Your practice has many resources it brings to bear in caring for patients: office space, equipment and instrumentation, eyewear and contact lens selections. But apart from the optometrists and their expertise, your staff are perhaps your most mission-critical asset, especially for practices that still want to grow.
After all, few patients will refuse to return to your practice because "that OCT was so 2010!" But patients will refuse to come back to your office if your staff is rude, even if it is filled to the gills with the latest and greatest in diagnostic equipment.
So, staff matter quite a lot. But any owner with more than one staff member knows that not all staff are created equal. And while every practice would like to have awesome performers in every role, most practices have a mix of great, good and OK staff. (Poor performers need not linger.)
And consider, if you’re in an expensive labor market, it might only be possible to pay for "A" players in a few spots on the staff. If that’s you, which roles are most important? I’d like to lay out the three critical roles I see in most practices, along with key attributes to look for in those roles.
For most practices, an optician is the first hire (that is, "optician plus whatever else needs doing"). Given that the typical practice gets 40% of its revenue from eyewear sales, your opticians are critical to turning the OD’s refractions and prescriptions into eyewear sales.
Of late I’ve been thinking that good opticians fall into two camps: salespeople or craftspeople.
Salespeople love the fashion and service aspects of the role – they are excited by frames and lenses they carry, and this enthusiasm alone helps bridge the gap between "yes, the doctor did say I need glasses" and "what do you mean it’s going to be $600 out of pocket?"
Craftspeople are phenomenal in the lab and they know lensometry inside and out; they enhance your practice’s service by making sure every job is ordered correctly and is correct before it’s dispensed.
For your first optician, I would rather you have an optician that can sell than a technical wizard, given how much support optical labs can now offer on the technical aspects of opticianry. And then I’d be sure to hire a technical wizard of a craftsperson for my second optician.
The second critical role is your billing manager. While most practices undoubtedly leave some money on the table by the way they code and manage their claims, I’ve seen a few instances where the process breaks down completely and practices simply don’t get paid for their work. There are few true catastrophes that can befall a practice, but this qualifies as one of them. Managing third party receivables is a critical role.
Small practices may even prefer to outsource their claims management to a third party. This can be a great move, though I think there’s real value to keeping your billing in-house. However you do it, be sure you have a details- and results-oriented person who has responsibility over receivables, even if it’s in conjunction with an outside vendor.
The third mission critical role isn’t normally needed until your practice reaches $750,000 or $900,000 in revenue. Every business has 'phases' of growth, and most practices hit their first plateau at this point.
Why? Well, in a $750,000 practice you’re typically a solo OD, carrying a nearly-full patient load, with five to six staff to manage and the administration of the practice on your shoulders. In short, most solo owners don’t have enough time and mental bandwidth to do all these things AND work on growing the practice.
The most important thing a manager needs to do is ensure that all the hourly, non-OD staff are doing what they’re supposed to be doing, so you can focus on patient care and practice building. And managers need to recognize that when push comes to shove, they’re there to represent your interests.
The other thing to ask when considering manager candidates is: "what are my least favorite administrative tasks?" Then pick a manager who can take those tasks off your plate, so you can do the things you’re best at.
What the OD Should Be Doing
Historically, OD owners have filled some or all of these roles themselves. But if you want to maintain your sanity while growing your practice, you cannot do everything for your practice. And consider this: if you went and filled in as an OD in another practice, you could earn at least $50 an hour. In most markets, opticians, billers and managers earn between $20 and $25 an hour.
As your practice grows, it’s only logical to delegate these roles so you can focus on the work only you, the OD owner, can do: patient care and business-building activities like networking for new patients or deciding on new services the practice can offer.
Hire well for these roles, and you’ll set yourself up to have the time and energy necessary to grow your practice revenues, your personal income, and your enjoyment of practice ownership for the long haul.
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.