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 By Neil B. Gailmard, OD, MBA, FAAO, Editor November 17, 2010 - Tip #457 
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Your Office Procedure Manual


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Chances are you don't have a procedure manual for your practice. Most practices are fortunate to just have what I call a policy manual, and that is much easier to write and much shorter. A policy manual is really about the rules of employment; a staff guide about vacations, sick days, dress code and personal phone calls (see tip # 291 for more on that). A procedure manual describes how to perform all the jobs in the practice from filing insurance claims to pretesting to optical dispensing.

Why have a procedure manual?
Writing a procedure manual sounds like a formidable task, but with lots of help from your staff and some organization, you'll see it is not that bad at all. And there are many benefits from having a procedure manual - such as easier staff training and clarity on how the office is supposed to run. Over time, office procedures and policies tend to change and not always for the better. Memories of what we are supposed to do fall short and each time a task is explained to someone new, it changes a bit. Employees put their own spin on things and eventually, the vision has changed.

We also know that staff members go on vacation, take extended absences and resign or retire. If the one employee who knows how to do a task in your office leaves, the practice can suffer and the remaining staff and doctors will feel the stress. If even the basics of how to do the job are recorded, work can proceed smoothly.

Start simple and share the work
Here are some tips on how to manage the project of writing a procedure manual:

  • All offices have periods of time when they are not busy with patients. The manual can be written during these times and especially when a doctor is on vacation and production is lower than usual.
  • The staff members currently doing the work know exactly what they do. They simply jot it down so someone else can do it.
  • The doctor or manager can determine the topics and organize the assignments.
  • Don't worry about grammar and writing style; just list the basic facts.
  • A topic section can simply be a list of key points. It does not even have to be written in complete sentences.
  • Include sources for help and other instructions, such as websites, phone numbers, names of people, etc.
  • Have all staff members write their sections in a word processing program and save the files. The sections can be reviewed, edited and combined into one document.

What you can exclude
It is not necessary to write about tasks that are an expected part of a job skill. For example, it would not be necessary to write how to measure a seg height or perform lensometry. An optician is expected to know those things. But you could write about how to enter or write up the eyeglass order, how frames should be shown, how vision plans should be calculated and how patient fees should be collected. Other forms and patient handouts could be covered.

A very detailed procedure manual could include technical aspects like pretesting and optical dispensing, but there are text books written on those subjects. To develop a functional manual from scratch, I would start with a simple goal. It will always be a work in progress and it will evolve over time.

What you might include
You should have sections that cover the various departments in your practice. There could be topics, for the front desk, general administration, clinic, optical dispensing, optical lab, and so on.

Start by thinking of the jobs in your office that would be difficult if a key person was no longer available.
These are your first priority. Add to that list all the basic things your staff does every day. Here are a few possibilities:

  • Filing insurance claims. The basic steps can be written down and it should not be a secret that only one person knows.
  • What to do if the server goes down or internet access is lost.
  • Converting time clock records into payroll.
  • Sending recall notices or confirming pre-appointments.
  • What to do when a patient shows up late or calls and wants to come in later than planned.
  • Checking in eyeglass jobs and calling patients.
  • What to do if a job is rejected.
  • What to say over the phone to callers who want an appointment.
  • Returning frames and lenses covered under warranty.
  • How and when to reorder trial contact lenses for stock.
  • How to do pretesting and notify the doctor that a patient is ready.
  • How to open and close exam rooms at the start and end of day.
  • How to offer an option for routine retinal photos.
  • Key shortcuts you've learned in the operation of clinical equipment, such as the acuity chart or the settings on the retinal camera in case someone changes things.
  • There are many more topics. Just break them up into bite-size pieces and let your staff work on them.

The idea of buying a template for a manual or borrowing one from a colleague is appealing to ECPs, but every office is so different that I strongly recommend that you write your own from scratch. You aren't reinventing the wheel; you are describing your unique system. The value of a procedure manual is in how well it describes your methods.


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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