Optometric Management Tip # 217   -   Wednesday, March 15, 2006
Delegation: The Key to Higher Income

If I had to pick one single management strategy that is the key to success in eye care practice, it would likely be delegation to staff. Unfortunately, there are many eye doctors who still donít delegate clinical activities for a variety of well intended reasons. In consulting with clients, I find that if you donít embrace delegation early in your career, itís easy to let the technique pass you by. Doing your clinical work yourself seems innocent enough at first glance, but it invisibly causes you to miss out on your maximum earning potential and stifles practice growth. Itís never too late to change to a better procedure.

Chicken or the egg?

There are probably a dozen common reasons why doctors choose to do most or all of their clinical work without assistance from an ophthalmic technician. Iíve heard them all, but the reasons are usually variations on a common theme that delegation will really not help much in ďmy particular situation.Ē Often, the thinking is ďIíll begin to delegate more when my practice becomes busy enough that itís needed.Ē The problem is, those practices often never become ďbusy enoughĒ because a small-thinking, do-it-all-myself, mentality develops. Furthermore, the practice is perceived by the public as a small player in the local eye care market and never develops strong reasons for word-of-mouth referral.

So which comes first? Does a practice delegate because it became big, or does a practice get big because it delegates? Itís often the latter.

Why delegate?

Delegation is always an effective technique, even if a practice is not very busy. It always makes sense for the doctor to conserve time by not performing routine tasks in order to perform more important tasks. Those more important tasks might include examining and treating more patients, if they exist, or they might be practice management related.

The smart approach in any business organization is to have a variety of employees at various levels of training, responsibility and salary. True economy is reached when each person works at his or her highest level. The CEO of a large corporation does not deliver the interoffice mail. Of course there are practical limits to this theory in a small eye care office, especially if it is just starting up, but the smart practice owner will push for the same principle. Delegate before it seems absolutely necessary.

Develop a plan

We can look at delegation on a scale. Some practices are on the highly-delegated end and some are on the non-delegated end, with many practices somewhere in the middle. No matter where you are on the scale, you can take a step up and find ways to increase delegation.

If you are fairly new to delegation, here are some steps to consider as you design a plan. Train your staff

After you have a plan, but before you get too far, hold a staff meeting to discuss and explore the idea of delegation. Some staff members resist change, but they do better if they have a hand in the development of a new idea. Start by discussing the high cost of doing business and the deep discounts required by vision plans. Explain the need to see more patients more efficiently. Increased responsibility is also a way for staff to grow in their career Ė which is often a complaint among eye care employees. If staff members have a worry, it may be that they will have to work harder. You may want to pledge your support as they try the new procedure and include hiring additional staff if the change is successful.

Next, show your staff how to do the tests you have selected for delegation. Have them practice on co-workers and then just jump in on real patients. Let them know that youíll be patient as they perfect the technique.

What to delegate

If you are just starting to delegate clinical procedures, consider these: Procedures for mid-level delegation practices: More advanced delegators can consider training staff in these procedures: Consolidating patients and practicing efficiently provides time for the doctor to lead the practice, creates a busy practice image for patients and develops good work habits for staff. If you have somehow let the technique of delegating pass you by so far, now is the time to change.


Best wishes for continued success,

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