Article Date: 3/1/2010

Warm Greetings For Opening Cold
fix this practice

Warm Greetings For Opening Cold

Here's how to sprint out of the starting block when first owning your practice.

RICHARD S. KATTOUF, O.D., D.O.S.

Q I have been an employed O.D. in a corporate practice for over five years. My desire is to open dilemma is “I don't know what I don't know.” In other words, what do I need to do to make this transition as stress free as possible?

Dr. T.K. Sellers via e-mail

A: T. K., allow me to congratulate you on your decision to own your practice. The key things you need to know are:

► Your initial space requirements for a solo doctor would range from 1,300 to 2,000 square feet. If you start too small, you grow out of the space prior to the termination of your lease and you wind up in a cramped environment. Obviously, cost is a major issue. I have always been in favor of a condo or building ownership if feasible. Street exposure and visibility to traffic are key. Starting in a professional building with no exposure, unless a consumer enters the building, can be a problem.

► Ensure you are on the provider list for your preferred insurance carriers, or risk creating a negative starting position. Work with a company that will take on all the credentialing duties. You cannot be credentialed without malpractice insurance.

► Develop practice separation — a mode of practice that is better than your competition's. For example, consider an in-house lab, sophisticated instrumentation and/or a frame inventory that is unique. Schedule your hours to accommodate your community.

► Your medical fee structure must be at the level of ophthalmology. This is critical for maximizing profits. Optometrists have a long history of charging a fraction of what M.D.'s charge for a similar service. O.D.s make the mistake of using Medicare maximum allowable reimbursements to dictate their medical fee schedule. Understand that the other medical insurance providers have a much higher payment schedule. They simply do not make it public.

► Be a forward thinker. When I started practicing, contact lens material profits were very high. Yet right before our eyes, Internet ordering and commercial care have taken this market from the independent practice. I am not saying we could have prevented this change, but we need to explore additional income producing services such as orthokeratology or nutraceuticals.

► Control staff for maximum efficiency, productivity and profitability through policies such as:

1) No cell phones in the office.
2) No Internet usage for non-office related purposes. Install a block in the software to eliminate this.
3) Require staff to clock in at least five minutes prior to their starting time.
4) Only you open the mail. This is a preventive measure against embezzlement.
5) Open some boxes from labs. This assures that all products ordered are for your patients.
6) Have organizational meetings each day prior to patient visits.

► Get involved in the community: the school board, chamber of commerce, service organizations, etc. Consider sponsoring local athletic teams.

► Learn how to operate a retail optical. We, as O.D.'s, have no training in this area. Many O.D.'s and M.D.'s overdelegate in this area and get embezzled.

As a “start up” you are investing hundreds of thousands of dollars. To assure a stress-free transition retain a competent management consultant. OM


DR. KATTOUF IS PRESIDENT AND FOUNDER OF TWO MANAGEMENT AND CONSULTING COMPANIES. FOR INFORMATION, CALL (800) 745-EYES, OR E-MAIL HIM AT ADVANCEDEYECARE@HOTMAIL.COM. THE INFORMATION IN THIS COLUMN IS BASED ON ACTUAL CONSULTING FILES.

Optometric Management, Issue: March 2010