PRACTICE MANAGEMENT TIPS

LEARN FROM THE AIR FORCE

IMPLEMENT EFFECTIVE PROCEDURES FOR SUCCESSFUL OPERATIONS

Charles “Chuck” Beatty, O.D., F.A.A.O.

I RECENTLY re-entered civilian practice after serving for 11 years in the U.S. Air Force. The skills I gained from my time there can be applied to optometric practice. Working in hospital environments, large clinics and satellite clinics afforded me a unique view of what works — and doesn’t work — for health care management.

Just as a complex military entity must adapt to remain the best in the world, so must a modern optometric practice be flexible and employ systems to ensure it is viable, competitive and agile in today’s fast-changing health care environment. Making lists, standardizing systems and recognizing employees are a few of the tasks I learned in the Air Force and implement at my practice to maximize efficiency; you can do the same.

CHECKLISTS

All rated pilots use checklists. You should, too. The self-assured swagger often seen in fighter pilots never stops them from using a checklist in the cockpit. They know they are fallible — so are optometrists.

Checklists save lives, help people work more efficiently and avoid costly mistakes. Utilize them throughout your day to conserve vital mental energy. For example, an exam room checklist to be completed at the day’s finish by an assigned ophthalmic technician would ensure certain surfaces are sanitized, trash emptied, tissue paper replenished, equipment shut down and covered, medications checked for expiration, safety hazards are addressed, etc.

Checklists also allow for enhanced efficiency. When you perform a multi-step task, write the steps you take. This draft can then be modified to augment or remove steps that are not aiding in efficiency. Also, it is useful to have checklists for daily operations, such as opening or closing your office, transitioning to lunch and preparing for weekly or monthly activities. The reason: They communicate your expectations to your staff members and streamline onboarding of new members.

WRITTEN GUIDELINES

Most military work centers and clinics (yes, even optometry clinics) have written operating instructions that describe, in detail, how operations are conducted at a particular location. Operating instructions address contingencies, such as what to do if the computer network or communications fail. This type of documentation is invaluable to learning how business is done with available resources and personnel and also acts as a resource for staff members to refer to. For example, in the event of computer network or EHR failure in the military, procedure dictates that personnel immediately fall back on hard copy documentation and outlines specific forms to be used. In this potentially emergent situation, there would be little confusion as to what steps to take.

Air Force instructions also cover how personnel should be dressed and conduct themselves. Hopefully, you have an employee handbook that similarly describes how your employees are to behave, perform, take leave (request vacation in civilian speak), etc. If these procedural instructions are not written, you may be legally exposed and also leave much open to interpretation by your employees. I am not advocating for presenting a Library of Congress-sized handbook to new employees, but rather to give them specific instructions, rules and operating procedures that spell out your expectations. This is especially advantageous to new associates and those to whom you may sell your practice.

Dr. Charles Beatty

SCRIPTS

Customs and courtesies in the Air Force reflect a history rich in tradition and pride. Induction, promotion, recognition and retirement ceremonies to name a few, all involve strict adherence to scripts and instructions describing how the event should flow. Similarly, your patients need to flow through your practice in an efficient, respectful, predictable and positive manner.

Undoubtedly, I am sure you’ve heard your staff say things to your patients that make you scratch your head and think, “Where did they get that?” A script conveys consistent information, professionalism and reassurance to your patients throughout their experience. For example, always answer the telephone properly, no matter how busy you may be. An example: “Doctor’s Eye Care and Contact Lens Clinic, this is (name), how may I help you?”

These canned speeches represent your ideal situation; however they need not be memorized and spoken verbatim to each patient. Have staff meetings where you role-play to practice the script and give staff members the opportunity to improvise, while also providing accurate knowledge.

TEMPLATES

It seems nothing is done in the military without a “DD-XXX,” or Department of Defense, form. Be it requesting a personnel action, ordering items or documenting something; DD forms are ubiquitous. Work centers (front desk, lab, dispensary, etc.) within your practice may not operate the same; however, standardization can prevent confusion, allow for easier growth and smoother operations.

Personnel at Buckley Air Force Base, circa 2006-2011.

Maintain an electronic repository of pre-constructed templates of forms, worksheets, pricelists, patient education and/or Q&A sheets. I kept virtual folders on network drives for all the clinics I managed; maintaining items such as department of motor vehicle vision reports for all states to prevent troops from having to travel long distances to update their expiring motor vehicle licenses. Quick access to templated referral forms, employee job descriptions, expectations and evaluations, school notes for kids and other vital bits will save you hours or even days over the course of a year. Additionally, you and your employees will literally be on the same page.

STANDARDIZATION

I could go to any Air Force base and know how to get things done, which facility does what or where to go for any particular need because everything is standardized. Work with your staff to develop procedures that work best, and then standardize those operations. For example, at my clinic, returning patients are presented with an electronic intake form on a tablet only requiring the entry of items that have changed since last visit, saving time and making the process easier and perhaps even semi-enjoyable for the patient. Today’s patients expect high levels of service no matter the location, staff member or provider. Consistency and familiarity are key concepts that keep customers loyal to companies like Coca-Cola. They can be hallmarks of your practice, too.

RECOGNITION

Watching a military member standing at attention in full dress uniform with a chest covered in brightly colored ribbons and medals is an impressive sight. Behind that stern face is almost certainly a proud smile you may not see. That smile gets a little bigger with each stripe, medal, milestone and level of responsibility earned. Your staff may not have a uniform adorned with medals, but do know they yearn for recognition just like that man or woman in the military.

Earning medals and promotions is a great way to keep troops loyal to their branch of service. Don’t you want your “troops” to be loyal to your practice? Clearly define roles and set goals for your staff, such as keeping patient wait times under five minutes or ensuring all contact lens patients are offered reduced fees on annual supplies. Regularly reward those who meet or exceed goals by recognizing them at weekly staff meetings, perhaps noting how patient comment cards mentioned a staff member by name. The key is to stimulate friendly competition within your staff whereby everybody benefits, especially the patient. Money only goes so far; support your staff in obtaining certifications, attending conferences and continually bettering themselves. Don’t forget that those “little things” make all the difference.

MAXIMIZING EFFICIENCY

As optometrists, we are primarily interacting with people and how they relate to systems: charting, insurance, account receivables, etc. This is no different than a large government entity like the Air Force. Airmen still walk with one foot in front of the other like any civilian. The context may be different, however the same methods that maintain, inspire and grow the greatest Air Force on the planet will surely work for you. (Saluting is optional.) OM

DR. BEATTY is a graduate of Nova-Southeastern College of Optometry. Motivated after the 9-11 attack, he served more than a decade in the Air Force as a medical officer. He continues his service as a Lieutenant Colonel in the Air Force Reserve and is in private practice at Alpine Eyecare Center in Boulder, Colo. Visit tinyurl.com/OMComment to join the discussion.