Optometric Management Tip # 453   -   Wednesday, October 20, 2010
Delegation: The Usual Excuses

I'd like to focus the next two tip articles on clinical delegation; or the lack thereof.  Delegation is a major key to success in practice, yet most optometrists think it does not apply to them.  They often think that delegation is something they will do when they become more successful.  They don't get that delegation must occur first in order to become successful.

Let's look at the usual excuses optometrists cite for why they don't delegate more.  Are you guilty of believing any of these myths?

I'm not busy enough to justify the extra staff member I would need.
This is the number one reason I hear for not delegating very much and I don't agree with it at all.  Look at the big picture.  If you think of the practice as a separate entity that must pay a salary to the doctor/owner, then doctor time is the biggest expense there is.  If you can save doctor time or maximize its purpose, you are saving money.  Even if you do not have enough patient demand to fill the appointment schedule, you would be better off seeing all the patients in fewer days with the help of a technician.  Why?  Because you would then create open days during the week that you can use to work on the practice.  And if your schedule is not full enough, that is exactly what you need the most.  Call on other physicians and introduce yourself.  Join a community organization.  Develop marketing programs.  Improve your practice website.  Read a book on business development.  Start a Facebook page for your practice.  There are countless things you can do to promote your practice, so don't just sit in your office and slowly see a few patients.

My patients would not like having an assistant do tasks that I typically do.
Sorry, but I don't buy it.  If this is true it is because the doctor creates the perception that his staff members are inferior.  And that perception can be reversed quickly if the doctor simply displays confidence and praise for the staff.  Patients are very accustomed to technicians and paraprofessionals delivering health care.  In fact, a practice that operates that way is more impressive than one where the doctor does everything.

I can perform the tasks better than any technician.
The clinical tasks that I recommend delegating are simply forms of data collection.  Anyone can be trained to do it perfectly and in many cases an automated instrument is involved which simplifies the procedure and confirms the accuracy of the result.  If patient flow is limited to just one person, it is impossible to see the number of patients necessary to generate a strong profit.  In this age of managed care and discount vision plans, it is imperative that practices become more efficient.  Train your technicians to perform tests and record the outcome the same way you would do it.  Don't condemn a new approach until you have tried it.

I do not have the office space needed.
There are generally ways to delegate more even with limited space, but if that is truly an obstacle to delegation, then you should begin to look for new office space.  A small office will definitely restrict the growth of your practice and limit your income.  You must have multiple exam rooms per working doctor and pretest rooms for technicians.  As you explore the possibility of moving to a new location, see if there is a way to take on vacant space adjacent to your present office or use your existing rooms differently.  Maybe the contact lens dispensing room can become a pretest room or perhaps you can use a storage room for patient care and move all the stuff to a remote storage facility.

I can't find enough good employees. 
With unemployment at an all-time high, it has never been easier to find good employees.  You must advertise the position in the local paper as well as online resources.  Help-wanted ads can be expensive, but you should run the ad until the position is filled.  Being understaffed is even more expensive.  If you are not seeing high enough quality in the applicants, you may have to pay more and be willing to accept people without eye care experience.  It is time consuming to train someone with no experience, but it is far more important to find the right person.  Look for an outgoing personality, plenty of smiles, good eye contact, a passion for customer service, intelligence, a knack for computers, and strong communication skills. 

Next week I will cover how to move forward with increased delegation.

Best wishes for continued success,

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