Here’s a not-too-controversial observation: everyone would like to earn more income. As practice owners, your income is a function of the revenues your businesses bring in and the expenses you have to pay.
So, if you want to increase your income, should you be going over your expenses with a fine-toothed comb? Or should you focus on growing your patient base and revenues?
In the short run, it’s obviously easier to cut costs from the practice. But what costs can you cut? Let’s consider the 7 Key Expense Areas and how easily they can be lowered.
Grow Your Revenue
Having said that cutting cost is easy but perhaps not as fruitful as people think, let’s discuss why focusing your energy on growing your revenues is the better way to go. Consider the impact of reducing one expense area by 5% versus growing your revenues by 5%. And when we talk about reducing expenses, Cost of Goods is the most obvious, as it’s the largest and easiest to affect.
Consider a $1M spending 27% of its revenues on materials. Reduce that by 5% and congratulations! You’ve increased profits by 1.35%, or $13,500 for the year. To do that, you may have simply clamped down on excess buying in the optical, but it probably also involved a series of contentious meetings with your vendors to fight for better deals.
Now, what if you had put your energy into growing your revenues 5%? 5% growth on $1M in revenue is an additional $50,000 in revenue. And what are the costs tied to that revenue growth? Did rents go up? Your software licenses? Utilities? Equipment costs? You may not even need to increase the patient care hours in your practice.
Probably only cost of goods increased, which we’ve said is about 27% of revenues. So for modest growth, you’ll see 73% of the revenue growth fall to the bottom line, before paying any ODs. That’s $36,500!
Even if you had to increase your non-OD staff to generate the growth, Cost of Goods combined with non-OD staff tend to consume 50% of a practice’s revenues, so that’s a $25,000 increase in profits, before paying an OD.
And it should be said that for practices with high cost of goods, the first solution we recommend is not to work on discounts but to review your markups and pricing strategies.
If Revenue Growth Was Easy…
So, now you’re probably thinking: that’s great, but I would have grown my revenues already if it was easy! And fair enough. Let’s consider the two ways revenues grow: more patients and more revenue per patient. Fundamentally, this is how any business grows.
This is where you should put your attention and energy. First and foremost, patients are the foundation and lifeblood of your practice. You and your staff must put effort into having systems and attitudes that are oriented towards your patients’ wants and needs.
In all my conversations with multimillion-dollar practices that have sustained double-digit growth rates for years, a focus on patient experience is the first reason they give for their success.
Other things to focus on include your recall process (keep the schedule full!), your practice brand, your internet and social media presence and your practice marketing.
For revenue per exam, the think I can’t recommend enough is that every practice needs to have a ‘standard of care’ that defines the suite of products the average patient needs for optimal eye health.
For revenue per patient, the low hanging fruit is to be sure and review your fees and markups every year. Vision plans aren’t raising their reimbursements, but you can at least capture more overages if you keep your pricing up and make up some ground with your private pay patients.
I know I’m pushing the bounds of that term, but while I think most OD practice owners really believe every contact lens patient NEEDS a pair of plain sunglasses and a backup pair of spectacles, I’m confident almost no staff really believes it. If they did, capture rates would be much higher.
Buy your staff the cheap stuff some they can ‘taste and see’ the difference. Make sure the know – in their bones – that your practice offers superior products and care.
Grow your revenues. Watch your costs. And your income will increase.
Hayley Stewart, IDOC Financial Services Manager
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Promoting a new associate OD through your social media channels is an effective strategy in... Read more
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As you set your 2022 revenue goals, don’t forget to celebrate the wins from last... Read more
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I had a consult with an Office Manager who... Read more
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FFCRA... Read more
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Many optometric practices are experiencing a surge in eyewear purchases due to pent-up demand and the ability to... Read more
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Multiple Pairs:... Read more
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Continuing Education is so important to your practice – your team can learn something new, you can expand the experience in your practice and it’s a great way to keep your team engaged. However, how do you determine payment for your employees during this time?
Let’s first look at the... Read more
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It is demonstrably true that if you have a passion for a product, your enthusiasm is actually very difficult to contain. Getting behind a product is almost inevitable if you are a satisfied customer yourself.
Are you... Read more
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First – What can you do before... Read more
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Keep the Main Thing the Main... Read more
A new year is an ideal time to establish a rational, cost-effective Buying Plan for the optical dispensary.
First, establish who is responsible to execute your buying plan. There needs to be one primary and one secondary person, to pick up at times of absence and for accountability.... Read more
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Instagram can have a real impact on growing awareness for your independently owned optometry practice in your community.
It’s primarily a visual medium where you can tell your independent brand story through images and videos, and it’s a very popular daily... Read more
Why do I have to do what you’re asking me to do?
If an employee of yours asked that, your response would likely be harsh.
What do you mean why do you have to do it? You’re an employee here. I sign your paycheck. You have to do it because I told you to do it!
In... Read more
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Whether I am advising a client or writing this blog, my primary objective is to give business owners actionable items that, if taken will positively impact them personally or improve their business in some tangible way.
The advice you receive, the articles you read, the software you... Read more
I have to admit something – I have been falling into Busy-ness Syndrome, where I feel like I am too busy with my responsibilities to do anything I perceive to be “extra”. That could be anything from an uncomfortable conversation to tending to obligations. Busy-ness Syndrome is not... Read more
This article assumes you’ve done your part in establishing value for the products and services you offer. If you fail to do this, then price inevitably becomes a factor as people will wonder if they can get what they need less expensively from another source. But let’s assume you’ve made a... Read more
How many private pay opportunities do you have each day?
With so many of your patients now covered by vision care plans, you would probably say, not many. I could ask you to look at the percentage of patients you see in each plan, I could ask you what percentage of patients are... Read more
A good marketing plan for your optometry practice should include opportunities to meet people in your community, face to face. Time spent engaging in the right kind of community involvement for the practice is a valuable investment in building your brand.
While promoting your... Read more
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If you have not already done so, embrace package pricing. It brings simplicity and potential for additional revenues.
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Facebook maintains its top spot amongst social media channels in 2019, particularly among people ages mid-thirties to early sixties in the United States. Facebook is designed to encourage people to connect with the people they know in their “real” lives – friends, classmates, neighbors, family... Read more
All practices will hit a point where there just isn’t enough time and headspace for a single owner to see all the patients, manage the team, and run the business. In order to grow, the owner has to delegate something. The first thing most owners will do is hire or promote a manager... Read more
Several years ago, I met with a financial advisor. I had been out of school a few years, and a friend suggested I speak with his father over lunch about debt management and financial planning. I thought I already had this under control, but why turn down a free lunch?
After some... Read more
Cost of Goods is the highest expense category for many – if not most – independent practices. And most owners feel like they’re spending too much or just don’t know – how does my Cost of Goods (COGS) compare to other practices?
I’ve heard practice management lecturers say that... Read more
Why am I the best option for my patients’ eyewear purchase?
Selection? Value? Convenience? Quality? Price? Expertise?
What messages am I sending in my marketing and interactions with them that makes the case that I am their best option?
There are three critical... Read more
Can you complete that sentence?
In one of my presentations titled “The Science of Selling: The Psychology Behind Why People Buy” I ask the audience this very question. This usually gets a mixed reaction of affirmative heads nods and looks of... Read more
From time to time, I’ll have a call that goes something like this: “Help! My revenues are down, and I don’t know why!”
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Sometimes, creating a policy for your practice can present more challenges than you expect. Meal Periods tends to be one of them. There are benefits and drawbacks to both style of meal period – Paid and Unpaid.
Unpaid Meal... Read more
Before you read this article, take three seconds and Google the name of your practice.
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In HR, documentation makes the world go ‘round. I talk about it in every consultation I have with our members. However, it isn’t because I like to hoard documents on my computer or pieces of paper on my desk (Although, my desk and computer might tell a different story). It... Read more
Establish guardrails. Employees should be permitted to make some of their own decisions, but there needs to be clarity on the boundaries. Micromanagement restricts employees. Boundaries empower them. A good example would be allowing your employees to use up to $200 to resolve... Read more
As an Optical Management Consultant, I often hear:
“I know what the numbers are, I need to know how to make them better.”
It is frustrating to have a vision for your practice and feel that you are alone on the journey to attain that vision. Spend some time thinking about what... Read more
My least favorite phrase to hear was “Michelle called out today”. It almost sucked the air out of the room. I had already planned out the whole day, for myself and the team. Before hearing that, I probably had a project in place, hopeful to progress in some way.... Read more
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It’s that time of year – practices are evaluating what went right – and wrong – in 2018 and setting goals for 2019. And with goals comes the age-old question: what should you do about a bonus plan next year?
First the theory of bonuses: people respond to incentives, and if you... Read more
Partnerships can be powerful drivers of growth, combining the energy, expertise and capital of multiple doctor owners to create a bigger practice than the sum of its owners individual abilities and contributions.
For all the benefits, partnerships come with their own sets of... Read more
“I have never had to hire like this before!”
“I’m embarrassed to say, my longest-term employee has only been with me 9 months.”
“I never used to have this... Read more
They closed the gym in my office building for renovations and it won’t reopen until January. That has no relevance here except for me to tell you that it has me really annoyed. I had a plan! I was going to be proactive! I was going to start my New Years Resolutions early! I was going to... Read more
Change is scary, risky and very necessary. Changing anything from small policies to major remodels can be very tense. But it is worth some degree of discomfort to give a jolt of energy to a business that may need just that. Take some time to... Read more
How do you create efficiencies in a high-cost, low-margin retail environment? That was the question I was going to answer.
First, I think you have to remind yourself why you are in a high-cost, low-margin retail environment. The answer, because Susan blabbered at me until I brought... Read more
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An independently owned optometry practice in the United States is a small business, and most marketing experts agree that your marketing budget as a small business should be anywhere from 1% to as much as 10% of your gross revenue, depending on where the practice is located and how much local... Read more
Doctor, I see floaters in my vision. I think I have a retinal detachment!
I don’t need an exam because I did a screening online.
I put a moist teabag on my eye so it would heal faster.
I know I can’t have glaucoma because I smoke pot every... Read more
Many practice owners will struggle for to grow their revenues and profits – and therefore their incomes – from a cold start. Others may buy a healthy, existing practice or see fast growth. Whatever the case, achieving even a modicum of success can bring its own set of questions and... Read more
If you’ve ever sweated making payroll or wondered how you could possibly scrounge up enough cash to pay your distributor bill on time or just found it hard to pay yourself, you know the... Read more
The new reality is that many of our patients are shopping online for everything before they make a purchase. A second reality that you may not be aware of is that for some people online ordering is not as easy as the advocates for this model would have you... Read more
A handbook could be the most important document you create for your business. Here are the top 3 reasons why:
A handbook is a collection of the policies of your practice. You use this... Read more
I can’t afford to hire is a common refrain in consulting with the independent optometrist. And, it’s true! If you don’t have any expectation that your employees will produce for you, and by extension, pay their own salaries. It’s all in how you frame your fear, and structure pay incentives and... Read more
Warby Parker, big box, shopping malls, oh my! While some private practice ODs respond to local commercial competitors with (typically irrational) fears of a mass exodus of patients leaving their practice for the cheap prices and convenience of a low-cost retailer, other respond with a... Read more
If you own or manage an optometric practice, you’ve probably observed that online reviews have become ubiquitous in American consumer marketing. An independent optometric practice is now likely to manage its reputation across several online profiles, including the Google listing for the... Read more
Good marketing for an independently owned optometric practice isn’t one size fits all, especially now when there are multiple generations with unique mindsets, characteristics, values and eye care needs in the United States.
Let’s say that as an independent Optometrist, you’ve decided to add new eyewear products into the mix at your practice, and now you’d like to market these products to existing and prospective patients.
I’d like to share an incredible customer service experience I had recently.
I was dissatisfied with the protein drink I had been using, since it had a slightly chalky taste and a higher sugar content than I wanted. I spoke with a friend of mine who suggested that I try a new protein... Read more
During his TedxTalk, Scott Hess recalled his first job out of college and a reaction from his boss. He said, “I was told that my performance was strong but that my appearance was a problem. I was upset… I thought I looked awesome. I couldn’t understand why this older boss of mine was making a... Read more
The Inevitable Plateau - “a state of little or no change following a period of activity or progress”
I spoke with an OD yesterday who was struggling to make a shift in the way they dispense contact lenses in their practice. The... Read more
I once suggested to a doctor struggling with employee motivation that he give his staff more positive feedback about the things they were doing well. Not his exact words, but his response was along the lines of, “I’m paying them to do a job, why should I have to stroke their... Read more
Picking up a new pair of glasses is exciting for the patient, the anticipation of new, clear lenses and updated beautiful frames. Celebrate with them, make a special event out of it. Prepare... Read more
A practice owner with a cash crunch recently pushed back on the advice I was giving – to defer some compensation for a quarterly distribution – with this statement: “I thought I was supposed to pay myself first!”
When I started working as a department manager in a large retail company, I joined a high traffic location in a mall and it was the highest volume store in the district. Despite that, I walked into a manager’s nightmare. The departments I was responsible for were experiencing double... Read more
Numbers don’t lie. A fact I am reminded of every time I step on the scale. Those ten little digits twixt naught and nine are our friends. And, like any good friend, we may not always like what they say, but they always tell us the truth.
I haven’t always been... Read more
I was named in a lawsuit once. Fortunately, I was the doctor who found the problem – not the one who misdiagnosed it. Nothing really came of this on my end, but I still recall the moments of terror that gripped my body every time a letter showed up from the legal firm handling the case.... Read more
Starting a solo optometry practice can be a daunting task, especially considering most optometrists do not graduate optometry school with a strong grasp of the business aspects of running a private practice. There are many things you need to do prior to your grand opening, but the work doesn’t... Read more
Office Managers are responsible for setting the expectations for all office employees. The optical staff is a unique situation because the patient experience is easily measured. Good communication and clear goals will go a long way to improve patient satisfaction in this very... Read more
Google and social media have changed the ways we look for information, discover area service providers and research options for health care, and as a result, many Optometrists who own a practice now question which tactics are the most effective to increase brand awareness, number of... Read more
The Science of Selling
Have you ever made what you considered an iron clad case for why a patient should purchase a certain product or service from you, only to have them walk out without ever making the purchase? As clinical professionals, we can be very logical in our approach with... Read more
Your optometry practice is incredibly valuable to you. “Well, Nathan” – you may say – “of course it is!” But have you ever thought of why it’s valuable?
You spend most days pouring your blood sweat and tears into it: hours and hours of patient care, planning,... Read more
Introduction: A simple framework for reenergizing your optical brand
Goal: To provide a structure to improve the optical dispensary and... Read more
The internet isn’t usually a popular topic in conversations I have with owners and staff members of optometric practices. Dealing with reviews and competition from web-based retailers along with the challenge of creating and maintaining a website and good social media marketing may have many... Read more
Optometrists in private practice sometimes fail to offer a clear reason why someone should choose them for their vision care over competitors - on their websites or in other marketing collateral – sometimes when you try to market to everyone, you fail to capture... Read more
When working with small business owners to create marketing plans and strategies, I run across the following scenario far too often: “Hey, I’m not sure how to log in to my Google listing. My office manager used to handle that for me, and she’s not on the team anymore... Read more
“You might as well ask me to describe the essence of music, or the color of starlight.”
Did you make any New Year Resolutions? Well, I did. I do every year, and in keeping with my obsession with goals and metrics that I have professed here repeatedly, I write them down... Read more
For starters, I’m not a licensed psychologist, I just play one as a practice management consultant. It’s been my observation that whenever human beings come together in an environment where they are required to work together and interact, inevitably some tension and conflict will arise.... Read more
Your schedule has gotten busier and you’ve hired an associate OD. While you would like to keep the associate’s schedule filled most of the time, it’s not uncommon for an associate to have some gaps in his or her schedule – at least in the beginning. This often leads to some resentment by the... Read more
Before anyone panics, I am not suggesting that most practices go out and spend $80,000 or $100,000 on a COO tomorrow, or that your manager is due a large raise for 2018. I typically only recommend that type of role for multi-location practices grossing over $2M-$3M per year: practices... Read more
Sometimes it’s not the inventory you choose to carry or the reps you choose to indulge. It’s not the pricing or the shipping or the cadence of your reorders. As we head into the tail end of the holiday season, I can’t help but think of the process of opening presents.
Everyone has... Read more
Texting is an incredibly tempting mode of communication for marketing-minded businesses competing for the attention of consumers, primarily because the open rates on a text from businesses to consumers are incredibly high (98%) compared to other forms of communication (email is around 20%,... Read more
“Ya gotta have a goal, do ya have a goal?!” – Kit De Luca, Pretty Woman
Wise woman. While it’s never too late to begin, I do recommend, even as we focus on maximizing the potential of the Holiday... Read more
“How many frames do I need?” “How many frames should I carry?” “How much stock should I have in inventory?” It doesn’t matter how you phrase it, at least 1/3 of my consultations start the same way. I’m going to make this all very, very easy for... Read more
If you are in a competitive area, you’ve already learned that marketing is a necessity to attract brand new patients to your practice. It’s easy to confuse marketing tactics – sending email, creating Facebook posts and advertising in a community magazine, for instance –... Read more
A practice owner pulled me aside at our most recent conference in Denver to start thinking of an exit plan. I always ask two questions when these discussions come up:
“How long do you see yourself continuing to own your practice?”
“How is your retirement savings coming... Read more
A consumer-centric culture with a focus on customer service is becoming increasingly important for brick & mortar businesses. While I do believe most practice owners strive to deliver on great service, it requires a team effort. I often hear owners tell me they want to be known in their... Read more
Most businesses have polices that employees are required to follow. In general, office policies are a good idea. Policies provide structure for how to conduct business and create consistency around processes and operations. But in a service-based industry, well intended but rigidly executed... Read more
With all the talk of private equity roll-ups and regional alliances, many practice owners are concerned that if they aren’t a large, multi-office, multi-doctor practice, they don’t have a future in independent optometry.
Is that... Read more
One of the interesting mysteries that I get to unravel in many practices is the mystery of tight cash flow. Sometimes it’s obvious – a small practice with low profitability, for instance. But other times it’s not.
First off, what is tight cash flow? Here’s my simple definition:... Read more
Doctor: Would you like to order your contacts today, Mrs. Smith?
Mrs. Smith: That’s OK. I’ll just take the prescription and get them online.
What happened here? You just did a thorough, high-tech eye exam... Read more
For practices looking to grow, there are basically two paths: see more patients or generate more revenue per patient. Ideally, a practice will do both. One thing I consistently hear from ODs is that it’s hard to generate high revenue from contact lens patients. Even when selling annual... Read more
Can you find 20 or 30 minutes a week to hold a staff meeting? You might be surprised at the impact that it has on your optometry practice.
Your staff is your most valuable business asset. Your investment in optometry marketing, technology, office design, etc. will fail to deliver an... Read more
The very phrase can cause irritation, anxiety and bewilderment in the minds of owners who understand that they should somehow be participating in the conversations across the various social media platforms – but which ones are the best for optometry practice... Read more
While there is more than one way to achieve success, there are a few common traits that successful independent optometry practice owners have in common.
They refuse to accept the status quo. While others remain stagnant, ignore trends, and complain about the... Read more