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 By Neil B. Gailmard, OD, MBA, FAAO, Editor October 20, 2004 - Tip #144 
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Clues that you're not delegating enough


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A sensitive subject

In speaking with optometrists about practice management over the years, I've found that the topic of delegation is a sensitive one for many. I've heard many objections to the concept - although I never really understand the resistance. I'll be the first to say that optometrists should practice any way they wish, so it's really an individual philosophy and decision, but my objective is to help my colleagues build more successful and more profitable practices, so if you're in the group that wants that, you owe it to yourself to analyze your delegation practices.

Even if you're comfortable with the concept of delegation of clinical and optical procedures to well-qualified technicians and opticians, you may say that there is no need to do so in your situation, and there is no one to delegate to. That's where we would disagree. All successful businesses need to have the owner move away from the task of doing the technical work and into the task of managing the business - it doesn't matter if you repair cars, cut hair, bake donuts, or examine eyeballs.

The early stages of practice

Granted, you can't practice maximum delegation if you're in the early stages of practice development - but you should be thinking about how it should be. I started my practice cold, so I'm quite familiar with all the phases. A fatal mistake occurs when the doctor/owner is performing tasks that could be delegated and becomes complacent about it and rationalizes that it's the best way. I want you to feel just a little bit badly when you do routine duties (like the ones listed below and many others) so you'll act on devising a plan to change it. You may have to do certain procedures at times for practical reasons, but don't lose sight of the master plan for your practice.

One common objection

A typical objection by an OD to the delegation concept might be: "Why should I hire someone and pay him or her to do something that I can do, and have time to do, in my current schedule?" That certainly sounds logical, and it's why optometrists don't delegate very much. This objection is built around the fact that many optometric practices have appointment schedules that are not completely full - and if the spotty schedule in question is structured to allow about 12 exams per day, the doctor will have plenty of extra time.

The fallacy of the objection above is that you don't have as much free time as you think. Not if you were doing the right things - and it's not all about patient care. Many ODs don't realize how and where they are needed in their practice. If you're practice is not booked solid, you need to spend even more time on practice marketing, self-training in business, staff training and customer service. So the non-busy practitioner should delegate some routine tasks because he or she will be using all non-clinical time on management activities. Ideally, you should reorganize and consolidate the schedule as you make the shift toward delegation. This would involve seeing a few more patients per day, so those days are really busy, while freeing up some half days or full days for management.

Clues about delegating

This list is just an example of a few tasks that are often performed by optometrists, which I think can and should be done by staff members. Are you doing any of these procedures? Do you plan on doing them forever?
  • Ordering contact lenses by phone, fax or on-line
  • Measuring a seg height
  • Taking visual acuity on every exam
  • Edging spectacle lenses in your lab
  • Calculating payroll hours
  • Teaching contact lens insertion, removal and care
  • Performing automated pre-tests, like auto-refraction or non-contact tonometry
  • Performing threshold visual fields
  • Performing corneal topography
  • Making bank deposits
  • Adjusting a frame
  • Doing routine lensometry on a patient's habitual Rx or on finished glasses as they arrive from the lab

Best wishes for continued success,

Read Past Tips Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week


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Send questions and comments to neil@gailmard.com.

Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com.
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