Article Date: 11/1/2010

Hire Learning

Hire Learning

Tips to help you get it right the first time

By Susan A. Resnick, OD, FAAO

IF YOU'VE CHOSEN TO go into independent practice, then you certainly have an entrepreneurial spirit. Whether you're going out on your own or with another doctor, once you put your sign out, you've got a business. But to get patients in the door and keep them there, you also need a staff.

The transition might seem fast — from student to doctor to businessperson in just a few years — but you can do it. You can be the boss. And when you hire and train the right people, they'll help you meet all of your goals and build a thriving new business.

Who's Your First Choice?

Most new practices start with a single employee. The first person you hire has to be almost like a partner — an extension of you. While you'll be seeing patients in the exam room, your first employee will do everything else.

You could hire someone cheap, but I'd want the first and even the second person I hire to be my “expensive” people. Start high and work your way down. You'll get a lot more out of one highly capable person who commands a higher salary than you will from two inexpensive people who take 3 or 4 times the energy to train. If a higher salary isn't in your budget right now, hire someone part time.

Here are some key characteristics to seek when you hire:

Experience: Because your first employee has to work very independently, it helps if the person has prior experience in a similar setting. Any kind of medical office experience helps. If you don't have experienced applicants, look for someone who has worked in a customer service role.

Education: Completing school — even a certificate or 2-year program — shows an applicant's ability to set and meet personal goals. I've hired very bright people with no higher education, but for a first employee, I'd only consider a college graduate or a high school graduate who has been out of school for a while and has solid, applicable work experience.

Organizational skills: Medical records, appointments, billing, phone calls and running the office — to do them all well requires excellent organizational skills. Keep in mind that your first employee will work with you to set up filing and billing and how those types of systems will work for years down the line.

Communication skills: Through the application and interview process, you'll see how well applicants communicate. The right person will express herself clearly and easily, make eye contact and be pleasant to talk to. The first impression your practice makes is often through a patient's conversation with your staff, so make sure it's going to be a positive one.

Take-charge attitude: You'll do some training, and then you'll be in the exam room while your employee works. She'll have a lot of responsibility. She can't wait for you to tell her what to do next. She must be an independent worker who can think on her feet.

Flexibility: You've already faced the fact that starting a practice isn't a 9-to-5 job. You'll need to work some evenings and weekends — whatever it takes to get the practice started. Although most people are looking for some stability in their jobs, you'll have to discuss work hours with all prospective employees. Try to set reasonable basic hours, then look for an applicant who's comfortable with covering some odd hours or being asked to work on short notice.

Entrepreneurial spirit: You're bringing someone on to help you grow, and if it works, there are benefits for both of you. Choose someone who gives you a sense that she understands the bigger picture. Some applicants want to sit at a desk and have tasks assigned to them, but you need someone who will bring ideas to the table.

That desire to partner with an employee has a side benefit of putting new ODs at ease with interviewees. If it feels strange to think of yourself as a boss to someone a decade or more older than you, remember that you don't have to put yourself above that person. Explain that you're confident in your training, but a doctor doesn't run a practice alone. Tell candidates you can trust to get things started and be that all-important front line: close to patients, monitoring what's working and what isn't, and helping you make key decisions for the practice.

Job Ads and Resumes

When you're ready to start looking for that essential first person, it's time to tackle practicalities such as running an ad for the job. You're looking for someone who will wear many hats. In fact, he will be the most cross-trained person on your staff, so leave out tasks that are too specific. This employee won't be a bookkeeper or an ophthalmic technician alone, so describe the position broadly as an office manager, practice manager or practice administrator. This will allow you to cull from a broad range of applicants.

Instead of listing the skills you want in an employee, list important character traits. You can teach any skill to a smart person, but you can't imbue character traits such as being friendly and energetic. “Excellent communication skills” is a key phrase for the ad to help ensure that your new employee will have a good rapport with you, your patients and your business contacts.

In my practice, we always put the words “energetic self-starter” in our ads. We're too busy for handholding, and although you may not be teeming with patients at the start, you'll be busy setting up shop. You'll give the employee some guidance on your software and recall process, but this person will need the energy and drive to successfully implement your approach to running the office, without being micromanaged.

When the resumes start coming in, look for loyalty. Consider it a red flag when you see applicants who have been job-hopping. With all of the training required for a new hire, it takes about 2 years for the investment to pay off, so we want at least 3 to 4 years of employment.

First Impressions

First impressions are important. The first impression you get of your applicants is likely the same first impression that your patients will get when they call or walk in of applicants from the moment they walk in the door — or before.

In my office, we have applicants fax or email a resume. Then we call them for a phone interview. What better way to find out how he sounds on the phone?

When we ask people to come in for an interview, we note their punctuality. This is a key factor for us. We look at how applicants present themselves in terms of dress, personal grooming and demeanor.

We also choose to do some simple tests up front to screen candidates. In addition to a typing test, we use verbal and math “quizzes” to give applicants real-life problems to handle. They itemize and format a patient's bill, calculate a refund and identify some misspelled words to give us an idea of their abilities. No matter what role you're hiring for, all of your employees should have these basic skills.

Interview Questions

If you've never conducted a job interview before, don't be nervous. Relax and keep a friendly but serious demeanor. Applicants should understand that your practice is a business; covering expenses and generating livelihood for all employees is the “bottom line.” This demands that all who are involved work hard to succeed. I always begin the interview by describing my practice philosophy, which is that we take care of patients and give them the best possible experience. And while a financially successful practice is important, our business decisions are always made with the goal of placing patient care first.

I ask applicants a mix of closed- and open-ended questions. The closed-ended questions are important because I need to know, for example, what kind of practice or business the interviewee has worked in. But I learn more from open-ended questions, such as:

What do you want to be doing in 5 years? Because you want someone to stay for 3 or 4 years, it's good to get an idea of what an applicant is planning for the future. People who want to have a graduate degree and be ensconced in a dream career in 5 years may not be planning to dedicate much time to the job. In fact, I always ask if an applicant is planning to go back to school and if so, I ask about their timing and plan. I've had many employees go back to school, so it can actually still be a good fit if a person is willing to work hard and earn a degree slowly.

What do you consider your weaknesses? Believe it or not, some applicants answer this question very honestly, which sometimes means telling you outright that they're always running late or losing or forgetting things. These are not acceptable weaknesses for your first employee. On the other hand, some may say their weakness is that they're a perfectionist. Bingo –that's a weakness you can live with!

What kinds of situations in your previous jobs made you uncomfortable? I want to know if applicants are shy. Maybe they've felt uncomfortable in tough situations such as dealing with an angry patient. Remember, your first employee needs gumption.

How do you get along with other people? It may just be you and your new employee for a while, but as your practice grows, so too will the mix of personalities. For me, the most difficult part of being a boss is dealing with the stress and conflicts of people working together. Ask some specific questions about how many people an applicant worked with in the past. Maybe it was a tiny practice, or maybe there was a large team and your applicant provided supervision. You want someone who can get along with others.

Your Decision

You should feel very confident in your decision to hire a first employee. If you're not confident, then perhaps you haven't found the right person. Only you know who makes a positive connection with you, but you can always call in a trusted friend to help with a second interview and provide another prospective.

When we hire people, we always tell them that the first 3 months are an exploratory and learning period. I present it as a mutual trial period — I'm deciding if the person is right for the job, and she's deciding if the job is right for her. It also establishes that new hires have 3 months to learn the job before being evaluated. It's a practical and helpful initial goal.

Throughout my years in practice, I've gotten some hires wrong, and that will probably happen to you too. But you'll know if the person is right within the first month or 2. Often, how quickly they learn is key. Down the road, when your staff is larger, you'll have the flexibility to steer employees toward roles that capitalize on their strengths and circumvent their weaknesses.

But your first hire — that cross-trained Renaissance employee — needs to have a wide range of skills. With preparation and clear thinking, you'll be ready when that person walks through your door. nOD

Dr. Resnick, a Diplomate in Cornea and Contact Lenses, is in private practice in New York City. E-mail her at

Save Time and Money on Staff Training
By Erin Murphy, Associate Editor
Once you've hired your staff, you have to make a major time investment in their training. But don't go it alone — there are programs out there designed to help.
One program from Essilor is called ECP University. It enables ODs to teach staff members dispensary roles in a few weeks, rather than doing the usual months of training.
“There's a lot of education out there, but it's usually focused on very targeted areas,” says Leslie Jennings, training manager. “Essilor wanted to be able to provide a broad service for eye-care professionals. We started with dispensers, but we'll continue to build the program for all of the roles in the practice.”

The Program

Essilor started by using extensive research and surveys in the field to determine what a top-notch dispenser looks like. They came up with a whopping 432 competencies, which they prioritized to build two levels of instruction: the New Dispenser Quick Start Program and the Apollo Program for Advanced Dispensing Professionals.
“Quick Start is aimed at the many new employees in Optometry offices who have little or no industry experience,” Ms. Jennings explains. “It teaches them the first 300 competencies to make them comfortable and competent in the dispensary. With traditional training techniques like shadowing, articles, and sessions with sales reps in the office, that would take 6 months. This program takes just 20 days, or it can be taken at a slower pace if desired.”
Both programs have a short assessment after each e-learning course, which helps practitioners and participants gauge progress. A written coach's guide helps a mentor to support the employee without requiring any time-consuming involvement, while a student guide helps Quick Start students move from e-learning to hands-on skill-building activities in the dispensary.


The Apollo and Quick Start programs have existed for 1 and 2 years, respectively, earning positive reviews from both doctors and staff.
Ms. Jennings explains, “Dispensers often tell us that the program really helps them learn things that have changed since their initial training and reminds them of things they've forgotten. From the other perspective, doctors and other mentors tell us that the program lets them spend their time doing their jobs instead of training new staff or cross-training existing employees. We've seen ODs use the program to train employees before the doors open, and some large group practices have implemented it for everyone as a standardization.”
Designed for busy experienced dispensers, the Apollo Program covers the remaining 132 competencies in 55 15- to 30-minute e-learning sessions. Those who are accredited through the American Board of Opticianry can get up to 18 hours of CE credit for the program. If a staff member is somewhere in between a newbie and an old pro, the Apollo has a built-in assessment that users can take up front to determine which competencies they should review and which ones they can skip.

For more information about training staff through ECP University, visit

Managing Skills Pay Off
Not ready to hire for your own practice? If you're applying as an associate at an existing practice, a senior partner may be looking for a “managing partner.” If you have some management experience under your belt, you can get your foot in the door with potential employers the same way you'd market low vision training or other special skill sets. As a new associate, you'll have fewer patients and more free time — time you can spend managing the practice and staff.

Optometric Management, Issue: November 2010