Article Date: 5/1/2005

fix this practice
Ideal Delegating
When it comes to delegating duties in your office, you may think you know what's best, but think again.
Richard S. Kattouf, O.D., D.O.S.

Q I've been in practice for 15 years and my daily pace with patients is creating professional burnout. I have a difficult time delegating to ancillary personnel because I feel that my patients prefer me performing all of their testing. Do you have any suggestions?

Dr. T.L. Blair, via e-mail

A: Fifteen to 30 years ago, many optometrists started their practices on a financial shoestring and didn't have any staff. They wore all hats: receptionist, optician, technician, therapist and optometric practitioner. Obviously, their patients became accustomed to this delivery of service.

Since then, most of these doctors have gone through an odyssey of delegation so that they could reach the level of diagnostician -- not data collector or optician. The trick to making this transfer of duties to staff acceptable is proper training and instituting a set of checks and balances that allow the practitioner to monitor the progress of the delegated duties.

Delegate a better image

Patients don't appreciate it when an optometrist performs duties that he could easily delegate to his staff. That's why it makes sense for you to work on your delegating skills -- patients will respect your authority and management skills.

The managed care environment demands that we delegate to our staff at higher levels. And proper delegation can lead to a higher net income.

Fixing a not-so-good situation

Dr. Fox (not his real name) called my consulting company with "burnout" issues as well as poor cash flow and low net income. He employed a receptionist and one employee who assisted him in the optical department. He had been in practice for 12 years and believed that his patients preferred that he perform all of their tests and participate in frame styling and dispensing.

Dr. Fox's practice was general in nature with little medical care and no specialization. His net income was only 19% of his gross collected receipts. Dr. Fox was stressed, exhibited poor dietary habits and was diagnosed with hypertension and borderline diabetes. His professional and physical stress was straining his marriage and Dr. Fox had little social life. After evaluating Dr. Fox's practice, my consulting company implemented the following changes:

► We taught Dr. Fox how hiring and delegating to ancillary personnel can produce income by training the staff to produce income rather than just use up overhead.

► We taught him that proper delegation elevates patients' images of his office and of him.

► We convinced Dr. Fox to choose to add orthoptics and developmental vision to his practice. He delegated all therapy to trained personnel. The gross income from this added service exceeded $100,000 in year two after the consulting services. The net income from these services equals more than 40%.

► We taught Dr. Fox to trust the data and performance of employees and we set up a system of checks and balances to ensure that Dr. Fox could oversee the delegated services.

► We monitored his progress for two years after our consulting program. His gross income doubled and his net income reached 38% of gross.

► Dr. Fox scheduled one-hour physical workouts five days each week and drastically changed his diet. After he lost 30 pounds, his doctor took him off of his blood pressure medication.

Take care

The bottom line is that after bringing Dr. Fox's finances under control and reducing his stress, he began enjoying optometry and had more time for his wife and family.

You must realize that your practice is a huge part of your life and that problems that develop in your professional life can spill into your personal life.


Optometric Management, Issue: May 2005