Optometric Management Tip # 550   -   Wednesday, September 19, 2012
Pushing the Mid-Level Practice Upward

I like to think of optometric practice in terms of three levels for simplicity. The optimum management strategy is different at each level. Consider these: The largest group by far is the mid-level and it is also the hardest to break out of, so I'd like to address that today. The high grossing practice can still have many challenges, but it has already proven it can generate revenue. The very small or new practice needs to do the right things to build patient referrals and loyalty, but these require nurturing over time.

Some mid-level practices are growing quickly and are already setting themselves apart. These practices are passing through average on their way to greatness. But most mid-level practices are kind of stuck. The owners may begin to accept average as good enough; they may rationalize that they don't want to see more patients per day. The owners may become accustomed to doing many things themselves. Everything depends on the doctor and that becomes the norm.

Consider the following factors within an average practice. Each factor is usually average as well and therefore it can't become a competitive advantage. How can a mid-level practice break free?
To make an average practice grow, the owner must make some things happen. Not wait for them to happen. The interesting thing is that there are a number of "things" that will work. That may actually make growth more difficult because the owner will have to choose one or maybe two things to work on and invest in. That is what CEOs do. They have a vision. They make a judgment about what would serve their company best. And they take some risk.

Here are some ideas for possible projects that can boost a practice out of the mid-level blues. These are your possible "things" to make happen. Which one do you feel would give your practice the most lift? Making it happen
Once you decide on the most important project (in your opinion), take action! Many ODs feel they can't take on a new business expense unless they see a sure way to pay for it. That may be true sometimes, but in other cases you should just arrange the financing or go to your savings. A great example is a new, larger office. On paper, the build out cost and the increased rent may seem like a challenge, but in nearly every case I've seen, a new nicer office results in a nice boost in patient demand. Production and revenue increase more than the cost.

Of course, you want to take on new debt with some caution and have a plan for paying for it, but in most cases business will improve, you will easily handle the increased expense, and you find yourself leaving your old mid-level practice in the dust. You begin to enjoy the benefits of a larger, more successful practice. Act as you mean to go.
Best wishes for continued success,

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