fix this practice

Solo-Practitioner Stress Solvers

Don't get overwhelmed by the pressures of private practice.

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

Q Three years ago, I purchased a practice. The financial- and employee stresses are causing me to become depressed.

Dr. E.A. Hebeka
via e-mail

A: Congratulations on your decision to purchase an independent practice. Even though you're having stresses and financial hardships, solutions are available. Most times, owning a practice is the first time an O.D. has employees — not a task for the faint of heart. Let me list some real practice problems.

Decreasing patient volume

Dr. Owens, a relatively new owner complained of decreased patient volume. During my on-site investigation, I found the staff had not sent out recall notices for months. I instructed Dr. Owens to appoint a department leader or manager to report to him on these vital, standard-operating procedures (SOPs). Assuming your staff is performing properly without some authority to monitor is naïve.

Dr. Barkett had similar volume concerns. When I visited her office, I discovered that her employees had developed a pact that they would tell all patients who called for appointments that none were available for five weeks, so they could work at their own pace. Dr. Barkett had no idea this behavior was causing the poor scheduling. The lesson is simple: The doctor or manager must be responsible for the daily operation of the practice.

Increasing cost of operations

Dr. Kennan reported an increase in cost of operation. I found that his staff was doing a horrible job in selling eye wear. Unit sales were low, and almost all managed-care patients were only getting what their plan would cover. I found the staff had never been trained in professional optical sales.

Dr. Diamond came to me reporting constant cash-flow problems and increased cost of operation. The problem: Staff felt bad "asking" for payment.

Hiring quality staff

It's extremely common for doctors to hire a "breathing organism" out of desperation. Combine poor-interview skills and lack of staff training and you have a formula for disaster and employee turnover. The result is employees who refuse to adhere to SOPs and have more interest in their paycheck than in the organization (practice).

When I went to Dr. Diamond's practice, I established an interview process including a perspective optician questionnaire and a standardized introversion/extroversion survey. These tests enable you to see the applicants' handwriting (legible or not), spelling and ability to think spontaneously. Ask opticians basic questions about materials, products and services and you'll know instantly whether this person is exaggerating his skills.

You should also call references, or ask for the last six months of paychecks to verify an applicant's true wage. Many employees say their salary was $13.00 per hour when it was really $11.00 per hour.

Educate yourself

Professional optometric training doesn't include business or management techniques. Even if it did, most students would not comprehend the importance of the issue at that point in their education.

You must implement controls, awareness and constant oversight to ensure all employees are performing their duties. What I see in consulting is that staff definitely feels the lack of your awareness, which, in turn, enables their poor performance. 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.