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Unfortunately, most optometrists underutilize one of the most powerful tools for practice
profitability and growth: delegation. In my experience, there is a wide range of delegatory
practices in existence in eye care, from the very low level to the extremely high level. I
call this range the delegation scale, and I firmly believe that at least 80% of ODs could benefit
from taking a step up on that scale, from wherever they happen to currently be. I admit that
delegation can have a downside, if it's not managed properly, but it is far too important of a
management principle to shy away from based on that fear.
Resistance to delegation
In my practice management lecture seminars, I often feel some resistance to delegation from
doctors in the audience. There are various reasons (I think they're excuses) cited for why they
don't like it. I'm not really sure why optometrists are slower to delegate than our counterparts
in medicine and dentistry - although I acknowledge that our professional training does not teach
us to embrace the concept. But there are lots of things we learn to do outside of optometry
school, and delegation is one of them.
Productivity and expense reduction
Most docs who delegate at the higher end of the scale do so because they've seen the great
benefits of higher production. Production in terms of number of exams per day, boxes of contact
lenses dispensed, pairs of glasses ordered, or any other revenue producing item you want to look
at. If you are one of my many colleagues who have not taken a step up on the delegation scale
for a long time, however, perhaps looking at delegation from the expense side, rather than the
revenue side, will entice you. You are losing money by under-delegating. No practice owner
willingly pays more than they need to for office supplies, rent, staffing, inventory or any other
expense. Yet, that's what you do when you perform many tasks in your practice that could be
CEO vs. doctor
Think of your practice as a separate entity, a company. You are the CEO. Consider your doctor
persona as a separate individual whom you hired for the job of optometrist. Consider the
doctor's skill level in eye care and his or her annual personal income. It would be wasteful to
assign simple, repetitive tasks to this person, when a technician could be hired to do them.
Using the proven philosophy of each person working at his or her greatest potential, even fairly
technical tasks should be shifted from the doctor, assuming techs can do the job as well (often
using special instrumentation). A CEO who does not staff properly is guilty of poor management.
It's not that the doctor is too good to do the menial tasks of changing light bulbs or ordering
contact lenses or taking entrance visual acuity, and from a practical standpoint, this might
have to happen for a while. I understand growth phases in a practice when staffing is not
optimum - yet. But the distinction between a growth phase and poor management occurs when the
assignment moves from temporary to permanent in the mind of the CEO. It becomes a problem when
the doctor does menial tasks for years and there is no longer any effort to move away from that
Many practitioners feel they can't increase delegation because they would have to hire another
staff member. Exactly! What's stopping you? The expense? But we just discussed how it's
really more expensive to do it yourself. After a new technician is hired, and you gain some
breathing room, you can experiment with a new clinical and optical process. You can reorganize
your appointment schedule and rearrange some exam rooms and equipment. It will not take much
for the gained efficiency to pay for the salary of the new employee. Grow into your new level
on the delegation scale and repeat the process.
An assignment for next week
This topic of delegation is so important to successful practice that I'm going to continue with
it next week. In the meantime, take a pad of paper and jot down on the left side all the tasks
that you currently delegate in your practice. Give this some thought, and include tasks from
office administration, clinical services, optical dispensing, and optical lab. Then jot down on
the right side all the tasks that your practice currently performs that could theoretically be
delegated to properly trained technicians and assistants. Put a check mark next to any tasks on
the right side that you know could be delegated, but you would not personally feel comfortable
We'll meet back here next week.
Best wishes for continued success,
Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week
A Proud Supporter of
Send questions and comments to firstname.lastname@example.org.
Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com.
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