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.

Time to sell your optometry practice?

Timing is key to the best investments, yet most investors will tell you not to try to time the stock market. Waiting for the perfect moment to sell your practice might mean missing out on opportunities that could actually help you more financially in the long run. Many optometrists advanced in their careers would like to reduce their hours spent on patient care, but are unable to. Being able financially and logistically to back off from a five-day work week requires planning ahead, and sometimes planning ahead requires selling your practice.

Three reasons to sell your practice now:

  1. Buyer Interest – over 400 optometry practices close doors yearly without a buyer. This is a scary thought if you own a practice. When another OD approaches you about associateship to owning, take it seriously. This may be the only buyer available. Selling and then being employed is an option that guarantees a sale.
  2. Financial Freedom – investing the proceeds of your office sale into rental property or securities can generate income to live off of and you’ll no longer need to be at the office seeing patients. Making your money work for you can start earlier and be a part of sustaining residual income for living and retirement.
  3. Outdated Technology – technology turnover for companies today can be as quick as every three years. The new meaningful use requirements continually need hardware and software updates so practices are becoming dated at faster and faster rates. This means that a buyer has to invest more capital into the practice upon purchase if the seller has not kept up with technology. I have had to deal with this burden and expense personally. Most solo optometry practice owners are further behind than they realize.

Preparing to sell your practice requires planning and being alert to opportunities that present themselves. Putting your practice up for sale and assuming you will sell is not only risky for your financial future, but it also leaves patients responsible for finding future eye care, and most patients have trusted you to care for them now and in the future.

Eyewear Service Agreement – Is it right for your optometry office?

The last time you purchased an appliance or piece of technology, you were most likely offered a service agreement. So many companies now offer this to consumers it has become an expected part of the sale. If your optical department does not offer a service agreement, do your patients have peace of mind regarding their purchases?

Many optometrists do not purchase service agreements when buying appliances or technology for their own homes. Why? They are confident they can self-insure purchases under $1,000. If they would have to replace something, it would not be a burden. Many patients are not like this, so they want to buy your services to ease their mind.

Offering a service agreement in your optical is an acceptable plan to meet patient needs. Here are reasons why:

  1. Patients need advocates – With a service agreement, you remain the expert that patients will seek for care of their purchased glasses. You remain the office where patients will buy odds and ends to repair the glasses. You become a part of the purchase. Offices that don’t have a service agreement lose both the service and the products.
  2. Pays for what you are most likely already doing – Some optometrists will argue that a way to win these patients back is to give the services away for free. Unfortunately, there is a breaking point where paying staff salaries does not equal the wins that are a product of free service. Most likely you are training your patients to buy their glasses online and take advantage of your services as a part of their yearly exams. We all take what is freely given to us without always feeling a sense of giving back.
  3. Competition awareness – Not only will your staff become more familiar with what is available outside your office, but your patients will as well. By servicing patients’ outside purchases, you become aware of the quality and products that are available. This allows for you as the CEO to compare and contrast what you offer in the optical department. When you compare, contrast, AND adjust your products and services appropriately it results in an optical that meets patients where they are at a value that they perceive as high.

If you are struggling with offering an eyewear service agreement, you need to change your mindset. To succeed in business, you need to shift with the changes of commerce. Optical departments are a major revenue source, so we must adapt to these changes. Do your research, visit with your colleagues, and then strongly consider an Eyewear Service Agreement to better serve your patients.

Perception is Reality – How clean are you?

Many medical offices I see are not clean. Although some people might relax standards for their homes, most agree that of all places, medical facilities should be clean. Patients form impressions of your office–whether consciously or not–before they ever meet you. As the CEO of your optometry business, the cleanliness of your facility needs to be a high priority.

Here are three actions to make sure your optometry business is delivering a pleasant perception:

  1. Appointing a staff member or doctor – Determine by observation or personality profile who your most detailed clean freak is and put him or her in charge of cleanliness. This person is responsible for evaluating your office with a magnifying lens and reporting to you or your manager when actions need to be taken.
  2. Hiring a cleaning service – This is a good place to start. There is not a cleaning service in America that will clean like you need your office cleaned. Yes, they will do a good job on the overall cleanliness of the office, but they will not clean base boards and dark corners on their hands and knees. Frankly, it will cost you too much. Hiring a cleaning service is good, but not good enough if you want to leave patients with the best impression possible.
  3. Observing your facility – Taking five or 10 minutes per week to walk around the office to see what patients observe will change how you manage your team. I sat in the reception room the other day for five minutes and made a list of “first impression” areas that we need to improve on.

The little things are what makes some offices continue to grow exponentially while others are left wondering where all the patients have gone. Cleanliness is one of those important fine details. Patients come into your optometry office with active, observant minds that eventually will give them an overall impression of their visit. Perception is reality.

Dating before a Partnership

By Ashley Blasi, OD, guest columnist

My husband and I dated for six years before we bit the bullet and got married. Those six years provided us an opportunity to know the good, the bad and the ugly about each other. No secrets were left untold before we became hitched. Ten years later we are still running strong. Entering an optometric partnership works much the same way. Here are a few tips to consider before taking the plunge:

Learn to communicate– Just like any strong relationship, communication is key. Express your desires and concerns to your potential partner. Ask what is expected of you if you do enter into a partnership. Talk about the finances. Compliment each other when compliments are in order, or let your potential partner know when you are frustrated about something. A relationship works best when all cards are on the table. Communication builds trust.

Join a practice where your weakness is another doctors strength– I enjoy cooking, and my husband is happy that we have a meal to eat every night. My husband is great with finances and I appreciate that he pays our bills. We complement each other. The same scenario holds true in a business partnership. I like using technology and all the benefits it has to offer. However, I am not the go-to person when something breaks or is not working properly. Thankfully, a doctor at our office loves all the ins and outs of technology and heads up this area of the practice. The stress level of a partnership can be reduced if each partner picks an area or areas of the practice that he or she would enjoy managing. Divide up who manages the HR, technology, accounting, optical, marketing, etc. then come together when decisions need to be made. Partnerships survive when everyone works as a team.

Get to know their family and hobbies- As cliche as it sounds, partnerships are like marriages. Go to dinner with your potential partners and their spouses. Ask questions about their kids and what they like to do on weekends. You want to be in business with people who have the same morals, values and beliefs as you. It also gives you a chance for your potential partner’s spouse and family to become familiar with you as a person.

Entering into an optometry business partnership is a huge decision. Many partnerships fail to thrive due to conflicting interests and broken communication. It is important to build a trusting relationship before committing long term. Taking the above steps will position you to enter a partnership that will succeed.

Blasi headshotAshley Blasi, OD a 2008 graduate from Southern College of Optometry in Memphis, Tennessee, and practices at Wichita Optometry, P.A. in Wichita, KS.

4 ways to ensure a successful first year of practice.

The first year of practice is both exhilarating and frustrating. New doctors must be mindful of many things, but concentrating on the following four areas can pave their way to a successful career:

1. Never stop learning –  After graduating, most new optometrists are relieved to finally be finished with four years of studying and testing. However, we must not forget that the field of optometry is always growing and advancing. In school we had access to the latest technology, treatments, and research, but now as doctors we must follow new developments on our own. It is important to continue reading optometric magazines, optometry journals, blogs and websites (some are even dedicated to new optometry grads). Research the areas where you feel you may need more knowledge. Continuing education courses are also good, but new graduates need to keep in mind that for the first few years some classes may simply be a review of recent education. The important thing is don’t relax in your office chair for too long, if you get behind the learning curve it is hard to catch up.

2. Take time to listen  –  Listening to your patients is crucial to success. As a new optometrist your schedule may not be as busy as a seasoned veteran. This allows you more time to spend with each individual patient. Listen closely to the patient’s symptoms and complaints. All of your patients are “new patients” so there’s a lot of history of which you are not aware. Get to know not only their ocular history, but also their career, family, hobbies, etc. This will build a rapport with them for future visits. Make notes in your chart about the things you talked about. At the next year’s exam you will be able to strike up a conversation, picking up where you left off. Listening to patients helps build relationships, which makes them feel as if they are an important part of your practice–and they are. Marketing to the patient sitting in your office is easier than trying to reach the masses in the community. Patients who are satisfied with their care are more likely to return, and they are also more likely to refer family and friends.

3. Don’t be afraid to ask questions  –  In school our attending doctors held our hands. They were always there for us to ask questions and for them to question us. When we walked across the graduation stage, they let go of our hands. Now our questions must be directed to different people. You will encounter many different situations with patient care, insurance reimbursements, billing, frame representatives, staff, etc. Do not be afraid to ask other doctors in your practice or at continuing education meetings. Especially consider the doctors you know and respect. No question is a dumb question when it comes to any of the previously mentioned concerns, and remember every optometrist was in your shoes at one time. Take the time to pick the brain of your colleagues and don’t have so much pride you can’t ask their opinion or advice on a particular patient or potential treatment plan. Some of the more thought-provoking conversations I have had came from discussing patient cases and treatment plans with my colleagues.

4.  Find a niche  –  Consider Low Vision, Specialty Contact Lenses, Vision Therapy, Dry Eye treatment, or other specialty and less commonly performed aspects of optometry. Look at the needs in your practice, among your patients, and even among your colleagues in your community. You may work in a practice with another doctor who does not have experience or interest in fitting SynergEyes or Scleral contact lenses. Consider discussing with this doctor options for the patients in your office who would benefit from these specialty contact lens fits. Or you may find the majority of your patients are on computers for more than eight hours a day and have concerns with eye strain, fatigue, and dry eye symptoms. Dry eye treatment is multi-factoral and requires several examinations to evaluate and treat. Also consider prescribing computer Progressive glasses with a blue-blocking filter technology. Not every private practice or corporate setting provides all areas of eye care or specialty eye care. Finding a niche in your group practice or community can ensure a successful first year and many years to follow.

Consider one or all of these areas and run with them. They may not only jump start your success for the first year but for many years to come. If your first year has not been as successful as you hoped or planned, don’t let it dictate your future. It’s never to late to plan for your success.

 

Heide headshot    Drew Heide, a 2014 graduate from Northeastern State University Oklahoma College of Optometry practices at Wichita Optometry, P.A. in Wichita, KS.

Playing the Vision Benefit games for better profits.

Putting the health of his eyes firstStaying on top of the optometric game’s changing rules can be daunting. The optical department especially has its own regulations. Vision benefit companies like VSP and Eyemed have cut reimbursements down to a dispensing fee, so it’s difficult to find the money to pay staff and keep patient care high. Most owners know that VSP and Eyemed “reward” practices financially for using their lenses and lab systems whether the practices order finished product or uncut product that they will edge themselves in office. We have decided to maintain profitability our optical department needs to edge our lenses.  We also have created a system for patients depending on their vision benefits.

Consider these three rubrics:

  1. VSP Package – Patients with VSP have a benefit that aligns them with certain services and products for their package as a VSP member. Even though the office may prefer a HOYA lens, the product that fits into the VSP package is the Unity lens. Is it the better of the two lenses? Maybe, maybe not. Is it the lens that VSP feels is best for their members? Yes, and they reimburse providers accordingly.
  2. Eyemed Package – Patients who present with Eyemed have product and incentives laid out as best for their members. When you purchase Eyemed lenses and edge them in-house, the opportunity for profits is greater. Eyemed seems to operate with the attitude “use our product and way of doing business” and we will reward you.
  3. Everyone else – For patients who do not have one of the above, office staff have the freedom to choose the lenses that they believe are best for the patients. Without a loaded advantage of using one product over another, staff can present patients with options for best technology and performance.

Business owners have the privilege of using whichever products they would like in the dispensary, however, prices will be higher if they don’t follow the vision benefit companies’ way. Imagine if the pharmaceutical companies were allowed to give doctors an incentive for using their product. If Aetna owned shares in a pharmaceutical company and a doctor was reimbursed more for prescribing a medication that Aetna indirectly owned, wouldn’t that be a conflict of interest?  So optometrists are put in a position where it seems as though there is a conflict of interest that allows vision benefit companies to reward optometric businesses for using their products. Many of us would like to go counter current, but find that doing so erodes profits to the point of “playing the vision benefit game” or dropping the vision benefit company altogether.

What do your patients think about eye care?

The advertising industry understands product education and uses it to win people over to their respective products. Through Facebook ads and ESPN commercials, we are constantly being educated about what we need and why we need it.

When patients receive education from their eye doctors about the proper care of their eyes, they often communicate this information to all their friends and family. For example, how many times have you heard something like, “My friend told me she can sleep in her contact lenses for months and the doctor says she is doing great. I want contact lenses like that.”

Whether you want to successfully pass your patients to the next generation of optometrists or you want to gain unlimited referrals, learning to educate patients about their eyes benefits everyone.

Be a great eye educator for your patients. Make sure they understand the importance of:

  1. Regular eye exams – Many patients do not understand why it is important to regularly (once a year) get their eyes examined. Use every interaction with patients to remind them of what you do when you care for their eyes. For example, when doing a slit lamp exam talk to the patient about what you are looking at and why. For the optometrist, the slit lamp is routine and monotonous, but for the patient it is a chance to learn something new or be reminded of something they think about only annually. Patients may not know that an eye doctor looks at the movement their contact lenses to make sure they don’t get an infection that could cause them to lose their sight.
  2. Not ignoring medical eye problems – During the course of a work day, an optometrist will likely see a patient who has early signs of macular degeneration and has ignored this medical eye problem for a long time. For example, the patient smokes but still hasn’t had an eye exam for five years, and is unaware that smoking increases the risk of blindness. The patient is also unaware that the macular degeneration started four years ago. How could this happen? Perhaps the patient’s last optometrist told her to return to the office in a year or two, but didn’t set an appointment. If the optometrist doesn’t educate the patient on her condition and insist on setting an annual appointment, the patient is left to assume that as long as her vision isn’t decreasing she doesn’t have a problem, and preventative care is optional.
  3. Comprehensive exams even if the result is refraction only – Optometrists will do a comprehensive eye exam and end the exam by telling the patient he needs to update his glasses. The optometrist did not discuss anything but the change in refraction because the optometrist did not find any problems. If the optometrist doesn’t mention the health of the eye, the patient logically assumes the eye exam was for glasses only. This not only hurts optometry but it is a disservice to the patient. Discuss healthy eyes also and what you are ruling out in an eye exam.

When whitewater rafting it is a break to ride the current through smooth waters. You get to rest, recuperate and prepare for the next whitewater. In optometry, riding the current can become a way of life and new ODs and experienced ODs alike can become comfortable with doing the minimum. You will get reimbursed the same for a comprehensive exam whether you barely talk to the patient or educate them extensively about their eyes. Everyone wins when all optometrists work together to educate our nation about the importance of regular eye care.

Is optometry less profitable than one year ago?

Everyone wants a piece of the pie. Decreasing margins and healthcare initiatives that focus solely on cost savings cause many of us to wonder if the good days will ever return. Making a decent profit in today’s environment is a difficult task for even the most astute business CEOs in optometry.

To find profits, increase the font so you can read between the lines in these three areas:

  • Vision Benefit and Medical Insurance – Many medical insurances need a vision rider to meet requirements to provide vision services to various demographics. Consequently, we have seen a huge influx of low-paying vision benefit providers with thousands of patients.  Most optometrists are on, have been on, or are thinking of joining these low-paying vision benefit panels. Without a profitability plan in place, you will be on the road to working harder for less money. There are ways to attack this animal:
    • See more patients.
    • Decrease cost of goods.
    • Increase “spiffs” (Special Payment Incentive For Fast Sales) from vision benefit providers in using their product.
    • Loss leader for the benefit of having access to the patients medical needs.
  • Optical – As mentioned above, decreasing cost of goods or increasing spiffs can be an answer to greater profits with low-paying vision plans. The market is rewarding opticals that commit to the vision benefits products. This does not seem fair in a free world but the vision benefit plans incentivize you (pay you more) for using their product. This was the mainstay in pharmaceuticals until the pharmaceutical companies were mandated to not incentivize doctors for prescribing their product.
  • Increase office efficiency – Numerous groups specialize in business efficiency. Many of us continue to do things the same way we did 10 years ago, although with the evolution of technology and patient care the business has completely changed. Many don’t even know where to start. It starts with breaking down the systems in the office and asking our colleagues how their systems work. For instance, how does our office spend significantly less time managing the frame board? Or how have we decreased the time spent on the phone scheduling an appointment?

 

 

All these ideas and thoughts take time and energy to think about and effectively execute. That is the difference between practices that are keeping large slices of the pie and those who only get a sliver. In today’s business world it requires adapting to change at a much faster rate then ever before. I’ve found that taking more time for administrative work and less time in patient care has allowed us to keep up with change and remain profitable.

Avoidable Mistakes of the Seasoned Optometrist

The farther I get in my career the harder it is to face mistakes that I have made. All optometrists make mistakes, the important thing it to learn from those mistakes.

“The hardest thing about being a doctor,” Dr. Karen Delgado said, “is that you learn best from your mistakes, mistakes made on living people.”

All new practicing optometrists face the dilemma of having a head full of knowledge while holding only an empty cup of experience. During the first couple of years we realize practicing optometry is exactly that, practice.

So when you have patients who need contact lenses for the first time, it is second nature to fit them with the latest technology in single use contact lenses. As the years go by the “go to” contact lens becomes the “old” lens as new and improved ones come on the market. This is what begins to separate the quality of care received by patients from different optometry practices, and I would venture to say the dilemma that ophthalmology faces when viewing our profession.

Avoidable Mistakes that optometrists make as time passes.

  1. Not keeping up with research – “If it ain’t broke, don’t fix it.”  This mantra does not work in optometry because too many patients are breaking down later in life because their optometrist never took the time to actively prevent future problems. Is it OK to not dilate a patient with diabetes because the Optos technology allows for a 200 degree field of view?
  2. Only fitting patients in contact lenses that the office keeps in stock – This is an easy one to overlook but I have had to humbly order multi-focal contact lenses because the two different companies that I prefer did not have a product that worked for the patient. In the last month, I have had two patients who have been happy because I ordered trials from a company we seldom use because they have a mainstream multi-focal contact lens that other ODs say works.
  3. Stop asking questions – New ODs are fun to practice with because they have questions and get excited about pathology that we seasoned doctors have seen multiple times. They come and ask us about what we would do in cases and they read about what they experienced in clinic. Too many of us seasoned doctors think that we are supposed to know most everything we encounter in practice by now. Let’s get honest, we need to regularly ask each other dumb questions. When we don’t ask questions patients suffer the most.

Some mistakes are avoidable. Don’t let these keep you from practicing at the highest level. It takes humility and a desire to give great patient care to embrace the above mistakes and not let them define your career.