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 By Neil B. Gailmard, OD, MBA, FAAO, Editor July 12, 2006 - Tip #234 
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Hiring an Office Manager

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Many eye care professionals ponder if they should have an office manager. For me to venture an opinion on most management questions, I usually have to know something about the practice, but in this case I can basically just answer yes. If a practice is too small for an office manager at the present time, the owner should at least be planning for one in the future. And even a one-assistant office could make that single employee an office manager.

After all, how can a business run properly without having someone working on it? I'd like to think the doctor/owner will remain actively involved in the business aspects of the practice, but he or she usually must see patients and the non-clinical time available is nowhere near enough. In my view, the main reason that practices don't grow fast enough or big enough is a lack of attention to the business! Most offices will reach a basic minimum level of patient demand simply by existing, but to grow beyond the average takes interest and effort in managerial and administrative roles.

It just makes sense that any business that approaches annual revenue of a half million dollars (or beyond) needs a full time business person. Businesses don't run themselves - at least not very well! Unfortunately, many optometrists don't like the business aspects and don't give it enough attention. The most successful practices have an owner who devotes some time to the business (and leadership) and has a full-time office manager.

Where to look
The question is often whether to look within the practice or search for new talent elsewhere. Both of these are good options and the answer depends on the practice. Promoting a current staff member is an excellent way to reward good work and there is the added advantage of having an office manager who knows the practice procedures from day one. A possible drawback is that employees who are passed over for the job may harbor resentment and morale problems could develop. Also, if the promoted employee is a good friend to the other employees, his or her loyalties may be sharply divided and the friends may win. Can the new manager see a problem and provide discipline to a co-worker? Will the employee recognize and accept a friend as a boss? If there is an obvious and natural choice among the current staff (perhaps a person who has been acting as office manager by default), that person will likely be well accepted by co-workers.

The alternative to promoting from within is to advertise on the open job market for an office manager. I would let your current staff know that you are doing this in advance, explaining that you are seeking someone with managerial and business experience. Warming up to the idea before it happens helps pave the transition. You might also make the point that the office manager will become primarily an administrative position and will not be as directly involved with patients; perhaps your current staff is too valuable with their present skills and the practice can't lose their patient care services.

I believe eye care experience is not a prerequisite to becoming a successful office manager. Having excellent people skills is. An office manager must have a passion for excellent customer service; I mean really get it and not just give the usual lip service. This person must also have a knack for diplomacy with patients and staff. He or she must be friendly, caring and patient. A college degree is a valuable benchmark, and a business major is all the better. A background in optical is valuable, but most offices have many experts on optical matters and the manager should be able to find many resources for answers to technical problems. It does not take long for a smart manager with no optical training to become knowledgeable in clinical eye care, optical dispensing, the office management computer system, and insurance billing and coding.

Authority and responsibility
An office manager is the boss. That is a good overview of that person's duties. In my opinion, if the other staff members don't know that the office manager is their boss, the effectiveness of the role is severely diminished. The manager needs authority and responsibility and that can only be granted by the practice owner (or some other person with higher authority). It may be difficult to announce to highly-valued veteran staff members that they have a new boss - but I think far bigger problems await if this is left vague.

The use of the term "manager" has been in and out of vogue over the years, but it is really simply semantics. One might use titles like team leader or coordinator, while some practices prefer the titles of practice administrator or clinic director. Really, any name will work if there is authority behind it. But if those titles have nothing behind them, they might actually cause confusion and internal bickering among workers. A team leader may think she has authority, for example, but a technician doesn't think he has to answer to her. It must be clear. I like manager because it is universally understood by employees and patients and I want it understood.

If a practice is large enough, the concept of departments or profit centers can work well. In my practice, we have four departments: patient care, business office, optical dispensing and optical laboratory. Each of these areas has a department manager who reports to our general manager, but has authority over the staff members who work in each department. These department managers also carry an "assistant manager" responsibility. One department manager is placed in charge of the entire office when the general manager is not in. This is very effective because the office is open six days per week plus two evenings and the office manager can't be present all the time. By always having a manager-on-duty assignment, the practice owners do not have to always be present as a manager back-up.

How much to pay
This varies too widely to give a simple dollar figure. An office manager would generally be paid on a salary basis and should receive a nice benefit package. How much salary would it take to attract and retain a smart, dedicated person with good managerial experience? How much could that person make in a field other than eye care? The office manager might be the highest paid employee in a practice, but does not have to be. Experienced technicians and opticians could earn more.

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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