Optometric Management Tip # 511   -   Wednesday, December 07, 2011
Attention Mid-Career Docs: An Associate Can Boost Your Practice

Optometry schools are working hard to find career opportunities for their graduates and I'd like to find a way to help.  I often champion the idea of new graduates who want to open a new practice or buy an existing practice, but many young ODs are simply not ready to take that step.  This need for an employment position matches very well with an unmet potential that exists within many mid-level optometric practices.  The practice type I'm targeting is one that might have gross revenue in the $500,000 to $800,000 range.  It is a traditional private practice with an OD owner in his/her 40s or 50s.  Read on to discover how these practice owners can benefit from an associate they didn't even know they needed.

The mid-level plateau
Many optometric practices grow very well for the first ten years or so and then level out.  If we examine the reason for this, I believe it is because the practice has reached the limit of its administrative capability.  There is not enough attention to the business side of the practice.  Typically the optometrist spends most of his or her time on patient care and squeezes in some management duties when possible.  There may be an office manager, but often that person does not have the vision or the authority to lead the practice to a higher level.

When a business is small, this unorganized approach to management can work fine because each patient and each job can get enough attention.  But when the volume of patients grows along with the number of employees, a better management system is needed.  More time is needed for administration and I believe the practice owner is best suited for the job.

In addition to the operational challenges of running a larger practice, more effort is needed in practice marketing to keep a steady supply of patients.  Most optometric practices do very little marketing at all.

Time allotment
The usual growth strategy by mid-career ODs is to try to see as many patients as possible.  The reasoning is that the doctor has the license and skill to examine eyes and that is his or her highest purpose.  Typically, these doctors hire an office manager to run the business side of the practice.  I propose a different approach.  Consider hiring an OD to see many of the existing patients so the OD/owner can devote more time to management.  An office manager is still an important asset to the practice, but together with the owner a strong management team is created.  New things start to happen in all areas of practice development and revenue increases dramatically.

A no-stress approach to adding a doctor
Many optometrists are reluctant to add another doctor for fear that it may not work out.  That fear is actually a pretty smart instinct, but here is a way to eliminate the concern: don't look for a partner.  Don't think that way.  Consider the job position of optometrist strictly as an employee.  A highly paid and important employee, but an employee.  Don't promise any future ownership.  Don't expect any practice building efforts from the new doc.

When viewed this way, there is no long term obligation.  Both parties hope it all works out and it will become a lasting career, but if it doesn't for some reason, you simply part ways.  The employment at will system works extremely well.  The new doctor provides services and receives a paycheck.

There are some details that should be in place such as a basic employment agreement and a restrictive covenant, but we can cover those topics another time.

Part time or full time?
In preparing to add an associate OD, you should have some backlog of patients.  The idea is that some of the existing patients and many new patients will be actively moved to the new doctor's schedule.  Yes, many patients will want the senior doctor, but with a little effort on the part of the staff and with much more convenient appointment openings, the new doctor can be fairly busy.  The level of patient demand is the key to deciding if it is a full time or part time position.  I would prefer it to be full time because you are more likely to find a doctor who is looking for a career and less likely to quit if another offer comes along.  But a part time associate is a great way to start if patient demand is low.  Keep in mind that if the senior doc reduces his or her patient care days per week to work on management projects, a bigger patient backlog is created.

Career options
When we think of pure employment options for ODs, we usually think of commercial practice, chain opticals, optometry schools and ophthalmology practices.  Why shouldn't traditional private optometric practice be an option as well?  Many new graduates would love to be employed in that mode of practice.

Best wishes for continued success,

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