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Many eye care professionals ponder if they should have an office manager. For me
to venture an opinion on most management questions, I usually have to know
something about the practice, but in this case I can basically just answer yes.
If a practice is too small for an office manager at the present time, the owner
should at least be planning for one in the future. And even a one-assistant
office could make that single employee an office manager.
After all, how can a business run properly without having someone working on it?
I’d like to think the doctor/owner will remain actively involved in the business
aspects of the practice, but he or she usually must see patients and the
non-clinical time available is nowhere near enough. In my view, the main reason
that practices don’t grow fast enough or big enough is a lack of attention to
the business! Most offices will reach a basic minimum level of patient demand
simply by existing, but to grow beyond the average takes interest and effort in
managerial and administrative roles.
It just makes sense that any business that approaches annual revenue of a half
million dollars (or beyond) needs a full time business person. Businesses don’t
run themselves – at least not very well! Unfortunately, many optometrists don’t
like the business aspects and don’t give it enough attention. The most
successful practices have an owner who devotes some time to the business (and
leadership) and has a full-time office manager.
Where to look The question is often whether to look within the practice or search for new
talent elsewhere. Both of these are good options and the answer depends on the
practice. Promoting a current staff member is an excellent way to reward good
work and there is the added advantage of having an office manager who knows the
practice procedures from day one. A possible drawback is that employees who are
passed over for the job may harbor resentment and morale problems could develop.
Also, if the promoted employee is a good friend to the other employees, his or
her loyalties may be sharply divided and the friends may win. Can the new
manager see a problem and provide discipline to a co-worker? Will the employee
recognize and accept a friend as a boss? If there is an obvious and natural
choice among the current staff (perhaps a person who has been acting as office
manager by default), that person will likely be well accepted by co-workers.
The alternative to promoting from within is to advertise on the open job market
for an office manager. I would let your current staff know that you are doing
this in advance, explaining that you are seeking someone with managerial and
business experience. Warming up to the idea before it happens helps pave the
transition. You might also make the point that the office manager will become
primarily an administrative position and will not be as directly involved with
patients; perhaps your current staff is too valuable with their present skills
and the practice can’t lose their patient care services.
I believe eye care experience is not a prerequisite to becoming a successful
office manager. Having excellent people skills is. An office manager must have a
passion for excellent customer service; I mean really get it and not just give
the usual lip service. This person must also have a knack for diplomacy with
patients and staff. He or she must be friendly, caring and patient. A college
degree is a valuable benchmark, and a business major is all the better. A
background in optical is valuable, but most offices have many experts on optical
matters and the manager should be able to find many resources for answers to
technical problems. It does not take long for a smart manager with no optical
training to become knowledgeable in clinical eye care, optical dispensing, the
office management computer system, and insurance billing and coding.
Authority and responsibility
An office manager is the boss. That is a good overview of that person’s duties.
In my opinion, if the other staff members don’t know that the office manager is
their boss, the effectiveness of the role is severely diminished. The manager
needs authority and responsibility and that can only be granted by the practice
owner (or some other person with higher authority). It may be difficult to
announce to highly-valued veteran staff members that they have a new boss – but
I think far bigger problems await if this is left vague.
The use of the term “manager” has been in and out of vogue over the years, but
it is really simply semantics. One might use titles like team leader or
coordinator, while some practices prefer the titles of practice administrator or
clinic director. Really, any name will work if there is authority behind it. But
if those titles have nothing behind them, they might actually cause confusion
and internal bickering among workers. A team leader may think she has authority,
for example, but a technician doesn’t think he has to answer to her. It must be
clear. I like manager because it is universally understood by employees and
patients and I want it understood.
If a practice is large enough, the concept of departments or profit centers can
work well. In my practice, we have four departments: patient care, business
office, optical dispensing and optical laboratory. Each of these areas has a
department manager who reports to our general manager, but has authority over
the staff members who work in each department. These department managers also
carry an “assistant manager” responsibility. One department manager is placed in
charge of the entire office when the general manager is not in. This is very
effective because the office is open six days per week plus two evenings and the
office manager can’t be present all the time. By always having a manager-on-duty
assignment, the practice owners do not have to always be present as a manager
How much to pay
This varies too widely to give a simple dollar figure. An office manager would
generally be paid on a salary basis and should receive a nice benefit package.
How much salary would it take to attract and retain a smart, dedicated person
with good managerial experience? How much could that person make in a field
other than eye care? The office manager might be the highest paid employee in a
practice, but does not have to be. Experienced technicians and opticians could
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.