Article Date: 8/1/2001

Business Advisor
Beyond School
Owning a successful practice often requires skills that aren't taught, but are learned through experience.
By Jerry Hayes, O.D.

When I deal with financially successful optometrists on a personal and consulting basis, I often find myself thinking, "Why are they so much more successful than the average guy?" (Average being a practitioner who grosses in the $300,000 to $400,000 range.) I rarely come away with the impression, "Boy, they know so much about anatomy, pathology and pharmacology -- it's no wonder they do well in practice!"

Not that I want to make light of these important disciplines, but exceptional knowledge in them rarely leads to outstanding practice success. Rather, I find the skills that help optometrists excel in private practice typically fall in three areas outside the realm of traditional optometric training: business management, people skills and employee leadership.

  1. Providing eyecare is your profession; running a practice is your business.
    Because all of our optometry training was focused on patient care, and the bulk of continuing education still is, many optometrists treat the business aspect of private practice as the proverbial red-headed stepchild. Yes, optometry is a profession. And as a professional, you're supposed to act in the best interests of your patients -- not of your wallet.
    However, as a practice owner, you hire and fire employees, implement marketing and promotional strategies, pay rent and collect money with the stated goal of making a profit.
    It doesn't matter what you call it. That, dear reader, is the same as being in business.
    It's okay to be totally focused on patient care if you plan to spend your career working for someone else. But to be a successful owner, you have to be both a good clinician and business manager.
    The reality of optometric education is that you don't learn much about management in school. Therefore, it falls to the individual O.D. to acquire business skills after graduation.
  2. Patients don't care how much you know until they know how much you care.
    One of the great fallacies of my early training was the cliché, "Just provide your patients with good vision care, and they'll come back again and again." If that's true, why is it that some of the best and brightest optometrists I knew from school aren't necessarily that successful in private practice?
    Unlike medical specialists, private practice optometrists have to generate their own referrals, one patient at a time. One of the drawbacks of being a great clinician is that you can become so focused on a patient's vision problem, that you forget to make sure that he's happy.
    While the most successful O.D.s provide good vision care, they're even better at providing really great people care. That is, they do more than just make their patients see well. They know how to make people feel heard and appreciated. It's a basic fact: Your patients will drive past 10 other eyecare providers to see you if they like you, and more importantly, if they think you like them.
  3. Being a good boss is hard work, but it's critical to practice growth.
    It's my observation that the ability to manage people effectively is the first limiting factor to revenue growth for most optometrists.
    • Hands on. Think about it. An O.D. starts out in solo practice with just himself and maybe one employee. Things are slow in the beginning, but over time, people call in to make appointments, a lot of them actually show up and before you know it, this little practice starts to get busy. Now the O.D. has patients coming in every day for exams and ordering eyeglasses and contact lenses. Instead of spending 1 hour on every checkup with time to spare, the doctor has to hustle between patients, paperwork and dispensings.
      This is the point where the rubber meets the road for any growing practice -- when there aren't enough hours in the day for the optometrist to be receptionist, clinician, dispenser and business manager all at the same time. Some never grow past this point.
      They understand the concept of delegation, but just can't bring themselves to do it with confidence. The usual reason is that they don't think their staffer does as good as job as they do. If that's true, there wouldn't be many large solo practices with multi-assistant staffs. But, some docs like to be hands on.
    • Hands off. Other O.D.s embrace delegation once they've seen a colleague do it successfully and they start hiring staff with the intent of handing off certain areas of patient care. However, when your staff grows beyond one person, you now have to deal with a different set of employee and management issues. If you're prepared to deal with these problems, or can learn quickly, growth continues. For others, managing employees is a painful experience. Even though patient demand may be there, practice growth for this group is slowed by staff turnover and morale problems.
      If you have a small or average size practice ($350,0000 gross) and are amazed at how some optometrists can individually gross $500,000 or $1,000,000 or more, I'll tell you one of their secrets: A lot of the work gets done by their staffs. And a great staff is a product of a great boss who's learned how to effectively develop systems, explain duties and lead employees toward the successful completion of agreed upon goals.

It takes skill

The skills that help us excel in private practice go far beyond what we learned in school. Some are acquired, some learned and some are just a clear understanding of what private practice is really about. 


Optometric Management, Issue: August 2001