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…
- 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.
- 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.
- 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.
One of the biggest pieces of the pie in managing expenses of an optometry business is staffing. The accepted percentage of overall staffing costs is between 20-25% of gross collected dollars. When you have regular staff turnover this percentage is going to increase accordingly. Most successful practices have learned to find great staff and keep them for years. Too many times you watch new staff come on board and ultimately fail. The presumed reason that they fail is a lack of drive, laziness, costly mistakes, not teachable, and they have no discipline. This mindset is dangerous for the CEO. It is like your friend who has been divorced three times and will talk your ear off about the problems with the women he has been married to. What is ironic is that he is the common denominator. As CEO of an optometry business you must reflect upon your practice culture. Are you the problem that staff continue to fail.
Here are a couple of thoughts to set your new hire up for success.
- Training – Do you have the proper training in place to give your new hire the tools to succeed? Every member of your team should have a written job description and job expectations outline. Whether you are an office of 50 or an office of 3 employees, this is highly important to the success of your staff.
- Assumptions – Do not make any assumptions that your new hire knows from “experience” how to properly adjust frames. There are many opticians that pick up bad habits along the way. Use the training time as a period to teach them “how we do it at Dr. Smith’s” It is always much easier to start off like this then have to correct them after multiple complaints from patients that their frames never fit right. Also, don’t assume that all new hires know how to answer the phone correctly. You should have scripts made out for how to answer the phone and what to say to multiple common questions.
- Own their success – One of my favorite books is the QBQ – Question Behind the Question, which discusses personal accountability. Until you are willing to look in the mirror and ask yourself how you can become a better leader, you are at the mercy of hiring someone who understands how to be successful. When you make the investment to involve yourself in raising up your new hire, the product of your efforts will be a staff member that has complete buy-in to you and your business.
I would greatly appreciate any comments regarding successful principles you use to turn a new hire into a long-term employee. Also, please leave topics of interest for future posts in the comment section. If you are interested in sample copies of the job description/job expectations we use at our office please leave a comment.
Q: What are the advantages of being in partnership with one or more optometrists?
- Shared responsibilities – There are numerous responsibilities of running a small optometry business, from accounting, to staff management, to implementing meaningful use. When you have a partner you can share the workload and thrive in your areas of strength. In contrast, a solo practitioner must be a “jack of all trades” or at least have some minimal understanding of the responsibility in question to properly delegate it and monitor the delegation. Staff management can also benefit from numerous coaches. Most likely employees will not all respond to your coaching and another personality may bring out the best in an employee where you were unable to get results. These are just a couple of reasons that partnerships are a favorable way to practice.
- Higher potential income – It has been documented in AOA literature and the MBA statistics that median incomes are greater in partnerships of 2-5 partners than they are of the solo optometrist. This is usually accomplished due to the sharing of overhead costs, buying power, and associated staffing costs.
- Team – There is nothing more powerful than a team that works together. There is a synergistic effect when two oxen pull a cart of increasing weight. Two oxen can pull much more weight than the combined total that each oxen can pull individually. This effect is possible when a team of doctors are working together with common goals, a great business model, and a common vision.
- Clinical accountability – This has been one of my personal favorites as daily I will bounce cases off of one of my colleagues at the office. One of the disadvantages of solo practice is that there is not another OD down the hall to come take a look at a pathological cornea or suspected retinal tear and given an opinion. Also, clinical accountability occurs when doctors tend to get lazy and keep fitting the same contact lens they have fit for the past 10 years. For doctors who have been in practice 15+ years and the status quo is comfortable, a partnership will challenge you to evaluate your clinical decisions against the latest in optometric education with the addition of a new graduate.
Thank you to the private practice club at The Ohio State University for the many questions that you had for myself and Ryan Parker, O.D. This question was one question, of two hours worth of questions, that the students asked.
I’ve been working on an article for AOA News regarding location analysis. Below is an excerpt from the article with some very practical tips for making your dream a reality. The complete article will be published in the May or June issue of the AOA News.
Key components of location analysis.
- Decide where to practice (family considerations, school, church, job opportunities for spouse, small town, medical emphasis, VT emphasis, etc.)
- After narrowing down the cities/towns to 3-5 then evaluate the number of surrounding optometrists (OD) for your location
- The analysis should factor in age of practicing ODs and any niche they may have. This will give you a clearer understanding of your competition. If 5 optometrists are in the area and they are all over age 60 and you are 28-32, then you just found yourself a great practice opportunity.
- I would recommend by starting with Google maps, searching “optometrists in City, State,” and then draw a 3 mile, 5 mile, and 10 mile radius circle around your location. Use a “screen capture” or clipping feature for the map. Evernote is a great tool for this. Also, there is a great free program called Skitch that works great for drawing on an image capture from your internet browser of the map results of what city you Googled.
- Research demographics and population statistics
- The demographic information on the Chamber of Commerce website should indicate the population base within those various areas. The average household income and average age of the area are also key characteristics to match your interests and the best location. Then note how many optometrists are practicing within your circles and compare population to number of optometrists. A single full-time OD needs approximately 5000-7000 people to support their practice. (reference Business Aspects of Optometry)
- The Chamber website should also help with: average household income, schools nearby (age range of nearby schools, average age of children per household), residential or commercial area (patients like convenience), surrounding insurance plans utilized by companies in area (email/visit HR departments), age of practicing ODs around area (30 y.o. optometrist attracts patients +/- 10 years of age)
I believe that accomplishments are made through failures. As a D1 golfer at Wichita State, I learned many times through failure. I learned that taking the time to prepare for a 3 ft putt is very important as it can be the difference between first place and 15th place. I learned that taking the risk to hit at the pin over a water hazard can lead to a two stroke penalty if not hit perfectly. Therefore, the safe play is to hit to the middle of the green and take the water out of play. I learned that golf is 90% mental and 10% skill, as many, many people have the skill but few have the mental fortitude to make a 10ft putt on the final hole to close the win. I’ve made my fair share of putts and missed my fair share. Actually, come to think about it, I would be golfing professionally and not be an eye doctor if I had made of those putts. All things work together for good. I’m glad I’m where I’m at, the lifestyle of an eye doctor is much more conducive for family life.
As in golf, the profession of optometry is much the same. I learned that staff are real people and that they are not just a part in the machine of optometry business. I learned that long time loyalty of a patient is more important then a $15 co-pay that was never communicated to them but ends up as a bill in their mailbox. And I am learning that all good things come with hard work and time. I continue to work through case reports in preparation for becoming a fellow of the academy of optometry, and I am reminded that nothing is easy and failure is the road to accomplishment. Failure is also in the eye of the beholder. When I receive a case report that I have spent hours and hours on and it is critiqued with marks on every page, I am tempted to think it is a failure. Yet, the changes are made and I mentally come to the realization that failure is part of the process of accomplishing.
If you sit in the valley of failure and discouragement has you paralyzed. Remember, you are on the road to accomplishing your goal.