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 By Neil B. Gailmard, OD, MBA, FAAO, Editor February 22, 2012 - Tip #521 
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Cross-training: Key to Efficiency and Great Service

  Sponsor: DAILIES® AquaComfort Plus®

If you look at the job titles and job descriptions in most eye care practices in the U.S., you find a separate staff working in the optical dispensary and the clinic. These staff members have different training and different skills. In my practice model, the optical and the clinic are both served by one staff group. All of our pretest technicians are also trained as opticians. It is a very efficient system and I recommend you consider it for your practice. I have never found it difficult to implement, maybe because we've always done it that way, but I've helped many other practice owners make the change.

Small and large practices
It is interesting that most practices start out with extensive cross-training of staff. A new start-up practice may only have the doctor and one employee. That staff member often ends up being trained to do everything. Front desk, optical dispensing, pretesting, cleaning bathrooms, whatever. In that environment, the doctor often ends up doing everything as well. As the practice grows, there is a shift toward specialization. I think this is a smart strategy in staffing. There are some benefits to having departments. The front desk staff can be very well trained in some tasks while the optician has different skills. But it is in our best interest to keep clinical services and optical products together. I like the transition between those two areas to be seamless. A handoff creates a more retail mindset for the patient and I'd rather they not even think about it.

Furthermore, the skill sets between opticians and clinical technicians are not that different. Before either group feels insulted by that comment, let me qualify by recognizing that there are many levels of skills by both professionals. There are master opticians who have vast technical knowledge that takes years to acquire. There are ophthalmic techs who are good refractionists and assist with eye surgery. But there is also a place in most optometric practices for well-trained staff members with good intermediate skills. They can accurately measure a seg height and they can perform all the usual pretests. Both opticians and technicians need to understand vision, eyeglasses, contact lenses and basic eye care. There is plenty of cross-over between clinic and optical.

Consider the following factors as you assess the potential of cross-training optical and clinical in your practice:

  • Flexibility for staff to go where they are needed. The clinic and the optical can go through random rush periods and cross-training lets staff go wherever they are needed most. Our business office staff pages our technicians to go where the patients are.
  • Customer service improves and wait times decrease because you have more staff who can do the job.
  • Increased depth of staff coverage during vacations and call-offs.
  • A smoother transition occurs between clinic and staff which can lead to a higher Rx retention rate.
  • Cross-trained techs can serve as scribes and can carry out whatever treatment plan is needed without having to find a different employee. The technician listens to the doctor and patient consult and follows through as required.
  • The doctor can give directions about the patient's glasses to the technician in the exam room and have them carried out.
  • Staff members do not become bored with their job as easily. The diverse duties make the job more interesting.
  • No battles between the two groups over whose job it is.

How to make the change
Start by changing the job description for new hires in the future. If the norm in your practice is for technicians to work in both clinic and optical, then job applicants won't view it as a big deal at all. It will be rare for you to find job candidates with experience in both areas, but just hire the best person you can find and train him or her for the skills that are missing.

I would also ask your present staff if they have any interest in learning the other skill. Many employees will view it as an opportunity to grow in their career. That's how I view it. You may find some resistance and you can decide how important that is to you. It's OK to let some staff have a "grandfather clause" and stay with the job they were brought in to do. But I view the staff member who embraces change as a true team player for the practice.

I realize that opticians in some jurisdictions are licensed, but that doesn't change the benefits of cross-training. You should always follow the regulations in effect in your state or province.

Full time optical coverage
It is very likely that you will still need one or more full time opticians on your staff to take care of optical walk-ins and to handle the work flow. That can work just fine. All of my clinical technicians are trained as opticians, but I have three opticians who do not work in the clinic at all. They are always on the optical floor. If needed, during very busy times, the clinical tech can hand off to one of the opticians and come back to the clinic.

There is a reason that most formal training programs for optometric technicians at optometry schools and community colleges include courses in both clinical eye care and optical dispensing in their curricula. It makes for a great staff member.

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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