Investment LossAs one of two owners in a large optometry practice, I have to face difficult employment issues each week. Like many optometry graduates, I had trained for the clinical aspect of optometry and had what I now see was a naive interest in being a business owner and employer. As job descriptions get more specialized traveling up the practice hierarchy, staff management risk increases. The associate OD position is near the top. I define risk as making employment changes or systems changes that may result in unhappy associate ODs.  The only thing worse is having a full schedule of patients and learning an OD just quit. So how do we navigate difficult employment conversations with associate ODs, even conversations that may result in their compensation being reduced?

  1. Warning lights before the danger – When you drive on a major highway and come upon backed-up traffic and a perpendicular state trooper vehicle, you know that there is most likely danger ahead. A well-structured employment manual will provide warning lights to an associate OD. Follow the guidelines outlined in your employment manual and the warning lights will be obvious.
  2. Associate agreement – When an associate agreement is designed with the end in mind, difficult situations like a pay decrease are no surprise to the optometrist. The reason great practices spend a large amount of time putting together a very clear and well-structured associate agreement is so there will be no surprises.
  3. Performance-based compensation – Designing a compensation package that rewards an employed OD for his or her passion, initiative and hard work will not only benefit the optometrist, but will also benefit the practice. When an employed OD is compensated based on performance, there is no need to adjust compensation according to the ebb and flow of the practice financials. Instead, it will adjust itself. If a practice is a successful growing practice the employer may also want to adjust compensation to a percentage of the gross based on performance of the practice. For example, if the compensation is 15 percent less of practice net, then when the practice nets 35 percent for the month the associate OD receives 20 percent of their gross collected production.  This motivates the associate to be aware of expenses and work to keep them low.

Managing other doctors is never easy. Many times the threat of an uncomfortable confrontation is enough to make you avoid the situation, which only makes things worse. Vision in staff management is the ability to see potential outcomes and position yourself for the smoothest ride through those outcomes. No one wants to decrease an associate OD’s pay, because that most likely means that the OD is struggling. By envisioning the potential outcomes you have a role as the CEO to assist in helping the associate be successful so that pay decrease may never need to happen after all.