You field complaints from the staff. Meet with your vendors. Pay the bills. Read up on the new HIPAA guidelines. Oh yeah, there are patients to be seen too! Practice owners often feel like there just aren’t enough hours in the day to get everything done.
And this is true of all small business owners, whether they’re butchers, bakers, candlestick makers…or optometrists. You have a skill – an expertise, really: diagnosing conditions of the eye and prescribing solutions and devices to help your patients see better. And if you’re an employed OD, that’s the extent of the role: you see patients, those patients pay the practice, and the practice pays you for your services.
But when you move from being an employee to a practice owner, suddenly you have two other roles: Manager and Entrepreneur (Michael Gerber describes these as Technician, Manager and Entrepreneur in the E-Myth Revisited). Practice owners ignore these other two roles at their peril.
The biggest mistake I see practice owners make is that they fail to make time to manage and grow their practices. I know: seeing patients is how you get paid. But if you’re only concerned with seeing patients, you’re going to be stuck on a hamster-wheel of frustration as the only way to increase your income is to work HARDER and see more and more patients.
If you want to grow your income without running yourself ragged, you’re going to have to build a business: with systems in place to make sure everything runs smoothly day in and day out, and with strategic plans to attract more patients and generate more revenue per patient encounter (which is another way of saying “prescribe more care to your patients and have them buy into the prescription”). Practice owners need chunks of time for these activities. It’s just too hard to bounce between patient care in the lane and strategic planning or staff management.
I recommend taking your admin time in blocks of at least four hours. Some owners will prefer having a whole day; some prefer half-days. Depending on the size of your practice, there are really only two obvious ways to make time to own and run the business.
For smaller practices (revenues less than $800,000 or so per year), owners might need to acknowledge that they don’t actually have five days’ worth of patients and compress their patient care schedules down to three or four days per week, leaving 1-2 days for administration, staff training and development, and strategic planning.
For larger practices, there ought to be enough profitability for the owner to ‘buy’ time, either by hiring a manager and delegating some of the operational management or by hiring an associate OD and delegating patient care hours. Or both.
Once you’ve made time to be Manager and Entrepreneur, what do those roles entail?
Though most practices have an employee with the title of manager, that doesn’t mean practice owners don’t have some obligation to oversee the day-to-day goings-on in their office. After all, the practice’s consistency in delivering a high level of patient care and its efficiency in getting patients through the exam and into the optical are how the owner gets paid. And if something goes wrong in those areas, it comes out of the owner’s pocket book.
Owners must have some oversight of each aspect of the practice: patient satisfaction, optical sales, inventory management, staff management and culture, billing and receivables, and the finances of the business.
You don’t have to be deeply involved; in fact, you probably shouldn’t. But in my experience, one of the worst feelings owners can have is to not understand what’s happening in your business and not feel in control. You must take responsibility for the management of your practice.
As a practice owner, you can delegate some of the daily management, but setting the vision and strategy for the practice is something only you can do. Wearing the entrepreneur hat means making strategic decisions about how to grow your practice:
How you differentiate yourself from your corporate (and other private practice) competitors. Why should a patient choose your practice over another?
When you invest in equipment, or staff, or a new space to support increasing patient volume through your practice. Investment is a balancing act: your practice needs it to grow, but there’s always the risk that it will just increase your expenses instead of increasing revenues and profits.
What new services you can add to increase revenues and attract new patients to your practice.
An Owner’s Income and Control Comes with Responsibility
As an optometrist, your profession, the skill you’re trained to bring to the market, is to help people see. Practicing optometry in any mode of practice can be incredibly rewarding. Practice ownership adds the opportunity to be in control and to increase your income potential well beyond what you would earn as an employed OD.
Remember though, that in order to fully realize those benefits you must make time to be the manager and the entrepreneur for your practice, in addition to being the optometrist.
Nathan Hayes is the Practice Finance Consultant for IDOC. He is a 10-year veteran of the eyecare industry, working at HMI Buying Group and Red Tray, Prima Eye Group from its inception and now IDOC. In his current role, Nathan helps OD practice owners manage their overhead, grow practice revenues and profits, and maximize their personal income, free time, and professional satisfaction. For questions or comments about this article, please contact firstname.lastname@example.org.