Article Date: 12/1/2004

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Keeping Busy
Sometimes you're busy, other times not. Learn to keep a more consistent flow.
By Gary Gerber, O.D.

  Like it or not, we may never find an answer to some management questions, but if we see a consistent pattern in business, then we can possibly answer questions such as, "Why am I always so slow on Wednesday mornings and so busy on Thursday nights?" (Feel free to substitute your own busy and slow times.) Let's take a closer look at this common problem.

Counting on past experience

I travel a lot. This year, I'll fly more than 100,000 miles, yet it's rare that I get bumped from a flight or even hear the dreaded gate announcement, "Ladies and gentlemen, we regret to inform you that we're in an oversold situation." (Both of these situations mean that the airline sold more tickets than it has seats.) But why would it do that?

Well, statistically, the airlines have norms that indicate (for example) that flight 525 from Newark to Cleveland has a history of 7.94% of passengers not showing up. So if the 737 holds 189 passengers, the airline can sell 204 tickets -- that way, it should have exactly 189 passengers.


If my experience is any indicator of the success of this system, I'd say it's uncanny how often it works. Planes are usually full and as I said, someone getting bumped is rare. We can benefit by using this system in two ways:

1. Schedule more patients for down time. No one likes when patients don't show up for their appointments, and the obvious loss or delay in revenue certainly isn't good for your practice. Of course, anyone can have an occasional lapse or circumstance that causes them to miss their appointment, but human nature being what it is, patterns usually apply to no-shows.

Our consulting company's experience with clients reveals that Saturday mornings and Wednesday afternoons are two common times for patient no-shows. Once you establish your own pattern of when no-shows are most common, accelerate the rate at which you book appointments. This doesn't necessarily mean "double booking," but it could.

For example, if you typically see patients every half hour, consider appointing three each hour during Saturday morning and Wednesday afternoons. These "oversold" appointment slots would also be a great place to appoint chronic known no-show patients.

2. Insomniac optometry. If your practice could only be open for two hours each week and your office hours were on Tuesday from 2:00 a.m. to 4:00 a.m., then you probably wouldn't be busy. However, if instead you chose Thursday's from 3:00 p.m. to 5:00 p.m., then you might have a waiting list a mile long. (Also, be sure your staff isn't manipulating the schedule to their advantage.)

Using our airline capacity booking model for setting office hours is another strategy you can benefit from. Once you determine those particular time slots that are historically busy or slow, consider expanding the former and contracting the latter. That way you are in effect "stacking the appointment deck" in favor of being continuously busy.

We counsel our clients on office hours and one of the first questions we ask them is, "Is there a reason why you open and close at the times that you do?" The most common answer we hear is, "We've always done it that way."

Prepare for take off, captain

Take a critical look at the seats on your airplane. Do you have too many empty aisle seats? Perhaps you need to adjust your flight schedule. It's a simple but effective solution. Try it for yourself.

Dr. Gerber is the president of the Power Practice, a company specializing in making optometrists more profitable.  Learn more at or call Dr. Gerber at (800) 867-9303.


Optometric Management, Issue: December 2004