fix this practice
The Glass Is Half Full
Focus on the care you provide, not the number of competitors in your area.

Q: The growth of my practice has been very slow, requiring me to depend on outside employment. Can you give me some insight?

Dr. R. A. Skaff, via e-mail

A: There are many critical areas to focus upon to assure practice growth. Optometry is presently in an era of intense competition. Independent and corporate O.D.s, commercial locations, H.M.O.s and ophthalmologists all want a piece of the primary-care pie.

The reason your practice is struggling is not due to your academic background. Your problem is a lack of attention to management details. The detailed areas are as follows:

Internal marketing

• Appearance is everything. Your body is a billboard, so dress for success. Staff dress and hygiene must also be impeccable. Base boards, bases of stands, exam chairs and optical displays need to be free of dust and very clean. Instruments should be wiped down in front of the patient.

• Doctors and staff must use professional language (vocabulary). Since optometry is the only allied health profession with levels (tiers of independent, corporate and commercial), be cognizant of the use of "retail" words vs. "professional" language. One example: say "diagnostic" lens (professional terminology) rather than "trial" lens (a retail term). Proper language is so important and is ignored in most practices.

• Mode of practice is critical. Most optometrists are generalists. Concentrate on expanding your medical and optometric specialties.

Dr. Layman called my company with a frustrating message of low net income, poor cash flow, inability to pay vendors on time and approaching optometric burn out. The first day I spent with Dr. Layman included a tour of his area. He wanted me to see that he was "surrounded" by competition. He is, and so are most of you. The question is how good are your competitors at paying attention to detail. I studied many of Dr. Layman's fellow O.D.s. I telephoned a sampling of offices to hear their language skills. As I suspected, they were general practitioners performing limited medical procedures with no optometric specialties. I would give their attention to detail a "C."

I taught Dr. Layman to stop thinking negatively and fretting about competition. He did not understand that his competitors were basically all the same in terms of their vision care delivery. They paid little attention to detail and ignored the fee-for-service areas of optometry that reap the highest financial growth. Dr. Layman's practice was stuck at $289,000 gross (collected) income for the last four years. His net was only 20% of the gross, which necessitated he continue to have outside employment.

After two years of consulting and management, Dr. Layman was grossing $689,000 and netting $262,000. He and his staff implemented the changes I suggested that now separate themselves from the "vanilla" competition.

Doctors, you have a degree of energy at your disposal that you must direct toward positive change. As a consultant, I see doctors wasting energy worrying about things they cannot control. Focus on your office, your mode of practice and pay attention to details. Make your office the one the competition is trying to catch up to.

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.