I’m very fortunate to have a really great staff in my practice. My office manager and I work hard to create a positive organizational culture and to provide excellent training programs. So, I was a bit surprised when my manager recently told me that we have a problem that is affecting our quality. She said many of our opticians and optometric technicians who dispense eyeglasses are not doing a great job with frame adjustments. This manager is an excellent optician herself and she noticed patients who returned for adjustments often did not have an ideal fit.
I understand how this can happen and I think the same issue may exist in many optometric practices. We try to hire highly skilled opticians, but we often can’t find anyone. We try to hire people with extensive optical experience, but we also need to find the right personality and someone who is successful at selling. We have to watch the payroll budget as well and when an employee quits, we need a replacement relatively fast.
Along with these human resource challenges, we have seen a gradual decline in formal training in optical dispensing. There are still some excellent college programs in dispensing, but much of the training actually occurs on-the-job all over the country. Optometrists no longer have training in optical dispensing in school, so we have dwindling resources available for training staff members. Since we have lost some aspects of the art of dispensing, especially the frame adjustment part, we end up with new staff members learning from others who are not well-trained in the first place.
Start your own training program
I decided that my managers and I will make training on frame adjustments a high priority for our practice. We designed a program that will be presented over several weeks at special staff meetings and then we will continue to provide refresher courses a few times per year.
Hopefully you have one or more employees, who are still very good at frame adjustments, who can present a similar course in your practice. The doctor may have learned some dispensing skills and can assist in the design of the course and help with content. If not, you may have to invest in hiring a really great optician who can bring these skills to your office.
I should note that there are some excellent training programs for optical dispensing online and also at major eye care conferences. I use these resources in my practice and I recommend other ODs use them for new employees and to enhance the skills of veterans. But even with these large-scale educational programs, you should also have your own in-house training, because frame adjusting requires lots of hands-on practice with actual frames. You can’t get good at it by reading about it or listening to a speaker.
Here are some ideas for how to develop your own training program on the art of adjusting eyewear.
Write a course outline with the help of a skilled optician from your staff. This is easy! Just make a list of the common frame adjustment problems you see every day. Add bullet points on how to look for these problems and how to fix them.
Use PowerPoint or other slide production software. PowerPoint gives your seminar a professional look while keeping your content organized. You can save the course and present it again to new staff in the future. Use your laptop or iPad and plug it into a computer monitor, large screen TV or a projector with a white wall.
Add photos to your slides showing frames with problems and more photos of how to use tools to adjust them. Take some photos of poorly fitting frames on a person’s face.
Add slides with just text to make your points.
Print handouts and give them out. Staff members need to have a reference to refer back to. You can print your PowerPoint as a handout.
Have lots of frames in metal, zyl and rimless along with dispensing tools and a salt pan or hot air blower to use for demonstration. You’ll also need nose pads and screws.
Have even more frames that you don’t mind if they break to allow lots of opportunities to practice. We collect used frames for mission trips on a continuous basis and some of these could be used for your training project.
You will come up with plenty of ideas on how to properly adjust frames, but here are a few thoughts to get you started.
Start with what a properly adjusted frame looks like on a face. What is proper alignment and size?
Once your staff can recognize a good fit, stress that they must achieve this at the time the glasses are ordered. Fit the frame at the time of the order so the patient gets the right size and shape to start with.
Teach staff to inspect a frame in front of the patient before working on it and point out any scratches or defects. This prevents the patient from thinking the optician damaged the glasses.
Know when to decline doing anything to the glasses, or get the patient’s approval to try and if it breaks, the patient will bear responsibility.
Many eyeglasses fit too tightly at the temples, which actually pushes the frame off the face. Pressure on the sides of the head is uncomfortable. Teach your staff how to widen the frame temples when needed.
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.