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. Fortunately, relative to other medical specialties, optometrists have a low likelihood of being sued. Nonetheless, it’s good to know why doctors get sued and what you can do to prevent it.
A Medscape Malpractice report published in 2015 found the top 3 reasons for a lawsuit against a medical professional was failure to diagnose, patient suffered an abnormal injury, and failure to treat. Other reasons, albeit with far fewer incidence, were poor documentation of patient instruction and education, errors in medical administration, failure to follow safety procedures and improperly obtaining / lack of informed consent. Interestingly, this report also found that women were less likely to be sued than men (64% of respondents reporting being sued were men as opposed to 49% women) and women were far less likely to be the only named defendant in a suit. Only 20% of lawsuits against physicians who responded to this survey went to trial. 41% of these cases were dismissed, and about a third reached a settlement before trial. The majority of malpractice suits against doctors are won by the doctor, with only 3% of verdicts in the plaintiff’s favor.
How much professional liability insurance should I carry?
This would be a matter to take up with a local insurance agent. For context, the survey mentioned above found that over half the cases resulted in no reward, 20% were under $100,000, and 29% were above this amount. Only 5% of verdicts or settlements exceeded a million dollars. A major study on claim payment by specialty found that the largest average settlements were against pediatricians, neurosurgeons, pathologists and ob/gyns with an average claim payment between $300,000 and $400,000.
The risk of a lawsuit often leads to over-testing or over-treatment not wanting to miss anything or be held accountable for not covering all your bases. Doctors perform extra tests or push for extra procedures or office visits because they think they will be at greater risk of being sued without doing this. This has come to be known as practicing defensive medicine, and it’s undoubtedly driven up health care costs in the U.S. health care system. Also noteworthy is that studies don’t support the notion that this extra precaution reduces the risk of a lawsuit.
Will an apology help?
Interestingly, 81% of doctors responded “no” to this question. Many physicians who were sued claimed they did not say I’m sorry because it was not their fault, that it would not have made a difference, or that they were among others named and, in some cases, never even met the plaintiff. Is this a wise approach? Read on.
Lawsuits aren’t random
I once heard a malpractice attorney claim that she had never heard a client say, “I just love my doctor, but I have to sue him/her”. And while doctors in the Medscape study may have overwhelmingly agreed that an apology would not have mattered, what might help doctors avoid getting sued is having better relationships with their patients. Be more empathetic and become a better communicator. Lawsuits aren’t random. One study found that one of the most significant predictors of being sued was being sued in the past. Another study found that doctors sued most often were complained about by patients twice as much as those doctors who were not. Common reasons for complaints were the doctor rushed them, did not explain reasons for tests or ignored them. Is it possible that patients are more likely to sue if, well… they just don’t like you?
Decades old studies have shown that that physicians sued less often are those more likely to spend time educating patients about their care, more likely to use humor when interacting with patients and more likely to try to get their patients to talk and express their opinions. While physicians and patients often disagree on the motives behind a lawsuit, both groups agree that improved communication could reduce future malpractice litigation.
Sometimes doctors screw up!
“Sometimes we simply DID screw up. It is usually failure to diagnose. And if we did, we don’t want to make an admission,” says attorney Craig Steinberg, O.D., J.D. ”If you screw up, or even if it’s just a bad result and you are concerned you might get sued, refer that patient to the best care you can get them to.” Here’s why…
According to Mr. Steinberg, the reason so many cases are dismissed is because it’s often hard to prove one of two key elements of the claim, causation and damages. We always think about standard of care, but the plaintiff also has to show that the outcome would have been different. Even in the case of an RD that was initially missed, if you catch it on a follow-up when the patient is now seeing a veil over their vision, then what are the damages if the OMD is able to treat the RD with a good result? The only “damage” is the delay in treatment. It is very hard to prove that the delay “caused” any damage that would not have been there anyway.
Below is a list summarizing the advice doctors who have been sued offered to other doctors in the Medscape study:
As research for launching a new service called IDOC Specialty Services, I interviewed several industry experts of various specialties. At the end of each call, I asked everyone the same question: “What prevents more ODs from succeeding with a specialty?”
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Practice owners feel the squeeze in multiple... Read more
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My feeling is we have an outright shortage of... 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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During a phone call with my favorite sister (now, let's not share this with anyone else), she shared the following sentiment with me, "I was just as excited for my kids to go back to school this year, until I realized that I have one kid staying home and doing virtual learning and the... Read more
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The review includes many details which makes it clear to anyone reading that they visited the practice, had an exam, and worked with an optician.... Read more
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This isn’t what I expected to hear on the tail end of the most prolonged economic catastrophe of our lifetime. But many practices, after leaning out all their expenses during the... Read more
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“Should I sell my practice now while prices are at all-time highs? How long does the private equity phenomenon last?”
Practice owners often focus on market trends in the pricing of practices when deciding when and whether to sell. Let me... Read more
Careful frame and lens purchasing habits are needed in an unpredictable time.
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
If your optometry practice is currently closed due to COVID-19, there are certain updates you should make on the listing to communicate to your community the temporary change in your practice operations. Google has prioritized the “
You may have closed or partially closed your practice temporarily. There is tremendous uncertainty around when we can resume anything that resembles a normal business or personal life. You may be in the office alone or with only one or two staff members. There are always ways to keep a... Read more
If you’ve temporarily closed or truncated the hours of operation at your optometry practice after the Centers for Disease Control and Prevention recommended that people delay routine eye care exams, please update your community by communicating the short-term changes through these... 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
Does your staff truly believe in the value you provide?
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
Picture it: You have just gotten back to your practice after The Connection, energized from the lectures and workshops, conversations with strategic partners and connecting with your peers. How do you apply your new perspective to your practice?
First – What can you do before... Read more
It all started when I was about 8, I was going to be a lawyer. This was my dream even though I was surrounded by what others may consider nothing. To me, it was motivation. I wanted more than to become a product of my environment. I wanted more than the promise of becoming another statistic. I... Read more
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Keep the Main Thing the Main... Read more
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I have a plant named Albert that I love dearly. I do not consider myself a “plant person,” but I inherited him from a co-worker 3 years ago because he was on the brink of death and they didn’t have the desire to care for him. I did a bunch of research to uncover Albert’s species... Read more
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Sunday is our day! Every Sunday we follow the same plan. We have been taking the same steps for so long that MY husband can do it on his own. I’m so proud!! We wake up bright and early, go downstairs into the kitchen and take a full inventory of the pantry, refrigerator and freezer and... Read more
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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Social media, online reviews and a well-performing website are all great tools in a good marketing plan for an optometrist in private practice, but the most successful practices understand that delivering remarkable service to their patients is the cornerstone of their marketing... Read more
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With Private Equity groups scooping up practices left and right (it seems that way at least), it stands to reason that most owners have at least thought about whether they would say yes to the right offer. I tell most owners that they should own their practices for as long as... 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.
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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
The last time unemployment was lower than it is now was 50 years ago, when there was only .1% less! Job growth continues month over month, mostly in the healthcare and service industry, and large companies are pulling out all the stops to hire. Let’s be honest, if you are hiring... Read more
If you have not already done so, embrace package pricing. It brings simplicity and potential for additional revenues.
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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 uncertainty.
My... 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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Smaller practices that have fewer employees have always cross-trained out of necessity. These practices may have only one person to perform the duties of receptionist, technician, biller and optician. As practices grow, they tend to look for people to “take over certain functions” and begin to... Read more
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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As business people, we are constantly inundated with advertising and offers for programs, software, products and advice that promise to improve our bottom line. Some will catch our attention; some we simply click past. Some we purchase and own; some we have access to through subscriptions we... Read more
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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.”
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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. Adjusting and... 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?
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“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
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How do you create efficiencies in a high-cost, low-margin retail environment? That was the question I was going to answer.
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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:
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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
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... 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 digit... 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
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
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 anyone.
What... 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 and check in... 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
“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 you. Consider it my holiday gift! To determine... 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... 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