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 By Neil B. Gailmard, OD, MBA, FAAO, Editor January 18, 2006 - Tip #209 
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What if your practice is really slow?

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Most optometric practices could use more patient volume, but this article is aimed at doctors who are seriously short on patients. Many of these extremely slow practices are new start-ups but no matter what the reason, the practice owner would love to see business pick up. Since most practices are built by word of mouth referral by happy patients, it takes time to develop volume. The growth is often exponential, but it must start somewhere before it reaches a critical mass. There is, however, quite a lot that a practitioner can do to cultivate referrals and jump start a practice. The one thing these doctors have on their side is time - there is usually plenty of that!

Here are some basic ideas to make things happen.

Keep the office open

As tempting as it is to save overhead costs when a practice is not earning much, I recommend you find a way to hire an employee to keep the office open and staffed during most regular business hours. This staff person need not have optical skills, so wages can be kept at a minimum, but you do want an ambassador for the practice who is friendly and outgoing.

Business may be slow, but you want to create the perception that your practice is strong and viable. Patients get a strongly negative signal when they call your office and rarely have the call answered by an actual human staff member. Answering services typically can't answer questions like "are my glasses ready?" People will also simply drop in at your office during regular business hours and finding the door locked says you're not a serious contender in the eye care arena. Posting odd hours is not enough if the visitor didn't see them or can't remember them. Access is a basic need of any consumer, and if it can't be met by your office, there are plenty of other providers that will. Patients can't judge the technical aspects of eye care, but they can and will judge the business basics.

The doctor in a new practice may have to take on the traditional role of the staff member at times out of sheer necessity, but I would work hard to keep it to a minimum. Try not to answer the phone yourself and try to have a receptionist greet patients. Your image is critical at this early stage of practice building.

Use some of the free time in your schedule to train your assistant in every aspect of practice administration and optical dispensing. As your employee becomes more skilled, he or she also becomes more productive without you.

Consolidate your patient schedule

Realize that you fill two vital roles in your practice: doctor and CEO. Since the doctor part is so slow, capitalize on the CEO part. Start by restricting your patient schedule so your management time is productive and uninterrupted. Of course, you want to offer enough patient care hours to be convenient, but there is no sense in spreading out a handful of appointments throughout the whole week. Consider something like this for patient appointments: Monday 9am-1pm; Tuesday none; Wednesday 2-7pm; Thursday 1-5pm; Friday none; Saturday 9am-1pm; Sunday office closed.

If appointment slots start filling up, just open up more days. Don't like evening or Saturday hours? Respectfully, I say work them anyway. Those times are the most convenient and the most demanded, and you need to cater to patient needs more then ever! When you're booked solid a week in advance, then you can consider working your preferred hours, although I'd be more likely to hire an associate to work the less desirable ones and keep the office open.

There are two big reasons for consolidating your appointments into fewer days. 1) You will take your management duties more seriously if they are scheduled. Don't be tempted to simply enjoy leisure time during your non-clinical times. You need to work on the practice. 2) Your practice will appear busier. When you group your patients together, your patients will see other patients and they will perceive a highly successful practice. That breeds referrals.

Get out of the office

Staying in the office all the time won't get you noticed. Consider these ideas to get out and about and make something happen.
  • Introduce yourself to other professionals. This may feel awkward at first, but start by visiting local optometrists, ophthalmologists and opticians. Most will be very receptive and friendly, and that is enough, but in some cases, inter-referral relationships may be built. Most eye care professionals don't want to handle all the eye care needs that exist. Can you take on what they don't want? Maybe it's low vision, or eye exams or glaucoma management. Who else can you meet - primary care MDs, school nurses, child psychologists, chiropractors?
  • Join the local Rotary Club, Chamber of Commerce or other civic organizations. The networking opportunities are huge and as you become known in the community as a person who is honorable, your practice will grow.
  • Become the optometrist at a local nursing home and bill Medicare and Medicaid for services.
  • Join the AOA and the affiliated state and local society. The professional membership is a good image builder and you'll be able to participate in events that build your practice. Local school vision screenings are one example.
  • Attend a national eye care conference. Pick one: SECO, AOA, AAO, Vision Expo East or West, and others. Travel is cheap today, you have the time, and the practice-building energy is abundant at these larger meetings. You will find many great new ideas. Take courses in practice management even if you don't get CE credit for them!

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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