Cornucopia of Practice Prosperity Tips

Practice, The Patient Journey

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KEEP THE SMALL PROMISES

If your patient is seated and hears your staff say, “The doctor will be right in to see you,” yet it takes 15 minutes before you enter the exam room, your patient may wonder if this failure to meet expectations pervades into other areas of service. With this in mind, if the little promises aren’t met, don’t be surprised if your patient feels uncertain about buying those $500 premium progressive lenses. So, as a team, set realistic expectations for your patients and aspire to meet or exceed them with consistency.

FERTILIZE THE FLOWERS SO THEY CROWD OUT THE WEEDS

Your practice is like a garden. You want flowers, not weeds. Some patients are like weeds in their behavior, yet it’d be inappropriate to kill them by spraying Roundup. In these cases, the better approach may be to water and fertilize the flowers (the good patients) so they grow and crowd out the weeds (the bad patients). I’m not saying to be rude or to offer poor service to the weeds, but refrain from going above and beyond in service because you don’t want to encourage them to refer their friends, family and co-workers, who will likely have a similar demeanor to them. Sure, you can also dismiss a patient, akin to pulling out a weed. Yet indiscriminant dismissal of patients can unnecessarily inflame feelings, especially if these patients were already not planning to return.

DIRECT ATTENTION WHERE IT’S NEEDED

Have you noticed how young children often do not know how to react to the air puff tonometer until looking at their mother? If the mother is fearful and communicates this to her child, even if non-verbally, it can make it difficult for your assistant to obtain a measurement. Yet if the mother’s expression is nonchalant, as if it’s no big deal, the measurement is often readily obtained. Similarly, adult patients look to their doctor to know how to respond in several instances. If you ask your new contact lens wearer, “Are you having any problems?”, rather than, “How are you enjoying freedom from glasses?”, you may accidentally train your patient into looking for problems and being overly critical and turning into an unpleasant whiner. In the same way, if you spend a significant amount of time discussing the change in the numeric value of the patient’s glasses prescription, you may misdirect attention from the patient’s need for UV protection due to pingueculae and an incipient cortical cataract.

BUILD VALUE BY EDUCATING INCREMENTALLY

Throughout the patient care cycle, there are opportunities to incrementally educate the patient on the value of your practice’s service. Instead of your reception staff just telling Mrs. Jones to, “Please fill out this welcome form,” make sure the patient also hears, “… because it helps us better serve your needs.” During the preliminary exam sequence, don’t just have your technician say, “Put your chin here,” but also have the patient hear, “This instrument measures the fluid pressure in the eyes, which can help the doctor diagnose eye health problems.” It doesn’t take much additional time to build value with short explanations, and doing so can make patients feel much better about their exam and for selecting your practice.

UNDERSTAND YOUR PLACE

You are an optometrist–not a rock star, celebrity or sports icon. I’m sorry to break it to you this way, but this means that few of your clientele truly want to follow you on Facebook and Twitter. The reality is that optometrists are closer in this realm to gynecologists and psychiatrists, as there isn’t much organic consumer desire to follow these professionals through social media. Therefore, while you need an online presence, realize that your time and attention is still best directed toward patient care and the patient experience, rather than digital expressions of narcissism and self-promotion. Providing a high level of consistent service is arguably still the most powerful form of marketing since your delighted patients will promote your business and serve as practice ambassadors.

PURSUE A SMALL NUMBER OF GOALS AT ONE TIME

In your strategic planning for 2015, make sure that you set a realistic number of goals. In the field of psychology, “goal dilution” describes how the more goals you have, the less likely each of them will actually get done. So, at any given time, prioritize the top three initiatives, but probably not more than that, and concentrate and expend enormous effort to implement them and see them through.

BRIAN CHOU, OD, FAAO

Brian Chou, OD, FAAO, is a partner with EyeLux Optometry in San Diego, Calif. To contact him: chou@refractivesource.com.

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Managing Your Online Reputation

Digital Marketing, Marketing, Practice, The Patient Journey

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Proper online reputation management is key to protecting your practice’s image and attracting new customers. A huge part of online reputation management is not only about obtaining good reviews, but it’s also about actively monitoring and managing unsolicited reviews. Thankfully, there are effective strategies your practice can utilize in order to ensure when people go looking for information about your business online, they’re going to like what they read.

The Importance of Your Online Reputation

Reviews are an essential element of online reputation management and can have a huge influence on your bottom line. They serve as online promotions to boost your business; the flip side is enough poor reviews and your practice may suffer the consequences.

There’s plenty of data to support the notion that people not only look for online reviews before doing business with a company or brand, but also trust these reviews. In fact, Nielsen reports1 that 66 percent of people trust online opinions and reviews from other consumers. Another report by BrightLocal2 found that 80 percent of people trust online reviews just as much as they trust a recommendation from a personal contact. In other words, your reputation is always at stake online, and people’s opinions carry serious weight.

Monitoring Is Key

One of the most important areas of online reputation management is proper monitoring of your practice across channels, whether it’s Yelp reviews, Facebook posts, or Twitter comments. At the same time, it’s also important to keep your eye on the niche sites that relate to your industry or community, such as specialist websites that offer reviews on local doctors, forums where customers may be discussing a retailer’s products, or even the comments section of a local newspaper.

In short, your online reputation extends beyond the typical social media channels, and you need to understand where these potential conversations might be taking place.

A Note About www.RateMDs.com.  One of the most popular sites Canadian patients use for rating and reviewing is www.RateMDs.com, which allows patients to leave anonymous reviews of practitioners. The site gives eye care practitioners the ability to “claim” their page, which comes with a verified check mark and benefits such as posting images and responding to the anonymous reviews. In addition, for a monthly fee of $179 US you are able to “promote” your practice, increase visibility to patients searching for practices in your area and prevent competitors’ ads from appearing on your page.

 

With the “Promoted Plus” fee of $359 US per month, you receive the ability to hide up to 3 suspicious reviews. Some Canadian doctors have been critical of the website’s practices1, but it continues to be one of the first Google search results patients will see when seeking information about their doctor.

CHECK YOUR OWN RATING ON RateMDs.   www.ratemd.com 

1. http://www.cbc.ca/news/canada/manitoba/winnipeg-doctor-questions-online-rating-website-ratemds-1.3416530

Unfortunately, it’s not only difficult to find all of the conversations surrounding your business online, but it’s also extremely time consuming. That’s why it’s important to work with an online reputation management specialist. The right specialist can use software to track all conversations, analyze trends, and pinpoint or flag reviews that are unfair to your business.

How to Properly Manage Reviews

At the same time, it’s important to actively manage unsolicited reviews. While these reviews might be perfectly positive, others might really attack your business. Here are some ways to handle a negative customer review:

  • Speak with the administrators of the review website. For example, if you can provide proof a rival business actually left the review, the website will generally remove it as this practice is against the reviewing policy of many websites.
  • Address the review publicly, and build a solid argument that refutes the reviewer’s comments.
  • Try to message the reviewer privately and solve their problem. Many negative reviews are simple misunderstandings. Once those are cleared up, reviews can be updated to better describe the full interaction.
  • Use an online reputation management service which can help you develop strategies for dealing with negative reviews, promote your website through search engine optimization (SEO) to conceal bad reviews, and work with you to show your business in a positive light.

How Online Reputation Management Helps With Good Reviews

There are a number of strategies for generating good reviews. Of course, every good review starts with excellent customer service and a commitment to the customer. However, certain strategies can help build on those experiences and translate them into actual reviews.

First, don’t be afraid to ask your customers for reviews. Of course don’t tell them to be positive, but instead ask for an “honest” review. In general, try to focus on highly engaged customers. Create an e-mail list of your most loyal customers and target them.

Second, when you go above and beyond for a customer, let them know how important a review is for your practice. This is usually the moment when a customer wants to pay you back, and a good review is a great way to do it.

Third, analyze the positive reviews you already have. They can give provide you with strong insight about what kind of service delivers a positive customer experience or what features of your product appeal to your core audience.

Ultimately, when someone searches online, you want them to see positive reviews that reflect the quality of your practice. For online reputation management services that provide you with the right mix of protection and promotion, it’s time to work with professionals that can help your practice grow.

  1. Global Trust in Advertising. (2015, September). Retrieved May 10, 2016, from http://www.nielsen.com/content/dam/nielsenglobal/apac/docs/reports/2015/nielsen-global-trust-in-advertising-report-september-2015.pdf
  2. Local Consumer Review. Retrieved May 10, 2016, from https://www.brightlocal.com/learn/local-consumer-review-survey/

HOLLY HOWSON-WATT

iMatrix

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Writing SEO Content for Your Eye Care Practice Website

Digital Marketing, Marketing, Resources

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Custom, search engine-optimized content is crucial to the online success of your practice. In an internet survey conducted by Pew Research Center, 72 percent of participants said that they went online for health-related information in the previous year, and 77 percent of those began their search with a search engine.[1]

These statistics highlight just how important it is to rank highly on Google’s search engine results pages. Custom content is one of the most powerful ways that you can improve your online search rankings. With this in mind, how should you optimized your website content to be favoured by search engines?

The answer to that question involves implementing several search engine optimization (SEO) best practices that satisfy Google’s complex search algorithm. Recent updates to this algorithm have made custom content an increasingly important aspect of search engine optimization to focus on.

Consider the following factors when writing SEO content for your eye care practice’s website:

  1. Quality over quantity

A search engine’s main goal is to provide users with a list of website that are most relevant to what they are searching for online. Websites that lack substantial content are commonly determined to be spam and lowered in the search rankings.

However, using unnecessary filler text just to satisfy a word length goal, or posting low-quality content in order to make a certain number of blog posts each week is poor practice. In order to provide a valuable resource to visitors to your website and improve your online search rankings, aim to post consistent, informative and relevant content to your website.

  1. Keep the content useful and informative

Search engines are designed to return search results of websites that they have decided are most relevant to the user. Therefore, your audience is the most important factor to consider when you write content for your website. Who are you writing for, and what are they looking for? A simple way to answer this question is to identify if any currently trending eye care topics apply to your practice and patient population. Once you have identified topics that your patients will find interesting, you can then decide what information would be most valuable to them.

Plus, if you are still searching for some content inspiration, a Pew Research Internet survey recently revealed that the most frequently researched topics are specific diseases and conditions, treatments or procedures, and profiles of health professionals.

  1. Keep it credible

New updates to Google and Facebook give considerable weight to credibility of content as a ranking factor. Now more than ever, the internet is rife with misinformation and articles that are deliberately meant to look credible, but are, in fact, completely false. Pay particular information to the credibility of your sources when drafting custom content, and make sure that it is entirely accurate and up-to-date.

  1. Write high quality and engaging content

As search engines learn more about how internet users make decisions, they do a better job of delivering exactly what users are looking for online. Health-seekers in particular are looking for substantive websites that offer quality advice and general answers to their health related questions. Search engines understand this and take measures to keep “click-bait” (websites that offer little value and are designed solely for getting clicks) from ranking highly on search engine results pages.

Click-bait sites are usually superfluously stuffed with keywords in order to gain favourability with search engines. It is okay to use some keywords, but try to keep the focus on quality and providing engaging information.

Wrapping up

Previously, high-quality content played only a secondary role in SEO strategy. It is now one of the main ranking factors used by search engine algorithms to judge whether or not a practice website is worthy to be displayed on the first page of results. If you lack the time to write your own content for your practice website, it is instrumental to the success of your practice to entrust a professional content writer with the task. Now is the time to start focusing on the online success of your practice.

 

Find out how the SEO experts at iMatrix can provide professionally written content designed to drive more potential patients to your practice website and convert them into treating patients by calling 877.596.7585 or visiting us online at imatrix.com/OPTIK216.html

[1] http://www.pewinternet.org/fact-sheets/health-fact-sheet/

RANDY TRAN

IMATRIX

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Four Steps to Prepare to Sell Your Practice

Buying-Selling A Practice, Practice

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When selling your practice, you can make more money if you prepare your practice for sale well in advance–and utilize the expertise of a broker.

Of the roughly 40,000 ODs in the US, only a minute portion fit the demographic who would be interested in buying a practice, at the exact time you decide to sell it, in your exact location. In other words, the buyer market is small; so small that you must take the proper steps to ensure your practice not only sells, but brings you the value you deserve.

SELLERS ARE POORLY PREPARED

As a practice broker, I have encountered countless OD practice sellers who contact me a few months before they are ready to sell with little-to-no preparation, having never spoken to a practice broker/appraiser/transition consultant. Or they had an associate who was supposed to buy the practice, but decided not to. Whatever the case, I cringe knowing that had the owner just contacted me at least a few years prior, their practice would sell better, faster and for more. It brings to mind the saying:“Proper prior planning and preparation prevents poor performance.” In this case, “performance” can be replaced with “practice purchase price.”

To end the injustice of practices selling for less than they should, or not selling at all, here are five key preparations practice owners should take as they ready their practices for sale:

Maintain the Proper Asset List: Practice appraisers calculate the fair market value of your assets based on useful life, whereas your accountant typically depreciates assets rapidly for tax benefits. Your accountant often won’t keep an itemized list of your assets, especially after they are depreciated. So, if you’d like to avoid searching for equipment receipts from 10+ years ago, I highly advise keeping itemized records of your assets in a simple, organized worksheet including the asset type, manufacturer/model number, date of purchase and cost basis. I’m happy to provide a blank Excel worksheet, partially depicted below, upon request:

Medical equipment tends to have a useful life of 15-18 years! So, start this asset list as early as possible, and rest assured all your assets will be added to the appraised value of your practice.

 

Properly Label Expenses for Add-Backs: Your accountant’s job is to reduce your income as much as possible to minimize taxes. Your practice appraiser’s job is the opposite – to show the true earning potential of your practice. One way we do this is by adjusting your net income on tax statements for “add-backs,” which are generally discretionary expenses not fundamental to the continued operations of the practice,( e. g., owner cell phone, family health insurance, auto lease, etc.).Your bookkeeper should start carefully labeling and itemizing such add-backs at least three years prior to the appraisal of your practice. Otherwise the add-backs may not qualify or can be overlooked. Your appraiser/broker can review your tax statements and explain how best to adjust your bookkeeping to properly label add-back expenses.

Order a Practice Appraisal: A practice appraisal is one of the most important components used in the sale of your practice. A practice appraisal should cost about $2,500 – $4,000 for a single OD/single-location practice. It should be completed by the same company that will be brokering your practice for sale, otherwise the appraiser may put an unrealistic value on the practice if they are not responsible for selling it. The appraisal should include a comprehensive financial analysis using industry standard methodologies, as well as qualitative data and descriptive content to serve as the prospective buyer’s “bible” and main point of reference to make an informed purchase decision. Buyers will submit the appraisal to commercial lenders when they apply for practice purchase financing. Order the appraisal about one to two months before you expect to list the practice for sale. Each practice is different, and there exist too many variables to offer an average length of time a practice remains on the market. Gun to my head, I would say 9-11 months, but I’ve seen practices sell in two months and others on the market for years. To plan accordingly, ask your broker when you should appraise and list the practice, which will depend on your unique goals, the practice itself and other relative market conditions at the time.

Exit at Full Speed. Buyers like to see consistency, and love to see growth. Too many practice owners slowly retire, weaning hours, and allowing financials and production to decline. Sun-setting like this will only hurt the value and marketability of your practice. At the very least, operate your practice as you would normally. Don’t skimp on usual and customary expenses as your transition date approaches. If you have broken equipment, replace it. If you’re wondering whether to replace old but functional equipment, ask your broker. Among many factors, it depends on the type of equipment, timing and condition of your existing equipment inventory. Should you convert to EHR now? At this point, the answer is almost always yes, convert. Aside from the looming penalties, having an EHR in place can be one of the most marketable attributes of a practice for sale.

Above are just several preparations one should take when approaching a practice sale. Many more come into play, such as negotiating property lease renewals; managing retail inventory before and during the sale; tracking patient demographics and production; and much more. These are all matters that should be carefully planned in advance with the support of a qualified optometric practice broker to enhance the marketability and value of your practice. Remember, “Proper prior planning and preparation prevents poor practice purchase prices!”

 

RELATED ARTICLES FROM REVIEW OF OPTOMETRIC BUSINESS

Purchase an Established Practice–and Grow It
Retirement Planning Options: Staff Retention Tool
Setting Goals for Your Future: Achieve Your Optometric Visions

ERIK FERJENTSIK, MBA

Erik Ferjentsik, MBA, is president and principal consultant of Visionary Practice Group, LLC, an optometric consulting and brokerage firm consisting of attorneys, MBAs, CPAs and OD practice owners and management experts “specializing in providing practice appraisals, brokerage, and consulting services for optometrists to bring ODs the most successful results in practice sales, purchases, partnerships, and transitions.” CONTACT: erikf@visionarypracticegroup.com.

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Revenue Before Cost: Focus on Revenue-Generation, Not Cost-Cutting

Accounting Basics, Finance|Wealth, Practice, Practice Metrics & Benchmarks, Resources

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Creating value for our patients is a key to success, but we also must capture profit. We can increase profits by increasing prices or volume, or both, or by decreasing costs or reducing assets. Michael Raynor and Mumtaz Ahmed, the authors Three Rules: How Exceptional Companies Think, have discovered that exceptional companies have a common way of increasing profits–by putting revenues before cost. This means that when exceptional companies increase revenue, they do it by increasing investment in their company, rather than by cost-cutting, even if it means incurring higher costs.

This article is based on the rule, “Revenue Before Cost,” highlighted in the book, Three Rules: How Exceptional CompaniesThink, by Micheal Raynor and Mumtaz Ahmed.

These authors set out to discover how some companies survive and thrive while others fade away and die. They analyzed 45 years of data on nearly 25,000 companies for their research, and used data from 1966 to 2010 to determine why some companies grow and others go out of business. They discovered three rules of management that differentiated profitable from less profitable companies.

I recently showed, in the ROB articles, Three Rules to Make Your Practice Greater, and Better Before Cheaper: Profit in Investing in Quality, how I have applied the concepts in this book to my own practice.

I like the three rules because they simplify things. As owners and leaders in our practices, we have a myriad of decisions to make every day about how best to run our practices. Use these three rules to guide you in your decision making processes, and make your practice life simpler and more profitable.–Ken Krivacic, OD, MBA

INVEST IN ADVANCED OPTICAL PRODUCTS

Carrying upscale, advanced products in the optical usually generates greater profits. A simple example would be frames. A wholesale cost of a frame that you purchased for $25, and marked up 3x, results in a profit of $50. Compare that to a frame you purchased for $50 and marked up 3x. That frame garners a profit of $100. In this simple example, doubling your cost resulted in doubling your profits.

Of course, there are exceptions to the rule. You could purchase even less expensive frames and mark them up much higher, such as a $10 wholesale frame. You would have to mark the frame up 11x to equal the profit of marking up the $50 frame 3x. Raynor and Ahmed note that once you start playing in the lower-end categories there usually is someone who will come along and undercut you. It can be done, but it is much wiser to compete on non-price factors to build your practice.

In our practice, for example,we brought in a low-end frame line that we coulddo a hefty mark-up onand still offer as a low-end cost alternative. We did this for several months, but discontinuedthe frame linedue to patients returning frames that broke or constantly needed adjustments. Sure, we could have continued the process because the mark-up was good, but we decided to discontinue the frame line because our opticians complained about the above-average amount of time involved with working with patientswho bought those frames.

We also worried that selling an inferior brand or product would lessen our brand. It had taken years to position ourselves as providers of nicer frames, and wedidn’t want to undo all that work because we wanted a low-end alternative for our patients. In effect, we said: “If you want something cheap, you’ll need to buy it somewhere else.”

INVEST IN HIGH-PERFORMING STAFF

Staff costs are one of the largest costs a practice incurs, usually second only to cost of goods. There is a temptation to cut staff during tough economic times. Yet what kind of message does that send to our patients? Are they going to have to wait longer than usual because we are short staffed? Are they going to have a less-than-stellar experience because you have hired someone you could pay less than the topnotch candidate for the position? Will patients sense the tension in the office due to being short staffed?

I prefer to look at employees as an investment, rather than an expense. What do I mean by that? A good employee can earn more for a practice than they are paid by growing both the practice and the practice revenue. Here are some tips for aligning the investment in employees with the theme of Revenue Before Cost:

• Hire the best person for the position, not the one you can pay the least.

• Don’t cut employee hours to reduce payroll, look for ways to make staff more efficient.

• Track revenue-per-staff payroll. Most metrics say that should be in the vicinity of $150,000/per staff person per year.

• If you do have to cut a staff member, replace them with a better, more efficient staffer, and constantly invest in your staffby offering:

    • Training – both clinical and customer service
    • Regular weekly staff meetings
    • Regular bi-annual company retreats (full-day offsite meetings)
    • Bonus plans and pay
    • Regular and spontaneous reviews
TRY TO AVOID CUTTING COSTS IN CHALLENGING FINANCIAL TIMES

“There Are No Other Rules,” another concept from Raynor and Ahmed, emphasizes that when times get tough, or profits are shrinking, you want to avoid the natural inclination to hunker down and carry less expensive products or cut costs in other areas, and, instead, to reaffirm your investment in quality products, staff and patient experience.

In our practice, we have tried to continue to be true to our focus. By that I mean if you are a high-end practice, stay high end when economic times are difficult. Resist the temptation to start promoting cheaper services or products. This will only dilute your brand and confuse your existing and potential patients. By contrast, if you are a lower-endhigher-volume type of practice, do not suddenly try to sell high-end products. There is more than one way to be successful in practice, but you need to stick to what works and not confuse your patients and staff on what the practice is known for.

An example of this philosophy happened for us a few years ago. We made the decision to upgrade our phoropters to the new digital phoropters. If we had based our decision on cost alone we would not have made this purchase as these units are much pricier than a standard phoropter, yet they helped grow our revenue by improving our practice image. Patients commented on the new equipment and how they had not ever had an exam with that type of equipment before. For the patient, it showed that we keep up with the latest technologies and our office wants to ensure that they have the best optometric experience possible.

From the perspective of the practice, even though we spent more on a piece of equipment that does a basic function, we have gained by a consistent increase of revenue in our optical sales. Our optical department has revenues of just over 1 million per year that has grown by just over 3 percent ever year that we have had the new digital phoropters. Granted, the phoropters were not the only reason for the growth, but they have helped and they have enhanced the image of our practice in the patient’s eyes.

Related ROB Articles

Six ROI Winners for Your Practice

Four Ways to Add Direct-Pay Products & Services

Six Steps to Achieve and Maintain a High Per-Patient Revenue

KEN KRIVACIC, OD

Ken Krivacic, OD, is the owner of Las Colinas Vision Center in Irving, Texas. To contact him: kkrivacic@aol.com.

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Six Steps to Achieve and Maintain a High Per-Patient Revenue

Practice, Practice Metrics & Benchmarks, The Patient Journey

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Our practice consistently achieves a high per-patient revenue (PPR) of $400 to $410 every year. Six steps keep our PPR high.

CALCUATE PPR

We use a very simple formula to track our PPR daily. Total receipts divided by number of refractions = PPR. I understand that this is a big picture number and that it does not separate out the medical visits or contact lens follow-ups from the routine eye exams.

DOCTOR PRESCRIBES FROM EXAM CHAIR

My staff of three and I practice chair-side doctor recommendations. I always recommend AR and Transitions to everyone. AR is standard on all lenses and is only not on lenses unless the patient specifically states they don’t want it and understand how they will be negatively impacted. When the lenses are presented to the patient we name all of the lens benefits without naming the brands.

The optical dispensary in Dr. Click’s office makes eyewear very accessible to patients.

We educate the patient how each benefit will directly impact their lifestyle issue or complaint. We also let them know the amount of savings they will have by using their vision benefits. If a patient decides they don’t want a specific item then we tell them what feature they are giving up. Most of the time patients decide not to downgrade their lenses once they understand what it means to their daily life. But sometimes they do and we try to make sure they truly understand everything, and aren’t making their decision based on misconceptions.

 

TALK PPR IN STAFF MEETINGS

We talk about the PPR at our weekly business meetings. I always believe the entire staff should know what all the goals are and how we are tracking because each staff member directly impacts the total patient visit. In our staff meetings, we teach the front desk to set the stage with a friendly, positive attitude. When the patient perceives that it is a warm, friendly and professional office, the patient is more likely to purchase glasses and/or contact lenses from us. I think the more knowledgeable each staff member is about their role, the more competent we are, and thus, the higher our perception of value.

PROVIDE NEEDED STAFF EDUCATION ON PRODUCTS

Everyone is encouraged and supported to obtain as much CE or courses as they can. The insurance specialist attends webinars and seminars about insurance updates. The optician and technician attend classes to keep their certification up to date. We also have vendors come in at least once a quarter to educate us. We recently had a Nike sunglasses seminar and we have a scheduled Transitions meeting in a few weeks. I have the entire team attend a portion of the meeting so that they know that we offer the product and know who to refer to within the team for more information if needed. My goal is to make sure that every team member knows what we are capable of doing for our patients even if they won’t be a part of the resolution.

HAVE VENDORS HELP STAFF PRESENT NEEDS-BASED SOLUTIONS

All the vendors are great in helping the practice improve PPR. Essilor is excellent at staff and doctor training for needs-based solutions. Needs-based solutions are where the entire team is recommending products that fit the patient’s needs. It involves everyone being more involved with the patient by asking detailed questions that lead to conversations about what people do for work, fun and hobbies. Every team member who works with a patient is encouraged to have three questions that they ask the patient to facilitate conversations.

Contact lens vendors are great in strategizing ways to increase annual supply sales, and our frame vendors help with frame board management so we can make sure we have fashionable and good quality frames. Our frames have a built-in two-year warranty, which increases the value of the frame because patients know they are covered if something unforeseen happens.

KNOW & ADDRESS COMMON CULPRITS BEHIND LOW PPR

I have found two main reasons for us having a lower PPR than expected some days. The first occurs when see a lot of patients who do not have a prescription need. We try very hard to educate all parents on the importance of children’s eye exams and we do see a lot of kids annually who don’t have a prescription need.

Fortunately, patients who have not had a prescription change still often purchase new eyewear because we reference our vision treatment plan from the previous year and base our recommendations on the part of the plan that wasn’t filled.

The second situation in which we see a lower PPR is when the practice is under-staffed. It is very important to have a well trained team as we have seen it negatively impact our bottom line.

MAINTAIN ADEQUATE STOCK OF KEY INVENTORY

The effort to increase per-patient revenue starts in the exam room with the doctor and is then reinforced in the optical. But you have to have a good selection of merchandise inventory. It is disappointing when a patient is excited to buy and then decides not to when you don’t have the frame look they want.

Our goal is to have a 3x turnover per year per frame. So, a smaller practice like mine has about 400 frames in inventory as our goal of refractions is 1,200 this year. In contact lens inventory, we stock 100 one-day boxes: 50 from two individual vendors. In contact lens trials, due to space, we have trials of the lenses that we prescribe the most. If someone wants or needs a different brand, we order in the trials as needed. The trial sets are big and different sizes; we don’t have the room to have all the fit sets available, but we make sure that we can always give patients something at the date of their exam.

Related ROB Articles

Annual Financial Review: Scrutinize Expenses, Fine-Tune Profits

Measure Your Capture Rate to Compute Your Profit Potential

Institute a Pricing Strategy to Maximize Profitability

RACHAEL CLICK, OD

Rachael Click, OD, is the owner of Preferred EyeCare Center in Mount Pleasant, SC. To contact her: drclick@preferredeyecarecenter.com.

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What Do Patients Think of You? Hint: There’s Room for Improvement

Practice, Resources, The Patient Journey

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Now that I’m retired, I can ask people the question that we optometrists would like to ask, but are uncertain if we would get an honest response: What don’t you like about your optometrist or the optometric experience? Some of the responses I got were expected, but some were a surprise.

Optometric literature is big on the doctor delegating tasks to staff members to free up time. One friend said that when she lived in New Jersey, her optometrist did all of the exam himself. He only had staff do the visual fields test when necessary. When she retired to Florida, her new optometrist delegated the majority of the exam procedures to his employees. My friend was not too thrilled about that. She said she felt uncomfortable with technicians doing procedures that her last optometrist did himself.

A major concern of my friend’s was how much training the technicians had. Did they have formal schooling or did they just learn on the fly from another staff member? “It is a little unsettling to not know how qualified the person is who is testing your eyes is,” she said. “Maybe it is my fault for not questioning it/them, but I have to wonder if I am the exception or the rule on not being familiar with their qualifications.”

New Jersey’s doctors seem to have a leg up on Florida’s. Another friend mentioned that her New Jersey eye doctor let her know what tests he was preforming and the reason behind each test. Her Florida doctor does not. She preferred to be informed and not left in the dark.

Equipment and technology are also a concern for some of my friends. Some people like up-to-date technology, while others feel that some of the “machines” are a waste of their time. One friend said he felt that he was exposed to a certain procedure just so the doctor could bill his insurance to pay for his new expensive machine. He was supposedly the only eye doctor in Florida with this new machine, so obviously most doctors did not think this procedure was necessary for a routine eye exam. Evidently, he was not impressed with the latest and greatest technology.

He, and other friends, mentioned a few pieces of equipment, in particular, as sources of irritation. The visual fields test was boring (“something has to be done to speed it up”), the bio-microscope is a poor design for a well-endowed woman (a friend said she felt like she was getting a mammogram having to push into it). No surprises with this one–NCTs should be retired. NCT haters would much rather have their eye numbed and have the tonometer probe pushed into it.

The optical also generated a few comments:

“Why do you have to ask for your prescription? Shouldn’t they just automatically give it to you like your medical doctor use to do before EHR became the norm? The staff makes you feel uncomfortable asking for it.”

“Why are glasses so expensive at the doctor’s office when you can get two pairs and the exam for $59 at another establishment? What gives with that?”

“If you do purchase at the doctors office, they like to push extras on you; whether it be second pairs, prescription sunglasses, specialty glasses or extra lens treatments.”

Perhaps having your optical staff on commission, or eligible for bonuses based on sales performance, is not a good thing if your patients feel they are being pressured to buy more than they had planned.

One friend noticed that she experienced a difference in treatment if she had a prescription problem with glasses she purchased from the doctor whose office she was at, versus if she purchased them from another source. If the glasses were purchased from the doctor, she got immediate service. A staff member would recheck her vision and verify the prescription. This was not the case if she had her prescription filled elsewhere. She felt she had no recourse if the prescription was wrong, but not purchased at the prescribing doctor’s office.

The optical is not the only place where the hard-sell can be a problem. One friend commented that her eye doctor has an interest in an eye vitamin business. ”He really pushes patients to purchase his ‘wonderful’ vitamin product,” my friend said. “They are quite pricey ($50 a bottle, I believe). I don’t ever remember being solicited at any other eye doctor I’ve been to, and since I don’t really like a hard-sell approach from sales people in general, I don’t appreciate being strongly encouraged to buy eye vitamins from him when I am in there for my routine eye exam.” It sounds like this doctor needs to back off a bit. No patient wants to be strong-armed by their doctor into making an unwanted purchase.

Finally, my friends mentioned that they felt strongly that insurance plans should not dictate their eye doctor. They said it’s frustrating to really like a doctor and then have their employer change insurance plans to one their eye doctor doesn’t accept. In addition, they noticed the inconvenience of being referred by their eye doctor to a specialist who is not on their insurance plan, and, therefore, not feasible to see.

Overall, I don’t think we fared too poorly. Some of these issues could probably be resolved by taking the time to explain things better. Others, like the insurance complaints, we have no control over.

“I have no negative issues – would just go elsewhere if that happened,” one friend told me. That’s something to keep in mind.

DIANE PALOMBI, OD

Diane Palombi, OD, now retired, owned Palombi Vision Center in Wentzville, Mo. To contact her: dlpod1@hotmail.com

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Capture a Prime Growth Opportunity with a Low Vision Centre of Excellence

Differentiation | Business Strategy, Practice, Resources, Specialty Practice

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Low vision, caused by diabetic retinopathy, macular degeneration, glaucoma and other conditions, is affecting more and more of your patients. By the year 2030, the National Eye Institute projects that nearly 5 million in the U.S. will be classified as having low vision.

Dr. Richman works with a low vision patient, showing the patient how to use a magnifying tool that projects small type onto a large screen

We have focused on low vision care, and have built up this niche, so that approximately 30 percent of our three-OD practice is now considered low vision, and 100 percent of my part of the practice is visually impaired or legally blind. I personally see only visually impaired and legally blind patients, but my husband and partner in the practice, Harvey Richman, OD, sees visually impaired children in addition to his other patients.

WHAT MAKES A LOW VISION PATIENT?

Everything from premature birth to age-related macular degeneration can create a low vision patient. Providing this type of care has allowed me to see patients with conditions so rare that there are less than 10 documented cases in the medical literature, and others who have traveled from Europe and Africa to see me.

INVEST IN NEEDED INSTRUMENTATION

The retinoscope, as refraction is so important, is an essential tool to help you serve low vision patients. All good low vision exams require the appropriate starting point, and finding the appropriate prescription is invaluable. We have treated patients who were classified legally blind, and by simply giving them the right corrective lenses, they were able to enjoy the activities of daily living, or even drive!

Visual acuity assessment needs to be modified to be able to be done at different working distances. Charts that vary in size and format should be available, depending on the patient’s needs. Additionally, having appropriate magnifiers, lighting options and wavelength-specific filters is paramount.

A basic retinoscope can cost as little as around $70, while the more advanced ones can be over $1,000. A few magnifiers are available for less than $50, but the electronic devices are thousands of dollars.

INCREASE YOUR KNOWLEDGE OF LOW VISION PATIENTS

The American Optometric Association used to have a Low Vision Rehabilitation Section that had materials and courses available. That is now merged into the online database for members. There is a large program called Envision that occurs annually in Kansas, and offers continuing education annually. The most effective option for educating yourself about caring for low vision patients, though, is to communicate with other doctors who are doing low vision currently and pick their brain. Most of us are happy to share our experiences, good and bad.

Wavelength-specific filters that Dr. Richman’s practice sells. Offering the products in-house gives patients “one-stop-shopping” ease, enabling them to get the products you prescribe without having to travel to another location.
INVEST IN INVENTORY

The primary low vision-oriented eyewear that we stock are wavelength-specific filters (450-550nm) in frames. We have a few prism readers with high plus, but primarily prescribe the appropriate prescription to be filled, as we don’t have an optical.

PROJECT PROFITABILITY

In our office, much of the profit is in the service end. Devices are opportunities to make additional income, but we still focus on the professional component. Often, doctors double their cost for retail. This is a personal decision, as is prescribing glasses. That being said, profit occurs from day one as the first patient who is successful tells their friends, and the referring physician, and more patients roll in the door.

More significant than the revenues that come directly from low vision patients is the loyalty of these patients, who stick with the practice for years, and often refer friends and family, and speak highly of your practice in your community, and even online sometimes.

MARKET YOUR SERVICES

Our community learns of our low vision services through word-of-mouth (satisfied patients who refer others), our practice web site, the telephone book (yes, we still
use it because many older patients still look to it), and by meeting with low vision support groups and senior citizen community groups.

We receive referrals for consults from dozens of ODs and MDs. The OD referrals are more diverse, but the MDs referrals come primarily from retina specialists.

HELP IMPROVE PATIENTS’ DAILY LIVES

The primary areas reported problematic are reading and driving. Near activities are usually the easiest to manage with either a high-add reading glass or hand or stand magnifier. Some patients need a CCTV (electronic magnifier) to read longer or smaller print. Driving and television are more difficult due to state regulations and optical options. As mentioned earlier, sometimes an update in their glasses is enough, but when a telescope is needed, it is much more time consuming for the doctor and the patient.

OFFER EMPATHY

Much of what differentiates a good low vision doctor from a great one is their ability to empathize and counsel the patient through their loss-of-vision grieving process. Although the doctor’s primary job is to get the patient functioning again, at times we act as social workers or lay psychologists. There are times, however, that we need to get outside support also, which is when you would refer the patient to a licensed social worker or psychologist for assessment and management.

Initially, we live at my practice by the idea that if the patient is willing to work to help themselves, we can offer them the tools to meet their goals.

CATER TO THE LOW VISION PATIENT’S NEEDS

The first thing to remember about low vision patients is that they are visually impaired, not blind or deaf. Most low vision patients come with a family member or friend to help with filling out forms and to do other detailed tasks. Otherwise, the paraoptomtretric will help with the documents. Next, you have to modify the way you do pre-testing as the patients may not see the chair as well, and definitely have difficulty maintaining fixation on automated equipment. The other issue is discussing the financial variables of the examination. This can get pretty complex as the patient may think that everything is covered by their insurance, and often that is not the case.

Patients are seen for an initial visit, then usually a few weeks later for the dispensing of devices, training of devices or follow-up if dispensed the first day. Then, they are seen again about three months later to ensure that the devices are successful. We work with the referring doctor to make sure that all medical follow-up is done with them.

Third-party payers often cover the evaluation and management components of the low vision exam. Medicare specifically excludes the refraction, which is a primary component of the visit, so that is private pay. Depending on the severity of the impairment, training with the devices is billable to the insurance carriers also. Devices are rarely covered, but there are some plans that do.

MARIA RICHMAN, OD, FAAO

Maria Richman, OD, FAAO, is co-owner, along with her husband, Harvey Richman, OD, of Shore Family Eyecare in Manasquan, N.J. To contact: drrichman@lowvision-nj.com

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Create a Dry Eye Centre and Make it a Practice Builder

Differentiation | Business Strategy, Practice, Resources, Specialty Practice

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Our aging population, along with the heavy use of digital devices and dry environments of work and living, mean more cases of dry eye. Creating a practice specialty–a dry eye center–as our practice has done, enables you to capture the opportunity to treat these patients, and keep them in your practice with services that address their needs.

I practice in a shared OD-MD practice with two ODs, including myself, and three MDs, and we seethousands of patients a year who experience dry eye.

The MDs and ODs typically share the same patients. Some cases are easily managed with lid hygiene and palliative care. More difficult dry eye cases are managed by the ODs through our dry eye center, which we call the Advanced Tear Analysis (ATA) clinic.

Our clinic is about 10,000 square feet. The exam room for ATA is about 100 square feet, so it does not require much space. The only thing that separates it from the other rooms is the addition of a LipiFlow machine.

The ATA exam can be used for any dry eye patients. However, the process is very thorough. Some cases of dry eye may not require the extensive testing. Patients who do not improve with treatment after one office visit will be referred to the ATA clinic, which is the minority of the patient population.
Each half-day may average from 9-13 post-operative and acute care patients. The ATA clinic will schedule only up to two additional patients for a half-day. Due to scheduling and post-operative care demands for time slots, the ATA schedules patients on two half-days a week. The exams can range from 45 minutes to an hour. We may see four ATA exams a week per OD. These exams take longer, but are 50 percent more profitable than a traditional office visit.

EXPANDED SET OF OPTIONS: NEW TOOLS

As the volume of dry eye patients grows, the OD can serve an unmet need. The OD can treat most cases of dry eye. For severe cases, the MD can do surgical procedures such as tarsorrhaphy, gold or platinum weighted eyelid implants, intraductal probing and punctal cautery.

CREATE A “DRY EYE CENTER”

The ATA exam represents the new exam that is dedicated to the diagnosis, management and treatment for the more difficult cases of dry eye. The patient must have had an initial comprehensive examination beforehand either at the practice, or at another practice. ATA exams share clinic space with post-operative exams and walk-in patients.

Comprehensive exams have their own set of rooms as these exams typically take the longest amount of time. The initial dry eye, or ATA, exams are held on two half-days a week for the initial testing and evaluation. Re-checks typically take less time, and can be scheduled throughout the week if necessary. LipiView II (TearScience) imaging is done on all patients, and the machine is centrally located near other pre-testing equipment. The exam room with the LipiFlow is reserved for the ATA clinic during scheduled treatments or possible treatments.

The Advanced Tear Analysis center at Durrie Vision. Having a specialized place, protocol and instrumentation for dry eye analysis and treatment.enables the practice tocare for a growing population of dry-eye patients.

There are many opportunities for managing dry eye in a refractive surgery practice, even if it is only during post-operative healing. Some post-operative patients need extra help with dryness. The majority of my exams are geared toward treating the ocular surface. Treating the ocular surface in general creates better surgical candidates, leads to improved visual outcomes and increases patient satisfaction.

DRY EYE: A GROWING PATIENT CHALLENGE

The prevalence of dry eye is estimated to be as high as 30 percent in some larger population studies for adults over age 50, with women suffering in greater numbers than men. Medications contribute to dryness. Environment and climate can also exacerbate dryness.

An unfortunate, newer trend of dry eye is that we now see younger patients in our practices. A less nutritious diet as compared to previous generations, increased electronic device screen time and contact lens overwear contribute to a poor tear film.

Dry eye is complex and multi-factorial. It is only getting worse, and the patients are increasing. Effectively managing dry eye is one of the greatest challenges in eyecare. Many patients who suffer from dryness struggle with vision, comfort, as well as quality of life. To ease the suffering of one of these patients is a rewarding experience. —Suzanne LaKamp, OD, FAAO

SET DIAGNOSIS & TREATMENT PROTOCOL

All dry eye patients need comprehensive exams. The following dry eye exam services incorporate additional testing for the ocular surface, that could not have otherwise been performed at the comprehensive exam.

The ATA patients get entrance testing with repeat retractions. The technician will then take the patient through HD analyzer imaging. The imaging is helpful in looking at image scatter from either problems with tear film or changes to the natural lens. It is a non-invasive test. Patients may get LipiView imaging if not already done at a previous exam. The patients all take the SPEED questionnaire.

At initial or subsequent visits, there may be various types of staining, tear break-up time, inspection for lid abnormalities, and Schirmer’s testing with anesthetic. A slit-lamp exam with meibomian gland functional testing is performed using either the Korb evaluator or with a cotton-tip applicator. There is no additional cost to providing questionnaires or a slit-lamp exam, other than chair time. LipiView and other equipment can be costly to a practice, and need to fit the practice budget. Dry eye exams services can help recover this cost, as well as performing LipiFlow.

Palliative treatments include a wide array of artificial tears (not sold in office) and punctal plugs. Specific artificial tears are recommended (Systane Balance and Retiane MGD are common), and samples are given. Our practice does temporary and permanent plugs. Plugs are a billable service for patients with insurance. Reimbursement for permanent plugs is typically good.

There are pharmaceutical options for treating dry eye. Patients are sometimes prescribed Restasis for tear film insufficiency. We have a new product, Xiidra, which is a promising treatment. More treatment options can lead to increased success. Corticosteroids and Doxycycline are prescribed for dry eye patients who experience a lot of inflammation, but carry a degree of risk with side effects. Many patients are now being treated with Omega 3 supplements or fish oil. We typically recommend higher quality brands such as PRN Omega Dry Eye formula or Nordic Naturals. Supplements can be sold in office, but we do not currently carry them.

Any patients with severe dry eye, such an non-healing epithelium or exposure, would be referred out of our practice. These cases could include surgical intervention, scleral lens fits, serum tears or amniotic membranes.

SELL DRY EYE TREATMENT ACCESSORIES

For managing meibomian gland dysfunction-related dry eye, therapeutic treatments include LipiFlow and BlephEx. We recommend all patients with meibomian gland dysfunction perform lid hygiene and warm, moist compresses for at-home maintenance. We sell the Bruder eye mask. While there are many warming moist eye masks on the market, patients like the convenience of having the mask available in office. Depending on quantity purchased, the Bruder mask can cost the practice $8-$12.50 each. Recommended mark-up would be at least 50 percent or greater.

We also sell Avenova lid cleanser. Most pharmacies charge the patient an average of 3x more for Avenova than for what we sell. It is much more affordable to get the product at our practice. The products are available at the check-out, where the patient will also schedule any following appointments. The warming eye masks and Avenova have been instrumental in helping our dry eye patients, as the majority have meibomian gland disease.

WHO MANAGES THE CASE: OD/MD

While all of the doctors at my current practice manage dry eye disease, the OD plays a larger role. The MDs spend more clinic time performing comprehensive examinations on surgical candidates, which is the largest revenue generator in the clinic. The OD sees a variety of patients including pre- and post-operative surgical care, acute care and patients for dry eye management.

Some of the dry eye patients include acute, resolving post-surgical dryness. There are also patients with chronic dryness for years without a history of surgery. The ATA clinic exams are performed exclusively by the ODs.

INVEST IN NEEDED INSTRUMENTATION

Most dry eye is evaporative, and some of the newer technologies work to improve meibomian gland dysfunction. The most valuable imaging equipment in diagnosing meibomian gland disease is the LipiView II. It is also one of best resources for educating our patients. For patients who suffer from meibomian gland disease, the LipiFlow is a great tool to have in clinic. LipiView and LipiFlow are essential to any dry eye clinic. While cost was previously a big hurdle for patient and practice alike, a recent decrease in activator pricing for the LipiFlow improves accessibility. More clinics will likely purchase the equipment, and hopefully the number of patients who get treatment will increase.

For patients with plaques along the lid margins, lid debridement is an effective procedure in restoring meibomian gland function. A golf club spud can be used in office, as well as the BlephEx.

Practices typically purchase the LipiView/LipiFlow and the BlephEx equipment. Length of time to profit varies per practice, and depends on what each practice charges for treatment. A typical yearly budget may require four LipiFlow treatments a month and 24 BlephEx treatments a month to be profitable.

As a cash-pay practice, we are fortunate to perform whatever testing we feel is best for the patient without concern for the varying insurer reimbursement policies. The testing aids in diagnosis and patient education. The patients are very receptive to testing. We charge for treatments such as BlephEx, LipiFlow, and punctal plugs. We also charge for products sold in-office such as the Bruder compress and Avenova. Each exam, including follow-ups, has a fee. We are reimbursed 100 percent for what we charge. For managed care patients, there is no current insurance coverage for meibomian gland dysfunction.

EDUCATE PATIENTS ABOUT DRY EYE SERVICES

Dry eye services are marketed within the practice by word of mouth. The doctors will refer current and new patients to the ATA clinic if the dry eye patients need further testing and follow-up. Current plans involve integrating the ATA online link into the main web site. We have one that we can give out to patients, but is not yet accessible to the general public.

We developed a dry eye handout that is available in all exam rooms. The handout includes various treatments for dry eye. LipiFlow and BlephEx are some of the listed treatments. It is helpful to have a handout that advertises provided services, which the patient may elect to later choose if palliative therapy is not enough.

The dry eye clinic is not currently advertised on the web site, but will be in the near future. The services are relatively new, and were mainly developed as a way to better serve our current patients. The practice model is direct business-to-consumer. Within a few months of beginning the dry eye clinic, patients new to the practice are scheduling. This was surprising considering we have not actively advertised outside of the practice. There have also been a few referrals from outside practitioners. The addition of LipiFlow has been driving some of this outside business for the dry eye clinic. Word-of-mouth is also contributing to the increase in new patients.

SUZANNE LAKAMP, OD, FAAO

Suzanne LaKamp, OD, FAAO, is an associate at Durrie Vision in Overland Park, Kan. To contact: dr.suzanne.lakamp@gmail.com

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Commit to Continuous Staff Training: It Pays Off

Human Resources, Training & Onboarding

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Recruiting the right employees only takes you halfway to delivering high-quality care to patients. The other half of the challenge is training those employees. My practice takes a systematic, consistent approach to ensuring staff is prepared to deliver service to patients, and to help grow the practice.

In addition to spending about $6,000 per year on hard staff training costs (materials, testing fees, travel, seminars/meetings, meals associated with training, etc.), in our practice of 22 team members, we spend an immeasurable amount of time to training. Although we have not calculated the soft costs (down time for the trainers and ramp-up time for new employees) associated with training new team members, as well as ongoing training for all team members, I’m sure the amount would be very high.

But, I would argue that our return on investment is also very high. We can measure its effectiveness in the quality of our team that performs to the best of its ability every day. Our patients constantly remark on the outstanding customer service our team delivers. They trust our team, the entire team – not just our doctors – to provide them with excellent care and education. Those patients reward that trust by referring their friends and family to us!

GIVE EMPLOYEES & TRAINER A LEARNING CHECKLIST

We assign each new employee a trainer from within their department who excels at teaching and training. The team lead for the department is sometimes the trainer, but in our practice the owners/doctors and practice manager are never directly involved in the day-to-day training of new employees. The first piece of training material the new employee is given is a shared reference between the new hire and the trainer. It is a spreadsheet of items/areas to be trained, listed in chronological order, to organize the learning track.

When each new topic is introduced, both the trainer and the trainee initial the particular section of training that has begun. They each have to re-initial when they both feel it has been sufficiently trained/learned and they are ready to move on to the next subject. This helps to reduce instances of “I was never told that,” and it gives the trainee a chance to express that they may need the pace to be adjusted, or that they are having a difficult time with a particular training module.

A few of the 22 team members at Clarke EyeCare Center in Wichita Falls, Texas. Dr. Clarke says committing to staff training pays off in a staff that can deliver care patients appreciate enough to refer others to the practice to experience.

We have all of our office processes, including staff training, typed up in a shared document on our server that everyone in the practice can access. It is searchable so that anyone can type in keywords to pull up a process within seconds if they’re unsure what to do. Training processes are reviewed and revised by our department managers regularly.

START WITH HIPAA TRAINING

The first step of the training process is HIPAA training with our compliance officer. After that’s complete, the applicant shadows an appointed person in the department for which they were hired to experience first hand the culture/patient experience they are expected to provide. How and when we say things are equally as important as what we say. The tasks of the job can and will be learned in time, but the exemplary attitude is our first priority of training.

WHOLE TEAM WORKS TOGETHER TO READY NEW EMPLOYEE

Although we have a designated person to perform the initial training, the entire team works together to integrate the trainee into the culture of our practice by making sure that person knows our goal is for their experience to be a positive one. Not only do we believe they can succeed, but that we will all do everything we can to help them transition through the learning process successfully. They need to feel it’s a safe place to ask questions and learn from everyone.

We have used vendors to assist in training, in-person training (at regional meetings), and online training resources, such as training modules on the AOA’s web site, but we mainly rely on our people, our best resource, to train our other team members.

USE A TRIAL PERIOD BEFORE MAKING HIRE PERMANENT

We hire most of our employees through a temp-to-hire agency. In using their services, the trainee is the employee of the staffing agency for a period of 90 days. This gives us time to objectively decide if the trainee is learning and retaining the knowledge at a good pace, is reflecting our core values and team culture effectively, and if we’re going to end the probationary term by hiring them permanently. This 90-day term is a time for constant communication of our very clear expectations and frequent reviews of how they are or are not progressing.

DAN CLARKE, OD

Danny Clarke, OD, owns Clarke EyeCare Center in Wichita Falls, Texas, which received an All-Star award by The Great Game of Business. The practicerecently was named the Family-Owned Business of the Year for the SBA Dallas/Ft. Worth district ofTexas. Dr. Clarke is also the President of MODUS Practice in Motion, which offers open-book management training to optometric practices. To contact him: dbc@clarkeeye.com

JOELY ANDERSON

Joely Anderson is the office manager for Clarke EyeCare Center and is also the Vice-President of MODUS Practice in Motion. To contact her: joely@clarkeeye.com

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