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 By Neil B. Gailmard, OD, MBA, FAAO, Editor September 9, 2009 - Tip #396 
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Two Subtle Red Flags


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Additional Information

I wanted to share two practice management observations that I believe are subtle signs of a deeper problem. These issues occur in a fairly large number of practices and I struggle with them in mine from time to time. See if you recognize either of these red flags.

Checkout time is too slow

Is your staff able to enter all the charges and transfer appropriate amounts to insurance... while the patient is standing at the front desk? In other words, is it fast and efficient to enter fees for goods and services into your office management software? Or is it so cumbersome that your staff will often give the patient a handwritten receipt statement and keep the file open to enter the charges later?

I strongly believe that charges should be entered with the patient present and a computer generated account receipt should be printed and handed to the patient. Why?

  • If files are saved to be processed later, some will inadvertently be filed or closed and charges will be never be entered. The balance will show as zero and optical materials could be ordered and dispensed without payment.
  • A policy of entering charges with the patient present reduces risk of embezzlement. The patient will review the computer printout and report anything that is incorrect, but if charges are never entered, theft becomes tempting.
  • If it takes too long to enter fees with the patient present then something is wrong with the system. It shouldn't take that long!

I find some office management programs are so complex that they interfere with the important goal of efficiency. In some software, correcting administrative errors is so difficult that employees want to recheck the math before entering charges! Shouldn't the software do that for us? I want the patient to receive a fully processed receipt slip, but I don't want him to have to stand at the desk for several minutes waiting. Generally, by the end of a visit, we have had the patient in our office for quite some time, often an hour or more. At the end, the patient just wants to go!

If you have this problem, analyze the process and talk to your staff to diagnose the cause. If there is nothing you can do internally to speed up the process, talk to your software company about updating the program to allow a quicker checkout.

Is there anyone at your front desk?

I have a challenge for you. Make a point of walking up to your front desk five times randomly during a day and note if there is a staff member present. Calculate your percentage for coverage. In many offices, the front desk is vacant a significant amount of time. Maybe it's just me, and it may be normal in many medical offices, but I'm trying to provide better service than that. I think it is a poor first impression if a patient walks into your office and is not greeted by a smiling face. How long will a patient stand there, not knowing what to do, before he starts to judge the service quality as low? And since we can't plan for when people walk in, I feel a staff member needs to be at the desk virtually all the time.

If you feel your office has become lax in customer service, start by talking to your staff about this issue. Frequently, the staff has just never thought about it much and they are busy doing other work. Receptionists often have other duties and they have to get a file or check for something in the lab. And it is certainly tempting to chat with a friend or get a snack. I'm not saying there is anything wrong with any of those actions, but maybe someone else can cover the front desk.

Of course, it is possible that the receptionist is at the desk but is busy on the phone or with another patient when someone walks up. That is understandable, but how easy is it to make eye contact with the newcomer, smile and gesture this will just take a moment? It's pretty easy and it is very effective.


Best wishes for continued success,

Read Past Tips Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week


A Proud Supporter of

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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