While the vast majority of staff are amazing, dedicated and loyal members of the team, the sad reality of business is that a few unscrupulous staff members can take note of a business’s strengths and weaknesses and exploit them.

To truly understand the threats, optometrists must come to accept that any staff member has the ability to steal from them. From the first-week newbie to the 20-year veteran, there is no shortage of reasons as to why — desperation in their financial life, thrill, revenge and greed, to name a few.

Here, I detail the three areas of focus vulnerable to thieves — money, product and time — and the procedures my multi-location practice introduced to inhibit them.

MONEY

Cash theft occurs either overtly or covertly, depending on the type of thief. Overt theft is the simple act of taking money from the drawer and walking away. While it is difficult to stop, overt theft can be discouraged via barriers that reduce its likelihood.

First, optometrists can create a buddy system policy: That is, they do not allow employees to open and close the offices by themselves. My practice’s policy is that a minimum of two employees must be present at these times. Additionally, I have all office locations perform a cash drawer count at the beginning of the day and at the end of the night. The front desk staff member performs the count, records it on a sheet and turns it in to the office manager. In this way, money that went missing the night before is discovered immediately. My practice’s security camera systems, while pointed at all product displays, are also focused on our front desks, chronicling any possible thefts.

Second, O.D.s can acquire a firm understanding of their EHR and its functionality, enabling them to track covert cash theft. Covert theft involves the staff member disguising a patient’s transaction or deleting it altogether and keeping the cash. If the optometrist does not feel comfortable running and analyzing the EHR reports, I recommend taking some time to learn how the EHR functions and how to generate this sort of data. Then, the O.D. can look at the security protocols necessary to protect the business.

My practice’s EHR, for instance, allows us to block the voiding of entire invoices from the system. The ability to void entire invoices leaves open the possibility for an employee to ring up a patient, take the cash, print a receipt and then void the transaction, removing all traces of its existence. While staff members may void individual line items from an invoice, the EHR places these in a red font and maintains a log of who entered them.

We also allow only the front desk employees to ring up a patient’s sale. Reason being: It can be far more difficult for a staff member to steal if someone else is also touching the transaction. Given that our EHR allows us to track who did what, we can also see whether, for example, one staff member entered the sale, but a different one voided line items from the bill.

Third, bank deposits should be made daily, by trusted employees, with verified deposit tickets returned to the practice owner the same day. Our deposits are made by the manager, the bookkeeper or long term, trusted employees and always during a shift. Bank deposits are prime targets of temptation for staff members, particularly if they are not made daily — potentially the difference between hundreds and thousands of dollars available for the taking. If not made at the end of the day, due to security reasons, bank deposits should be locked in a manager’s office, safe or lockbox overnight to deny access to staff. Optometrists should investigate discrepancies in dates and deposit amounts immediately: The more time that passes from an event, the more difficult it is to discern what occurred.

PRODUCT

While everything in one’s practice is up for grabs, in terms of product theft, frames are the most likely target for the internal crook in my experience. If optometrists fail to monitor their inventory and a staff member takes just one frame per day, the O.D. is looking at a loss of almost $19,000 annually.

My practice performs frame counts twice a day, by brand. A simple Excel sheet provides a morning count, evening count and details of the number of frames sold, added or removed from the board for the day. Every day must balance or be investigated. This level of awareness and attention to detail helps deter an internal thief, in my experience.

To further protect our assets and bottom line, we strictly control individual frame orders from our vendors. Specifically, all frame-order deliveries, whether one piece or 200, may only be opened by a manager or other trusted, authorized employee. Also, all single-frame purchases must be tied to a receiving patient, with their EHR patient ID number written on the invoice.

Spot checking and end-of-the-month statement reconciliation reveal any discrepancies. An employee may take the entire box, but double checking our invoices vs. the statement at the end of the month reveals the issue. Missing invoices are requested from the vendor, delivery signatures checked with the shipping company and security footage reviewed. We have yet to have an invoiced frame go entirely unaccounted for in the five years since we began these measures. One might have been stolen, but we know by whom and when.

To further reduce the likelihood of staff members taking frames, as well as lenses and contact lenses, we provide these items to our staff at cost. The loss of a job and possible prosecution over a frame hardly seems worth it when staff is able to purchase these at cost. I recommend optometrists familiarize themselves with the employee purchase programs of all their vendors, as most of them offer deep discounts over wholesale pricing or even free frames to staff.

Lastly, O.D.s should remember that it’s not simply frames, lenses and contact lenses that find their way out the door. I once worked for a company where a young employee was periodically taking rolls of toilet paper and hiding them in the drop ceiling in preparation for a festive Halloween event. He had over 50 rolls stashed away when he was discovered. Keep in mind toner, copy paper and other office supplies all have resale value outside the practice. For example, a toner cartridge can easily cost $159.

I suggest such high-value targets be monitored and kept in doctor and manager offices, to be requested by the staff when needed. Additionally, I recommend holding cost of goods and profit and loss meetings regularly to monitor acceptable cost levels and percentages. Further, O.D.s should immediately investigate anomalies that are pushing costs higher without evident explanations. Consider this: In a $1 million practice, a 1% increase in costs results in a $10,000 decrease in your take-home pay.

TIME

Our final area of focus involves time theft, either the direct falsification of timecards by a staff member in order to be overpaid by the company or the failure of an employee to perform actual work for significant periods of time while on the clock. Both have the potential to cost an employer thousands of dollars per year and can significantly hamper the practice’s production level.

Falsification of timecards has been made more difficult with electronic timecards. Hundreds of online sites are available, ranging from free to extravagant that can cut down on issues. They do not, however, protect from, for example, the optician clocking in the practice’s insurance coordinator, who may be running 15 minutes behind. For such circumstances, security cameras and investigation are the O.D.’s truest friends to discover and prevent time theft. Highly visible cameras pointing directly at the clock-in computer are a strong deterrent to staff members who seek to help their friends who can’t get out of bed on time.

In regard to employees spending time on what they are being paid to do, I have found that an office culture of personal accountability and high standards and expectations is the greatest ally. While we don’t rigidly control all aspects of the staff’s time, clear expectations, to-do lists and consistent follow up all produce a staff that doesn’t spend hours on the practice’s dime discussing their weekend plans and social habits.

Additionally, I suggest tackling the dreaded cell phone issue early on. If staff cannot control their habits, optometrists should insist on cell phones being turned in at the start of the day. If staff protest, O.D.s should consider banning the devices from the office. A staff of three people, each at $15 an hour, that each spend 5 hours a week goofing around on the job costs an office almost $12,000 annually.

KEEP IT PROFESSIONAL

Internal theft is a difficult issue for many doctors to accept and tackle due to the close, personal relationships they sometimes develop with staff members. An inability to separate themselves as business owners can cost tens of thousands of dollars a year. While experience over the years can open many eyes to the realities of the employment world, clear and decisive action up-front can do wonders to tackle many easily preventable scenarios. O.D.s should spend a few days analyzing their practices — looking at them with fresh eyes — to pinpoint weak areas and then build defenses before a culprit strikes. OM

DR. NASSER is a therapeutic optometrist and glaucoma specialist at Vision Source in Houston Texas. He is a member of the Texas Optometric Association and the AOA. Dr. Nasser is also an honorary committee member of Prevent Blindness Texas and does extensive charitable work in his native Tanzania through Optometry Giving Sight. He is a Vision Source administrator and serves on the optometric advisory board for Zeiss.