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A recent tip article focused on office policies and I recommended that all practice
owners write an office manual. Even doctors who already have a policy manual
generally find that it is an evolving document that undergoes occasional
revisions. In this tip and in more to come, I'll cover some of the topics that we all
wrestle with as we try to decide on the details of employment policies. There is
really not a right or wrong way to do these things, but I'll share what I do and give
you some food for thought.
Patient service first
The motto in my practice is "We look at everything we do from the patient's point
of view." That overriding philosophy is what builds success over time. I've seen
many practices where the policies are primarily decided with the wants and
needs of the doctor or staff in mind. As much as possible, I believe we should
base the policies on the wants and needs of patients.
Because of this approach, I believe in keeping the office open during the lunch
hour. While it is certainly nice for the staff and doctor to just close up shop, I
don't like patients to find the office door locked or to have phone calls routed to
voice mail. Remember that lunch time is the only opportunity many people have
during the day to take care of personal errands, like scheduling appointments or
picking up glasses or contact lenses.
Policies for small and large practices
How you manage to keep the office open depends on the size of practice. Many
small practices simply do not schedule any appointments during the lunch period,
but they require employee(s) to eat lunch in the office and take care of any drop-ins
and phone calls. Many employees like this arrangement because they are
paid for the lunch period and in smaller practices, there is not much lunch time
activity anyway. I would probably make the lunch period one hour long in this
case, to allow employees to have enough time for a nice break even with
interruptions. Of course, food should be eaten in a break room, back office or
lab, rather than the front desk.
Keep in mind that lunch breaks are not always started precisely on time if the
morning patients take longer than expected. Since we need the afternoon
appointments to start on time, we must allow for that by making the lunch period
long enough or placing a block-out before lunch.
As the practice grows and there are more employees, I like to hold lunches in two
shifts, with half the staff working the first shift and the other half working the
second shift. Again, management would designate a period of time when no
appointments are scheduled. I use one hour and thirty minutes in my office, so
each lunch shift is 45 minutes long. This allows me plenty of time in the middle
of the day to finish the morning patients, catch up on management issues, return
phone calls and enjoy a relaxed lunch. Employees punch out on a computer
time clock software program when they go to lunch and they punch back in when
they return to work. In this scenario, staff members may go out to lunch or eat in
the office. Our office manager supervises who is assigned to first or second
lunch so we maintain good office coverage, but we try to honor requests when
A few more points
- We start the lunch period at noon on days that we close the office at 5pm,
but we start lunches at 1pm on days that we are open until 7pm.
- Our office manual states that employees must start work as soon as they
punch in, so any personal tasks such as touchups of hair or make-up
should be done prior to that.
- We do not have any scheduled breaks other than lunches.
- If an employee is due to start lunch but is busy with a patient, we may
assign another employee to interrupt and take over in order to maintain
- My office has a staff lounge with refrigerator, microwave, sink, and soft
drink and snack machines for people who choose to bring their lunch.
Cable television in this room has proven quite popular.
Best wishes for continued success,
Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week
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Dr. Gailmard offers consulting services to eye care professionals through Prima Eye Group; information is available at www.primaeyegroup.com.
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