to make those strengths visible and shared with the rest of the profession.

THE POWER OF PRACTICE CULTURE

My research shows that positive culture isn’t just aspirational, it’s happening now. It proves that resilience is built in people, not just systems.

By making cultural strengths more visible, and finding ways to measure and share them, successful practices can position themselves as role models for the profession.

The research behind this work became the foundation for the Positive Optometry Culture Framework, a practical model I’ve started exploring within my own practice and through Impact Culture Group, to explore how we can make culture something visible, measurable, and lived each day.

My hope is that this framework becomes a tool to support more leaders across the profession in building workplaces where people thrive together.

A SHARED OPPORTUNITY

This research opens a new conversation for our profession. For the first time, we can see evidence that many independent optometry practices already hold cultural strengths that directly drive resilience.

The opportunity is threefold:

1. To promote the independent pathway as a strong, positive career choice.

2. To recognise independents as cultural role models, and to make their strengths more visible, measurable, and shared across the industry.

3. To encourage all practices to make workplace culture a KPI.

The future of optometry will not be secured by technology or clinical skill alone. It will be shaped by the cultures we build. Cultures where people thrive, and patients receive care at its most human.

As both a clinician and a leader, this matters deeply to me. Everybody deserves the opportunity to work in environments where we feel supported, valued, and able to grow. That’s not just good for us, it’s good for our patients.

Independent practices are already demonstrating what’s possible when we prioritise culture. How can we continue to advance these conversations and share insights across the profession? It’s an important dialogue and one worth continuing.

Shaina Zheng BOptom MBA GAICD is a clinical optometrist, Vice President of the Dry Eye Society, and co-owner and optometrist at Eyecare Plus Mermaid Beach in Queensland.

She is the Founder of Impact Culture Group, a consultancy that helps healthcare leaders build thriving, values-based workplaces where people and performance grow together.

Her formal research at Queensland University of Technology led to the development of the Positive Optometry Culture Framework, an evidence-based model for building high-performing, psychologically safe teams. Through this work, Ms Zheng aims to make culture visible, measurable, and a true driver of wellbeing and sustainable success across the profession.

References available at mivision.com.au.