Most Important Goal Other Than More Profit? More Free Time.
January 13, 2016
When I work with optometrists who own their practices, I ask them about their goals. The most common goal I hear revolves around some aspect of creating a larger financial profit, but a very close second is how to create more free time. Of course, everyone has their own priorities in life. The younger OD might want more time with family, including more participation in kids’ activities. The mid-career doctor may want time for hobbies, sports or travel. The optometrist closer to retirement might want any of these options, but generally does not want to work so many hours.
Whatever your reason for wanting more free time, let’s look at some big picture ideas for how to create it, without reducing your gross or net income.
Free time must come from somewhere
The best way to create more free time is to become more efficient in certain parts of your life. We can analyze this by dividing your life into three buckets: personal time, patient care time and business management time.
We want to create more personal time, so I won’t try to reduce that. I find most ODs do not spend enough time on practice management, so I’d rather not cut that. I think many ODs (not all, but most) are inefficient when it comes to delivering clinical care, so I’ll provide some ideas on how to see the same number of patients per week in less time and without stress.
The amount of time you can save varies, but it could easily be 10% to 50%. If you are currently seeing patients 30 hours per week, you may be able to do the same work in 20 hours. Could you use 10 free hours per week?
The first step to being more efficient in your clinic without stress is to delegate more. Only you know what items you could delegate that you are not now. Make a list on paper of all the steps you perform in a typical eye exam. Check the items that you could delegate if you had the staff support. It might be having staff take more of the case history. It might be more pretesting or scribing. Some ODs still do tonometry on all their routine patients. Make this exercise idealistic, even if you don’t have the staff for it yet.
Hire more staff
The fastest way to push yourself to delegate more is to just go ahead and hire another employee. Most ODs are very guarded about doing this because of the payroll cost, but sometimes you just have to take a chance in business. Nothing will make you delegate more than having staff members standing around doing nothing and that would be a good step! In most cases, the additional salary cost is more than made up for with increased exams per day and increased sales in optical.
Hiring another employee also reduces the push-back you might get from your current staff if you go to them with the idea of delegating more. They really can’t complain if the extra work is not falling on them!
One might consider electronic health records as an administrative duty and not patient care, but since it happens at the same time as patient care and because it is so time consuming, let’s cover it here. The first easy answer to reducing doctor time spent on records is to use scribes, but let’s also consider immediate ways to speed it up. Consider if you might be too much of a perfectionist when it comes to your records. You can use some shortcuts and abbreviations as long as they are standardized and you have a log detailing what they mean. And if there is some aspect of your EHR system that is terribly inefficient, you could devise a work-around that involves paper and abandon the method that is hurting your speed. All EHRs have a method of scanning a paper document, so have your staff do that if it is much faster.
Change your exam routine
Are you still doing some test procedures out of habit, and they are not usually adding anything useful in your diagnosis or treatment? Do you perform some tests because you think it might impress the patient? Be honest. If so, I would rethink that and save the time.
Time spent talking
Take a cold hard look at how much time you spend on patient education and explanations about what you are doing. We can all agree that that those are very valuable activities to some extent, but it is easy to provide more than the patient needs or wants. Don’t kid yourself into thinking patients love those detailed mini-lectures on the eye or refraction. It may be more interesting to us than it is to them. They might smile and nod because they are being polite.
Most of us tend to try to get everything done in one visit, so we don’t inconvenience the patient. But realize that health care is changing and the reimbursement for a routine exam is quite low and it should be matched with a short visit. If medical issues are present, we can and should reappoint to take care of them.
Change your appointment template
Finally, as you make the changes above, you will need to make your appointment slots shorter in order to take advantage of the increased efficiency. This step can be a little scary to doctors and staff, so try them on a limited basis at first and make some tweaks in your routine. But eventually, you must change the 30 minute slots to 20 minute slots. When you do that, you will find ways to be more efficient because you have to.