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Management Tip of the Week > You Need Two Exam Rooms and One More Technician

Exclusive Date: January 8, 2014

You Need Two Exam Rooms and One More Technician


 Sponsor: Alcon® - DAILIES TOTAL1®

Much of my work involves helping optometrists to be more efficient. If the practice happens to have enough patient demand so it is booked ahead even for a few days, the steps we take will instantly generate more gross and net income. If the practice is not booked ahead, greater efficiency still pays off because it allows the doctor to see the same number of patients in fewer days, leaving more time for other projects inside or outside of the practice. 

Many optometrists find it very difficult to change their office procedures and one of the big challenges is what to do first. How can you see patients more efficiently (faster) without causing stress and reducing quality? It is a great question and the answer can vary depending on many factors, but a good place to start lies in the title of this article. 

Invest in infrastructure first
When implementing change, it is best to start with the things you need in place to allow the change to occur. This may be a bit painful, because it requires some money up front, but you have to make a commitment to this change or it won't happen. The risk is usually quite small and you are simply making a business investment. It is actually more painful to try to change your operational process without making the investment first. That causes stress on staff members and service quality often suffers, which hurts your reputation. 

In most cases, you will start to see a rapid return on your business investment and the increased profit can be quite large. 

Multiple exam rooms
Having at least two fully-equipped exam rooms per working doctor is certainly not a new principle in practice management, but many offices don't have it. Consider these situations:
  • There is simply not enough space in the office for a second exam room. This can certainly be true, but I have been able to create the second room in some extremely small spaces. In some cases, you have to get rid of some junk and move it off site. In other cases, a room may serve multiple purposes at different times. Maybe offices, labs and administrative areas can be moved to an upper or lower floor, which creates space for exam rooms and pretest rooms.
  • An ideal exam room size might be 10 X 14 feet, but you can make it much smaller. 8 X 10 feet is about the smallest I'd go without feeling too uncomfortable.
  • If available, try to acquire some additional office space next to your office from the landlord or from another tenant. · If there is really no more space to be had in your office, consider looking for a new, larger location close to your current one.
  • There may be a second exam room, but it only has a slit lamp and it is used for follow-ups and dilations. It's better than nothing, but nowhere near the efficiency you need.
  • The office has three exam rooms, but there are often two doctors working at the same time. The goal is to have each doctor working out of two rooms and this does not achieve that. The efficiency is gained when a technician prepares a patient in the second room while the doctor is working with a patient in the first room. The doctor should ideally just go from room one to room two and back again.
  • There is a second exam room in the office, but it is not equipped because the doctor is not that busy yet. This is a judgment call, but even a slight increase in efficiency will easily pay for the equipment.
  • Three or four exam rooms per doctor are even better than just two, but the big jump in efficiency comes when you move from one to two.
Multiple exam rooms per doctor should be a goal all practice owners work toward because a huge increase in efficiency occurs.

Adding another technician
If you want to see patients at a faster pace, hire and train another staff member first. After all, you will have to delegate more procedures and you will need more help. You will need someone to perform some additional tests for you. You may want someone else to insert contact lenses, instill eye drops or walk the patient out to optical. You may have your new technician educate patients on eye care, write up fees, make a referral or discuss insurance billing. Finally, there will be more patients looking at frames at the same time than there used to be and you will need staff members to assist them. We have just scratched the surface on the tasks you could delegate, but first you need someone to delegate to! 

Don't worry about the increased cost of the additional employee. You will generate a lot more revenue when you see more patients per day. 


Best wishes for continued success, 

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

Best wishes for continued success,

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


Management Tip of the Week > You Need Two Exam Rooms and One More Technician