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 By Neil B. Gailmard, OD, MBA, FAAO, Editor September 14, 2005 - Tip #191 
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Out to Lunch

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Additional Information

Your office policies and procedures define how your practice operates and, therefore, how it is perceived by your patient base. Individually, a single procedure can seem rather minor, but collectively, the effect is huge. Let's look at one office policy that's decided on early in the lifespan of any practice: lunch break scheduling.

Optometric offices often have very unusual business hours, especially around lunch. Many offices close for lunch and others may only be open for a half-day on certain days of the week, which eliminates the lunch hour. The typical reason for the special hours is that it is easier to work out staffing issues, which brings me to my point. Office policies are often decided based on what's best for the owner and staff, not what's best for the patients.

Lunch breaks as marketing

Marketing is the main way that any business attracts customers (including eye care practices attracting patients). Since most practices suffer from too few patients, it surprises me that optometrists don't put more effort into marketing. Let's be clear about marketing; it's defined as identifying and satisfying customers' wants and needs. It's not necessarily advertisements or promotional gifts.

Office lunch policy is extremely visible to the patient base and the general public, and it speaks volumes about what's important to the practice. That makes the lunch hour an important part of marketing. While it's easy to rationalize that patients don't mind when an office closes for lunch and that there is no practical alternative, the fact is an intangible perception is created in the mind of the patient. It seems like the office can't afford to remain open during full time business hours and patient convenience is not very important. Consumers only care how policies affect them - they don't care about the behind the scenes problems of a business.

  • An office that is closed during normal business hours (weekdays from 9 to 5) does so because it's convenient for the owner and employees.
  • Patients often make time during their lunch hour to run errands. Even if that's not enough time for an eye exam, it could include picking up glasses or contacts, having a frame repaired, buying a cool pair of sunglasses for the coming weekend or making an appointment or a payment.
  • A locked office door is always an unpleasant surprise for a visitor; otherwise he wouldn't have pulled on it. It evokes annoyance at having made a wasted trip.
  • A telephone answering machine, voice mail or an answering service never satisfies a need as well as a live staff member.
  • Large, successful OD or MD offices and optical chain stores are generally open during lunch. Office hours can separate the big time players from the mom and pop shops.
How to keep the doors open

There are a variety of ways to serve the needs of the public while keeping staff members happy about lunch periods. Of course, the size of the practice is a big consideration, but that changes over time.

An obvious first step is to not schedule any appointments during the lunch period. The goal then becomes handling walk-in tasks and phone calls. In my practice, staff members are provided a 45-minute lunch break, so we block out all appointments for 1.5 hours, which allows two lunch shifts. Half my staff goes to lunch on the first shift, leaving the other half to care for the office, then they switch. That gives the doctor a long break, but by the time morning patients are actually finished and with a little administrative time built-in, the time is actually quite welcome.

If you use the two-shift lunch idea, you may have to assign people to lunch shifts to keep the office staffed properly. Not a fun job, because a staff member may want to eat with a friend, but the office needs come first. Try to work out a fair system.

Many offices are simply understaffed and try to get by in order to save the costs. This can be a false economy because if service levels fall, loyalty and referrals fall with it. This lack of growth is an invisible cost, but it's often more expensive than an increase in payroll!

Small practices may not have enough staff for two shifts, although two shifts could be accommodated with as few as two people if there is some cross training of duties. A receptionist could dispense a pair of glasses and a technician could make an appointment.

In my early days of practice I simply hired staff with the understanding that I would pay for lunch periods and the office would not schedule any patients during that time, but employees were expected to take lunch in the office when time permitted and handle walk-ins and answer phones. Of course, there weren't many walk-ins and the phone didn't ring much in those days, so staff still had a nice lunch.

Respect the schedule

If you often run behind schedule, you'll have problems releasing staff to go to lunch when they should, which creates stress all afternoon because staff won't be back from lunch on time to start seeing patients. Lunch is an important break for staff and employers who care about morale won't invade that territory by asking them to cut it short, or rush to catch up with work - at least not on a regular basis. Fix this problem first, if it exists, so you can be on time. Insert some block-outs into your schedule where they will allow you to catch up... 11:30 A.M. might be a good spot. Or, delegate more tests and hire more staff so you can see more patients in a shorter time period.

Are you concerned that a change in your appointment schedule will create a drop in productivity? Don't see fewer appointments per week - just find a way to be more efficient during the times you are in the clinic, and see more people.

Get your staff involved in understanding the need for the office to be open first, and then jointly work on the solution that works best.

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.

Please Note: The views expressed in Management Tip of the Week do not necessarily reflect those of the sponsor.

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