I realize that most eye care professionals (ECPs) do not get the chance to be away from their offices much, except for a vacation here and there. But more and more ECPs are working part time and some are increasingly dedicated to practice administration while leaving patient care to partners or associate optometrists. It is certainly possible to manage your practice from your home in town, from a second home out-of-town or while traveling.
I've long been an advocate of designing a practice that does not depend solely on the doctor/owner. Consider these benefits:
The owner operates at a higher level as both a doctor and as a CEO.
It is easier for patients to accept delegation of services to staff members.
It is easier to transfer patients to associate doctors.
It is easier to sell the practice in retirement.
It is possible for the practice to generate income without the doctor/owner being present.
Managing the practice remotely is a great goal because it forces you to think of the practice as a business that has important people running it besides you.
A full time manager
A full time office manager is a necessity for a practice that does not have the owner always present. Someone must be in charge and have the authority to direct work and make decisions. And since everyone gets a regular day off, calls in sick sometimes and takes vacation days, it is a good idea to have an acting manager or an assistant manager as a backup for the manager. The actual duties of the manager can evolve and increase over time, but the basics begin with telling employees what jobs to do, supervising the flow of money and properly closing the office at the end of the day.
The owner can work quite closely with the manager while away from the office. Over time, the manager becomes trained to think the way the owner does. Eventually, it's up to the owner to decide how much micro-managing he or she wants to do. It is best to let the manager function at a high level and not have to check with the owner on every routine decision.
Clear office policies and a functional employee manual are tools that greatly assist with remote management. If you don't have them when you start such a venture, you will develop them quickly.
Even though information will always be available to the absent owner, it is best to have some items delivered as a matter of daily routine without having to ask for them. The following items can be emailed or faxed every day that the owner is away from the office.
Daily appointment schedule. At the beginning of the day, each doctor's schedule should be sent. Review for openings and speak with staff about efforts to fill gaps.
Employee call-offs. Send a list of people who called off for any reason.
Daily production report. All reports of interest from the practice management software system should be sent at the end of the day. The owner should review gross revenue and receipts along with the quantities of services and products that were sold. Spot check that appropriate fees were charged.
Manager's email summary. The manager can send a short email at the end of the day reviewing any events of interest that occurred.
Drawer balance worksheet and deposit ticket. Send a summary of the day's receipts and the bank deposit.
Technology Technology certainly makes it easier to keep track of your practice from any computer in the world. Consider these ideas:
You need a secure method that allows you to log into your office computer system from another computer – at home or on the road. Microsoft has a system called Remote Desktop Protocol built into Windows PCs and there are other software programs you can purchase. With a high speed internet connection, you can see and operate your office PC from home and you can hardly tell the difference. You can even email a document from the office to yourself and receive it at home
If you travel a lot, invest in the nominal monthly fee for a USB wireless modem. Just plug the device into your laptop and you can be online, using the internet and email, anywhere. These devices now offer fast internet speeds.
Faxing is very old school. Sign up for a service that gives you a toll free fax number and all faxes come to your email inbox as a PDF file. You can print the file if you want to, just like a fax, but now you have it stored electronically so you may not need to. Instead of sending faxes, you can scan a document using your multipurpose printer and save it as a PDF file. Then attach that file to an email and send it. This is better than faxes because you now have the document stored in your system.
To create a PDF file from any document in your PC, you download free software that lets you “print to a PDF file.” Instead of printing the document, you select a virtual printer and create a PDF file for it.
A personal data assistant (PDA) (Blackberry, i-Phone, Droid or whatever you wish) is very helpful in remote management because email becomes an important business tool and you will always have access to it. Plus you have your cell phone, contact list, calendar, and to do list all in one device.
Overnight delivery service is not high tech, but it is a great tool when you need original documents or mail fast.
Video conferencing. This sounds pretty fancy but most laptops have built in webcams and add-on models run about $35. The software is free from suppliers like Skype, AOL and Yahoo. There isn't even a long distance phone expense. Why not see the people you are talking to?
If you really want to monitor the operation remotely set up a security camera system with webcam access. You can position cameras at key locations and just log on to any PC, or even from your PDA, and watch what's going on. Some cameras can even have audio. You will reduce the chance of theft or embezzlement.
Don't forget the telephone! It's not high tech but it still works great!
Practice finance Most practices I know use business financial software like QuickBooks to manage their bank accounts and track expenses. This works perfectly for a practice owner to keep close tabs on the practice finances by using the remote log-on system described above. If you simply log on from any computer in the world via a high-speed internet connection, you can access your accounting software and see all transactions and accounts. You may even develop a system where invoices to be paid are prepared electronically by a manager or bookkeeper, but the checks are placed on hold. The practice owner reviews the entries every few days and decides which ones to pay and when by placing a check mark next to the approved items. The bookkeeper then prints those checks that are marked, uses an official signature stamp and mails the payments.
More and more suppliers can be paid by auto debit with a bank draft or on business credit cards, and this process offers many advantages. Major insurance payors are also moving toward electronic deposits of funds. This makes administration much easier and instead of making deposits and payments, the practice owner simply reconciles the accounts, which can be done from anywhere.
Best wishes for continued success,
Neil B. Gailmard, OD, MBA, FAAO
Editor, Optometric Management Tip of the Week
Dr. Gailmard's new book, Practice Management in Optometry: A Blueprint for Success Based on the Optometric Management Tip of the Week, is now available on Amazon.