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 By Neil B. Gailmard, OD, MBA, FAAO, Editor July 19, 2006 - Tip #235 
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Jump-start Your Practice: Part 1

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There are many practices that need a jump-start. They may be relatively new start-ups, which obviously don't have enough patients yet, or they could be average, established practices that are growing much too slowly. Some practices have been around a long time and they've reached a plateau or have begun to decline in earnings. Most offices simply are not busy enough.

By the term jump-start, I'm referring to something the owner can do to make things happen, rather than waiting for things to happen. I'm a big fan of being proactive and controlling one's destiny and I've found that there are often unexpected consequences (good ones) to our actions. A jump-start might involve a financial investment, but it should have a very quick return.

I've identified some major management decisions that can jump-start an underperforming practice and I'll put them together in a series of tips over the next several weeks. I hope you will find these management concepts a refreshing departure from the conventional practice building ideas. They are aggressive.

Jump-start #1: Hire one new staff member.

That's right; consider hiring a new, additional, full-time employee. Here is where some of my colleagues may be questioning my sanity. Why on earth would a struggling practice hire an additional person? Many ODs won't hire an additional staff member even when times are good! My reasoning is sound; stay with me.

The entire essence of this jump-start strategy is to do something before it is clearly necessary and in doing so, the practice begins to behave as if it were more successful!

Many good things happen when you simply hire a new staff member, but most of us only see the payroll cost and the management hassle. There are many not-so-visible benefits:
  • Customer service improves. Many offices are so thinly staffed that service is not all that great. Job orders are not checked on and they run late. Patients are not getting called when they should be. There is no one at the front desk when a patient walks in for an appointment. Am I right? You may have accepted this as "good enough". It isn't.
  • Productivity increases. What exactly do I mean by productivity? Choose any measure you wish that deals with how much work your practice does - number of exams per month, number of eyeglasses dispensed, number of contact lenses prescribed, number of threshold visual fields performed, gross revenue deposited, etc. How do these things increase just by having an extra assistant? By delegating more of your work, you may be able to see just one more patient per day. By having more time to speak with a patient, you'll find yourself bringing up a new idea that you wouldn't have before - like trying on bifocal contact lenses just to see what they're like. You'll reappoint a suspicious field screening test for a threshold because there is someone to run the test for you. It just happens.
  • Office hours may be extended. This depends on your practice situation, of course, but it would be a good thing for practice building because patients like to have their eye care office open every weekday plus Saturdays. Obviously, the doctor doesn't have to be present every day, but patients like to reach humans on the phone, pick up eyewear, have repairs, etc. If you had an extra staff member, you might decide to stay open on a day that you're currently closed.
  • Delegation is increased. Delegation is the key to practice success. Many doctors try to do it all in the name of economy, but it's a false economy. They could be doing so many more important things (like thinking about the practice) if they had an assistant to do the basic things. Delegation does not have to refer to pretesting (although that is often a good place to concentrate), many doctors are ordering contacts and diagnostic drugs and filing insurance claims.
  • Office culture and morale will change. It will improve if the current staff feels overworked and underappreciated, but I admit, new staff can also create morale problems. Some veteran staffers like to protect their turf and do not want any new blood. Having an additional employee may allow you to dismiss a troublemaker that you've held onto for too long. Some offices are so set in their ways that shaking things up produces positive change in the end.
  • New skills may be learned by you and your other staff. Hiring a new staff member with previous eye care experience may introduce you to new ways of doing things. He or she may bring new skills in computer technology, a knack for decorating optical displays, frame repair skills, marketing know-how, and so on.
The cumulative effect of all of the above is a better practice, due to better staff attitudes and better service. Patients are more enthusiastic and they refer more friends and relatives - immediately. They also buy more and they return more often. The referrals and repeat business drives greater productivity.

It doesn't really matter what job title you hire for. It could be a receptionist, an optician or an optometric technician. You probably know what skills your practice needs most.

Can you afford it?

The cost of a new employee is the ultimate time payment plan: a staff member is a valuable asset to any business, but you get to pay for this asset over time - paycheck by paycheck. Really, a single paycheck is not going to break many practices - nor will six or seven paychecks. In taking my practice from a single part-timer to a staff of 26, I've never had a new employee not increase productivity more than the cost of his or her salary.

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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