Should you remodel your optical?

Over the past decade, remodeling has become entertainment. Shows on HGTV and other networks show dramatic transformations, and may make you think it might be time for your optical to get a face-lift. However, the improved space always comes at a price. For example, if I was remodeling my home, HGTV would probably set my budget at $150,000 to $200,000, which seems absurd.

The experts will charge thousands of dollars to design and contract a team of local or company run experts to put a new face on your optical. You will be told that the more you invest, the more return on your dollars. This is necessarily true and needs to be considered. The most likely reason to remodel is to keep up with competitors.*

But before you commit, you need to make sure an extensive optical remodel fits in your strategic plan for growing your business. A remodel may not be necessary to keep patients purchasing frames from your practice. As managed vision plans decrease, patients aren’t as free to shop around. Then investing core dollars in patient service becomes most important.

So should you, or not?

It’s time to remodel if:

  • Your optical has been unchanged for over 10 years.
  • A competitive optometry office set up within a three-mile radius and is pulling patients away from your office.
  • At least 10 percent of your patients are new each week.

Forego remodeling if:

  • You net over 40 percent and you are continuing to grow.
  • Your average demographic patients do not remodel their homes. If you serve socioeconomic patients in middle-to-lower class, they may perceive it as a waste of resources.
  • Frame turnover rate is greater than 3x.

When was the last time you left a retail establishment because they had not remodeled in the past 10 years? I doubt you can think of an example. However, I suspect you can think of a time when you vowed to never return to a business due to poor service or lack of cleanliness. As doctors we tend to have higher expectations, but what if most of your patients are not doctors or professionals? Spend money to keep the practice looking nice, but consider carefully before you spend a significant amount.

Reference

*http://www.retailleader.com/top-story-capital_management-how_much_is_a_facelift_worth_-1124.html

Work smarter not harder – Maximize high demand seasons

A wise person once asked, “Who makes the best business partner?”

  1. Dumb, lazy person.
  2. Dumb, hard worker.
  3. Smart, lazy person.
  4. Smart, hard worker.

Most of us would pick the smart, hard worker. However the wise person will choose a smart, lazy person any day. The smart, lazy person will figure out a way to get the work done right with half of the effort.

This principal holds true as you manage your optometry schedule. Many optometrists are working 4.5 days to 5.5 days per week. They wonder why they are burning out and feeling controlled by the practice.

The typical optometry schedule has ebb and flow. There are seasons where the schedule is so packed you can’t get all of your patients in, and there are slow seasons that have a higher number of cancellations and no shows. Use these ways to work smarter by reducing clinical hours without reducing production.

  • Pick the four slowest production months of the year and reduce your time in clinic by a day per week. (February, May, September, December)
  • Pick your three busiest months and work an extra half day in clinic. When people are wanting to be seen and your clinic doesn’t have time available, they start looking elsewhere (March, July, August)
  • Find the month with the highest no show rates/cancellations and reduce clinic days by a half or full day. (May)
  • Open the office longer for high demand seasons (March, July, August) and in return take more time off during other months of the year.

Of course, the suggestions above will vary depending on your practice setting. Keep in mind the principal is to work smarter by scheduling smarter and maximizing the high demand times of the year so you can work less at other times of the year. This approach makes for a much more enjoyable and sustaining career and can avoid burnout.

Does your optometry office struggle to keep staff?

Cheerful co-workers taking self portraitManaging the optometric practice is one of the most difficult pieces of the CEO puzzle. The people you are trying to manage are sometimes emotional, unpredictable, and fickle. Sometimes they leave. At times people leave for good reasons, or situations that are out of the CEO’s control. However, to build a solid optometric business you must retain a loyal staff, and that starts with you. If you have employees looking for similar jobs elsewhere they might be satisfied with your business, but they are not loyal. Building loyal staff depends on your relational abilities and leadership. If your staff is committed to the practice and the patients, you most likely are investing in people. If this is not occurring, invest in staff by practicing these three Important loyalty builders:

  1. Skillful Listening – Successful clinical optometrists are successful because they have learned to listen to the patient and discern the chief complaint. This is crucial because a patient’s view of good clinical care depends on solving the chief complaint. Skillfully listening to staff members shows them that you truly care about them and builds relationships. For a great resource on becoming a better listener read Powerful Listening. Powerful Influence. Work Better. Live Better. Love Better.: by Mastering the Art of Skillful Listening by Tim Hast
  2. Financial CompensationCompensate staff fairly. When you pay staff above the averages they most likely will not be looking around to just look around. Check current wages for your area yearly to verify your staff is well compensated. Don’t wait for them to look for another job before you offer them more money.
  3. Family Environment – If you are a small office, which most optometry offices are, you truly are a small family. Most of the week is spent at the office. Creating an environment that encourages and nurtures these relationships makes the staff members want to stick together over the long haul. Regular events like eating out together give staff and doctors time to build relationships. This time is invaluable and returns more on your investment than a bonus or raise. It also requires you as the owner to be active and involved in the family.

Great patient care requires a supporting staff that is loyal and dedicated to the success of the practice. Great staff begins with you creating a great culture.

Hire the best….Future optometrists

Right now we have two staff members who have decided to make optometry their life profession and are applying to optometry school. These future ODs are excited, and their excitement is contagious to the rest of the staff, even the sometimes complacent and burned out OD who has been practicing for years. When you employ a future optometrist you benefit from his or her hopes and dreams and it makes your practice better.

Future optometrists upgrade your practice in 3 ways:

  1. Positive, contagious attitude – Future ODs want to learn and do the best they can. Doctors naturally respond positively to this passion that future ODs bring to the practice, and other staff members will take note. If your practice has a culture that needs change, hire an aspiring optometrist to infuse it with positivity.
  2. Capacity – There is a capacity rule that many CEOs have seen in the various staff members they have employed. Typically, higher-paid individuals have a capacity to rise to the increasing demands of the office and can manage multiple tasks. A future optometrist has the mental capacity to manage higher-level demands and learn new things at a quicker pace. This is obviously not a hard-and-fast rule, but typically aspiring future ODs have a high capacity for performance.
  3. Increase the bottom line – Prior to school, I worked for an optometrist and didn’t really care what I was getting paid. I knew my employment was temporary and I didn’t have a long history of employment, so I wasn’t too picky, I was just happy to be getting real-life experience in my chosen field. Future ODs, if they were around for a long period of time, would warrant higher hourly compensation. However, since they are usually only around for a year or two, they do not demand a high hourly wage. Their benefit is the experience they are gaining by working at your office. Pay them fairly but don’t expect to pay them like a 5-plus year employee.

Hiring employees is always difficult. You strive to find someone who will fit nicely into the practice culture, and will also put patients first. Future optometrists are some of the best people you can hire. Managing a successful optometry practice begins with putting the right individuals on the team, and future ODs are a great choice.

What the experts don’t say about Managed Vision Care Plans

Game ChangerAs a practicing OD who sees patients 3.5 days a week and manages a large multi-location practice with one other owner, I find my primary job is making decisions. As owners, my partner and I have the responsibility to make key decisions that will impact the health of the practice immediately and for years to come. One decision that is never easy involves Managed Vision Care Plans. We balance what the experts in our field are recommending with what we predict will be the impact on the practice. Analyzing the financial costs is simple math. What is trickier is determining how it will affect working and interacting with our patients.

Three easily-overlooked aspects of Managed Vision Care Plans.

  1. Relationships – Optometrists are one of a few types of doctors who develop relationships that transcend the patient-doctor interaction. Sit one day with a doctor who has practiced for more than 20 years and you will quickly realize he is as much a psychologist or family friend as he is an optometrist. Our patients view us as friends. They have chosen to come to us for over 20 years and have shared their children, marriages, job changes and personal struggles. When a new MVCP starts at the beginning of the year and cuts the optometrist’s reimbursement in half, keeping the patient no longer makes sense financially. But what about relationally?
  2. Your Brand – Strong brands are consistent and weather the storms of competition and poor profit margins. For my brand, Wichita Optometry, to be strong for decades, our team must adapt to MVCPs and learn to be profitable through the changes.
  3. The WHY behind YOU – Optometrists and people in general have a difficult time defining the life-long question of WHY they do what they do. Let’s face it, when we decide to say “No” to a low reimbursing MVCP, we are trying to keep our yearly take-home pay from shrinking. The truth is we want to have successful businesses that make lots of money. ODs who have giving hearts and care for patients no matter the cost will have less angst about MVCPs than others.

Deciding to take or drop MVCPs is a task that owners wish was not a yearly decision. Unfortunately, we are in a culture of health care that changes quickly and often. In the past, successful practices have stood arm in arm and said no to MVCPs. Today, optometry practices are embracing the changes. Instead of complaining, successful practices are fighting MVCPs by becoming better business managers and actively adjusting the systems within to stay competitive.

Vision or Medical?

“I just want to see patients and not worry about what vision coverage or medical insurance they have.”

Many doctors have expressed this desire to focus on their patients and not be concerned about the financial side of things.

However, if those same doctors would also like to thrive in their private practice, they will need to skillfully communicate with their patients about vision and medical insurance to accurately code and bill each visit.

Successfully transitioning from all-vision exams to ones that include appropriate medical billing requires clearly communicating this to your patients. If a patient is told ahead of time that the exam is medical, he or she will not be surprised when it is billed as such and is applied to the deductible.

Under the old model, an eye exam included refraction and a detailed review of all medical eye problems. Because today’s model reimburses separately for vision and medical, the single comprehensive exam is no longer acceptable. Insurance companies used to reimburse exams at the amount they now pay for a medical evaluation and refraction with vision benefits combined.

Most patients have vision benefits because it is attached to their medical.  To resolve this, the medical insurance industry will need to take on the comprehensive yearly exam and then add a medical eye equipment rider for glasses and contacts.

Until then, doctors and staff will need to use examples below to communicate effectively to their patients.

No previous medical eye problems

Beginning the exam – “Today you are in for your vision and eye wellness evaluation.”  Then at the beginning of the slit lamp exam, “I am going to do an evaluation of the health of your eyes. If any concerns are noted we will follow up with a medical eye encounter to look further into the concerns.”  The vision benefit would be the primary in this case.

Previous medical eye problem

Beginning the exam – “Your insurance indicates that you have coverage for a vision and eye wellness evaluation and medical eye insurance. Since you have both vision needs in glasses and contact lenses and medical eye concerns, we will do the vision assessment today with wellness check and you will return in 6 months to evaluate further the (diagnosis).”

Many optometry offices have already made this change. However, some optometrists are continuing to give their services away for a simple refraction reimbursement. Billing for both vision and medical is not unethical. Actually, it is doing the right thing by closely following the guidelines of vision benefits and medical insurance. Ironically, many patients appreciate you taking the time to assess their eye problems with more testing and educational dialog during additional visits.

Does optometry have you feeling stuck?

When you chose your career path in optometry, you might have been unaware of the many ramifications. You are now at risk of being responsible for someone going blind. You must be committed to life-long learning. If you decided to buy an optometry practice, you have taken on the responsibilities of a business owner. Even carefully-researched decisions will have unseen consequences, and you can’t absolutely predict what tasks you will love if you’ve never done them.

So here you are with the accumulation of your choices, and it isn’t exactly what you thought you were getting. And you are so far down the path it feels you can’t go back, or even veer to the left or right. You feel stuck. Depressed. Burned out.

Admitting you are stuck can lead to some of the best decisions of your life. Knowing when to end an old relationship can make you available for a great relationship. Working in an optometry practice is a journey that by nature gets harder and harder to change course, because patients see you as their eye doctor, they return for their yearly visits and they refer their family and friends. When schedules are full and their careers are financially rewarding, many professionals experience job satisfaction.

If, however, you are still feeling stuck, now is the time to consider all of your options. Families relocate and thrive. Jobs change and career fulfillment occurs. Life is too short to remain stuck in a position that daily drains you. It is not an unreasonable expectation to wake up looking forward to the office. Many optometrists really enjoy seeing patients and managing their practices. You are one decision away from becoming that doctor. Choose today to change the course of your life and get out of being stuck.

What should a CEO know about contact lenses and UPP?

The buzz acronym these days is UPP. With the Unilateral Pricing Policy, businesses must charge a minimum price for a product. This UPP was introduced for the newest and most innovative brands of contact lens, so eye care professionals could take the time to educate, fit, and prescribe these breakthrough lenses for their patients without having to worry that their patients would be able to purchase them for less at a discount retail store. Now it seems all contact lens vendors are positioning themselves to benefit from UPP minimum prices.

As the CEO of your optometry business, it’s important to periodically check the profit margins of your optical product, and adjust price at least one time per year. If you have not recently taken the time to analyze your contact lens cost and retail pricing, now is the time.

What is best for your patients must come first, but when your options are of equal quality, choosing your contacts should also be a good business decision.

Steps to analyze your first choices in contact lenses:

  • Decide first what is in the best interest of patient (i.e. – modality and materials)
  • Know which companies provide the widest parameters for meeting most patient needs.
  • Analyze each of the costs per box.
  • Create a Google spreadsheet as below.  (See which contact lenses are the most competitively priced against your costs)

  • Fill in your costs per annual supply and costs posted per online sales company (to compare pricing
  • Create another box to compare net dollars per annual supply as below. (Our cost is annual supply, retail cost for annual supply)
    Use spreadsheet “Data” drop down to sort the difference to find out your most profitable and least profitable lenses.

As the doctor you always have the discretion to choose the contact lenses which are best for your patients. First, communicate with them to determine their wants and needs. When those questions are answered, formulate a decision that is best for your patients and best for the practice. All successful practices know that doing what is in the best interest of the patients will keep the business growing and thriving. Those same successful practices are savvy in choosing products that ensure the practice’s survival in the increasingly competitive marketplace.

So what should a CEO know about contact lenses and UPP?  UPP is most likely not as important as you think when you do the math.

Don’t sweat a negative online review

I’ve attended numerous meetings about managing an optometry office’s online presence. The big question is always, “What should I do with a negative review?”

A negative review is exactly what it is–negative. What’s nice about mathematics is that a negative and a positive cancel each other out. When you have a strategic online marketing plan that includes posting reviews, positive experiences can far outweigh the negative. To ensure people online are getting a good reflection of your office do this:

  1. Give your patients the option to submit reviews on your website. These reviews should be syndicated to multiple avenues such as Google plus, Facebook, yelp, and a general review on your website that has both negative and positive.
  2. Don’t debate a negative review online, contact the person directly. Have a good heart-to-heart talk and try to find a way to fix the problem. Most patients are sensible and you can find a solution for their concerns. If they are unreasonable, give them their money back and recommend another OD in town.
  3. Use the opportunity as a teachable moment for staff. Many times a negative review is not a surprise to someone in the office, because he or she is familiar with the incident that led to the review. Create a culture where staff and doctors are not afraid to discuss the not-so-positive moments, then proactively find ways to turn them into positive reviews.

All optometry offices are going to get a negative review at some point in the life cycle of the practice. Be proactive and start building online reviews. You won’t need to sweat the one on two negative reviews because you can confidently point to dozens–or even hundreds–of positive ones.

Rules of engagement: Hiring employees from other optometry practices

Understood rules of engagement among competing optometry practices lay the groundwork for professionalism and ethical business practices. For our purposes, I define competitors as any company within a 50-mile radius that practices optometry, opticianary, or ophthalmology and requires staffing with the same job skills.

When a person applies at your office, it’s important to know how he or she heard about the opening. Was it from an online ad, a friend, or one of your staff members? To establish and maintain good working relationships with practicing doctors, follow these rules for engaging a potential new hire.

  1. Do notify the applicant’s current employer – If you are planning to hire someone from a competitor, it is always good practice to let the other owner know. We have made phone calls to doctors in the area to let them know we are considering offering one of their employees a position at our office. We do this after visiting with the applicant first and letting him or her know our plans. In return, we have been extended the same respect which has allowed us to communicate better with staff members who are considering leaving and addressing any unseen issues.
  2. Do not let your staff solicit other offices – It is never OK for any of your staff members to call other offices and solicit applicants to work with them. This is not only unprofessional but unethical and should be stopped. Remember, employees who do this for you will work against you once they leave and go work somewhere else. It perpetuates the problem.
  3. Do use customary hiring methods – It is common and acceptable to use online methods of classified ads to introduce a position that has opened at your office. It is OK to post on Facebook that a position is now open.

The short-term temptation of filling the vacant spot can cloud our long-term vision of what the practice stands for. Never compromise your office’s integrity and excellence by soliciting from another office and justifying it by thinking the staff member will be happier with you. This is presumptuous. When you have the courtesy to communicate with other owners about potentially hiring their staff, you are paying it forward. It’s amazing what can happen when professionals work together as professionals.