As an employer you hired an optometrist to clinically evaluate patients and work as described in an Associate Agreement. So what happens when your associate OD uses patient clinical data generated when working with your company?
For example, the associate examines patients four days a week and uses down time during those hours to write papers that are then published in both peer-reviewed journals and professional journals alike. Depending on the length and depth of the topic, the associate may be compensated for the work. Should this time and use of clinical data and records that are owned by the employing optometrist’s practice be property of the associate, or the owner?
Should employee be a recipient of any research grant, books, publications or other revenue-generating materials involving retrospective, current, or prospective studies on patients of “Your Practice Name” who have been examined and/or treated primarily by the Employee during the ordinary course of business, all revenue received from such efforts shall be the property of Employer and shall be added to and considered to be a part of the gross revenues generated by Employee.
Associates may feel they would have their hands tied with the above stipulation. That’s why it is so important to read associate agreements thoroughly and to not sign anything with which you are not comfortable. If you plan on researching or writing during the time of your employment, then negotiate for the privilege of doing just that. I would recommend consulting your attorney prior to signing the associate agreement to make sure you have the freedom to work at the optometry practice and do research and writing.
Prior to placing a name on birth certificate, many parents spend countless nights and Google searches looking for a name that resonates with them and will ultimately define their next child. The importance of a name should not be underestimated, especially when naming an optometry practice.
Two types of people will read the above and come to different conclusions. An individual with a fixed mindset will say a name really doesn’t make much difference, so changing the practice name isn’t worth the effort. The individual with the fixed mindset will also continue to blame the economy and insurance companies for lack of growth.
In contrast, an individual with a growth mindset will see changing the optometry practice’s name as an opportunity to be relevant today while preparing for tomorrow. Growth mindset optometry CEOs know change is inevitable and change is occurring at a faster pace than ever. For more on fixed mindset versus growth mindset read Carol S. Dweck, Ph.D’s book, Mindset: The New Psychology of Success.
The best advice for growing a practice is starting with a new name. A good name defines location and relevance to what you do.
Donald Trump’s reality show is known for two words dreaded words: “You’re fired!” As an aspiring entrepreneur, I remember watching The Apprentice every week trying to glean wisdom. I was hoping I could get all the right words and actions down so firing staff would be easy. After 12 years, I have come to the conclusion that hiring and firing is never easy. Letting staff members go is difficult, especially after investing in them for years. It’s also painful to realize it was a mistake to keep them so long.
Even though firing is not easy, here are three ways to make the process as fair and painless as possible.
Document – Start documenting at the very beginning of hiring your staff. I use a digital notebook, Evernote, to create a “Staff Profile” on every staff member and document any problems that arise during the year. It allows me to review the concerns over the past year, and it helps me and my partner discern if we are simply frustrated with current situations, or if this has this been a long-term pattern. Document, document, document.
Communicate – Visit with your staff members regularly to communicate how they are meeting and exceeding expectations, as well as where they are under-performing. Too many optometrists wait to communicate to their staff after they have become so frustrated that they have to do something. This is too late. Begin early by communicating behaviors that are good and those that need improvement. This will create an environment with no surprises. It is much easier to fire someone if they have a good idea it is coming.
Just do it – NIKE’s long-time slogan is easy to say but hard to do. It finally comes down to scheduling the meeting and walking through letting them go. This part should be as short as the slogan. To keep yourself from getting in trouble, experts say schedule the meeting and keep it short and sweet.
Being the CEO of your company requires you to have big shoulders, and sometimes the weighty job of firing a staff member is required. Do not back down, or your patients will suffer. When a staff member needs to go, take it from Donald Trump and get comfortable with “You’re fired!”
Are optometrists who work at commercial establishments real doctors?
I take offense when patients walk into my exam room and tell me they have been getting their eyes checked at a commercial establishment, but now that they think they have problems they have come to see a “real” doctor.
This patient assumes that my being in a free-standing practice makes me, an optometrist, a real doctor while my colleague at a commercial establishment is not. I take offense to this because the doctor they had been seeing went through the same trials and tribulations that I went through to get the same degree I have. In my opinion, that doctor is as real as I am.
So why does this patient perceive the doctor at the commercial establishment as not a “real” doctor?
Here are 3 ways you control the patient’s perception:
Look like one – First appearances are extremely important and can make or break a patient’s perception of you. Do you look professional in the way that you dress? It may be more comfortable to have a “jeans Friday,” but does it communicate professionalism? It may be more comfortable to wear those Tom shoes, but do they look like you’re headed to the cabin for the weekend?
Talk like one – This may seem trivial, but I have witnessed doctors who are unprofessional and speak like they are with three of their best friends hanging out. Also, use medical terminology that differentiates you from a refractionist who is only concerned about the prescription for glasses or contact lenses. You should be educating your patients, telling them that the exam is part of keeping their eyes healthy for life. As you look behind the slit lamp, describe what you are looking at and what problems you are looking for (i.e. – “I’m looking at the surface of your cornea to determine if you have signs of dry eye.”) Also consider your staff–do they talk to the patient as though the patient is receiving medical eye care along with the prescription for glasses?
Diagnose and treat like one – Many optometrists believe the only reason patients go to commercial establishments is for glasses. Don’t assume this. Instead, diagnose and manage their eye diseases so they perceive you as managing their medical eye problems. If you have them return for a dry eye check, use terms that would indicate they are returning for a “medical eye encounter.”
Patients will always believe what they want to believe and make their own choices. Like many marketing agencies will tell you, the choice of your words and actions make a huge impact on the way a person will perceive another person or service. If you feel you are a doctor by name but a refractionist by perception, then choose to change the impression you are giving your next patient.
Do you find your staff making the same mistakes over and over? When confronted, do they say no one ever told them differently?
Never mind that the issue was discussed in the past two staff meetings. We’ve noticed staff members rarely save staff meeting notes for future reference, even when we email the notes or print them and physically hand them out.
As managers, we need to make sure staff members have the tools to be successful. For our practice that means having all staff meeting notes available for easy reference. Here’s what has worked well for us:
Member Content Section – Creating a “members only” section on your website can be done with various website building platforms. This allows staff members to sign in and access password-protected information on your website. Our office has titled our password-protected section “What’s Happening Now”. The staff meeting notes and all important updates are put on this page for staff to reference. When issues come up, we are able to point them towards this information. Having this resource for them to access communicates they are responsible for knowing the information and working accordingly. We have found that this keeps our staff accountable for staying on top of current operations and procedures. We use iMatrix as our optometry practice website platform.
Guiding staff successfully is never easy for leaders of optometric practices. Staff members naturally push the blame to systems or people who have not allowed them to succeed. Finding little ways to provide your staff with all the resources for success not only improves their performance, but it eases the management burden and ultimately gives patients better care.
If you’ve been practicing optometry for more than 10 years, you should plan your exit strategy. Many optometrists put off thinking about their transition to retirement.
Unfortunately, today’s practicing ODs will not have the luxury of seeing graduating optometrists lining up to buy their practices. Nor will they find many interested in working as associates with the goal of eventually becoming partners.
The world of optometry practice mergers and acquisitions is evolving. Make sure you are positioning yourself for the new market by working towards a plan that is lucrative, but still ensures continued patient care.
In this new market, three successful exit strategies are emerging:
Corporate buyout – Buyouts are currently happening across the United States as corporations and investors are capitalizing on optometry practices’ profit margins. Optometry practice, as a business, is lucrative. Many businesses consider 8-10 percent profit margins desirable, and optometry practices can generate 20 percent or more after all salaries are paid–including ODs. Buyouts seem to be a viable option as a future exit strategy.
Large OD practice acquiring small OD practice – As healthcare evolves and government regulations increasingly strangle the internal systems of optometry practices, small optometry offices are losing any competitive advantage. Larger practices are able to consolidate resources and cut overhead to compensate for the increased IT costs and staffing costs related to government mandates. Being acquired by a larger practice will give small optometry practices their best chance to exit, assuming the market is right. However, the buyer will have the advantage when negotiating practice purchase price.
Integrated health systems - The big unknown in the future is integrated health systems. Across the country, big healthcare bodies are consolidating and looking for optometry practices that fit their model. These large healthcare bodies are buying out medium to large optometry practices at dollar amounts that exceed the current market value of optometry practices. This pattern appears to be a growing option as an exit strategy for optometrists who have built medium to large practices.
Of course, other means of transitioning your optometry practice may be available when it is time. However, the traditional mode of transition is becoming extinct, something only to reminisce about over an evening glass of wine at the regional CE meeting. By addressing this reality, you will position yourself to be rewarded for your hard work in building a successful practice.
Those who assume nothing has changed will find themselves disappointed when their exit strategy leaves them working longer than wanted, and–worse yet–selling at a much reduced price.
Finding a partner can feel like searching for a misplaced, unnamed file on your computer. Which search criteria will bring up the right one?
Associate optometrists who desire to own and manage their own practice are a dying breed. Over the past 10 years, more optometrists have decided they prefer employment over being the owner. Owning and managing a practice while still allotting time for patient care has also become much more difficult. So if you are an owner-optometrist looking to employ an associate who wants to buy in to the business, where do you look? And where do you look anonymously so that your current associates or surrounding optometry practices are unaware?
With an unlimited budget this problem could be easily solved. However, most ODs do not have an unlimited budget, and if they do they are too frugal to spend the money.
Here are three ideas to find the perfect associate who desires to own and manage a practice with other ODs.
Placement Services – Companies like The Eye Group will recruit an optometrist who meets your associate-to-partner needs. These companies are effective, but costly, charging as much as 10-15 percent of the associate’s first year compensation. For a practice that produces $1 million a year and wants to pay an associate $80k, that translates into a significant chunk of change.
School Placement Services – Most of the optometry schools have some form of a placement service that matches practice owners with associates. To ensure success, clearly specify you are looking for a future partner. Example of said service.
Direct Contact – Meeting with different optometrists takes time and requires patience, but it can cost much less than a head hunter. Schedule yourself or your child with an area optometrist of interest. When you go to the appointment, take the time to visit with him or her about the opportunity. Remind them of patient-doctor confidentiality. This approach requires humility and some risk. However, if the payoff is a future partner it’s well worth it. This works best when visiting ODs in commercial settings.
Job postings on sites like Optometry’s Career Center is always an option, but most optometrists I visit with seem to assume the “classified” ads option. Whether you are looking to add an optometrist now or considering one later, finding an optometrist interested in and capable of owning a practice is less common than one might think.
With the right planning, an update can be completed quickly with simple copying and pasting in editing software. Most ODs have some form of electronic note taking or record keeping. My chosen software is Evernote, which works like a traditional notepad. During the year, when I serve in a volunteer position or have an additional leadership position, I make a note. At the end of the year, I transfer all notes to my CV.
LinkedIn, a professional online network, also works as a CV that can be updated immediately for users to review. Get in the habit of updating your profile at least yearly.
However you choose to list your professional accomplishments, here are three good reasons to keep your CV current:
Plan B – Many beginning optometrists assume past performance guarantees future success. Veterans know the ebb and flow of optometric practice can sometimes leave you drifting near the rocks. Having a “plan B” is never a bad idea and being prepared with a current CV is a great way to grab an opportunity that presents itself.
The Unhealthy Athlete – Appearances can be deceiving and it is no different in optometry. Practices that appear to be doing very well have poor financial health. Some optometry practices are literally three months away from bankruptcy or a significant downgrade of staff. If you as an associate OD are not privy to the internal finances, give the practice your best, but keep updated CV ready if needed.
Competitive Advantage – Most professionals who do not update their CV until necessary will forget key aspects that should have been added over the years but, due to poor record keeping, have been forgotten. If two optometrists are competing for an associate position, the one with the most comprehensive CV will get the early lead.
The start of a new year is a great time to update your CV. Tomorrow is a whole new day and it may be the day you need your updated CV. Be ready by fine-tuning your CV yearly.
Selling an optometry practice is not like it once was. Decades ago, when a solo optometrist approached retirement he would put his office up for sale and within 12 to 18 months the practice would sell. The buyer might have requested the seller remain working in the practice for a year or two, but most likely the seller would hand the keys to the buyer and walk away.
Welcome 2015 and the new normal. Most graduating ODs are looking to work as associates so they can maintain an active lifestyle outside of their optometry career. They are prime candidates for the employing OD, but they are not potential buyers.
As a seller some day, I worry about the pool of potential buyers continually decreasing. Optometrists are consolidating to create increasingly larger practices while more and more solo practitioners are closing the doors without a sale. To ensure that this is not my fate, my partner and I have worked to find ODs who have expressed a long-term goal of owning a practice. Once they become associate optometrists of our practice we begin mentoring them to develop an owner mindset.
Three fundamental practices of mentoring an associate:
Meet regularly – Make a weekly commitment to meet for 30 minutes and discuss the week. Talk about clinical care cases and staff management issues that you have dealt with. Let them know you are available and willing to answer their questions.
Lead by example – Most of what is caught is not taught. Your associate OD is watching how you handle situations and wondering, “If I were the boss, would I be capable of managing day-to-day operations successfully?” Your associates are trying to decide if they would succeed owning a practice.
Work to make them successful – As an optometry CEO, you will need to lead your associate in the process of becoming a leader within the practice. Most students did not apply for optometry school with aspirations of leading, they wanted to practice medicine of the eye. Your initiative to walk alongside them and make them successful will be the key. This may mean using their ideas in the practice. They need to see that they can lead. They also need to see that they can achieve buy-in of the senior staff. You can help this by building up the associate OD’s leadership characteristics in front of the staff.
If you own a practice and are worried about potentially selling your practice, it is never too late to get started in the mentoring process. The above practices not only develop great future owners, but it gives them the confidence to move forward in the purchasing process. I’ve mentored many optometrists looking to purchase practices, and I have found they all share one common characteristic–an underlying fear of failure. You as the owner can understand and recognize this fear of failure in your associates and help them to alleviate it. Doing so will not only provide you with a committed buyer, but it will ensure that your long-time patients are still in good care.
Let’s face it, optometry practices are a lot like different offerings on the stock market. Some stocks do well in both bull and bear markets, and others seem to perform poorly no matter what the climate. The similarities in the optometry business are shocking. Why do some optometry practices seem to grow year after year while others struggle to net 25 percent and seem to be dying a slow death?
The optometry practices that will thrive in 2015 do not have a secret formula, nor have they cracked a code for generating new patients. Instead, they have become adept at self-evaluation. At the end of 2014 these practices are reflecting on what areas of the practice have grown and why, they will be looking at what marketing investments paid off, and they will be looking at what risks paid rich dividends. These thriving practices will then repeat the good and throw out the bad.
Here are 3 habits of thriving practices at the turn of the new year:
Staff – Pruning unproductive staff members is a necessary habit. If it takes more effort to manage a team member than that team member produces, it is time let him or her go. Necessary Endings are a part of being the CEO of your optometry practice and key to assembling a great team.
New Patients – People will always be looking for new eye doctors. Capturing these new patients could be the difference between a mediocre year and year with explosive growth. Online continues to be an amazing space for generating new patients. Investing in a website produced by a high quality company to maximize your marketing dollars makes all the difference.
Patient Advocacy – Most medical practices are caught in the middle of the changing tide of insurance, ACOs, meaningful use requirements, and electronic medical records. We are all complaining about the destitute culture of health care. The practices that will thrive in 2015 are those who become patient advocates. Forget about the negative issues facing the health care industry and focus on helping your patients. You might be surprised with exponential practice growth.
If you are leading your practice and have not taken the time to reflect on 2014 and plan for 2015, then you will find yourself playing catch-up throughout the new year. Be proactive in preparing your team to have a successful 2015 no matter what comes your way.