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A sensitive subject
In speaking with optometrists about practice management over the years, I’ve found that the topic of delegation is a
sensitive one for many. I’ve heard many objections to the concept – although I never really understand the
resistance. I’ll be the first to say that optometrists should practice any way they wish, so it’s really an
individual philosophy and decision, but my objective is to help my colleagues build more successful and more
profitable practices, so if you’re in the group that wants that, you owe it to yourself to analyze your delegation
Even if you’re comfortable with the concept of delegation of clinical and optical procedures to well-qualified
technicians and opticians, you may say that there is no need to do so in your situation, and there is no one to
delegate to. That’s where we would disagree. All successful businesses need to have the owner move away from the
task of doing the technical work and into the task of managing the business – it doesn’t matter if you repair cars,
cut hair, bake donuts, or examine eyeballs.
The early stages of practice
Granted, you can’t practice maximum delegation if you’re in the early stages of practice development – but you
should be thinking about how it should be. I started my practice cold, so I’m quite familiar with all the phases.
A fatal mistake occurs when the doctor/owner is performing tasks that could be delegated and becomes complacent
about it and rationalizes that it’s the best way. I want you to feel just a little bit badly when you do routine
duties (like the ones listed below and many others) so you’ll act on devising a plan to change it. You may have to
do certain procedures at times for practical reasons, but don’t lose sight of the master plan for your practice.
One common objection
A typical objection by an OD to the delegation concept might be: “Why should I hire someone and pay him or her to do
something that I can do, and have time to do, in my current schedule?” That certainly sounds logical, and it’s why
optometrists don’t delegate very much. This objection is built around the fact that many optometric practices have
appointment schedules that are not completely full – and if the spotty schedule in question is structured to allow
about 12 exams per day, the doctor will have plenty of extra time.
The fallacy of the objection above is that you don’t have as much free time as you think. Not if you were doing the
right things – and it’s not all about patient care. Many ODs don’t realize how and where they are needed in their
practice. If you’re practice is not booked solid, you need to spend even more time on practice marketing,
self-training in business, staff training and customer service. So the non-busy practitioner should delegate some
routine tasks because he or she will be using all non-clinical time on management activities. Ideally, you should
reorganize and consolidate the schedule as you make the shift toward delegation. This would involve seeing a few
more patients per day, so those days are really busy, while freeing up some half days or full days for management.
Clues about delegating
This list is just an example of a few tasks that are often performed by optometrists, which I think can and should
be done by staff members. Are you doing any of these procedures? Do you plan on doing them forever?
Ordering contact lenses by phone, fax or on-line
Measuring a seg height
Taking visual acuity on every exam
Edging spectacle lenses in your lab
Calculating payroll hours
Teaching contact lens insertion, removal and care
Performing automated pre-tests, like auto-refraction or non-contact tonometry
Performing threshold visual fields
Performing corneal topography
Making bank deposits
Adjusting a frame
Doing routine lensometry on a patient’s habitual Rx or on finished glasses as they arrive from the lab