study groups

Where to Find Great Ideas

You can harness the best of what other practices have to offer. Here's how.

Ted A. McElroy, O.D., Tifton, Ga.

It has been my experience that if you want to forego practice growth, all you need to do is reject all outside advice and assistance. For the rest of us, a question arises: What is the most effective and economical way to uncover the “outside” intelligence that can build our practices? In my search, I've found a cost-effective solution that has allowed me to:

► Gain great advice.
► Interact with staff and colleagues at other practices who are at the top of their game.
► Take my practice to a higher level.

This solution? A study group.

The idea struck a chord with me at a meeting in Atlanta a few years ago when a consultant asked, “Why not spend some time in one of your colleague's practices and watch what they do, and they come to your office and do the same?”

It was brilliant. My staff and I could visit another practice and observe the staff at work. Yes, my team would observe both good and bad habits. But if we returned with one idea that ultimately saved time or made the practice more profitable — all at a fraction of the cost of a professional consultation — that time would be well worth it.

For example, during one of these visits, I observed a better way to track “aging” frames. Once we adopted this program, our boards were no longer occupied with frames that cost more money (in lost opportunity costs) than I had paid for them.

Recognizing the value of such visits, my only question was, why stop at one? Visiting four or more practices through several years would surely provide even more benefits (more successful practices = more ideas), especially if all the practices met regularly to talk about what they had learned. And so, I was sold on the idea of the study group.

A proven strategy

The study group concept is long proven in other industries. In the 1940s, a group of successful Ford dealerships formed what would become known as the Dealer 20 Group peer collaboration process. The group brought 20 different franchises together to discuss how each dealership operated with regard to financials, advertising, human resources, etc. In other words, each franchisee shared experiences, best practices, strategies and other ideas that could build all the dealerships participating in the group.

Today, 20 Groups operate across the dealerships of 24 auto manufacturers and can be found in more than 20 other industries.

Mining the jewels

Organizing such a group is no small endeavor. First, as in sports, you need to find a player who is as good as or better than you to “compete” against, or you will never improve. (If you are the best of the bunch, do yourself a favor and become a consultant so you can start charging for your expertise.) Some additional tips on finding study group partners and the right practices include:

► Consider colleagues who have been open to new ideas in the past.
► Consider a mix of practices in diverse settings — for example, different-sized towns, different practice styles or different staff demographics
► Look for a good mix of practice ages. Here's why: Newer practices may tend to make changes to their protocols much faster than larger, established practices.

Once you find these jewels of practices, it may be tough to collect the pearls, as these practices could consider you a potential competitor. For this reason, I recommend you look to practices that do not compete in your geographic area, preferably those located at least an hour's drive from your practice.

Second, and here is the tough part for O.D.s, make sure that all the practices who wish to become involved are willing to share all their practice's financial information. (Legal alert: Don't share your fees, as the Federal Trade Commission would consider this illegal price fixing.) The shared information includes:

► Monthly adjusted receipts.
► The number of new and established comprehensive eye health evaluations per month.
► Revenue per patient.
► Revenue per doctor and staff hour.
► Revenue per square foot.
► No-show percentages.
► Other metrics you think must be managed and evaluated.

What is the value in sharing all these measurements? To modify a line from the movie Field of Dreams, “If you measure it, it will grow.”

Once practices agree to share financial/practice information, make sure that everyone involved takes an oath of confidentiality — what happens in the group stays in the group.

It is worth noting that even if the other practices agree to share information, you may still find it difficult to form a study group. In fact, it took me seven years to find practices that comprise my group. Why? People could not find the time to commit to the process. How did I win them over? I told my plan to colleagues I know well. Then, I presented the plan again and again until we had four practices in the group.

Keeping the group together

The key to success with a study group is producing a quality product. Put another way, if everyone does not contribute good work, the group will die. (I am proud to say that our group includes three of the four original members.) As the group progresses, the next challenge becomes adding new members. We've found that each O.D. in the study group must agree on the new doctor, otherwise you risk losing your core group. Also, be aware that when a new member joins the group, the entire dynamic of the group changes — guaranteed.

A final challenge is staying on task. Getting side tracked is easy. As a solution, I'd recommend establishing several shared goals. This helps get everyone on the same page at the start.

To ensure that each practice is dedicated, remains enthusiastic and follows up on information, I recommend that group meetings take place at least semi-annually. If you include staff in the meetings, consider having no more than five practices involved in the group. Otherwise, the group becomes too big to manage. Also, if staffs are involved, set a time where the staffs meet apart from the doctors. However, set this ground rule for both groups: The meeting is not to become a gripe session. A focus on complaints cuts the productivity of the study group.

Success beyond the numbers

While we've focused on financial information, the benefits of the study group extend beyond data sharing. For our meetings, we require that every member bring one good idea that they have instituted in their practice. Examples include color-coded tags to judge frame turn-over rates, contact lens profitability programs, efficient office processes, new instrumentation or technology, ways you build customer loyalty or even the way customers are greeted at the spa one's spouse visits.

Optometric practices and other businesses face a huge problem with customer service issues. (Just consider how many books are written on the subject.) One solution is for your study group to share customer service success stories.

Another valuable idea is to share copies of each practice's process manual. As the manuals spell out the processes used in other successful practices, search these documents for ideas new to your practice. You will be amazed at the efficiencies you can pick up.

Field trips (no permission slips required)

Remember in school how much fun it was to go on field trips? Well, do this with the group as well. In addition to visiting other practices, contact one of the vendors located close to you — one that all or most of the group uses — and ask to visit the vendor's manufacturing facility. This will give staffs a greater appreciation of how products are made and will allow your staff to better relate the quality of the vendor's products to your patients.

Be sure you ask the vendor whether meeting space is available onsite, which you can use to conduct your study group meeting while at the facility. In addition, consider offering the group up to the vendor as a focus group so that the vendor can gain some valuable customer feedback during the meeting.

A “quasi-consultation”

When we visit a colleague's practice, or invite them to visit our office, the trips become “quasi-consultation visits.” Here's why:

First, as visitors, your staff can view the practice objectively to identify problem areas and offer solutions. For example, the office you visit might need a little sprucing up (you can't depend on “Brady-Bunch” style wallpaper to make a comeback). Perhaps the staff is taking too many steps to carry out a process that your staff accomplishes more efficiently. Your staff can identify these problems and then recommend how to address them.

Or, you may find that the greeting your staff received was the warmest and most caring they had ever experienced. You may observe efficiencies that your practice does not fully exploit. These details become invaluable. They enable your practice to grow and become more productive. Just as important, your practice receives the same benefits when another staff visits your offices.

After each practice visit, write a report on what you saw in a constructive, non-critical way. If there are sensitive issues, relay them doctor-to-doctor, face-to-face, unless you, as the host, want to talk about how you handled the sensitive matter. Also, take the time in your next study group to review what you learned in the previous visit.

Time to start

The best time to form a study group is now. Remember, starting this process is no small task, so it will take time. You will have to talk to a great many of your colleagues to get some takers on the idea. It will take time to arrive at a meeting schedule that works for each practice. It will take more time to collect data. But once the initial work is done, the truly hard part is over. You will get much more out of this process than you will ever put into it. The rewards will be huge. Not just for your practice and staff, but also for all involved.

One other benefit of a study group is the friendships this process builds. By the time I get home from one meeting, I can hardly wait to get the next meeting (six months away) because I miss these friends so much. The time we share has been the most rewarding gift I have received from the profession we all love. OM

Dr. McElroy is the president and CEO of Vision Source-Tifton, a group primary care and contact lens practice located in Tifton, GA and a member of the Vision Source network. E-mail him at tmcelroy@friendlycity.net, or send comments to optometricmanagement@gmail.com.