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I think most eye care practices are understaffed if the goal is to produce optimum net income for
the owners. That is a bold generalization, but go with me for a moment.
Reasons many doctors remain understaffed
There are three major factors that lull doctors, practice owners and managers into believing they
are making the right decision about their number of staff.
The payroll expense category in the practice already seems too high, and hiring another employee
will only drive it higher. We read and hear that the norm for staff compensation in optometry is
about 17 to 19% of gross revenue and it is increasingly difficult to stay in that range.
It seems like the practice can’t find qualified employees.
The practice is not that busy, so hiring another employee will only take away from the bottom
I find that all three of these lines of reason have major flaws, which will get into later in this
Another employee can jump-start productivity
It’s ironic, but hiring an additional staff person before it is apparent that one is needed can actually
jump-start a slow practice. It seems like that would be the opposite of what one should do in that
situation, but the opposite of what you think often works! After all, how well has “what you think”
been working (semi-kidding)?
Here is why hiring another employee is often a good idea for business:
Service improves in the practice because there are enough people to take care of the busy times.
This results in increased patient loyalty, multiple purchases and referrals.
Delegation is increased because there is someone to delegate to. The doctor may now see a couple
more patients per day without working any harder. If there are not enough patients anyway, they can
still be consolidated.
The doctor can use the newfound efficiency to create some scheduled time every week for planning,
marketing and staff training projects. The practice will do better if the doctor spends time on
Reviewing the three factors
Here is why the hiring concerns I mentioned above are often not valid:
A payroll expense category of 17 to 19% is the typical average when we survey optometric practices;
it doesn’t make it right or desirable. More importantly than that, the percentage very likely will not
increase if you hire another staff member! The reason is that gross revenue will very likely increase
much more than the wages of the employee. Calculate how much a typical employee earns in eight hours.
It’s pretty easy to make that up in gross revenue.
Finding great staff people can be challenging, but I often find doctors give up much too easily.
If finding another employee is good for your practice and good for your net income, then we just have
to work at it. Quite often, a doctor will tell me she would like to hire another employee, but can’t
find anyone. At that point I’ll ask the doc if she is running a help wanted ad in the local paper right
now. The answer is almost always no. I don’t get that. If I decide that my practice needs another
employee, I run an ad until the position is filled. There are many other ways to find staff also – but
an ad is basic! That brings up a good side point. I just ran an ad for an ophthalmic technician and
the cost of the ad was $650 per week. That is a lot more than a classified ad would cost if you wanted
to sell something – but that is the marketplace. I would not avoid an employment ad just because it seems
expensive. I say bite the bullet and run the ad and find the employee! I found a great new tech with
excellent training and experience. One more point: if you really can’t find any good staff and you have
really tried, it means you need to pay more.
The final concern was about the payroll expense taking away from the profit because the practice is
not busy enough. The section above about jump-starting covered that pretty well. The increased productivity
and service more than covers the additional cost. Remember that the payroll expense of one additional
employee is really not that large and it is spread out over time. You’ll have time to overcome the cost.
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.