The key to great patient care

Business trainingFinding, training, and retaining great personnel is the key to a great–and profitable–optometry practice. Of the three actions, training is the most important. Staff need to be trained in your practice’s specific way of doing things. Even if you’ve hired experienced opticians, you’ll need to train them for uniform patient care. As the CEO, you don’t necessarily have to do all of the training yourself, but through delegation you are responsible for making sure it happens.

Training Camp (this can be done on a monthly or quarterly basis)

  1. Introduction – Discuss the importance of training as part of your hiring process and at staff meetings.
  2. Doodle – Use this free online software to minimize the frustration of scheduling an off-hours training camp. This software will allow your staff to check their schedules outside of the office and then it recommends the best date for the training session.
  3. Outline – Observe your staff and listen for areas of patient care that could use improvement. Make a list and from that outline your agenda.
  4. Delegate – Labs and vendors have great educational resources available. Just remind them that you want a non-biased presentation that supports your practice philosophies and not the respective vendor. Below is the email that I send to all sales reps who will be presenting in front of our staff.
    • Thank you for your interest in hosting a lunch/educational event for us at our office. The 1st Tuesday of March would be great. We ask that you provide lunch for each of the staff members and doctors. It should be ready by 12:20pm and you are welcome to call our office to place individual orders or bring in a buffet. For individual orders we like Jason’s Deli, McAlister’s, or Jimmy John’s. For a buffet, we’ve had good luck with On The Border. During lunch from 12:20pm to 12:55pm you would have the floor. If you need any AV setup please let me know. We have a television with an HDMI connection. We ask that you direct your time to educating our staff about what is best for the patient. We are not looking for how the practice can increase profits or make more money per patient. Wichita Optometry staff meetings focus on what is best for the patient and we would ask that you partner with us in communicating that to our staff. Please confirm that this will work for you and let me know if you need any special arrangements. Thank you,
  5. Attend – It is very easy to do the above four and skip this part. After all, you are a very busy individual and could use the break. However, that would be an opportunity missed. Your presence at the session reiterates the importance of the training and will encourage staff members to put their new knowledge into practice. You are their leader and they need you.

Profitability is difficult to measure when one plus one does not equal two, so the time spent training your staff is sometimes hard to justify. As a leader you need to keep thinking long-range and being committed to the belief that the best staff members have a thorough knowledge of product, systems, philosophies of practice, and technical components. These staff members will be the key to your office providing top-notch patient care.

3 things to do when your schedule is slow

Most optometry practices have months when the schedule is not bursting at the seams. This can be discouraging and stressful, or it can be beneficial and rejuvenating, depending how you as a leader approach it. Here are three ways to make the most of a slow schedule:

  1. Reflect for encouragement – Be encouraged by looking at all the the previous years’ numbers as a whole and not as a month-by-month win or loss. It’s important to remember your business will go through ups and downs. By yourself or corporately with your staff write down all the positive things that happened in the previous year. Too many times we hyper focus on what needs improvement and forget to celebrate the great things that are going on in the practice.
  2. Plan strategies to improve – Slow times typically are cyclical and can be scheduled. For instance, many practices experience a lull in February. Throughout the year when you have ideas that you don’t have time to act on, make a note in a folder on your hard drive. In February or some slow period, choose a few growth ideas to implement. Be careful not to freak out and throw money at random marketing schemes or other things with limited payback. Also, prepare your staff members for this by building a list of “someday maybe” tasks that they can work on when the office is slow. One thing we do is pull out the office manuals for our equipment and have staff deep clean the instruments.
  3. Rest to rejuvenate – Generally optometrists are high achievers which makes resting a difficult task. However, rest can be the catalyst for the business’ next breakout growth experience. Take this slow time as a blessing and spend more time at home. If you have a spouse, plan a marriage renewal trip. Visit your parents. Whatever you do, rest and relax. Hint – take two weeks if possible, it might take you up to four days to really unwind.

A slow schedule will come and go. If you plan wisely, your next slow season might not be quite so slow.

How to save $1,000 on a NEW visual acuity chart

Our old projection charts were not cutting it.  The optotypes were no longer clear, and they didn’t look good. We had to do something.
So we updated a few of them, but each new digital iMac visual acuity chart was costing us between $2,400-$2,700–and we needed five more!

Instead of simply shelling out the cash, I did a little research and found we could get the same updated technology for less. What I discovered saved us thousands.
Here are the steps to upgrade to new digital charts for under $1,000:


  1. Buy a Mac mini – This will cost you $499 plus tax. It works great and will serve its purpose for years to come.
  2. Buy a wireless keyboard and mouse – This does not come with the Mac mini but you are still way ahead.  This will run approximately $70 per item. Your total for keyboard and mouse should be no more than $140 plus tax.
  3. Buy the Visual Acuity app from the app store –  Search “visual acuity” and you will find the Visual Acuity app under Medical for $99.99.Screen Shot 2016-01-25 at 11.46.38 AM
  4. Buy a monitor – This will range from $100 to $250 depending on the model that you choose. We used old Dell flat panel monitors that we already had and they have been great. If you run HDMI you will need a 6-foot cord, which will cost about $15. If the monitor is older and has VGA, you will need a $29 adapter (example here)
  5. Buy a monitor wall mount – One can be purchased from Amazon. $15-$30 plus tax. We bought three of these and they work great. (example here)
  6. Put it all together and calibrate the chart (app steps you through calibration – very easy)

TOTAL cost for digital acuity chart – $940

If you are still using the old projector charts please try this test:  stand about 40 cm away from a projector chart and a digital chart on a monitor. Notice the difference, it’s huge.
If you have been trying to convince the rest of your ODs to upgrade to digital visual acuity charts, you now have a budget-friendly solution to acquire the new technology.

If you’re frustrated with the rising costs of information technology and budgets that continue to increase while your net decreases, start looking for ways to minimize costs. Many times a little research and some time can save you thousands of dollars. I am hoping this post will save you money like it did us.

Screening Applicants – Finding the right next staff member

As the CEO of your company, you are ultimately responsible for every staff member that you hire and their success in your optometric practice.

Starting the application process and finding the right staff can be frustrating and lead to bad hires. A bad hire is not only very costly financially but can kill staff morale in creating a successful team the patients return to your office for.

There are three steps in hiring the right person. The first step tends to be the one that is the most time consuming in trying to find a couple great applicants in a sea of jobseekers.

3 steps to a great hire

  1. Online screening (first round) – once your classified has been placed in your local paper and online with a company like Career Builders, applicants will follow your request to apply for a job. Your first request should send them to your website that has a short online application. Finding a few great applicants in a sea of job seekers is time consuming, but it is the important first step in finding the next staff member who will be a good fit. Requiring people to type information directly into your application will give you a good idea if they have the office skills you are looking for.
  2. In office (second round)- The second round is best done by a staff member and an associate doctor. If you do not have an associate, begin the second round with a staff member and/or a doctor. This interview should center on why the applicant applied for the position and what would make him or her a good fit. I would not recommend more than five or six questions. The best applicants proceed to the third round.
  3. In office with owner (third round) – usually no more than three applicants make it to this final and third round. The owning doctor and/or office manager are conducting these interviews. The focus is on the character and chemistry of the applicant, and at this point compensation will be discussed. Deciding who will be the best fit has a lot to do with the current culture of your team and how the applicants fit into that culture. Character and chemistry still remain your top hiring priorities.

Hiring great staff who will be loyal and stay with you for many years is becoming more and more difficult. These days if people become a bit disillusioned with their positions they often feel free to quickly seek new opportunities elsewhere. That’s why it’s essential that owners of optometry practices improve their systems and efficiencies in hiring great staff.

5 essential upgrades to ensure optometry business success this year

Being selective on what you upgrade is the key to running a successful business. Which upgrades are worth the investment?

Upgrade these 5 things:

  1. Online management vendor – whether you manage your business’ online presence or hire it out, this is the most important area to invest money and resources in. Not only does your office need a user-friendly place for returning patients to interact with you, but they need a comfortable place to schedule appointments, update personal health information, and interact with staff. Wichita Optometry averages four or five new patients per week through our website. iMatrix, a partner of OptometryCEO, drives that growth.
  2. Online appointment scheduling – By 2019, 80 percent of appointment volume will be self-scheduled, according to the most recent publication of SolutionReach. Optometry offices that are easy to do business with will be the most successful. Patients want to interact with you when it is convenient for them, and that may be 10 p.m.  Be available.
  3. Staff Education – When was the last time your office had formal staff education? I’m not talking about emailing them a 20/20 article about better patient care. I’m talking about you, the owner, preparing a motivational and educational presentation. Educate your staff about exam room procedures, teach them to professionally interact with patients, and inform them how they can increase their compensation when the offices grows.
  4. Cleaning Team – A clean office is more important than having the latest decor. Many patients will stick with their optometrist even though the office might be a little dated. However, if they catch the optometrist blowing dust bunnies off the auto-refractor, they may decide to go elsewhere. Having a cleaning team is actually an easy upgrade and doesn’t require capital investment, only better organization of staff responsibilities.
  5. Employment Manual – The employment manual is one of the most important documents that you create for your team. When you hire staff members and do not give them direction, they are beginning the journey to failure. This is your fault. As a coach has a game plan with a play book, so must the owner optometrist have a guide manual for success. A well-written policy manual and job descriptions are also a part of setting your staff up for success. Click here to begin the process of upgrading your employment manual.

If you are wondering why your practice is not growing or you are concerned about selling your practice in the future, then continue to invest in the practice. Investing in the practice by upgrading can be difficult because you don’t always see a direct return on your investment. However, if you look at the successful optometry practices across the nation you will see that they have many things in common. One of those is knowing what to invest in and when to upgrade those investments.

How do optometrists define job satisfaction?

Job satisfaction means many different things. For some, job satisfaction means 45 percent net at the end of the year and over $300,000 in take-home pay. For others, job satisfaction may be getting off work early enough to greet their children as they step off the school bus.

Finding your own definition of job satisfaction is important, because it determines the direction of your professional career. If it’s not clearly defined the choices you make day-to-day, month-to-month, and year-to-year may lead you in a direction that you never set out to be your destination.

Listening to continuing education seminars and reading journals would lead one to believe that job satisfaction is solely financial. However, I think optometry provides many opportunities even beyond financial that can lead to ultimately satisfying careers.

Three non-financial aspects of job satisfaction.

  1. Autonomy – this is a game changer for many of the generation X, Y and millennials. To have the freedom to work when we want, how we want, and how often we want supersedes the carrot of financial freedom and a comfortable retirement at the end of the road. Yes, we want to be paid well, but much more importantly we want to enjoy the journey.
  2. Flexible schedule – now more than ever, a flexible schedule that allows freedom to pursue other interests or attend to family matters has become as important–if not more important–than financial compensation.
  3. Clinical mosaic – practicing full-scope optometry in a setting that embraces the medical model leads to a variety of tasks that can be extremely fulfilling. The associate optometrists who I have talked to who are unhappy with their jobs spend nearly all of their time doing refractions and contact lens fittings. Whether it is a commercial setting or a private practice that doesn’t embrace the medical model, working in an environment that lacks the equipment and means necessary to practice all aspects of optometry will be less satisfying. Finding a practice with great financial compensation and a clinical mosaic can be very fulfilling professionally and should be part of your job satisfaction definition.

Before making long-term decisions like buying a practice or going into corporate optometry, it is important to define your long-term desires. If not, you might find that you’ve given everything for what you thought to be financial job satisfaction but you’ve lost autonomy, a flexible schedule, and a clinical mosaic that challenges you. Job satisfaction is a journey. When well-planned it is enjoyable, fulfilling, and rewarding.

Fair compensation in a multiple-owner optometry practice

Disagreements over money–it’s the main reason multiple-owner practices split up. In large optometry practices each owner has multiple responsibilities and brings in different amounts in the clinic, so deciding on a fair compensation model is daunting.

Many consultants give formulas that look good on paper, but they fail to factor in the emotional component. Discussing the touchy subject of fair compensation is like navigating through a minefield.

For example, what happens if everyone in the office is compensated based on production only? When one of the owners takes a three-week vacation, the burden to produce falls on the owners that are left working.

To solve the compensation dilemma in one blog post is impossible. However, here is a suggestion for fairly compensating multiple owners with additional associate ODs.

Divide the net dollars (Net dollars = all monies remaining after overhead expenses, staffing, etc. – referred to as “practice net income” in Budget Categories)

  1. Clinic Production – Start by agreeing that all owners will be compensated as a percentage of production. If your practice net is 30 percent then you may consider compensating each owner at 20 percent for the Clinic Production. Each owner would have a set “draw” from this pool of money as their salary. Any money left over in the clinic production pod is put in a money market and tagged for the respective doctor. If you wish, dividends could be paid from this or a bonus at the end of the year that zeros out this pod.
  2. Owner responsibilities – List all owner responsibilities from IT to accounting oversight. This may include the responsibility of sales rep relations or HR vice president. This list should be created outside and before the meeting to discuss how the dollars will be divided.
  3. Associate – If you pay your associates 20 percent of their production and the practice nets 30 percent, then 10 percent will be left over in associate profits. This sum total should then be divided based on ownership. If there are three equal owners, the total dollars should be split evenly three ways. If owners have different percentages of the practice, this portion would be divided respectively. The risk involved with having associate ODs is reflective of ownership percentages and should be paid accordingly.

The key to making this work is that every owner must agree to the model. If the usual means of communication don’t seem sufficient, consider hiring an optometric business mediator.  It is very important for a healthy successful optometry practice to have owners working as a team without hidden animosity. Fair compensation–or the perceived lack of it–will make or break a practice. When practices break up from disagreements over money no one wins, especially the patients.

Owner or Investor? Making optometry business work for you.

Dreams give us something to shoot for, and keep us going when things are difficult.

Many of you dream about owning an optometry practice. You imagine yourself putting your name on the sign and people around town talking about you as though you are some superhero. Maybe your dream is being introduced at a cocktail party to all of your spouse’s friends and they ask what you do. You feel your chest puffing out as you proudly say, “My name vision.”

To further crystallize your dream about your profession in optometry, you should ask yourself an important question:  Do I want to be an owner or investor in the practice?  There is a big difference between the two.

Makes or delegates all the decisions
Not part of day-to-day operations
Works all day Saturday should an associate be ill
Can count on having weekends off
Requests his or her family to be flexible with schedule
Goes home at the same time every night
May go a day or two of the week not seeing the children
Will most likely see the children everyday if desires
Financially benefits the greatest from the risk and sacrifice.
Financial benefit has no upward limits
Makes up the difference should the bills exceed the production.
Protected from downside limits of losing only what was invested.
Double stress of clinical responsibilities and day-to-day operation responsibilities.
Clinical stress

Don’t stop dreaming and working to realize your dreams. However, be prepared to count the cost and walk into your dreams with a strong sense of reality. If you are considering ownership, visit with owners who will give you the real-life truth about the benefits and sacrifices of ownership.

Are your patients scheduling their eye appointments online?

People naturally like to do business with companies that make their lives easier.

Unfortunately, in our world today calling and scheduling an appointment with the optometrist is not easy. The optometry office is only open Monday through Friday from 8 a.m. to 5 p.m.  Most people are busy during the day and do not have time to make a phone call, navigate a phone tree, and answer 10 minutes worth of questions about insurance and demographics.

For example, a mother who manages her family is busy during the day driving kids to school and practice. At 9 p.m., when she finally has time to sit and relax, she remembers she forgot–again–to call the optometrist for her kids’ eye appointments. She notices her friend on Facebook mentioned she just scheduled eye appointments online for all three of her kids. Which office will this mom schedule with?

Online scheduling gives patients the option to contact the office or schedule when it is convenient for them. Here are three software options with various capabilities.

  1. Limelight – This is a new feature by SolutionReach that allows patients to schedule appointments. The available times will show up when the patients say they want to schedule appointments online.  For more information contact them for a review.
  2. iMatrix – The software through iMatrix allows for patients to request appointments any time online. This does not sync with your practice management software, but it does allow for individuals to communicate in ways that best fits them. We have found that requests for appointments online through this method are averaging one per day.
  3. 4patientcare – At this point, it appears that 4patientcare has the upper hand on the most advanced software for patient online scheduling. We’ve used 4patientcare through Ocuhub at our office and found the software to be very nice.

Online scheduling is an upcoming trend, and successful offices are using it to meet patients where they are and be easy to do business with.

Should an optometrist fire a staff member for texting?

Many of my colleagues email me with questions regarding our policy for texting. I don’t think there’s one rule that all offices should follow because each office is unique. However, I believe all offices should have clear guidelines on what is and is not acceptable when it comes to text messaging, social media, and internet/smartphone use.

Here are the written expectations for our staff members:

During all open business hours the internet and computers are for office use only (i.e.- filing insurance, address inquiries, OM, etc.). Staff members are not to use the office computers for personal email, instant messaging, shopping, games, etc. The only exception is the computer internet downstairs is available for personal use during break. Also, all staff should refrain from using personal cell phones (i.e.- phone calls, text messaging, internet use, etc.) during business hours. The only exception would be during each member’s one morning break and one afternoon break. Appropriate places to use personal cell phones are the coffee nook, the basement, the lab (out of view of patients), or outside. Cell phones must be turned to silent (vibrate is not silent) or be downstairs where any noise coming from the phone is out of hearing distance from patients. This policy is designed to increase office accessibility for our patients as well as increase office efficiency. Please advise your friends and family of this policy. Any breach of this policy will result in referral for consideration of dismissal as noted in the dismissal policy.
It is always easier to address a problem before the problem exists. A clear policy regarding the office stance on text messaging will give you the foundation to correct staff members the next time you find they are not following your directives. Be proactive and communicate your policy often.