fix this practice

Solutions For Stressful Practices

Structure can relieve stress and build a high-performance practice.

RICHARD S. KATTOUF, O.D., D.O.S.

Q As an independent O.D. for 14 years, my stress level is increasing. I have 3.5 patient-interaction days, yet I'm in the office 5.5 days. My net is low, my staff is out of control, I feel extremely anxious, my practice growth is flat, my weight and health are not good. Can you help?

Dr. R.E. Gears via e-mail

A: Dr. M.E. Koslow called my company with many of R.E.'s issues. He experienced a flat gross income. He saw patients three days per week, yet he spent eight hours per day at the office on "non-patient" days.

As this was a suburban practice in a large metropolitan area, we scheduled two early evening slots that would allow commuters some prime exam times. These six patient interaction hours allowed for 18 additional comprehensive examinations — more than $5,000 of additional gross income per week.

Dr. Koslow established strict rules to save these times for income-producing visits that required no reevaluations. He delegated much of his work on his "non-patient" days — general bookkeeping, evaluating bills, staff scheduling and accounts receivable — to an in-house bookkeeper. After a successful year with the early evening hours, we added another six hours of patient interaction with optometric-specialty patients. This was a great change of pace for Dr. Koslow. Prior to the change, he was under great financial stress, morale was low, and he "felt better on non-patient days." As the practice and income grew, Dr. Koslow developed a renewed energy for optometry.

Dr. Koslow was only 40 years old. He purchased the practice of a 70-year-old. It was next to impossible to grow the practice without expanding the schedule beyond what the seller had done.

Panic attacks

Dr. R.M. Khouri, also 40 years old, presented a multitude of management issues. he had bought out his partner about two years ago. The partner was the "stronger" leader/manager. Dr. Khouri's symptoms of anxiousness, light-headedness and rapid pulse raised their ugly heads just after the partner sold, he said.

Dr. Khouri gained 60 pounds and developed some stress-related medical issues. He said he arrived at his practice later and later to put off the pain. This created a vicious cycle of additional stress, as he constantly ran behind schedule. It was evident to me that if we didn't change Dr. Khouri's lifestyle, he might never see age 50. The solutions were as follows:

► My company undertook significant managerial duties for two years.

► We developed an internal management team of employees along with Dr. Khouri and myself.

► We placed Dr. Khouri on a structured exercise program and a lifestyle nutritional approach (not a diet) to shed the extra pounds.

► We scheduled Dr. Khouri to be at the office with staff 30 minutes prior to opening for a daily organizational session. This enabled proper intra-office communication, raised staff morale, alleviated running behind and reduced stress.

Dr. Khouri has lost 60 pounds and no longer requires hypertension medication. He looks and feels great and is enjoying optometry with a limited amount of stress.

We too can learn negative behavioral patterns. So, we must be wise enough to step out of ourselves and self assess. One of my favorite quotes sums this up: "Life is an obstacle course with me as the primary obstacle — if I could just get out of my own way." OM

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.