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Staff Delegation

The benefits of entrusting staff to perform diagnostic testing and how to delegate

CRAIG THOMAS, O.D., DALLAS, TEXAS

I joined my first practice 31 years ago. Back then, after a patient selected a frame the senior optometrist would measure his or her pupillary distance and segment heights with a PD ruler. After a few weeks on the job, I trained the two-person staff to take those measurements. Initially, it was hard for the senior doctor to let go, but he did.

When I asked why he never trained the staff to obtain these measurements, he said that his patients expected him to do it, and that his measurements would be more accurate. Within a few months, we purchased a pupillometer, and the rest is history.

Fast-forward to 2014, and some optometrists are not only still taking routine measurements, they are also personally performing OCT scans and acquiring fundus photographs. If you ask them why, many will reply the same way the aforementioned senior doctor did.

Here, I discuss the benefits of delegating diagnostic testing to staff and four tips to accomplish this.

A trained staff member at First Eye Care – Southwest Dallas presents test results using a large, flat-screen monitor in the exam room.

Why delegate

All practice management experts agree that the best return on investment is staff training. A well-trained staff makes the office more efficient, helps you to see more patients, increases patient satisfaction and always results in higher profitability. If you are one of those O.D.s who thinks your staff can’t get the job done, think again.

Let’s say your best technician earns $15 per hour. With proper training, that person should be able to perform even the most complex diagnostic test. (If not, is he worth his salary?) On the other hand, the average optometrist who owns his or her practice usually earns at least $100 per hour. Why would you pick the doctor making $100 per hour to do a task that could easily be performed by a $15-per-hour employee? That’s not a good business decision, and it doesn’t make sense.

There are some things only you, the doctor, can do. For example, most optometrists still perform retinoscopy and refract their patients. I believe I’m the best refractionist in my practice, so I still perform retinoscopy and refract patients myself.

Also, I still perform ophthalmoscopy on all my patients because I don’t believe my staff can equal or outperform me in this area. In addition, I perform Goldmann tonometry, although I have two staff members who can get the job done if I’m too busy.

That said, my staff routinely performs many functions in our office, including fundus photography, visual acuities, automated pupillary testing and anterior and posterior segment imaging, among others.

How to achieve delegation

Now that you know “why” delegation is so important to a practice, let’s look at the four steps needed to achieve staff delegation in your practice.

1 Train your staff

Most staff members admire and respect their doctor. Use that goodwill to your advantage, and help them help you. Specifically, teach your staff how to operate the OCT, the fundus camera or the ultrasound device. If necessary, the device’s sales representative or a manufacturer’s installation technician can be a great resource for training.

Most staff members want to learn new things. If they don’t, they should probably be replaced with someone who does. After all, lack of staff motivation can hurt a practice.

2 Have faith

If your staff members have undergone proper training, trust them. Some doctors don’t believe staff members can deliver the same quality of care they can. Although staff members are not as educated in optometry as doctors are, most can get the job done with a high degree of accuracy if given the latitude to learn through time and practice and make a few mistakes along the way.

Nobody is perfect, including you. If you’ve always measured PDs, taken patient history or performed OCT testing, it’s time to let it go so you can focus your attention on being the doctor, not the technician.

3 Provide encouragement

When your staff members do a good job, tell them. Compliment them in front of patients so they feel good about themselves, and patients know you trust their skills. Go over clinical findings with them in the examination room. Let them see what you do, so they can do some of it for you.

Often, I’m amazed that staff members at some offices have never been in the examination room while the doctor is explaining test results, clinical findings or giving recommendations. Include them. Make your staff active participants in the delivery of quality eye care, not the bystanders.

The knowledge they gain with each discussion and the example you set as to how to speak to patients will only make them better at their job.

4 Empower your staff

In addition to performing diagnostic tests and the various service components of an eye examination, our clinical staff is trained to present information on various eye diseases, such as ocular allergy, dry eye disease, and the treatment options available to the patient.

Contrary to what some doctors believe, most patients readily accept clinical information from well-trained, confident staff members.

In our office, all examination findings and diagnostic test results are presented on large, flat-screen monitors in the examination rooms. This type of modern technology elevates the prestige of the staff member doing the presentation, creating a high level of patient satisfaction.

More time

Delegating to staff allows me more time to do what I do best: have fun, diagnose and treat eye disease, talk to patients and ensure my patients have a good experience in my office. Also, because I don’t have to spend time running tests or taking measurements, I have the time to properly run my business.

In my experience, the benefits of delegating multiple tasks to a well-trained staff far surpass the effort and expense required to train them. For most, it’s the best investment you can make in your practice. OM

Before delegating tasks to staff, be sure to check with your state’s governing authorities to ensure you are in compliance with the laws.

Dr. Thomas is a partner of First Eye Care – Southwest Dallas and a noted consultant, lecturer and author. E-mail him at thpckc@yahoo.com, or send comments to optometricmanagement@gmail.com.