Three reasons to fire a patient

hand farewellAs optometrists, we have to make many decisions, both clinical and business-related. One of the hardest decisions is whether to fire a patient. Ironically, early in our careers we were willing set up any living body with an exam. As our careers advance, we see in rare instances that keeping every patient is not beneficial. With our core principles of practice in mind, I have personally had to request three patients see other providers. Below are three real-life examples of habitual patient behavior that signal it is time for that patient to be fired.


  1. Irrational requests – Unfortunately, some patients have unrealistic ideas of what health care should include. In rare instances patients will make requests that are irrational. For example, a patient might repeatedly request to have her prescription rechecked by the doctor, and then raises a fuss at the front desk because a staff member informs her additional charges may be incurred to carry out that request. That same patient also does not expect to pay for her glasses, even though she broke them. She also might raise her voice in disgust when staff refuse to continue to supply her with trial contact lenses because she neglected to show up for eher follow-up contact lens exams. After putting up with all of these irrational behaviors and arguments, we finally drafted an exit letter and gave her all of her patient records.
  2. Theft – When you have a kleptomaniac as a patient, you may want to ask him where he would like to have his records sent. Our practice lost condensing lenses, tonometer tips, dilating drops and anything else that would be considered customary to store in an exam room cabinet. We discovered after the second time this individual and his wife were in that they had a habit of cleaning out our cabinets. The patient was politely told that supplies and equipment seemed to disappear when they were in the exam room. We sent them a letter and sent their charts to another office.
  3. False accusations – A patient’s mother repeatedly accused me and staff members of intentionally messing up her son’s glasses prescription so we could charge her extra. She wrote me a nasty letter that included many inaccurate statements she claimed were spoken in the exam room about her child. We kindly asked the mother to have her family’s records sent to another office, and we gave her a letter explaining that our office is not a good fit for her and her family. Ironically, she was surprised that we would terminate them as patients. What we felt was ironic was that it took us as long as it did.
In all three situations above, we gave the patients second and sometimes third or fourth chances to redeem themselves after the initial conflict. Our office leadership firmly believes in forgiveness and second chances. However, after repeated incidents we believe some patients are not meant to be a part of our practice. Firing a patient is one of the difficult responsibilities of owning your own practice.

Easy Tips for Using Online Video for Your Practice

Don’t be intimidated by video marketing. With the advancements and popularity in smart phones, making online video is a snap. Before your start recording video on your smart phone or tablet, check out these 5 easy tips for creating online video.

Man Having Video Chat With Doctor

1. Have a Plan
Create a general strategy for your optometry online video efforts by answering a few questions. Who is your audience? What is your goal? What resources can you draw on to record, edit, and publish the video?

Determine if you are trying to reach potential patients or educate existing optometry patients. Next, set goals for your videos. Decide whether you are looking to increase new patient appointments, patient referrals, or increase brand awareness of your optometry practice. Lastly, determine which smart phone or tablet that you have access to has the best video quality. In many cases, you will likely use YouTube to edit and publish your video, although Apple has video editing software that is easy to use as well.

2. Write a Schedule
Create a simple schedule that includes topics and dates. As a busy optometrist, your best bet is to create a monthly schedule and plan out six months to a year in advance. Address topics that your optometry patients frequently ask about or common vision and eye health conditions.

3. Enlist Help
While you can record video yourself, it’s best to enlist help for recording and publishing video. Many members of your staff are comfortable with recording video on a smart phone or tablet. Ask around to see who is willing and excited to help.

4. Choose Quality Over Quantity
Once you get the hang of recording online video for your optometry practice, it’s easy. Don’t get carried away with recording and publishing a multitude of videos. Rather, stick to your schedule and ensure each video is clearly thought out, properly recorded, and optimized online.

5. Take the Plunge
There is no time like the present to get started. Once you have laid out a strategy and enlisted additional resources, get started. For many optometrists, online videos will improve over time. Have realistic expectations, relax, and have fun with creating great optometry online videos.

RachelRachel 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.

Your Ideal Online Video Promotion Strategy

The facts don’t lie. Not only is YouTube the second largest search engine after Google, research has shown that 80% of online visitors prefer to watch videos rather than read text on a website.*

Youtube Music Playlist On Apple Ipad Air

Online videos for optometrists have a range of benefits including:

  • Increasing new patient appointments
  • Reaching a broader audience
  • Increasing brand awareness
  • Building trust in viewers
  • Becoming an authority in optometry
  • Enhancing patient education

Once you have recorded an online video for your optometry practice, it’s time to publish and promote it. Start by publishing the video on YouTube, Vimeo, or another reputable video hosting website. I recommend YouTube because it is easy to use, it’s a popular network, and it’s owned by Google.

Publish, Promote, Engage
After you publish and optimize your optometry video online, grab the unique URL for that video and start sharing! Post the video on your social media business pages. Facebook, Google+, Twitter, Pinterest, and Instagram are all great for sharing and engaging with video. Write an engaging status update to go with the video and include relevant hashtags.


Next, grab the embed code for your video. Choose a relevant webpage on your optometry website and add the embed code to the HTML. If you don’t have a relevant webpage, take fifteen to twenty minutes to write one. For example, if your latest video is about a First Eye Exam for Kids, write a few paragraphs about why eye exams are important for children. Create a new page and add the text and video to the page.
Additionally, share the video in a blog post. Similar to a webpage, make sure you write up relevant text to include with the video. Even a simple introductory paragraph is enough to post with your online video on your optometry blog.
Follow these steps for all the future online optometry videos you create to get more views, engagement, and build trust in your audience.

*DigitalSherpa, 2014

RachelRachel 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.

It’s My Fault. . . . Please forgive me.

SorryThese can be the hardest words to tell a staff member after you have made a mistake. We all hate making mistakes, and even worse is having to admit to those mistakes. As the leader of the optometry practice, you feel you are not supposed to make mistakes. However, we are human, and we all make mistakes–in clinic, in staff management, and in life in general. It is how we handle those mistakes that makes the difference between being a great optometry CEO leader and being someone people don’t care to follow.

On a recent Wednesday afternoon I had just returned to the office after our weekly owners’ lunch. My partner and I had made some decisions and I was pumped to carry out the action points for which I was responsible. The problem was I did not curb my enthusiasm at the door. Instead, I came into the building with a corrective whip.

One of my staff members took my suggestions personally and concluded she was failing at her job. Instead of coming directly to me, she told another staff member, so a senior staff member made me aware of how the staff member had perceived my actions. As I listened to her explain the situation I realized I had been completely wrong in my approach. I felt badly and knew I needed to take care of the situation in a manner that reflects our core value, integrity.

After some thought about how to address the staff member, I pulled her aside and apologized. It was a simple gesture but it went a long way. She immediately said that it was OK and that she was surprised that I came to her and apologized. We discussed a better way to approach the situation and she reinforced her commitment to do better.

I do not have it all figured out, by any means, but taking the time to admit my mistake resulted in greater loyalty from a staff member who I hope to employ for many years. A senior optometrist taught me that the most successful optometrists have learned the secret to keeping great staff is not only paying them well, but treating them well.

3 ways optometrists are getting patients to use the online patient portal

Frustrated at futile attempts to get your patients logged into your patient portal? As part of meeting Meaningful Use 2, our practice has been working to engage patients on the EHR (Electronic Health Record) patient portal. We have some patients who embrace it with enthusiasm, but I would say most are apprehensive–if not frustrated–that they have to comply with our requests. Professionals, like you, tend to embrace technology much sooner than the general public. If your patient population is not skewed toward technology-savvy individuals, transitioning your patients to interact using your patient portal can be difficult.

“You can lead a horse to water but you can’t make it drink”

You can lead your patients to the patient portal, and if you give them helpful tools and information, there is a greater chance that they will comply. Here are three ways you may find helpful in your optometry practice:

1. Create a handout with username & password – This is one way to put something in the hands of the patient. Your staff will write down their username and password on a pre-made tear-off piece of paper like the example below. The staff then takes two minutes to explain to the patient that they can see the results of their exam and track any optical orders through the online portal. Make sure your portal is a part of your practice website.


2. iPad upon arrival – Many patients may not take the time to login prior to their appointments. A couple of older-generation iPads can be used for this purpose when patients arrive. Extra styluses for electronic writing on the iPads can be purchased $12 for 20, and protective covers can be purchased through Amazon to ensure the iPads are not damaged. To make sure the iPad is only used for logging into the patient portal and not browsing the internet, go to the settings app and select “Guided Access.”

3. Health history – Many of the patient portals have some form of “interview” or “health history” that is available when the patient logs on. When the patient schedules an appointment, or is contacted at their one month prior confirmation call, they can be instructed on the importance of completing the online health history through the portal. Our office has found that when the doctors communicate to the staff how important the information is to them, the staff emphasize this to the patient. This leads to higher compliance.

There is no easy solution to increasing the number of patients who engage your practice online through the portal. However, we know for sure that whether patients are asking for it or not, health care is being pulled in a direction that will require patients to interact if they want to be a part of the healthcare system. The practices that make it the easiest for patients are the ones that are going to win by increased patient loyalty and continued practice growth.

Optometrist burnout? Watch for these 3 signs

burned matchesBurnout can happen to the best of us, and it usually happens to those who least expect it. Burnout is a state of emotional, mental, and physical exhaustion caused by excessive and prolonged stress. Most people think burnout happens to individuals who only half-heartedly like optometry, or the ones who just went into the profession for the money. How could it possibly happen to optometrists who love their profession?  How could it happen to owners who can’t afford to take their practices through an emotional and physical roller coaster?

The sobering reality is burnout does happen. Be prepared for when it does by knowing the three signs of burnout and the three steps you can take to survive it.

Symptoms of Burnout

  1. Every day is a bad day
  2. You are tired all the time
  3. Caring about work seems like a waste of energy

Beating Burnout

  1. Recognize- You most likely have a good idea if you are experiencing the symptoms of burnout. The difference between stress and burnout is burnout characteristically shows a complete lack of care.
  2. Share your concerns with others and let others help- This is always the hardest step because it requires humility. Men especially may be unwilling to practice this trait. The best advice I have taken in my professional and personal life is to meet weekly with an accountability partner and mentor. Meeting with this person has helped me work through seasons of burnout.
  3. Do activities that build your physical, spiritual and emotional health- Studies have shown that physical exercise is not only good for stress relief and physical health, but it also plays a huge role in emotional health. Taking the time to exercise three or four times per week is one non-negotiable appointment that every optometrist should keep.
Burnout can be like any addictive or compulsive behavior. These behaviors control us emotionally and physically and can be difficult to escape. Optometrists suffering from burnout have lost their practices because staff members have quit and patients have gone elsewhere. If you are feeling burned out in our profession of optometry, you are not alone. Seeking help maybe one of the best practice management decisions you make this year.

Making the medical model a reality

thinking manQuestion:  What do you do when patients expect their visits to be covered under their vision benefit plans, but their complaints are medical and should be billed as such?

This is the No. 1 question that I receive as the Business & Career Coach for AOAExcel. Transitioning to the medical model requires changing the mindset of both staff and patients. Below is a sample one-page handout to educate staff and patients on the differences.


What is the difference between routine vision benefits & medical eye insurance?


Vision benefit plan (example plans are VSP, Eyemed, Superior)
Routine exams that update prescriptions for glasses or contact lenses and assess the overall health of the eye are filed under vision benefit plans. During that exam, if eye health problems are discovered a follow-up exam will be scheduled. That visit will be billed to your medical insurance.


Medical insurance (example plans are Medicare, Blue Cross/Blue Shield, Coventry, Aetna)
An office visit for conditions such as glaucoma, diabetes, macular degeneration, and dry eye are filed under medical insurance. Most complaints of pain, redness, swelling, itching, and loss of vision are related to eye health and would most likely be diagnosed as medical. If you have a systemic disease that has eye complications, this would also be considered a medical eye encounter and would be filed toward your medical insurance.

In the past our office has used your vision benefit for both routine and medical eye at your yearly exam. Due to the ever-changing landscape of health care we will now be billing your vision benefit and/or your medical insurance. In some instances, the services are split and billed to both your vision benefit plan and medical insurance. This will be determined based on the reason you are in the clinic to see the doctor. We are committed to working for our patients and will continue to assist you through these changes. Thank you for your understanding.

3 Baby Steps to Practicing the Medical Model

Putting the health of his eyes firstOptometry practices today are struggling to re-invent themselves as practitioners of optometric medicine. This evolution began over a decade ago when Medicare first recognized optometrists as equal to ophthalmologists. This classification makes sense, because optometry students are educated alongside medical students. Now new laws are allowing optometrists to practice as they have been trained. However, some optometrists are having difficulty reconditioning themselves, staff, and patients to think outside of the traditional “glasses and contacts” mindset. They know they need to be mirroring medicine in how they practice, but are having trouble making the switch. Practitioners who have been in clinical practice for a long time will remember comprehensive exams that included diagnosing, managing, and treating everything in one all-inclusive exam. Today those practitioners have the difficult task of now seeing comprehensive as a full eye and health assessment with the appropriate party responsible for the visit. Beginning this transition process starts by taking several baby steps.

1. Collect vision benefit cards & medical insurance for ALL patients
When a patient schedules an appointment, your staff should already be discussing what the patient needs to be prepared for the exam. This includes both vision benefits and medical insurance information. If patients say they only want a vision exam, the staff should not argue with them, or discuss it further. However, they should still kindly request patients bring both sets of information for their files. The seeds have been planted in their minds, and that is the initial purpose.
2. Communicate in the exam room the difference between “vision” and “medical”
The next step in shifting the mindset of patients occurs during the exam. The doctor’s assistant and doctor should both be communicating in a way that differentiates vision assessment from medical assessment. For example, when the doctor’s assistant is asked what the eye pressure test is for, the assistant should immediately respond, “We check your eye pressures to look for any medical eye conditions that could negatively impact your vision now or in the future.” Alert staff and doctors can find many opportunities to communicate to patients the difference between vision assessments and medical eye assessments.
3. Lead staff to think vision AND medical eye
A shift in mindset is best caught, not taught. Just like children learn more from watching what their parents do, not listening to what they say, so too much of what your staff learns is from watching you. You can lecture to your staff all day but until they see it in action it won’t change their behavior. The staff and patients should hear you talk about vision and medical eye in two different ways. For example, when you communicate to your staff in front of the patient that you need to see the patient back in one month for a dry eye evaluation, make sure you let them know that the intermittent blurry vision today was not from a glasses prescription problem but from dry eye, which is a medical eye problem. Don’t be afraid to say to your staff, “We will need to make sure Mrs. Smith’s medical insurance is on file as the next visit is medical.” This reinforces to the patient that not only do you offer vision care, but medical eye care as well. This also helps the staff not to have to introduce this to the patient.

To be successful with most things in life, you must have a plan and be intentional about executing the plan. This is no different. You cannot walk into the office and immediately start making the above changes, but you can begin to discuss these changes with your patients and staff. You have intentionally or unintentionally trained your patients and staff to think and act a certain way. Your future success as the CEO of the optometry business and as an optometrist will depend on your ability to successfully make this transition.

Mirroring: Why some Associate ODs get pay increases and others do not.

When new optometrists begin practice they are often so happy with the security of an associate position they simply accept the compensation offered. However, many are underpaid. A good associate OD can bring the practice a lot of money. The smart new optometrists know their potential and take the risk to discuss compensation.

Maybe you are a new optometrist and want to have the feared compensation conversation, but you are unsure how to go about it. Some people seem to automatically make a social connection, so they breeze through interviews and compensation conversations without breaking a sweat. Although there are many reasons why some people excel socially, one important one is they know that most of the connection is subconscious. The good news is anyone can take steps to gain trust from an employer.

two business women at the meetingMirroring is the seasoned communicator’s secret weapon. Successful sales representatives use it so skillfully that it is undetected by others. Mirroring is the art of connecting your unconscious mind with the unconscious mind of another. Here’s how it can work with your employing optometrist:


In discussions with your employer, don’t try to win him or her over with your strong personal presence and eager enthusiasm. Instead, allow the owner/doctor to do most of the initial talking. As the conversation progresses, gradually begin to imitate your employer’s posture and body position. Follow the owner/doctor’s movements slowly and subtly, making sure you are a couple of seconds behind his or her lead. Be careful–if you are too fast or rigid he or she will notice and feel mocked, not mirrored. Once you have established the physical mirroring, begin to mirror his or her mood. After you have mirrored the owner/doctor for a while, transition to you taking the lead physically and emotionally.  When you notice the owner/doctor mirroring you, you have successfully established trust.


Alex `Sandy’ Pentland, a professor at MIT, says that in the above scenario, an associate will likely receive a 33 percent compensation increase by successfully mirroring the employer. In salary negotiations, understanding social behavior pays.

5 marketing strategies to keep your optometry practice schedule full

LoudspeakersThe biggest marketing mistake most optometrists make is waiting until the practice schedule slows down to start advertising. Proactive marketing gives the greatest return on an investment. Successful practices market when things are good so that three to six months later when other optometrists experience a slowdown, their schedules will still be full.
In the past, satisfied patients would tell their friends by word-of-mouth. With today’s technology and social media, that same information is transmitted by clicking “Like” on Facebook, sending a “re-tweet,” or clicking a link. This “word of click” has the potential to quickly extend far beyond a two-person conversation. Strong marketing strategies use “word of click” as a foundation with other supporting strategies. Here are five marketing strategies that will bring more patients into your office.

  1. “Word of Click” – This is the most reliable and most successful means of generating new patients to your office. “Word of click” incorporates a social media plan that allows current patients to make online recommendations to future patients. This social media approach is successful when the internal experience patients have is exceptional, so pay close attention to staff training and patient care.
  2. Optometry Website Company – iMatrix website company for optometry is currently the best company for generating new patients through the web. Our office has used this company for over a year. We recently upgraded our service plan to include the media package because we calculated the return on our investment has more than paid for itself. As an owner of our practice, I find it extremely important to continue to keep the associate ODs busy.
  3. EDDM – Every Door Direct Mailing (EDDM) is a service provided by the U.S. Postal Service. To send a mailing, sign in and choose your target zip code(s). A cover sheet is generated that is then put on the stack of postcards that need to be delivered. Our most recent EDDM included 1700 residential homes and cost about $0.17 per mailing. A sample postcard image (front and back) is included in this post for your review.
  4. Tangibles – This includes all the handouts that patients receive during their visit. Customizing handouts for acute care or diabetes eye exams is not difficult. A tri-fold brochure with your logo and details of your practice can be created in Photoshop by one of your associates or staff members. If you do not have anyone skilled in creating this, use a marketing company. Our practice saves thousands of dollars each year by creating our own tangibles and then using and for printing.
  5. In-Office Communication – An important job of each doctor is communicating to patients the services your office offers. For instance, if you want patients to call when emergency eye problems arise, for a closing remark say, “As a patient of ours, you have access to our acute eye care services. We are available during office hours and in the evenings and on weekends for eye problems that you may encounter.” Training your patients to think about where to go for all their eye problems takes time and effort, but the result is practice growth for you and your associates.
Investing in marketing sometimes is tough for the optometrist CEO who doesn’t always see a direct benefit. However, today’s practice management software allows staff to track how patients found your office, making it easier to determine the effectiveness of your various marketing tools. Marketing is an essential part to a growing optometry practice’s success.