Article Date: 3/1/2003

o.d. to o.d.
Doctors and Business
Why do so many optometrists have an aversion to the business aspects of practice?
BY NEIL B. GAILMARD, O.D., M.B.A., F.A.A.O., Chief Optometric Editor

Aside from my work in my own practice, I've spent much of my career teaching doctors to be business minded. I taught the practice management course at Illinois College of Optometry for 20 years, presented many continuing education (CE) lectures throughout the United States and wrote numerous journal articles on the subject. Mostly that effort has been well received, but I've also met many docs who just don't like the business aspects of optometry. Some tolerate it because they have to. Some are actually offended by it.

Why the aversion?

I know many doctors who won't attend a practice management CE course because their state board won't grant credit for that topic (as if credit is the most important reason to attend such a course). It's common for doctors to learn of a great management concept, but to never make the effort to put it into effect. Lots of O.D.s resist the idea of delegation in their practices because they don't want to manage a bigger staff. Many optometrists just don't want to grow their practices -- even though they have the potential to do so.

I think the business aversion even prevents many O.D.s from owning their own practices. While I believe in every doctor's right to practice any way he wishes, I think many would like to own their own practice but are too intimidated to try. I don't believe any one mode of practice is better than another, but I think it's healthy that in our profession many O.D.s own practices and dispensaries.

You have to make the time

We're all working hard to continually improve our clinical skills, but management skills pays big rewards too. Reading OM and books on business, attending practice management courses, working with optometric consultants and holding regular staff meetings are professional responsibilities we should make time for.

I schedule specific management days for myself in my practice. These are blocks of time without patient appointments, but they provide structured time for me to work on the business aspect of my practice when my staff is present. There's no end to projects that need my attention!

So as not to reduce my patient volume, I add the patients that I would have seen on those management days into my clinical days. I delegate more so I can see more patients each day. This strategy makes the practice instantly appear busier, which is an immediate image boost.

We're capable of learning

I must admit that many O.D.s aren't good business people, but it's not because they aren't smart enough. I found the courses in optometry school much harder than those in business school, and we all passed those. Most optometry schools only teach the bare minimum in practice management, but that's no excuse for not learning it on our own. I'd like to see more emphasis on practice management in the schools, but the curriculum is jammed with traditional optometric and medical courses.

Get over your insecurities

Perhaps some docs avoid business topics because they're hypersensitive about appearing as merchants and want to be sure they're perceived as real doctors. But isn't that just so 1970s? Haven't we gotten over that yet? I don't think this is a valid concern, but the quickest way to avoid it is to develop your own practice and to project the image you want. You can't do that, however, without having some business skills.

We should take a lesson from dentists. They seem secure with the business aspects of professional practice and their image is just fine.

Think business

If your practice isn't all you want it to be, try embracing the business aspects of optometric practice. It can become a welcome diversion from day-to-day clinical practice and it's rewarding -- both financially and professionally.


Optometric Management, Issue: March 2003