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.

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.