More and more optometrists are trying the “super-tech” concept that I have been using in my practice for many years. I have written and lectured about this strategy many times, but I receive a lot of questions on this topic, so I’ll review the highlights in this article.
The concept of a scribing technician/optician works extremely well in my practice, but like most practice management strategies, it is not a good fit for every practice.
What is a super-tech?
A super-tech is a clinical technician who is also a scribe and is also an optician. This person assists the optometrist with all aspects of direct patient care. The doctor delegates a great deal of the clinical and optical management of each patient to a super-tech.
The super-tech approach to scribing differs from the idea of hiring one assistant to follow the doctor and record exam data. The super-tech is a well-trained ophthalmic technician who performs the case history and extensive pretesting before the doctor sees the patient. That technician becomes the scribe for the doctor’s exam and can enter exam data at a higher level than an administrative scribe. The super-tech assists the doctor as needed during the exam, listens to the case summary by the doctor and can carry out whatever final care is needed.
The super-tech is also a trained optician and walks patients who need glasses to the optical area and conducts the frame selection, takes all measurements and writes up the fees. No hand-off is needed because the optician was in the exam room to hear the recommendations first-hand. The super-tech also carries out the treatment plan if it does not involve eyeglasses, such as additional medical testing, contact lens fitting, referral to a specialist or patient education.
The super-tech concept assigns one technician to stay with each patient at all times throughout the entire visit. Multiple super-techs are needed in a busy practice; the doctor will work with several technicians as they rotate and go to wherever they are needed most. Super-techs are also paged to the optical dispensary as needed to handle walk-in patients who are picking up glasses or need an adjustment or repair.
Why implement this?
There are many benefits of the super-tech concept, but here are a few key points:
Extremely high level of customer service; the patient is never left alone.
A high degree of bonding occurs between the technician and the patient. The patient experience is improved.
The full benefits of scribing: a huge amount of doctor time is saved and the doctor’s attention is always on the patient with no distractions.
Patients are impressed with the clinical exam process; hearing the exam findings spoken out loud is interesting to them.
Better clinical records in the EHR system because the scribe has the time to make them complete.
A more accurate billing and coding process because the data is entered properly at the time of service. Fee questions are handled by staff, not the doctor.
The doctor never has to search for a technician or optician.
The doctor never has to waste time walking patients to another part of the office.
A higher eyeglass retention rate occurs because the transfer from clinic to optical is seamless.
How many super-techs does a practice need?
It is best to arrive at the proper staffing number through some experimentation, because there are many factors at play. In my practice, we schedule three super-techs per working doctor. On a three doctor day, we would have nine super-techs. That may seem like a lot, but these technicians are often pulled to optical for dispensing tasks and they also have some side administrative duties. And we see a high number of patients; each doctor does an exam every 15 to 20 minutes. We also have three master opticians who do not do any clinical work. They are always on the optical floor and they could take a handoff from a super-tech if we needed the tech on the clinic side.
A good way to test the super-tech concept is to introduce a pilot program. Train one of your best technicians to scribe and to do basic optical dispensing and try it on a few patients. Decide from there if you want to implement the strategy on a practice-wide basis.
It is fairly common to meet some resistance from staff members when you present the idea of super-techs. Staff members who are mostly clinical are not always interested in retail sales and traditional opticians may not want to learn clinical skills. When I introduce change in my practice, I try to see the situation from the employees’ point of view and I try to identify their fears. Once I do that, I can usually reassure the staff and overcome their objections. I approach change with great patience and understanding and I promise to provide the resources the staff needs, such as training and additional staff if the pilot program is successful and if it makes economic sense.
As I work through change with my staff, I also position the new program as an opportunity for career advancement. That is not always an easy thing to find in optometric practice and I expect employees to be interested in expanding their horizons. If an employee has a very poor attitude about trying new strategies, I may realize that he or she was not as valuable as I previously thought.
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.