Article Date: 6/1/2012

Building a Successful Practice That Endures

Building a Successful Practice That Endures

Panelists discuss how they view success and the goals and metrics they feel are most important to continued practice growth.

Mile Brujic, OD • Kerry Pearson, OD

Dr Castleberry: Each doctor on our panel has taken a slightly different path to success. When you started in practice, what did you think long-term practice success would look like?

Dr Bobst: It's difficult to think long-term when you're just starting out because you're more focused on filling your schedule and paying your bills, but for me, I think practice success was about embracing and adopting new technology and giving my patients the best care possible.

Dr Brujic: My goal was to make our practice the go-to place for eye care in our community. I wanted people to think of our practice first whenever they thought of eyeglasses, contact lenses, dry-eye treatment or anything related to their eyes.

Dr Castleberry: Coming from Texas, my goal was to have the biggest practice in America. After a week, I decided I just wanted to be the best. I've been focused on that mission ever since. I haven't gotten there yet, and I'll probably never be fully satisfied, but I'm enjoying the ride.

Dr LaHiff: I've always believed if you take care of the patients, the rest will come. My long-term vision is to build lasting relationships with each and every person who comes in the door.

Dr Pearson: Success may look different in different practices, but I believe in the Socrates principle: Know thyself. We all have to adapt and change with the landscape, but understanding what you want — to me — is really the key.


Dr Castleberry: Regularly measuring practice performance is important to long-term success. What metrics do you use to determine if you're on track to meet your goals?

Dr Bobst: We closely monitor the percentage of patients who respond to our recalls within 60 days, because that's important for keeping patients. In addition, we communicate with our patients via text and e-mail, and after every encounter, we ask them to evaluate us. Those comments, good or bad, are published online, which helps motivate us to provide a good experience for all of our patients.

Dr Brujic: Achieving our goals often requires changing how we do things. Continuous communication with everyone in the office through regular meetings has helped us successfully implement change. Just 1 hour dedicated to discussing our goals and how we'll meet them pays dividends a thousand-fold. It helps our team function as a coordinated unit.
Dr Pearson: Keeping everyone on the same page can be challenging, especially for those of us with multiple locations. In our practice, we plan to start using a cloud-based application to hold virtual staff meetings. For our internal communications and e-mail, we use an online dropbox, and we also have various websites where we share information. All of these tools ensure that everyone understands and is continually reminded of what we're doing, which is beneficial for patients and the practice.

Dr LaHiff: Responding to what we learn from our metrics is crucial. Otherwise, we're just measuring things for the sake of measuring them. For example, we've found patients are more likely to keep appointments when we personalize our recalls. If someone doesn't respond to a mailed reminder, a staff member calls and mentions a specific reason why the patient should come in for his examination. She may say, “Dr LaHiff saw signs of a cataract starting at your last visit, and he wants to check on that.” By personalizing these calls, patients know that we care about their eye health.

Dr Brujic: In addition to understanding our established patients and what keeps them coming back, we try to learn what's driving in new patients, so we can capitalize on that. It's important to know what's contributing to our growth. Is it merely from a spike in population growth, or are people finding us because we rank high in a Google search? One of the best compliments we can receive is when we learn one of our established patients recommended us. Those are just a few of the things we track so we can judge, one, how well we're doing right now, and two, what we can do to ensure future success.

Dr Castleberry: In terms of measuring, evaluating and guaranteeing success now and in the future, absolutely the most important thing I do is review our profit and loss (P&L) statement every month. Those numbers never lie. In 28 years, looking at the P&L statement is the one constant that has kept me out of trouble.


Dr Castleberry: Let's talk about the goals we set to grow our practices. I used to set goals to increase my revenue by a certain percentage, but I now realize that all I've ever wanted is an unfair advantage. What I mean by that is, whether my practice is small or large, I want a pristine facility that is the best it can be. To accomplish that, my goal is to deploy the most advanced diagnostic and health information technology on the market. Now, I focus on maintaining my unfair advantage, and the growth is there.

Dr Brujic: My goal is to exceed patients' expectations. It's an easy equation. People come to our office with certain expectations, and if the care they receive is better than they expected, it's a positive experience. Creating positive experiences is directly linked to gross revenue.

Dr LaHiff: Simplifying things for patients and respecting their time have been two of my top goals, mainly as a result of my visit to our clinic as a patient. I made an appointment, sat in our reception area and filled out our forms. It's amazing what you notice when you're a patient. One thing I noticed was that our forms were long and wordy, so we simplified them. We still obtain a good history, but anything that doesn't have to be there is gone. We've also tried to improve flow through the office to shorten the time a patient is in the clinic, because we know patients are busy.

Dr Castleberry: We've taken that a step further and eliminated paper forms altogether. Patients give us their basic information when they schedule their appointments, then we take their history during the interview and enter everything into the electronic health record. Patients love that they don't have to complete any forms. If I had to pick one thing my patients love the most, that's it.


Dr Pearson: Everything we're talking about today is about care and communication. When you think about how to build a successful practice that will endure, you realize the key is to take care of patients and then communicate with them about that. I've seen dozens of practices across the country, and I'm always amazed how so many are successful even though they're doing things differently. What's their secret? They're passionate about what they do, and they do it well.

Dr Castleberry: Our panelists have generously shared some of the tactics they use, many of which are adaptable to many types of practice settings, to create exceptional experiences for their patients and net those ever-important referrals. Hopefully, you can implement these approaches to build a strong — and happy — patient base that will support ongoing success in your practice. ■

Dr Castleberry: In “What It Takes to Be Great” (Fortune, 2006), Geoffrey Colvin* reported that researchers found a lack of natural talent is irrelevant to great success. Even the most accomplished people — investor Warren Buffett, opera star Luciano Pavarotti, pro golfer Tiger Woods — needed about 10 years of hard work before becoming world-class. Do you agree with the premise that hard work trumps talent? Does the 10-year rule apply in optometry?
Dr Bobst: Yes, I think it does. In optometry school, we were told to join the Rotary or Kiwanis clubs and get involved in the community to ensure success. I did that, but I quickly learned that's not enough. I had to learn on the spot and on the go how to read financial statements, how to calculate return on investment and the myriad of other details that affect my bottom line. During my 25 years in practice, I've logged a lot of extra hours, way beyond “which is better, one or two?”
Dr Pearson: I agree to a certain extent, but I think you can work really hard on your golf game and still not reach the level of a Tiger Woods. A certain amount of talent is necessary, whether you're practicing golf or optometry. In sports, there's a saying: Hard work beats talent when talent doesn't work hard. The point is, hard work is the differentiator.
Dr Castleberry: I think I'm a really good example of someone who's not naturally talented but a hard worker. Successful practice is all about managing thousands of details and doing every one of them right. It takes time to learn how to do that.
Dr Pearson: In optometry, we wear many hats. We're medical professionals, but many of us are also business managers and retailers. For me, learning how to manage the diverse aspects of practice has been energizing. It's taken hard work, but I've enjoyed the learning process, and I'm now comfortable in my practice.
Dr LaHiff: Even if you're not talented in certain areas, you can surround yourself with talented people. If you're not a people person, hire a very friendly person to be the face of the practice. If you're not a businessperson, hire a practice manager, so you can concentrate on your strengths. You have to invest in yourself and your practice, otherwise you'll fall behind, and once you fall behind, it's difficult to catch up.
Dr Brujic: The one constant in practice today is change, and successful practitioners are constantly adapting to the new environment. That's hard work, but that work ethic — promoting efficiencies and best practices — influences everyone in your practice.
Dr LaHiff: We also need to adapt to meet our patients' needs. My schedule is always full at the end of the day — always. So we're extending our hours. That's not convenient for me, but it's convenient for patients.
Dr Castleberry: It's a good way to build a practice.
Dr LaHiff: It is, and if you don't want to do it, hire an associate who will, because the patients are there, you just have to meet their needs.

*Colvin G. What It Takes to Be Great. Fortune. 2006. Accessed March 31, 2012.

Optometric Management, Issue: June 2012, page(s): 9 - 11