Author Archives: Chad Fleming

3 first steps to taking the FEAR out of purchasing your first practice

  By Chad Fleming | June 12, 2013 - 11:00 am | ,
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Nightmares become even scarier when you realize you are paralyzed by fear and can’t run away from danger. Unfortunately, fear paralysis can also sidetrack your career if you are unable to make sound decisions while facing risks and the unknown.

As a new graduate who carries $125,000 or more in student debt and whose job outlook is short of promising, buying your first practice can strike fear at the core. Maybe you have been practicing for a while, but your current work situation has sent you home at night wishing you were the boss. Don’t let fear stand in the way of your dreams to buy your first practice. Instead, be encouraged. Even the most savvy risk-taking entreprenuers have to deal with fear.

There are a few steps you can take to take hold of your fear and prepare your mind for sound decision making. Fear is an emotion inside yourself. With intentional planning and a great strategy, you can successfully set your fears to rest as you prepare yourself for purchasing your first practice. To begin the process follow these initial steps . . .

  1. Practice preferences – Take the time to list all the expectations that you have in a place you want to live and a place that you want to practice. Decide if you want to practice   where you want to live or live where you want to practice. If you choose the latter you will have more options regarding a practice available to purchase. This potentially could limit your family options in schools, churches, and activities. The list should consist of patient demographics, size of staff, work hours, scope of practice (size of town/city will affect medical patient management), risk level by practice size, competition, EHR capability, managed care impact, and many others. The list will be a great asset when you are at risk of making rash decisions influenced too heavily by emotions. I recommend Evernote as my software of choice for doing this.
  2. Need to Know – This is the list of items that you “need to know” about the practice to make an informed purchase. You will want to know exam totals by doctor (last three years), yearly production by doctor, practice debt, age and type of equipment, patient demographics by percentage, patient demographics by zip code, staff demographics (age, length of employment, extent of training), insurance panels and percentage of revenue of each, daily schedules for past year, fee structure (services and hardware), dispensary capture rate, and actual expenditures by budget categories. This list is not all-inclusive but should be a good start on preparing you to assess a practice.
  3. Potential Practices – Start by pulling up a map of the area of the country that you would like to practice in based on #1 above.  Take a selected screenshot of the map (on a Mac it is Command+Shift+4 then select area) then mark potential places on the map (Skitch works great) from your advanced search done on Optometry’s Career Center - Search Opportunities. Many optometrists make the mistake of eliminating opportunities too fast. Keep open to the possibility of exploring options that you may not initially consider. There are golden opportunities within an hour or so of major metropolitan areas. Many small practices in rural America net so high that you could work three days of the week and spend four days with your family in the big city.

This may not be the most exciting part of purchasing a practice, but a quick decision laced with fear will lead to many more quick decisions that can result in business chaos. You can be very successful as CEO of your own practice. Those who have gone before you did not become successful by accident. They knew what they wanted, put aside their fears, and went after it.

 

3 things you can do now to make yourself more attractive to optometrist employers.

  By Chad Fleming | June 5, 2013 - 11:00 am |
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It’s been 3 days and you haven’t had a wink of sleep. Your feet hurt from pacing the halls of your apartment and one more meal of spaghetti will trigger the gag reflex. How could this be?  Just two weeks ago you accepted your diploma and thanked all your professors for their inspiration. The time has arrived, but your dream seems to have hit a dead end. Where is the big house, the Mercedes, and all the latest Apple technology gadgets packed in the back of your shiny new SUV with spinners on the wheels?  That’s what life after graduation is supposed to be, not pacing hallways and eating leftover spaghetti every night.

If you feel the above scenario hits way too close to home, here are 3 things you can do now to increase your chances of obtaining a great optometry associateship.

  1. Study your business – I know, I know, studying is the last thing you want to do right now. However, I’m not talking about studying ocular pathology–you’ve already done that. Now you need to study how to build a business that depends heavily on referrals. Start reading books like The Referral Engine by John Jantsch. It also means understanding the operations of a small business. Spend hours on the internet reading and researching articles on optometry practice management and employee/employer relationships. Be prepared for your interview with a prospective employer by going outside the clinical box. Market yourself as a “staff trainer” or show how you could  help administrative personnel by reviewing and revising employment manuals, training manuals, and policy manuals. The majority of employers will assume that if you graduated from optometry school you are ready to practice optometry. Make yourself stand out by highlighting additional skills.
  2. Learn a second language – The world is getting smaller and not everyone speaks English. To be more marketable in today’s economy you must have multi-cultural knowledge. A second language is going to make you much more competitive when trying to land your first associateship. The Rosetta Stone language system has helped millions of people learn another language. Find out what the secondary language is for the area you want to practice and begin your new language today.
  3. Improve your Curriculum Vitae (CV) – All CVs are not created equal, and the look is as important as the content in getting the interview. Your CV must be perfect in appearance, grammar, spelling, and content. Many consultants to high-profile, high-income earners recommend hiring a professional to review and assist you with your CV. In today’s ultra-competitive job market this is money well spent. A professional can take the content of your CV and package it to outshine the competition.

Graduating at the top of your class gets you the prestige in the academic world and probably a million pictures with your mom. However, graduating at the top does not guarantee you a job. Getting a job requires time and effort above and beyond the classroom and clinic of optometry school.

5 techniques in making your telephone recalls successful

  By Chad Fleming | May 29, 2013 - 11:00 am |
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Texting patients to remind them of upcoming appointments is the latest craze.  While texting can be a successful way to communicate with patients, it still remains a distant second to an old-school phone call.  If your office uses the phone to remind patients of their upcoming appointments, whether pre-appointed or not, here are a couple of techniques to pass along to your staff:

  1. Calling time is crucial – It is recommended that patients be called between 10-11 a.m. and then from 2-4 p.m.  For those offices struggling to connect with patients, the ideal time for phone calls is between 4-7 p.m.
  2. Smile – Your voice will sound more inviting and congenial if you smile while you are talking on the phone.  Remind your staff to keep their home life at home and put on a smile each day as they walk in the door.  Each day brings new patients who are forming their first impressions.
  3. Open Patient Chart – To be most prepared to visit with the patient on the phone, open the patient’s chart prior to making the call.  Many patients will have questions for your staff and if they are fumbling trying to find the chart on the computer this can lead to a bad impression.
  4. Repeat – Patients need to hear and be reaffirmed of their appointment numerous times.  To avoid patients showing up at the wrong time or–even worse–the wrong day, make sure the appointment time and date is repeated two to three times on the call.
  5. Be personable – Always give your name followed by the name of the doctor or doctor’s office.  It is recommended that you use the doctor’s name the patient will be seeing so there is a more personal connection during the call.  No matter how much your practice grows, always strive for a personal touch.

Recent graduates and other techno-savvy doctors may dismiss this advice, planning instead to simply text and email all of their patients.  However, I would ask you to consider your patients.  Statistically, not all of your patients will be available by digital media.  In fact, offices leaving behind some of the basic communication practices of the past are finding they are also leaving behind patients.  Unfortunately, those patients begin to open the doors of other practices.

I love the power of technology, and I have a feeling that if I were flying solo, I would leave numerous patients behind.  Thanks to the buffering senior doctors and staff, we find that communication among the generations is most successful as a multi-platform approach.

5 roads to partnership failure

  By Chad Fleming | May 22, 2013 - 11:00 am | ,
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Think about the last time you stopped your car to ask for directions. If you own a Smart Phone, you probably haven’t done this recently because of the phone’s ability to also function as a GPS. However, if your phone uses Apple’s maps, you might have had to ask for directions because you ended up in downtown Dallas when you typed in the airport. My current opinion of the iPhone map is not very high as it made seven mistakes on my last use. Unlike utilizing the iPhone app, in business you cannot afford to be taken down a road that leads to a dead end. Below are a list of roads that lead to partnership failure. 

  1. Partners feel treated unfairly – Clear, concise and specific agreements should be outlined prior to the beginning of a partnership.  These agreements should be assessed yearly.
  2. Competition for patients – As a successful eye doctor, you most likely did not learn to take second place very gracefully. In my practice, I intentionally do not look at each doctor’s production throughout the month. By nature I am very competitive and I know that is not healthy for our partnership.
  3. Senior partner pulling rank too often on junior partner – Senior partners do have the privilege to pull rank when they see impending danger. If done too often this can not only discourage an exuberant younger doctor but can lead to a younger doctor fleeing the practice for a more fulfilling opportunity.
  4. Junior partner disrespecting senior partner with comments that the practice is out-of-date or too conservative – As I reflect on this, I am guilty of letting my senior doctor know too many times that we needed to be more progressive and we were not keeping up with what patients expected. If you are a junior partner, don’t make the same mistake I did in my naivety and hubris. If you have partnered with a previously successful optometrist, chances are he or she is successful for a reason. Take notes, ask good questions, and keep your comments in a journal that only you read.
  5. Junior partners are highly encouraged to dispense, do lab work, and fill the role of technician – From day one of your partnership you should be treated as a partner and respected as such. Of course, you may need to help in other areas from time to time, but your main role is that of a doctor, and you need to be practicing as one in the exam room.  If times are slow, work on building your practice through social media, social engagements, or inexpensive marketing.

Highways are often used for fast travel because they lack resistance points called stop signs. The road to failure is also a well-traveled highway. The most successful partnerships know that taking the time to stop, reflect and reassess the partnership agreement is the road to high profits and career fulfillment.

3 reasons why high grossing and/or high netting practices don’t motivate the next generation of ODs

  By Chad Fleming | May 15, 2013 - 11:00 am |
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Is the next generation motivated by money?

The Baby Boomer generation grew up as products of war and the Great Depression. Their work ethics are impeccable, because their motivation is to save their earnings and retire to a life of travel and leisure.

In optometry we have always listened to consultants and business-minded individuals tell us about grossing over $1 million as a single doctor or netting more than $200,000. This idealism has driven ODs for years, but will this carrot drive the next generation of optometrists?  Probably not.  Don’t get me wrong, optometrists desire to make good money, but according to studies documented in a top-selling book by Daniel Pink, the next generation wants more than money.  Here are the 3 elements that Pink describes in his book, Drive, and where I believe we stand as optometrists.

  1. “Autonomy” – New optometrists are looking for positions that afford them the opportunity to make their career the means to an exciting life now.  Instead of working long hours to ensure an affluent retirement, today’s new optometrists are seizing the opportunity to live now.  This is one of the reasons that we have far fewer new eye doctors who want to commit their life to owning a practice.
  2. “Mastery” – Routine procedures like refraction have become repetitive and the reward of mastering this does not provide the satisfaction that medical optometry does behind the slit lamp.  New eye doctors see the opportunity to be more than a refractionist and be an integrated part of the medical model.  This drives new ODs to seek employment instead of owning their own clinic.  This way, they can focus on patient care and increasing their clinical knowledge, instead of worrying about business management. This allows them to master optometry in a way that provides intrinsic fulfillment, compared with the extrinsic fulfillment of money.
  3. “Purpose” – The success of TOMS and now Warby Parker reveals that the next generation wants to be a part of something bigger than themselves.  The new eye doctors are looking for employment that allows them to put their efforts into a larger cause.  They want autonomy that will allow them flexibility and time to be involved in something bigger.

If you have read this far than maybe you do see that the extrinsic motivation of money is still important, but contrary to popular belief, it is not the primary motivator for the next generation.  If you want to successfully employ new optometrists and have them possibly buy your practice in the future, you must understand what they are looking for in motivating them to press ahead.  High-producing offices and optometrists committed to working at the office 60-plus hours a week reflects a Baby Boomer generation committed to not ending up poor like their parents in the Great Depression.  Now we have a generation raised by these hard-working parents who are wanting to take a little time off work to stop and smell the flowers along the way.

Make Your Online Marketing Strategy Efficient

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  By Chad Fleming | May 8, 2013 - 11:00 am |
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Guest post by Rachel Cunningham of iMatrix.

Online marketing for optometry encompasses a broad range of mediums and tools, making it easy to get lost or side-tracked.  A comprehensive online marketing strategy should include everything from a dynamic website, to social media pages, to professional quality videos, to pay-per-click advertising, to search engine optimization. It may seem simple, but when you start to delve into each category, all of the options often become overwhelming.  For instance, when considering social media, the first question should always be which ones should I use?  Jumping into social media, without first asking that question, is setting yourself up for a mountain of extra work with little-to-no ROI.  A smart strategy will save you time and money.

There are several things you can do to streamline the online marketing strategy for your practice and make it both efficient and effective.  The main things that will help you get the most out of your marketing efforts are a clear strategy, effective tools, focus, and metrics.  The following tips will help you to design and execute a smart marketing strategy that maximizes your time and available resources.

Strategy

Start with a plan. Ask yourself what you can reasonably manage, given your current workload and budget.  A website is essential to a local optometry office as it will enable you to be found by patients searching online.  Social media is a great, cost-effective way to connect with your patient-base, but how much time do you have to manage it?  If you have not invested in a professional website or organized your social networking, it will not make sense to jump to video marketing, pay-per-click ads, or search engine optimization.  Those aspects of marketing can be added to your marketing strategy once you have built the proper foundation.

Set goals for your strategy and create timelines.  Creating a schedule of goals and deadlines is the best way to stay on track and eliminate activities that waste time.  Stick to your deadlines and do not push them back unless something urgent comes up.

Professional Website

You may have heard the saying, “You get what you pay for.”  With the advent of sites like Groupon, people are expecting more and more for less.  This can be said of websites as well.  While a free website may seem like the best option when you open up a new practice, it will not sustain the growth of your practice.  Additionally, a free website will likely not have the professional design, interactive tools, and simple usability that come standard with a skillfully designed website.

Investing in a professional website will not only save you money long term, it will save you time.  The design and functionality will already be there and you will typically have access to a support team that can troubleshoot issues for you.  As more and more people turn to online searches to locate local service providers, including doctors, a website is instrumental.  Without a website, your practice will likely not appear in search results. If you do have a website, it will likely be the first impression that a potential patient sees of you and your practice.  The website should reflect your professional nature and instill trust in the user.

Social Media

Before launching into social media and setting up pages for your optometric practice, make sure you have a narrow focus.  Do not go and set up a page on Facebook, Google+, Twitter, Pinterest, Instagram, YouTube, LinkedIn, and every other social network you hear about.  As a small practice owner, it would be a nightmare to manage all of those accounts concurrently and if you neglect any of them, it looks as if you do not maintain any of them.

Rather, select one or two sites that you feel you can properly maintain an active presence on.  Facebook is always a great option due to the sheer number of users and the availability of applications for managing it.  Facebook is also tightly connected with Bing and may help to increase you visibility on the quickly growing search engine. Selecting the right social media site will always depend on your goals for sharing.  If you plan on sharing a lot of videos and images, such as the frames you offer, Pinterest may be a great choice.  If you only plan on sharing quick tips or funny optometry jokes, Twitter might be a good bet.  Either way, limit yourself to what you can reasonably manage given your time restraints.

Alerts

Alerts are a great way to stay on top of your social media or your website traffic without having to login to your computer.  Set up alerts when a new patient signs up on your website or requests an appointment. You can often select the email address the alerts go to.  For social media, you can use notifications to alert you when someone mentions your practice or interacts with your business page.  Socialmention is one such resource. With alerts you do not have to check your website or social media each day, freeing up your time to manage other aspects of your practice.

Tracking

A quality website and most social media sites provide analytics on traffic and interactions.  These tools are invaluable when it comes to your strategy.  They enable you to see what is working, what users like, and what you can improve to make the visitor experience better.  Check your analytics on a weekly or monthly basis and adjust your strategy or actions based on the metrics.  For instance, if patients don’t interact with your “joke of the week” post, try posting it on a different day or at a different time. Always use your metrics when redefining your strategy.

An online marketing plan should always add value to your overall marketing plan. Create an effective, smart online marketing plan that is also reasonable and efficient. Maximize the time you spend marketing by targeting your efforts on aspects that will give your practice the solid online presence you need to succeed.

Rachel Cunningham is a Marketing Content Writer at iMatrix, a provider of affordable web marketing solutions for small, practice based businesses. She earned a Master of Arts degree in English from CSU Long Beach and a Bachelor of Science from Boston College in General Management. Rachel is experienced in writing content optimized for search engines and users, creating engaging content for social media, and crafting articles about SEO and social media marketing for small businesses.

3 approaches to resolving staff conflict

  By Chad Fleming | May 1, 2013 - 11:00 am |
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Human beings are going to have conflict, no matter what. That’s why learning to resolve conflict is so important–it can mean the difference between social harmony or social disorder. 

The same holds true in the community of your optometry practice. As CEO of your company you directly or indirectly manage social groups that influence the mood of the office. Staff members in conflict negatively impact the perception patients carry of the office, which can result in an office visit the patient hopes is the last.

Here are 3 things to consider when you manage staff in conflict. . .

  1. Win/win – One of the secrets of negotiating is finding a win/win solution. When two staff members are at odds with each other it’s usually due to differences of opinion or preserving reputations. They do not want to look bad in front of the patient or the doctor. Before discussing the problem corporately with all those involved, make sure you take the time to interact with staff members individually to find out their side of the story. This will allow you to find out the crucial concerns of each staff member.
  2. Face to Face – Many of the younger generations have not learned to interact effectively unless they are texting or chatting online. Generation X, Y and Millenials are more comfortable with meeting in virtual space instead of physical.  However, in a small office situation meeting face-to-face is key. By meeting face-to-face, the problem can be resolved in a timely manner with the clearest understanding and the least amount of collateral damage. Once you have determined what the problem is from each individual staff member and figured out their “win,” then you can have a meeting to discuss the problem. Face-to-face is difficult but results in better outcomes in the long run.
  3. Emotions – To reduce the emotional response, plan your meeting in advance.  Sometimes the worst response to a problem is to pull those in conflict together immediately. In my impatience, I have mistakenly tried to solve the problem right away and didn’t allow time to pass and emotions to settle. Give each of your staff a heads up on when you would like to meet and then put it on the calendar. Many times the staff members will resolve the conflict before the scheduled meeting because they want to avoid the discomfort of being “on the spot” in a formal meeting with the boss.

However you choose to resolve conflict, assume the best in each of the staff members. Many times both staff members are trying to do what is best for the patient and for the office. They simply see the situation from different angles. When you can discover their views and help them see each others’ position from a broader perspective, everybody wins.

3 ways for an optometrist to keep from getting sued for malpractice

  By Chad Fleming | April 24, 2013 - 11:00 am |
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We live in a litigious society that hovers over us every day waiting for us to make a mistake. The problem is we all make mistakes.

An optometrist friend of mine looks at everything in life as a potential minefield. When assessing a situation, he asks himself how he can avoid a catastrophe, or at least escape with the least collateral damage. Unfortunately, this often leads to losing patients by referring them to specialists.

I believe we should work to keep our patients, yet still take precautions to keep us out of court. After all, I think most optometrists would rather be in the clinic than in court.

Here are three ways to keep the collateral damage to a minimum and have the greatest chance of keeping yourself out of litigation.

  1. Dilate patients – Many ODs are faced with increasing pressure to see more patients. Even though dilating patients requires more time, do not skip this important step. Instead, consider such options as dilating appropriate 60-year-olds in pretest, utilizing a dilating agent like Paremyd for faster dilation, or using an OPTOS to provide a great screening. Whatever you decide, dilating patients regularly has become a must. Our practice guidelines is every 1-4 years for patients under 40, every 1-2 years for patients 40-50, and every year for ones over 60. It is recommended that you reference the AOA for guidelines on dilation (page 10).
  2. Communicate all findings to patients – Effective communication is an art that needs practice and intentional development. What your patients walk away remembering about their visit is the grade card of how good a communicator you are. Always tell patients every finding that you document and let them know if it is worth being concerned about or if it is just a benign anatomical finding. One common liability is not communicating increased IOPs to patients.
  3. Do visual field testing on children – It is easy to bypass visual field tests on children by justifying that they are too young to take it. However, when tumors occur the first questions asked are if the child was capable of taking the test, and if the test would have identified the tumor earlier. You do not want to be in court watching a six-year-old take a reliable visual field test and have a jury determine you were negligent in missing the diagnosis. It is better to try and fail than to never try.

If you are like me, you read through a list of potential areas to be sued and you think of the one case where you did not follow the guidelines. In our litigious society a patient can sue you for almost anything. Limit the potential collateral damage by always following the best accepted practices. Don’t practice optometry in fear. Practice in confidence by making wise decisions to not cut corners and provide appropriate care.

One last thought: patients do not typically sue doctors they like. Be likeable.

3 ways to get a PCP to call you

  By Chad Fleming | April 17, 2013 - 11:00 am |
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The larger the town or city the more difficult it is to incorporate yourself into the healthcare system.  You know, being respected by all the primary care doctors in the area you practice.  Many patients have a red-eye and end up going to their primary care physician for care.  If the primary care physician is unable to help them they are usually referred on to ophthalmology where they typically do not have a long-term relationship with the patient like an optometrist would.  With the right approach many of those patients can and will end up in your chair as the primary doctor.  If you are dissatisfied with patients turning to other providers for their primary eye care, consider this…

  1. Letter Writing – With advent of EHRs it is no longer necessary to dictate a letter and send to a transcriptionist.  An easy way to communicate to PCPs in your area about your knowledge and ability to care for the eye is to write a 3-5 sentence note in the management section of your EHR.  Put the doctor’s name, John Smith, MD, and then type your note that describes why you evaluated the patient.  In brief, describe your management plan in terminology they understand and then finish by letting them know they are welcome to call you or refer other cases similar to the one you are treating.
  2. Phone call – I received a phone call today from a PCP letting me know that he was treating a patient of mine for a conjunctivitis that was not getting better.  He gave the history and then asked what I would recommend that he do next.  Just as any OD would, I stated my thoughts and recommended that she be seen by myself or one of my colleagues to consider introducing a steroid.  He was extremely appreciative and sent the patient right over.  I had never talked to this particular MD on the phone, however, I know that I have written many letters to him regarding patient care.  He was familiar with the services our office offered.  Many MDs don’t know if you are an optometrist that treats primary care or just does refractions.  It is based on perceptions and communicating by phone is a powerful tool.  Call them the next time you need blood work or an MRI.
  3. Educate patients – Your patients talk to their other doctors and your patients are a marketing opportunity.  If your patients are aware of the medical eye services you provide, then they will communicate this to their primary care doctors.  Many times our office will receive a phone call from the PCPs office requesting that we take care of an eye condition.  The patient had voluntarily requested that they be evaluated by their eye doctor, which in those cases were one of our doctors.  At the end of each exam consider educating your patients with this statement.  ”As a patient Wichita Optometry, you have access to our after hours services for any eye problems you may have (ie – red eyes, something in the eye, “pink eye” etc).  We should be the first place you call and we file your medical insurance for these cases.”

Good communication is the key to building a practice that is part of the medical community.  Many PCPs would appreciate the opportunity to build a relationship with you.  It does take time, but once you establish these relationships your medical eye practice will grow.

11 questions for finding great optometric staff

  By Chad Fleming | April 10, 2013 - 11:00 am |
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The most successful optometry practices have a great staff. Let’s face it, most of us doctors could be replaced and the practice would not miss a beat if the staff is made up of warm, caring professionals who brighten patients’ days with each interaction.

Even with all the practice management tips in the world, a doctor can not surpass an office with staff who genuinely care about people. The difficulty is finding those people that others love to be around.

 

Here are eleven questions to consider asking the next time you interview:

  1. Why did you apply for the position?
  2. Why are you looking for a job change?
  3. Which previous employer was your favorite? Why?
  4. Why do you think this job will be better than previous jobs?
  5. What did you like most about your most recent job?
  6. What was a typical day in your previous job?
  7. Rate your previous employer on a scale of 1-10. Why did you give this rating?
  8. What does an optometrist do and what do you imagine a day in an optometry office to be like?
  9. Did your previous job require you to take on new duties?  What were they?  How did you adapt to the additional responsibilities?
  10. If we hire you, how long would you like to work here if you are satisfied with the job?
  11. Why should we hire you?

Many questions you might ask potential employees will gather the same basic information. However, the main thing you need to discern from their answers is if they will work for the patients or work for themselves.

Genuinely caring about other people is an important character trait that all staff members must have. When a staff member truly cares she will follow up with a patient who seemed to have a bad visit, or she will call someone who came in with a red eye just to make sure it’s healing. Staff members who care will stay that extra thirty minutes to make sure all jobs are checked in so patients receive their glasses a day earlier.

Successful optometry practices know how to find and keep staff who will care about the patients. Start today by asking great questions.