fix this practice

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

Out of Time

Not enough hours in the day? Try these tips to keep you on schedule.

Q Scheduling is such a problem in my office. I constantly run behind. Any suggestions?

Dr. A. KEENAN

A: There's no generic answer to scheduling and staying on time. The factors that affect scheduling are multifaceted:

• Staff size and level of training
• Delegation
• Size of the office, i.e. number of data-entry and exam rooms
• Understaffed (Note: This is rare. Every staff I see feels they need more help, but most don't.)
• Level of embezzled time
• Employee computer skills
• Doctor/employee tardiness and/or amount of "social chatter."

The following are some real practice situations that I've confronted and solved.

Insurance coordinator O.D.?

Dr. Hayle complained of scheduling issues. After observing Dr. Hayle and her staff, it was evident she was spending ten or more minutes with every managed-care patient explaining their coverage.

Dr. Hayle had failed in a number of areas: staff training and empowerment, delegation and confidence in her employees. Dr. Hayle's office was actually overstaffed by 1.5 employees. Prior to my consultation, her solution to many office issues was to hire another body.

I advised Dr. Hayle to immediately stop discussing insurance with patients, schedule training programs on vision insurance for the entire staff, train each employee to become an income producer and cut 1.5 employees. The result: Dr. Hayle was able to see three more patients per day, reported less stress and increased employee morale and income.

Too many hats

Dr. Lozzi had been in practice for 15 years. Patients continued to ask her to adjust their glasses and verify measurements prior to ordering. He enabled this behavior, despite the fact that he'd adequately trained opticians and frame stylists to perform these duties.

Most O.D.s go through an odyssey in their practice. For example, when I started practice I had no employees, so I wore all the hats. As my practice developed, I delegated to ancillary personnel until reaching the present level, in which the staff does everything except diagnosis and medical procedures.

My solution for Dr. Lozzi: Explain to your patients what a wonderful optician you have. The script I developed for him included the sentence: "Actually, the optician has better skills at frame adjusting and measurement than I do." I also told Dr. Lozzi to be sure to say this in front of the optician, as doing so empowers delegation. Make everything completely positive and for the benefit of the patient. Patients (consumer) don't expect you to perform duties you can delegate.

The social doctor

O.D.s have always had the reputation of being more empathetic and communicative than M.D.s. We should continue this reputation, but not to the detriment of the schedule. Many staff have indicated that the practitioner is the root cause of running behind.

To determine whether this is the case in your practice, position a voice-activated tape recorder, without patient awareness, to document the time spent and the actual conversation. The realization of your behavior and the stress placed upon the staff as a result are generally enough to correct this.

Staying on time is a multifaceted procedure. It takes the full cooperation of you and your staff. It's amazing how many years an office will continue on a negative path with no realization that a problem exists. Take a close inventory of your organization. It's easy to become complacent. OM