Optometric Management Tip # 114   -   Wednesday, March 24, 2004
Should You Have an Office Manager?

A reader suggested that I write a tip on this subject, and I agree that it's a good topic. Of course, I realize that many readers of this e-newsletter are office managers - or practice owners who already have a manager. That's OK, because reviewing the factors involved with hiring a manger is valuable for these readers also.

Many medium sized practices - grossing in the $300,000 to $500,000 range - develop from start-up practices that simply have a doctor/boss with one or two staff members. The practice grows and evolves, but the organizational chart is still the same: all job title boxes report directly to the owner/optometrist. Many of these practices stay this way for years, or even forever. After all, it seems to be working.

The main reason you need a manager

Well, my short answer to the question in the title above is, yes, virtually all optometric practices should have an office manager - also called practice administrator, clinic director, or other combinations. I'll describe some of the benefits an office manager can bring to a practice, but before we get to that, I'd like to stress that I always believe in doing pro-active things in a practice before they seem like they are "truly needed". I believe in making the practice appear to be the way you want it to become. There are many ways to do this, but appointing an office manager is one very good way.

Having an office manager makes the practice feel like it is bigger and more successful. The doctor and the staff members begin to think differently about the practice - and even patients notice it and respond positively. The practice culture changes - for the better. It is positioned for growth, even before the growth is there. It has a higher status level. It is an organization. It is more professional - less "Mom and Pop shop" oriented.

Benefits and duties

Here are some of the ways a manager can help a practice:
  1. The business aspects of a practice need constant attention and most doctors simply don't have the time to work on it enough.
  2. A manager acts as a staff supervisor and work coordinator while the doctor does the clinical work that drives the practice.
  3. Acts as a buffer between the doctor and patient in financial matters. It's better for the practice's reputation if financial matters are not seen as the doctor's main concern.
  4. Handles public relations and practice marketing.
  5. Prepares staff schedules.
  6. Orders and manages staff uniforms.
  7. Interviewing - hiring - disciplining - firing of staff members.
  8. Supervises (or performs) billing, insurance claims and manages accounts receivable.
  9. Manages recall system and appointment verification.
  10. Maintains office inventories and supplies.
  11. Conducts staff training programs.
  12. Handles basic bookkeeping tasks and assist with accounts payable.
  13. Manages employee work hours and submits practice payroll reports.
  14. Fills in as needed to cover temporary staff shortages.
  15. Many more tasks too numerous to mention.
Responsibility and authority

While you'll expect the new manager to take responsibility for the tasks above, the owner of the practice must first give him or her clear authority to do so. This means telling all staff members that the manager is their boss, and telling them the rules of the chain of command in the office. For managers to be effective and to have their decisions respected by all, they need to have the owner's support. You can't go half way. If the other staff members aren't clear on the authority, and think they don't have to respond to the new manager, or if they think only the doctor is the real boss, -- the manager can't succeed. Train the manager in private and over time to share your management philosophy, and to make the right decisions.

Hire from within - or seek new talent?

There isn't a right or wrong answer to this. It depends on the individuals and the practice, and both methods have some benefit. Hiring from within brings someone into management who knows the systems and methods of the practice, and it rewards good work with a promotion (and that is not that easy to do in most practices). On the other hand, it can be difficult to make the transition from worker to boss, and it may be impossible to discipline a friend. Loyalties may be stronger to the fellow employee then they are to the practice and the owner. And, hiring from within can build resentment and morale problems within the staff who weren't chosen, and they may refuse to support or cooperate with the new manager. Go into this decision with your eyes wide open and do your best to evaluate your situation and the leadership characteristics of your current staff.

Change is always difficult for employees, and bringing in a new boss ranks up there with the biggest concerns an employee can have. Approach this by explaining the need for the change and the benefits of it and by getting staff input in the early stages. Understand the fears that easily exist when faced with a change in administration, and alleviate them in an open and honest way.

An office manager can be an employee who has other regular duties - often a senior receptionist. This person may still function as a receptionist, but carries the job title and authority of a manager. Be aware that a true manager needs time to do the job properly. In my view the eventual goal is to make the job position a full time dedicated manager.

If you're a doctor who spends time on routine administrative duties, hiring a manager will free you up so you can concentrate on the vision of the practice. The practice will grow because of it. The salary of the office manager is not a drain on practice finances, but rather is an investment that stimulates growth.


Best wishes for continued success,

Neil B. Gailmard, OD, MBA, FAAO
Chief Optometric Editor, Optometric Management