My column last week was about not selling your practice and not adding a partner too early. Adding an employed OD instead can change your exit strategy. I had some nice comments from readers on that article, but one colleague asked me to write about how to find the right doctor for the practice with an eye on reducing turnover and setting realistic expectations. I’ll cover that in this piece.
Plan for your needs
As you interview and evaluate candidates for the associate optometrist job position, a big factor to consider is how many choices you have. Some markets have many ODs who are looking for work and others have very few. You can be more selective if you have several candidates or if you are not in a hurry. Of course, you can attract more candidates if you are willing to pay more in salary.
There are many advantages to hiring a doctor on a full time basis, including less turnover, but some practices do not have enough patient demand to keep a doctor busy full time. Part time optometrists generally do not receive employment benefits, like paid vacation, continuing education payments or health insurance.
While we want to reduce doctor turnover, realize that you can’t force an employee to work for you. Either party can end employment at any time. It helps to retain doctors if you pay well and treat them well, but some factors that make employees quit are beyond your control.
Don’t think of this employee as a partner. I think it is your job to fill the new doctor’s schedule. Don’t hire an associate optometrist if you don’t have a backlog of patients. Reducing the senior doctor’s patient care load, however, will encourage some patients to move to the new doctor if handled properly by the staff.
Decide what is good for the practice and don’t make too many concessions in your enthusiasm to attract someone. Hiring an associate is a perfect time to expand into evening and Saturday hours. The practice owner should decide on the appointment schedule and it should be fast-paced.
For a new doctor to fit well into the practice, the personalities of the senior doctor, the new doctor and the staff must interact well together. At the most simple level, you determine this by getting to know the candidate through general conversation. Do you hit it off well? Do you have some things in common? Do you see eye-to-eye on most issues?
To carry this effort further, read up on personality types and consider giving the job candidate a personality test.
One factor that I’m especially wary of is the possibility of an over-sized ego. If some jobs in the office seem beneath the new doctor, or if the new doctor thinks he is more important than the staff, problems are likely to develop. I want an associate who is friendly, down-to-earth and respectful of others. This personality not only fits in with the office culture, but it builds a good relationship with patients, which results in more word-of-mouth referrals.
After a general discussion about optometric practice and trends in our industry, be sure to focus on some practical real world issues like the following:
Dilation preferences and frequency, with and without retinal imaging.
Discuss interest in specialties like orthokeratology, scleral lens fitting, vision therapy, low vision, dry eye, nutrition and ocular disease.
How does the new doctor feel about seeing urgent medical cases that are worked into the schedule?
Electronic health record-keeping can be time consuming and managed care requires records to reflect the level of care provided. Ask the new doctor about his or her skills in that area and also in billing and coding.
Discuss how the practice will handle after-hours emergency phone calls and eye care.
Discuss evening and Saturday hours. I prefer the practice owner to decide on the hours and make it non-negotiable.
Given some time to adapt and learn new techniques, will the new doctor be able to perform about 25 eye exams (a mix of comprehensive exams and office visits) in an eight hour day? Set the expectations early for the schedule the practice needs and give doctors who prefer a slower pace a chance to bow out before they start.
There are plenty of optometrists who do not want to own a practice and operate a business. Those of us who own practices can understand that; it is no bed of roses. Many new graduates want to practice clinical eye care and would love to do that in a traditional optometric private practice. The professional image, the great staff, the excellent instrumentation and the full service optical are all positive factors.
The ideal OD candidate for this CEO model of practice is one who does not want to be a partner or owner. If the candidate asks about opportunities to buy in, I think we owe it to him or her to be honest and reply that the position available is for employment only and at this time, there are no other opportunities. Of course, some years down the road, anything can happen and an associate may become a natural buyer of the practice, but don’t mislead or make promises.
A restrictive covenant is an important consideration and should be presented and discussed openly and early in the discussion.
Here are a few good resources for advertising your available job position:
The AOA national placement service is an excellent resource: Optometry’s Career Center.
Your state optometric association may list practice opportunities in its publications.
Most optometry schools provide placement services for their graduates. I’d post a position available announcement in all of them.
There are many online career placement services available.
Use your own network of friends and colleagues to spread the word about the position and to recommend someone.
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.