Article Date: 12/1/2008

Step 4 in Starting a Practice from the Ground Up

Step 4 in Starting a Practice from the Ground Up

Take these final steps as you come down to the home stretch.

By Gina Wesley, OD, MS, FAAO, Medina, Minn.

This article is the final installment in a four-part series about what it takes for a new OD to start a private practice. Gina Wesley, OD, MS, FAAO, a 2006 graduate of The Ohio State University School of Optometry, will discuss how to hire the best employees and prepare for opening day. Plus, she'll provide marketing tips to help build your practice in the years that follow.

IN PARTS ONE, two and three of this series, I discussed how to search for office space, develop an office design, manage your finances, negotiate a lease, choose equipment and implement office systems. Now that you've completed these crucial steps, you're well on your way to opening the doors of your practice. In this article, I'll focus on the hiring process because of its immeasurable complexities and other small but important details that contribute to a successful opening day.

Dr. Wesley practices at Complete Eye Care of Medina and Crystal Vision Clinic in Minnesota. You can reach her at

Hiring Process

Hiring full-time employees was one of the most frustrating parts of opening my practice. Fortunately, I knew two experienced, part-time employees from the office in which I used to work, who were willing to work a couple of hours a week to help me get started. One of them became my financial associate who handled bookkeeping, payroll and bill management. The other handled patient insurance claims and billing statements. Some ODs like to have control in these areas, but I believed my time was better spent developing relationships within the community to build my practice. Currently, my financial associate and I communicate weekly about practice finances, and she generates detailed reports that I carefully review.

The nice part for my employee who handles the insurance claims and billing statements is that she can work from home. My electronic records are web-based, so everything she needs is at her fingertips on her home PC. If we have any questions, we can communicate with each other via our electronic records, e-mail or phone. This has worked wonderfully since I've opened my practice.

Challenging Hire

What was most challenging in the last several weeks before opening my office was finding a qualified optician/office manager. I had to determine the right timing to hire this particular employee. If I hired the person too soon, I'd risk losing him to another employer. If I hired him too late, I'd risk bringing someone on board out of desperation to fill the position and not have the best candidate. To avoid this, I discussed my need for an optician/office manager with representatives from frame and contact lens companies and optical labs.

I also advertised in newspapers and on the Internet. Because of the area in which my office is located, advertising the job in the newspaper was expensive and ineffective. Perhaps if I was located in a smaller city, the newspaper might have been the perfect medium. Choosing to advertise in a newspaper or exclusively on the Internet, or both, is something you'll need to consider when you begin looking for employees.

Narrow the Field

Once the resumes started coming in from industry contacts and Internet applicants, I was surprised to see the disparity in quality. I immediately ruled out any resume that had spelling errors, seemed disorganized or looked unprofessional. I contacted candidates whose resumes looked appealing via e-mail to schedule an exploratory phone interview. I prepared a list of questions I wanted them to answer regarding years of experience, reasons why they wanted the job and commuting issues. For instance, if someone had many years of experience, but lived 45 miles from my new office, I really probed him to determine if he was truly interested in working for me. One of the candidates I interviewed told me he didn't drive. Since I knew there was no bus service to my office, I quickly took this person off my list.

I warned each person that the position wouldn't be available for several months or weeks, depending on how close I was to opening my practice. And I discussed my expectations upfront: The optician/office manager would serve as the point person for the practice and manage daily office functions. He'd specialize in both optical and contact lenses and be willing to accept that the office would be slow in getting off the ground until patient volume increased. After outlining the specific job responsibilities and expectations, a few people declined to continue interviewing for the position because they couldn't meet or agree to these demands.

If I was satisfied with a candidate's qualifications based on the initial phone conversation and the person wanted to pursue the position, I scheduled a formal, face-to-face interview. For this meeting, I prepared more complex questions about job style, attitude and leadership abilities. I also asked questions about their protocol for making recommendations for eyeglasses. I wrapped up the interview by asking if they had any questions for me. I was very skeptical about a candidate who didn't ask any questions. I suggest you list all of the attributes you'd like in an employee and keep them at the forefront of your mind during the interviewing process.

In addition, I strongly urge you to check references. I was surprised by the number of references who gave only mediocre recommendations. One candidate with whom I was impressed didn't get the job because her reference urged me not to hire her based on past workplace dishonesty. Needless to say, I was grateful that person told me the truth.

When you find an ideal candidate, develop a formal job offer in writing that outlines the job description, hourly wages, benefits, number of vacation days and bonuses. Present this to the prospective hire and give him a deadline for when you want his decision. I found this helpful when one of my primary candidates didn't get back to me for a week. As a result, I didn't hire him. You also should be prepared to negotiate. Think about what you're willing to pay or offer a person to bring them on board.

One candidate I offered the job to negotiated back and forth with me about salary, work hours, vacation and other matters for 3 weeks. Eventually, I reached my limit of patience, and I finally told her that my most recent proposal was my final offer. Meanwhile, I interviewed a wonderful candidate who responded quickly and favorably to my job proposal. That's the person I hired. Later, I learned the first candidate really wanted the job, but she lost the opportunity when she put me through dizzying rounds of demands and clarifications. She was highly qualified, but I figured that this sort of convoluted communication would continue on the job, and it was probably for the best that my current optician/office manager came along when she did.

Throughout this hiring process, I had offered the job to three different applicants before I decided on my current optician. Six months into the job, she and I both value the working relationship we've developed, and we're seeing the practice grow through our efforts. I had to wade through many resumes and potential candidates, but it was well worth it.

Prepare for Opening Day

As you come down the final stretch in your office planning, you'll need to make decisions about last-minute details. For instance, make sure you stock up on all of the supplies you'll need, such as diagnostic contact lenses, solutions, fluorescein strips, dilating drops, and so on. Determine the best prices for frames, and organize your optical displays. To smooth out the rough spots regarding patient flow, take family members or friends through the exam lane process.

In addition, look toward the months ahead and plan when you'd like to hold your grand opening and other open house events. First, I hosted a "professionals" open house to announce and showcase my new practice to local business owners, referring physicians and vendors with whom I planned to do business. Second, I held a ribbon-cutting event through my local chamber of commerce. Finally, I held my grand opening 6 weeks after I officially opened my practice. This enabled me to eliminate any problems concerning my computer and office systems and electronic health records before grand opening day. You may choose to combine or hold other types of open house events. Your main goal is to let the community know you've arrived and are ready to meet its eyecare needs.

Marketing Tips

Once you've held open-house events, you're ready to move to the next step in marketing your practice. One of the best marketing strategies I've found is community networking. You can attend meetings at your local Chamber of Commerce, the Lions Club International or Rotary International. At first, you won't know anyone at these events. But that will change as you begin to see the same business people time and again. Soon, these same people became my new patients.

Another effective marketing strategy involves asking patients for referrals. At the end of each exam, I say to patients, "If you had a good experience today, please tell your friends and family." Granted, it takes time to see the fruit of word-of-mouth advertising. But be patient. My practice has been open for less than a year, and already I've seen the results from this strategy. And chances are you will, too.

Enjoy the Journey

Writing these articles has been refreshing as I've dealt with the frenzy and flurry of activity leading up to opening day. As you embark on this exciting journey, make sure you seek wise legal and financial advice during the entire process. There were, and still are, times of stress. However, I don't regret choosing this path. I believe going after my dream as a young optometrist will allow me to further broaden my professional experiences and opportunities. If I've helped even one optometrist in this series, I've accomplished my goal in writing these articles. Best of luck to all aspiring cold starts! nOD

Optometric Management, Issue: December 2008