Adding an associate optometrist to your practice is one of the best management decisions you can make. It can increase practice revenue and profit dramatically while allowing the practice owner to reduce time spent on patient care. The additional free time can be used to concentrate on practice administration or to just enjoy life. In this article, I’ll cover ideas that will help you know when the time is right to hire an OD.
Do you mind if your personal income drops?
It might seem obvious that most practice owners do not want to see a drop in their personal income, but it is a good question to start with. This question gets to the heart of the timing for bringing in an associate OD and what the goals and expectations are. In some cases, a senior OD might place so much value on gaining some free time that it does not really matter if personal income drops a little.
If you want to maintain or even increase your personal income from the practice, you need to avoid the situation where you are paying a new doctor to see patients that you could have seen. If you do that, your personal net income will decrease by that portion of the new doctor’s salary. Read on to learn how to predict and avoid that.
Will you see more patients per week?
This is the most important point that relates to paying the new doctor’s salary and benefits, and possibly making some additional profit. Project how many exams per week you will be able to see with the new doctor on board. This will require you to answer some questions:
Will you be decreasing your patient care days per week? If you hire an OD to work two days a week and you drop two days, you did not increase the number of patients.
It will help if the new doctor works a couple of evenings per week and every Saturday. Those are highly desirable days to patients and those days may be booked far in advance.
It might seem difficult at first to get patients to accept seeing the new doctor, but there are ways to improve that. One good way is to decrease the senior doctor’s patient care days per week so his or her backlog gets much further out. Some patients will see the new doctor because appointments are available sooner.
How far ahead are you booked?
This is the key element to look at, even though it is not perfect. In general, how far ahead in your schedule is the next appointment opening? Of course, you may have a cancellation tomorrow, but if you look at your patient schedule, how many days ahead are you booked fairly solid? Be very cautious in evaluating this if you preappoint because your schedule could appear fairly full, but in reality, you may get a fair amount of last minute cancellations, reschedules and no shows. In that case, look backward and see how many patients you actually see per day and make a judgment if you consider that to be a full day or not.
If your schedule and that of all associate ODs in your practice is booked ahead at least a week, and you have a well-delegated practice and see at least 20 patients per day, I think you are ready for a full time associate. If you are booked a few days in advance, you may be ready for a part time doctor. If you are not booked ahead much at all, you should not hire an associate, unless you don’t mind having your personal income drop.
Why not just expect the associate to build his or her own following?
Some doctors who are not booked ahead very much will reason that they had to build their patient following, why shouldn’t the new doctor do the same? In my experience, that approach does not work well. Usually, the new doctor will not be able to do this fast enough and will not produce enough revenue to pay himself a fair salary. When that happens, the new doctor will be unhappy and will eventually quit.
The validity of the earn-your-own way approach also comes down to the question: is the new doctor an employee or an owner? This point sometimes gets blurred because the senior doctor wants to respect the new doctor, but it is best to keep this clear. An employee does not typically agree to take on the business risk of an owner. In my view, if you hire an associate doctor, he or she is an employee and it is up to the owner to supply the patients.
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.