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 By Neil B. Gailmard, OD, MBA, FAAO, Editor March 26, 2008 - Tip #321 
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Things You Shouldn't Delegate


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If you follow this e-newsletter at all, you probably know that I'm a big believer in delegation in the eye care practice. There are many clinical, optical and administrative tasks that are best handled by well-trained staff members rather than the doctor/owner. But I've also learned that there are some things that should not be turned over to employees and we'll focus on that in this article.

There are many business benefits that accrue when the owner stays active in key practice areas, but there is another reason I recommend it. I don't like to see important business departments or procedures dependent on any one staff person.

Employees can resign at any time and the power of knowledge and control can be abused. In some cases, staff members avoid sharing their knowledge with others in order to maintain sole control. It's not a healthy situation. Cross training of multiple employees is desirable, but in the end the practice owner should always retain some level of basic knowledge in key areas.

Of course, everything is relative and I think it's great to have plenty of staff assistance with the following procedures, but these areas should not be completely managed and supervised by employees. For maximum profitability and productivity, the independent practice owner should remain knowledgeable and interested in the following topics.

Accounts payable

Overhead costs can have a huge impact on practice net income and the best way to be certain that costs are kept in line is for the owner to have involvement in the paying of the bills. By knowing the names of all suppliers and by having a sense of what the usual monthly expenses are, the practice is safeguarded against errors and against employees buying goods or services from unauthorized sources.

I think the ideal system for management of accounts payable is to use a computer software program like QuickBooks. A smart way to delegate some of the burden of paying bills is to have a trusted staff member, such as an office manager or bookkeeper, enter all the payment information and prepare the checks in advance of the due date, but place the checks on hold. Having the software and data available on a network is a great setup so the bookkeeper can use a different workstation. The practice owner reviews the pending payments and approves them within the check register. Only after checks are approved can the staff person print them and mail them.

Another excellent way to monitor this check-paying system is to have the owner sign all checks, but that can be cumbersome if the owner travels often. The important factor is that no bills are paid until approved. There are many great features to paying bills electronically, including the quick review of previous payments to specific vendors and the generation of financial reports. There are many programs that allow remote access of the office system from any other computer, so the owner can monitor accounts payable activity from home or when traveling.

Accounts receivable

The fees that are owed to the practice by patients and insurance companies are extremely important and I believe the practice owner should see the summary report every month. Staff members should be assigned to follow-up on unpaid balances with patients or insurance plans.

A closely related area is the posting of charges to the practice management system, the balancing of the cash drawer and the daily bank deposits. The owner should establish strict rules about these procedures and should supervise and spot check to be sure that office protocol is being followed.

Optical dispensing policies

Many eye care practitioners feel it's smart to delegate the management of optical duties to well-qualified staff members. While I'm sure there are many competent, dedicated opticians and managers in place, I think the doctor/owner should stay involved and interested in the optical department. I know how busy doctors are and the clinical aspect of eye care is challenging enough, so it's tempting to just turn over the whole optical department to someone else.

I think it's smart to have an optical manager to assist, but I still like to see the doctor/owner involved in all pricing strategies and warranties, frame lines that are carried, labs and lens brands used, policies and procedures of the optical department, quality control, staff training, and all other important matters.

Insurance plans

The insurance billing department of the practice is an area that is often completely delegated. This area is specialized and complex enough that it's quite common for doctors to have no knowledge at all of what goes on. I would not allow that to occur. The owner should know the basic steps of how to file insurance claims and should be able to observe and supervise the activity to see that it's being handled efficiently. It's wise to have additional staff members learn the insurance billing procedures and not be dependent on just one person. In many cases, business office staff can file claims or post payments from any computer during slow times.

The ECP/owner should make all decisions with regard to what vision plans and medical plans are accepted by the practice.

Computer systems

I acknowledge that computer systems are so complex that it's highly unlikely that an ECP can completely understand the technology behind the office system, but it's important to invest enough time to learn the basics. Many practices use the services of an independent computer technician or information technology specialist and this person can be a great resource for learning. Try to be available to spend time with the IT specialist when work is done in your office, ask questions and take notes.

It's great if you have one or two staff members with valuable expertise in computer hardware and software, but don't delegate total management of it. Be sure you know: how to reboot your server, the basics of all the office software, all the passwords, and how the data is backed up. Verify that the backups will work if needed. If you're not sure, ask someone in your office who knows these tasks, while you're still on good terms.

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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