With the spike in patient demand following the COVID-19 Pandemic, many owners are actively recruiting associate ODs to help carry their increased demand. And any owner looking to hire an associate right now knows that the market is tight.
My feeling is we have an outright shortage of ODs. At the very least, optometrists are misallocated relative to demand; there are too many in cities and not enough in rural settings. Still, many urban practices also struggle to find associate ODs.
So it's hard to find an available experienced associate. Should you turn to students of optometry, then? They're available and looking for work, after all. On the other hand, they're unproven. $120k a year for a full-timer is a significant outlay for "potential". What's an owner to do?
How to manage associates’ production
More and more, I’m surprised at how little owner ODs give feedback and oversight to their associate doctors. These ODs are seeing YOUR patients, after all. You SHOULD care how they’re practicing.
From a metrics standpoint, I’m a firm believer in managing to collected gross revenues for your whole team (including associates), not net profit. Opticians influence cost of goods, but only owners control net income. So why focus on gross collected revenues?
Revenues in your practice result from two things: how many patients you care for, and how much care those patients consume from you. In benchmark terms: Comprehensive exams x Revenue per Comprehensive Exam = Collected Gross Revenue.
Remember that revenue is the output. The input is caring for patients’ eyes. This doesn’t mean your practice should push solutions on patients that they don’t need. It does mean that the more comprehensively you care for your patients, the more you deserve to be paid.
This also applies to associate ODs. Their production is the result of how many patients they see and how much care they provide.
Priorities for the new grad
It’s one thing to hire an associate who has learned the ropes, but what about an OD who’s fresh out of school?
I think the first priority for the new grad is to help them get their rhythm down as they build to a full schedule. Pre-pandemic, most students only saw four patients a day in clinic (not including externship or residency). So, to get up to fifteen or twenty-five patients a day is going to take some time.
The second priority is prescribing. How do they educate and persuade patients to take on the full suite of solutions – both products and services – that will most fully preserve and enhance the patients’ vision?
Finally, be sure that your new-grad associate is coding fully and appropriately for the care they provide. New grads often worry about over-coding. Reassure your entire team – doctors and non-OD staff, that you deserve to get paid for the care you provide.
The process for everyone
Here’s what I would do with any and all doctors in your practice, including partners. Have a monthly clinicians’ lunch, preferably off-site. For each OD, bring:
Compare everyone’s results. The goal should be that each doctor’s revenue per comprehensive exam is the same, assuming everyone sees a similar pool of patients. Remember, revenue per exam is the output for the standard of care, so what we’re really saying is:
“We want to have a consistent standard of care across all the ODs in this practice. It shouldn’t matter which doctor a patient sees; the results should be roughly the same.”
There’s a real cost for an owner when an associate averages $325 per comprehensive exam to the owner’s $540 per exam. The owner WANTS to hand patients off to the associate, but she would be giving up revenue potential for every patient she doesn’t see.
And that’s where the charts come in. Do a mini “grand rounds” on each doctor's charts. Ask questions and give feedback. And owners, this is key: take questions from your fellow doctor(s) and accept feedback. Keep it collegial: this is more about collaboration than correction. The goal, again, is to have a consistent standard of care, measured by revenue per exam.
It’s lonely in the lane
One other advantage of the monthly clinicians’ huddle is that you get the chance to talk shop, learn, and grow clinically and professionally. And trust me: taking time away from patient care to work on the practice, done consistently, WILL pay you back in spades.
Bringing on additional ODs is a great way to grow your practice and get more time for yourself. Use metrics and meetings to help them grow professionally and take away the question that gnaws at many owners: “what exactly IS my associate doing in that lane with MY patients?” Do this and adding doctors will lead to higher revenues and profits, more free time, and less stress for YOU.
Hayley Stewart, IDOC Financial Services Manager
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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.
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I’d like to share an incredible customer service experience I had recently.
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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”
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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