people management

Even before COVID, independent Optometrists shared a common complaint. How do you see patients all day as well as manage staff and the business demands of the practice? The answer is often an Office Manager. Even with a small team, it is important that someone is leading the ship when the Owner is seeing patients.

How’s Right for the Job?
For many offices, the Office Manager can be someone who has shown interest in managing tasks and taking on a bigger role within the office. It is also possible to hire someone with an affinity for office management but doesn’t have optical experience.

I have seen some wonderful Office Managers come from other backgrounds and bring new insight and perspective to the practices they work in.

Ultimately, the main responsibility of the Office Manager is to be the contact person for staff and patients, in your absence. It is imperative that they have a consistent and direct line to you on a regular basis. The staff will be accountable to the Office Manager and the Office Manager will be accountable to you.

A great office  manager can fill the gaps.
Just recently, a client mentioned that their associate’s appointment book was starting to look sparse in the week or two ahead.

They were looking for some guidance on how to approach staff. This is the perfect example of how an Office Manager could be of great assistance. In charge of overseeing the general business functioning of the clinic, the Office Manager will have independently identified this concern. The Office Manager will “huddle” will staff and brain storm action steps to get the appointments booked.

Often, when I am speaking to Office Managers, or even Practice Owners, they will express a concern about micromanaging the team. In fact, teams need managing – and even inspiring!

Recently, when mentoring a teammate in one office to become the Office Manager, we reviewed the action steps the team had already taken – getting caught up on recalls being the big one – and it appeared the team was being proactive. I asked if the team was also asking if there were other members in the household that were due for an eye exam that wanted to come in at the same time.

Particularly during COVID, it actually benefits the family and clinic if they come into the office at once and in their bubble. The future Office Manager graciously acknowledged that although they had done so in the past, they had stopped asking this question when patients were booking.

Now armed with a suggestion that could bring fresh perspective to the situation, the future Office Manager left our call to meet with her team to brainstorm ideas to get the schedule booked! I challenged her to do a similar exercise with the front desk staff in the spirit of unearthing ideas that had simply fallen off their radar.

This type of mentorship and coaching is necessary to transfer authority to the Office Manager, so that ultimately, the Office Manager can start independently assessing the business needs and acting accordingly. It takes some time and guidance, but the end result is well worth the effort.


is the co-founder and managing partner of Simple Innovative Management Ideas (SIMI) Inc. and expert Practice Management contributor for Optik magazine. She can be reached at


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Does your practice have an office manager? You might want to consider hiring one. Here are the key benefits of an office manager, including points to help you decide if hiring one is right for your practice.

Recently we read an article that got our attention by making the following three statements about office management: (1) “One of the biggest costs in any business—medical or not—is employee incompetence,” (2) “Management is a learned skill,” and (3)” ‘Evidence-based management’ is as similarly important as ‘evidence-based medicine.’”

Let’s explore these three thoughts further.

Employee Incompetence
Employee incompetence is a common problem in many practices. We’ve all heard and seen things when walking through the practice that makes us wince. We thought staff was trained appropriately, but obviously, based on what we saw or heard, there’s a problem somewhere.

The most common drivers of incompetence are: laziness, poor communication (just because you’ve said something doesn’t mean the other person understood), lack of people skills and lack of training. So, who in the practice is addressing these drivers of incompetence?

Is the doctor the best person to handle these drivers? Not always. Often the doctor has a very distorted view of what is happening in the office. The doctor spends the majority of their office time in the examination rooms in back of the office.

A staff member bringing to the doctor a problem occurring in the front of the office often gives the doctor a perception of the problem which may not be an accurate description of what is really going on. It is the perception of that staff member. Other staff members may have different perceptions. If there is no office manager, the doctor must investigate to get an accurate understanding before making a decision. That takes time. Time that the doctor could be spending on patient care, or time the doctor has to add on top of patient care.

An office manager – one with time dedicated to management – is the best person to address the drivers of incompetence. The office manager is going to have the best understanding of what is going on in the office with both patients and staff. Rather than being reactive, a good office manager is proactive in handling the four drivers of incompetence because the office manager is managing in real-time, versus the doctor, who will hear about what happened in past-time.

Management Is a Learned Skill
One of the core tenets of any successful person is the drive to always become better. There is always something new that can be learned that enables you to do your job better. But some staff members (and some doctors) have plateaued. Learning has stopped. Performance improvement has plateaued. The office manager is no different.

Here’s a core question that needs answered: Have you provided targeted, effective and ongoing training for your office manager? In many practices the office manager is given the title, but no, or little, training on how to do the job. When this happens, beware the Peter Principle. “According to the Peter principle, employees continue to be promoted as long as they perform well in their roles; as a result, they rise to their level of incompetence: the point at which they fail to do a good job.”

The antidote to the Peter Principle is training. Even the office manager needs training. Training on how to do their job. Training on how to manage people. Training on how to move the practice forward.

Let’s make a list of what we want the office manager to accomplish, so we can see what training is needed.
Starting with the big picture, there are two primary things that we want from the office manager. They are to ensure the smooth functioning of the practice and to help grow the practice.

To ensure the smooth functioning of the practice, the office manager needs to manage at least these things:
1) Find, hire, train and fire staff and vendors
2) Keep and enforce office policies
3) Ensure that expenses remain as low as possible
4) Handle problems with staff and patients
5) Make and implement day-to-day decisions
6) Allocate resources, decide staff schedules and vacations
7) Supervise and manage employees in a fair and consistent manner

To help grow the practice, the office manager needs to manage at least these things:
1) Inspire staff members to perform better
2) Look for ways to improve the practice
3) Report to leadership
4) Plan with leadership
5) Implement the leadership plan

So, how does the office manager get the skill-sets necessary to ensure the smooth functioning of the practice, and to help us grow the practice? Training. This is not a one-and-done. Training is an ongoing activity, so the office manager is doing the job better and better. We need to make sure that we invest in training for our office managers.

Evidence-Based Management
In the 1990s, we began to hear about evidence-based medicine. Now the concept of “evidence-based” has expanded to include other disciplines, including business management.

“The starting point for evidence-based management is that management decisions should be based on a combination of critical thinking and the best available evidence. And by ‘evidence,’ we mean information, facts or data supporting (or contradicting) a claim, assumption or hypothesis. Evidence may come from scientific research, but internal business information, and even professional experience, can count as ‘evidence’.”

We believe that practice management rule number one is measure to manage. There are three things about a practice that need measured: (1) how are we doing now compared to last year, (2) how are we doing compared to other like-sized practices, and (3) how are we doing compared to our goals. This information is available in the office practice management software and from reports from vendors in our profession.

With a little work you can establish reporting systems that gather this information for you, or you can purchase dashboard management software that can do this for you.

Training your office manager on how to read the numerical evidence, and how to use an evidence-based management approach, maximizes the performance of your office manager. When done properly, this approach enables the office manager to do the job in such a way as to ensure the smooth functioning of the practice and to help grow the practice.




Dr. Wright is the founding partner of a nine-partner, three-location full-scope optometric practice. As CEO of Pathways to Success, an internet-based practice management firm, he works with practices of all sizes. He is faculty coordinator for Ohio State’s leading practice management program.


Dr. Burns is the senior partner of a nine-doctor full-scope optometric practice that she built with her husband, Dr. Wright. She is also the COO of a state-wide nursing care optometry practice. Dr. Burns lectures nationally on practice management and staffing issues. Dr. Burns authored the Specialty Practice section of the textbook, Business Aspects of Optometry.


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