A total of 50.6 million US workers resigned in 2022. This made up 70% of job separations and logged the highest level in the history of the “Job Openings and Labor Turnover Survey,” which dates back to 2001. Additionally, the turnover rate within the health care space in 2022 was 13.07%, coming in fourth behind Artificial Intelligence, Software, and Data/Analytics. Specifically, almost 1.7 million health care workers quit their jobs in the first half of 2022. This is equal to 3% of the entire health care workforce turning over per month, according to the “Employee Turnover Rates by Industry, Location, and Role in 2022” report issued by Praisidio. (Praisidio is an artificial intelligence-powered people analytics software company.)

While the jury is still out on staff retention in health care in 2023, this year’s Optometric Management“Readers’ Survey” indicates optometrists continue to contend with high staff turnover. The good news: Action steps are available to enable ODs to increase the likelihood of securing sensational staff.

Here, I discuss five such steps: (1) Compensate and reward; (2) Offer flexibility (3) Continue to develop; (4) Staff to avoid burnout; and (5) Onboard thoroughly.

1 Compensate and reward

“The State of Work in America Survey,” issued June 13, 2023, from Grant Thornton, an audit, tax, and advisory company, reveals that base pay (base salary or hourly pay) is the No.1 reason health care workers stay at their jobs. Additionally, a total of 78% of all employees say they believe they will get better pay by changing jobs, according to Joblist’s “2023 U.S. Job Market Trends Report.”

Action step. The easiest way to combat this cause for quitting is to offer fair wages and never skimp on deserved raises. If you are unsure of what is considered “fair wages” nationally and in your area, job sites, such as Indeed and ZipRecruiter, have databases to help. Both resources allow you to compare your area to other areas in the country, as well as the national average for positions, such as optometric technician, optician, optometric assistant, and medical receptionist.

In my practice, every employee receives a raise at least once per year. I calculate this raise in two parts: (1) a base cost-of-living raise that they receive for sticking with the company for the year, and (2) a discretionary performance raise. Additionally, throughout the year, I offer rewards in the form of gift cards, bonuses and, occasionally, small raises (such as $0.25 to $0.50) to show appreciation for exceptional work.

For example, I recently had a technician resign to pursue changes in her personal life. In her absence and before I found an appropriate replacement, my optician stepped into this role, while maintaining the responsibilities of her own position. As a “thank you,” I surprised her with a $100 gift card and a few of her favorite snacks.

It can be challenging to remember the importance of compensating and rewarding employees when office bills are increasing due to inflation. However, optometrists must remember that a staff makes the office. I have seen first-hand in other practices at which I have worked how defeated and frustrated staff become when they feel they are due for a raise, yet do not receive one. This defeat and frustration can lead to low morale, which can hurt patient care and, therefore, business.

In addition to monetary compensation, other benefits should be considered as well. While offering extensive benefits can be challenging in a small practice, studies have found that 36% of health care employees stay at their jobs due to benefits, according to the Grant Thornton survey. With that in mind, offering any type of extra benefits (paid time off, vision materials at the practice’s cost, paid holidays, etc.) can make an impactful difference.

2 Offer flexibility

A total of 16% of health care employees desire schedule flexibility, and 17% want a work-life balance that matches their needs, according to the Grant Thornton survey.

Action step. So, how can the OD owner/manager provide employees with flexibility? One way is through remote work. Some tasks within an optometry office, such as scheduling, billing, phone management, insurance verification, and even scribing can be done remotely in today’s tech world.

Recently, I hired a remote employee through a company that provides health care virtual assistant solutions. This employee can remote in to one of our office computers to complete tasks, such as insurance verification, confirming appointments, answering basic patient questions, and filing insurance. Taking this route has been extremely successful in my office so far.

Something else to keep in mind: Hour flexibility can often be provided to optometric practice employees. I recommend optometrists allow staff to work shifts, so they may have mornings or afternoons off, depending on staff member preference. If I have a slow day or an administrative day in the office, I let my staff stagger their hours, so that the office is covered but they have some time off. During my administrative days, my employees have the option of working a staggered six-hour day instead of a full 8.5-hour day. This allows time for their errands, appointments, or simply relaxation away from work. (It also saves on payroll!)

3 Continue to develop

Lack of development can contribute to staff quitting. Specifically, 13% of health care employees interviewed for the “State of Work in America Survey” said advancement opportunities have kept them at their jobs, and 16% said lack of such opportunities would cause them to leave.

Action step. Consistent performance reviews that incorporate goal setting are an effective way to keep this line of communication open and course correct if an employee feels underutilized. Pro tip: I recommend having the employee identify and express goals for growth within the office to ensure management and the employee are on the same page long term.

As a brief, yet related aside, I have found that encouraging feedback and input is another way to keep valued staff, as they appreciate having a seat at the table. Incidentally, 15% of health care employees say they’ve stayed at their job, due to “feeling valued as an employee,” according to the Thornton Survey.

When I opened my office, I hired a receptionist who had a desire to move into the technician position. She quickly demonstrated drive and a passion for learning, was dependable, and earned my trust quickly, leading to her promotion to the technician role she desired. Her clear interest in both her personal and the office’s success led to her becoming a leader amongst our team.

Additionally, offering incentives for employees to further themselves within the optometric profession is a great way to motivate growth. At my office, any staff member who wishes to become a certified paraoptometric or optician is encouraged to do so. If they pass their certification test, the employee is rewarded with reimbursement for the test fees and a raise. I also recommend sending staff to local or national CE meetings where they can learn outside of your office.

4 Staff to avoid burnout

Burnout, defined as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed,” according to the World Health Organization, can lead an otherwise productive employee to look elsewhere for a job. In fact, 40% of all workers say they’ve left their jobs due to burnout, according to Zippia, a job search company.

Action step. While being occasionally short staffed is unavoidable, it’s clear this should be minimized as much as possible. Essilor’s Management and Business Academy may help with this endeavor: Specifically, according to the Academy’s data, the median number of staff per OD is 3.9, with the minimum in small practices 2.8 employees per 1.1 OD. Thus, maintaining this ratio within the practice should keep tasks appropriately delegated and allow for staff to perform to the best of their abilities.

In my office, I have strived to maintain this ratio as best as I can, while navigating the staffing challenges of our current world. During times when we have been understaffed, I have made a conscious effort to express gratitude and check in with employees to gauge their level of burnout and avoid losing more team members due to being overwhelmed. These check ins have been consistently appreciated, so I highly recommend them.

It can be tempting to keep a lean staff for budgeting purposes. That said, when a practice is understaffed, practice revenue declines, as clinic flow is impacted. Additionally, the impact on clinic flow can threaten patient referrals and prompt patients to go elsewhere for their eye care.

5 Onboard thoroughly

It has been reported that poor onboarding makes all employees eight times more likely to be disengaged, while positive onboarding makes them 2.6 times as likely to feel workplace satisfaction. This is according to Builtin, a job site. What’s more, employees are approximately 87% less likely to leave a job if they are engaged and motivated, according to Zippia.

Action step. Thorough onboarding should include reviewing the office’s mission, communicating expectations and job duties of the new employee, and extensive training. In my practice, the latter includes online modules reviewing our EHR, video and interactive training courses specific to their role, as well as optometry, and one-on-one training with myself or another qualified staff member.

Maintaining employee loyalty

Turnover will always be a challenge within optometry offices, particularly during a changing economic environment. By following the action steps illustrated, ODs can increase the likelihood of keeping valued employees. OM

 DR. FULMER opened her practice, Legacy Vision Center, in Huntsville, Ala., in December 2020. She also serves as the Secretary/Treasurer of the Alabama Optometric Association and the Optometric Advisor on the Board of Directors of HEALS, Inc, a local non-profit organization.