fix this practice
Who Runs Your Practice?
There's a fine line between running your practice and being run by it.
RICHARD S. KATTOUF, O.D., D.O.S.

Q Presently I am in my third independent practice. All three have been in different states. Even though I sold the first two, I made no profit and I am struggling in the third. A point of comparison: My husband has started non-optometric businesses in all three states with a "Midas-touch." What am I doing wrong?

Dr. J.L. Alio, via e-mail

A: Maybe we need to have an elbow-rubbing session with your spouse? Unfortunately the solution to your situation is not that simple. Normally in these types of situations the doctor has all or some of the following problems:

•   Absence of staff control

•   Inadequate staff training

•   Blame everyone for difficulties except yourself

•   Enable staff members to exhibit negative behavioral patterns

•   Absentee owners, employees not monitored

•   Poor hiring and interviewing techniques

•   No standard operating procedures or consequences.

Assess the damage

Dr. C.C. Dudley had a similar scenario. She had two practices, the first of which was sold at a loss and the second with one foot in the grave and the other on a banana peel. In my telephone interview with Dr. Dudley, she continually asked, "Why won't the employees do what I ask?" I suspected a number of the above issues were present. After my on-site consultation, it was evident that all of the above scenarios were in play.

Dr. Dudley was guilty of not running her practice. Her practice and staff of three employees were controlling her. Staff exhibited horrible communication skills with patients. They used improper grammar with absolutely no script. When performing data entry, employees had no concept how to be income producers. The practice had a history of product, money and time embezzlement. The doctor was under significant daily stress due to poor cash flow and staffing issues. The owner is directly responsible for this messy situation. She failed to formally train staff and set boundaries for behavior. Each employee was hired to fill a slot and no aptitude testing was done prior to hiring.

I informed Dr. Dudley that since these employees had no training or boundaries, she risked losing some or all of her staff. I began consulting the practice and administered standardized testing to determine staff members' IQ and behavioral strengths and weaknesses. None of the three staffers scored above 90 on the I.Q. test. All exhibited introverted behavioral patterns. The test results combined with no training and lack of doctor awareness creates a formula for failure.

Starting over

I set clear boundaries and developed a sophisticated ophthalmic technician training program. I told the staff if they resisted required behavioral changes, they would be given a short probationary period. If they did not improve during this time, they would be terminated. Two of the employees refused to change and were released. The remaining staffer was willing and able to make all the changes requested and has become a B+ member of the new team. Two new employees were hired after undergoing multiple testing and reference checks. You must hire the proper talent to get the performance you desire.

The most important focus in this program was on Dr. Dudley. I trained her to be aware of staff communication and overall behavior. We addressed and corrected each of the negative issues mentioned above. Dr. Dudley is now in control of her office and staff.

The lesson of this article: You must be a business-person as well a doctor. Operating a business requires complete and total awareness.

DR. KATTOUF IS PRESIDENT AND FOUNDER OF TWO MANAGEMENT AND CONSULTING COMPANIES. FOR INFORMATION, CALL (800) 745-EYES OR E-MAIL HIM AT ADVANCEDEYECARE@HOTMAIL.COM. THE INFORMATION IN THIS COLUMN IS BASED ON ACTUAL CONSULTING FILES.